Made available in DSpace on 2014-12-17T15:32:28Z (GMT). No. of bitstreams: 1 MartaRP.pdf: 1904281 bytes, checksum: 2912c6b8ea9a773c553d0776245f93a5 (MD5) Previous issue date: 2009-02-27 / Conselho Nacional de Desenvolvimento Cient?fico e Tecnol?gico / The Oral Epithelial Dysplasia (OED) is the lesion that precedes or co-exists with the Oral Squamous Cell Carcinoma (OSCC), presenting molecular and/or histological similar alterations. The divergences about the malignization potential of OEDs and the role of inflammation in this process make hard the early diagnosis and evaluation of OSCCs aggressiveness. Thus, it became the goal of this study to evaluate the role of inflammation in oral carcinogenesis and tumoral aggressiveness. For this purpose a morphological study was performed in 20 OED cases and 40 OSCC cases to detect the malignization potential of OEDs and the histologic malignancy grading (HMG) of OSCCs, analyzing superficial masses for dismorphism evaluation and the invasive front for evaluation of tumoral growing; and immunohistochemical, using anti-CD8, anti-FOXP3, anti-TGF?, anti-TNF? and anti-NF-?B antibodies, comparing their with the types lesion, histological degree and intensity of the inflammatory infiltrate. The results were statistically significant for the parameters: cell maturity (p=0,0001), masses presence (p=0,038) and dismorphism (p=0,037), when associated to HMG. To compare the expression of the markers with the types lesion, a significantly higher expression of CD8 (p=0,001) and NF-?B (p=0,002) in the OED, and also a smaller expression of the epithelial TGF? in the severe OEDs (p=0,011), without significant expression between OSCC degrees. By relating the expression of the studied markers with the inflammatory infiltrate intensity, a positive relation was observed with: inflammatory TNF?(p=0,003), epithelial TNF? and NF-?B (p=0,051 and p=0,004), in OEDs; and with CD8 (p=0,021) and TNF? (p=0,015) in conjunctive OSCCs; and a negative relation with epithelial TNF? (p=0,034) in OSCCs. No significant relation was found between FOXP3 with any of the studied variables. These findings lead to the conclusion that, the study of the invasive front is as important as the study of superficial masses for the evaluation of tumoral aggressiveness; the intensity of the inflammatory infiltrate has no use as a parameter for prognostic evaluation of OSCC in routine exams, but, the molecular events detected in this study may be necessary to give basis for determining the malignant potential in OEDs and aggressiveness in OSCCs / A Displasia Epitelial Oral (DEO) ? a les?o que precede ou co-existe com o Carcinoma Epiderm?ide Oral (CEO), apresentando altera??es moleculares e/ou histol?gicas semelhantes. As diverg?ncias sobre o potencial de maligniza??o das DEO e o papel da inflama??o nestes processos t?m dificultado o diagn?stico precoce e a avalia??o da agressividade dos CEO. Sendo assim, tornou-se objetivo deste estudo avaliar o papel da inflama??o na carcinog?nese oral e agressividade tumoral. Para isso foi realizado estudo morfol?gico em 20 casos de DEO e 40 casos de CEO para detectar o potencial de maligniza??o das DEO e o Grau Histol?gico de Malignidade (GHM) dos CEO, analisando as massas superficiais para avalia??o do dismorfismo e o front invasivo para avalia??o do crescimento tumoral; e imuno-histoqu?mico, utilizando os anticorpos anti-CD8, anti-FOXP3, anti-TGF?, anti-TNF-? e anti-NF-?B, para comparar a express?o dos mesmos com o tipo de les?o, grau histol?gico e intensidade do infiltrado inflamat?rio. Os resultados foram estatisticamente significantes para os par?metros, maturidade celular (p=0,0001), presen?a de massas (p=0,038) e dismorfismo (p=0,037), quando associados aos GHM. Ao comparar a express?o dos marcadores com o tipo de les?o, encontrou-se uma express?o significativamente maior do CD8 (p=0,001) e do NF-?B (p=0,002) nas DEO, assim como uma menor express?o do TGF? epitelial nas DEO severas (p=0,011), n?o tendo express?o significativa entre os graus dos CEO. Ao relacionar a express?o dos marcadores estudados com a intensidade do infiltrado inflamat?rio, observou-se uma rela??o positiva com o TNF? inflamat?rio (p=0,003), o TNF? e o NF-?B epiteliais (p=0,051 e p=0,004), nas DEO; com o CD8 (p=0,021) e o TNF? (p=0,015) no conjuntivo dos CEO; e uma rela??o negativa com o TNF? (p=0,034) epitelial dos CEO. N?o foi encontrada rela??o significativa da FOXP3 com nenhuma das vari?veis estudadas. Esses achados levaram a concluir que, o estudo do front invasivo ? t?o importante quanto o estudo das massas superficiais para avalia??o da agressividade tumoral; a intensidade do infiltrado inflamat?rio n?o pode ser utilizado como par?metro para avalia??o progn?stica do CEO no exame de rotina; mas os eventos moleculares detectados neste estudo podem ser necess?rios para embasar a determina??o do potencial de malignidade nas DEO e da agressividade nos CEO

