RESUMO

Identifying marker combinations for robust prognostic validation in primary tumour compartments remains challenging. We aimed to assess the prognostic significance of CSC markers (ALDH1, CD44, p75NTR, BMI-1) and E-cadherin biomarkers in OSCC. We analysed 94 primary OSCC and 67 metastatic lymph node samples, including central and invasive tumour fronts (ITF), along with clinicopathological data. We observed an increase in ALDH1+/CD44+/BMI-1- tumour cells in metastatic lesions compared to primary tumours. Multivariate analysis highlighted that elevated p75NTR levels (at ITF) and reduced E-cadherin expression (at the tumour centre) independently predicted metastasis, whilst ALDH1high exhibited independent predictive lower survival at the ITF, surpassing the efficacy of traditional tumour staging. Then, specifically at the ITF, profiles characterized by CSChighE-cadherinlow (ALDH1highp75NTRhighE-cadherinlow) and CSCintermediateE-cadherinlow (ALDH1 or p75NTRhighE-cadherinlow) were significantly associated with worsened overall survival and increased likelihood of metastasis in OSCC patients. In summary, our study revealed diverse tumour cell profiles in OSCC tissues, with varying CSC and E-cadherin marker patterns across primary tumours and metastatic sites. Given the pivotal role of reduced survival rates as an indicator of unfavourable prognosis, the immunohistochemistry profile identified as CSChighE-cadherinlow at the ITF of primary tumours, emerges as a preferred prognostic marker closely linked to adverse outcomes in OSCC.

Assuntos

Família Aldeído Desidrogenase 1 , Biomarcadores Tumorais , Caderinas , Carcinoma de Células Escamosas , Neoplasias Bucais , Adulto , Idoso , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Família Aldeído Desidrogenase 1/metabolismo , Biomarcadores Tumorais/metabolismo , Caderinas/metabolismo , Carcinoma de Células Escamosas/metabolismo , Carcinoma de Células Escamosas/patologia , Carcinoma de Células Escamosas/mortalidade , Receptores de Hialuronatos/metabolismo , Imuno-Histoquímica , Metástase Linfática , Neoplasias Bucais/patologia , Neoplasias Bucais/metabolismo , Neoplasias Bucais/mortalidade , Neoplasias Bucais/diagnóstico , Células-Tronco Neoplásicas/metabolismo , Células-Tronco Neoplásicas/patologia , Proteínas do Tecido Nervoso/metabolismo , Complexo Repressor Polycomb 1/metabolismo , Complexo Repressor Polycomb 1/genética , Prognóstico , Receptores de Fator de Crescimento Neural/metabolismo , Retinal Desidrogenase/metabolismo

RESUMO

PURPOSE: To describe a new B-mode ultrasound examination technique to assess cheek tumors. MATERIALS AND METHODS: 30 cheek oral cavity lesions of different histological types (11 benign and 19 malignant) from 23 patients (11 women and 12 men, 7-82 years old, mean age of 49.5 years) were analyzed. Transcutaneous oral B-mode ultrasound (5-12 MHz transducer) was carried out in two stages. Initially it was performed conventionally with an empty mouth. Next, the patient was asked to keep their oral cavity filled with water (like when using a mouthwash) during imaging for the new test examination technique. The anatomical layers of this region and the characteristics of the tumors were evaluated. Lesions were classified as ill defined, partially defined, or defined. Conventional findings were compared to those of the new technique using the Wilcoxon signed-rank test. Ultrasound results were compared to histological findings analyzed by an independent team. RESULTS: The conventional empty mouth technique was able to confidently define lesion extension in only 6 of the 30 lesions, while the water-filled mouth technique was able to confidently define lesion extension in 29 of the 30 lesions (p<0.00001). CONCLUSION: We present a novel technique that dramatically improves ultrasound staging of cheek oral cavity tumors. In addition to the increase in ultrasound accuracy, this technique does not require any special equipment or extra cost, is very well tolerated by patients, and thus should be considered in the evaluation of every patient undergoing transcutaneous cheek ultrasound for oral cavity lesion characterization.

Assuntos

Neoplasias Bucais , Masculino , Humanos , Feminino , Pessoa de Meia-Idade , Criança , Adolescente , Adulto Jovem , Adulto , Idoso , Idoso de 80 Anos ou mais , Bochecha/diagnóstico por imagem , Bochecha/patologia , Neoplasias Bucais/diagnóstico por imagem , Neoplasias Bucais/patologia , Ultrassonografia

