RESUMO
BACKGROUND: Human papillomavirus (HPV) prevalence in head and neck squamous cell carcinomas (HNSCC) diverges geographically. The reliability of using p16(INK4a) expression as a marker of viral infection is controversial in HNSCC. We evaluated HPV types and HPV-16 variants prevalence, and p16(INK4a) expression in HNSCC specimens provided by two different Institutions in São Paulo. METHODS: HPV DNA from formalin-fixed specimens was accessed by Inno-LiPA, HPV-16 variants by PCR-sequencing, and p16(INK4a) protein levels by immunohistochemistry. RESULTS: Overall, HPV DNA was detected among 19.4 % of the specimens (36/186). Viral prevalence was higher in the oral cavity (25.0 %, 23/92) then in other anatomical sites (oropharynx 14,3 %, larynx 13.7 %) when samples from both Institutions were analyzed together. HPV prevalence was also higher in the oral cavity when samples from both Institutions were analyzed separately. HPV-16 was the most prevalent type identified in 69.5 % of the HPV positive smaples and specimens were assigned into Asian-American (57.2 %) or European (42.8 %) phylogenetic branches. High expression of p16(INK4a) was more common among HPV positive tumors. CONCLUSION: Our results support a role for HPV-16 in a subset of HNSCC.
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The purpose of this investigation was to analyze the immunoexpression of FasL, Fas, FADD, cleaved caspase 8, and cleaved caspase 3 in gastric cancer. Formalin-fixed and paraffin-embedded gastric adenocarcinoma tissues from 87 patients, including adjacent normal tissues, were included on tissue microarray by immunohistochemistry. The tumor and the adjacent normal tissues were positive for FasL in 66.7% and 90.6%, for Fas in 52.8% and 52.4%, for FADD in 67.4% and 82.3%, for cleaved caspase 8 in 27.9% and 37.7%, and for cleaved caspase 3 in 33.7% and 8.3%, respectively. FasL and the FADD from tumor were statistically different in relation to the histological type. Cleaved caspase 8 was statistically different in relation to clinical stage (p=0.031). The FADD from normal tissue was statistically different in relation to age (p=0.039), sex (p=0.055), clinical stage (p=0.019), and Fas was different in relation to tumor size (p=0.012). In the tumor, we observed a correlation between FasL and Fas, FasL and FADD, and FasL and cleaved caspase 3. In the adjacent normal tissue, a correlation was observed between FasL and Fas, FasL and FADD. There was no association of another marker with sex, age, clinical stage, and survival. Our results suggest that these proteins mediate the early extrinsic apoptotic pathway in gastric cancer and adjacent normal mucosa. FasL protein binds to Fas protein and subsequently binds to death receptor FADD signaling activation of the extrinsic apoptotic pathway. In this phase, there was inhibition of caspase 8 and, consequently, decreased apoptosis.
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Adenocarcinoma/metabolismo , Adenocarcinoma/patologia , Apoptose/fisiologia , Transdução de Sinais/fisiologia , Neoplasias Gástricas/metabolismo , Neoplasias Gástricas/patologia , Adulto , Idoso , Idoso de 80 Anos ou mais , Caspase 3/análise , Caspase 8/análise , Proteína Ligante Fas/análise , Proteína de Domínio de Morte Associada a Fas/análise , Feminino , Humanos , Imuno-Histoquímica , Masculino , Pessoa de Meia-Idade , Estadiamento de Neoplasias , Análise Serial de Tecidos , Receptor fas/análiseRESUMO
AIM: The aim of this study was to analyze the immunoexpression of metalloproteinase-1, metalloproteinase-7, and p53 in colorectal adenocarcinoma, and to correlate this with clinicopathological prognostic factors. MATERIAL AND METHODS: Formalin-fixed paraffin-embedded tumor tissue from 82 patients was analyzed by means of immunohistochemistry, using the streptavidin-biotin method and the tissue microarray technique. Protein tissue expression was correlated with the variables of the degree of cell differentiation, stage, relapse-free survival, recurrence, survival, and specific mortality. RESULTS: All of the tumors were positive for metalloproteinase-1, while 50 (61%) were positive for metalloproteinase-7, and 32 (39%) were negative for the latter. For p53, 70 (85.4%) of the tumors were positive and 12 (14.6%) were negative. Correlation of the marker expressions separately and in conjunction did not produce any statistically significant data. CONCLUSION: The immunoexpression of metalloproteinase-1, metalloproteinase-7, and p53 did not correlate with recurrence, mortality, relapse-free survival, survival, degree of cell differentiation, or staging of colorectal cancer.
