- Email: [email protected]
Oral potentially malignant disorders – efficacy of diagnostic adjuncts
OOOO Volume 114, Number 4 Results: Lamella BTT proportion in OF(52.5%) was significantly higher than in FD(30%);mixed BTT proportion in FD(70%) was significantly higher than in OF(50%)(p⬍0.05). Woven BTT proportion in FD(60%) was not significantly higher than in OF(55%). Mean AgNOR score for OF (130.4069⫾32.3392/ 100cell) was significantly higher than that of FD(92.3369⫾27.4207/ 100cell) (p⬍0.05). Conclusion: Lamella and mixed BTT proportions and mean AgNOR score are important in distinguishing FD from OF. Woven BTT proportion is a poor indicator. This is the first demonstration of mixed BTT in distinguishing FD from OF.
FACTITIAL ORAL LESIONS IN A PAEDIATRIC PATIENT Feio PSQ1, Pedroso EG1, Totti V1, Graner KM1, Gomes CBF1, Ramos LMA1, Lopes MA1 - 1PIRACICABA DENTAL SCHOOL, UNIVERSITY OF CAMPINAS - DEPARTMENT OF ORAL DIAGNOSIS, OROCENTRO An 8-year-old boy was referred by his physician to our diagnosis service for evaluation of 2-month history of multiples aphthous ulcer on the oral mucosa. His mother reported an increase in frequency, extension and pain of these lesions, also an intestinal constipation was reported. On oral examination, there was an ulcer, measuring 2,0 ⫻ 1,0, on the lower lip and another smaller ulceration on the upper lip mucosa. The lesions did not resolve with topical clobetasol propionate 0,05 %. Coagulation blood test and complete blood count showed no alterations. Absence of positive pathergy, no deficiency of vitamin B12, normal folate and iron levels were observed. After one month of follow-up the diagnosis of a self-induced injury was established. Patient’s mother was advised by a psychologist. Factitious injury of the oral mucosa may present a confusing clinical picture and the diagnosis may be challenging particularly in children.
ACTIVATED WNT SIGNALING PATHWAY IS NOT INFLUENCED BY ABSENCE OF GALECTIN-3 IN MICE DURING TONGUE MALIGNANT TRANSFORMATION Souza MVR1, Lopes MLC, Chammas R3, Santana JMA, Santos DO, Loyola AM4, Faria PR2 - 1UNIVERSIDADE FEDERAL DE UBERLÂNDIA - FACULDADE DE MEDICINA, 2 UNIVERSIDADE FEDERAL DE UBERLÂNDIA - INSTITUTO DE CIÊNCIAS BIOMÉDICAS, 3UNIVERSIDADE DE SÃO PAULO - FACULDADE DE MEDICINA, 4UNIVERSIDADE FEDERAL DE UBERLÂNDIA - FACULDADE DE ODONTOLOGIA Background/Objective: To study cyclin D1 and APC expression in lesions developed in tongues from galectin-3 deficient (GAL3⫺/⫺) and wild-type (GAL3⫹/⫹) mice. Study design: 60 GAL3⫺/⫺ and GAL3⫹/⫹ mice were treated with 4NQO for 16 weeks and killed at week 16 and week 32. Tongues were removed and sections were stained with H&E to diagnosis of dysplasias and carcinomas. An immunohistochemical assay was employed. Results: Oral carcinogenesis occurred in both groups (p⬎0.05). Cyclin D1-positive cells in dysplasias and carcinomas from GAL3⫺/⫺ was 36% each, and 28% and 34%, respectively, in GAL3⫹/⫹ mice (p⬎0.05). In dysplasias from GAL3⫺/⫺ mice, the intensity for APC ranged from weak (31.7%) to strong (2.4%), and from weak (48.1%) to strong (7.4%) in carcinomas. In dysplasias from GAL3⫹/⫹ mice predominated a weak expression (59.4%) and in carcinomas ranged from weak (50%) to moderate (40%) (p⬎0.05).
ORAL ABSTRACT Abstracts e129 Conclusion: Activated Wnt signaling was observed in both groups of mice (FAPEMIG).
