RESUMO
Traditional guidelines for determining the prognosis of patients with head and neck squamous cell carcinoma (HNSCC) are used to make therapeutic decisions. However, only 50% of the patients had lived for more than five years. The present study aimed to analyze the correlation of traditional prognostic factors such as tumor size, histological grading, regional metastases, and treatment with the survival of patients with HNSCC. A total of 78 patients diagnosed with HNSCC were followed up for 10 years after diagnosis and treatment. The health status of the patients was tracked at four time points, and according to the evolution of the patients and their final clinical status, we performed a prognostic analysis based on the clinical outcomes observed during the follow-up period. The final study cohort comprised 50 patients. Most patients had tumors < 4 cm in size (64%) and no regional metastases (64%); no patients had distant metastases at the time of diagnosis. Most individuals had tumors with good (48%) and moderate (46%) degrees of malignancy. At the end of the follow-up period, only 14% of the patients were discharged, 42% died of the tumor, and 44% remained under observation owing to the presence of a potentially malignant disorder, relapse, or metastases. This analysis showed that traditional prognostic factors were not accurate in detecting subclinical changes or predicting the clinical evolution of patients.
Assuntos
Carcinoma de Células Escamosas , Neoplasias de Cabeça e Pescoço , Humanos , Carcinoma de Células Escamosas de Cabeça e Pescoço , Seguimentos , Prognóstico , Carcinoma de Células Escamosas/patologia , Neoplasias de Cabeça e Pescoço/terapia , Recidiva Local de Neoplasia/patologiaRESUMO
Abstract Traditional guidelines for determining the prognosis of patients with head and neck squamous cell carcinoma (HNSCC) are used to make therapeutic decisions. However, only 50% of the patients had lived for more than five years. The present study aimed to analyze the correlation of traditional prognostic factors such as tumor size, histological grading, regional metastases, and treatment with the survival of patients with HNSCC. A total of 78 patients diagnosed with HNSCC were followed up for 10 years after diagnosis and treatment. The health status of the patients was tracked at four time points, and according to the evolution of the patients and their final clinical status, we performed a prognostic analysis based on the clinical outcomes observed during the follow-up period. The final study cohort comprised 50 patients. Most patients had tumors < 4 cm in size (64%) and no regional metastases (64%); no patients had distant metastases at the time of diagnosis. Most individuals had tumors with good (48%) and moderate (46%) degrees of malignancy. At the end of the follow-up period, only 14% of the patients were discharged, 42% died of the tumor, and 44% remained under observation owing to the presence of a potentially malignant disorder, relapse, or metastases. This analysis showed that traditional prognostic factors were not accurate in detecting subclinical changes or predicting the clinical evolution of patients.
RESUMO
Malignant neoplasms may be composed of several cell groups, including cancer stem cells (CSC). These cells have been related with the capacity of metastasis, relapse and resistance to multiple drugs during chemotherapy. This study aims to identify CSC biomarkers and their expression pattern in human head and neck carcinomas. This study was conducted following the PRISMA checklist. The search for articles was carried out in five databases (PubMed, Scopus, Web of Science, Lilacs and Scielo). The articles found were selected in two phases: 1) reading the titles and / or abstract and 2) reading the full text. At the end, the selected articles were evaluated by QUADAS-2. Most studies evaluated oral neoplastic tissues and, as a control, samples of normal local mucosa. All studies performed immunohistochemistry as a method of immunolocalization and some also applied immunofluorescence. The most commonly used biomarker was CD44. However, other such as Sox2, Oct4, Nestin, Nanog, BMI1, ALDH1, CD133 and CD166 were also found. Several biomarkers were (ALDH1, Sox2, Oct4, ABCB5, AGR2 and TAZ) correlated with clinical characteristics of the tumor, such as staging, tumor size and lymph node metastasis. These data reinforce the CSC theory and favor the use of these biomarkers as possible determinants of prognosis.
