Juliana Lucena Schussel

Global and gene-specific DNA methylation pattern discriminates cholecystitis from gallbladder cancer patients in Chile

Aim The aim of the study was to evaluate the use of global and gene-specific DNA methylation changes as potential biomarkers for gallbladder cancer (GBC) in a cohort from Chile. Material & methods DNA methylation was analyzed through an ELISA-based technique and quantitative methylation-specific PCR. Results Global DNA Methylation Index (p = 0.02) and promoter methylation of SSBP2 (p = 0.01) and ESR1 (p = 0.05) were significantly different in GBC when compared with cholecystitis. Receiver curve operator analysis revealed promoter methylation of APC, CDKN2A, ESR1, PGP9.5 and SSBP2, together with the Global DNA Methylation Index, had 71% sensitivity, 95% specificity, a 0.97 area under the curve and a positive predictive value of 90%. Conclusion Global and gene-specific DNA methylation may be useful biomarkers for GBC clinical assessment.

Expression and epigenetic regulation of DACT1 and DACT2 in oral squamous cell carcinoma

BACKGROUND DACT genes regulates Wnt as well TGF-β pathway, and were already associated with hepatocellular and lung cancer. Alterations on Wnt/β-catenin were associated with head and neck cancer through β-catenin cytoplasmatic accumulation. OBJECTIVE The aim of the study was to evaluate DACT1 and DACT2 expression and methylation on oral squamous cell cancer (OSCC). METHODS 47 samples of salivary rinse and tissue were collected from 29 OSCC and 18 control patients. qMSP and RT-PCR reactions were performed in order to detect hypermethylation and expression of DACT1 and DACT2 genes. Statistical analysis was conducted to evaluate these genes as possible biomarkers for OSCC. RESULTS As expected man over 60 years old with tobacco and alcohol consumption history were associated with OSCC. There was no statistical difference between groups concerning DACT1 and DACT2 either in promoter hypermethylation or transcript levels. Age was associated with DACT2 promoter hypermethylation, especially over 56 years old. CONCLUSION Patients older than 56 years old were about 5 times more likely to have DACT2 promoter hypermethylation. These findings could partially explain why older subjects are more prone to carcinogenesis. Wnt/β-catenin pathway plays an important role in carcinogenesis, and the study of their regulators may help understand malignant transformation.

Canalicular adenoma of the minor salivary gland in the upper lip: case report

Canalicular adenoma is a rare benign tumor of the minor salivary glands that is the most prevalent in older adults (mean age, 60 years). The upper lip is the most commonly affected site, followed by the buccal mucosa and palate. It presents as a nodular lesion without a tendency for recurrence. Here, we describe a case of canalicular adenoma presenting as a nodular, painful mass in the upper lip of a 62-year-old man with a history of trauma. Fine needle aspiration biopsy yielded inconclusive results but excluded malignancy. The lesion was enucleated, and a definitive diagnosis of canalicular adenoma was established by histological and immunohistochemical analyses. No signs of recurrence were noted at the 8-month follow-up examination. The case emphasizes the importance of differential diagnosis of nodular lesions in the oral mucosa for appropriate treatment and histological analysis for definitive diagnosis.

Significance of p16 Positive Expression in Oropharyngeal Cancers

BACKGROUND The involvement of HPV in oral and oropharyngeal carcinogenesis was first proposed in 2004, based on epithelial HPV tropism and detection of HPV genotypes in oral squamous cell carcinoma samples. While 60-70% of oropharynx tumors may be HPV-positive, only 10 to 19% of tumors of the oral cavity, larynx and hypopharynx appear to have HPV infection. The aim of the study was to evaluate HPV infection associated with oropharyngeal cancer. MATERIALS AND METHODS Seventy-eight cases were selected for p16 immunoexpression reactions, and demographic data were collected for comparisons. RESULTS Most patients were over 60 years old, and 64.1% were smokers. Immunohistochemistry results showed that 86.3% of cases stained positive for p16 protein. CONCLUSION The oropharyngeal cancer profile at Erasto Gaertner Hospital presented a high index of smokers over 60 years as well a high number of p16+ tumors, for what we can not determinate the main etiologic factor, but can be aware of the number of patients that presented HPV infection. Since prevention is still the best way to deal with cancer disease, it is important to analyze the interaction of these two etiologic factors and how to detect lesions at an early stage.

