Maria Cássia Ferreira de Aguiar

Prognostic impact of metallothionein on oral squamous cell carcinoma

Metallothionein (MT), a low-molecular-weight protein with high cysteine content, seems to be related to neoplastic resistance to oncologic treatment and therefore has been studied as a prognostic factor for a variety of human malignant tumors. MT overexpression in neoplasms of ectodermal origin is usually associated with a poor prognosis. MT expression was evaluated in 60 samples of oral squamous cell carcinoma by immunohistochemistry to study its prognostic influence on oral cancer. Possible associations of MT immunoexpression were also investigated with respect to clinical stage (TNM), histological grading, and proliferation index (Ki-67) of the lesions. No significant statistical correlation was observed among these variables. The impact on overall survival was assessed by uni and multivariate statistical tests. Mean MT labeling index was 60%. High MT labeling indexes (over 76%) predicted shorter survival in univariate statistical analysis. In multivariate analysis, MT labeling index and clinical stage were independent prognostic factors. MT overexpression in oral squamous cell carcinoma seems to be related to a worse prognosis for patients.

Clear-cell ameloblastoma (clear-cell odontogenic carcinoma): Report of a case

Clear-cell ameloblastoma (clear-cell odontogenic carcinoma) is an uncommon odontogenic epithelial neoplasm. We report a case of a well-circumscribed 2 cm radiolucent lesion of the anterior mandible in a 30-year-old woman; this tumor was curetted. The first recurrence (at 5-year follow-up) was treated by aggressive curettage, and in the second recurrence a block resection was performed. However, 2 years after the resection was performed, the tumor recurred for a third time as an extraosseous gingival tumor, and 6 months later a recurrence was noted involving only alveolar mucosa.

Prevalence of oral hemangioma, vascular malformation and varix in a Brazilian population.

Hemangioma, vascular malformation and varix are benign vascular lesions, common in the head and neck regions. Studies about the prevalence of these lesions in the oral cavity are scarce. The aim of this study was to estimate the prevalence of and to obtain clinical data on oral hemangioma, vascular malformation and varix in a Brazilian population. Clinical data on those lesions were retrieved from the clinical forms from the files of the Oral Diagnosis Service, School of Dentistry, Federal University of Minas Gerais, Brazil, from 1992 to 2002. Descriptive analysis was performed. A total of 2,419 clinical forms in the 10-year period were evaluated, of which 154 (6.4%) cases were categorized as oral hemangioma, oral vascular malformation or oral varix. Oral varix was the most frequent lesion (65.6%). Females had more oral hemangioma and oral varix than males. Oral vascular malformation and oral varix were more prevalent in the 7th and 6th decades, respectively. Oral hemangioma and oral varix were more prevalent in the ventral surface of the tongue and oral vascular malformation, in the lips. Oral hemangioma was treated with sclerotherapy (54.5%), and vascular malformation was managed with sclerotherapy and surgery (19.4% each). The data of this study suggests that benign vascular lesions are unusual alterations on the oral mucosa and jaws.

Oral Mucosal Conditions in Chronic Hepatitis C Brazilian Patients: A Cross‐Sectional Study

OBJECTIVE Our purpose was to carry out an epidemiological study to assess the prevalence of oral mucosal conditions in Brazilian patients with chronic hepatitis C. METHODS A cross-sectional survey was carried out on 215 patients with chronic hepatitis C who were examined for oral mucosal conditions, including oral mucosal lesions and variations of normality. RESULTS The prevalence of patients with chronic hepatitis C presenting oral mucosal conditions was 96.3 percent (207 patients). Oral mucosal lesions were present in 147 patients (68.4 percent), whereas variations of normality were observed in 173 patients (80.5 percent). The most common lesions included cheek biting in 42 cases (19.5 percent), candidiasis in 39 cases (18.1 percent), and leukoplakia in 28 cases (13.0 percent). The association of oral lichen planus with hepatitis C virus (HCV) infection proved to be statistically significant (P = 0.002). The most frequent variations of normality included Fordyces spots in 96 cases (44.7 percent), lingual varicosities in 67 cases (31.2 percent), and fissured tongue in 60 cases (27.9 percent). CONCLUSION The prevalence of patients with chronic hepatitis C presenting oral mucosal conditions was 96.3 percent. Despite this high prevalence, only the association between oral lichen planus and hepatitis C showed statistical significance. Considering that HCV infection may be associated with extrahepatic disorders, such as oral manifestations, efforts should be made to clarify the possible relation between oral conditions and HCV infection. This may be helpful in the earlier diagnosis of the infection mainly in asymptomatic patients.