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Neoplasias do Colo/patologia , Neoplasias Colorretais/patologia , Metaloproteinase 2 da Matriz/metabolismo , Metaloproteinase 7 da Matriz/metabolismo , Neoplasias Retais/patologia , Proteína Supressora de Tumor p53/metabolismo , Adulto , Idoso , Idoso de 80 Anos ou mais , Neoplasias do Colo/genética , Neoplasias do Colo/metabolismo , Neoplasias do Colo/mortalidade , Neoplasias do Colo/cirurgia , Neoplasias Colorretais/genética , Feminino , Humanos , Imuno-Histoquímica , Masculino , Pessoa de Meia-Idade , Estadiamento de Neoplasias , Análise de Sequência com Séries de Oligonucleotídeos , Neoplasias Retais/genética , Neoplasias Retais/metabolismo , Neoplasias Retais/mortalidade , Neoplasias Retais/cirurgia , Análise de Sobrevida , Sobreviventes , Adulto JovemRESUMO
UNLABELLED: Maytenus ilicifolia is a native plant from South America, with several medicinal properties including antioxidant effects. AIM: using an original cisplatin induced ototoxicity model, we evaluated a possible otoprotection caused by Maytenus ilicifolia extract. MATERIALS AND METHODS: clinical and experimental study design with female albino guinea pigs divided in groups as follows: 9 animals receiving cisplatin only (three doses of 7.5mg/kg/day), 4 animals receiving the plant extract only, 10 animals receiving the cisplatin protocol and 1g/kg/day of extract for 8 days, 5 animals with cisplatin and 3g/kg/day of extract for 8 days, and 5 animals receiving extract for 3 weeks and cisplatin in the last week. The tests were distortion product otoacoustic emissions, brainstem auditory response, before and after medication and scanning electron microscopy. RESULTS: the animals receiving cisplatin plus plant extract, had alterations in all the tests, showing lesions on the basal cochlear region under electron microscopy. CONCLUSIONS: Despite of the plant extract's antioxidant effect, it was not sufficient to protect the cochlea against cisplatin ototoxicity.
Assuntos
Antineoplásicos/toxicidade , Cisplatino/toxicidade , Perda Auditiva/prevenção & controle , Maytenus , Fitoterapia , Extratos Vegetais/uso terapêutico , Animais , Antineoplásicos/administração & dosagem , Antioxidantes/uso terapêutico , Cisplatino/administração & dosagem , Cóclea/efeitos dos fármacos , Cóclea/ultraestrutura , Avaliação Pré-Clínica de Medicamentos , Feminino , Cobaias , Perda Auditiva/induzido quimicamente , Microscopia Eletrônica de VarreduraRESUMO
The granular cell tumor (GCT) is an uncommon neoplasm, with slow progression, usually benign, that can be found in any organ. The most common region for GCT involvement is in the head and neck. Laryngeal involvement is uncommon and accounts for 6 to 10% of all cases reported. Among the major theories of origin and based on the strongest evidence, the most accepted one is that the tumor stems from neuronal tissue. The GCT has a higher incidence in African-descendent patients, and most commonly in their 4th and 6th decades of life. The posterior larynx is the most common laryngeal site. Pediatric laryngeal GCT is rare, anterior subglottis involvement has been described and extensive glottic involvement may occur. Affected patients typically present with hoarseness, dysphagia, cough, haemoptysis, stridor and pain. The GCT presents as a small, firm nodule, sessile or polypoid, with intact mucosa, well outlined but not encapsulated. Cytoplasm granules are typically seen under light microscopy, and the cells are positive for S100 immunoperoxidase and neuron-specific enolase. Treatment of laryngeal GCT is based on surgical excision. This paper describes a pediatric patient with GCT and its clinical course before and after surgical treatment, stressing the importance of GCT diagnosis in the pediatric population. We review clinical course, pathology characteristics and treatment.
Assuntos
Tumor de Células Granulares/patologia , Neoplasias Laríngeas/patologia , Criança , Diagnóstico Diferencial , Feminino , Tumor de Células Granulares/cirurgia , Humanos , Neoplasias Laríngeas/cirurgia , Laringoscopia , Proteínas S100/análiseRESUMO
Maytenus ilicifolia é uma planta sul americana apresenta várias propriedades medicinais, entre elas, a ação antioxidante. OBJETIVO: Por meio de um modelo original de ototoxicidade induzida pela cisplatina, verificar uma possível ação otoprotetora do extrato aquoso desta planta. MATERIAL E MÉTODO: Estudo clínico e experimental com cobaias fêmeas, albinas divididas em 5 grupos: 9 animais recebendo somente 3 doses de 7,5mg/kg/d do protocolo de cisplatina, 4 animais somente com o extrato, 10 animais com cisplatina e 1g/kg/d de extrato por 8 dias, 5 animais com cisplatina e 3g/kg/d do extrato por 8 dias e 5 animais recebendo extrato por 3 semanas e cisplatina na última semana. Os exames foram emissões otoacústica por produtos de distorção, potencial de tronco encefálico pré e após administração de cisplatina e, microscopia eletrônica de varredura. RESULTADOS: Os animais que receberam a cisplatina com o extrato, independente da dose, obtiveram alterações em todos os testes, com lesões na região basal na microscopia eletrônica. CONCLUSÃO: Apesar do efeito antioxidante da Maytenus ilicifolia, ela não foi suficiente para bloquear o efeito ototóxico da cisplatina.
