Invasão neoplásica perineural e vascular de carcinomas de células escamosas orais : estudo clinicopatológico e imunoistoquímico
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Data
2013-05-24
Autores
Cavalcante, Wanessa Siqueira
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Universidade Federal do Espírito Santo
Resumo
Oral squamous cell carcinoma (OSCC) is the most common oral cancer and occurs mainly in oral mucous membranes and oropharynx, prevailing in adults in range from 50 to 70 years old and it is associated with smoking and alcoholism. Aspects as perineural and vascular invasions of the OSCC have been associated with bad prognosis, increased recurrence rates, aggressive behavior, metastasis and low survival. The diagnosis is crucial for proper treatment and, even though it is based on their clinical and histopathological features, it may be improved through immunohistochemistry technique. The purpose of this retrospective study was to identify perineural and vascular invasions in OSCC lesions diagnosed by the Program for Prevention and Early Diagnosis of Oral Cancer and Oral Lesions at Dental School, UFES from 2004 to 2011. Overall, the records of 29 OSSC-diagnosed patients had been found and their clinical and demographic data were collected. In order to determine tumor grading and to identify invasive process, it were performed sections processed through the hematoxiline and eosin staining technique and immunohistochemistry with CD31 and CD34 antibodies to identify vessels and S100 and PGP9.5 antibodies to identify nerves. The obtained data were statistically assessed by qui-square test, Fisher’s exact test, maximum likelihood ration, Kappa test and McNemar’s non-parametric test. It was found 69% of cases with well differentiated tumor grade, significantly related to juxtaposed peritumoral inflammatory infiltrated. Vascular and perineural invasions were found in 17.2% and 31% of cases analyzed through H&E staining, respectively. There was intense peritumoral microvascular density in 82.8% of cases, as immunostaining with CD31. The CD34 antibody recorded 6.9% of cases with vascular invasion. Perineural neoplasic invasion was detected in 44.8% of cases immunostained with S100 protein and in 58.6% of cases immunostained with PGP9.5 protein. On agreement analysis between H&E and immunohistochemistry techniques, as regards presence of perineural invasion, the PGP9.5 protein was more effective than the others. It was concluded that the identification of vascular and perineural neoplasic invasions is a useful tool for the diagnosis and prognosis of patients with OSCC, might be used histopathological and immunohistochemistry methods, being the latter more effective for that analysis.
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Palavras-chave
Squamous cell carcinoma , Neoplasic Invasiveness , CD31 antigens , CD34 antigens , S100 proteins , PGP9.5 human protein , Invasividade neoplásica , Antígenos CD31 , Antígenos CD34 , Proteínas S100 , PGP9.5 proteína humana
Citação
CAVALCANTE, Wanessa Siqueira. Invasão neoplásica perineural e vascular de carcinomas de células escamosas orais : estudo clinicopatológico e imunoistoquímico. 2013. 106 f. Dissertação (Mestrado em Clínica Odontológica) - Programa de Pós-Graduação em Clínica Odontológica, Universidade Federal do Espírito Santo, Vitória, 2013.