Introdução. O Tumor Odontogênico Queratocístico (TOQC) é uma lesão de origem odontogênica que se apresenta exclusivamente nos ossos gnáticos e possui alto potencial de agressividade local. Pode estar associado à Síndrome do Carcinoma Nevóide Basocelular (SCNBC), que se caracteriza por apresentar inúmeras alterações de desenvolvimento, múltiplos carcinomas basocelulares (CBCs) além de anormalidades esqueléticas. Cerca de 65 a 100% dos pacientes com a síndrome podem apresentar múltiplos TOQCs. Objetivo. Avaliar e correlacionar os achados clínicos, histopatológico e expressão imunoistoquímica (IQ) dos marcadores de prognóstico (p53 e ki-67) e de histogênese tumoral (Citoqueratinas 14, 17 e 19) em TOQCs associados ou não à SCNBC diagnosticados entre 1970 e 2009 no Hospital AC Camargo, São Paulo. Pacientes e Métodos. Estudo retrospectivo em que foram avaliados 74 pacientes, 60 não portadores da SCNBC (Grupo 1) e 14 portadores da SCNBC (Grupo 2). Os dados clínicos dos pacientes foram obtidos a partir dos prontuários médicos e sumarizados em fichas clínicas padronizadas para o estudo. Os pacientes do Grupo 1 apresentaram 61 TOQCs primários e 15 TOQCs recorrentes. O Grupo 2 apresentou 31 TOQCs primários e 8 recorrentes. Resultados. No Grupo 1, houve predomínio de pacientes nas 3ª e 4ª décadas de vida e no Grupo 2, na 2ª década (p = 0.02). De acordo com o sexo, houve predileção pelas mulheres em ambos os Grupos (53,33% no Grupo 1 e 64,29% no Grupo 2). A mandíbula foi mais frequentemente acometida nos dois Grupos (81,96% no Grupo 1 e 58,06% no Grupo 2). Contudo, a discrepância em relação à distribuição entre mandíbula e maxila foi menor no Grupo 2 (p = 0.009). O padrão radiográfico multilocular foi mais frequente no Grupo 1 (39,34%) e unilocular no Grupo 2 (48,39%) (p = 0.008). A associação de enucleação e curetagem foi frequentemente realizada em ambos os Grupos (55,74% no Grupo 1 e 96,78 no Grupo 2). A taxa de recorrência foi de 21,31% no Grupo 1 e 22,58% no Grupo 2. As manifestações clínicas mais comuns dos pacientes com SCNBC foram CBCs, calcificação da foice cerebral e pits palmares. De acordo com a análise imunoistoquímica dos marcadores CQ 14, CQ 17, CQ 19, p53 e ki-67, não foram observadas diferenças no padrão de expressão entre os Grupos de TOQCs avaliados. Conclusões. Os TOQCs associados à SCNBC acometem mais frequentemente indivíduos do sexo feminino e em idade mais precoce do que os TOQCs esporádicos. Múltiplos TOQCs foram frequentemente observados em pacientes sindrômicos e consequentemente houve menor discrepância em relação à distribuição entre mandíbula e maxila. O aspecto radiográfico unilocular é mais frequente em TOQCs associados à SCNBC e multilocular em TOQCs esporádicos. As taxas de recorrências foram similares em TOQCs associados e não associados à SCNBC. / Introduction. Keratocystic odontogenic tumor (KCOT) is a lesion of odontogenic origin which arise exclusively in gnatic bones and demonstrates high potential of local aggressiveness. KCOT may be associated with Nevoid Basal Cell Carcinoma Syndrome (NBCCS) which is characterized by development defects, multiple basal cell carcinoma (BCC) and skeletal anomalies. Around 65 to 100% of patients with NBCCS present multiple KCOT affecting jaws. Objective. Evaluate clinical, histopathological and immunohistochemical (IHC) expression of prognostic markers (p53 and ki-67) and tumor histogenesis (citokeratin 14, 17 and 19) in KCOT associated or not to NBCCS diagnosed between 1970 and 2009 at AC Camargo Hospital (São Paulo). Patients and methods. Retrospective study which has evaluated 74 patients, being 60 not associated with NBCCS (Group 1) and 14 associated with NBCCS (Group 2). Clinical data of patients was obtained from medical charts and summarized into standardized records for this study. The patients of Group 1 presented 61 primary KCOT and 15 recurrent KCOT. Group 2 presented 31 primary KCOT and 8 recurrent KCOT. Results. In Group 1, patients was frequently affected in 3rd and 4th decades and Group 2, in 2nd decade (p = 0.02). According to gender, a predilection for females was observed in both groups (53.33% in Group 1 and 64.29% in Group 2). The mandible was more affected in both Groups (81.96% in Group 1 e 58.06% in Group 2). However, the discrepancy regarding the distribution between mandible and maxilla was shorter in Group 2 (p = 0.009). Radiographic pattern more observed was multilocular in Group 1 (39.34%) and unilocular in Group 2 (48.39%) (p = 0.008). The treatment mostly performed was association of enucleation and curettage in both Groups (55.74% in Group 1 and 96.78 and Group 2). Recurrent rates were 21.31% in Group 1 and 22.58% in Group 2. Most clinical manifestations of NBCCS patient´s beyond KCOT were BCC, falx cerebri calcification and palmar pits. According to IHC analyses of Ck14, Ck 17, Ck19, p53 and ki-67, there were no differences of expression in all groups of KCOT evaluated. Conclusions. KCOT associated with NBCCS affects more commonly female individuals and in earlier age than in KCOT not related to NBCCS. Multiple KCOT were frequently observed in patients with NBCCS and consequently there was less discrepancy in relation to the distribution between maxilla and mandible. Multilocular pattern is more frequent in sporadic KCOT and unilocular in syndromic KCOT. Recurrence rates were similar in KCOT associated and not associated to NBCCS.

