Accuracy of clinical diagnosis for the identification of potentially malignant disorders and malignant lip lesions

The aim of this study was to assess the accuracy of clinical diagnosis for lip lesions based on sensitivity and specificity. The retrospective analysis focused on the detection of lesions caused by potentially malignant disorders (PMDs) and malignant lesions (n = 1195). All cases were classified as benign, PMD, and malignant lesions. Concordance between diagnoses based on clinical examination and those based on histopathological analysis was assessed, and accuracy for the identification of PMD and malignant lesions was calculated. Histopathological analysis revealed 44 lesion types; PMD and malignant lesions comprised 8.3% of all cases. Compared with histopathological analysis, clinical examination showed 97.4% accuracy for the identification of non-malignant and potentially malignant/malignant cases. Degrees of specific sensitivity ranged from 34% to 77% for different lesions, and were highest for autoimmune (77%) and reactive (72%) lesions. Positive and negative predictive values for the identification of PMD and malignant lesions were 81.9% and 98.9%, respectively. Clinical examination showed a high degree of accuracy for the detection of PMD and malignant lip lesions, indicating good reliability

Competence in Streptococcus pneumoniae and Close Commensal Relatives: Mechanisms and Implications

The mitis group of streptococci comprises species that are common colonizers of the naso-oral-pharyngeal tract of humans. Streptococcus pneumoniae and Streptococcus mitis are close relatives and share ~60–80% of orthologous genes, but still present striking differences in pathogenic potential toward the human host. S. mitis has long been recognized as a reservoir of antibiotic resistance genes for S. pneumoniae, as well as a source for capsule polysaccharide variation, leading to resistance and vaccine escape. Both species share the ability to become naturally competent, and in this context, competence-associated killing mechanisms such as fratricide are thought to play an important role in interspecies gene exchange. Here, we explore the general mechanism of natural genetic transformation in the two species and touch upon the fundamental clinical and evolutionary implications of sharing similar competence, fratricide mechanisms, and a large fraction of their genomic DNA

Hidden Gems in the Transcriptome Maps of Competent Streptococci

Natural transformation is regarded as an important mechanism in bacteria that allows for adaptation to different environmental stressors by ensuring genome plasticity. Since the discovery of this phenomenon in Streptococcus pneumoniae, remarkable progress has been made in the understanding of the molecular mechanisms and pathways coordinating this process. Recently, the advent of high-throughput sequencing allows the posing of questions that address the system at a larger scale but also allow for the creation of high-resolution maps of transcription. Thus, while much is already known about genetic competence in streptococci, recent studies continue to reveal intricate novel regulation pathways and components. In this perspective article, we highlight the use of transcriptional profiling and mapping as a valuable resource in the identification and characterization of “hidden gems” pertinent to the natural transformation system. Such strategies have recently been employed in a variety of different species. In S. mutans, for example, genome editing combined with the power of promoter mapping and RNA-Seq allowed for the identification of a link between the ComCDE and the ComRS systems, a ComR positive feedback loop mediated by SigX, and the XrpA peptide, encoded within sigX, which inhibits competence. In S. pneumoniae, a novel member of the competence regulon termed BriC was found to be directly under control of ComE and to promote biofilm formation and nasopharyngeal colonization but not competence. Together these new technologies enable us to discover new links and to revisit old pathways in the compelling study of natural genetic transformation