ORAL POTENTIALLY MALIGNANT DISORDERS – EFFICACY OF DIAGNOSTIC ADJUNCTS Elzubier S, Goodson ML, Thomson PJ1 - 1NEWCASTLE UNIVERSITY - ORAL & MAXILLOFACIAL SURGERY Introduction: Management of oral potentially malignant disorders (PMD) requires clinical recognition of mucosal changes and interpretation of incision biopsy specimens. A range of diagnostic adjuncts have been proposed in recent years including VELscope (tissue autofluorescence) imaging and oral exfoliative cytology using brush biopsy techniques to collect cells for analysis. The aim of this study was to assess the efficacy of such techniques in establishing diagnoses. Methods: Following ethical approval and informed consent, new patients with PMDs attending Dysplasia Clinics enrolled in the study. All underwent standardized management protocols with conventional oral examination supplemented by VELscope imaging and Orcellex® brush biopsy, followed by incision biopsy for histopathological diagnosis. VELscope, cytology and histopathology were thus directly compared for each PMD. Results: 34 patients (10 males, mean 49.4yrs and 24 females, mean 60.3yrs) were examined. 25 leukoplakias, 7 erythroleukoplakias and 2 erythroplakias were identified on: ventrolateral tongue (10), floor of mouth (9), alveolar/gingival mucosa (5), labiobuccal mucosa (4), palate (3) and tongue dorsum (3). Histopathological diagnoses included hyperkeratosis (14), mild (9), moderate (4) and severe dysplasias (5), carcinoma in situ (1) and squamous cell carcinoma (1). Brush cytology coincided best with histopathology, with VELscope examination less reliable; both were more efficient in recognizing severe dysplasias or carcinoma. Conclusions: Diagnostic adjuncts cannot replace ‘gold standard’ incision biopsy and histopathology and are most useful in identifying severe disease.
ORAL, OROPHARYNGEAL AND GASTROINTESTINAL MUCOSITIS IN PATIENTS UNDERGOING AUTOLOGOUS STEM CELL TRANSPLANTATION Queiroz PM1, Fernandes KS1, Rumiato AC2, Faune CC2, Trigo FC2, Gordan LN2, Ito FA3 - 1STATE UNIVERSITY OF LONDRINA, 2 UNIVERSITY HOSPITAL - STATE UNIVERSITY OF LONDRINA - UNIT OF BONE MARROW TRANSPLANTATION, 3 STATE UNIVERSITY OF LONDRINA - ORAL PATHOLOGY Objective: This study evaluates the frequency and severity of oral, oropharyngeal and gastrointestinal mucositis in patients undergoing autologous stem cell transplantation. Study design: Clinical data from patients treated between 2010 and 2011 were gathered from files. All patients received oral hygiene instructions, cryotherapy and low-level laser as oral mucositis prevention. Results: Of the 22 patients, 7 (31.8%) presented oral mucositis, 7 (31.8%) had oropharyngeal mucositis and all patients developed gastrointestinal mucositis. Most cases of oral mucositis (85%) presented as asymptomatic erythema (WHO grade 1 mucositis). Topical lidocaine spray was used for symptomatic relief of oropharyngeal mucositis. Gastrointestinal mucositis was treated with dietary supplementation of glutamine 20g/day.
FACTITIAL ORAL LESIONS IN A PAEDIATRIC PATIENT Feio PSQ1, Pedroso EG1, Totti V1, Graner KM1, Gomes CBF1, Ramos LMA1, Lopes MA1 - 1PIRACICABA DENTAL SCHOOL, UNIVERSITY OF CAMPINAS - DEPARTMENT OF ORAL DIAGNOSIS, OROCENTRO An 8-year-old boy was referred by his physician to our diagnosis service for evaluation of 2-month history of multiples aphthous ulcer on the oral mucosa. His mother reported an increase in frequency, extension and pain of these lesions, also an intestinal constipation was reported. On oral examination, there was an ulcer, measuring 2,0 ⫻ 1,0, on the lower lip and another smaller ulceration on the upper lip mucosa. The lesions did not resolve with topical clobetasol propionate 0,05 %. Coagulation blood test and complete blood count showed no alterations. Absence of positive pathergy, no deficiency of vitamin B12, normal folate and iron levels were observed. After one month of follow-up the diagnosis of a self-induced injury was established. Patient’s mother was advised by a psychologist. Factitious injury of the oral mucosa may present a confusing clinical picture and the diagnosis may be challenging particularly in children.