Made available in DSpace on 2017-07-10T14:57:30Z (GMT). No. of bitstreams: 1 Dissertacao_Renata Zoraida_ Rizental Delgado.pdf: 2641394 bytes, checksum: c9a23494ed97bde58dcc144b147a740f (MD5) Previous issue date: 2015-02-20 / Coordenação de Aperfeiçoamento de Pessoal de Nível Superior / Introduction: Gorlin syndrome (GS) also known as Nevoid Basal Cell Carcinoma Syndrome, is a rare disease resulting from mutations in Patched-1 gene and characterized by triad of disorders comprising multiple basal cell carcinomas, numerous keratocystic odontogenic tumors (KOT) and skeletal abnormalities. About 90% of patients develop KOTs in gnathic bones, preferably in the posterior mandible, presenting radiographically as radiolucent lesions uni- or multilocular. Studies suggests that KOTs associated with GS (KOTGSs) have distinct and more aggressive behavior compared to those who developing sporadically (KOTSPs). Objectives: This study aimed at comparing clinical, histopathological and immunohistochemical features of KOTSPs and KOTGSs from different institutions in Brazil and abroad, and understand the role of proteins associated with proliferation/cell cycle (p53, p63 and Ki-67), the alpha-smooth muscle actin (α-SMA) and syndecan-1 (CD138) in an attempt to associate the expression with biological behavior of KOTs. Methodology: Were previously reviewed and selected 30 KOTGSs and 8 KOTSPs, in which were performed qualitative and semi-quantitative analysis histopathological and immunohistochemical to p53, p63, Ki-67, SMA and CD138. Results: 30 cases of KOTGSs were obtained from 12 patients with GS, 5 females (41.66%) and 7 men (58.33%); whereas in group of KOTSPs, 5 cases (62.50%) was in females and 3 males (37.50%). About 58.33% of patients with GS had more than one lesion throughout life. The average age of individuals with GS was 14.66 ± 16.81 years, while in patients with KOTSPs was 41 ± 39.59. The predominant radiographic pattern was radiolucent unilocular, preferably affecting the posterior mandible. Histopathological features in both groups was analyzed, and the most frequent was pleomorphism in KOTGSs. In addition, there was increased expression of p53 and p63 in KOTGSs and similar expression of SMA and Ki-67 between groups. It was also observed that there was a lower reactivity for CD138 in the basal epithelial layer of KOTGSs and stromal expression of CD138 was similar between the groups. Conclusions: Agressiveness of KOTGSs can be explained by increased cellular pleomorphism rate and expression of p53 and p63 and tendency to loss of syndecan-1 expression compared to KOTSPs. / Introdução: A Síndrome de Gorlin (SG) também conhecida como Síndrome do Carcinoma Nevóide Basocelular, é uma doença rara resultante de mutações no gene Patched-1 e caracterizada por uma tríade de alterações que inclui múltiplos carcinomas basocelulares, numerosos tumores odontogênicos queratocísticos (TOQs) e anormalidades esqueléticas. Cerca de 90% dos portadores desenvolvem TOQs no interior dos ossos gnáticos, preferencialmente na região posterior da mandíbula, apresentando-se radiograficamente como lesões radiolúcidas uni ou multiloculares. Estudos têm sugerido que os TOQs associados à SG (TOQSG) apresentam comportamento distinto e mais agressivo em comparação àqueles que desenvolvem-se de modo esporádico (TOQEs). Objetivos: O presente estudo teve como objetivo analisar comparativamente os aspectos clínicos, histopatológicos e imuno-histoquímicos de TOQEs e TOQSGs oriundos de diferentes instituições do Brasil e do exterior, além de entender o papel de proteínas associadas com proliferação/ciclo celular (p53, p63 e Ki-67), da actina de músculo liso-alfa (α-SMA) e da proteína sindecano-1 (CD138), na tentativa de associar a expressão das mesmas com o comportamento biológico dos TOQs. Metodologia: Foram previamente revisados e selecionados 30 TOQSGs e 8 TOQEs, nos quais foram realizadas análises qualitativas e semi-quantitativas histopatológicas e imuno-histoquímicas para p53, p63, Ki-67, AML e CD138. Resultados: Trinta casos de TOQSGs foram obtidos de 12 pacientes com SG, 5 do gênero feminino (41,66%) e 7 do gênero masculino (58,33%); ao passo que no grupo dos TOQEs, 5 casos (62,50%) acometeram o gênero feminino e 3 o masculino (37,50%). Cerca de 58,33% dos pacientes com SG apresentaram mais de uma lesão ao longo da vida. A média de idade dos indivíduos com SG foi de 16,81 anos ± 14,66 enquanto dos portadores de TOEs foi de 41 anos ± 39,59. O padrão radiográfico predominante foi o radiolúcido unilocular, afetando preferencialmente a região posterior de mandíbula. Foram avaliadas as características histopatológicas de ambos os grupos de lesões, sendo o pleomorismo celular mais frequente nos TOQSGs. Além disso, observou-se maior expressão de p53 e p63 nos TOQSG e expressão similar de AML e Ki-67 entre os grupos. Observou-se ainda que houve menor reatividade para CD138 no estrato epitelial basal dos TOQSGs e a expressão estromal de CD138 foi similar entre os grupos analisados. Conclusões: A maior agressividade dos TOQSGs pode ser explicada pela maior taxa de pleomorfismo celular, maior expressão de p53 e p63 e tendência à perda de expressão de sindecano-1 quando comparados aos TOQEs.