Assuntos
Biomarcadores Tumorais/biossíntese , Neoplasias de Cabeça e Pescoço , Células-Tronco Neoplásicas , Neoplasias de Cabeça e Pescoço/diagnóstico , Neoplasias de Cabeça e Pescoço/metabolismo , Neoplasias de Cabeça e Pescoço/patologia , Humanos , Metástase Linfática , Estadiamento de Neoplasias , Células-Tronco Neoplásicas/metabolismo , Células-Tronco Neoplásicas/patologia , PrognósticoRESUMO
The aim of the present study was to evaluate the expression of transforming growth factor-ß1 (TGF-ß1) and osteonectin (ON) in pulp-like tissues developed by tissue engineering and to compare it with the expression of these proteins in pulps treated with Ca(OH)2 therapy. Tooth slices were obtained from non-carious human third molars under sterile procedures. The residual periodontal and pulp soft tissues were removed. Empty pulp spaces of the tooth slice were filled with sodium chloride particles (250-425 µm). PLLA solubilized in 5% chloroform was applied over the salt particles. The tooth slice/scaffold (TS/S) set was stored overnight and then rinsed thoroughly to wash out the salt. Scaffolds were previously sterilized with ethanol (100-70°) and washed with phosphate-buffered saline (PBS). TS/S was treated with 10% EDTA and seeded with dental pulp stem cells (DPSC). Then, TS/S was implanted into the dorsum of immunodeficient mice for 28 days. Human third molars previously treated with Ca(OH)2 for 90 days were also evaluated. Samples were prepared and submitted to histological and immunohistochemical (with anti-TGF-ß1, 1:100 and anti-ON, 1:350) analyses. After 28 days, TS/S showed morphological characteristics similar to those observed in dental pulp treated with Ca(OH)2. Ca(OH)2-treated pulps showed the usual repaired pulp characteristics. In TS/S, newly formed tissues and pre-dentin was colored, which elucidated the expression of TGF-ß1 and ON. Immunohistochemistry staining of Ca(OH)2-treated pulps showed the same expression patterns. The extracellular matrix displayed a fibrillar pattern under both conditions. Regenerative events in the pulp seem to follow a similar pattern of TGF-ß1 and ON expression as the repair processes.
Assuntos
Hidróxido de Cálcio/farmacologia , Polpa Dentária/efeitos dos fármacos , Osteonectina/análise , Células-Tronco/efeitos dos fármacos , Fator de Crescimento Transformador beta1/análise , Animais , Hidróxido de Cálcio/uso terapêutico , Células Cultivadas , Polpa Dentária/citologia , Dentina/efeitos dos fármacos , Matriz Extracelular/efeitos dos fármacos , Regeneração Tecidual Guiada/métodos , Humanos , Imuno-Histoquímica , Camundongos , Odontoblastos/efeitos dos fármacos , Osteonectina/efeitos dos fármacos , Reprodutibilidade dos Testes , Fatores de Tempo , Engenharia Tecidual/métodos , Alicerces Teciduais , Fator de Crescimento Transformador beta1/efeitos dos fármacosRESUMO
Abstract The aim of the present study was to evaluate the expression of transforming growth factor-β1 (TGF-β1) and osteonectin (ON) in pulp-like tissues developed by tissue engineering and to compare it with the expression of these proteins in pulps treated with Ca(OH)2 therapy. Tooth slices were obtained from non-carious human third molars under sterile procedures. The residual periodontal and pulp soft tissues were removed. Empty pulp spaces of the tooth slice were filled with sodium chloride particles (250-425 µm). PLLA solubilized in 5% chloroform was applied over the salt particles. The tooth slice/scaffold (TS/S) set was stored overnight and then rinsed thoroughly to wash out the salt. Scaffolds were previously sterilized with ethanol (100-70°) and washed with phosphate-buffered saline (PBS). TS/S was treated with 10% EDTA and seeded with dental pulp stem cells (DPSC). Then, TS/S was implanted into the dorsum of immunodeficient mice for 28 days. Human third molars previously treated with Ca(OH)2 for 90 days were also evaluated. Samples were prepared and submitted to histological and immunohistochemical (with anti-TGF-β1, 1:100 and anti-ON, 1:350) analyses. After 28 days, TS/S showed morphological characteristics similar to those observed in dental pulp treated with Ca(OH)2. Ca(OH)2-treated pulps showed the usual repaired pulp characteristics. In TS/S, newly formed tissues and pre-dentin was colored, which elucidated the expression of TGF-β1 and ON. Immunohistochemistry staining of Ca(OH)2-treated pulps showed the same expression patterns. The extracellular matrix displayed a fibrillar pattern under both conditions. Regenerative events in the pulp seem to follow a similar pattern of TGF-β1 and ON expression as the repair processes.