RESUMO

Introduction: Human anatomy is essential for both clinical and surgical practice. Although the anterior jugular veins (AJVs) are of great importance in many surgeries, there are few studies addressing the anatomic variations of these vessels. This study highlights the venous drainage of the head and neck and the importance of anatomical variations in the AJVs. Objective: To observe and describe the anatomy of the jugular veins and evaluate whether there are patterns influenced by anthropometric factors or comorbidities. Methods: Neck dissections were performed on 30 cadavers. The anatomical characteristics of the AJVs were described considering diameter, midline distance, anastomosis, and presence of the jugular venous arch. Results: Cadavers of 14 women and 16 men were dissected. Ninety percent (90%) of the jugular veins had a rectilinear path and 37% presented anastomosis: H-shaped (63.7%),N-shaped (27.3% ), and Y-shaped (9%). In relation to the number of veins, 20% of the cadavers had only one AJV, 63.3% had two, 10% had three, and 6.7% presented a total of four. Mean distance between jugular veins was 12 mm, and most veins (60%) had a diameter <5 mm. There was no statistically significant correlation between anatomical variations and anthropometric factors. Conclusion: AJVs were always present in the dissected cadavers, and the configuration most commonly found was two veins, each <5 mm in diameter. They were less than 10 mm away from the cervical midline and, when they presented anastomosis, it was H-shaped in most cases.

RESUMO

Extracellular vesicles (EVs) are mediators of the immune system response. Encapsulated in EVs, microRNAs can be transferred between cancer and immune cells. To define the potential effects of EVs originated from squamous cell carcinoma cells on immune system response, we performed microRNA profiling of EVs released from two distinct cell lines and treated dendritic cells derived from circulating monocytes (mono-DCs) with these EVs. We confirmed the internalization of EVs by mono-DCs and the down-regulation of microRNA mRNA targets in treated mono-DCs. Differences in surface markers of dendritic cells cultivated in the presence of EVs indicated that their content disrupts the maturation process. Additionally, microRNAs known to interfere with dendritic cell function, and detected in EVs, matched microRNAs from squamous cell carcinoma patients' plasma: miR-17-5p in oropharyngeal squamous cell carcinoma, miR-21 in oral squamous cell carcinoma, miR-16, miR-24, and miR-181a circulating in both oral and oropharyngeal squamous cell carcinoma, and miR-23b, which has not been previously described in plasma of head and neck squamous cell carcinoma, was found in plasma from patients with these cancer subtypes. This study contributes with insights on EVs in signaling between cancer and immune cells in squamous cell carcinoma of the head and neck.

Assuntos

Células Dendríticas/metabolismo , Vesículas Extracelulares/genética , Neoplasias de Cabeça e Pescoço/genética , MicroRNAs/genética , Linhagem Celular Tumoral , Regulação Neoplásica da Expressão Gênica , Neoplasias de Cabeça e Pescoço/sangue , Humanos , MicroRNAs/sangue , Transcriptoma

RESUMO

INTRODUCTION: Immune cells contribute with mediators in the protein expression profile of the tumor microenvironment. Levels of plasminogen activator inhibitor-1 (PAI-1) are elevated in non-malignant inflammatory conditions; however, the association between PAI-1 expression and inflammation remains uncertain in oral squamous cell carcinoma (OSCC). This study aimed to investigate PAI-1 expression in mononuclear inflammatory cell infiltrate in OSCC and its role as a prognostic marker. METHODS: Samples were collected from patients with OSCC, treated surgically, and followed for 24 months after the procedure. Thirty-nine tumoral tissue were analyzed using immunohistochemistry. Correlation between protein expression, clinicopathological parameters, and the prognosis was investigated. RESULTS: Positive PAI-1 expression in mononuclear inflammatory cell infiltrate was significantly associated with lymph node status (p = 0.009) and with the cytoplasmic expression of vascular endothelial growth factor A (VEGFA) (p = 0.028). Multivariate analysis revealed weak PAI-1 expression as an independent marker for lymph node metastases, with approximately 8-fold increased risk compared to strong expression (OR = 8.60; CI = 1.54-48.08; p = 0.014). CONCLUSION: Our results suggest that the strong PAI-1 expression in intratumoral inflammatory infiltrate is an indicator of a better prognosis for patients diagnosed with oral squamous cell carcinoma.

RESUMO

OBJECTIVE: To determine the implication of the new AJCC staging system for pT classification in a cohort of patients with SCC of the lip mucosa and compare it to other oral cavity sites. METHODS: Retrospective cohort of 744 patients treated between 2002 and 2017, by the Head and Neck Surgery Department of the University of Sao Paulo. RESULTS: Of 95 lip patients, 42 had pT upstage (58.1% of pT1 to pT2-3 and 50% of pT2 to pT3). Similar DFS/OS observed for those pT1 maintained or upstaged to pT2-3, pT2 patients upstaged to pT3 presented worse OS (49.4% versus 92.3%, P = .032). The comparison between lip and other mouth topographies, denoted better prognosis for pT1-2, but not for pT3-4a. Lip tumors had lower DOI, rates of perineural/angiolymphatic invasion, nodal metastasis, recurrence, and death. CONCLUSION: The inclusion of DOI to the new pT classification better stratifies patients with SCC of the lip mucosa upstaged to pT3 by assessing inferior OS. LEVEL OF EVIDENCE: 3 Laryngoscope, 131:E2770-E2776, 2021.