BRCA1 polymorphism in breast cancer patients from Argentina

Breast cancer is the most common type of cancer in females in Argentina, with an incidence rate similar to that in the USA. However, the contribution of the BRCA1 or BRCA2 mutation in breast cancer incidence has not yet been investigated in Argentina. In order to evaluate which BRCA1 polymorphisms or mutations characterize female breast cancer in Argentina, the current study enrolled 206 females with breast cancer from several hospitals from the southeast of Argentina. A buccal smear sample was obtained in duplicate from each patient and the DNA samples were processed for polymorphism analysis using the single-strand conformational polymorphism technique. The polymorphisms in BRCA1 were investigated using a combination of 15 primers to analyze exons 2, 3, 5, 20 and 11 (including the 11.1 to 11.12 regions). The BRCA1 mutations were confirmed by direct sequencing. Samples were successfully examined from 154 females and, among these, 16 mutations were identified in the BRCA1 gene representing 13.9% of the samples analyzed. One patient was identified with a polymorphism in exon 2 (0.86%), four in exon 20 (3.48%), four in exon 11.3 (3.48%), one in exon 11.7 (0.86%), two in exon 11.8 (1.74%), one in exon 11.10 (0.86%) and one in exon 11.11 (0.86%). The most prevalent alteration in BRCA1 was located in exon 11 (11 out of 16 patients; 68.75%). The objective of our next study is to evaluate the prevalence of mutations in the BRCA2 gene and analyze the BRCA1 gene in the healthy relatives of BRCA1 mutation carriers.Fil: Jaure, Omar David Argentino. Consejo Nacional de Investigaciones Científicas y Técnicas. Centro Científico Tecnológico Conicet - Bahía Blanca. Centro de Recursos Naturales Renovables de la Zona Semiárida. Universidad Nacional del Sur. Centro de Recursos Naturales Renovables de la Zona Semiárida; ArgentinaFil: Alonso, Eliana Noelia. Consejo Nacional de Investigaciones Científicas y Técnicas. Centro Científico Tecnológico Conicet - Bahía Blanca. Centro de Recursos Naturales Renovables de la Zona Semiárida. Universidad Nacional del Sur. Centro de Recursos Naturales Renovables de la Zona Semiárida; ArgentinaFil: Aguilera Braico, Diego Máximo. Consejo Nacional de Investigaciones Científicas y Técnicas. Centro Científico Tecnológico Conicet - Bahía Blanca. Centro de Recursos Naturales Renovables de la Zona Semiárida. Universidad Nacional del Sur. Centro de Recursos Naturales Renovables de la Zona Semiárida; ArgentinaFil: Nieto, Alvaro. Consejo Nacional de Investigaciones Científicas y Técnicas. Centro Científico Tecnológico Conicet - Bahía Blanca. Centro de Recursos Naturales Renovables de la Zona Semiárida. Universidad Nacional del Sur. Centro de Recursos Naturales Renovables de la Zona Semiárida; ArgentinaFil: Orozco, Manuela. Consejo Nacional de Investigaciones Científicas y Técnicas. Centro Científico Tecnológico Conicet - Bahía Blanca. Centro de Recursos Naturales Renovables de la Zona Semiárida. Universidad Nacional del Sur. Centro de Recursos Naturales Renovables de la Zona Semiárida; ArgentinaFil: Morelli, Cecilia. Consejo Nacional de Investigaciones Científicas y Técnicas. Centro Científico Tecnológico Conicet - Bahía Blanca. Centro de Recursos Naturales Renovables de la Zona Semiárida. Universidad Nacional del Sur. Centro de Recursos Naturales Renovables de la Zona Semiárida; ArgentinaFil: Ferro, Alejandro M.. Hospital Italiano; ArgentinaFil: Barutta, Elena. Medifem; ArgentinaFil: Vincent, Esteban. Medifem; ArgentinaFil: Martínez, Domingo. Provincia de Buenos Aires. Ministerio de Salud. Hospital Municipal de Agudos Dr. Leónidas Lucero; ArgentinaFil: Martínez, Ignacio. Provincia de Buenos Aires. Ministerio de Salud. Hospital Municipal de Agudos Dr. Leónidas Lucero; ArgentinaFil: Maegli, Maria Ines. Provincia de Buenos Aires. Ministerio de Salud. Hospital Municipal de Agudos Dr. Leónidas Lucero; ArgentinaFil: Frizza, Alejandro. Medifem; ArgentinaFil: Kowalyzyn, Ruben. Clínica Viedma; ArgentinaFil: Salvadori, Marisa. Hospital Dr. Lucio Molas; ArgentinaFil: Ginestet, Paul. Provincia de Buenos Aires. Ministerio de Salud. Hospital y Maternidad Municipal Pigüé; ArgentinaFil: Gonzalez Donna, Maria L.. Hospital Italiano; ArgentinaFil: Balogh, Gabriela Andrea. Consejo Nacional de Investigaciones Científicas y Técnicas. Centro Científico Tecnológico Conicet - Bahía Blanca. Centro de Recursos Naturales Renovables de la Zona Semiárida. Universidad Nacional del Sur. Centro de Recursos Naturales Renovables de la Zona Semiárida; Argentin

