RESUMO
Abstract The purpose of this population-based, observational, and cross-sectional study was to evaluate alterations in the oral cells of a population of older people from a Brazilian rural area, using the micronucleus technique to investigate possible associated genotoxic factors. A questionnaire was applied and clinical examination and collection of oral mucosal cells were performed for all older people (≥ 60 years) from a town in southern Brazil. Demographic and socioeconomic variables, deleterious habits (drinking and tobacco use), presence of gastro-oesophageal reflux disease (GERD), and the use of proton pump inhibitors (PPIs) were considered the exposure variables, whereas metanuclear changes (MCs) and the prevalence of cell micronuclei (MN) were considered outcomes. Out of 489 older people, 447 were included in the study, among whom 50.8% were men with a mean age of 70.9 years and 83.9% had a monthly family income greater than US$ 500.00. GERD symptoms were present in 36.2% of the individuals, and 29.1% used PPIs daily, 53.3% consumed alcoholic beverages, and 46.7% used tobacco. The analysis of 1,000 oral mucosal cells per subject showed a MN frequency of 0-2 per individual, and MCs were detected with an average of 15 units per individual (median = 11 per individual). Poisson regression did not show statistical association between the exposure variables and the outcomes (presence of MN and MCs), except for the use of PPIs, which was a protective factor for the prevalence of MN [PR 0.6 (CI 0.3-0,9)]. Age, sex, family income, tobacco use and drinking, and GERD were not associated with the number of MN and MCs in oral mucosal cells of the investigated older people.
RESUMO
Introdução: O carcinoma epidermoide é uma patologia que corresponde a 90% dos tumores malignos da cavidade oral. Objetivo: Avaliar o perfil epidemiológico, o tratamento e a sobrevida dos pacientes diagnosticados com carcinoma epidermoide oral em um hospital referência na Região Norte do Estado do Rio Grande do Sul, Brasil. Método: Estudo observacional retrospectivo, com análise dos prontuários dos pacientes com diagnóstico dessa patologia, no período de 1993 a 2008, no banco de dados desse hospital. Os dados foram analisados pelo programa estatístico SPSS versão 18 utilizando testes paramétricos e não paramétricos. Resultados: Foram coletados e analisados dados de 303 prontuários que revelaram que 88,4% eram homens, leucodermas, com maior incidência na faixa etária entre 51 e 60 anos. A associação de álcool e tabaco foi observada em 84,7% dos pacientes. O local mais afetado foi a língua (45,5%) e a maioria dos casos apresentou estádios tardios III e IV com uma sobrevida de 17,83 meses. Embora o tratamento cirúrgico tenha sido o mais realizado (55,9%) e apresentado a maior sobrevida, não foi observada significância estatística deste com relação aos demais tratamentos (p=0,185). Conclusão: O perfil epidemiológico dos pacientes é muito semelhante aos registros de vários países. Neste caso, o diagnóstico tardio diminuiu significativamente a expectativa de vida dos pacientes (2,5x), e o tratamento executado bem como o local inicial da lesão não tiveram influência significativa na sobrevida
Introduction: The squamous cell carcinoma is a pathology accounting for 90% of all the malignant tumors found in the oral cavity. Objective: This study aimed to assess the epidemiological profile, treatment, and survival of patients diagnosed with oral squamous cell carcinoma at a reference hospital of the northern region of the state of Rio Grande do Sul, Brazil. Method: Retrospective observational study with analysis of the patients' charts diagnosed with this condition from 1993 to 2008 at this hospital database. The data collected were analyzed using the statistical program SPSS version 18 using parametric and non-parametric tests. Results: From the 303 charts analyzed, 88.4% were men, Caucasian, leukoderma, with higher incidence in the age range between 51 to 60 years old. The association of alcohol with tobacco was detected in 84.7% of the patients. The most affected site was the tongue (45.5%), and most of the cases were diagnosed in late stage III and IV, with survival of 17.83 months. Although surgical treatment has been performed more frequently (55.9%) and presented higher survival rates, its statistical significance in comparison with other treatments was not demonstrated (p=0.185). Conclusion: The epidemiological profile of patients is very similar to the charts of several countries. In the present case, the late diagnosis significantly decreased life expectancy of patients (2.5-fold), and that the treatment, and the initial site of the lesion had no significant influence on survival
Introducción: El carcinoma de células escamosas es una patología que corresponde aproximadamente a 90% de los tumores malignos de la cavidad bucal. Objetivo: Evaluar el perfil epidemiológico, el tratamiento y la sobrevida de los pacientes diagnosticados con carcinoma epidermoide oral en un hospital referencia en la región norte del estado de Rio Grande do Sul, Brasil. Método: Estudio observacional retrospectivo con los prontuarios de los pacientes con el diagnóstico de esa patología en el período de 1993 a 2008, en el banco de datos de este hospital usando el programa estadístico SPSS versión 18 usando pruebas paramétricas y no paramétricas Resultados: Se recogieron y analizaron datos de 303 prontuarios, que revelaron que 88,4% eran hombres, leucodermas, entre 51 a 60 años. La asociación de alcohol y tabaco fue observada en el 84,7% de los pacientes. El local más afectado fue la lengua (45,5%) y la mayoría de los casos ha presentado estadios tardíos III y IV con una sobrevida de 17,83 meses. Aunque el tratamiento quirúrgico fue el más realizado (55,9%) y presentado la mayor sobrevida, no se observó la significancia estadística de éste con relación a los demás tratamientos (p=0,185). Conclusión: El perfil epidemiológico de los pacientes es muy similar a los registros de varios países. En este caso, el diagnóstico tardío disminuyó significativamente la expectativa de vida de los pacientes (2,5x) y el tratamiento realizado, así como el lugar inicial de la lesión no tuvieron influencia significativa en la sobrevida