A 10-year study of specimens submitted to oral pathology laboratory analysis: lesion occurrence and demographic features

The purpose of the present paper was to describe the range of lesions histologically diagnosed in an oral pathology laboratory in southern Brazil. A retrospective study of 8,168 specimen analyses recorded between 1995 and 2004 was conducted. The records were retrieved from the Oral Pathology Laboratory, School of Dentistry, Federal University of Rio Grande do Sul, RS, Brazil. A total of 6,831 valid cases (83.63%) were examined. Of these, inflammatory lesions were the most common occurrences (n = 4,320; 63.24%). Benign and malignant tumors accounted for 7.66% (n = 523) and 1.9% (n = 130) of the occurrences, respectively. Significant associations were observed between nonneoplastic proliferative disorders and benign mesenchymal tumors in females, and between squamous cell carcinoma and leukoplakia in males. Most diagnoses were benign in nature and had an inflammatory etiology. The association of some demographic characteristics with the occurrence of lesions suggests that these characteristics should be considered in performing differential diagnoses.

A 10-year study of specimens submitted to oral pathology laboratory analysis: lesion occurrence and demographic features.

The purpose of the present paper was to describe the range of lesions histologically diagnosed in an oral pathology laboratory in southern Brazil. A retrospective study of 8,168 specimen analyses recorded between 1995 and 2004 was conducted. The records were retrieved from the Oral Pathology Laboratory, School of Dentistry, Federal University of Rio Grande do Sul, RS, Brazil. A total of 6,831 valid cases (83.63%) were examined. Of these, inflammatory lesions were the most common occurrences (n = 4,320; 63.24%). Benign and malignant tumors accounted for 7.66% (n = 523) and 1.9% (n = 130) of the occurrences, respectively. Significant associations were observed between nonneoplastic proliferative disorders and benign mesenchymal tumors in females, and between squamous cell carcinoma and leukoplakia in males. Most diagnoses were benign in nature and had an inflammatory etiology. The association of some demographic characteristics with the occurrence of lesions suggests that these characteristics should be considered in performing differential diagnoses.

Head and neck squamous cell carcinoma: decline in clinical stage at the time of diagnosis in a reference hospital in southern Brazil

Objective: Developing countries have a high incidence of head and neck squamous cell carcinoma (HNSCC). Risk factors are smoking and alcohol consumption; socioeconomic status and oral health may be associated with etiology. The aim of this study was to evaluate the sociodemographicprofile and oral health of patients with primary HNSCC, as well as the clinical and histopathological characteristics of the tumor. Material and Methods: We evaluated 78 patients; data about sex, age, skin color, schooling, oral hygiene, smoking, alcohol consumption and socioeconomic status were collected using a structured questionnaire. An intraoral examination provided dataabout caries, missing teeth and dental prosthesis. Hospital records were reviewed to collect clinical tumor information. Results: Mean age was 57.6 years; most participants were male,white, former or current smokers and moderate or high consumption of alcoholic beverages with low socioeconomic and educational levels. The majority of patients were disease-free at 2 year-follow up. Classification showed 60.2% of the tumors as T1 and T2 and 59% had no regional involvement. Most tumors were found in the mouth, and the tongue was the most frequent site. Histopathological examination revealed that 57.7% of the tumors were classified as moderateand poor prognosis. Conclusion: The profile of patients with HNSCC was similar to that found in other populations, but there is a decline in clinical stage at the time of diagnosis, and detecting this tumor at an early stage can be an effective mean to determine a better prognosis for patients

Odontogenic epithelium: immunolabeling of Ki-67, EGFR and survivin in pericoronal follicles, dentigerous cysts and keratocystic odontogenic tumors.

The aim of this study was to evaluate the biological profile of odontogenic epithelium by immunolabeling of epidermal growth factor receptor (EGFR), Ki-67 and survivin in keratocystic odontogenic tumors (KOT), dentigerous cysts (DC), and pericoronal follicles (PF). Immunohistochemical analysis was performed in 13 KOTs, 14 DCs and 9 PFs. Immunolabeling was analyzed in the basal and suprabasal layers of KOTs and DCs, and in the islands of odontogenic epithelium and/or reduced enamel epithelium of PFs. KOTs showed the highest proliferation rate among the three groups, mainly in suprabasal layers. EGFR immunolabeling was observed mainly in the cytoplasm in basal and suprabasal layers of KOTs and in the suprabasal layer of DCs. Immunolabeling in both membrane and cytoplasm was greater in PFs. In PFs, membrane-only staining was observed. Survivin immunolabeling showed a greater percentage of positive cells (scoring +++) in the suprabasal layer of KOTs. In DCs, both layers showed similar percentages of cells scoring +++; PFs showed the highest percentage of these cells. In KOTs, epithelial cells showed stimulus-independent neoplastic proliferative characteristics, suggesting the presence of a suprabasal proliferative compartment, maintained by inhibition of apoptosis. In DCs, the basal layer seemed to proliferate in response to stimulus. Although PFs showed low proliferative activity, the expression of EGFR indicates that some cells have a high capacity to respond to stimuli, which could probably explain the origin of odontogenic lesions.