Clinicopathological analysis of salivary gland tumors over a 15-year period

Abstract Salivary gland tumors (SGT) are rare neoplasms that generate interest due to their histopathological diversity and clinical behavior. The aims of the present study were to investigate clinicopathological aspects of SGTs diagnosed at a tertiary health center and compare the findings with epidemiological data from different geographic locations. Cases of tumor in the head and neck region at a single health center in the period between 1995 and 2010 were reviewed. Patient gender, age and ethnic group as well as anatomic location, histological type and clinical behavior of the tumor were recorded. Availability of complete information about these aspects was considered the inclusion criteria. Descriptive statistical analysis of the data was performed using the frequencies of categorical variables. Among the 2168 cases of tumors in the head and neck region, 243 (11.20%) cases were diagnosed in the salivary glands, 109 of which met the inclusion criteria: 85 (78%) benign tumors and 24 (22%) malignant tumors. Mean patient age was 46.47 years. The female gender accounted for 56 cases (51.4%) and the male gender accounted for 53 (48.3%). The major salivary glands were affected more (75.2%) than the minor glands. The most frequent benign and malignant SGTs were pleomorphic adenoma (81.2%) and adenoid cystic carcinoma (58.3%), respectively. In conclusion, pleomorphic adenoma and adenoid cystic carcinoma are the most frequent benign and malignant lesions, respectively. Comparing the present data with previous studies on SGTs, one may infer that some demographic characteristics and the predominance of malignant tumors vary in different geographic regions

Content of Ki-67 and TGF-β1, but no Elastin, is significantly altered in the lip carcinogenesis and associated to behavior of Actinic Cheilitis and Lip Squamous Cell Carcinoma

