Marília Oliveira Morais

Effect of intraoral low-level laser therapy on quality of life of patients with head and neck cancer undergoing radiotherapy.

Low‐level laser therapy has been used to reduce complications of head and neck cancer treatment. The aim was to assess the impact of laser in the quality of life (QOL) of patients receiving radiotherapy.

Effect of low level laser therapy in the reduction of oral complications in patients with cancer of the head and neck submitted to radiotherapy.

The aim of this study was to assess the effect of low level laser therapy on reducing the occurrence and severity of oral complications in patients with head and neck cancer undergoing radiotherapy. Sixty head and neck cancer outpatients from a cancer hospital receiving radiotherapy were selected and randomly assigned into two groups. The laser group was irradiated with an InGaAlP laser and the control received sham laser. The assessment of complications (oral mucositis, pain) was carried out one week after starting radiotherapy, and at the fifteenth and thirtieth sessions of radiotherapy. All patients from both groups showed some degree of oral mucositis. Better outcomes were observed in the laser group when compared with the control in the follow-up sessions, indicating lower degrees of oral mucositis, pain and higher salivary flow (p < .05). These findings support the use of laser therapy as an adjuvant treatment for the control of oral complications.

Effect of low-level laser therapy on chemoradiotherapy-induced oral mucositis and salivary inflammatory mediators in head and neck cancer patients.

Oral mucositis (OM) is considered a painful and debilitating side effect in patients receiving head and neck cancer treatment. Low‐level laser therapy (LLLT) proved to be effective to prevent and treat chemoradiotherapy‐induced OM. The aim of this study was to evaluate the effect of LLLT in the severity of OM in patients with head and neck cancer and on the release of salivary inflammatory mediators. Clinical (score of OM severity) and biochemical parameters (concentration of inflammatory mediators, growth factors, and enzymes in saliva) were used.

E-cadherin, β-catenin, and α2β1 and α3β1 integrin expression in primary oral squamous cell carcinoma and its regional metastasis.

To investigate E-cadherin, β-catenin, and α2β1 and α3β1 integrins in 40 samples of non-metastatic and metastatic oral squamous cell carcinoma (OSCC) with positive cervical lymph nodes (LN). Immunohistochemistry was used to evaluate expression in the lesion center (LC) and invasive tumor front (ITF) of non-metastatic (n=18) and metastatic (n=22) OSCC and in the LN on the metastatic neoplastic cells (MNC; n=22). In metastatic OSCC, E-cadherin and β-catenin presented significantly lower cytoplasmic membrane expression in the ITF and MNC when compared to the LC and lower cytoplasmic expression in MNC when compared to the LC and ITF (p<0.05). Integrins α2β1 and α3β1 showed high cytoplasmic expression in the LC, ITF and MNC (p>0.05). A positive correlation was observed between E-cadherin cytoplasmic expression and α2β1 (p=0.860) and α3β1 (p=0.975) expression. When comparing the primary sites of metastatic and non-metastatic disease, β-catenin presented lower cytoplasmic membrane (p=0.013) expression in metastatic OSCC. E-cadherin presented low expression and the integrins high expression in both groups. Abnormal expression of β-catenin and E-cadherin associated with high expression of α2β1 and α3β1 integrins contribute to LN metastasis in OSCC.

Expression of adhesion proteins (E-cadherin and β-catenin) and cell proliferation (Ki-67) at the invasive tumor front in conventional oral squamous cell and basaloid squamous cell carcinomas

OBJECTIVE Investigate, on a comparative basis, the expression of the adhesion molecules E-cadherin (E-cad), β-catenin (β-cat) and the proliferation index (Ki-67) at the invasive tumor front (ITF) in squamous cell carcinoma (SCC) and basaloid squamous cell carcinoma (BSCC). MATERIAL AND METHODS Thirty-five SCC and 16 BSCC cases were evaluated by immunohistochemistry. Clinicopathological and survival data were also evaluated and compared. RESULTS There was a low expression of E-cad in the cytoplasmic membrane (p=0.50) as well as in the nucleus (p=0.31) for both SCC and BSCC. A high expression of E-cad was seen in the cytoplasm for the SCC group (80%) when compared to the BSCC group (25%) (p<0.01). The expression of β-cat was low in the cytoplasmic membrane and high in the cytoplasm in both SCC and BSCC groups. Both types of carcinoma presented low expressions of β-cat in the nucleus (p=0.03). The Ki-67 expression was low irrespective of tumor variant. The high expression of E-cad in the cytoplasm was associated with T3/T4 tumors (p=0.04) in the SCC group and there was no significant association of E-cad, β-cat, Ki-67 with the other clinical variables. In terms of disease-free survival and overall survival, there were no significant differences between SCC and BSCC. CONCLUSION The E-cad-β-cat system was found to be dysregulated in both oral SCC and oral BSCC. The Ki-67 cell proliferation index was extremely low in the cases investigated and consequently had no prognostic value.