Introdução. O Tumor Odontogênico Queratocístico (TOQC) é uma lesão de origem odontogênica que se apresenta exclusivamente nos ossos gnáticos e possui alto potencial de agressividade local. Pode estar associado à Síndrome do Carcinoma Nevóide Basocelular (SCNBC), que se caracteriza por apresentar inúmeras alterações de desenvolvimento, múltiplos carcinomas basocelulares (CBCs) além de anormalidades esqueléticas. Cerca de 65 a 100% dos pacientes com a síndrome podem apresentar múltiplos TOQCs. Objetivo. Avaliar e correlacionar os achados clínicos, histopatológico e expressão imunoistoquímica (IQ) dos marcadores de prognóstico (p53 e ki-67) e de histogênese tumoral (Citoqueratinas 14, 17 e 19) em TOQCs associados ou não à SCNBC diagnosticados entre 1970 e 2009 no Hospital AC Camargo, São Paulo. Pacientes e Métodos. Estudo retrospectivo em que foram avaliados 74 pacientes, 60 não portadores da SCNBC (Grupo 1) e 14 portadores da SCNBC (Grupo 2). Os dados clínicos dos pacientes foram obtidos a partir dos prontuários médicos e sumarizados em fichas clínicas padronizadas para o estudo. Os pacientes do Grupo 1 apresentaram 61 TOQCs primários e 15 TOQCs recorrentes. O Grupo 2 apresentou 31 TOQCs primários e 8 recorrentes. Resultados. No Grupo 1, houve predomínio de pacientes nas 3ª e 4ª décadas de vida e no Grupo 2, na 2ª década (p = 0.02). De acordo com o sexo, houve predileção pelas mulheres em ambos os Grupos (53,33% no Grupo 1 e 64,29% no Grupo 2). A mandíbula foi mais frequentemente acometida nos dois Grupos (81,96% no Grupo 1 e 58,06% no Grupo 2). Contudo, a discrepância em relação à distribuição entre mandíbula e maxila foi menor no Grupo 2 (p = 0.009). O padrão radiográfico multilocular foi mais frequente no Grupo 1 (39,34%) e unilocular no Grupo 2 (48,39%) (p = 0.008). A associação de enucleação e curetagem foi frequentemente realizada em ambos os Grupos (55,74% no Grupo 1 e 96,78 no Grupo 2). A taxa de recorrência foi de 21,31% no Grupo 1 e 22,58% no Grupo 2. As manifestações clínicas mais comuns dos pacientes com SCNBC foram CBCs, calcificação da foice cerebral e pits palmares. De acordo com a análise imunoistoquímica dos marcadores CQ 14, CQ 17, CQ 19, p53 e ki-67, não foram observadas diferenças no padrão de expressão entre os Grupos de TOQCs avaliados. Conclusões. Os TOQCs associados à SCNBC acometem mais frequentemente indivíduos do sexo feminino e em idade mais precoce do que os TOQCs esporádicos. Múltiplos TOQCs foram frequentemente observados em pacientes sindrômicos e consequentemente houve menor discrepância em relação à distribuição entre mandíbula e maxila. O aspecto radiográfico unilocular é mais frequente em TOQCs associados à SCNBC e multilocular em TOQCs esporádicos. As taxas de recorrências foram similares em TOQCs associados e não associados à SCNBC. / Introduction. Keratocystic odontogenic tumor (KCOT) is a lesion of odontogenic origin which arise exclusively in gnatic bones and demonstrates high potential of local aggressiveness. KCOT may be associated with Nevoid Basal Cell Carcinoma Syndrome (NBCCS) which is characterized by development defects, multiple basal cell carcinoma (BCC) and skeletal anomalies. Around 65 to 100% of patients with NBCCS present multiple KCOT affecting jaws. Objective. Evaluate clinical, histopathological and immunohistochemical (IHC) expression of prognostic markers (p53 and ki-67) and tumor histogenesis (citokeratin 14, 17 and 19) in KCOT associated or not to NBCCS diagnosed between 1970 and 2009 at AC Camargo Hospital (São Paulo). Patients and methods. Retrospective study which has evaluated 74 patients, being 60 not associated with NBCCS (Group 1) and 14 associated with NBCCS (Group 2). Clinical data of patients was obtained from medical charts and summarized into standardized records for this study. The patients of Group 1 presented 61 primary KCOT and 15 recurrent KCOT. Group 2 presented 31 primary KCOT and 8 recurrent KCOT. Results. In Group 1, patients was frequently affected in 3rd and 4th decades and Group 2, in 2nd decade (p = 0.02). According to gender, a predilection for females was observed in both groups (53.33% in Group 1 and 64.29% in Group 2). The mandible was more affected in both Groups (81.96% in Group 1 e 58.06% in Group 2). However, the discrepancy regarding the distribution between mandible and maxilla was shorter in Group 2 (p = 0.009). Radiographic pattern more observed was multilocular in Group 1 (39.34%) and unilocular in Group 2 (48.39%) (p = 0.008). The treatment mostly performed was association of enucleation and curettage in both Groups (55.74% in Group 1 and 96.78 and Group 2). Recurrent rates were 21.31% in Group 1 and 22.58% in Group 2. Most clinical manifestations of NBCCS patient´s beyond KCOT were BCC, falx cerebri calcification and palmar pits. According to IHC analyses of Ck14, Ck 17, Ck19, p53 and ki-67, there were no differences of expression in all groups of KCOT evaluated. Conclusions. KCOT associated with NBCCS affects more commonly female individuals and in earlier age than in KCOT not related to NBCCS. Multiple KCOT were frequently observed in patients with NBCCS and consequently there was less discrepancy in relation to the distribution between maxilla and mandible. Multilocular pattern is more frequent in sporadic KCOT and unilocular in syndromic KCOT. Recurrence rates were similar in KCOT associated and not associated to NBCCS.

