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IMMUNOEXPRESSION PTEN IN ORAL EPITHELIAL DYSPLASIAS AND SQUAMOUS CELL CARCINOMA
OOOO Volume 129, Number 1 QUADROS DE BORTOLLI, RUCHIELI LOUREIRO BORGHETTI, LETICIA SPINELLI JACOBY, FERNANDA GONCALVES ¸ SALUM, KAREN CHERUBINI and, MARIA ANTONIA ZANCANARO DE FIGUEIREDO Objective: To evaluate the effect of cannabidiol (CBD) on the healing of rats’ oral wounds. Study Design: Traumatic ulcers were induced in 60 Wistar rats using a 5-mm biopsy punch on the midline of the ventral tongue. Animals received daily intraperitoneal (ip) injections of CBD at doses of 0 (control), 5 or 10 mg/kg. Rats were weighed daily and sacrificed after 3 and 7 days of treatment. Clinical (ulcer area and weight variation) and histopathologic (inflammation scores) analyses were performed. Data were analyzed statistically at the significance level of 5%. Results: CBD was unable to clinically influence the size of ulcerative lesions. However, treatment with CBD in both tested concentrations decreased inflammatory scores after 3 days post-wounding (P < .05) compared to control. Conclusions: Five and 10 mg/kg CBD exerted promising anti-inflammatory effect in oral ulcerative lesions, not being enough to accelerate clinical wound healing at 3 and 7 days.
CANCER GENE MUTATION PROFILING IN CALCIFYING EPITHELIAL ODONTOGENIC TUMOR. SILVIA FERREIRA DE SOUSA, MARINA GON¸CALVES DINIZ, JOSIANE ALVES FRANCA, ¸ RENNAN GARCIAS MOREIRA, JEAN NUNES DOS SANTOS, RICARDO SANTIAGO GOMEZ and, CAROLINA CAVALIERI GOMES Objective: To identify in calcifying epithelial odontogenic tumor (CEOT) mutations in oncogenes and tumor suppressor genes. Study Design: A panel of 50 genes commonly mutated in cancer was sequenced in CEOT by next-generation sequencing. Sanger sequencing was used to cover the region of the frameshift deletion identified in one sample. Results: Missense single nucleotide variants (SNV) with minor allele frequency (MAF) <1% were detected in PTEN, MET, and JAK3. A frameshift deletion in CDKN2 A occurred in association with a missense mutation in the same gene region, suggesting a second hit in the inactivation of this gene. APC, KDR, KIT, PIK3CA, and TP53 missense SNV were identified; however, these are common SNV, showing MAF >1%. Conclusions: CEOT harbor mutations in the tumor suppressor PTEN and CDKN2A and in the oncogenes JAK3 and MET. As these mutations occurred in only 1 case each, they are probably not driver mutations for these tumors.
METHOTREXATE METABOLISM AND BILIRUBIN LEVELS AS PREDICTORS OF ORAL MUCOSITIS IN PEDIATRIC ONCOLOGIC PATIENTS. JESSICA BERTE VALER, AMANDA DE FARIAS GABRIEL, MARIA BEATRIZ CARDOSO FERREIRA, ^ MARCO ANTONIO TREVIZANI MARTINS, LAURO GREGIANIN, MANOELA DOMINGUES MARTINS and, MARINA CURRA Objective: To evaluate the relation of oral mucositis (OM) with time of methotrexate (MTX) metabolism and levels of bilirubin (BB).
ABSTRACTS
e167
Study Design: 146 cycles of chemotherapy with MTX in high doses (>1.0 g/m2) were evaluated in patients aged 0 to 18 years. Several information were collected such as dose of MTX infused, OM grade from D1 to D15, total BB levels and MTX serum metabolite concentration. Pearson multiple comparisons correlation test and Spearman test adjusted for the correlations between the times were used. Results: Patients who received doses above 8 g/m2 of MTX presented more than 72 hours to metabolize it (P = .003). In addition, longer time to metabolize MTX was associated with ulcerated lesions of OM (P = .017). A relation between BB increasing and higher severity of OM (grade 3 and 4) was observed (P = .004). Conclusions: Serum metabolite concentration of MTX and BB should be monitored as relative predictors of higher OM risk.