Made available in DSpace on 2014-12-17T15:32:34Z (GMT). No. of bitstreams: 1 ErickaJDS_tese.pdf: 814077 bytes, checksum: c31b79040c7db1898443078febad2a0d (MD5) Previous issue date: 2007-03-09 / Coordena??o de Aperfei?oamento de Pessoal de N?vel Superior / The progression of the oral squamous cells carcinomas (OSCCs) seems to suffer influence from related factors to the host, as local and systemic immunologic response, which are essential to the antineoplasic defenses. The purpose of this study was evaluate the local immunity in 30 tongue and 20 lower lip SCC by immunohistochemistry method, utilizing antibodies anti-CD3, CD4, -CD8, -CD25 e -ζ(zeta), which immunoexpressions were compared considering the anatomical localization, the intensity of the inflammatory infiltrate into the front of invasion and metastases. The CD4/CD8+ ratio was calculated for each case and associate with the mentioned variable, being the intensity of the inflammatory infiltrated also compared with the anatomical localization and metastase and for this the cases had been grouped in two categories: (n = 10) absent/scarce inflammatory infiltrate; and (n = 40) moderate/intense infiltrate. Fisher?s exact test was performed (α= 0.05) and it was not observed any significant correlation between these groups with anatomical sites and metastases. With regard to the immunoexpression, the CD3+, CD4+, CD8+ and CD25+ cells count was higher in the lower lip SCCs while the anti-ζimmunomarcation was more evident in the non metastatic cases. Through the statistical analyses, it was verified that the CD3 exhibited positive-significant correlation with the inflammatory infiltrate (p = 0.023). Furthermore, antibodies against CD8 and CD25 cells were also significantly correlated with the inflammatory infiltrate (p = 0.002 and 0.030, respectively) and with the anatomical site (p = 0.004 and p = 0.004) mainly in the lower lip SCCs. CD4/CD8 ratio did not show significant association with metastase nor with anatomical localization. We conclude that the inflammatory infiltrated of the Bryne s (1998) system did not constitute an indicator of aggressiveness in the tongue and lower lip SCCs analyzed and that clinical behavior of the SCCs studied was related in part to the immunohistochemical profile of infiltrated the inflammatory present in tumoral invasion front / A progress?o dos carcinomas epiderm?ides orais (CEOs) parece sofrer influ?ncia de fatores relacionados ao hospedeiro, como a resposta imunol?gica local e sist?mica, as quais parecem ser essenciais para a defesa anti-neopl?sica. O presente estudo teve por objetivo analisar a imunidade local em 30 casos de CEs de l?ngua e 20 de l?bio inferior, atrav?s do m?todo da imuno-histoqu?mica, utilizando os anticorpos anti-CD3, -CD4, -CD8, -CD25 e -ζ(zeta), comparando a imunomarca??o em ambas as localiza??es, com a intensidade de infiltrado inflamat?rio no front de invas?o e com presen?a ou n?o de met?stase. A raz?o de c?lulas CD4/CD8+ foi calculada para cada caso e associada com as vari?veis mencionadas, sendo a intensidade do infiltrado inflamat?rio comparada tamb?m com a localiza??o anat?mica e met?stase e para isso os casos foram agrupados em duas categorias (infiltrado escasso ou ausente E/A e infiltrado intenso ou moderado I/M), sendo encontrado 10 casos na categoria E/A e 40 na categoria I/M. Aplicado o teste exato de Fisher n?o verificamos associa??o significativa destes grupos com o s?tio anat?mico ou com met?stase. Em rela??o ? imunomarca??o, a contagem das c?lulas CD3+, CD4+, CD8+ e CD25+ foi maior nos CEs de l?bio inferior e sem met?stase, enquanto que o anti-ζfoi mais expresso apenas nos casos sem met?stase. Atrav?s da an?lise estat?stica verificou-se que os anticorpos anti-CD3, anti-CD8 e anti-CD25 exibiram associa??o significativa positiva com o infiltrado inflamat?rio (p=0.023, p=0.002 e p=0.030, respectivamente); e os anticorpos anti-CD8 a anti-CD25 estiveram associados de forma positiva com a localiza??o anat?mica, ambos com valores de p=0.004, estando estes mais presentes nos CEs de l?bio inferior. A raz?o CD4/CD8 n?o exibiu associa??o significativa com met?stase nem com localiza??o anat?mica. Conclu?mos que o padr?o infiltrado inflamat?rio da grada??o histol?gica de malignidade de Bryne (1998) n?o constituiu um indicador de agressividade nos CEs de l?ngua e l?bio inferior analisados, e que o comportamento cl?nico dos CEs estudados esteve relacionado em parte ao perfil imuno-histoqu?mico do infiltrado inflamat?rio presente no front de invas?o tumoral