Assuntos

Carcinoma de Células Escamosas/diagnóstico , Neoplasias Labiais/patologia , Mucosa Bucal/patologia , Neoplasias Bucais/patologia , Estadiamento de Neoplasias/métodos , Idoso , Brasil/epidemiologia , Carcinoma de Células Escamosas/classificação , Carcinoma de Células Escamosas/mortalidade , Estudos de Coortes , Intervalo Livre de Doença , Feminino , Humanos , Metástase Linfática/patologia , Masculino , Pessoa de Meia-Idade , Invasividade Neoplásica/patologia , Recidiva Local de Neoplasia/patologia , Prognóstico , Estudos Retrospectivos

RESUMO

BACKGROUND: We evaluated microRNAs and extracellular matrix component profiles in squamous cell carcinoma of the oral cavity (OSCC) in comparison to healthy mucosa. METHODS: Retrospective study investigating 64 microRNAs related to oncogenic process and to constituents of the extracellular matrix. We also performed immunohistochemical assays for molecules involved in the same biological processes. RESULTS: High expression of miR-21-5p (p < 0.001) and miR-106-5p (p < 0.001) and low expression of miR-320a (p = 0.001) and miR-222-3p (p = 0.001) were predictors of malignancy. Individually, miR-21-5p exhibited the best statistical performance (area under the curve = 0.972; 95% confidence interval: 0.911-1.000) in the differentiation between tumor tissue and healthy mucosa. Moreover, tumor sample showed increased expression of MMP-2, MMP-9, α-laminin, and ß-laminin in tumor-related fibroblasts and lower continuity of type IV collagen in the basement membrane. CONCLUSION: The present study demonstrates the biological effects of microRNAs on the carcinogenesis of OSCC as well as the intense modification of the tumor microenvironment.

Assuntos

Carcinoma de Células Escamosas , MicroRNAs , Neoplasias Bucais , Carcinoma de Células Escamosas/genética , Linhagem Celular Tumoral , Proliferação de Células , Matriz Extracelular/genética , Regulação Neoplásica da Expressão Gênica , Humanos , MicroRNAs/genética , Neoplasias Bucais/genética , Estudos Retrospectivos , Microambiente Tumoral/genética

RESUMO

OBJECTIVES: To verify the pyramidalis muscle's frequency (bilaterality, unilaterality, or absence) and morphometry (length of the medial border and width of its origin/base) in a sample of the Brazilian population and the anthropometric influence. METHODS: Dissection of 30 cadavers, up to 24h post-mortem. RESULTS: The pyramidalis muscle was present bilaterally and unilaterally in 83.33% and 3.33% of the cadavers, respectively, and absent in 13.33%. The muscles on the right and left sides were symmetrical in length but not in width; the pyramidalis muscles of men were longer, while those of the women were wider. We also found that there was greater variation in the dimensions (length and width) of the men's muscles. Finally, in this sample of the Brazilian population, the pyramidalis muscle's unilaterality was more prevalent than in other populations, and its complete absence was less prevalent. CONCLUSIONS: There were no cases of muscle duplication in one or both sides, as described in some studies. Despite all of its morphometric variation, the pyramidalis muscle maintained its triangular shape with longitudinal fibers in every case. Furthermore, no statistically significant correlation was noted between the muscles' dimensions and person's age, height, weight, or gender.

Assuntos

Músculos Abdominais , Adulto , Brasil , Cadáver , Feminino , Humanos , Masculino

RESUMO

OBJECTIVES: To verify the pyramidalis muscle's frequency (bilaterality, unilaterality, or absence) and morphometry (length of the medial border and width of its origin/base) in a sample of the Brazilian population and the anthropometric influence. METHODS: Dissection of 30 cadavers, up to 24h post-mortem. RESULTS: The pyramidalis muscle was present bilaterally and unilaterally in 83.33% and 3.33% of the cadavers, respectively, and absent in 13.33%. The muscles on the right and left sides were symmetrical in length but not in width; the pyramidalis muscles of men were longer, while those of the women were wider. We also found that there was greater variation in the dimensions (length and width) of the men's muscles. Finally, in this sample of the Brazilian population, the pyramidalis muscle's unilaterality was more prevalent than in other populations, and its complete absence was less prevalent. CONCLUSIONS: There were no cases of muscle duplication in one or both sides, as described in some studies. Despite all of its morphometric variation, the pyramidalis muscle maintained its triangular shape with longitudinal fibers in every case. Furthermore, no statistically significant correlation was noted between the muscles' dimensions and person's age, height, weight, or gender.