Notre équipe a développé un protocole d’ingénierie de l’organe dentaire basé sur la biomimétique et l’utilisation de cellules dentaires embryonnaires dissociées. La recherche de ressources cellulaires permettant d’éviter le recours aux cellules embryonnaire reste un défi majeur, et nécessite une meilleure connaissance des paramètres limitants. Nous avons testé les potentialités odontogènes de lignées cellulaires, dentaires ou non, embryonnaires ou adultes. Le développement dentaire étant contrôlé par des interactions réciproques entre ectomésenchyme dérivé des crêtes neurales et épithélium, ces cellules ont été réassociés à un épithélium dentaire compétent. Nous avons recherché la formation de dents in vitro et/ou après implantation chez la souris adulte et étudié un certain nombre de paramètres biologiques et techniques. Ainsi, nous avons étudié l’impact de l’âge, de la mise en culture, et de l’hétérogénéité cellulaire sur les potentialités odontogènes des cellules mésenchymateuses. Nos résultats montrent que le potentiel odontogène des différentes lignées mésenchymateuses testées pouvait être lié à l’âge des cellules et qu’il est perdu lorsque les cellules mésenchymateuses sont cultivées avant d’être ré-associées. Ceci pouvant s’expliquer par un changement phénotypique, nous avons testé un certain nombre de gènes essentiels au développement dentaire, et suivi l’expression de marqueurs de surface. Les changements observés peuvent être liés à une sélection cellulaire in vitro pouvant conduire à des modifications de l’hétérogénéité des cellules en monocouche. / Our laboratory has developed a protocol for tooth organ engineering, based on biomimetic and the use of dissociated embryonic dental cells. Searching for mesenchymal cell sources avoiding the use of embryonic cells still remains a major challenge. We tested the odontogenic potential of several cell lines, dental or not, embryonic or adult. These cells were re-associated with a competent intact dental epithelium. We searched for tooth formation in vitro and/or after implantation in adult mice and studied different biological and technical parameters. For this purpose we analyzed the effects of the age, of a pre-culture step, and of the cellular heterogeneity on the odontogenetic potential of mesenchymal cells. To test the heterogeneity, we compared the patterns of expression of cell surface markers in cultured and implanted re-association with those observed during tooth development..Our results show that the absence of odontogenetic potential in the different cell lines that were tested, in part depends on the age of cells and that it is lost when mesenchymal cells are cultured in monolayer before their re-association. This could be explained by phenotypical changes as shown by testing several genes involved in tooth development, and tracing cell surface markers expression. Changes were observed, wich could be related to a cell selection in vitro, leading to variations in cellular heterogeneity. Indeed, pulpal cellular heterogeneity shows specific patterns of expression, that are space-time defined during tooth development, and is controlled by epithelial-mesenchymal interactions.

Made available in DSpace on 2014-12-17T15:32:15Z (GMT). No. of bitstreams: 1 BetaniaFR.pdf: 636142 bytes, checksum: 6061eebe55028f4725bba3031ee70b7a (MD5) Previous issue date: 2008-02-26 / Conselho Nacional de Desenvolvimento Cient?fico e Tecnol?gico / Ameloblastoma and adenomatoid odontogenic tumor are odontogenic tumors arising from the odontogenic epithelium with distinct clinical behavior. In attempt to comprehend the interaction between the odontogenic tumor cells and the extracellular matrix, the present work evaluated and compared the immunohistochemical expression of the matrix metalloproteinases-1 (MMP-1), -2 (MMP-2) and -9 (MMP-9) in 20 cases of ameloblastoma and 10 adenomatoid odontogenic tumor. MMP-1 exhibited exuberant expression in the parenchyma and in the stroma of both studied tumors, while the MMP-2 showed varied expression with about of 80% and 60% of the neoplastic cells exhibiting positivity in the ameloblastoma and adenomatoid odontogenic tumor, respectively. With relation to the MMP-2 expression by the mesenchymal cells, it was observed that 65% of the ameloblastoma and 80% of the adenomatoid odontogenic tumor were positive. The immunoreactivity of MMP-9 was detected in all studied cases, although its expression had occurred predominantely in less than 50% of the parenchyma cells of the ameloblastoma, while in about of 60% of the adenomatoid odontogenic tumor more than 50% of cells were positive. The mesenchymal cells were positive to MMP-9 in 65% of the ameloblastoma and in 80% of the adenomatoid odontogenic tumor, respectively. Statistically significant difference was observed to the MMP-1 expression with relation to MMP-2 and MMP-9 in the ameloblastoma (p < 0.001). It was not possible to perform statistical analysis to the cases of adenomatoid odontogenic tumor, however there was a tendency toward a differential expression of the MMP-1 with relation to other studied MMPs. These results suggest that MMP-1, - 2 and -9 are implicated in the growth and progression of both tumors analyzed as well as the more pronounced participation of the stroma in the ameloblastoma could together to be related to the higher clinical aggressiveness / O ameloblastoma e o tumor odontog?nico adenomat?ide s?o tumores odontog?nicos derivados do epit?lio odontog?nico que possuem comportamentos distintos. Na tentativa de compreender a intera??o existente entre as c?lulas tumorais e a matriz extracelular, o presente trabalho teve como objetivo avaliar e comparar a express?o das metaloproteinases-1 (MMP-1), -2 (MMP-2) e -9 (MMP-9), atrav?s da t?cnica imuno-histoqu?mica em 20 casos de ameloblastoma e 10 de tumor odontog?nico adenomat?ide. A MMP-1 teve uma marca??o predominante