Fibronectin as an adjuvant in the diagnosis of oral inflammatory myofibroblastic tumor

Inflammatory myofibroblastic tumor is a distinctive lesion composed of myofibroblastic spindle shaped cells accompanied by inflammatory infiltrate that may arise in various organs. It is believed to be a noneoplastic inflammatory condition, although this is still controversial. The recognition of inflammatory myofibroblastic tumor as an entity is important especially to avoid unnecessary surgery. A few cases have been reported in the oral cavity. This report primarily presents a case of inflammatory myofibroblastic tumor that arose in the floor of mouth of a 23-year-old woman. The proliferating spindle cells were immunoreactive for vimentin, smooth muscle actin, and muscle specific actin and negative for desmin, AE1/AE3, S-100, CD68, MyoD1 and caldesmon. In an attempt to assess the potential neoplastic nature of this lesion, immunohistochemical expression of ALK protein was performed, although no immunoreactivity was detected. Also, the presence of well differentiated myofibroblasts identified by fibronectin is discussed, as well as the importance in establishing an immunoprofile to better consolidate the diagnosis. We conclude that the study of fibronectin in case series may aid the diagnosis as well as the prediction of the tumor course

p53 and MDM2 protein expression in actinic cheilitis

Actinic cheilitis is a potentially malignant lip lesion caused by excessive and prolonged exposure to ultraviolet radiation, which can lead to histomorphological alterations indicative of abnormal cell differentiation. In this pathology, varying degrees of epithelial dysplasia may be found. There are few published studies regarding the p53 and MDM2 proteins in actinic cheilitis. Fifty-eight cases diagnosed with actinic cheilitis were histologically evaluated using Banóczy and Csiba (1976) parameters, and were subjected to immunohistochemical analysis using the streptavidin-biotin method in order to assess p53 and MDM2 protein expression. All studied cases expressed p53 proteins in basal and suprabasal layers. In the basal layer, the nuclei testing positive for p53 were stained intensely, while in the suprabasal layer, cells with slightly stained nuclei were predominant. All cases also tested positive for the MDM2 protein, but with varying degrees of nuclear expression and a predominance of slightly stained cells. A statistically significant correlation between the percentage of p53 and MDM2-positive cells was established, regardless of the degree of epithelial dysplasia. The expression of p53 and MDM2 proteins in actinic cheilitis can be an important indicator in lip carcinogenesis, regardless of the degree of epithelial dysplasia

Importance of cone beam computed tomography for diagnosis of calcifying cystic odontogenic tumour associated to odontoma : report of a case

The calcifying cystic odontogenic tumour (CCOT) is a rare benign cystic neoplasm not infrequently associated with odontoma. This report documents a case of CCOT associated with compound odontoma arising in the anterior maxilla in a 25-year-old woman. Conventional radiographs showed a large calcified mass with poorly visualized radiolucent margins. The extent and condition of the internal structure of the CCOT associated with odontoma was able to be determined based on radiographic findings from cone beam computed tomography. This advanced image technique proved to be extremely useful in the radiographic assessment of this particular neoplasm of the jawbones

Expression of transcripts of genes located on chromosome 11q in squamous cell carcinoma of mouth and its relation to criteria of aggressiveness

A instabilidade genética é um importante evento associado ao carcinoma epidermóide de boca, sendo alterações na região cromossômica 11q constantemente relatadas. Neste estudo, genes localizados na região cromossômica 11q, especificamente os genes CTTN, PPFIA1, SHANK2, TAOS1 e MMP-7, foram investigados quanto a diferenças de expressão de transcritos entre carcinomas epidermóides de boca e suas margens correspondentes. A expressão desses genes foi relacionada com aspectos clínicos e histológicos, com critérios de agressividade estabelecidos, e com a sobrevida dos pacientes. Foram analisadas pela técnica de qRT-PCR 29 amostras congeladas de tumores e 25 margens. Todos os genes apresentaram maiores valores de expressão nos tumores em comparação com as margens, embora apenas o gene MMP-7 tenha exibido valores estatisticamente significantes. A expressão do gene MMP-7 mostrou fraca associação com tumores menos agressivos, e os outros genes apresentaram maiores valores de expressão em tumores mais agressivos, sem significância estatística. Não houve diferença estatística entre a freqüência das variáveis clínicas e histopatológicas com a expressão dos genes estudados, porém o PPFIA1 demonstrou maiores níveis de expressão em tumores de assoalho. Em relação à sobrevida, a expressão elevada de PPFIA1 pode implicar em um maior risco de óbito. Assim, é possível a participação do gene MMP-7 no desenvolvimento da neoplasia, e a relação do PPFIA1 com o risco de óbito, porém a expressão de transcritos dos genes CTTN, SHANK2, TAOS1 e MMP-7 não pode ser relacionada com agressividade tumoral e prognóstico.Genetic instability is an important event associated with oral squamous cell carcinoma, and alterations in the chromosome region 11q are constantly reported. In this study, genes located on chromosome region 11q, specifically genes CTTN, PPFIA1, SHANK2, TAOS1 and MMP-7, were investigated for differences in the expression of transcripts in oral squamous cell carcinoma and their corresponding margins. The expression of these genes was correlated with clinical and histological aspects, aggressiveness criteria established, and with patient survival. Twenty-nine frozen samples of tumors and 25 samples of margin tissue were analyzed using qRT-PCR. All genes showed a higher expression in tumors, compared with the margins, although only the MMP-7 gene demonstrated statistically significant values. The expression of the MMP-7 gene showed weak association with less aggressive tumors, and the other genes showed higher expression in more aggressive tumors, without statistical significance. There was no statistical difference between the frequency of clinical and histopathological variables and the expression of genes studied, however the PPFIA1 gene demonstrated higher levels of expression in tumors of the floor of mouth. With regard to survival, the high expression of PPFIA1 may imply a greater risk of death. Thus, it is possible that the MMP-7 gene participates in the development of malignancy, and PPFIA1 expression may also be associated with risk of death, however, the expression of transcripts of the CTTN, SHANK2, TAOS1 and MMP-7 genes may not be related to tumor aggressiveness and prognosis