Pleomorphic adenoma of oral minor salivary glands: An investigation of its neoplastic potential based on apoptosis, mucosecretory activity and cellular proliferation

OBJECTIVE The aim of this study was to investigate the neoplastic potential of the PA of minor oral salivary glands measured by apoptosis (Bcl-2, Bax and p53), mucosecretory activity (MUC1), and cellular proliferation (Ki-67). DESIGN Thirty-one cases of PA of the oral cavity and four controls (C) taken from normal oral minor salivary glands were analyzed using the immunohistochemistry technique. The proteins were detected utilizing a semi-quantitative method (scores) as follows: (-) negative ≤5%, (+) low 6-25%, (++) moderate 26-50% and (+++) high >50% of positive tumour cells. The apoptotic indices were evaluated by the ratio Bcl-2/Bax. Non-parametric comparison and correlation tests were used for analysis. RESULTS The data showed high staining of anti-apoptotic protein Bcl-2 in both groups (PA=57.9%; C=67.7%) and a significantly lower expression of pro-apoptotic protein Bax (PA=22.7%; C=97.7%) and MUC1 (PA=14%; C=82.3%) in PA than in C (p<0.001). On the other hand, a similar expression of Ki-67 and p53 proteins (≤5%) was seen in both PA and C. In PA, only 2/31 cases showed the ratio Bcl-2/Bax<1.There was no difference in cellular expression with regard to clinical variables or clinical outcome (p>0.05). CONCLUSION The neoplastic potential of PA could be associated with an imbalance in apoptotic processes and a lower index of cellular proliferation. Mucosecretory activity does not play a significant role in primary PA.

Expression Of Ki-67 and MUC1 In mucoepidermoid carcinomas of young and adult patients: Prognostic implications

Mucoepidermoid cancer (MEC) is the most malignant neoplasm of minor salivary glands. The aim of this study was to compare the expression of Ki-67 and MUC1 and clinicopathological data of mucoepidermoid carcinoma (MEC) in minor salivary glands of young and adult patients. The MEC cases in patients under 25 years old (n=8) and over 26 year old (n=8) were matched by gender, location and TNM staging. Immunohistochemical analysis of Ki-67 and MUC1 was carried out and correlated with clinicopathological data. The expression of Ki-67 and MUC1 was similar between the groups, although a tendency towards higher Ki-67 and MUC1 expression was observed in the younger group. Despite no significant differences, survival time was shorter in adults (71.37±17.44 months) compared to the younger group (97.62±25.81). While no patient deaths or tumor recurrences were found in the younger patient group, the adult group presented recurrence in 25% of cases and one patient died. In conclusion, our findings showed that age can be an important factor in MEC prognosis.

Glucocorticoids, calcitonin, and osteocalcin cannot differentiate between aggressive and nonaggressive central giant cell lesions of the jaws

OBJECTIVE To evaluate the expression of glucocorticoid receptor (GR), calcitonin receptor (CTR), and osteocalcin (OC) in aggressive and nonaggressive central giant cell lesions (CGCLs). The numbers of mitotic and multinucleated giant cells were also evaluated. STUDY DESIGN Thirty-one cases of CGCL were submitted for immunohistochemistry. Mitotic figures and multinucleated giant cells were assessed through histochemical analyses. RESULTS Positive staining for GR, CTR, and OC was observed in all cases studied. There were no differences between CGCL variants with regard to the expression of GR, CTR, or OC. The aggressive group showed a higher number of multinucleated giant cells compared with the nonaggressive group (P < .05). CONCLUSIONS Nonaggressive and aggressive CGCLs cannot be distinguished by OC, CTR, or GR expression, although the number of multinucleated giant cells may help differentiate between CGCL types.