Maytenus ilicifolia is a native plant from South America, with several medicinal properties including antioxidant effects. AIM: using an original cisplatin induced ototoxicity model, we evaluated a possible otoprotection caused by Maytenus ilicifolia extract. MATERIALS AND METHODS: clinical and experimental study design with female albino guinea pigs divided in groups as follows: 9 animals receiving cisplatin only (three doses of 7.5mg/kg/day), 4 animals receiving the plant extract only, 10 animals receiving the cisplatin protocol and 1g/kg/day of extract for 8 days, 5 animals with cisplatin and 3g/kg/day of extract for 8 days, and 5 animals receiving extract for 3 weeks and cisplatin in the last week. The tests were distortion product otoacoustic emissions, brainstem auditory response, before and after medication and scanning electron microscopy. RESULTS: the animals receiving cisplatin plus plant extract, had alterations in all the tests, showing lesions on the basal cochlear region under electron microscopy. CONCLUSIONS: Despite of the plant extract's antioxidant effect, it was not sufficient to protect the cochlea against cisplatin ototoxicity.
Assuntos
Animais , Feminino , Cobaias , Antineoplásicos/toxicidade , Cisplatino/toxicidade , Perda Auditiva/prevenção & controle , Maytenus , Fitoterapia , Extratos Vegetais/uso terapêutico , Antineoplásicos/administração & dosagem , Antioxidantes/uso terapêutico , Cisplatino/administração & dosagem , Cóclea/efeitos dos fármacos , Cóclea/ultraestrutura , Avaliação Pré-Clínica de Medicamentos , Perda Auditiva/induzido quimicamente , Microscopia Eletrônica de VarreduraRESUMO
O tumor de células granulares (TCG) é uma neoplasia incomum, de evolução lenta, na maioria dos casos de caráter benigno e que pode acometer qualquer órgão do corpo. Entre as hipóteses que tentam explicar sua origem, a teoria da gênese neural apresenta embasamento sólido e é a mais aceita atualmente. O TCG é mais comum na raça negra, entre a 4ª e 5ª décadas de vida, acometendo com maior freqüência a região da cabeça e pescoço. A localização laríngea é rara, e quando ocorre é mais comum na porção posterior. É muito raro em crianças em geral acomete a porção anterior da subglote, podendo estender-se para a glote. O sintoma predominante é a rouquidão, podendo ocorrer disfagia, dor, tosse, hemoptise, e estridor. Macroscopicamente o TCG se manifesta como nódulo de pequeno tamanho, firme, séssil ou pediculado, não-ulcerado, de coloração clara, e usualmente bem circunscrito, porém sem cápsula. À microscopia, as granulações citoplasmáticas são características, apresentando positividade para a imunoperoxidase S100 e para a enolase neurônio-específica. O tratamento do TCG laríngeo consiste na exérese cirúrgica. Neste trabalho descrevemos um caso pediátrico de TCG laríngeo e sua evolução clínica após a remoção cirúrgica, alertando para o diagnóstico do TCG na população pediátrica. Foi realizada revisão de literatura abrangendo as características clínicas e histopatológicas do TCG, assim como as formas atuais de tratamento.
The granular cell tumor (GCT) is an uncommon neoplasm, with slow progression, usually benign, that can be found in any organ. The most common region for GCT involvement is in the head and neck. Laryngeal involvement is uncommon and accounts for 6 to 10 percent of all cases reported. Among the major theories of origin and based on the strongest evidence, the most accepted one is that the tumor stems from neuronal tissue. The GCT has a higher incidence in African-descendent patients, and most commonly in their 4th and 6th decades of life. The posterior larynx is the most common laryngeal site. Pediatric laryngeal GCT is rare, anterior subglottis involvement has been described and extensive glottic involvement may occur. Affected patients typically present with hoarseness, dysphagia, cough, haemoptysis, stridor and pain. The GCT presents as a small, firm nodule, sessile or polypoid, with intact mucosa, well outlined but not encapsulated. Cytoplasm granules are typically seen under light microscopy, and the cells are positive for S100 immunoperoxidase and neuron-specific enolase. Treatment of laryngeal GCT is based on surgical excision. This paper describes a pediatric patient with GCT and its clinical course before and after surgical treatment, stressing the importance of GCT diagnosis in the pediatric population. We review clinical course, pathology characteristics and treatment.