nos dois tumores, sendo observada tanto no par?nquima como no estroma de todos os tumores estudados. Para a MMP-2, observou-se uma express?o variada, sendo 80% e 60% das c?lulas tumorais imunorreativas nos ameloblastomas e tumores odontog?nicos adenomat?ides, respectivamente. Em rela??o ?s c?lulas do mes?nquima, 65% dos ameloblastomas e 80% tumores odontog?nicos adenomat?ides exibiram positividade. Verificou-se imunoexpress?o para a MMP-9 nas c?lulas parenquimatosas e estromais em todos os casos, sendo que nos ameloblastomas, houve o predom?nio de menos de 50% das c?lulas imunomarcadas; enquanto que em 60% dos tumores odontog?nicos adenomat?ides mais de 50% das c?lulas apresentaram positividade. Observou-se diferen?a estatisticamente significante na express?o da MMP-1 em rela??o ? MMP-2 e -9 nos ameloblastomas (p<0,001). A an?lise estat?stica n?o p?de ser aplicada para os tumores odontog?nicos adenomat?ides, por?m verificou-se tend?ncia de maior express?o da MMP-1 em rela??o ?s outras MMPs avaliadas. Os resultados deste estudo sugerem que as MMPs-1, -2 e -9 est?o relacionadas com crescimento e progress?o dos tumores analisados e, particularmente no ameloblastoma, sua maior agressividade pode resultar, em parte, pela participa??o tamb?m do estroma presente de forma bem mais marcante permeando o par?nquima tumoral e sendo fonte tamb?m das proteases estudadas

Made available in DSpace on 2014-12-17T15:32:17Z (GMT). No. of bitstreams: 1 GustavoPG.pdf: 468493 bytes, checksum: 5f74059b167ef7c7965d0eddca9dca0c (MD5) Previous issue date: 2006-05-19 / Coordena??o de Aperfei?oamento de Pessoal de N?vel Superior / The aim of this study was to evaluate the clinical and pathological features of cases diagnosed as dentigerous cyst by the Department of Oral Pathology, School of Dentristy at the Federal University of Rio grande do Norte, attempting the possible correlation between histomorphological findings and epidemiological data contained at the files of the patients, in order to define a suggested variation of lesion named inflammatory dentigerous cyst. It was verified that dentigerous cyst are more frequently present in the earfy three decades of life, with the majority of cases occuring in the second decade (40,740/0 ), and also male (57,41%) and white patients (68,52%) were most affected. In relation to anatomic site, the dentigerous cyst was more prevalent at anterior maxila and posterior mandible, showing, usually, a slow growth pattem. The majority of lesions were asymptomatic and the radiographic observed was frequently na unilocular radiolucency. In regard to the histomorphological analysis, it was noticed that the lesions showed commonly a thin epithelium, with a capsule of fibrous connective tissue, richly vascularized and collagenized with an intense mononuclear inflammatory infiltrate. Finally, clinicopathological was performed and it was find out that cysts that showed a thick epithelium, with a high degree of vascularization and collagenization, intense inflammatory infiltrate in the cystic capsule, were located in the pre-molares region, in patients under 12 years old and the majority showing painfull sintomatology, properly, compatible with inflammatory dentigerous cyst. The findings of the present study indicate that, probably, there is a variant of the dentigerous cyst, and therefore, we suggest the denomination inflammatory follicular cyst for this entity / Este estudo teve como objetivo realizar uma analise clinicopatologica de casos diagnosticados como cisto dentigeno na Disciplina de Patologia Oral do Departamento de Odontologia da UFRN,enfatizando uma possivel correla??o entre os achados histomorfologicos e os dados epidemiologicos constantes nas fichas de solicita??o de exame histopatologico,no intuito de caracterizar uma possivel variante da les?o,denominada cisto dentigero de origem inflamatoria.Foi verificado que o cisto dentigero apresentou-se com maior frequencia nas tres primeiras decadas de vida,com maior numero de casos observados na segunda decada(40,74%);tendo sido o genero masculino o mais afetado,com 57,41% dos casos,e os pacientes leucodermas os mais acometidos com 68,52% da amostra total.A regiao anatomica mais atingida foi a anterior de maxila e a posterior de mandibula, sendo o padrao de crescimento lento o mais comumente observado.A maioia das lesoes apresentou-se assintomatica,e o aspecto radiografico frequentemente identificado foi o radiolucido inilocular.Quanto a analise histomorfologica,observou-se que as lesoes

Made available in DSpace on 2014-12-17T15:32:22Z (GMT). No. of bitstreams: 1 CassianoFWN.pdf: 2062817 bytes, checksum: d3cc1231e84c63282116f5950923db98 (MD5) Previous issue date: 2006-02-23 / Conselho Nacional de Desenvolvimento Cient?fico e Tecnol?gico / The odontogenic myxoma shares cellular and structural aspects with dental papilla, which has been implicated as probable origin of this neoplasm. The aim of the present study was to perform a comparative immunohistochemical analysis for the expression of collagenase-1 (MMP-1) and gelatinases A (MMP-2) and B (MMP-9) in odontogenic myxomas and dental papilla of teeth germs. Twelve cases of odontogenic myxomas and eight specimens of teeth germs were selected. It was taken into consideration the presence or absence of immunoreactivity, the pattern of immunohistochemical distribution of proteases within extracellular matrix, as well as, the number of cells revealing immunostaining for matrix metalloproteinases (MMPs). It was verified a significant difference (p<0,05) in relation to MMP-2 immunoexpression, which was observed only within extracellular matrix of myxomas. Nevertheless, MMP-1 labeling was revealed by most of the cases of odontogenic myxoma, at levels close to those observed in dental papilla. In relation to the pattern of distribution, a significant difference was obtained between specimens (p<0,05), with