Evaluation of cell proliferation rate in non-dysplastic leukoplakias.

OBJECTIVE: Analyze whether the most frequent cases of non-dysplastic leukoplakias, hyperkeratosis (H), acanthosis (A), and hyperkeratosis with acanthosis (HA) have similar cell proliferation rates and to compare them with epithelial dysplastic (ED) leukoplakias and normal oral epithelium (NOE). STUDY DESIGN: The sample comprised 10 cases of normal oral epithelium, 10 cases of hyperkeratosis, 10 cases of acanthosis, 10 cases of hyperkeratosis with acanthosis and 10 cases of epithelial dysplasia. The mean number of AgNORs per nucleus (mAgNOR) and the mean percentage of cells with 1, 2, 3 and 4 or more AgNORs per nucleus (pAgNOR) were recorded. RESULTS: The results of mAgNOR showed differences between disorders in the evaluation of the basal layer, of the parabasal layer, and in the overall evaluation. mAgNOR and pAgNOR=2 increased progressively from normal oral epithelium to hyperkeratosis with acanthosis, hyperkeratosis, acanthosis and epithelial dysplasia (p<0.05). Cell proliferation rate was different between different subtypes of non-dysplastic leukoplakias and this group presented a higher proliferative behavior when compared to normal oral epithelium. CONCLUSION: It may be suggested that non-dysplastic leukoplakias had different characteristics regarding cell proliferation rates and sometimes showed a proliferative behavior similar to that found in epithelial dysplasia. More studies should be conduced to increase knowledge about the biological profile of non-dysplastic leukoplakias, especially as it pertains to acanthosis.

Immunohistochemical analysis of the patterns of p53 and PCNA expression in odontogenic cystic lesions.

OBJECTIVE: the role of p53 expression in odontogenic lesions has not been fully determined, but has been associated with cell proliferation. The purpose of this study was to analyze p53 and proliferating cell nuclear antigen (PCNA) expression in 4 different odontogenic lesions. DESIGN: expression of p53 and PCNA was analyzed in radicular and dentigerous cysts, odontogenic keratocysts, and calcifying odontogenic cysts (Gorlin cysts) using monoclonal antibodies for detection of p53 and PCNA. RESULTS: PCNA expression was significantly greater in the basal layer of radicular cysts and in the suprabasal layer of odontogenic keratocysts; the percentage of p53 positive cells was significantly greater in the suprabasal layer of odontogenic keratocysts. CONCLUSIONS: The patterns of p53 and PCNA expression in dentigerous and radicular cysts were similar although the two lesions are of different origin. In odontogenic keratocysts and Gorlin cysts, results indicate a different pattern of tumor growth.

Proliferative activity in clinically healthy oral mucosa exposed to tobacco smoking and alcohol: a longitudinal study using the agNOR staining technique.

OBJECTIVE: To evaluate cell proliferation in clinically healthy oral mucosa exposed to smoking and alcohol carcinogens over a period of 24 months using the AgNOR staining technique. STUDY DESIGN: Sixty patients were initially evaluated: 17 were control individuals, 25 were smokers and 18 were smokers and alcohol drinkers. Fifty-two of these patients were reevaluated. Specimens for cytology were obtained from swabs of lower lip mucosa, border of the tongue and floor of the mouth and underwent AgNOR staining for evaluation of mean number and mean area of AgNOR dots per nucleus and percentage of nuclei with > 3 and > 5 AgNOR dots. Student t and Kruskal-Wallis tests were used to compare values obtained. RESULTS: A statistically significant increase was found in mean number of AgNOR dots per nucleus in 2 groups. One group showed a tendency toward increase of these values. The results of the longitudinal evaluation (Kruskal-Wallis test) revealed a statistically significant difference in number and area of AgNOR dots in the cells of the lower lip. CONCLUSION: The increase of the variables suggests that the longitudinal evaluation of changes in cell proliferation in individuals exposed to smoking and alcohol carcinogens may be a useful monitoring tool.

