p16 (INK4a) has clinicopathological and prognostic impact on oropharynx and larynx squamous cell carcinoma

CDKN2A encodes proteins such as p16 (INK4a), which negatively regulate the cell-cycle. Molecular genetic studies have revealed that deletions in CDKN2A occur frequently in cancer. Although p16 (INK4a) may be involved in tumor progression, the clinical impact and prognostic implications in head and neck squamous cell carcinoma (HNSCC) are controversial. The objective of this study was to evaluate the frequency of the immunohistochemical expression of p16 (INK4a) in 40 oropharynx and 35 larynx from HNSCC patients treated in a single institution and followed-up at least for 10 years in order to explore potential associations with clinicopathological outcomes and prognostic implications. Forty cases (53.3%) were positive for p16 (INK4a) and this expression was more intense in non-smoking patients (P = 0.050), whose tumors showed negative vascular embolization (P = 0.018), negative lymphatic permeation (P = 0.002), and clear surgical margins (P = 0.050). Importantly, on the basis of negative p16 (INK4a) expression, it was possible to predict a probability of lower survival (P = 0.055) as well as tumors presenting lymph node metastasis (P = 0.050) and capsular rupture (P = 0.0010). Furthermore, increased risk of recurrence was observed in tumors presenting capsular rupture (P = 0.0083). Taken together, the alteration in p16 (INK4a) appears to be a common event in patients with oropharynx and larynx squamous cell carcinoma and the negative expression of this protein correlated with poor prognosis.

Loss of Y-chromosome does not correlate with age at onset of head and neck carcinoma: a case-control study

Loss of Y-chromosome has been correlated with older age in males. Furthermore, current evidence indicates that Y-chromosome loss also occurs in several human tumors, including head and neck carcinomas. However, the association between Y nullisomy and the occurrence of neoplasias in elderly men has not been well established. In the present study, the association between Y-chromosome loss and head and neck carcinomas was evaluated by comparison to cells from peripheral blood lymphocytes and normal mucosa of cancer-free individuals matched for age using dual-color fluorescence in situ hybridization. Twenty-one patients ranging in age from 28 to 68 years were divided into five-year groups for comparison with 16 cancer-free individuals matched for age. The medical records of all patients were examined to obtain clinical and histopathological data. None of the patients had undergone radiotherapy or chemotherapy before surgery. In all groups, the frequency of Y-chromosome loss was higher among patients than among normal reference subjects (P < 0.0001) and was not age-dependent. These data suggest that Y-chromosome loss is a tumor-specific alteration not associated with advanced age in head and neck carcinomas.

Education, tobacco smoking, alcohol consumption, and IL-2 and IL-6 gene polymorphisms in the survival of head and neck cancer

The association of education, tobacco smoking, alcohol consumption, and interleukin-2 (IL-2 +114 and -384) and -6 (IL-6 -174) DNA polymorphisms with head and neck squamous cell carcinoma (HNSCC) was investigated in a cohort study of 445 subjects. IL-2 and IL-6 genotypes were determined by real-time PCR. Cox regression was used to estimate hazard ratios (HR) and 95 percent confidence intervals (95 percentCI) of disease-specific survival according to anatomical sites of the head and neck. Mean age was 56 years and most patients were males (87.6 percent). Subjects with 5 or more years of schooling had better survival in larynx cancer. Smoking had no effect on HNSCC survival, but alcohol consumption had a statistically significant effect on larynx cancer. IL-2 gene +114 G/T (HR = 0.52; 95 percentCI = 0.15-1.81) and T/T (HR = 0.22; 95 percentCI = 0.02-3.19) genotypes were associated with better survival in hypopharynx cancer. IL-2 +114 G/T was a predictor of poor survival in oral cavity/oropharynx cancer and larynx cancer (HR = 1.32; 95 percentCI = 0.61-2.85). IL-2 -384 G/T was associated with better survival in oral cavity/oropharynx cancer (HR = 0.80; 95 percentCI = 0.45-1.42) and hypopharynx cancer (HR = 0.68; 95 percentCI = 0.21-2.20), but an inverse relationship was observed for larynx cancer. IL-6 -174 G/C was associated with better survival in hypopharynx cancer (HR = 0.68; 95 percentCI = 0.26-1.78) and larynx cancer (HR = 0.93; 95 percentCI = 0.42-2.07), and C/C reduced mortality in larynx cancer. In general, our results are similar to previous reports on the value of education, smoking, alcohol consumption, and IL-2 and IL-6 genetic polymorphisms for the prognosis of HNSCC, but the risks due to these variables are small and estimates imprecise.

Reconstucao da mandibula por enxerto autogeno de crista iliaca. / Mandibular reconstruction using autogenous iliac bone graft

Os autores apresentam a experiencia do Servico de Cabeca e Pescoco do Hospital Heliopolis em reconstrucao imediata de mandibula com enxerto autogeno de crista iliaca. Sao analisados, pormenorizadamente os 10 casos tratados entre Agosto/1979 e Junho/1982. Apresentam as idversas alternativas de reconstrucao imediatas e tardias da mandibula. Discutem as vantagens e desvantagens de cada metodo, e destacam os resultados dos transplantes osseos autogenos. Discutem os detalhes tecnicos indicacoes e resultados imediatos e tardios das reparacoes com crista iliaca. Concluem que os enxertos autogenos de crista iliaca oferecem bons resultados funcionais e esteticos, e que devem ser indicados nas recosntrucoes mandibulares apos resseccao de neoplasias benignas ou malignas de baixa gravidade

Linfomas gastricos primitivos.Analise de 19 casos. / Primary gastric lymphomas. Analysis of 19 cases

Os linfomas gastricos primitivos sao lesoes incomuns (0,81% da serie de neoplasias gastricas), de diagnostico extremamente dificil com os exames clinicos, radiologicos ou endoscopicos, falhando em estabelecer o diagnostico pre-operatorio em 95% dos nossos casos. Contudo, em vista do melhor prognostico que o carcinoma gastrico, todo o esforco deve estar voltado para o estabelecimento do diagnostico. A terapeutica e cirurgica nos casos que obedecem aos criterios que definem um linfoma como primitivo do estomago. A radioterapia tem indicacoes precisas e a poliquimioterapia deve ser associada em todos os casos

A histologia do linfonodo axilar como elemento prognostico nos tumores malignos da mama. / Histology of axillary lymph nodes as a prognostic element in carcinoma of the breast

E analisada a relacao existente entre o aspecto histologico reacional de linfonodos axilares em 83 casos de pacientes portadores de tumores malignos de mama, com o grau de imunidade sistemica determinada pelo teste cutaneo do dinitroclorobenzeno (DNCB). Observou-se que nao existe correlacao entre a histologia do linfodono e do prognostico. Concluiu-se que o numero de linfonodos axiliares acometidos por metastases e ainda o melhor parametro para o prognostico e a selecao de pacientes que devem receber tratamento adjuvante