DERMOID CYSTS OF THE ORAL CAVITY: A 48-YEAR-RETROSPECTIVE ANALYSIS. GUSTAVO ALCANTARA DA TRINDADE, HELLEN BANDEIRA DE PONTES SANTOS, CAIO CESAR DA SILVA BARROS, ISRAEL LEAL CAVALCANTE, LARISSA SANTOS AMARAL ROLIM, ROSEANA DE ALMEIDA FREITAS and, LELIA BATISTA DE SOUZA Objective: To evaluate the clinical and histopathologic aspects of the dermoid cysts (DCs) of the oral cavity. Study Design: All DCs kept in the archives of an oral pathology service for 48 years were reviewed. Data were collected from patient charts and a total of 14 microscopy slides were reviewed by 2 previously trained examiners. Results: DCs were slightly more common in women (71.4%) and the mean age was 37.2 § 28.6 years. The lesions measured 3.3 § 3.3 cm on average. Histologically, stratified squamous epithelium was noted in 14 (100%) cases followed by respiratory epithelium (14.3%). Hair follicle was present in 85.7% of the cases. Sweat (28.6%), sebaceous (85.7%), and salivary (14.3%) glands were observed in the cystic wall, and 10 (71.4%) cases showed chronic inflammatory cells. Adipose and neural tissues were observed in 7 (50%) cases and Pacini bodies was noted in 1 case (7.1%). Conclusion: This study reinforces the importance of knowledge of the clinical and histopathologic aspects of DCs for the correct diagnosis of these lesions. The clinical and histopathologic data of the DCs in our series are similar to studies in other populations.
IMMUNOEXPRESSION PTEN IN ORAL EPITHELIAL DYSPLASIAS AND SQUAMOUS CELL CARCINOMA. FILIPE NOBRE CHAVES, ^ THAMARA MANOELA MARINHO BEZERRA, PAULO ^ GOBERLANIO DE BARROS SILVA, FABIO WILDSON GURGEL COSTA, ANA PAULA NEGREIROS NUNES ALVES, MARIO ROGERIO LIMA MOTA and, KARUZA MARIA ALVES PEREIRA Epithelial oral dysplasia (OED) is a risk factor for developing subsequent oral squamous cell carcinomas (OSCC). PTEN is a tumor suppressor gene of the PI3K/AKT pathway, which is 1 of the most deregulated pathways in cancer. Objective: To perform immunohistochemical analysis of PTEN in OED and OSCC samples with different histologic gradations of malignancy.
ABSTRACTS
e168
Study Design: Formalin-fixed paraffin-embedded samples of 19 OED and 16 OSCC were included to immunohistochemistry analysis of PTEN (Abcam, clone 31392, 1:400, overnight). Quantitative and qualitative evaluation of PTEN immunostaining in 5 fields at 400 x magnification was performed, correlating PTEN immunoexpression in different degrees of DEO and histologic stages of CEO. Results: The PTEN immunostaining pattern showed both homogeneous and heterogeneous in samples of OSCCs and OEDs. The average number of cells with nuclear immunostaining was significantly higher in OSCCs compared to OEDs and control (P <0.001). Conclusions: The heterogeneity of PTEN protein expression in OED and OSCC samples was demonstrated. Immunoexpression of PTEN was higher in OSCC and severe and moderate dysplasia compared to the control and mild OED, which suggested the functional inactivation of PTEN in this cancer. This work was supported by grants from Conselho Nacional Desenvolvimento Cientıfico e Tecnol ogico (CNPq).
