Diminuição da expressão de angiotensinogênio e dipeptidil peptidase 1 pode estar associada ao desenvolvimento de leucoplasia verrucosa proliferativa

Orientador: Marcio Ajudarte LopesTese (doutorado) - Universidade Estadual de Campinas, Faculdade de Odontologia de PiracicabaResumo: OBJETIVO: A leucoplasia verrucosa proliferativa (LVP) é uma variante rara e ainda pouco compreendida de leucoplasia oral com um comportamento de progressão persistente para malignidade apresentando uma taxa de malignização entre 40-100%. Além disso, a detecção precoce da LVP às vezes é um desafio para os clínicos, porém desempenha um papel crucial para estabelecer um contínuo e rigoroso acompanhamento. Aspectos moleculares subjacentes são relevantes e nenhum estudo anterior investigou a saliva de pacientes com LVP. O aumento do interesse no estudo do proteoma salivar ocorre porque as proteínas são consideradas as moléculas mais importantes do fluido salivar com potencial para atuar como biomarcador para o diagnóstico de várias doenças sistêmicas e locais. Com base nestes aspectos, o presente estudo teve como objetivo traçar o perfil do proteoma salivar de pacientes com LVP, a fim de identificar potenciais biomarcadores para a melhor compreensão desta entidade visando o possível uso clínico. MATERIAIS E MÉTODOS: A saliva total não estimulada foi coletada de 30 voluntários (15 pacientes com LVP e 15 controles). Uma abordagem proteômica baseada na associação de cromatografia líquida acoplada à espectrometria de massa foi realizada para análise de 20 µg de proteínas das amostras. Os testes de qui-quadrado, análise de variância e regressão logística foram utilizados na análise estatística. RESULTADOS: Um total de duzentas e oitenta e três proteínas foram identificadas. Entre estas, 31 proteínas apresentaram diferença estatisticamente significativa em relação à abundância, sendo 25 proteínas com maior abundância no grupo controle e 6 proteínas com maior abundância no grupo LVP. A combinação das proteínas angiotensinogênio e dipeptidil peptidase 1 criaram um modelo de diferenciação de grupo com um índice de concordância de 94,2% revelando ambas as proteínas como potenciais biomarcadores para o diagnóstico de LPV. CONCLUSÕES: Apesar deste estudo ser o primeiro a avaliar o proteoma salivar em pacientes com LVP, os resultados mostraram que a triagem da saliva pode ser um teste útil no diagnóstico de indivíduos com risco para o desenvolvimento de LPVAbstract: OBJECTIVE: Proliferative verrucous leukoplakia (PVL) is a rare variant and still poorly understood of oral leukoplakia with a behavior of persistent progression to malignancy showing a rate of malignancy between 40-100%. Moreover, the early detection of PVL is sometimes challenging for clinicians, but plays a crucial role to establish a continuous and rigorous follow-up. Underlying molecular aspects are relevants and no previous study investigated the saliva of PVL patients. The increased interest in the salivary proteome study is because proteins are considered the most important molecules in the salivary fluid with potential to act as biomarker for diagnosis of various systemic and local diseases. Based on these aspects, the present study aimed to draw the salivary proteome profile of patients with PVL in order to identify potential biomarkers to better understanding of this entity targeting the possible clinical use. MATERIALS AND METHODS: Unstimulated whole-mouth saliva was collected of 30 voluntaries (15 PVL patients and 15 controls). Proteomic approach based to liquid chromatography coupled to tandem mass spectrometry was performed to 20 µg of proteins of the samples. Chi-Square, analysis of variance and logistic regression test were used in the statistical analysis. RESULTS: A total of two hundred eighty-three proteins were identified. Among of them, 31 proteins showed statistical significance difference in relation to abundance, being 25 proteins with higher abundance in control group and 6 proteins with higher abundance in PVL group. The combination of angiotensinogen and dipeptidyl peptidase 1 created a model for group differentiation with a concordance index of 94.2% revealing both proteins as potential biomarkers for diagnosis of PVL. CONCLUSIONS: Although this study is the first to evaluate the salivary proteome in PVL patients, the results showed that saliva screening may be helpful test to diagnosis of individuals with risk to PVL developmentDoutoradoPatologiaDoutora em Estomatopatologi

Odontogenic keratocysts located in the buccal mucosa : a description of two cases and review of the literature