Assuntos

Humanos , Masculino , Feminino , Adulto , Músculos Abdominais , Brasil , Cadáver

RESUMO

Oral squamous cell carcinoma (OSCC) is an extremely aggressive disease associated with a poor prognosis. Previous studies have established that cancer stem cells (CSCs) actively participate in OSCC development, progression and resistance to conventional treatments. Furthermore, CSCs frequently exhibit a deregulated expression of normal stem cell signalling pathways, thereby acquiring their distinctive abilities, of which self-renewal is an example. In this study, we examined the effects of GLI3 knockdown in OSCC, as well as the differentially expressed genes in CSC-like cells (CSCLCs) expressing high (CD44high) or low (CD44low) levels of CD44. The prognostic value of GLI3 in OSCC was also evaluated. The OSCC cell lines were sorted based on CD44 expression; gene expression was evaluated using a PCR array. Following this, we examined the effects of GLI3 knockdown on CD44 and ESA expression, colony and sphere formation capability, stem-related gene expression, proliferation and invasion. The overexpression of genes related to the Notch, transforming growth factor (TGF)ß, FGF, Hedgehog, Wnt and pluripotency maintenance pathways was observed in the CD44high cells. GLI3 knockdown was associated with a significant decrease in different CSCLC fractions, spheres and colonies in addition to the downregulation of the CD44, Octamer-binding transcription factor 4 (OCT4; also known as POU5F1) and BMI1 genes. This downregulation was accompanied by an increase in the expression of the Involucrin (IVL) and S100A9 genes. Cellular proliferation and invasion were inhibited following GLI3 knockdown. In OSCC samples, a high GLI3 expression was associated with tumour size but not with prognosis. On the whole, the findings of this study demonstrate for the first time, at least to the best of our knowledge, that GLI3 contributes to OSCC stemness and malignant behaviour. These findings suggest the potential for the development of novel therapies, either in isolation or in combination with other drugs, based on CSCs in OSCC.

Assuntos

Carcinoma de Células Escamosas/metabolismo , Neoplasias Bucais/metabolismo , Células-Tronco Neoplásicas/metabolismo , Proteínas do Tecido Nervoso/genética , Proteínas do Tecido Nervoso/metabolismo , Proteína Gli3 com Dedos de Zinco/genética , Proteína Gli3 com Dedos de Zinco/metabolismo , Adulto , Idoso , Carcinoma de Células Escamosas/genética , Carcinoma de Células Escamosas/patologia , Linhagem Celular Tumoral , Movimento Celular , Proliferação de Células , Transição Epitelial-Mesenquimal , Regulação Neoplásica da Expressão Gênica , Técnicas de Silenciamento de Genes , Humanos , Receptores de Hialuronatos/metabolismo , Masculino , Pessoa de Meia-Idade , Neoplasias Bucais/genética , Neoplasias Bucais/patologia , Invasividade Neoplásica , Células-Tronco Neoplásicas/patologia , Prognóstico , Transdução de Sinais , Análise de Sobrevida , Carga Tumoral

RESUMO

Context: Persistent disease after surgery is common in medullary thyroid cancer (MTC), requiring lifelong radiological surveillance. Staging workup includes imaging of neck, chest, abdomen, and bones. A study integrating all sites would be ideal. Despite the established use of gallium-68 (68Ga) positron emission tomography (PET)/CT with somatostatin analogues in most neuroendocrine tumors, its efficacy is controversial in MTC. Objective: Evaluate the efficacy of 68Ga PET/CT in detecting MTC lesions and evaluate tumor expression of somatostatin receptors (SSTRs) associated with 68Ga PET/CT findings. Methods: Prospective study evaluating 30 patients with MTC [group 1 (n = 16), biochemical disease; group 2 (n = 14), metastatic disease]. Patients underwent 68Ga PET/CT, bone scan, CT and ultrasound of the neck, CT of the chest, CT/MRI of the abdomen, and MRI of the spine. 68Ga PET/CT findings were analyzed by disease site as positive or negative and as concordant or discordant with conventional studies. Sensitivity and specificity were calculated using pathological or cytological analysis or unequivocal identification by standard imaging studies. Immunohistochemical analysis of SSTRs was compared with 68Ga PET/CT findings. Results: In both groups, 68Ga PET/CT was inferior to currently used imaging studies except for bone scan. In group 2, 68Ga PET/CT sensitivities were 56%, 57%, and 9% for detecting neck lymph nodes, lung metastases, and liver metastases, respectively, and 100% for bone metastases, superior to the bone scan (44%). Expression of SSTRs, observed in 44% of tumors, was not associated with 68Ga-DOTATATE uptake. Conclusions: 68Ga PET/CT does not provide optimal whole-body imaging as a single procedure in patients with MTC. However, it is highly sensitive in detecting bone lesions and could be a substitute for a bone scan and MRI.

Assuntos

Neoplasias Ósseas/diagnóstico por imagem , Neoplasias Ósseas/secundário , Carcinoma Neuroendócrino/diagnóstico por imagem , Carcinoma Neuroendócrino/secundário , Neoplasias da Glândula Tireoide/diagnóstico por imagem , Neoplasias da Glândula Tireoide/secundário , Adulto , Idoso , Feminino , Radioisótopos de Gálio , Humanos , Imageamento por Ressonância Magnética , Masculino , Pessoa de Meia-Idade , Compostos Organometálicos , Tomografia por Emissão de Pósitrons combinada à Tomografia Computadorizada/métodos , Estudos Prospectivos , Sensibilidade e Especificidade , Ultrassonografia , Adulto Jovem