COMPARISON OF WORLD HEALTH ORGANIZATION AND BINARY GRADING SYSTEMS IN ACTINIC CHEILITIS. THAMIRIS ^ CA, CASTRO ABRANTES, THAMYRES CAMPOS FONSE MARIENE DA SILVA MONTEIRO, PAULA HELENA ^A ACCIOLY, MARCIA GRILLO CABRAL, ALINE CORRE e e ABRAHAO and, MARIO ROMANACH Objective: To compare the role of histologic epithelial changes of epithelial dysplasia (ED) in actinic cheilitis (AC) in 2 grading systems: World Health Organization (WHO) and binary (BS). Study Design: Cytologic and architectural changes of ED, proposed by WHO, were microscopically evaluated in 26 AC by 2 observers. Data correlation was performed using kappa and chi-square tests (P < .05). Results: Most cases were graded as moderate ED (41.7%) and low risk in BS (58.3%). There was a positive interobserver correlation in WHO grading (k = 0.515; P = .001) and between WHO and BS grading systems (k = 0.385; P = .017). Intense ED and high-risk cases were statistically associated with 3 architectural changes: irregular stratification, dyskeratosis, and loss of cell polarity (P < .05). It was also observed, in high-risk cases, an association between the increase in the number of mitotic figures. Among cytologic changes, atypical mitosis was associated with both high-risk cases and intense ED, the last also associated to cellular and nuclear pleomorphism (P < .05). Conclusions: The presence of both architectural and cytologic changes is necessary for the 2 grading systems. However, our results suggest that architectural changes were more significant to indicate high risk in BS in actinic cheilitis.
INFLAMMATORY INFILTRATE AND TUMOR BUDDING IN LIP SQUAMOUS CELL CARCINOMAS. KARINE DUARTE DA SILVA, PATRICIA CARLOS CALDEIRA, ANA CAROLINA UCHOA VASCONCELOS, ANA PAULA NEUTZLING GOMES, MARIA CASSIA FERREIRA DE AGUIAR and, SANDRA BEATRIZ CHAVES TARQUINIO Objective: This study aimed to describe the morphologic characteristics of lip squamous cells carcinomas focusing
OOOO January 2020 in the invasive front and its association with tumor budding, and the presence of neutrophils and T lymphocytes. Study Design: We included 43 surgical specimens of lip squamous cells carcinoma and classified them in accordance with a histologic invasive front grading system. Immunohistochemistry was performed for CD66b and CD3 for evaluation of neutrophils and T lymphocytes, respectively, in the invasive front of the tumors. Tumor budding was evidenced by AE1/AE3 staining. Results: Thirty-six (83.7%) tumors were well-differentiated tumors. Eleven (25.6%) cases exhibited high-intensity tumor budding. There were low neutrophil and high T lymphocyte infiltrations in the invasive front, leading to a low neutrophil to T lymphocyte ratio in the same region. Moreover, we found an association between tumor budding and pattern of invasion, and also between CD3+ cell count and inflammatory infiltrate (P < .05). Conclusions: The few cases showing high-intensity tumor budding, as well as the low neutrophil and high T-lymphocyte infiltration in the invasive front, are in accordance with the histopathological features of well-differentiated tumors. These morphologic parameters should be adjunct tools in the evaluation of lip squamous cell carcinomas. Support: FAPEMIG.
STUDY OF ORAL LESIONS BIOPSED AND DIAGNOSED IN STOMATOLOGY CLINIC OF THE UNIVERSITY DURING THE PERIOD FROM 2002 TO 2017. RUTH TRAMONTANI RAMOS, ^ e ISRAEL, CARLA RENATA PETILLO DE MONICA SIMOES PINHO, TULIO FERNANDES DE SOUZA, KARINNE RODRIGUES ALVES LIMA, MARCELA ASSIS VAZ BATISTA OLIVEIRA and, JULIA BARBOSA LEITE Our objective was to report the principal biopsied and diagnosed oral lesions in a stomatology clinic in a private university between 2002 and 2017. We have conducted a descriptive study in which the data from the histopathologic reports were analyzed on ExcelT and were compared to each other so as to analyze age, sex, type, and prevalence of lesions. Data from this study has been compared with data from other studies published between 2015 and 2017 dealing with the prevalence of oral lesions. We have also compared the relation between the diagnostic hypothesis (when informed by the dentist) and the definitive diagnosis (informed by the pathologist). We observed that a larger percentage coincided to each other, but 42.5% were observed to be contrary. The most incident lesion found on our results was fibrous hyperplasia, followed by the reaction lesion and nonneoplastic lesions. Gercica (2015), in her study, has also found that fibrous hyperplasia also appeared as the most recurrent lesion. Other studies have yielded fewer specific results, however, reporting the occurrence of nonneoplastic proliferative processes or softtissue reactive lesions. We have concluded from our analysis that fibrous hyperplasia was the main oral lesion diagnosed in patients of our clinic.