Odontogenic keratocysts make up 4%–12% of all odontogenic cysts. Most cysts are sporadic but sometimes they arise in the context of basal cell nevus syndrome (Gorlin syndrome). Most odontogenic keratocysts arise in the posterior region of the mandible, but they can occur anywhere in the jaw. In rare instances, they are located peripherally in the gingiva. Even more rare, they are found in the soft tissues of the mouth. There have been a few case reports and small case series of such peripheral odontogenic keratocysts. Some controversy exists as to whether these truly represent a peripheral counterpart of the intraosseous odontogenic keratocysts and if their origin is at all odontogenic. We hereby present two cases of peripheral odontogenic keratocysts, both being located in the soft tissue of the buccal mucosa, and review the literature on peripheral odontogenic keratocysts

Protección radiológica en Odontología : conocimientos y prácticas

The present study aimed to identify the knowledge and attitudes of dental surgeons regarding the guidelines contained in Ordinance SVS/MS No. 453, dated June 1, 1998, in force until the year 2019 and later replaced with Collegiate Board Resolution (RDC) No. 330/19. Our objective was to identify the practices of professionals working inthe dental field regarding the knowledge of the essential criteria for performing periapical, interproximal, panoramic, cephalometric or even cone beam computed tomography imaging exams. The research tool was a questionnaire consisting of 45 questions based on Administrative Rule 453/98, which addresses the requirements for the organization and operation of diagnostic radiology services. The questionnaire was sent to 150 dentists via institutional e-mail, and only 55 professionals returned it. The responses revealed that 64% of the dentists declared not to be aware of the guidelinesof ordinance 453/98 and 49.1% did not know the basic principles of radioprotection. Regarding the norms related to the environment, including the use of a chronometer, thermometer and time-temperature table, the study revealed that 83.6% of the interviewees did not use such equipment and that 74.5% of them were not aware of the technical details ofthe equipment. Regarding radiographic films, 64.5% answered that they did not know their sensitivity, and 25.5% did not use them as a protective barrier during the exams. Finally, the study revealed that the professional practices adopted by dental surgeons are insufficient to meet the principle contained in ordinance 453/98 and in theRDC 330/19,regarding the exposure of patients to a radiation dose.O presente estudo teve como objetivo identificar os conhecimentos e atitudes dos cirurgiões-dentistas em relação às diretrizes contidas na Portaria SVS/MS n°453, de 1 de junho de 1998 vigente até o ano de 2019, posteriormente substituída pela Resolução da Diretoria Colegiada nº 330/19. Essa abordagem visou identificar as práticas dos profissionais que trabalham na área odontológica, no que diz respeito ao conhecimento dos critérios essenciais para a realização de exames de imagem periapicais, interproximais, panorâmicos, cefalométricas ou mesmo tomografia computadorizada de feixe cônico. O método de pesquisa contou com a utilização de um questionário composto por 45 perguntas elaboradas com base na portaria 453/98, que aborda os requisitos para a organização e operação de serviços de radiologia diagnóstica, o qual foi enviado aos participantes 150 cirurgiões-dentistas via e-mail institucional, tendo obtido retorno apenas de 55 questionários. Dentre as respostas, 64% dos cirurgiões-dentistas declararam não ter conhecimento das diretrizes da portaria 453/98; 49,1% não conheciam os princípios básicos da radioproteção. Já quanto às normas relativas ao meio ambiente,incluindo uso de cronômetro, de termômetro e tabela de tempo-temperatura, o estudo evidenciou que 83,6% dos entrevistados não utilizam tais equipamentos, assim como 74,5% dessesnão souberam informar detalhes técnicos acerca dos equipamentos. Relativo aosfilmes radiográficos, 64,5% respondeu desconhecer a sensibilidade desses, bem como 25,5% não os utilizam como barreira de proteção durante os exames. Por fim, o estudo revelouque as práticas profissionais adotadas pelos cirurgiões-dentistas são insuficientes para atender ao princípio que que constava na portaria 453/98 e que constam na RDC 330/19, quanto a exposição dos pacientes à dose de radiação.El presente estudio tuvo como objetivo identificar los conocimientos y las actitudes de los cirujanos dentistas en relación con las directrices contenidas en la Ordenanza SVS/MS nº 453 del 1 de junio de 1998 en vigor hasta el año 2019, posteriormente sustituida por la Resolución del Consejo Colegiado nº 330/19. Este enfoque tenía como objetivo identificar las prácticas de los profesionales que trabajan en el ámbito odontológico, en relación con el conocimiento de los criterios esencialespara la realización de exámenes de imagen periapical, interproximal, panorámica, cefalométrica o incluso de tomografía computarizada de haz cónico. El método de investigación empleó un cuestionario compuesto por 45 preguntas basadas en la Norma Administrativa 453/98, que aborda los requisitos para la organización y el funcionamiento de los servicios de radiodiagnóstico, que se envió a 150 dentistas por correo electrónico institucional, y sólo se devolvieron 55 cuestionarios. Entre las respuestas, el 64% delos dentistas declaró no conocer las directrices de la ordenanza 453/98; el 49,1% no conocía los principios básicos de la radioprotección. En cuanto a las normas relacionadas con el medio ambiente, incluyendo el uso de cronómetro, termómetro y tabla de tiempo-temperatura, el estudio evidenció que el 83,6% de los encuestados no utilizan dichos equipos, así como que el 74,5% fueron incapaces de informar sobre los detalles técnicos de los mismos. En cuanto a las películas radiográficas, el 64,5% contestó que no conocía su sensibilidad, así como el 25,5% no las utilizaba como barrera de protección durante los exámenes. Por último, el estudio revela que las prácticas profesionales adoptadas por los cirujanos-dentistas son insuficientes para cumplir con el principio que establece la ley 453/98 y que establece el RDC 330/19, en cuanto a la exposición de los pacientes a la dosis de radiación

