Potencial de transformación maligna de las lesiones blanquecinas bucales / Potential for malignant transformation of whitish oral lesions

Introducción: Las lesiones blanquecinas bucales con potencial maligno, son un grupo reconocible de enfermedades de las mucosas, que preceden a la aparición de cánceres invasivos de la cavidad bucal. Objetivo: Determinar el potencial de transformación maligna de las lesiones blanquecinas de la cavidad bucal. Métodos: Se realizó un estudio observacional, descriptivo y transversal, de enero del año 2016 hasta enero de 2020, de todos los pacientes que acudieron al servicio de Cirugía Maxilofacial, con lesiones blanquecinas bucales. Las variables utilizadas fueron: edad, sexo, factores de riesgo, tiempo de evolución, sitio de la lesión, diagnóstico histológico y potencial de transformación maligna. Se exploró asociación mediante ji cuadrado. Resultados: Se encontraron lesiones con potencial de transformación maligna en el 24 por ciento de los mayores de 50 años, en el 24,3 por ciento de los hombres y en el 40 por ciento de pacientes con queilitis actínicas. El 83,3 por ciento fueron leucoplasias y entre ellas, el 20 por ciento con potencial de transformación maligna. Conclusiones: La leucoplasia es el diagnóstico histológico más común. Las lesiones con potencial de transformación maligna aumentan con la edad, son mayores en los hombres y en pacientes con queilitis actínicas. Los sitios anatómicos en que más aparecen son: paladar blando y labio superior; entre los factores de riesgo de mayor asociación está la exposición al sol(AU)

Introduction: Potentially malignant whitish oral lesions are a recognizable group of mucosal diseases that precede the appearance of invasive cancers of the oral cavity. Objective: To determine the potential malignant transformation of whitish lesions in the oral cavity. Methods: An observational, descriptive and cross-sectional study was carried, from January 2016 to January 2020, of all patients who attended the Maxillofacial Surgery service with whitish oral lesions. The variables used were: age, sex, risk factors, time of evolution, and site of the lesion, histological diagnosis and potential for malignant transformation. To explore the association between categorical variables, the Chi square distribution was used. Results: Lesions with the potential for malignant transformation were found in 24 percent of those over 50 years of age, in 24,3 percent of men and in 40 percent of patients with actinic cheilitis. 83,3 percent were leukoplakia, and among them 20 percent with the potential for malignant transformation. Conclusions: Leukoplakia was the most common histological diagnosis. Lesions with the potential for malignant transformation increased with age, were greater in men and in actinic cheilitis patients. The anatomical sites in which they appeared most were on the soft palate and upper lip and among the risk factors with the greatest association was sun exposure(AU)

Expresión de E-cadherina y factor de crecimiento epidérmico en leucoplasias orales / Expression of E-cadherin and epidermal growth factor in oral leukoplakia

Introducción: se define a las leucoplasias orales como una placa blancaque no puede desprenderse por raspado y que no puede clasifi carse comoninguna otra lesión. Son lesiones con potencial maligno, relacionadascon la presencia de displasia epitelial. Estos cambios preneoplásicospueden ser evidenciados histológicamente como también a travésde técnicas que pongan en evidencia los diferentes cambios a nivelmolecular. La E-cadherina es una glicoproteína membranosa quedesempeña papeles importantes en el mantenimiento de la adhesióncélula-célula, la preservación de la polaridad del tejido epitelial y laintegridad estructural. Los factores de crecimiento epidérmico son unconjunto de moléculas de naturaleza proteica, biorreguladores, cuyafuncionalidad fundamental radica en el control del ciclo celular. Elobjetivo del presente trabajo es identifi car y comparar parámetros histológicosy moleculares predictores de riesgo de transformación malignaen leucoplasias orales. Material y métodos: El estudio correspondea un diseño observacional descriptivo. Se seleccionaron muestras de26 biopsias de leucoplasias orales, las cuales fueron evaluadas contécnica histológica de rutina y tinción con hematoxilina y eosina, luegosometidas a inmunomarcación con factor de crecimiento epidérmico yE-cadherina, donde se evaluó la intensidad de tinción y cambios en laexpresión de cada marcador, así como la localización en los diferentessubtipos celulares. Resultados: De las 26 leucoplasias observadas,16 mostraron histología con cambios hiperplásicos y 10 con cambiosdisplásicos leves a moderados. La expresión de E-cadherina no mostróalteraciones signifi cativas en leucoplasias sin displasia, sólo hubopérdida de expresión en aquellas leucoplasias con cambios displásicosde alto grado, en concordancia a los hallazgos histológicos...

Introduction: oral leukoplakia is defined as a white plaque thatcannot be removed by scraping and cannot be classifi ed as any otherdisease entity. They are potentially malignant lesions related to thepresence of epithelial dysplasia. These preneoplastic changes can bedetected histologically, as well as through techniques that demonstratediff erent changes at the molecular level. E-cadherin is a membraneglycoprotein that plays a major role in maintaining cell-cell adhesion,preserving structural integrity and the polarity of epithelial tissue.Epidermal growth factors are a group of bio-regulatory proteins,whose primary function is to control the cell cycle. The aim of thisstudy is to identify and compare the parameters for histological andmolecular markers for malignant transformation in oral leukoplakia.Material and methods: The study was observational and descriptive indesign. Samples were selected from 26 oral leukoplakia biopsies, whichwere routinely evaluated for histology and stained with hematoxylinand eosin, then subjected to immunostaining with epidermal growthfactor and E-cadherin, with the intensity of staining and changes inthe expression of each marker being evaluated. Results: Of the 26leukoplakia examined, 16 showed hyperplastic changes and 10 mildto moderate dysplastic changes. The expression of E-cadherin showedno signifi cant changes in non-dysplastic leukoplakia, while a lossof expression was found in only those leukoplakias with high-gradedysplastic changes, which was consistent with the histological fi ndings...

Management of Oral Leukoplakia Using Diode Laser: A Pilot Study.

Aim: To evaluate the effectiveness of 810-nm diode LASER in the management of patients with oral leukoplakia. Materials and Methods: A total of 10 cases diagnosed clinically and histopathologically as leukoplakia were included in the present study. All the cases were treated using 810-nm diode LASER at a power of 5 watts and followed up for 3 months and assessed for pain and healing post-operatively. Results: All the lesions healed within duration of 3-4 weeks without scarring. Complications or recurrence has not been noticed in any of the patients except for mild pain during follow up period. Conclusion: Patient acceptance was found to be high using 810-nm diode LASER without compromising health and function. Thus usage of diode LASER may indeed be the best choice in the management of oral leukoplakia.

Clinical study in treatment of leukoplakia vulvae with high-intensity focused ultrasound / 解放军医学杂志

Objective To evaluate the feasibility and efficacy of treatment of leukoplakia vulvae with high-intensity focused ultrasound. Methods 65 patients with leukoplakia of the vulva were treated with high-intensity focused ultrasound. The patients were followed up after the treatment, and the symptoms including itch of the vulva, color change, the elasticity of the vulva lesions, and release of adhesions were observed and evaluated at the different times after treatment. Result All of the patients experienced relief in different degree (the ratio of effectiveness was 100%). Of them 28 patients were complete cured, 29 were distinctly improved, 8 were improved. In 5 patients there was a recrudescence with mild itch 2-3 months after treatment, but there was still a positive response to the second course of treatment. Conclusions High-intensity focused ultrasound is a highly effective instrument in the treatment of leukoplakia of the vulva. The treatment not only stops itch, but enables the color and elasticity of the vulva to recover as well.