RESUMO

BACKGROUND: Tongue squamous cell carcinoma (SCC) contains a cell subpopulation referred to as cancer stem cells (CSCs), which are responsible for tumor growth, metastasis, and resistance to chemotherapy and radiotherapy. The CSC markers have been used to isolate these cells and as biomarkers to predict overall survival. METHODS: The CSC markers CD44, NANOG, OCT4, and BMI1 were investigated using reverse transcriptase-quantitative polymerase chain reaction (RT-qPCR) and immunohistochemistry and correlated with clinicopathological parameters. RESULTS: The CD44 overexpression was associated with disease-related death (P = 0.02) and worst prognosis. NANOG was upregulated in nontumoral margins and associated with T1/T2 classification, lymph node metastasis, and worst prognosis. OCT4 was associated with lymph node metastasis and worst overall survival. BMI1 and CD44v3 were overexpressed in tongue SCC. Coexpression of CD44++ /NANOG++ was associated with worst overall survival when compared with patients with CD44-/+ /NANOG-/+ . CONCLUSION: The CSC markers might play an important role not only in CSC trait acquisition but also in tongue SCC development and progression.

Assuntos

Carcinoma de Células Escamosas/mortalidade , Receptores de Hialuronatos/metabolismo , Proteína Homeobox Nanog/metabolismo , Fator 3 de Transcrição de Octâmero/metabolismo , Complexo Repressor Polycomb 1/metabolismo , Neoplasias da Língua/mortalidade , Adulto , Biomarcadores Tumorais/metabolismo , Carcinoma de Células Escamosas/metabolismo , Células Epiteliais/metabolismo , Feminino , Humanos , Receptores de Hialuronatos/genética , Imuno-Histoquímica , Queratinócitos/metabolismo , Metástase Linfática , Masculino , Proteína Homeobox Nanog/genética , Fator 3 de Transcrição de Octâmero/genética , Complexo Repressor Polycomb 1/genética , Prognóstico , RNA Mensageiro/metabolismo , Reação em Cadeia da Polimerase Via Transcriptase Reversa , Neoplasias da Língua/metabolismo , Regulação para Cima

RESUMO

BACKGROUND: In oral squamous cell carcinoma (OSCC), the HIF-1 complex promotes the expression of genes involved in specific mechanisms of cell survival under hypoxic conditions, such as plasminogen activator inhibitor-1 (PAI-1), carbonic anhydrase 9 (CAIX), and vascular endothelial growth factor A (VEGFA). The study aimed to investigate the presence and prognostic value of PAI-1, CAIX, and VEGFA in OSCC. MATERIALS AND METHODS: Immunohistochemistry was used to analyze the expressions of these proteins in 52 tumoral tissue samples of patients with OSCC, surgically treated and followed by a minimum of 24 months after surgery. The correlations between protein expressions and clinicopathological parameters and prognosis were analyzed. RESULTS: Positive PAI-1 membrane expression was significantly associated with local disease relapse (P = .027). Multivariate analysis revealed that the positive PAI-1 membrane expression is an independent marker for local disease relapse, with approximately 14-fold increased risk when compared to negative expression (OR = 14.49; CI = 1.40-150.01, P = .025). Strong PAI-1 cytoplasmic expression was significantly associated with the less differentiation grade (P = .027). Strong CAIX membrane expression was significantly associated with local disease-free survival (P = .038). Positive CAIX cytoplasmic expression was significantly associated with lymph node affected (P = .025) and with disease-specific survival (P = .022). Multivariate analysis revealed that the positive CAIX cytoplasmic expression is an independent risk factor for disease-related death, increasing their risk approximately 3-fold when compared to negative expression (HR = 2.84; CI = 1.02-7.87, P = .045). Positive VEGFA cytoplasmic expression was significantly associated with less differentiation grade (P = .035). CONCLUSION: Our results suggest a potential role for these expressions profiles as tumor prognostic markers in OSCC patients.

Assuntos

Antígenos de Neoplasias/biossíntese , Biomarcadores Tumorais/biossíntese , Anidrase Carbônica IX/biossíntese , Neoplasias Bucais/metabolismo , Inibidor 1 de Ativador de Plasminogênio/biossíntese , Carcinoma de Células Escamosas de Cabeça e Pescoço/metabolismo , Fator A de Crescimento do Endotélio Vascular/biossíntese , Idoso , Antígenos de Neoplasias/metabolismo , Biomarcadores Tumorais/metabolismo , Anidrase Carbônica IX/metabolismo , Intervalo Livre de Doença , Feminino , Humanos , Imuno-Histoquímica , Linfonodos/patologia , Masculino , Pessoa de Meia-Idade , Neoplasias Bucais/patologia , Análise Multivariada , Recidiva Local de Neoplasia/metabolismo , Recidiva Local de Neoplasia/patologia , Inibidor 1 de Ativador de Plasminogênio/metabolismo , Prognóstico , Carcinoma de Células Escamosas de Cabeça e Pescoço/patologia , Análise de Sobrevida , Fator A de Crescimento do Endotélio Vascular/metabolismo

