Detection of AA-type amyloid protein in labial salivary glands

Objectives: Among the diverse forms of amyloidosis, secondary type is the most frequent one. Diagnosis of amyloid deposition is based on the identification of the fibrillary protein amyloid by means of Congo Red (CR) or crystal violet (CV) stains, but these techniques do not differentiate between the different types of amyloid fibrils. The aim of this study was to identify by immunofluorescence (IF) AA amyloid a pathological fibrillar low-molecularweight protein formed by cleavage of serum amyloid A (SAA) protein in labial salivary gland (LSG) biopsies from patients with secondary amyloidosis. Study design: 98 LSG were studied, 65 were from patients with secondary amyloidosis and 33 from subjects with chronic inflammatory diseases without evidence of this anomaly. All sections were stained with hematoxylin and eosin (H and E), CV, CR and IF using anti-AA antibodies. Positive and negative controls were used for all techniques. Results: CV and CR demonstrated that the amyloid substance was found mainly distributed periductally (93.8%), followed by periacinar and perivascular locations (p<0.001); however, the IF demonstrated that amyloid AA substance predominates in the periacinar area (73.8%), followed by periductal and perivascular locations (p<0.001). IF has a sensitivity of 83%, 100% of specificity, 100% of predictive positive value and 75% of predictive negative value.Conclusions: The results of this study confirm the efficacy of the LSG biopsy as a highly reliable method for diagnosis of secondary amyloidosis

Epidemiology of the sarcomas of the jaws in a Peruvian population

Objective: Analysis of the clinical characteristics of patients with Sarcomas of the Jaws treated in the ?Instituto Nacional de Enfermedades Neoplasicas. Dr. Eduardo Caceres Graziani? from 1952-2007. Study Design: Review of 155 clinical records of patients with Sarcomas of the Jaws and record of age, gender, size, location, clinical symptoms and signs, histopathological diagnoses and type of treatment. The data obtained were analyzed by means of Student?s statistical t-test, Fisher and Friedman?s test. Results: Analysis of 155 Sarcomas of the Jaws. The average age of patients was 36.8 years old (range: 1-80 years); the female gender was the most frequent (52.9%); the average tumor size was 5.5 cm; in upper jaw 54.84% occurred and 45.16% in the lower jaw; the predominant sign was facial asymmetry (87.74%) and the predominant symptom: pain (63.23%). The most frequent diagnosis was Osteosarcoma 50.3% followed by Chondrosarcoma 18%. Surgery plus radiation therapy was the treatment type of choice with 21.94% of cases. Conclusion: The results of this study demonstrate the delayed diagnosis and facial asymmetry and pain appear as the most important events for the diagnosis of Sarcomas of the Jaw

Malignant melanoma of the oral cavity. Review of the literature and experience in a Peruvian Population

Objective: To determine the epidemiological profile of malignant melanoma cases treated at the National Institute for Neoplastic Diseases "Dr. Eduardo Caceres Graziani" (INEN) over the period 1952 to 2008. Study Design: All clinical records with complete data of patients presenting a histopathological diagnosis of malignant melanoma of the oral cavity were reviewed. Data such as age, gender, location, tumor size, disease length, presence of metastasis, treatment received and year of admission recorded. Results: During the study period 97 cases found. The average age of patients was 52.85±1.6 years old mostly between 50 and 59 years old; the predominant gender the female. The most common location the palate and there 58.8% of cases with a tumor size bigger than or equal to 4 cm. The length of the disease in 38.1% of the cases was longer than a year and in great part of the cases (69.1%) there no metastasis. The treatment of choice the surgery plus radiotherapy in 38.1% of the cases. According to the admission date it also noted that the number of cases is increasing. Conclusion: The results of this study demonstrate a late diagnosis and an increasing frequency of this neoplasia in the oral cavity. © Medicina Oral S. L

Malignant lymphoma of the oral cavity and the maxillofacial region: overall survival prognostic factors

Objective: To identify the overall survival and prognostic factors of malignant lymphoma of the oral cavity and the maxillofacial region. Study Design: Clinical records data were obtained in order to determine overall survival at 2 and 5 years, the individual survival percentage of each possible prognostic factor with the actuarial technique, and the survival regarding the possible prognostic factors with the actuarial technique and the Log-rank and Cox's regression tests. Results: Of 151 subjects, an overall survival was 60% at 2 years, and 45% at 5 years. The multivariate analysis demonstrated statistically significant differences for clinical stage (p=0.002), extranodal involvement (p=0.030), presence of human immunodeficiency virus (p=0.032), and presence of Epstein-Barr virus (p=0.010). Conclusion: The advanced clinical stage and the larger number of involved extranodular sites are related to a lower overall survival, as well as, the presence of previous infections such as the human immunodeficiency and the Epstein-Barr virus

Prognostic factors in patients with jaw sarcomas

The aim of this study was to identify the prognostic factors related to the survival of patients with sarcomas of the jaw treated in the Dr. Eduardo Caceres Graziani National Institute for Neoplastic Diseases, Lima, Peru. Age, gender, delay in consultation, diagnostic delay, therapeutic delay, tumor size, tumor location, facial asymmetry, pain, treatment type, and histopathological diagnosis were all evaluated as possible prognostic factors that would influence survival in those with jaw sarcomas. In the analysis, the following was used: mortality tables, Kaplan-Meier's product-limit method, log-rank, and Breslow and Tarone-Ware tests; for the prognostic factors, Cox's Regression Model was used. The overall survival rate, with the patient being free from disease at two years, was 55%, and that at five years was 45%. In the independent analysis of the prognostic factors, four variables were statistically significant in influencing survival: gender (p = 0.043), histopathologic diagnosis (p = 0.019), tumor location (p = 0.019), and treatment type (p = 0.030). According to Cox's Regression Model for the multivariate analysis, statistically significant prognostic factors were: gender (p = 0.086), tumor location (p = 0.020), and treatment type (p = 0.092). Thus, the variables of gender, tumor location, and treatment type were determined to be predictive factors for prognosis of survival