Immunohistochemical staining of Langerhans cells in HPV-positive and HPV-negative cases of oral squamous cells carcinoma

The Human Papillomavirus (HPV) has been strongly implicated in development of some cases of oral squamous cell carcinoma (OSCC). However, the immunological system somehow reacts against the presence of this virus. Among the cells involved in such mechanism of defense Langerhans cells (LC) stand out, which are responsible for processing and presenting antigens. OBJECTIVES: The purposes of this study were to investigate the presence of HPV DNA and to evaluate the immunohistochemical reactivity for Langerhans cells between HPV-positive and HPV-negative OSCC. Twenty-seven cases of OSSC were evaluated. MATERIAL AND METHODS: DNA was extracted from paraffin-embedded tissue samples and amplified by Polymerase Chain Reaction (PCR) for the detection of HPV DNA. Viral typing was performed by dot blot hybridization. Immunohistochemistry was performed by the Streptavidin-biotin technique. RESULTS: From the 27 cases, 9 (33.3%) were HPV-positive and 18 (66.0%) HPV-negative. HPV 18 was the most prevalent viral type (100% cases) and infection with HPV-16 (co-infection) was detected in only 1 case. In the OSCC specimens examined, immunoreactivity to S-100 antibody was detected in all cases, with a mean number of 49.48±30.89 Langerhans cells positive for immunostaining. The mean number of immunostained Langerhans cells was smaller in the HPV-positive cases (38 cells/case) than in the HPV-negative cases (42.5 cells/case), but this difference was not significant (p=0.38). CONCLUSIONS: The low frequency of detection of HPV DNA in OSCC indicates a possible participation of the virus in the development and progression of only a subgroup of these tumors. There was no association between the immunohistochemical labeling for Langerhans cells (S-100+) and HPV infection of in OSSC. These findings suggest that the presence of HPV in such OSCC cases could not alter the immunological system, particularly the Langerhans cells

Prognostic significance of the anatomical location and TNM clinical classification in oral squamous cell carcinoma

Objetives: The aim of this study was to investigate the existence of correlation between the TNM clinical classification, anatomical location and prognosis of oral squamous cell carcinoma. Study design: A total of 130 oral squamous cell carcinomas were selected from the files of the Dr. Luiz Antonio Hospital (Natal, Rio Grande do Norte, Brazil). Data concerning TNM clinical classification, anatomical location and prognosis were obtained. Pearsons correlation test was applied for the statistical analysis of data. Results: It revealed a statistically significant correlation (p = 0.01) between TNM clinical classification and prognosis. It also revealed correlation between TNM classification and the anatomical location of oral squamous cell carcinomas (p = 0.01). Conclusions: We concluded that TNM classification presented correlation with prognosis and with the different anatomical locations of oral squamous cell carcinomas

Clinicopathological evaluation and survival of patients with squamous cell carcinoma of the tongue

Early detection of oral cancer is the most effective means of reducing morbidity, complexity, and extent of treatment. This study evaluated the clinicopathological profile of epidermoid carcinoma of the tongue, including treatment and survival. This observational, retrospective cross-sectional study evaluated patients with squamous cell carcinoma of the tongue treated at the Dr. Luiz Antônio Hospital, Natal, Brazil, from January 2001 to December 2011. Survival variables were calculated using the Kaplan-Meier method and compared by log rank tests. Of the 412 patients diagnosed in this period, 298 (72.3%) were men; their mean age was 60.5 years, and 69.2% were diagnosed with stage III/IV tumours. Improved survival was associated with early stage diagnosis, absence of affected lymph nodes at diagnosis, and treatment with surgery alone. Late stage diagnosis of oral cancer negatively affects patient survival. In addition, the general public should be made aware of the prognostic factors for oral SCC of the tongue and of the importance of periodic examinations of the oral cavity

Prognostic and clinicopathological significance of tumor-stroma ratio in head and neck squamous cell carcinoma:a systematic review

Analysis of the tumor microenvironment has been proposed as a strategy for the treatment and prognosis of different neoplastic processes. A grading system based on the tumor-stroma ratio (TSR), which evaluates the proportion of stroma in relation to neoplastic parenchyma at the invasion front, has shown a strong prognostic value in different neoplastic processes. The aim of the present systematic review was to understand the role of the TSR in head and neck squamous cell carcinoma (HNSCC), evaluating its correlation with clinical and prognostic parameters. An electronic search was performed in PubMed/Medline, Web of Science, Science Direct, Scopus, Embase, and the Cochrane Collaboration Library. Publications assessing the relationship between TSR and prognosis in cases of HNSCC were eligible. The quality of the studies was assessed independently by four evaluators using the Newcastle-Ottawa scale. After application of the previously es+lished inclusion/exclusion criteria, nine articles were included in the qualitative synthesis. With regards to quality on the Newcastle-Ottawa scale, an overall value of 4.55 was obtained. This systematic review demonstrated a strong association between TSR and prognosis in esophageal and oral squamous cell carcinomas. Histopathological analysis of the TSR can optimize the analysis of the prognosis of cases diagnosed with HNSSC. In addition, the TSR is a reliable and simple parameter that can be evaluated in hematoxylin/eosin-stained slides during routine laboratory examinations, showing high inter- and intraobserver agreement