RESUMO

BACKGROUND: The purpose of the present study was to investigate the role of tumor volume in the prognosis of patients with oral cavity squamous cell carcinoma (SCC). METHODS: One hundred twenty-three patients with T4a oral cavity SCCs underwent surgical treatment. The volumes of the primary cancer were calculated by the multiplication of 3 macroscopic dimensions of the surgical specimen and related to recurrence and death. RESULTS: There were 54 recurrences (43.9%) and 75 deaths (60.9%). The mean tumor volume among the patients living without disease during the follow-up period was 28.2 cc, compared to 88.2 cc for patients living with disease, and to 78.9 cc for patients who died of the disease (p < .001). Multivariate analyses showed that volume and perineural invasion were independent factors for recurrence, whereas volume and lymph node metastasis were independent factors for death. CONCLUSION: Among patients who already have advanced cancers, tumor volume can significantly impact their prognoses. © 2017 Wiley Periodicals, Inc. Head Neck 39: 960-964, 2017.

Assuntos

Carcinoma de Células Escamosas/mortalidade , Carcinoma de Células Escamosas/patologia , Neoplasias Bucais/mortalidade , Neoplasias Bucais/patologia , Recidiva Local de Neoplasia/epidemiologia , Idoso , Carcinoma de Células Escamosas/terapia , Estudos Transversais , Feminino , Humanos , Estimativa de Kaplan-Meier , Masculino , Pessoa de Meia-Idade , Neoplasias Bucais/terapia , Invasividade Neoplásica , Fatores de Risco , Taxa de Sobrevida , Carga Tumoral

RESUMO

OBJECTIVE: As a lifestyle-related disease, social and cultural disparities may influence the features of squamous cell carcinoma of the head and neck in different geographic regions. We describe demographic, clinical, and pathological aspects of squamous cell carcinoma of the head and neck according to the smoking and alcohol consumption habits of patients in a Brazilian cohort. METHODS: We prospectively analyzed the smoking and alcohol consumption habits of 1,633 patients enrolled in five São Paulo hospitals that participated in the Brazilian Head and Neck Genome Project - Gencapo. RESULTS: The patients who smoked and drank were younger, and those who smoked were leaner than the other patients, regardless of alcohol consumption. The non-smokers/non-drinkers were typically elderly white females who had more differentiated oral cavity cancers and fewer first-degree relatives who smoked. The patients who drank presented significantly more frequent nodal metastasis, and those who smoked presented less-differentiated tumors. CONCLUSIONS: The patients with squamous cell carcinoma of the head and neck demonstrated demographic, clinical, and pathological features that were markedly different according to their smoking and drinking habits. A subset of elderly females who had oral cavity cancer and had never smoked or consumed alcohol was notable. Alcohol consumption seemed to be related to nodal metastasis, whereas smoking correlated with the degree of differentiation.

Assuntos

Consumo de Bebidas Alcoólicas/epidemiologia , Carcinoma de Células Escamosas/patologia , Neoplasias de Cabeça e Pescoço/patologia , Fumar/epidemiologia , Distribuição por Idade , Idoso , Consumo de Bebidas Alcoólicas/efeitos adversos , Brasil , Carcinoma de Células Escamosas/epidemiologia , Carcinoma de Células Escamosas/secundário , Estudos Transversais , Feminino , Neoplasias de Cabeça e Pescoço/epidemiologia , Humanos , Estilo de Vida , Masculino , Pessoa de Meia-Idade , Gradação de Tumores , Metástase Neoplásica , Fatores de Risco , Distribuição por Sexo , Fumar/efeitos adversos , Fatores Socioeconômicos

RESUMO

OBJECTIVE: As a lifestyle-related disease, social and cultural disparities may influence the features of squamous cell carcinoma of the head and neck in different geographic regions. We describe demographic, clinical, and pathological aspects of squamous cell carcinoma of the head and neck according to the smoking and alcohol consumption habits of patients in a Brazilian cohort. METHODS: We prospectively analyzed the smoking and alcohol consumption habits of 1,633 patients enrolled in five São Paulo hospitals that participated in the Brazilian Head and Neck Genome Project - Gencapo. RESULTS: The patients who smoked and drank were younger, and those who smoked were leaner than the other patients, regardless of alcohol consumption. The non-smokers/non-drinkers were typically elderly white females who had more differentiated oral cavity cancers and fewer first-degree relatives who smoked. The patients who drank presented significantly more frequent nodal metastasis, and those who smoked presented less-differentiated tumors. CONCLUSIONS: The patients with squamous cell carcinoma of the head and neck demonstrated demographic, clinical, and pathological features that were markedly different according to their smoking and drinking habits. A subset of elderly females who had oral cavity cancer and had never smoked or consumed alcohol was notable. Alcohol consumption seemed to be related to nodal metastasis, whereas smoking correlated with the degree of differentiation. .