Journal of Oral Pathology and Medicine

Trabalho completo: acesso restrito, p. 708–715Oncogenic Wnt/b-catenin signaling occurs in numerous types of cancers, but little is known about the role of the Wnt protein family member, WNT- 5A, in lip carcinogenesis. The aim of this study was to investigate WNT-5A, b-catenin, and matrix metalloproteinase (MMP)-3 protein expression in actinic cheilitis (AC), and lip squamous cell carcinoma (LSCC). METHODS: Twenty-one cases of AC, and fifty-one cases of LSCC were analyzed, with normal lip mucosa used as a control. Qualitative and semi-quantitative analyses of WNT-5A, b-catenin, and MMP-3 immunostaining pattern and cellular distribution were performed. RESULTS: WNT-5A was observed in more than 50% of the cells, scattered in all layers of AC, in contrast to the absence of immunostaining in normal lip mucosa. AC presented a higher level of WNT-5A expression than LSCC (P = 0.0289, Fisher test), while MMP-3 immunoexpression was statistically more significant in LSCC than in AC (P = 0.0285, Fisher test). Immunolabeling of b-catenin protein was differentially distributed between samples; the majority of AC cases (61.90%) demonstrated a membranous-cytoplasmic pattern, while a considerable number of LSCC cases (29.41%) revealed a cytoplasmic pattern, instead of the usual membranous pattern. CONCLUSIONS: The present results suggest that WNT-5A may be an important marker during initial events of AC malignant transformation, in which noncanonical and canonical Wnt/b-catenin signaling pathways could be involved. Additionally, WNT-5A might recruit other events in LSCC, such as MMP-3 protein synthesis, as its presence is increased in established malignant processes without b-catenin dependency

Journal of Molecular Histology

Texto completo: acesso restrito. p. 131-137Actinic cheilitis (AC) is a potentially malignant disorder, which can present degrees of epithelial dysplasia, and may even evolve into lip squamous cell carcinoma (LSCC). Since p63 is a protein homologous to p53, which can be associated with tumorigenesis in epithelial tissues, this study aims to evaluate it in AC and LSCC, in the hopes to estimate the biological behavior of these lesions. Forty AC lesions and sixty-five cases of LSCC were quantitatively analyzed by immunohistochemistry, using anti-p63 antibody with ten cases of normal lip mucosa used as a control group. In all AC and LSCC cases studied, it was possible to detect the presence of the p63 protein. There was no statistically significant difference between immunostained cells and degree of epithelial dysplasias, nor between the LSCC grading malignancy. Nevertheless, p63 immunoexpression showed to be significantly correlated with AC and LSCC lesions as compared to normal lip epithelium. The results indicate that p63 protein is consistently expressed in AC and LSCC, and might be of help in the differential diagnosis between normal and dysplastic/neoplastic epithelium, although the evaluation using a primary antibody to all isotypes did not prove to be a risk biomarker during lip carcinogenesis. Thus, the production of antibodies for the six different p63 isotypes is urged, since in isolation they can have predictive value, mainly the ΔNp63 isoforms

Oral Surgery Oral Medicine Oral Pathology Oral Radiology and Endodontology

Acesso restrito: Texto completo. p. 403-410Clear cell odontogenic carcinoma (CCOC) is a rare odontogenic tumor associated with aggressive clinical behavior, metastasis, and low survival. We report a case of CCOC affecting the mandible of a 39-year-old man. The tumor presented a biphasic pattern composed of clear cell nests intermingled with eosinophilic cells and separated by collagenous stroma. Immunoreactivity to cytokeratin (CK), specifically AE1/AE3 and CK 8, 14, 18, and 19 was found, as well as to epithelial membrane antigen (EMA). The tumor cells were negative for S100 protein, CK 13, vimentin, smooth muscle actin, laminin and type IV collagen. Low labeling indices for the proliferation markers Ki-67 and proliferating cell nuclear antigen and to p53 protein might predict a favorable prognosis for the lesion. A surgical resection was performed, followed by adjuvant radiotherapy. A 2-year follow-up has shown no signs of recurrence. The significance of histochemical and immunohistochemical resources in the correct diagnosis of CCOC is analyzed. (Oral Surg Oral Med Oral Pathol Oral Radiol Endod 2008;106:403-10

Oral Surgery, Oral Medicine, Oral Pathology and Oral Radiology

Texto completo: acesso restrito. p. 614–625Objective: Possible differences in splicing variants of TGIF1 in oral squamous cell carcinoma (OSCC) have not yet been reported. This study analyzed the expression levels of different splicing variants of the TGIF1 gene in OSCC compared with nontumoral epithelium (NT) and the relationship with clinical-pathologic features of tumors. Study Design: Forty-eight frozen samples of OSCC and 17 of NT were analyzed using quantitative reverse transcription polymerase chain reaction. Results: TGIF1v2 and v8 are overexpressed in OSCC, whereas TGIF1v5 is underexpressed when compared with NT. Low TGIF1v8 expression was correlated with lower cellular differentiation, positive blood vascular invasion, advanced pathologic stage, and positive vascular lymphatic invasion of OSCC. TGIF1v8 is also related to overall survival over time, with lower values associated with an increased risk of cancer-related death. Conclusions: These data suggest that alternative splicing of TGIF1 is deregulated in OSCC, with overexpression of some splicing variants, especially TGIF1v8, which is associated with advanced stages of OSCC