RESUMO
The purpose of this study was to compare the immunohistochemical expression of tenascin-C (Tn-C) regarding clinicopathological variables and its association with the clinical behavior of central giant cell lesions (CGCLs). Forty-eight paraffin-embedded samples of CGCLs were selected. Based on clinical and radiographic features, the lesions were classified as aggressive (A-CGCLs) and non-aggressive (NA-CGCLs) subtypes. Histological assessment included the microvessel count (MVC), multinucleated giant cell (MGC) count, and the proportion of tissue area involved by mononuclear stromal cells/interstitial fibrosis. Immunoreactivity, immunolocalization, and distribution patterns of Tn-C were studied immunohistochemically. The association between Tn-C expression and clinicopathological characteristics was analyzed separately and adjusted for confounders using logistic regression models. A significantly greater proportion of cases with moderate-to-intense, intracellular, and diffuse staining of Tn-C was observed in A-CGCLs. CGCLs with a size ≥3.3 cm, fast growth, cortical disruption, high MVC/MGC counts, and low interstitial fibrosis showed a significantly greater frequency of moderate-to-intense, intracellular, and diffuse staining. Logistic regression analysis indicated a strong/independent association of these three immunohistochemical parameters with the aggressiveness of lesions. These data appear to suggest a possible role for Tn-C in the etiopathogenesis of CGCLs of the jaws, where its upregulation might favor the destructive behavior of A-CGCLs.
Assuntos
Regulação da Expressão Gênica , Células Gigantes/patologia , Doenças Maxilomandibulares/metabolismo , Doenças Maxilomandibulares/patologia , Tenascina/metabolismo , Humanos , Imuno-Histoquímica , Masculino , Pessoa de Meia-IdadeRESUMO
BACKGROUND: This study analyzed the immunoexpression of calcitonin receptor (CTR) and glucocorticoid receptor (GR) in central giant cell lesions (CGCLs) and verified potential associations with patient's response to clinical treatment with intralesional injection of triamcinolone. MATERIALS AND METHODS: Fifty-four cases of CGCLs, including 22 non-aggressive, and 32 aggressive, were investigated by immunohistochemistry. RESULTS: Surgery was the therapeutic choice for 53.1% of the aggressive CGCLs, and 46.9% were submitted to the conservative treatment with intralesional triamcinolone injections. Among patients submitted to conservative treatment, 60% (n = 9) showed favorable response. CTR expression was observed in 68.51%, and GR in 94.44% of the total sample. There were no differences in the expression of CTR, neither GR in mononucleated stromal cells (MSCs) or multinucleated giant cells (MGCs), in relation to aggressiveness, treatment performed for and the response to conservative treatment. Both markers showed a positive correlation between their expression in MSCs and MGCs in the total sample (P < 0.0001). CTR expression on MSCs showed a positive correlation with MGCs in the aggressive and non-aggressive groups (P < 0.0001). CONCLUSIONS: Calcitonin receptor and GR expression were diffuse and similar in non-aggressive and aggressive cases, and it did not influence the response to clinical treatment with triamcinolone in the sample studied.
Assuntos
Células Gigantes/metabolismo , Granuloma de Células Gigantes/tratamento farmacológico , Granuloma de Células Gigantes/metabolismo , Imuno-Histoquímica , Doenças Maxilomandibulares/tratamento farmacológico , Doenças Maxilomandibulares/metabolismo , Receptores da Calcitonina/metabolismo , Receptores de Glucocorticoides/metabolismo , Triancinolona , Adolescente , Adulto , Criança , Feminino , Expressão Gênica , Humanos , Injeções Intralesionais , Masculino , Pessoa de Meia-Idade , Receptores da Calcitonina/genética , Receptores de Glucocorticoides/genética , Estudos Retrospectivos , Resultado do Tratamento , Adulto JovemRESUMO
A lesão periférica de células gigantes (LPCG) e a lesão central de células gigantes (LCCG) são patologias histologicamente semelhantes que acometem a região de cabeça e pescoço. O estudo objetivou analisar a expressão imuno-histoquímica dos marcadores GLUT-1, GLUT-3 e M-CSF em uma série de casos de LPCG e LCCG, na tentativa de compreender os diferentes comportamentos biológicos destas entidades patológicas. A amostra foi constituída por 20 espécimes teciduais de LPCG, 20 de lesão central de células gigantes não agressivas (LCCGNA) e 20 de lesão central de células gigantes agressivas (LCCGA), oriundos do Serviço de Anatomia Patológica da Disciplina de Patologia Oral do Departamento de Odontologia da UFRN. Foi realizada a análise semiquantitativa e qualitativa da expressão imuno-histoquímica dos marcadores nas células gigantes e nas células mononucleares. Em relação ao GLUT-1, verificou-se uma diferença estatisticamente significativa na quantidade de células mononucleares imunomarcadas entre a LPCG e a LCCGNA e entre a LPCG e a LCCGA. Em relação à intensidade da marcação também foi verificado uma diferença estatisticamente significativa tanto para as células mononucleares quanto para as células gigantes entre LPCG e LCCGNA e entre LPCG e LCCGA, nas células gigantes também ocorreu uma diferença estatisticamente significativa entre a LCCGNA e a LCCGA. Em relação ao GLUT-3, foi encontrada uma diferença estatisticamente significativa entre LPCG e LCCGA e entre LCCGNA e LCCGA na quantidade de células mononucleares imunomarcadas. No que concerne à intensidade de marcação para a referida proteína foi verificado uma diferença estatisticamente significativa nas células gigantes entre LPCG e LCCGA. Para o M-CSF foi observada apenas uma diferença estatisticamente significativa na intensidade de marcação nas células mononucleares entre LPCG e LCCGNA e entre LPCG e LCCGA. Com base nestes resultados, pode-se concluir a participação do GLUT-1, GLUT-3 e do M-CSF na patogênese das lesões estudadas. A maior imunomarcação destas proteínas nas células mononucleares evidenciam que tais células desempenham uma maior atividade metabólica e osteoclastogênica, principalmente nas LCCGA. Constatou-se que as células mononucleares estavam mais relacionadas à patogênese das lesões estudadas do que propriamente as células gigantes (AU).