Assuntos
Humanos , Animais , Camundongos , Células-Tronco/efeitos dos fármacos , Hidróxido de Cálcio/farmacologia , Osteonectina/análise , Polpa Dentária/efeitos dos fármacos , Fator de Crescimento Transformador beta1/análise , Fatores de Tempo , Hidróxido de Cálcio/uso terapêutico , Imuno-Histoquímica , Osteonectina/efeitos dos fármacos , Células Cultivadas , Reprodutibilidade dos Testes , Engenharia Tecidual/métodos , Polpa Dentária/citologia , Dentina/efeitos dos fármacos , Regeneração Tecidual Guiada/métodos , Matriz Extracelular/efeitos dos fármacos , Fator de Crescimento Transformador beta1/efeitos dos fármacos , Alicerces Teciduais , Odontoblastos/efeitos dos fármacosRESUMO
The aim of this study was to evaluate the influence of the poly-L-lactic acid (PLLA)-based scaffold's pore size on the proliferation and differentiation of dental pulp stem cells (DPSCs). The scaffolds were prepared in pulp chambers of 1-mm-thick tooth slices from third molars using salt crystals (150-250 µm or 251-450 µm) as porogen. DPSC (1x105 cells) were seeded in the scaffolds with different pore sizes, and cultured in 24-well plates. The cell proliferation was evaluated using the WST-1 assay after 3-21 days. Furthermore, RT-PCR was used to assess the differentiation of the DPSCs into odontoblasts, using markers of odontoblastic differentiation (DSPP, DSP-1 and MEPE). RNA from human odontoblasts was used as control. Cell proliferation rate was similar in both scaffolds except at the 14th day period, in which the cells seeded in the scaffolds with larger pores showed higher proliferation (p<0.05). After 21 days DPSCs seeded in both evaluated scaffolds were able of expressing odontoblastic markers DMP-1, DSPP and MEPE. In summary, both scaffolds tested in this study allowed the proliferation and differentiation of DPSCs into odontoblast-like cells.
Assuntos
Polpa Dentária/citologia , Poliésteres/química , Células-Tronco/fisiologia , Alicerces Teciduais/química , Materiais Biocompatíveis/química , Diferenciação Celular , Proliferação de Células , Cavidade Pulpar/anatomia & histologia , Humanos , Dente Serotino , Reação em Cadeia da Polimerase em Tempo Real , Propriedades de Superfície , Técnicas de Cultura de Tecidos , Engenharia TecidualRESUMO
The aim of this study was to evaluate the influence of the poly-L-lactic acid (PLLA)-based scaffold's pore size on the proliferation and differentiation of dental pulp stem cells (DPSCs). The scaffolds were prepared in pulp chambers of 1-mm-thick tooth slices from third molars using salt crystals (150-250 µm or 251-450 µm) as porogen. DPSC (1x105 cells) were seeded in the scaffolds with different pore sizes, and cultured in 24-well plates. The cell proliferation was evaluated using the WST-1 assay after 3-21 days. Furthermore, RT-PCR was used to assess the differentiation of the DPSCs into odontoblasts, using markers of odontoblastic differentiation (DSPP, DSP-1 and MEPE). RNA from human odontoblasts was used as control. Cell proliferation rate was similar in both scaffolds except at the 14th day period, in which the cells seeded in the scaffolds with larger pores showed higher proliferation (p<0.05). After 21 days DPSCs seeded in both evaluated scaffolds were able of expressing odontoblastic markers DMP-1, DSPP and MEPE. In summary, both scaffolds tested in this study allowed the proliferation and differentiation of DPSCs into odontoblast-like cells.