neoplasms predominantly exhibiting a focal pattern for MMP-1. The quantitative analysis of neoplastic cells labeled for MMPs denoted a significant difference (p<0,05), demonstrating a higher proportion of MMP-1 in comparison to MMPs-2 and -9. It can be concluded that immunohistochemical expression of MMP-1 at levels comparable to those observed in dental papilla and quantitatively superior in relation to MMPs-2 and -9, suggest an implication of this protease on extracellular matrix degradation of odontogenic myxomas. Moreover, the possibility of interactions with receptors involved in cellular adhesion, particularly with integrins, suggests a plausible function on local invasiveness of such neoplasms. Additionally, the presence of a descent immunoexpression gradient for these MMPs on odontogenic myxomas, associated to substrate specificity inherent in each enzyme, suggest the existence of a coordinated mechanism between interstitial collagenase and gelatinases A and B in order to allow an efficient degradation of extracellular matrix and local invasion by neoplastic cells / O mixoma odontog?nico compartilha aspectos celulares e estruturais com a papila dent?ria, tendo-se implicado esta ?ltima como prov?vel origem deste neoplasma. O prop?sito desta pesquisa consistiu em analisar comparativamente a express?o imuno-histoqu?mica de colagenase-1 (MMP-1) e gelatinases A (MMP-2) e B (MMP-9) em mixomas odontog?nicos e papilas de germes dent?rios. Foram selecionados 12 casos de mixoma odontog?nico e 08 esp?cimes de germes dent?rios, para an?lise da presen?a ou aus?ncia de express?o imunohistoqu?mica e padr?o de distribui??o destas proteases em meio ? matriz extracelular, bem como, o n?mero de c?lulas positivamente marcadas para estas metaloproteinases de matriz (MMPs). Constatou-se diferen?a significativa (p<0,05) em rela??o ? imunorreatividade para MMP-2, apresentando-se expressa apenas em meio ? matriz extracelular dos mixomas. Para MMP-1 foi verificada imunorreatividade na maioria dos casos de mixomas, com propor??es semelhantes ?s constatadas nas papilas dent?rias. Em rela??o ao padr?o de distribui??o, evidenciou-se diferen?a significativa apenas para MMP-1 (p<0,05), com predomin?ncia do padr?o focal nos neoplasmas. Por sua vez, a quantidade de c?lulas imunorreativas ?s proteases, nos mixomas odontog?nicos, revelou diferen?as significativas (p<0,05), estando a MMP-1 presente em maiores propor??es, em compara??o com as MMPs-2 e -9. Concluiu-se que a express?o de MMP-1, em n?vel compar?vel ao constatado nas papilas de germes dent?rios e numericamente superior ?s MMPs-2 e -9, sugere a implica??o desta protease no processo de degrada??o da matriz extracelular nos mixomas odontog?nicos e, em decorr?ncia da possibilidade de associa??o das MMPs a receptores envolvidos no processo de ades?o celular, especialmente ?s integrinas, ainda um prov?vel papel na invasividade local destes neoplasmas. Adicionalmente, a evidencia??o de um gradiente descendente na express?o imuno-histoqu?mica das MMPs nos mixomas odontog?nicos, associada ? especificidade de substrato inerente a cada uma destas proteases, sugerem a exist?ncia de um mecanismo coordenado entre colagenase intersticial e gelatinases A e B, direcionado ? degrada??o eficiente da matriz extracelular e invas?o local por parte das c?lulas neopl?sicas

Made available in DSpace on 2014-12-17T15:32:22Z (GMT). No. of bitstreams: 1 MarceloABN_DISSERT.pdf: 4711000 bytes, checksum: ea3602bfcefe0d8448e9d402030634a2 (MD5) Previous issue date: 2014-02-14 / Coordena??o de Aperfei?oamento de Pessoal de N?vel Superior / BMPs are components superfamily ligands transformation growth fator-&#946; (TGF-&#946;) secreted into the extracellular environment, with mechanisms of intercellular communication through specific ligands and receptors in various target cells, being recognized for its influence in osteogenic induction, also play an important role in tissue homeostasis, cell proliferation, differentiation control , in addition to being present in the development of various malignancies. The aim of this study was to compare the immunohistochemical expression of BMP-2, BMP-4 and its receptors BMPRIA and BMPRII in cases of ameloblastoma and adenomatoid odontogenic tumor. The sample consisted of 20 cases of solid ameloblastoma (SA), 10 cases of ameloblastoma unicystic (UA) and 16 cases of adenomatoid odontogenic tumor (AOT). The expression of BMPs and their receptors was evaluated in the parenchyma and stroma of lesions, establishing the percentage of immunopositive cells (0 - negative; 1-1 % to 10 % of cells positive; 2 - 11% to 25% of positive cells; 3 - 26% to 50% of cells positive; 4 - 51% to 75 % of positive cells; 5 - more than 75% positive cells). Analysis of the expression of BMP-2 revealed no statistically significant differences in parenchymal (p = 0.925) and stromal component (p = 0.345) between the groups, as well as BMP-4 (p = 0.873 / p = 0.131). In the epithelial component, SA and AOT had a higher frequency of score 5. In turn, all cases of UA were classified as score 5. The analysis of the stromal component showed no statistically significant difference between groups with respect to median scores BMPRIA positivity (p = 0.768) and BMPRII (p = 0.779). In the epithelial component of SA and UA, no statistically significant correlations between imunoexpression proteins analyzed were observed. In turn, the group of AOT, statistically significant positive correlations between the scores of expression of all studied proteins were found. In the stromal component, statistically significant positive correlations were found only in the SA group in BMP -4 and BMPRII (r = 0.476; p = .034), in the UA in BMP-4 and BMPRIA (r = 0.709; p = 0.022). The results of this study suggest that the BMPs and their receptors are involved in the development process odontogenic tumors. BMP-4, in turn, besides