Teste dos micronúcleos: um biomarcador de dano genotóxico em células descamadas da mucosa bucal / Micronucleus assay: a biomarker of genotoxic damage in exfoliated oral mucosa cells

O objetivo deste trabalho é fazer uma revisão de literatura a respeito do ensaio dos micronúcleos, explicando o seu significado e sua aplicação em células esfoliadas da mucosa bucal. Micronúcleo (MN) é um núcleo acessório, originado a partir de fragmentos de cromossomo ou de cromossomos inteiros que não são incluídos no núcleo principal durante a mitose. MNs surgem por alterações genéticas espontâneas ou são induzidos por agentes genotóxicos. A análise dos micronúcleos tem sido utilizada como uma ferramenta importante de biomonitoramento de populações. Estudos demonstram que consumidores de fumo e álcool, assim como grupos expostos a determinados agentes em função de sua ocupação ou estilo de vida apresentam um elevado número de MNs nas células bucais esfoliadas.

The aim of this study is to summarise the literature on micronucleus assay, explaining its meaning and its application in exfoliated oral mucosal cells. Micronuclei (MN) is an extra nuclei, originated from chromosome fragments or whole chromosomes that are not included in the main nuclei during mitosis. MNs arise from spontaneous genetic damage or are induced by genotoxic agents. MN analysis has been used as an important tool to biomonitore populations exposed to life-style agents. Studies demonstrate that tobacco and alcohol users, as well as occupationally exposed groups present increased number of MNs in exfoliated oral mucosa cells. Despite the fact that the role of MN frequency has not yet been fully understood, the MNs assay is considered to be an effective biomarker of oral squamous cell carcinoma risk factors effects.

P53 protein reactivity in odontogenic lesions: an immunohistochemical study

O objetivo deste estudo foi investigar a expressão da p53 em algumas lesões odontogênicas. Foram selecionadas 57 lesões odontogênicas: 12 cistos radiculares, 17 cistos dentígeros, 16 cistos odontogênicos calcificantes e 12 ceratocistos odontogênicos paraceratinizados. Todos os espécimes foram marcados, pela técnica da imunohistoquímica, para a p53. O número de células positivas e a intensidade de marcação variaram nos diferentes tipos de lesão. Os cistos radiculares apresentaram o maior número de células positivas seguido pelo cisto odontogênico calcificante. A maioria das células positivas nos ceratocistos odontogênicos estavam localizadas na camada suprabasal. Tanto o ceratocisto odontogênico quanto o cisto odontogênico calcificante apresentaram marcação mais intensa e melhor definida que os outros tipos de cistos. Considerando as características do ceratocisto odontogênico e a expressão da p53 semelhante ao cisto odontogênico calcificante, os autores sugerem que o ceratocisto odontogênico seja classificado como uma lesão tumoral.

Tongue Squamous Cell Carcinoma: RelationshipBetween Argyrophilic Nucleolar Organizer Regions(AgNORS) and Histopathologic Grading

Current available data from the literature have suggestedcorrelation among histopathological differentiation(tumor grade), treatment, and prognosis in oralmalignant tumors. Cell proliferation is an importantfactor in the prognosis of malignant neoplasia.Argyrophilic nucleolar organizer regions (AgNORs)quantification is strongly associated to cell proliferation.OBJECTIVE: The aim of this study is to verify therelationship between total AgNORs mean value(mAgNOR) and/or the percentage of cells with 1, 2, 3, 4or more AgNORs (pAgNOR) with histopathologicgrading of tongue squamous cell carcinoma accordingto Wahi. RESULTS: AgNOR mean value/nucleus has rangedaccording to the histopathologic grading; the mean valuehas increased as the histopathologic grading increased.A negative correlation among pAgNOR series (1,2,3,4or more) was obtained between grade I and grade IIIlesions, whereas grade II lesions have shownintermediate values of correlation. CONCLUSION: Adirect relationship between AgNORs/nucleus mean,percentage of AgNORs/nucleus and malignancy gradingwas observed. correlation between tumor histopathologicaldifferentiation, their treatment and prognosis.Wahi,2 in a World Health Organization (WHO)report, has commented that oral primary carcinomasprognosis should be established alwaystaking into consideration the histologicalgrading, tumor site and their clinical features

AgNOR quantification in cells of normal oral mucosa exposed to smoking and alcohol. A cytopathologic study.