Assuntos
Criança , Feminino , Humanos , Tumor de Células Granulares/patologia , Neoplasias Laríngeas/patologia , Diagnóstico Diferencial , Tumor de Células Granulares/cirurgia , Laringoscopia , Neoplasias Laríngeas/cirurgia , /análiseRESUMO
OBJECTIVE: The mechanisms involved in the mucosal alterations of laryngopharyngeal reflux (LPR) have not been well established. Reports indicate a decrease in the salivary epidermal growth factor (EGF) of patients with reflux esophagitis, but there are no reports of its behavior in LPR. Our objective was to determine the salivary concentration of EGF in adults with LPR. STUDY DESIGN AND SETTING: Salivary EGF concentration of 26 patients with LPR and 20 healthy controls was determined using a commercially available ELISA kit. Patients with LPR were graded according to endoscopic and laryngoscopic criteria. RESULTS: Salivary EGF concentration was significantly lower in the LPR group when compared with controls (P = 0.002). No correlation between the severity of laryngeal findings or esophagitis and salivary EGF concentration could be determined. CONCLUSIONS: The decreased salivary concentration of EGF in adults with LPR suggests that a deficiency in this polypeptide could be associated to the disease.
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Fator de Crescimento Epidérmico/análise , Refluxo Gastroesofágico/complicações , Laringite/metabolismo , Saliva/química , Adulto , Idoso , Ensaio de Imunoadsorção Enzimática , Feminino , Humanos , Masculino , Pessoa de Meia-IdadeRESUMO
A laringectomia parcial é uma alternativa no tratamento do câncer de laringe. Este tipo de cirurgia tem vantagens na qualidade de vida do paciente, pois permite a não realização de traqueostomia permanente. OBJETIVO: Comparar os resultados das laringectomias parciais com e sem realização de traqueostomia. FORMA DE ESTUDO: Caso-controle. MATERIAL E MÉTODO: Foram estudados 22 pacientes submetidos a laringectomias parciais, sendo 11 sem traqueostomia e 11 com traqueostomia no intra-operatório. RESULTADOS: O grupo de pacientes sem traqueostomia apresentou vantagens quanto ao tempo de cirurgia, de internação e de permanência da sonda nasoenteral. CONCLUSÃO: A laringectomia parcial sem traqueostomia é um procedimento vantajoso para o paciente, diminuindo a morbidade e não apresentando diferença quanto a positividade das margens das lesões.
RESUMO
INTRODUÇÄO: A Doença do Refluxo Gastroesofágico (DRGE), chegando até a faringe e laringe, pode cursar com intensa inflamaçäo local e rica sintomatologia (Refluxo Laringofaríngeo RLF). Os estudos atuais näo foram capazes de provar que o ácido refluído é o causador das alteraçöes visualizadas na laringite crônica. O Fator de Crescimento Epidérmico (EGF) é um polipeptídeo produzido pelas glândulas salivares, sendo implicado na induçäo do crescimento epitelial, na inibiçäo da secreçäo gástrica e na aceleraçäo da cicatrizaçäo. Deficiência salivar deste fator foi encontrada na esofagite de refluxo, mas näo há relatos sobre a concentraçäo salivar de EGF em indivíduos com RLF. OBJETIVO: Determinar a concentraçäo salivar do EGF em indivíduos com RLF. FORMA DE ESTUDO: Caso controle. CASUíSTICA E MÉTODO: A concentraçäo salivar de EGF de 39 indivíduos com RLF e 20 controles normais foi estudada pela técnica de ELISA. O RLF foi diagnosticado por história e exame videolaringoscópico característicos. Os 39 pacientes com RLF foram estratificados de acordo com os achados de endoscopia digestiva (com ou sem esofagite associada) e de acordo com a intensidade da laringite crônica. Foram, também, submetidos a manometria esofágica e pH-metria esofágica de 24 horas com dois canais. RESULTADOS: Constatou-se uma concentraçäo de EGF significativamente menor nos indivíduos com RLF quando comparados aos controles normais (p=0,002). Näo houve diferença estatisticamente significante na concentraçäo salivar de EGF entre os indivíduos com RLF, nem em relaçäo à presença de esofagite, nem quanto à intensidade da laringite. CONCLUSÖES: Este estudo sugere que uma deficiência na concentraçäo salivar do Fator de Crescimento Epidérmico pode estar associada à patogenia da DRGE, e que este polipeptídeo poderia ser um co-fator na gênese do RLF