being present in odontogenic tumors have the capacity to form mineralized material. / As BMPs s?o componentes da superfam?lia de ligantes do fator transformador de crescimento-&#946; (TGF-&#946;), secretados no meio extracelular, com mecanismos de comunica??o intercelular por meio de ligantes e receptores espec?ficos em diversas c?lulas-alvo, sendo reconhecidas por sua influ?ncia na indu??o osteog?nica, tamb?m desempenhando importante papel na homeostase tecidual, prolifera??o celular, no controle de diferencia??o, al?m de estar presente no desenvolvimento de diversas neoplasias. O objetivo deste estudo foi comparar a express?o imuno-histoqu?mica da BMP-2, BMP-4 e seus receptores BMPRIA e BMPRII em casos de Ameloblastoma e Tumor odontog?nico adenomat?ide. A amostra foi constitu?da de 20 casos de Ameloblastoma s?lido (AS), 10 casos de Ameloblastoma unic?stico (AU) e 16 casos de Tumor odontog?nico adenomat?ide (TOA). A express?o das BMPs e seus receptores foi avaliada no par?nquima e estroma das les?es, estabelecendo-se o percentual de c?lulas imunopositivas (0 negativo; 1 - 1% a 10% das c?lulas positivas; 2 - 11% a 25% das c?lulas positivas; 3 - 26% a 50% das c?lulas positivas; 4 - 51% a 75% das c?lulas positivas; 5 - mais 75% de c?lulas positivas). A an?lise da express?o de BMP-2 n?o revelou diferen?as estatisticamente significativas no componente par?nquimatoso (p = 0,925) e estromal (p = 0,345) entre as les?es estudadas, assim como a BMP-4 (p = 0,873 / p = 0,131). No par?nquima, o AS e TOA apresentaram maior frequ?ncia do escore 5. Por sua vez, todos os casos de AU foram classificados como escore 5. A an?lise do componente estromal revelou n?o haver diferen?a estatisticamente significativa entre os grupos em rela??o ?s medianas dos escores de positividade para BMPRIA (p = 0,768) e BMPRII (p = 0,779). No par?nquima do AS e do AU, n?o foram observadas correla??es estatisticamente significativas entre as imunoexpress?es das prote?nas analisadas. Por sua vez, no grupo dos TOAs, foram constatadas correla??es positivas, estatisticamente significativas, entre os escores de express?o de todas as prote?nas avaliadas. No componente estromal, foram constatadas correla??es positivas, estatisticamente significativas, apenas no grupo do AS em BMP-4 e BMPRII (r = 0,476; p = 0,034) e do AU em BMP-4 e BMPRIA (r = 0,709; p = 0,022). Os resultados do presente estudo sugerem que as BMPs e seus receptores est?o envolvidos no processo de desenvolvimento de tumores odontog?nicos. A BMP-4, por sua vez, al?m de estar presente em tumores odontog?nicos possui a capacidade de forma??o de material mineralizado

Made available in DSpace on 2014-12-17T15:32:23Z (GMT). No. of bitstreams: 1 VivianeAOM_DISSERT.pdf: 3188421 bytes, checksum: 338aa2ec46045198a33e6eea1db0d483 (MD5) Previous issue date: 2014-02-13 / The radicular cysts (RCs) and dentigerous (DCs), despite having different etiologies, form a pathological cavity lined by epithelium, which grows due to the buildup of fluid inside, as the surrounding bone is reabsorbed and the epithelium will being induced to proliferate. The epithelial proliferation, which has been identified as one of the key processes in the growth of odontogenic cystic lesions, is influenced by growth factors such as EGFR (epidermal growth receptor factor) and podoplanin (PDPN), many of which may have its production stimulated mainly during inflammatory processes. The objective of this research was to evaluate and compare the immunohistochemical expression of EGFR and PDPN in 30 cases of RCs and 30 cases of DCs, semiquantitatively, in light microscopy, associating it with the degree of inflammation, cellular localization of immunostaining and with the immunostained epithelial layers. Data were statistically analyzed by Chi-square test and Fisher exact test, considering a significance level of 5 %. The results showed high immunoreactivity of both proteins in the lesions studied, only statistically significant difference was observed in immunostaining of PDPN (p=0.033), which proved higher in RCs. The other analyzed parameters showed no relevant significant differences. We conclude that, as EGFR and PDPN showed high immunoreactivity in cystic lesions analyzed, these proteins participate the pathogenesis of these lesions through the epithelial stimulation process, despite having different etiologies. Furthermore, it can infer that the higher immunostaining of PDNP in RCs that DCs showed no distinction indicator between the two lesions, regarding their etiologies, once this protein also showed a considerable expression in DCs, independent of the intensity of the inflammatory infiltrate / Os cistos radiculares (CRs) e dent?geros (CDs), apesar de possu?rem etiologias diferentes, formam uma cavidade patol?gica revestida por epit?lio, a qual cresce em fun??o do ac?mulo de l?quido em seu interior, ? medida que o osso ao redor ? reabsorvido e o epit?lio vai sendo induzido a proliferar. A prolifera??o epitelial, que tem sido apontada como um dos processos determinantes no crescimento das les?es c?sticas odontog?nicas, ? influenciada por fatores de crescimento como o EGFR (receptor do fator de crescimento epid?rmico) e a podoplanina (PDPN), muitos dos quais podem ter sua produ??o estimulada principalmente durante processos inflamat?rios. O objetivo desta pesquisa foi avaliar e comparar a express?o imunoistoqu?mica do EGFR e da PDPN em 30 casos de CRs e 30 casos de CDs, de forma semiquantitativa, em microscopia de luz, associando-a com o grau de inflama??o, localiza??o celular da imunocolora??o e com as camadas epiteliais imunomarcadas. Os dados foram avaliados estatisticamente por meio de testes do Qui-quadrado e Exato de Fisher, considerando-se um n?vel de signific?ncia de 5%. Os resultados mostraram que houve elevada imunorreatividade das duas prote?nas nas les?es estudadas, sendo observada apenas diferen?a estat?stica significativa na imunoexpress?o da PDPN (p=0,033), que se mostrou mais elevada nos CRs. Os demais par?metros analisados n?o demonstraram diferen?as significativas relevantes. Conclui-se que, como o EGFR e a PDPN apresentaram elevada imunoexpress?o nas les?es c?sticas analisadas, essas prote?nas participam da patog?nese dessas les?es atrav?s da estimula??o epitelial, apesar de apresentarem etiologias diferentes. Al?m disso, pode-se inferir que a maior imunomarca??o da PDPN em CRs do que em CDs n?o se mostrou indicador de distin??o entre as duas les?es, com rela??o ?s suas etiologias, uma vez que nestes ?ltimos essa prote?na tamb?m apresentou express?o consider?vel, independente da intensidade do infiltrado inflamat?rio

