Orientador: Fábio Luiz Mialhe / Dissertação (mestrado profissional) - Universidade Estadual de Campinas, Faculdade de Odontologia de Piracicaba. / Made available in DSpace on 2018-08-18T20:57:56Z (GMT). No. of bitstreams: 1 Alves_JoseCarlos_M.pdf: 1402201 bytes, checksum: ea5b0fd1af3d34939a23b18b3244a523 (MD5) Previous issue date: 2011 / Resumo: O câncer bucal é um problema de saúde pública e foi responsável por 13% das mortes no mundo, no ano de 2005. O rastreamento é um método que pode ser aplicado para detectar os indivíduos mais vulneráveis à doença, identificar lesões com e sem suspeita de malignidade oferecer assistência precoce e assim reduzir os danos. Os objetivos deste estudo foram analisar a reprodutibilidade e a acurácia diagnóstica nos exames de rastreamento para detecção de câncer bucal realizado por Cirurgiões Dentistas (CDs) na população de 40 anos de idade e mais, cadastrada no programa saúde da família, implantado em 18 Unidades Básicas de Saúde da Secretaria Municipal da Saúde de São Paulo, sob contrato de gestão da Casa de Saúde Santa Marcelina. Para análise da reprodutibilidade, dados primários, relativos à calibração realizada através das metodologias in lux (30 imagens) e in vivo (560 indivíduos), com 39 CDs, foram coletados de outubro a novembro de 2009. Para a análise da acurácia, dados secundários, relativos ao rastreamento realizado de novembro de 2009 a dezembro de 2010, pelos mesmos profissionais, em 653 indivíduos foram obtidos. Durante a calibração e o rastreamento os indivíduos foram classificados em uma das 3 categorias: (0) tecidos moles aparentemente saudáveis, (1) alterações em tecidos moles sem potencial de malignidade e (2) alterações em tecidos moles com potencial de malignidade. Na calibração pela metodologia in lux, o valor de Kappa interexaminador foi de 0,67, sensibilidade de 93,72%, especificidade de 77,56%, e a acurácia foi de 87,43%. Na calibração in vivo o valor do Kappa interexaminador foi de 0,45, sensibilidade foi de 52,14%, especificidade foi de 90,44% e acurácia foi de 81,78%. No rastreamento os CDs identificaram 336 lesões sendo que o semiologista confirmou 288 casos, sendo 276 sem suspeita de malignidade e 12 com suspeita de malignidade. Dos 12 casos suspeito o exame histológico confirmou 7 casos de câncer bucal. Conclui-se que a reprodutibilidade e a acurácia do teste diagnóstico pode ser avaliada através das metodologias de calibração in lux e in vivo que verificou uma reprodutibilidade boa e regular respectivamente. O rastreamento realizado mostrou uma alta capacidade do CD clínico em diagnosticar lesões na cavidade bucal, porém não se mostrou eficaz na identificação de câncer bucal / Abstract: The oral cancer is a public health problem and was responsible for 13% of deaths worldwide in 2005. The application of screening techniques for identifying malignant lesions and malignant potential is a method that can be applied in order to detect individuals more vulnerable to disease, provide assistance early and thus reduce the damage. The objectives of this study were to analyze the reproducibility and diagnostic accuracy in screening tests for detection of oral cancer by dentists (CDs) in the population 40 years of age or older, enrolled in the family health program, implemented in 18 Basic Units Health of the Municipal Health Secretariat of São Paulo, under the management contract of the Casa de Saúde Santa Marcelina. For reproducibility analysis, primary data relating to the calibration performed using the methodologies in lux (30 images) and in vivo (560 patients), with 39 CDs, were collected. For the analysis of accuracy, secondary data relating to the screening performed by the same professionals in 653 patients were obtained. During calibration and tracking, the subjects were included in one of three categories: (0) soft tissue apparently healthy (1) changes in soft tissues without malignant potential and (2) changes in soft tissue with malignant potential. In the calibration method in lux, the value of inter Kappa was 0.67, sensitivity 93.72%, specificity of 77.56%, the positive and negative predictive value of 86.54 and 87.90 respectively and accuracy of 87.43%. In vivo calibration the value of inter Kappa was 0.45. In the case of tracking the CDs, the semiology confirmed that 276 (95.83%) had no oral lesions and 12 malignant lesions with suspicion of malignancy, and of these seven cases were confirmed as oral cancer. We conclude that the reproducibility of the diagnostic test can be assessed by in vivo calibration methodology found that a regular reproducibility (inter-examiner kappa of 0.45). The screening performed revealed a high-capacity CD clinician in diagnosing lesions in the oral cavity / Mestrado / Odontologia em Saude Coletiva / Mestre em Odontologia em Saúde Coletiva

<p>The Application of Magnetic Resonance (MRI) and Computed Tomography Imaging (CT) in the Diagnosis and Management of Maxillofacial Tumours. For decades maxillofacial surgeons over the world have been frustrated by the high and often fatal recurrence of certain advanced jaw tumours. This study conclusively proves that Computed Tomography and especially Magnetic Resonance Imaging significantly decreases recurrence of Odontogenic Keratocyst and Ameloblastoma and allows surgical planning to avoid these recurrences.</p>