O objetivo desse estudo foi avaliar a influência do tamanho dos poros de um scaffold à base de poli ácido láctico (PLLA) sobre a proliferação e diferenciação de células tronco da polpa dental (dental pulp stem cells - DPSC). Os scaffolds foram preparados dentro da câmara pulpar de discos de terceiros molares (1 mm), utilizando sal como porógeno (150-250 µm ou 251-450 µm). DPSC (1x105 células) foram semeadas nos scaffolds com diferentes tamanhos de poros e cultivadas em placas de 24 poços. A proliferação celular foi avaliada utilizando WST-1 após 3-21 dias. Além disso, RT-PCR foi utilizado para avaliar a diferenciação odontoblástica das DPSC utilizando marcadores da diferenciação odontoblástica (DSPP, DMP-1 e MEPE). RNA obtido de odontoblastos humanos foi utilizado como controle. A taxa de proliferação celular foi semelhante nos dois scaffolds avaliados, exceto no 14° dia, no qual as células cultivadas nos scaffolds com os maiores poros apresentaram uma maior taxa de proliferação (p<0,05). Após 21 dias, as DSPC cultivadas em ambos scaffolds avaliados foram capazes de expressar os marcadores odontoblásticos DMP-1, DSPP e MEPE. Em resumo, ambos scaffolds avaliados nesse estudo permitiram a proliferação e diferenciação odontoblástica das DPSC. .
Assuntos
Polpa Dentária/citologia , Poliésteres/química , Células-Tronco/fisiologia , Alicerces Teciduais/química , Materiais Biocompatíveis/química , Diferenciação Celular , Proliferação de Células , Cavidade Pulpar/anatomia & histologia , Dente Serotino , Reação em Cadeia da Polimerase em Tempo Real , Propriedades de Superfície , Técnicas de Cultura de Tecidos , Engenharia TecidualRESUMO
Tumor angiogenesis and lymphangiogenesis are key features of tumor progression and metastasis. The role of tumor cells-derived factors in the promotion of associated angiogenesis and lymphangiogenesis is much studied and, no doubt, very important for the understanding of cancer progression. This review aims to present and discuss the work done on the pro-angiogenic and lymphangiogenic cellular interactions within the tumor microenvironment and the signaling pathways that regulate this crosstalk. Such multifactor studies are critical for the development of future therapeutic approaches for cancer because they take into account the complexities of cellular interactions within the tumor microenvironment.
Assuntos
Linfangiogênese/fisiologia , Neoplasias/irrigação sanguínea , Neovascularização Patológica/fisiopatologia , Transdução de Sinais/fisiologia , Animais , Comunicação Celular/fisiologia , Endotélio Linfático/fisiopatologia , Endotélio Vascular/fisiopatologia , Fibroblastos/fisiologia , Humanos , Macrófagos/fisiologia , Neoplasias/fisiopatologiaRESUMO
Alginate hydrogel (AH) has intrinsic physical and biological limitations that hinder its broader application in tissue engineering. We hypothesized that the inclusion of nanofibers in the hydrogel and the use of a biotemplate that mimics nature would enhance the translational potential of alginate hydrogels. In this study, we have shown a method to obtain nano-/microfibers of titanium (nfTD) and hydroxyapatite (nfHY) using cotton as a biotemplate. These fibers were incorporated in the alginate hydrogel and the mechanical characteristics and biological response to these reinforced materials were evaluated. We observed that these nanofibers resembled the structure of natural collagen and did not mediate cell toxicity. The incorporation of nfTD or nfHY to the AH has not increased the viscosity of the hydrogel. Therefore, this is a feasible method to produce a scaffold with improved physical characteristics, while at the same time generating an enhanced environment for cell adhesion and proliferation.
Assuntos
Alginatos/química , Durapatita/química , Hidrogéis/química , Nanofibras/química , Alicerces Teciduais/química , Titânio/química , Células 3T3 , Animais , Materiais Biocompatíveis/química , Sobrevivência Celular , Ácido Glucurônico/química , Ácidos Hexurônicos/química , Camundongos , Nanofibras/ultraestrutura , Engenharia TecidualRESUMO
UNLABELLED: Tissue engineering is an interdisciplinary field that combines the principles of engineering, material and biological sciences toward the development of therapeutic strategies and biological substitutes that restore, maintain, replace or improve biological functions. The association of biomaterials, stem cells, growth and differentiation factors has yielded the development of new treatment opportunities in most of the biomedical areas, including Dentistry. The objective of this paper is to present the principles underlying tissue engineering and the current scenario, the challenges and the perspectives of this area in Dentistry. SIGNIFICANCE: The growth of tissue engineering as a research field has provided a novel set of therapeutic strategies for biomedical applications. Indeed, tissue engineering may lead to new strategies for the clinical management of patients with dental and craniofacial needs in the future.