Assuntos

Idoso , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Consumo de Bebidas Alcoólicas/epidemiologia , Carcinoma de Células Escamosas/patologia , Neoplasias de Cabeça e Pescoço/patologia , Fumar/epidemiologia , Distribuição por Idade , Consumo de Bebidas Alcoólicas/efeitos adversos , Brasil , Estudos Transversais , Carcinoma de Células Escamosas/epidemiologia , Carcinoma de Células Escamosas/secundário , Neoplasias de Cabeça e Pescoço/epidemiologia , Estilo de Vida , Gradação de Tumores , Metástase Neoplásica , Fatores de Risco , Distribuição por Sexo , Fatores Socioeconômicos , Fumar/efeitos adversos

RESUMO

The search for molecular markers to improve diagnosis, individualize treatment and predict behavior of tumors has been the focus of several studies. This study aimed to analyze homeobox gene expression profile in oral squamous cell carcinoma (OSCC) as well as to investigate whether some of these genes are relevant molecular markers of prognosis and/or tumor aggressiveness. Homeobox gene expression levels were assessed by microarrays and qRT-PCR in OSCC tissues and adjacent non-cancerous matched tissues (margin), as well as in OSCC cell lines. Analysis of microarray data revealed the expression of 147 homeobox genes, including one set of six at least 2-fold up-regulated, and another set of 34 at least 2-fold down-regulated homeobox genes in OSCC. After qRT-PCR assays, the three most up-regulated homeobox genes (HOXA5, HOXD10 and HOXD11) revealed higher and statistically significant expression levels in OSCC samples when compared to margins. Patients presenting lower expression of HOXA5 had poorer prognosis compared to those with higher expression (P=0.03). Additionally, the status of HOXA5, HOXD10 and HOXD11 expression levels in OSCC cell lines also showed a significant up-regulation when compared to normal oral keratinocytes. Results confirm the presence of three significantly upregulated (>4-fold) homeobox genes (HOXA5, HOXD10 and HOXD11) in OSCC that may play a significant role in the pathogenesis of these tumors. Moreover, since lower levels of HOXA5 predict poor prognosis, this gene may be a novel candidate for development of therapeutic strategies in OSCC.

Assuntos

Biomarcadores Tumorais/genética , Carcinoma de Células Escamosas/genética , Proteínas de Homeodomínio/genética , Neoplasias Bucais/genética , Adulto , Idoso , Biomarcadores Tumorais/metabolismo , Carcinoma de Células Escamosas/metabolismo , Carcinoma de Células Escamosas/patologia , Linhagem Celular Tumoral , Perfilação da Expressão Gênica , Regulação Neoplásica da Expressão Gênica , Proteínas de Homeodomínio/metabolismo , Humanos , Pessoa de Meia-Idade , Neoplasias Bucais/metabolismo , Neoplasias Bucais/patologia , Prognóstico , Taxa de Sobrevida

RESUMO

O carcinoma epidermóide de cabeça e pescoço (CECP) é um problema de saúde relevante no mundo, por sua prevalência e agressividade. Os papéis do tabaco e do álcool estão bem definidos na sua etiologia, mas uma minoria crescente dos pacientes acometidos pela doença não é tabagista ou etilista. A infecção pelo papilomavirus humano (HPV) parece ser responsável por parte desses casos. Sugere-se que o CECP que acomete pacientes não tabagistas e não etilistas (NTNE) tenha processos carcinogênicos e evolução clínica distintos daqueles de pacientes tabagistas e etilistas (TE). Os objetivos desse estudo foram verificar se os aspectos demográficos, clínicos e histopatológicos de pacientes com CECP são diferentes conforme os hábitos tabágico e etílico; verificar se os CECPs de pacientes NTNE e TE diferem em relação à positividade para HPV; e comparar a sobrevida específica pela doença e a expressão de marcadores biológicos em amostras tumorais e de mucosa normal do trato aerodigestório de pacientes NTNE e de pacientes TE. Para tanto, realizamos estudo transversal de pacientes com carcinomas epidermóides de cavidade oral (exceto lábio), orofaringe, laringe e hipofaringe, prospectivamente incluídos em um banco de tumores de CECP de 2001 a 2009, pelo grupo de pesquisa multi-institucional GENCAPO. Seus dados demográficos, clínicos e patológicos foram analisados conforme os hábitos de tabagismo e etilismo. Através de análise de pareamento, pacientes NTNE e TE foram comparados em relação à sobrevida, à positividade para o HPV no tumor por reação em cadeia da polimerase (PCR) e aos marcadores imunohistoquímicos p53, FHIT, Ki-67, VEGF, EGFR e p16 tanto em amostras tumorais como de epitélio não tumoral. Dos 1633 pacientes selecionados, 80 eram NTNE (4,9%), 1374 TE (84,1%), 140 tabagistas atuais ou no passado mas não etilistas (TNE:8,6%) e 39 apenas etilistas atuais ou no passado, mas não tabagistas (NTE:2,4%). O grupo de pacientes NTNE constituiu-se principalmente por mulheres...