Oral lichen planus and chronic hepatitis C: a controversial association.

Our aim was to study the possible association between oral lichen planus and chronic hepatitis C in patients from the state of Minas Gerais, Brazil. Two groups of patients were studied: group 1, 50 patients with oral lichen planus evaluated for the presence of chronic hepatitis C; and group 2, 215 patients with chronic hepatitis C examined for evidence of oral lichen planus. Diagnosis of oral lichen planus in both groups was based on clinical and histologic findings. One case of chronic hepatitis C was diagnosed in group 1 (2.0%), which was not considered statistically significant (P = .464). In group 2, the prevalence of oral lichen planus was 2.3% (5 cases), which showed statistical significance (P = .002). Although our results suggest oral lichen planus as an extrahepatic manifestation of chronic hepatitis C in the studied population, the association between these two entities should be further investigated.

Retrospective analysis of oral peripheral nerve sheath tumors in Brazilians

Traumatic neuroma, neurofibroma, neurilemmoma, palisaded encapsulated neuroma and malignant peripheral nerve sheath tumor (MPNST) are peripheral nerve sheath tumors and present neural origin. The goal of this study was to describe the epidemiological data of oral peripheral nerve sheath tumors in a sample of the Brazilian population. Biopsies requested from the Oral Pathology Service, School of Dentistry, Federal University of Minas Gerais (MG, Brazil), between 1966 and 2006 were evaluated. Lesions diagnosed as peripheral nerve sheath tumors were submitted to morphologic and to immunohistochemical analyses. All cases were immunopositive to the S-100 protein. Thirty-five oral peripheral nerve sheath tumors were found, representing 0.16% of all lesions archived in the Oral Pathology Service. Traumatic neuroma (15 cases) most frequently affected the mental foramen. Solitary neurofibroma (10 cases) was more frequently observed in the palate. Neurofibroma associated with neurofibromatosis type I (2 cases) was observed in the gingival and alveolar mucosa. Neurilemmoma (4 cases) was more commonly observed in the buccal mucosa. Malignant peripheral nerve sheath tumors (3 cases) occurred in the mandible, palate, and tongue. Palisaded encapsulated neuroma (1 case) occurred in the buccal mucosa. The data confirmed that oral peripheral nerve sheath tumors are uncommon in the oral region, with some lesions presenting a predilection for a specific gender or site. This study may be useful in clinical dentistry and oral pathology practice and may be used as baseline data regarding oral peripheral nerve sheath tumors in other populations.

Clinical significance of EGFR, Her-2 and EGF in oral squamous cell carcinoma: a case control study

BackgroundThe erbB receptors and their ligands are involved in the pathogenesis and progression of oral squamous cell carcinoma (OSCC). Although EGFR and Her-2 are frequently overexpressed in OSCC, few studies evaluated these proteins in saliva and their association with the tumor, which may represent potential usefulness in a clinical setting.MethodsThe levels of EGFR, Her-2, and EGF were evaluated in saliva of 46 patients with OSCC before and after the surgical removal of the lesion, as well as in matched healthy controls. The relationship of salivary levels and EGFR and Her-2 immunoexpression in tumor samples with clinicopathological features was analyzed.ResultsEGFR and Her-2 salivary levels did not show difference between to pre-surgery and control groups, however, both demonstrated an increase after surgical removal of the tumor. No association was detectable among receptor salivary levels, tissue expression and clinicopathological features. EGF levels in pre-surgery group were significantly lower when compared to the control group.ConclusionsEGFR and Her-2 were not considered to be valuable salivary tumor markers in OSCC, however, lower levels of EGF in saliva may suggest a higher susceptibility for OSCC development.