ACTIVATED WNT SIGNALING PATHWAY IS NOT INFLUENCED BY ABSENCE OF GALECTIN-3 IN MICE DURING TONGUE MALIGNANT TRANSFORMATION Souza MVR1, Lopes MLC, Chammas R3, Santana JMA, Santos DO, Loyola AM4, Faria PR2 - 1UNIVERSIDADE FEDERAL DE UBERLÂNDIA - FACULDADE DE MEDICINA, 2 UNIVERSIDADE FEDERAL DE UBERLÂNDIA - INSTITUTO DE CIÊNCIAS BIOMÉDICAS, 3UNIVERSIDADE DE SÃO PAULO - FACULDADE DE MEDICINA, 4UNIVERSIDADE FEDERAL DE UBERLÂNDIA - FACULDADE DE ODONTOLOGIA Background/Objective: To study cyclin D1 and APC expression in lesions developed in tongues from galectin-3 deficient (GAL3⫺/⫺) and wild-type (GAL3⫹/⫹) mice. Study design: 60 GAL3⫺/⫺ and GAL3⫹/⫹ mice were treated with 4NQO for 16 weeks and killed at week 16 and week 32. Tongues were removed and sections were stained with H&E to diagnosis of dysplasias and carcinomas. An immunohistochemical assay was employed. Results: Oral carcinogenesis occurred in both groups (p⬎0.05). Cyclin D1-positive cells in dysplasias and carcinomas from GAL3⫺/⫺ was 36% each, and 28% and 34%, respectively, in GAL3⫹/⫹ mice (p⬎0.05). In dysplasias from GAL3⫺/⫺ mice, the intensity for APC ranged from weak (31.7%) to strong (2.4%), and from weak (48.1%) to strong (7.4%) in carcinomas. In dysplasias from GAL3⫹/⫹ mice predominated a weak expression (59.4%) and in carcinomas ranged from weak (50%) to moderate (40%) (p⬎0.05).
ORAL ABSTRACT Abstracts e129 Conclusion: Activated Wnt signaling was observed in both groups of mice (FAPEMIG).
ORAL POTENTIALLY MALIGNANT DISORDERS – EFFICACY OF DIAGNOSTIC ADJUNCTS Elzubier S, Goodson ML, Thomson PJ1 - 1NEWCASTLE UNIVERSITY - ORAL & MAXILLOFACIAL SURGERY Introduction: Management of oral potentially malignant disorders (PMD) requires clinical recognition of mucosal changes and interpretation of incision biopsy specimens. A range of diagnostic adjuncts have been proposed in recent years including VELscope (tissue autofluorescence) imaging and oral exfoliative cytology using brush biopsy techniques to collect cells for analysis. The aim of this study was to assess the efficacy of such techniques in establishing diagnoses. Methods: Following ethical approval and informed consent, new patients with PMDs attending Dysplasia Clinics enrolled in the study. All underwent standardized management protocols with conventional oral examination supplemented by VELscope imaging and Orcellex® brush biopsy, followed by incision biopsy for histopathological diagnosis. VELscope, cytology and histopathology were thus directly compared for each PMD. Results: 34 patients (10 males, mean 49.4yrs and 24 females, mean 60.3yrs) were examined. 25 leukoplakias, 7 erythroleukoplakias and 2 erythroplakias were identified on: ventrolateral tongue (10), floor of mouth (9), alveolar/gingival mucosa (5), labiobuccal mucosa (4), palate (3) and tongue dorsum (3). Histopathological diagnoses included hyperkeratosis (14), mild (9), moderate (4) and severe dysplasias (5), carcinoma in situ (1) and squamous cell carcinoma (1). Brush cytology coincided best with histopathology, with VELscope examination less reliable; both were more efficient in recognizing severe dysplasias or carcinoma. Conclusions: Diagnostic adjuncts cannot replace ‘gold standard’ incision biopsy and histopathology and are most useful in identifying severe disease.
ORAL, OROPHARYNGEAL AND GASTROINTESTINAL MUCOSITIS IN PATIENTS UNDERGOING AUTOLOGOUS STEM CELL TRANSPLANTATION Queiroz PM1, Fernandes KS1, Rumiato AC2, Faune CC2, Trigo FC2, Gordan LN2, Ito FA3 - 1STATE UNIVERSITY OF LONDRINA, 2 UNIVERSITY HOSPITAL - STATE UNIVERSITY OF LONDRINA - UNIT OF BONE MARROW TRANSPLANTATION, 3 STATE UNIVERSITY OF LONDRINA - ORAL PATHOLOGY Objective: This study evaluates the frequency and severity of oral, oropharyngeal and gastrointestinal mucositis in patients undergoing autologous stem cell transplantation. Study design: Clinical data from patients treated between 2010 and 2011 were gathered from files. All patients received oral hygiene instructions, cryotherapy and low-level laser as oral mucositis prevention. Results: Of the 22 patients, 7 (31.8%) presented oral mucositis, 7 (31.8%) had oropharyngeal mucositis and all patients developed gastrointestinal mucositis. Most cases of oral mucositis (85%) presented as asymptomatic erythema (WHO grade 1 mucositis). Topical lidocaine spray was used for symptomatic relief of oropharyngeal mucositis. Gastrointestinal mucositis was treated with dietary supplementation of glutamine 20g/day.