AUTHORS: Stella Chukwu DDS, Daniel Caplan, DDS, PhD, Michelle R. McQuistan, DDS, MS, Alice M. Horowitz, PhD, Christopher Squier PhD, Fang Qian, PhD TITLE: KNOWLEDGE OF RISK FACTORS FOR ORAL CANCER AMONG ADULT IOWANS OBJECTIVE: To gather baseline data from adult Iowans regarding their knowledge, opinions and practices about oral cancer (OC) prevention and early detection; with a focus on their knowledge of risk factors for OC. METHODS: A statewide, computer assisted random-digit dial telephone survey was conducted to gather information about OC prevention and early detection among Iowans age 18 and older. The survey contained 36 questions and lasted about ten minutes per respondent. Telephone numbers included landline and cell phone sampling lists provided by a private survey research firm. RESULTS: Of the 89 % of respondents that answered "yes" when asked if they had ever heard of OC, 54% had high OC risk factor knowledge; while of the eleven percent of those who said they had never heard of OC, 33% had high knowledge (p=0.003). Those that had an OC exam were more likely to have high OC risk factor knowledge (59%) compared with those that answered "no or don't know" to having had an OC exam (45%; p=0.002). Those that were "very or extremely" confident filling out medical forms were more likely to have high OC risk factor knowledge compared to respondents who were "not at all, slightly or moderately" confident filling out forms (54% vs. 45 %; p=0.097). CONCLUSIONS: The results suggest strongly that educational interventions are needed to increase knowledge of OC risk factors, early signs of OC, and the need to promote comprehensive OC examinations by healthcare providers. SOURCE OF FUNDING: Delta Dental of Iowa Foundation

Bibliography: leaves 186-211.

Not available / text

Not available / text

Autofluorescence spectroscopy can improve the early detections of oral cancer. Biochemical and structural changes associated with dysplastic progression alter the optical properties of oral mucosa and cause diagnostically significant differences in spectra from normal and neoplastic sites. This dissertation describes experimental and modeling studies aimed at revealing biological reasons for the diagnostically significant differences observed in depth-resolved fluorescence spectra from normal and neoplastic oral mucosa. An experimental approach, based on high-resolution fluorescence imaging, is used to study the autofluorescence patterns of oral tissue. At UV excitation, most of the epithelial autofluorescence originates from cells occupying the basal and intermediate layers, while stromal signal originates from collagen and elastin crosslinks. With dysplasia, epithelial autofluorescence increases, while autofluorescence from subepithelial stroma drops significantly. Benign lesions also display a drop in autofluorescence from subepithelial stroma, but have different epithelium fluorescence patterns compared to dysplasia. Optical probes that measure mostly stromal fluorescence, may reveal a similar loss of fluorescence intensity and thus fail to distinguish benign inflammation from dysplasia. These results emphasize the importance of using probes with enhanced detection of epithelial fluorescence for improved diagnosis of different types of oral lesions. The second part of this work presents a Monte Carlo model that predicts fluorescence spectra of oral mucosa obtained using a depth-selective probe as a function of tissue optical properties. A model sensitivity analysis determines how variations in optical parameters associated with neoplastic development influence the intensity and shape of spectra, and elucidates the biological basis for differences in spectra from normal and premalignant oral mucosa. Spectra of oral mucosa collected with the depthselective probe, are affected by variations in epithelial optical properties and to a lesser extent by changes in superficial stromal parameters, but not by changes in the optical properties of deeper stroma. Changes in parameters associated with dysplastic progression lead to a decreased fluorescence intensity and a shift of the spectra to longer emission wavelengths. Decreased fluorescence is due to a drop in detected stromal photons, whereas the shift of spectral shape is attributed to an increased fraction of detected photons arising in the epithelium.

The Application of Magnetic Resonance (MRI) and Computed Tomography Imaging (CT) in the Diagnosis and Management of Maxillofacial Tumours. For decades maxillofacial surgeons over the world have been frustrated by the high and often fatal recurrence of certain advanced jaw tumours. This study conclusively proves that Computed Tomography and especially Magnetic Resonance Imaging significantly decreases recurrence of Odontogenic Keratocyst and Ameloblastoma and allows surgical planning to avoid these recurrences. / Doctor Scientiae (Odontology) - DSc(Odont)

<p>The Application of Magnetic Resonance (MRI) and Computed Tomography Imaging (CT) in the Diagnosis and Management of Maxillofacial Tumours. For decades maxillofacial surgeons over the world have been frustrated by the high and often fatal recurrence of certain advanced jaw tumours. This study conclusively proves that Computed Tomography and especially Magnetic Resonance Imaging significantly decreases recurrence of Odontogenic Keratocyst and Ameloblastoma and allows surgical planning to avoid these recurrences.</p>