Exacerbation of oral lichen planus lesions during treatment of chronic hepatitis C with pegylated interferon and ribavirin

It is estimated that 170-200 million people in the world are chronically infected with the hepatitis C virus. This fact indicates that the prevention and treatment of hepatitis C virus infection are a priority in public health care. To date, the best treatment consists of the combination of pegylated interferon (IFN) and ribavirin. IFN is costly and associated with low tolerance and severe side effects. Ribavirin is also problematic because it causes secondary anemia in most patients. It has been described that oral lichen planus (OLP) can appear or be exacerbated during the treatment of chronic hepatitis C. The improvement of the lesions of OLP after the discontinuation of therapy suggests that IFN may induce or worsen these lesions in some patients. This study examines three cases of exacerbation of OLP during the treatment of chronic hepatitis C with pegylated IFN and ribavirin.

Effect of Smoking on Langerhans and Dendritic Cells in Patients With Chronic Gingivitis

BACKGROUND Previous literature showed contrasting results regarding dendritic cell (DC) counts in patients with periodontal diseases. Although smoking decreases the number of DCs in the lungs, the effect of smoking on the quantitative distribution of Langerhans cells (LCs) and DCs in patients with chronic gingivitis has not been investigated to our knowledge. METHODS Gingival samples were obtained from 30 patients (15 smokers and 15 non-smokers). Immunohistochemical staining was performed to identify CD1a+ immature LCs and CD83+ mature DCs. The inflammatory infiltrate was evaluated and counted. Densities of cells were calculated within the oral epithelium (OE), sulcular epithelium (SE), and lamina propria (LP) for CD1a+ cells and within the LP for CD83+ cells. Results were compared between groups. This study evaluates whether the high number of cigarettes and smoking years affects densities of cells. Correlations among densities of LCs and DCs with densities of inflammatory infiltrate, number of cigarettes, and smoking years were performed. RESULTS Densities of inflammatory infiltrate and CD1a+ cells from the SE and LP were significantly lower for smokers than for non-smokers (P <0.05). This result could not be identified for CD1a+ cells from the OE and for CD83+ cells from the LP. The number of cigarettes and smoking years did not affect densities of cells. No statistically significant correlations could be drawn among densities of LCs and DCs and inflammatory infiltrate, number of cigarettes, and smoking years. CONCLUSION Smoking proved to affect the quantitative distribution of LCs and DCs in patients with chronic gingivitis.

A comparative study of microvessel density in squamous cell carcinoma of the oral cavity and lip

OBJECTIVES The objective of this study was to comparatively evaluate the density of lymphatic vessels (LVD) and neoformed microvessels (NMVD) in squamous cell carcinoma of the oral cavity (OCSCC) and lip (LSCC). Association between LVD/NMVD and vascular endothelial growth factor (VEGF)-A/-C was also assessed. STUDY DESIGN OCSCC and LSCC were compared with regard to immunoexpression of LVD, NMVD, and vascular endothelial growth factor-A (VEGF)-A/-C. Association between VEGF-A/-C with vascularity was also assessed. Statistical analyses were performed using t test, Pearson χ(2), and Mann-Whitney tests. Statistical significance was accepted at P less than .05. RESULTS The NMVD and VEGF-C expressions were significantly higher in OCSCC compared with LSCC. NMVD was associated with VEGF-C in OCSCC, but not in LSCC. CONCLUSIONS Differences in NMVD and VEGF-C were found between OCSCC and LSCC. Positive association between VEGF-C and NMVD was observed in OCSCC, but not in LSCC, which may be one of the contributing factors that account for the distinctive clinical-biological behavior of these lesions.