Leucoplasias bucais: relação clínico-histopatológica

The relation between the clinical aspects and histologic characteristics of oral leukoplakias was evaluated on 28 adult patients presenting with oral leukoplakia. The lesions were clinically classified as homogeneous and nonhomogeneous, and divided regarding their histopathologic characteristics in six groups: hyperkeratosis without epithelial dysplasia; mild epithelial dysplasia; moderate epithelial dysplasia; severe epithelial dysplasia, squamous cell carcinoma in situ and invasive carcinoma. Homogeneous leukoplakia comprised 78.6% of the cases and nonhomogeneous, 21.4%. Microscopically, 32.2% of the lesions disclosed hyperkeratosis without evidences of epithelial dysplasia, 53.5% epithelial dysplasia (39.3% mild, 7.1% moderate, and 7.1% severe) and 14.3% invasive carcinoma. Homogeneous leukoplakia showed discreet histologic changes, while nonhomogeneous lesions evidenced histologic characteristics of severe epithelial dysplasia and even of invasive carcinoma. The results suggest great precaution in the diagnosis and follow-up of leukoplakia, considering the possibility of malignant transformation.A relação entre o aspecto clínico e as características histológicas das leucoplasias bucais foi avaliada em 28 pacientes adultos, que apresentaram lesões leucoplásicas na mucosa bucal. As lesões foram divididas quanto ao aspecto clínico em homogêneas e não-homogêneas, e classificadas segundo suas características histopatológicas em seis grupos: hiperceratose com ausência de displasia epitelial; displasia epitelial leve; displasia epitelial moderada; displasia epitelial severa, carcinoma in situ e carcinoma invasivo. Os resultados clínicos mostraram maior ocorrência de leucoplasias homogêneas (78,6%) do que não-homogêneas (21,4%). Os achados histopatológicos demonstraram que 32,2% dos casos apresentaram hiperceratose com ausência de displasia epitelial, 53,5% evidenciaram displasia epitelial (39,3% leve, 7,1% moderada e 7,1% severa) e 14,3% diagnosticados como carcinoma invasivo. As leucoplasias homogêneas apresentaram alterações celulares discretas, enquanto as não-homogêneas evidenciaram displasia epitelial severa e carcinoma invasivo. Os resultados sugerem um maior cuidado no diagnóstico e controle de leucoplasias dada a possibilidade de transformação maligna

Detection of HPV DNA and immunohistochemical expression of cell cycle proteins in oral carcinoma in a population of brazilian patients

This study investigated the presence of human papillomavirus (HPV) DNA and viral types in 33 cases of oral squamous cells carcinoma (OSCC) and compared the immunohistochemical expression of the cell-cycle markers p21 and pRb between cases of the disease with and without HPV. DNA was extracted from paraffin-embedded tissue and amplified by PCR for the detection of HPV DNA. Viral typing was performed by dot blot hybridization. Immunohistochemistry was performed by the streptavidinbiotin technique. HPV DNA was detected in 11 (33.33%) of the 33 cases. The prevalent viral type was HPV 18 (81.81%). A significant association was observed between the presence of HPV and immunohistochemical expression of pRb, but not between p21 expression and the presence of the virus. The low frequency of detection of HPV DNA in OSCC suggests a possible participation of the virus in the development and progression of only a subgroup of these tumors

Pindborg tumor associated with a supernumerary tooth: a case report

The calcifying epithelial odontogenic tumor is a rare benign neoplasm that accounts for approximately 1% of all odontogenic tumors. Most of the cases occur in the posterior mandible, and a few involve the maxilla. Despite their relatively indolent biological behavior, tumors in the maxilla tend to grow fast. We report the case of a 33-year-old female patient exhibiting swelling in the right maxilla. An isodense area associated with an impacted supernumerary tooth was found on imaging examination. The histopathologic diagnosis was a calcifying epithelial odontogenic tumor. The treatment of choice was surgical removal of the lesion and associated dental elements. The patient has been followed up for 11 months and shows no signs of recurrence. Besides describing this case, we reviewed the literature on the association of calcifying epithelial odontogenic tumors with supernumerary teeth and found two case reports addressing this subject

Hiperplasia epitelial focal (doença de Heck) em descendente de índios brasileiros: relato de caso Focal epithelial hyperplasia (Heck's disease) in Brazilian indian descent: report of a case

A hiperplasia epitelial focal, ou doença de Heck, é uma enfermidade rara, benigna, que afeta a mucosa oral de crianças e adultos jovens de diversas regiões do mundo e em diferentes grupos étnicos, como indígenas e esquimós. Apresenta correlação com o papilomavírus humano (HPV) no qual os tipos 13 e 32 têm sido consistentemente detectados nessas lesões. Este artigo relata um caso de uma paciente de 18 anos de idade, descendente de índios potiguares, que compareceu ao serviço de estomatologia da Universidade Federal do Rio Grande do Norte (UFRN), exibindo lesões bem definidas, arredondadas, planas, localizadas em cavidade oral, com tempo de evolução de aproximadamente dois anos. As lesões foram submetidas a biópsias incisionais, constatado-se no exame histopatológico alterações epiteliais, como acantose, cristas epiteliais em forma de "taco de golfe" além de células mitosóides. Esses achados histopatológicos foram compatíveis com a hipótese clínica de hiperplasia epitelial focal (doença de Heck).<br>The focal epithelial hyperplasia or Heck's disease is a benign rare pathology, that affects children and young adults oral mucosal in many world regions, and different ethnic groups, for example Indians and Eskimos. Presents correlation with the subtypes 13 and 32 of human papillomavirus (HPV). This article report a case of an 18-year-old patient, descent of potiguar indian, attended in stomatology service of Federal University of Rio Grande do Norte (UFRN), presenting well defined lesions, round, plane, localized in oral cavity with an evolution of two years. The lesions were submitted to incisional biopsies, verifying in histopathologic exam, epithelial alterations, like acanthosis, epithelial projections in "parquet block of golf" beyond mitosoid cells. These histopathological findings were compatible with clinical hypothesis of focal epithelial hyperplasia (Heck's disease)