Orientador: Ricardo Della Coletta / Dissertação (mestrado) - Universidade Estadual de Campinas, Faculdade de Odontologia de Piracicaba / Made available in DSpace on 2018-08-10T10:13:18Z (GMT). No. of bitstreams: 1 Bitu_CarolinaCavalcante_M.pdf: 2697106 bytes, checksum: fa0aa1863121c0b931af7b4d2def776b (MD5) Previous issue date: 2008 / Resumo: Genes homeobox, especialmente os da família HOX, exercem um papel importante no desenvolvimento por meio de um intenso controle da proliferação, diferenciação e morte celular. Os genes HOX também estão relacionados com o surgimento de diferentes tipos de neoplasias, incluindo os cânceres de próstata, ovário, rim, pulmão, pele e leucemias, sendo pouco estudados em câncer oral. O objetivo deste estudo foi quantificar os genes da família HOX, especificamente dos loci A e D, que são expressos em amostras orais de mucosa normal e carcinoma espinocelular (CEC) por meio de ensaios semi-quantitativos de transcriptase reversa-reação em cadeia da polimerase (RT-PCR) ¿duplex¿. Pares de amostras orais de mucosa normal e CEC do mesmo paciente e amostras de mucosa oral normal de indivíduos sem história de tabagismo ou alcoolismo foram utilizadas para este propósito. Adicionalmente, nós avaliamos o perfil de expressão destes genes em linhagens celulares de queratinócitos normais e CEC oral. Nossos resultados demonstraram que os membros HOXA1, HOXA3, HOXA4, HOXA10, HOXA11, HOXA13, HOXD1 e HOXD13 foram expressos em níveis elevados nas linhagens de CEC oral quando comparado com a linhagem de queratinócito normal. Os membros HOXA3, HOXA5, HOXA7, HOXA10, HOXA11, HOXA13, HOXD3, HOXD4 e HOXD12 não foram expressos por nenhuma das amostras de mucosa oral normal provenientes de pacientes não associados a fatores de risco para o CEC oral, enquanto que apenas o membro HOXD12 não foi expresso pelas amostras de mucosa morfologicamente normal proveniente de pacientes portadores de CEC. Comparado às amostras de mucosa normal proveniente de pacientes com e sem fator de risco para CEC oral, nós observamos que as expressões de HOXA1, HOXA2 e HOXD8 foram estatisticamente maiores nas amostras oriundas de indivíduos com história de tabagismo e etilismo. A expressão dos genes HOXA4, HOXA5, HOXA7, HOXA10, HOXD9, HOXD10, HOXD11 e HOXD13 foi significantemente maior nas amostras de CEC oral comparado com mucosa normal, independente da associação com fatores de risco. Interessantemente, os membros HOXA6 e HOXA9 não foram expressos por nenhuma das amostras deste estudo. Estes resultados sugerem que uma expressão desregulada dos membros da família HOX de genes homeobox dos loci A e D foi identificada no desenvolvimento e/ou progressão do CEC oral. / Abstract: Homeobox genes, specifically the HOX family, play an important role in the development by controlling cellular proliferation, differentiation and apoptosis. Expression of HOX genes is associated with many cancers including those of the prostate, ovary, kidney, lung, skin and leukemia, but still there is little understanding of their roles in oral cancer. The aim of this study was to quantify the HOX genes from loci A and D expressed in oral samples from normal mucosa and squamous cell carcinoma (SCC) by semi-quantitative reverse transcriptase-polymerase chain reaction (RT-PCR) duplex method. Normal oral mucosa and oral SCC obtained from the same patient, and normal oral mucosa from patients without history of exposition to risk factors related to oral SCC (smoking habit and alcohol consumption) were included in this study. Additionally, we analyzed the expression profile of those genes in normal keratinocyte and oral SCC cell lines. Our results demonstrated that HOXA1, HOXA3, HOXA4, HOXA10, HOXA11, HOXA13, HOXD1 and HOXD13 were expressed in higher levels in oral SCC cell lines compared with normal keratinocyte cell line. None of the normal oral mucosa samples from patients without risk factors related to oral SCC expressed HOXA3, HOXA5, HOXA7, HOXA10, HOXA11, HOXA13, HOXD3, HOXD4 and HOXD12, whereas only HOXD12 was not expressed by the normal mucosa samples from patients with oral SCC. Comparing the two groups of normal oral mucosa, we found that HOXA1, HOXA2 and HOXD8 had statistically significant higher expression levels in samples from patients with history of smoking habit and alcohol consumption. The expression of HOXA4, HOXA5, HOXA7, HOXA10, HOXD9, HOXD10, HOXD11 e HOXD13 was statistically higher in oral SCC samples when compared with those from normal oral mucosa, regardless of the risk factor association. Interestingly, HOXA6 and HOXA9 were not expressed by either the cell lines or tissue samples. The results of our study suggest that a dysregulated expression of specific members of the loci A and D of the HOX family of homeobox genes may be related to the tumorigenesis and/or tumor progression of oral SCCs. / Mestrado / Patologia / Mestre em Estomatopatologia