As alterações epiteliais observadas nas queilites actínicas (QA) e carcinomas espinocelulares (CEC) de lábio vem sendo estudadas por meio de diferentes marcadores, a fim de observar os fatores de diagnóstico e prognóstico para ambas as lesões. O objetivo do presente estudo foi analisar a imunomarcação do Ki-67, TGF- β1 e elastina nas QA e CEC de lábio, com o intuito de verificar um possível papel destas proteínas na carcinogênese labial, bem como correlacioná-los com fatores de risco, graduação histológica e acompanhamento dos pacientes. Foram coletados dados sobre características demográficas, fatores de risco, aspectos clínicos, tratamento e evolução de 29 casos de QA e 53 casos de CEC de lábio. As QA foram classificados de acordo com a OMS e os CEC de lábio de acordo com Bryne et al. As imunomarcações para Ki-67, TGF-β1 e elastina foram analisadas quantitativa ou semi-quantitativamente. Os dados foram analisados pelo teste do qui-quadrado, teste exato de Fisher e análise de regressão logística . A QA mostrou aumento de células positivas para o Ki -67 conjuntamente com o aumento do grau de displasia epitelial (p<0,01). Observou-se uma correlação significativa entre o Ki-67 com o consumo de tabaco (p < 0,05), graduação histopatológica (p<0,01) e evolução (p=0,01). Nos casos de CEC de lábio houve associação entre maior número de células Ki-67 positivas com a recidiva do tumor (p<0,01). Correlação significativa entre Ki-67 com o consumo de tabaco (p=0,009), graduação histopatológica (p<0,01) e recidiva do tumor (p<0,01) também foi observada. A QA mostrou imunomarcação para o TGF-β1 em ambos os tecidos (parênquima e estroma), e uma correlação inversa foi observada com o Ki-67 e o grau de displasia epitelial (p<0,01). O CEC de lábio mostrou imunomarcação inversa em relação ao TGF-β1 e a graduação histopatológica do tumor (p<0,01). Quanto à expressão de elastina, todos os casos de QA demonstraram uma organização das fibras elásticas como massa difusa e compacta. Observou-se uma correlação significativa entre o grau de elastina com a exposição ao sol (p<0,01). No CEC de lábio a elastose foi mais fina e interrompida quando comparado com as QA, e esta diferença no padrão de imunomarcação elastina foi estatisticamente significativa entre os grupos (p<0,01). Em conclusão, os resultados deste estudo indicam que o alterações no perfil de Ki-67 e TGF-β1 contribuem para a carcinogênese labial. Além disso, a elastina reflete as alterações da matriz extracelular em QA e CEC de lábio.Epithelial changes observed in actinic cheilitis (AC) and lip squamous cell carcinoma (LSCC) have been studied using different markers in order to observe diagnostic and prognostic factors for both lesions. The aim of the present study was to analyze the immunostaining of Ki-67, TGF-β1 and elastin in AC and LSCC, in order to verify a possible role of these proteins in lip carcinogenesis, as well as correlate them with risk factors, histological graduation and patient follow-up. Data were collected regarding demographic features, risk factors, clinical aspects, treatment and outcome in 29 cases of AC and 53 cases of LSCC. AC were classified according to WHO and LSCC according to Bryne et al. The immunostainings for Ki-67, TGF-β1 and elastin were analyzed quantitative and semi-quantitative. Data were analyzed by chi-square, Fisher’s Exact Test and logistic regression analysis. The AC showed higher positive cells for Ki-67 with increase of epithelial dysplasia (p<0.01). A significant correlation between Ki-67 with tobacco consumption (p<0.05), histopathological graduation (p<0.01) and evolution (p=0.01) was observed. The LSCC exhibited an increase in the percentage of Ki-67 positive cells associated with worse tumor graduation (p<0.01). A significant correlation between Ki-67 with tobacco consumption (p=0.009), histopathological graduation (p<0.01) and tumor recurrence (p<0.01) also was observed. The AC showed immunolabeling for TGF-β1 in both epithelial (parenchyma) and stromal tissues, but an inverse correlation was observed with Ki-67 positive and degree of epithelial dysplasia (p<0.01). The LSCC showed that epithelial and stromal TGF-β1 labeling was reversed to tumor histopathological graduation (p<0.01). Regarding expression of elastin, all AC cases demonstrated an organization of elastic fibers as diffuse and compact mass. A significant correlation between elastin grade with sun exposure was observed (p<0.01). The elastosis in LSCC was thinner and discontinued when compared to AC, and this difference in elastin immunolabeling pattern was statistically significant between the groups (p<0.01). In conclusion, the results of this study indicate that altered content of Ki-67 and TGF-β1 contributes to lip carcinogenesis. Furthermore, elastin reflects the alterations of ECM in AC and LSCC

Estudo clínico randomizado para comparar o efeito do laser de baixa potência com corticóide tópico na dor e resolução de lesões atróficas/erosivas do líquen plano bucal.

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Estudo clínico randomizado para comparar o efeito do laser de baixa potência com corticóide tópico na dor e resolução de lesões atróficas/erosivas do líquen plano bucal.

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Content of Ki-67 and TGF-β1, but no Elastin, is significantly altered in the lip carcinogenesis and associated to behavior of Actinic Cheilitis and Lip Squamous Cell Carcinoma