OBJECTIVE: To evaluate cell proliferative activity by counting and measuring argyrophilic nucleolar organizer regions (AgNORs) per nucleus in cell smears from mucosa clinically exposed to smoking and alcohol. STUDY DESIGN: Group 1 (control) consisted 17 patients, group 2 (smoking) of 25 and group 3 (smoking and alcohol) of 18. Cell smears collected from the mucosa of the lower lip, border of the tongue and floor of the mouth underwent AgNOR staining. Mean number and mean area of AgNORs per nucleus were calculated for the first 50 cells in each smear. ANOVA and the Tukey test were used for statistical analyses at a 5% significance level. RESULTS: Statistical analyses revealed a greater mean number and larger mean area of AgNORs per nucleus in groups 2 (smoking) and 3 (smoking and alcohol). Samples from the border of the tongue had the lowest mean values for number and area of AgNORs per nucleus in comparison with samples from the lower lip and floor of the mouth in the 3 groups. CONCLUSION: Anatomic sites exposed to smoking or to smoking and alcohol had increased cellular proliferative activity.

Quantification of silver-staining nucleolar organizer region in epithelial cells of tongue of mice after exposure to, or intake of, alcohol.

The purpose of the current study was to evaluate the effect of alcohol on the proliferative activity of epithelial cells in the lingual mucosa of mice by means of silver-staining nucleolar organizer region (AgNOR) count and area measurements. Forty-eight CF1 mice were separated into three groups. The test groups were submitted to topical exposure to, or intake of, 40% (volume/volume) ethyl alcohol. Biopsy specimens were collected from the middle third of the dorsal tongue at 0, 6, and 12 months, and samples were stained according to the AgNOR technique. Mean number and mean area of AgNOR per nucleus were calculated for 50 basal layer cells and 50 intermediate layer cells. Increases in mean number and mean area of AgNOR per nucleus in intermediate cells were observed at 12 months in the alcohol intake group (P < .05). Results showed that intake of 40% alcohol increased epithelial cell proliferation in the dorsal surface of lingual mucosa.

Fascite nodular: relato de caso clínico com estudo imunohistoquímico / Nodular fasciitis: case report with immunohistochemical analisys

O fasciste nodular é uma lesão benigna de células fusiformes que freqüentemente é confundida com lesões malignas. O relato do caso clínico coincide com os aspectos clínicos, microscópicos e imunohistoquímicos. Os autores salientam que a definição do diagnóstico desta lesão deve ser realizada a partir de suas características microscópicas que orientam a definição do painel imunohistoquímico

Quantificação de AgNORs e expressão do PCNA em ceratocisto odontogênico / Quantification of AgNORs and expression of PCNA in odontogenic keratocyst

Para realização deste estudo foram selecionadas quinze casos de Ceratocisto Odontogênico e submetidos à técnica histoquímica de AgNOR e à técnica imunohistoquímica do PCNA. Observou-se que o Ceratocisto Odontogênico possui uma média de 1,84 AgNORs por núcleo e que 74,98 por cento das células são positivas ao PCNA. Uma característica constante foi que tanto para o AgNOR quanto para o PCNA a camada suprabasal apresentou médias estatísticamente superiores à camada basal. Conclui-se, portanto, que o Ceratocisto Odontogênico é uma lesão benigna com proliferação do epitélio, principalmente na camada suprabasal

O que säo regiöes organizadoras nucleolares (NORs) e qual a utilidade da técnica de AgNOR / What are NORs and what for

O presente trabalho tem por finalidade fazer uma revisäo de literatura sobre o que säo as regiöes Organizadoras Nucleolares (NORs) e quais as prováveis aplicaçöes da marcaçäo pela Prata destas regiöes com a técnica chamada AgNOr. Esta técnica tem sido usada para estabelecer a distinçäo entre malignidade e benignidade, grau de malignidade, avaliaçäo de prognóstico e atividade proliferativa. Na revisäo de literatura foi encontrado que há controvérsia quanto a eficácia da técnica mas com relaçäo a algumas lesöes há consenso quanto a indicaçäo de aplicabilidade da mesma

O efeito das diferentes técnicas histológicas em estudos que envolvem mensuraçöes / The effect of different histological technics in studies that evolve measurement

O trabalho analisa as alteraçöes dimensionais decorrentes das diferentes técnicas de processamento histológico em estruturas complexas como a mandíbula, que abriga diferentes tecidos mineralizados e diferentes tecidos moles. A partir dos resultados obtidos conclui-se que, em estudos que envolvem mensuraçöes em cortes histológicos é necessário considerar que a técnica de inclusäo em parafina produz contraçäo no material, o mesmo ocorrendo, porém em menor escala com material congelado, quando comparados com material näo descalcificado