A RETROSPECTIVE ANALYSIS OF 597 ORAL VASCULAR ANOMALIES DIAGNOSED IN A BRAZILIAN POPULATION. KATIANNE SOARES RODRIGUES, URSULA COSTA, AMANDA e DA SILVA KATARINNY GOES GONZAGA, TIAGO JOAO FILHO, DENISE HELEN IMACULADA PEREIRA DE OLIVEIRA and, LELIA MARIA GUEDES QUEIROZ
CANCER GENE MUTATION PROFILING IN CALCIFYING EPITHELIAL ODONTOGENIC TUMOR. SILVIA FERREIRA DE SOUSA, MARINA GON¸CALVES DINIZ, JOSIANE ALVES FRANCA, ¸ RENNAN GARCIAS MOREIRA, JEAN NUNES DOS SANTOS, RICARDO SANTIAGO GOMEZ and, CAROLINA CAVALIERI GOMES Objective: To identify in calcifying epithelial odontogenic tumor (CEOT) mutations in oncogenes and tumor suppressor genes. Study Design: A panel of 50 genes commonly mutated in cancer was sequenced in CEOT by next-generation sequencing. Sanger sequencing was used to cover the region of the frameshift deletion identified in one sample. Results: Missense single nucleotide variants (SNV) with minor allele frequency (MAF) <1% were detected in PTEN, MET, and JAK3. A frameshift deletion in CDKN2 A occurred in association with a missense mutation in the same gene region, suggesting a second hit in the inactivation of this gene. APC, KDR, KIT, PIK3CA, and TP53 missense SNV were identified; however, these are common SNV, showing MAF >1%. Conclusions: CEOT harbor mutations in the tumor suppressor PTEN and CDKN2A and in the oncogenes JAK3 and MET. As these mutations occurred in only 1 case each, they are probably not driver mutations for these tumors.
METHOTREXATE METABOLISM AND BILIRUBIN LEVELS AS PREDICTORS OF ORAL MUCOSITIS IN PEDIATRIC ONCOLOGIC PATIENTS. JESSICA BERTE VALER, AMANDA DE FARIAS GABRIEL, MARIA BEATRIZ CARDOSO FERREIRA, ^ MARCO ANTONIO TREVIZANI MARTINS, LAURO GREGIANIN, MANOELA DOMINGUES MARTINS and, MARINA CURRA Objective: To evaluate the relation of oral mucositis (OM) with time of methotrexate (MTX) metabolism and levels of bilirubin (BB).
ABSTRACTS
e167
Study Design: 146 cycles of chemotherapy with MTX in high doses (>1.0 g/m2) were evaluated in patients aged 0 to 18 years. Several information were collected such as dose of MTX infused, OM grade from D1 to D15, total BB levels and MTX serum metabolite concentration. Pearson multiple comparisons correlation test and Spearman test adjusted for the correlations between the times were used. Results: Patients who received doses above 8 g/m2 of MTX presented more than 72 hours to metabolize it (P = .003). In addition, longer time to metabolize MTX was associated with ulcerated lesions of OM (P = .017). A relation between BB increasing and higher severity of OM (grade 3 and 4) was observed (P = .004). Conclusions: Serum metabolite concentration of MTX and BB should be monitored as relative predictors of higher OM risk.