The peripheral giant cell lesion (PGCL) and the central giant cell lesion (CGCL) are lesions histologically similar affecting the head and neck region. The study aimed to analyze the immunohistochemical expression of markers GLUT-1, GLUT-3 and MCSF in a series of cases of PGCL and CGCL, in trying to understand the different biological behavior of these pathologies. The sample consisted of 20 tissue specimens of PGCL 20 central lesion of not aggressive giant cell (CLNAGC) and 20 central lesion of aggressive giant cell (CLAGC), coming from the Pathology Unit of Oral Pathology of the Department of Dentistry of UFRN. Was performed the semi-quantitative and qualitative analysis of immunohistochemical expression of the markers in giant cells and mononuclear cells. In relation to the GLUT-1, it was found a statistically significant difference (p <0.05) in the number of mononuclear cells immunomarked between the PGCL and the CLNAGC and between the PGCL and CLAGC. Regarding the intensity of staining was also observed a statistically significant difference both at the mononuclear cells as in giant cells between PL and CLNAGC and between PGCL and CLAGC, at the giant cells there was also a statistically significant difference between the CLNAGC and CLAGC. In relation to GLUT-3, was found a statistically significant difference between PGCL and CLAGC and between CLAGC and CLNAGC in amount of mononuclear cells immunomarked. Regarding the intensity of labeling for such protein was found a statistically significant difference at the giant cells between PL and CLAGC. To the M-CSF was observed only a statistically significant difference in the intensity of labeling at the mononuclear cells between PGCL and CLNAGC and between PGCL and CLAGC. Based on these results, we can conclude the participation of GLUT-1, GLUT-3 and M-CSF in the pathogenesis of the lesions studied. The bigger immunostaining of these proteins in mononuclear cells show that these cells perform a higher metabolic activity and osteoclastogenic, especially in CLAGC. It was found that the mononuclear cells were more related to the pathogenesis of the studied lesions than properly the giants cells (AU).
Assuntos
Imuno-Histoquímica/métodos , Granuloma de Células Gigantes/patologia , Células Gigantes/patologia , Transportador de Glucose Tipo 1 , Transportador de Glucose Tipo 3 , Fator Estimulador de Colônias de Macrófagos , Estatísticas não ParamétricasRESUMO
INTRODUCTION AND OBJECTIVE: The peripheral and central giant cell lesions (PGCL and CGCL) are a group of pathological entities with similar histopathological features and whose origin has not been fully elucidated. The former is reactive and the latter exhibits a non-neoplastic proliferative behavior. This article aims to review the literature on peripheral giant cell lesions (PGCL) and central giant cell lesions (CGCL) by discussing the most important aspects pertaining to each of them. RESULTS: These lesions are found in different locations and show diverse clinical signs despite having the same histopathological features. The treatment consists in the surgical resection by different techniques depending on the type of the lesion and clinical conditions. In the case of CGCL, drug therapy may also be employed. CONCLUSION: Although there is no consensus in the literature, it is essential to know the etiology of these lesions as well as the exact origin of the giant cells. Due to their singular biological behavior, it is of utmost importance to establish a differential diagnosis between the two lesions and other processes that have similar clinical, radiological and histological characteristics, inasmuch as this procedure is essential to provide a suitable treatment and establish a prognosis.
INTRODUÇÃO E OBJETIVO: As lesões periféricas e centrais de células gigantes (LPCG e LCCG) constituem um grupo de entidades patológicas com características histopatológicas semelhantes e natureza incompletamente elucidadas. A primeira lesão apresenta caráter reacional, enquanto a segunda, comportamento proliferativo de natureza não neoplásica. O artigo tem como objetivo fazer revisão de literatura sobre as LPCGs e as LCCGs, discutindo os aspectos mais importantes inerentes a cada uma delas. RESULTADOS: As duas lesões apresentam localização e comportamento clínico distintos, apesar de exibirem as mesmas características histopatológicas. O tratamento para ambas as lesões consiste na remoção cirúrgica, mas com técnicas distintas, dependendo do tipo da lesão e do estado clínico, sendo que no caso da LCCG uma terapêutica medicamentosa também pode ser empregada. CONCLUSÃO: Embora não haja um consenso na literatura, é fundamental que se conheça a etiologia dessas lesões, bem como a exata origem das células gigantes. Por causa de seus comportamentos biológicos diferentes, torna-se importante realizar o diagnóstico diferencial entre ambas as lesões e outros processos que apresentem características clínicas, radiográficas ou histológicas semelhantes, visto que esse procedimento é essencial para executar um tratamento adequado e estabelecer um prognóstico.