Simple and aneurysmal bone cyst : aspects of jaw pseudocysts based on an experience of Brazilian pathology service during 53 years

Jaw pseudocysts are benign osseous lesions of unclear etiology. Among these, the simple bone cyst (SBC) and aneurysmal bone cyst (ABC) are intriguing bone pathologies still rarely studied together. This retrospective study aimed to present the long-term case series of patients with jaw pseudocysts focusing on the clinical, radiographic, and transoperative aspects. A retrospective case series of patients with SBC and ABC was performed. Clinical, radiographic, and transoperative aspects of both pseudocysts were reviewed from the histopathological archives of 20,469 cases between 1959-2012. All descriptive data were summarized. Of 354 (15.25%) bone pathologies, 54 cases of jaw pseudocysts were found, with 42 (11.86%) SBC and 12 (3.39%) ABC cases. For both lesions, most of the sample were young Caucasian women with an asymptomatic posterior mandible lesion with undetermined time of evolution and none trauma history. A unique radiolucent scalloped lesion presenting an empty cavity were also observed for both conditions. However, some atypical findings were found for SBC including: the expansion of bone cortical, tooth resorption, displacement of the mandibular canal, and recurrence. The absence of painful symptoms and the lack of classical blood-filled cavity were observed in some cases of ABC. The SBC and ABC are bone pathologies with few retrospective studies, no previous studies on the two conditions, varied nomenclature, and atypical aspects in some cases. Therefore, the knowledge of clinical, imaging, and transoperative features of such pseudocysts are clinically valuable as diagnosis hypothesis of radiolucent lesions of the jaws

Overexpression of ALDH1 and EMT marker profile are linked with unfavorable outcome in head and neck cancer

The aim of this research was to assess the expression of aldehyde dehydrogenase 1 (ALDH1) and epithelial-mesenchymal transition (EMT) markers in head and neck squamous cell carcinoma (HNSCC), and to correlate them with the clinical and histopathological parameters of a patient cohort with follow-up over an 8-year period. For this, seventeen HNSCC and non-neoplastic adjacent epithelium (AE) samples were subjected to laser microdissection and real-time PCR to evaluate the mRNA expression of ALDH1, E-cadherin (E-CAD), N-cadherin (N-CAD), and vimentin (VIM). Also, immunohistochemistry was performed for ALDH1, E-CAD, N-CAD, and VIM in the tumor center (TC), invasion front (IF), and AE of the seventeen samples. Mann-Whitney, Kruskal-Wallis and Chi-square tests were used to correlate the mRNA and immunohistochemical expression with different variables, considering p<0.05. Kaplan-Meier curves were produced for local recurrence, regional metastasis and treatment. A mRNA overexpression of ALDH1 in primary tumors was associated with regional metastasis and a high ALDH1 immunostaining was related to metastasis and a worse patient outcome. Additionally, a favorable outcome was associated with the transition phase and an unfavorable outcome was associated with EMT event. An overall 26.9 months was observed with longer survival associated with surgery and radiotherapy. However, due to the intense variability inherent to the indicator proteins in the EMT process, the complete profile markers related to this biological process should be continuous investigated