DERMOID CYSTS OF THE ORAL CAVITY: A 48-YEAR-RETROSPECTIVE ANALYSIS. GUSTAVO ALCANTARA DA TRINDADE, HELLEN BANDEIRA DE PONTES SANTOS, CAIO CESAR DA SILVA BARROS, ISRAEL LEAL CAVALCANTE, LARISSA SANTOS AMARAL ROLIM, ROSEANA DE ALMEIDA FREITAS and, LELIA BATISTA DE SOUZA Objective: To evaluate the clinical and histopathologic aspects of the dermoid cysts (DCs) of the oral cavity. Study Design: All DCs kept in the archives of an oral pathology service for 48 years were reviewed. Data were collected from patient charts and a total of 14 microscopy slides were reviewed by 2 previously trained examiners. Results: DCs were slightly more common in women (71.4%) and the mean age was 37.2 § 28.6 years. The lesions measured 3.3 § 3.3 cm on average. Histologically, stratified squamous epithelium was noted in 14 (100%) cases followed by respiratory epithelium (14.3%). Hair follicle was present in 85.7% of the cases. Sweat (28.6%), sebaceous (85.7%), and salivary (14.3%) glands were observed in the cystic wall, and 10 (71.4%) cases showed chronic inflammatory cells. Adipose and neural tissues were observed in 7 (50%) cases and Pacini bodies was noted in 1 case (7.1%). Conclusion: This study reinforces the importance of knowledge of the clinical and histopathologic aspects of DCs for the correct diagnosis of these lesions. The clinical and histopathologic data of the DCs in our series are similar to studies in other populations.
IMMUNOEXPRESSION PTEN IN ORAL EPITHELIAL DYSPLASIAS AND SQUAMOUS CELL CARCINOMA. FILIPE NOBRE CHAVES, ^ THAMARA MANOELA MARINHO BEZERRA, PAULO ^ GOBERLANIO DE BARROS SILVA, FABIO WILDSON GURGEL COSTA, ANA PAULA NEGREIROS NUNES ALVES, MARIO ROGERIO LIMA MOTA and, KARUZA MARIA ALVES PEREIRA Epithelial oral dysplasia (OED) is a risk factor for developing subsequent oral squamous cell carcinomas (OSCC). PTEN is a tumor suppressor gene of the PI3K/AKT pathway, which is 1 of the most deregulated pathways in cancer. Objective: To perform immunohistochemical analysis of PTEN in OED and OSCC samples with different histologic gradations of malignancy.
ABSTRACTS
e168
Study Design: Formalin-fixed paraffin-embedded samples of 19 OED and 16 OSCC were included to immunohistochemistry analysis of PTEN (Abcam, clone 31392, 1:400, overnight). Quantitative and qualitative evaluation of PTEN immunostaining in 5 fields at 400 x magnification was performed, correlating PTEN immunoexpression in different degrees of DEO and histologic stages of CEO. Results: The PTEN immunostaining pattern showed both homogeneous and heterogeneous in samples of OSCCs and OEDs. The average number of cells with nuclear immunostaining was significantly higher in OSCCs compared to OEDs and control (P <0.001). Conclusions: The heterogeneity of PTEN protein expression in OED and OSCC samples was demonstrated. Immunoexpression of PTEN was higher in OSCC and severe and moderate dysplasia compared to the control and mild OED, which suggested the functional inactivation of PTEN in this cancer. This work was supported by grants from Conselho Nacional Desenvolvimento Cientıfico e Tecnol ogico (CNPq).
COMPARISON OF WORLD HEALTH ORGANIZATION AND BINARY GRADING SYSTEMS IN ACTINIC CHEILITIS. THAMIRIS ^ CA, CASTRO ABRANTES, THAMYRES CAMPOS FONSE MARIENE DA SILVA MONTEIRO, PAULA HELENA ^A ACCIOLY, MARCIA GRILLO CABRAL, ALINE CORRE e e ABRAHAO and, MARIO ROMANACH Objective: To compare the role of histologic epithelial changes of epithelial dysplasia (ED) in actinic cheilitis (AC) in 2 grading systems: World Health Organization (WHO) and binary (BS). Study Design: Cytologic and architectural changes of ED, proposed by WHO, were microscopically evaluated in 26 AC by 2 observers. Data correlation was performed using kappa and chi-square tests (P < .05). Results: Most cases were graded as moderate ED (41.7%) and low risk in BS (58.3%). There was a positive interobserver correlation in WHO grading (k = 0.515; P = .001) and between WHO and BS grading systems (k = 0.385; P = .017). Intense ED and high-risk cases were statistically associated with 3 architectural changes: irregular stratification, dyskeratosis, and loss of cell polarity (P < .05). It was also observed, in high-risk cases, an association between the increase in the number of mitotic figures. Among cytologic changes, atypical mitosis was associated with both high-risk cases and intense ED, the last also associated to cellular and nuclear pleomorphism (P < .05). Conclusions: The presence of both architectural and cytologic changes is necessary for the 2 grading systems. However, our results suggest that architectural changes were more significant to indicate high risk in BS in actinic cheilitis.