Made available in DSpace on 2014-12-17T15:32:24Z (GMT). No. of bitstreams: 1 LuizERJ_DISSERT.pdf: 1737074 bytes, checksum: 8941b0b8844e6080e5a540ee05d65531 (MD5) Previous issue date: 2014-02-28 / Conselho Nacional de Desenvolvimento Cient?fico e Tecnol?gico / Ameloblastomas and keratocystic odontogenic tumors (KOT) represent odontogenic lesions that, despite their benign nature, are distinguished by a distinct biological behavior, characterized by locally aggressive growth and recurrent episodes. The gnathic bone resorption caused by the growth of these lesions is a key to the expansion of the same, both being mediated by osteoclastic cells like enzymatic activity of various matrix metalloproteinases (MMPs) factor. The expression of stimulatory factors and inhibitors of bone resorption has been correlated with the development of these lesions, with emphasis to some MMPs such as collagenases and gelatinases and tissue inhibitors of metalloproteinases (TIMPs), among others. Based on the premise that stimulatory and inhibitory factors of osteolytic processes can be decisive for the growth rate of intraosseous odontogenic lesions, this experiment evaluated the immunoreactivity of MMP-9, -13 and TIMP-1 protein in the epithelium and mesenchyme of ameloblastoma and the KOT specimens, by a quantitative analysis of the immunoreactivity cells. Statistical analysis was performed using the Mann-Whitney and Wilcoxon tests with a significance level set at 5 %. Immunohistochemical expression of MMP-9, -13 and TIMP-1 was observed in 100% of cases both in the epithelium and in mesenchyme. The immunoreactivity in the epithelium of KOT and ameloblastomas revealed a predominance of score 3 for MMP-9 (p=0.382) and MMP-13 (p=0.069) and no statistically significance for TIMP-1, the latter being significantly higher immunoreactivity in ameloblastomas. In the mesenchyme, there was a higher score immunoreactivity of MMP-13 (p=0.031) in ameloblastomas in relation to KOT, whereas for MMP-9 and TIMP-1 no statistically significant difference (p=0.403 was observed, p=1.000). The calculation of the ratio of scores revealed expression of proteins in general, similarity of the lesions, a significant predominance of equal expression of TIMP-1 and MMP-9 was observed only in the epithelium of ameloblastoma. The marked immunostaining of MMP-9 , MMP-13 and TIMP-1 in epithelium and mesenchyme of the lesion indicate that these proteins involved in ECM remodeling required for tumor progression, however, specific differences in the expression of some of these proteins, are not sufficient to suggest differences in the biological behavior of ameloblastomas and KOTs / Os ameloblastomas e tumores odontog?nicos ceratoc?sticos (TOC) representam les?es odontog?nicas que, apesar de sua natureza benigna, se destacam por um comportamento biol?gico distinto, caracterizado pelo crescimento localmente agressivo e epis?dios recidivantes. A reabsor??o dos ossos gn?ticos provocada pelo crescimento dessas les?es constitui um fator determinante ? expans?o das mesmas, sendo mediada tanto por c?lulas osteocl?sticas como pela a??o enzim?tica de diversas metaloproteinases de matriz (MMPs). A express?o de fatores estimuladores e inibidores da reabsor??o ?ssea vem sendo correlacionada com o desenvolvimento destas les?es, merecendo destaque algumas MMPs como as colagenases e as gelatinases e os inibidores teciduais de metaloproteinases (TIMPs), dentre outros. Baseados na premissa de que fatores estimuladores e inibidores de processos osteol?ticos podem ser determinantes para o ritmo de crescimento de les?es odontog?nicas intra?sseas, o objetivo de estudo foi avaliar a imunoexpress?o das prote?nas MMP-9, -13 e TIMP-1 no epit?lio e mes?nquima de esp?cimes de ameloblastomas e TOC. A an?lise estat?stica foi realizada atrav?s dos testes de Mann-Whitney e Wilcoxon com n?vel de signific?ncia estabelecido em 5%. Atrav?s de uma an?lise quantitativa das c?lulas imunomarcadas, foi observada a express?o imuno-histoqu?mica das MMP-9, -13 e TIMP-1 em 100% dos casos, tanto no epit?lio quanto no mes?nquima tumoral. Mais de 76% das c?lulas epiteliais (escore 3) dos TOC e ameloblastomas apresentaram imunomarca??o para MMP-9 (p=0,382) e MMP-13 (p=0,069), sendo estatisticamente significativa para o TIMP-1 (p=0,003) nos ameloblastomas. No mes?nquima, observou-se maior escore de imunomarca??o da MMP-13 (p=0,031) nos ameloblastomas em rela??o aos TOC, enquanto para a MMP-9 e TIMP-1 n?o se observou diferen?a estatisticamente significativa (p=0,403; p=1,000). O c?lculo da raz?o entre os escores de express?o das prote?nas revelou, de uma maneira geral, similaridade entre as les?es, sendo observado predom?nio significante de igualdade de express?o do TIMP-1 e da MMP-9 apenas no epit?lio dos ameloblastomas. A imunoexpress?o marcante das MMP-9, MMP-13 e TIMP-1 no epit?lio e mes?nquima das les?es estudadas indica que estas prote?nas participam na remodela??o da MEC necess?ria ? progress?o tumoral, no entanto, as diferen?as pontuais observadas na express?o de algumas destas prote?nas, n?o s?o suficientes para sugerir diferen?as no comportamento biol?gico dos ameloblastomas e dos TOCs