Odontogenic fibroma WHO-type simulating periodontal disease: Report of a case

Central odontogenic fibroma World Health Organization (WHO)-type (OFWT) is a rare lesion that has differential diagnosis with other radiolucent periapical lesions. It has a slow growth and is usually an asymptomatic lesion found in routine examinations. We report a case of a central OFWT occurring in the maxilla, for which the first symptom was teeth mobility, simulating a periodontal condition. A 54-year-old woman, with superior premolar mobility, was referred to our clinic. An oral examination showed teeth vitality and advanced periodontal disease. Radiography showed a unilocular radiolucent area between the left superior lateral incisor and first left molar, with bone reabsorption. The granulomatous tissue was removed and microscopic examination revealed cellular connective tissue with multiple islands of odontogenic epithelium, covered by stratified squamous epithelium, confirming the OFWT diagnosis. The central OFWT is a non-aggressive lesion, with rare recidivism. Biopsy is an important procedure for correct diagnosis and treatment, as some radiolucent lesions can lead to misdiagnosis.

Effect of fractionated radiotherapy on the parotid gland: an experimental study in Brazilian minipigs

Summary Introduction: Radiotherapy (RT) of head and neck neoplasms often damages the salivary glands. Aim: To examine the pattern of morphologic changes resulting from RT of the head and neck region in minipig parotid glands in a clinical and experimental research setting. Methods: Twelve 18-month-old male Brazilian minipigs weighing 30–40 kg were selected. Eight minipigs were assigned to the experimental group (group 1) and 4 to the control group (group 2). The RT was performed under general anesthesia at Erasto Gaertner Hospital, Curitiba, Brazil, using an á/â ratio of 2.5. The minipigs from group 1 underwent 3 sessions of irradiation with Cobalt 60 of the head and neck, bilaterally, with 3 exposures of 8 Gy each at 7-day intervals for a total dose of 24 Gy. The animals were sacrificed 12 weeks post-RT. Results: The irradiated parotid glands displayed reductions in the size and number of acini as well as loss of secretory granules. The presence of fibrosis and loss of parenchyma relative to non-irradiated glands were observed, with an average reduction in volume of 54%. Conclusions: Our results demonstrate that this model for parotid gland damage resulting from an RT regimen appears to be useful for preclinical large animal studies of RT-induced damage and testing novel potential treatment options. Although recent advances in radiation therapy, such as intensity-modulated radiation therapy, have reduced the dose and limited the field of radiation, considerable salivary gland injury still occurs and can greatly impact the patients quality of life after cancer treatment.

Oral and Maxillofacial Complex Lesions in Adolescents: A Retrospective Study of 20 Years

Los estudios que evaluan la prevalencia de lesiones orales muestran que entre el 5,2% hasta el 12,8% de las muestras de biopsia corresponden a ninos y adolescentes. En Brasil, hay pocos estudios que hayan analizado la distribucion de las lesiones orales enesa poblacion. Por lo tanto, el objetivo de este estudio fue evaluar la distribucion de las lesiones orales y maxilofaciales de adolescentes, ingresados en el Servicio de Diagnostico Oral de la Universidad Federal de Parana (UFPR) entre 1994 a 2013. Se llevo a cabo la revision de historias clinicas y las lesiones halladas fueron clasificadas en 11 categorias: enfermedad de glandulas salivales, patologia dental, patologia gingival y periodontal, quistes odontogenicos, tumores odontogenicos, quistes no odontogenicos, patologia osea, patologia de la mucosa, patologia del tejido conectivo, tumores malignos y otras patologias. Tambien se evaluaron otras variables como edad, genero, etnia, diagnostico y localizacion de la lesion. Luego del analisis, se identificaron 376 lesiones, la mayoria en ninas (51,9%), siendo el 77,1% de los pacientes de raza blanca. La localizacion mas frecuente fue el labio inferior seguida de la encia. El mucocele fue la lesion mas comun (27,6%), seguido de hiperplasia fibroepitelial (8,2%) y granuloma piogeno (5,3%). Aunque existe una amplia serie de patologias que pueden ocurrir en la cavidad oral, las lesiones traumaticas son las mas comunes en este grupo de edad.