INFLAMMATORY INFILTRATE AND TUMOR BUDDING IN LIP SQUAMOUS CELL CARCINOMAS. KARINE DUARTE DA SILVA, PATRICIA CARLOS CALDEIRA, ANA CAROLINA UCHOA VASCONCELOS, ANA PAULA NEUTZLING GOMES, MARIA CASSIA FERREIRA DE AGUIAR and, SANDRA BEATRIZ CHAVES TARQUINIO Objective: This study aimed to describe the morphologic characteristics of lip squamous cells carcinomas focusing
OOOO January 2020 in the invasive front and its association with tumor budding, and the presence of neutrophils and T lymphocytes. Study Design: We included 43 surgical specimens of lip squamous cells carcinoma and classified them in accordance with a histologic invasive front grading system. Immunohistochemistry was performed for CD66b and CD3 for evaluation of neutrophils and T lymphocytes, respectively, in the invasive front of the tumors. Tumor budding was evidenced by AE1/AE3 staining. Results: Thirty-six (83.7%) tumors were well-differentiated tumors. Eleven (25.6%) cases exhibited high-intensity tumor budding. There were low neutrophil and high T lymphocyte infiltrations in the invasive front, leading to a low neutrophil to T lymphocyte ratio in the same region. Moreover, we found an association between tumor budding and pattern of invasion, and also between CD3+ cell count and inflammatory infiltrate (P < .05). Conclusions: The few cases showing high-intensity tumor budding, as well as the low neutrophil and high T-lymphocyte infiltration in the invasive front, are in accordance with the histopathological features of well-differentiated tumors. These morphologic parameters should be adjunct tools in the evaluation of lip squamous cell carcinomas. Support: FAPEMIG.
STUDY OF ORAL LESIONS BIOPSED AND DIAGNOSED IN STOMATOLOGY CLINIC OF THE UNIVERSITY DURING THE PERIOD FROM 2002 TO 2017. RUTH TRAMONTANI RAMOS, ^ e ISRAEL, CARLA RENATA PETILLO DE MONICA SIMOES PINHO, TULIO FERNANDES DE SOUZA, KARINNE RODRIGUES ALVES LIMA, MARCELA ASSIS VAZ BATISTA OLIVEIRA and, JULIA BARBOSA LEITE Our objective was to report the principal biopsied and diagnosed oral lesions in a stomatology clinic in a private university between 2002 and 2017. We have conducted a descriptive study in which the data from the histopathologic reports were analyzed on ExcelT and were compared to each other so as to analyze age, sex, type, and prevalence of lesions. Data from this study has been compared with data from other studies published between 2015 and 2017 dealing with the prevalence of oral lesions. We have also compared the relation between the diagnostic hypothesis (when informed by the dentist) and the definitive diagnosis (informed by the pathologist). We observed that a larger percentage coincided to each other, but 42.5% were observed to be contrary. The most incident lesion found on our results was fibrous hyperplasia, followed by the reaction lesion and nonneoplastic lesions. Gercica (2015), in her study, has also found that fibrous hyperplasia also appeared as the most recurrent lesion. Other studies have yielded fewer specific results, however, reporting the occurrence of nonneoplastic proliferative processes or softtissue reactive lesions. We have concluded from our analysis that fibrous hyperplasia was the main oral lesion diagnosed in patients of our clinic.
A RETROSPECTIVE ANALYSIS OF 597 ORAL VASCULAR ANOMALIES DIAGNOSED IN A BRAZILIAN POPULATION. KATIANNE SOARES RODRIGUES, URSULA COSTA, AMANDA e DA SILVA KATARINNY GOES GONZAGA, TIAGO JOAO FILHO, DENISE HELEN IMACULADA PEREIRA DE OLIVEIRA and, LELIA MARIA GUEDES QUEIROZ