As alterações epiteliais observadas nas queilites actínicas (QA) e carcinomas espinocelulares (CEC) de lábio vem sendo estudadas por meio de diferentes marcadores, a fim de observar os fatores de diagnóstico e prognóstico para ambas as lesões. O objetivo do presente estudo foi analisar a imunomarcação do Ki-67, TGF- β1 e elastina nas QA e CEC de lábio, com o intuito de verificar um possível papel destas proteínas na carcinogênese labial, bem como correlacioná-los com fatores de risco, graduação histológica e acompanhamento dos pacientes. Foram coletados dados sobre características demográficas, fatores de risco, aspectos clínicos, tratamento e evolução de 29 casos de QA e 53 casos de CEC de lábio. As QA foram classificados de acordo com a OMS e os CEC de lábio de acordo com Bryne et al. As imunomarcações para Ki-67, TGF-β1 e elastina foram analisadas quantitativa ou semi-quantitativamente. Os dados foram analisados pelo teste do qui-quadrado, teste exato de Fisher e análise de regressão logística . A QA mostrou aumento de células positivas para o Ki -67 conjuntamente com o aumento do grau de displasia epitelial (p<0,01). Observou-se uma correlação significativa entre o Ki-67 com o consumo de tabaco (p < 0,05), graduação histopatológica (p<0,01) e evolução (p=0,01). Nos casos de CEC de lábio houve associação entre maior número de células Ki-67 positivas com a recidiva do tumor (p<0,01). Correlação significativa entre Ki-67 com o consumo de tabaco (p=0,009), graduação histopatológica (p<0,01) e recidiva do tumor (p<0,01) também foi observada. A QA mostrou imunomarcação para o TGF-β1 em ambos os tecidos (parênquima e estroma), e uma correlação inversa foi observada com o Ki-67 e o grau de displasia epitelial (p<0,01). O CEC de lábio mostrou imunomarcação inversa em relação ao TGF-β1 e a graduação histopatológica do tumor (p<0,01). Quanto à expressão de elastina, todos os casos de QA demonstraram uma organização das fibras elásticas como massa difusa e compacta. Observou-se uma correlação significativa entre o grau de elastina com a exposição ao sol (p<0,01). No CEC de lábio a elastose foi mais fina e interrompida quando comparado com as QA, e esta diferença no padrão de imunomarcação elastina foi estatisticamente significativa entre os grupos (p<0,01). Em conclusão, os resultados deste estudo indicam que o alterações no perfil de Ki-67 e TGF-β1 contribuem para a carcinogênese labial. Além disso, a elastina reflete as alterações da matriz extracelular em QA e CEC de lábio.Epithelial changes observed in actinic cheilitis (AC) and lip squamous cell carcinoma (LSCC) have been studied using different markers in order to observe diagnostic and prognostic factors for both lesions. The aim of the present study was to analyze the immunostaining of Ki-67, TGF-β1 and elastin in AC and LSCC, in order to verify a possible role of these proteins in lip carcinogenesis, as well as correlate them with risk factors, histological graduation and patient follow-up. Data were collected regarding demographic features, risk factors, clinical aspects, treatment and outcome in 29 cases of AC and 53 cases of LSCC. AC were classified according to WHO and LSCC according to Bryne et al. The immunostainings for Ki-67, TGF-β1 and elastin were analyzed quantitative and semi-quantitative. Data were analyzed by chi-square, Fisher’s Exact Test and logistic regression analysis. The AC showed higher positive cells for Ki-67 with increase of epithelial dysplasia (p<0.01). A significant correlation between Ki-67 with tobacco consumption (p<0.05), histopathological graduation (p<0.01) and evolution (p=0.01) was observed. The LSCC exhibited an increase in the percentage of Ki-67 positive cells associated with worse tumor graduation (p<0.01). A significant correlation between Ki-67 with tobacco consumption (p=0.009), histopathological graduation (p<0.01) and tumor recurrence (p<0.01) also was observed. The AC showed immunolabeling for TGF-β1 in both epithelial (parenchyma) and stromal tissues, but an inverse correlation was observed with Ki-67 positive and degree of epithelial dysplasia (p<0.01). The LSCC showed that epithelial and stromal TGF-β1 labeling was reversed to tumor histopathological graduation (p<0.01). Regarding expression of elastin, all AC cases demonstrated an organization of elastic fibers as diffuse and compact mass. A significant correlation between elastin grade with sun exposure was observed (p<0.01). The elastosis in LSCC was thinner and discontinued when compared to AC, and this difference in elastin immunolabeling pattern was statistically significant between the groups (p<0.01). In conclusion, the results of this study indicate that altered content of Ki-67 and TGF-β1 contributes to lip carcinogenesis. Furthermore, elastin reflects the alterations of ECM in AC and LSCC