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Head and neck squamous cell carcinoma (HNSCC) is a major health problem worldwide, due to its prevalence and aggressiveness. The role of tobacco and alcohol in its etiology is well established; however, a growing minority of patients with HNSCC neither smokes nor consumes alcohol. Human Papillomavirus (HPV) infection seems to be responsible for some of these cases. It is suggested that HNSCC affecting non smoking and non drinking (NSND) patients has different carcinogenesis and outcomes than those in smoking and drinking (SD) subjects. The objectives of this study were to test if demographic, clinical and pathological aspects of patients with HNSCC vary according to smoking and drinking habits; to test if HNSCC in NSND and SD patients differ in terms of HPV positivity; and to compare NSND and SD patients with HNSCC according to survival and biomarkers in tumor and mucosal samples of the aerodigestive tract. We conducted a cross-sectional study of patients with oral cavity (lips excluded), oropharynx, larynx and hypopharynx tumors prospectively included in a multi-institutional HNSCC tumor bank - GENCAPO, from January 2001 to February 2009. Demographic, clinical and pathological data were analyzed in regards of smoking and drinking habits. Using matched-pair analysis, we compared NSND and SD patients in relation to disease-free survival, HPV positivity through polymerase chain reaction (PCR) and Immunohistochemical staining of p53, FHIT, Ki-67, VEGF, EGFR and p16 biomarkers in tumor and mucosal samples. From 1633 patients, 80 were NSND (4.9%), 1374 SD (84.1%), 140 current or past smokers, but non drinkers (SND:8.6%) and 39 current or past drinkers, but non smokers (NSD:2.4%). NSND patients were most frequently women, remarkably elderly, with oral cavity cancers more commonly than the other groups (p<0.001).Comparing to the other groups, SD patients were younger (p<0.001); SND patients were more frequently affected by larynx tumors (p<0.001) and NSND...

Assuntos

Humanos , Masculino , Feminino , Alcoolismo , Carcinoma de Células Escamosas , Neoplasias de Cabeça e Pescoço , Imuno-Histoquímica , Infecções por Papillomavirus , Análise de Sobrevida , Tabagismo

RESUMO

Introdução: pacientes com carcinoma espinocelular de cabeça epescoço (CECP) frequentemente têm quadro de desnutriçãoassociado à doença, seja pelo acometimento direto do tratodigestivo alto, seja pela modalidade terapêutica empregada.Objetivo: avaliar o estado nutricional de pacientes com CECP emdiferentes fases do tratamento. Métodos: estudo transversal com155 pacientes assim divididos: 103 com CECP (29 pré-tratamento,47 pós-tratamento sem doença e 27 pós-tratamento com recidivatumoral) e 52 controles sem CECP. Foram coletados dados clínicose epidemiológicos, realizada avaliação nutricional a partir de dadosantropométricos (peso, altura e índice de massa corpórea – IMC),de composição corpórea por meio de bioimpedância (porcentagemde massa magra) e laboratoriais (albumina e contagem total delinfócitos – CTL). Resultados: a estatura e a massa magra emhomens e mulheres não foram diferentes entre os grupos. Asmédias do IMC, albumina e CTL foram normais, porém, menoresnos pacientes com recidiva da doença. Os casos pré-tratamentoapresentaram média do IMC menor que a dos controles, contudo,as médias de albumina sérica e CLT foram semelhantes entre eles.O grupo de pacientes pós-tratamento com doença recidivadaapresentou médias dos três critérios menores do que aquelas dogrupo sem doença. Nos casos tratados sem doença, pacientessubmetidos à cirurgia exclusiva apresentaram maiores índices deIMC e CTL que aqueles que receberam tratamentos combinados.Conclusão: pacientes com CECP apresentaram média de IMCmenor do que controles. Os casos com doença recidivada tiverampior estado nutricional que aqueles que se encontravam semdoença após o tratamento.

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Introduction: Patients with head and neck squamous cellcarcinoma (HNSCC) usually present nutritional disorders,secondary to the upper aerodigestive tract involvement or due tothe treatment sequels. Objective: To assess the nutritional status ofpatients with HNSCC in different phases of the disease treatment.Methods: Cross-sectional study with 155 patients divided in 4groups: 103 patients with HNSCC (29 before treatment, 47 posttreatment with no recurrence and 27 post treatment with recurrentdisease) and 52 controls without HNSCC. Clinical and epidemiologicaldata were collected and a nutrition assessment wasperformed from anthropometric parameters (weight, height andBody Mass Index – BMI), electric bioimpedance (thin masspercentage) and biochemical parameters (albumin and totallymphocyte count – TLC). Results: Height and thin masspercentage were similar between the groups. The means of BMI,albumin and TLC were normal; however, they were lower in posttreatment patients with recurrent disease. The patients beforetreatment had BMI average lower then control patients but albuminand TLC were similar between them. The post treatment groupwithout recurrent disease had averages of the three parametershigher than those of the patients with recurrent disease group. Inthe post treatment group without recurrent disease, the patientswho underwent surgical treatment exclusively had BMI and TLChigher than those who received adjuvant therapy. Conclusion:Patients with HNSCC had lower BMI average then control patients.Cases with recurrent disease had worst nutritional status thenpatients treated without disease.