Incidence of second primary oral cancer tumors: a retrospective study

OBJETIVO: A maioria das neoplasias malignas de cabeca e pescoco e diagnosticada em estagios avancados. O alto risco de desenvolver um segundo tumor primario (STP) diminui a taxa de sobrevida dos pacientes. STP piora significativamente o prognostico e estudos sobre ele devem ser realizados para se descobrir seus fatores de risco e melhor forma de tratamento. O principal objetivo deste estudo foi analisar a ocorrencia de STP em pacientes com carcinoma epidermoide bucal (CEB) tratados no Hospital Erasto Gaertner (HEG), Curitiba, PRP, Brasil, num periodo de 16 anos. METODOLOGIA: Um estudo retrospectivo foi realizado a fim de revisar os pacientes com CEB que desenvolveram STP entre Janeiro de 1990 e Dezembro de 2005. Os dados demograficos e clinicos foram coletados atraves dos prontuarios medicos dos pacientes e foram analisados por estatistica descritiva. RESULTADOS: Neste periodo, 34.637 pacientes foram admitidos no HEG. Um total de 1637 (4,4%) pacientes recebeu diagnostico de CEB, dos quais 37 (2,7%) desenvolveram STP. Os pacientes que desenvolveram STP eram 29 (78,4%) homens e 8 (21,6%) mulheres, com media de idade de 58 anos. Os sitios anatomicos mais frequentes para o STP foram a boca, orofaringe e esofago; a taxa de sobrevivencia foi de 27%. CONCLUSAO: Pacientes tratados de CEB devem ser examinados cuidadosamente e monitorados regularmente por causa do alto risco de desenvolver um STP, especialmente aqueles que mantem os habitos de tabagismo e etilismo.

Gingival proliferative lesions in children and adolescents in Brazil: A 15-year-period cross-sectional study

Background: Studies assessing the prevalence of oral lesions in children and adolescents, particularly in gingiva are scarce in the literature. The aim of the study was to describe the distribution of gingival proliferative lesions based on clinical and histopathological diagnoses in children and adolescents. Materials and Methods: A review of clinical charts of children and adolescents aged between 0 and 18 years old, admitted to the Oral Medicine Outpatient Unit, of Universidade Federal do Paraná, for 15 years (1994–2009) was performed. Results: Six hundred and sixty-nine out of 5,129 patients treated during this period were aged between 0 and 18 years old, and 45 of these had gingival lesions. The largest number of lesions was observed between 11 and 16 years old. The majority of the patients were referred by Curitibas public health system. Pyogenic granuloma was the most frequent lesion (19 = 42.2%), followed by peripheral giant cell lesion (11 = 24.4%), gingival fibromatosis (10 = 22.2%), and peripheral ossifying fibroma (5 = 11.1%). Conclusion: Gingival proliferative lesions can show similar clinical characteristics. Appropriate clinical and histopathological diagnoses are necessary to guide the healthcare professional to establish the adequate treatment and to estimate the risk of recurrence.

Accuracy, Sensitivity and Specificity of Fine Needle Aspiration Biopsy for Salivary Gland Tumors: A Retrospective Study from 2006 to 2011

Objective: This article concerns evaluation of the sensitivity, specificity and accuracy of FNAB for pre-surgical diagnosis of benign and malignant lesions of major and minor salivary glands of patients treated in the Department of Head and Neck Surgery of Erasto Gartner Hospital. Methods: This retrospective study analyzed medical records from January 2006 to December 2011 from patients with salivary gland lesions who underwent preoperative FNAB and, after surgical excision of the lesion, histopathological examination. Results: The study had a cohort of 130 cases, but 34 cases (26.2%) were considered unsatisfactory regarding cytology analyses. Based on the data, sensitivity was 66.7% (6/9), specificity was 81.6% (71/87), accuracy was 80.2% (77/96), the positive predictive value was 66,7% (6/9) and the negative predictive value was 81.6% (71/87). Conclusion: Despite the high rate of inadequate samples obtained in the FNAB in this study the technique offers high specificity, accuracy and acceptable sensitivity.