Yes / Background: High HOX gene expression has been described in many cancers, including oral squamous cell carcinoma and the functional roles of these genes are gradually being understood. The pattern of overexpression suggests that inhibition may be useful therapeutically. Inhibition of HOX protein binding to PBX cofactors by the use of synthetic peptides, such as HXR9, results in apoptosis in multiple cancers. Methods: Activity of the HOX-PBX inhibiting peptide HXR9 was tested in immortalised normal oral (NOK), potentially-malignant (PMOL) and squamous cell carcinoma (OSCC) cells, compared to the inactive peptide CXR9. Cytotoxicity was assessed by LDH assay. Expression of PBX1/2 and c-Fos was assessed by qPCR and western blotting. Apoptosis was assessed by Annexin-V assay. Results: PMOL and OSCC cells expressed PBX1/2. HOX-PBX inhibition by HXR9 caused death of PMOL and OSCC cells, but not NOKs. HXR9 treatment resulted in apoptosis and increased expression of c-Fos in some cells, whereas CXR9 did not. A correlation was observed between HOX expression and resistance to HXR9. Conclusion: Inhibition of HOX-PBX interactions causes selective apoptosis of OSCC/PMOL, indicating selective toxicity that may be useful clinically. / Intercalated Degree Scholarship from the Harry Bottom Trust; scholarship by Becas Chile, Comisión Nacional de Investigación Científica y Tecnológica de Chile (CONICYT), Grant 72160041

Bakgrund: Årligen diagnostiseras 350 000 nya patienter med oral cancer i världen. Denna cancer klassas som en av de vanligaste cancerformerna. Oral cancer påverkar munhälsan och cancerbehandlingarna medför ofta svåra biverkningar där fysiska symptom riskerar att bli ihållande vilket kan leda till psykiska och sociala svårigheter. Det primära omvårdnadproblemet är att sjuksköterskor saknar tillräcklig kunskap för att utföra evidensbaserad omvårdnad för denna patientgrupp. Syfte: Syftet var att beskriva patienters upplevelser av att ha oral cancer. Metod: En litteraturstudie där tio vetenskapliga artiklar granskats på ett strukturerat vis. Resultat: I resultatet framkom fyra huvudkategorier: Upplevelser av fysiska utmaningar, Upplevelser av psykiska utmaningar, Upplevelser av sociala utmaningar samt Upplevelser av hanterbarhet och acceptans. Upplevelser av fysiska utmaningar var grundat i smärta, tal, ät och sväljsvårigheter. Psykiska utmaningar bestod huvudsakligen av oro och rädsla. I sociala utmaningar upplevde patienterna svårigheter att interagera med andra människor. Upplevelser av hanterbarhet och acceptans innefattar patienternas strategier att hantera och acceptera den nya livssituationen. Konklusion: Patienters upplevelser av oral cancer är viktiga att uppmärksamma då forskning visar att tidigt insättande av omvårdnadsåtgärder är relevanta utifrån fysiska, psykiska och sociala perspektiv. Sjuksköterskor avsaknad av relevant grundkunskap om oral hälsa kräver därför kontinuerlig utbildning om munhälsa och förebyggande omvårdnadsåtgärder. / Background: Annually, 350,000 new patients are diagnosed with oral cancer in the world. This cancer is classified as one of the most common forms of cancer. Oral cancer affects oral health and cancer treatments often cause severe side effects where physical symptoms risk becoming persistent, which can lead to psychological and social difficulties. The primary nursing problem is that nurses lack sufficient knowledge to perform evidence-based nursing for this patient group. Aim: The purpose was to describe patients' experiences of having oral cancer. Method: A literature study where ten scientific articles were reviewed in a structured manner. Results: The results revealed four main categories: Experiences of physical challenges, Experiences of psychological challenges, Experiences of social challenges and Experiences of manageability and acceptance. Experiences of physical challenges were based on pain, speech, eating and swallowing difficulties. Mental challenges mainly consisted of worry and fear. In social challenges, patients experienced difficulty interacting with other people. Experiences of manageability and acceptance include the patients' strategies to manage and accept the new life situation. Conclusion: Patients' experiences of oral cancer are important to pay attention to as research shows that early initiation of nursing measures is relevant based on physical, psychological and social perspectives. Nurses lacking relevant basic knowledge about oral health therefore require continuous education about oral health and preventive nursing measures.

Oral cancer is the sixth most common cancer worldwide and has been marked by high morbidity and poor survival rates that have changed little over the past few decades. Beyond prevention, early detection is the most crucial determinant for successful treatment and survival of cancer. Yet current methodologies for cancer diagnosis based upon pathological examination alone are insufficient for detecting early tumor progression and molecular transformation. Development of new diagnostic tools incorporating tumor biomarkers could enhance early detection by providing molecular-level insight into the biochemical and cellular changes associated with oral carcinogenesis. The work presented in this doctoral dissertation aims to address this clinical need through the development of new automated cellular analysis methods, incorporating lab-on-a-chip sensor techniques, for examination of molecular and morphological biomarkers associated with oral carcinogenesis. Using the epidermal growth factor receptor (EGFR) as a proof-of-principle biomarker, the sensor system demonstrated capacity to support rapid biomarker analysis in less than one-tenth the time of traditional methods and effectively characterized EGFR biomarker over-expression in oral tumor-derived cell lines. Successful extension from in vitro tumor cell lines to clinically relevant exfoliative brush cytology was demonstrated, providing a non-invasive method for sampling abnormal oral epithelium. Incorporation of exfoliative cytology further helped to define the important assay and imaging parameters necessary for dual molecular and morphological analysis in adherent epithelium. Next, this new sensor assay and method was applied in a small pilot study in order to secure an initial understanding of the diagnostic utility of such biosensor systems in clinical settings. Four cellular features were identified as useful indicators of cancerous or pre-cancerous conditions including, the nuclear area and diameter, nuclear-to-cytoplasm ratio, and EGFR biomarker expression. Further examination using linear regression and ROC curve analysis identified the morphological features as the best predictors of disease while a combination of all features may be ideal for classification of OSCC and pre-malignancy with high sensitivity and specificity. Further testing in a larger sample size is necessary to validate this regression model and the LOC sensor technique, but shows strong promise as a new diagnostic tool for early detection of oral cancer. / text

Magnetic resonance imaging plays an important yet underutilized role in determining the natural history and prognosis of oral carcinoma. Depth of tumour invasion is an emergent factor in the oral cancer literature. However, problems exist with the definition of cut-points suitable for inclusion in TNM staging criteria. Statistical methodology represents a possible explanation but is underexplored. In this work, a review of the depth of invasion literature is conducted with emphasis on statistical technique. As well, statistical simulation is used to explore the implications of the of the minimum p-value method. The results demonstrate that the use of continuous variable categorization and multiple testing is widespread, and contributes to cut-point variability and false-positive tests. Depth, as a predictor of OCLNM and survival, must be questioned. The volume of tumour invasion is a promising prognostic factor that has not been fully investigated in the oral carcinoma literature. In this work, the volume of tumour invasion is measured on MRI and compared to thickness and maximum diameter in its capacity to predict 2-year all-cause, disease-related and disease-free survival, as well as occult cervical lymph node metastasis prediction. As part of a comprehensive approach, morphometric factors are incorporated into multifactor predictive models using regression, artificial neural networks and recursive partitioning. It is evident that MRI-based volume is superior all other linear measurements for both occult cervical lymph node metastasis and survival prediction. Artificial neural networks wee superior to all other techniques for survival prediction. There is a case for a unified artificial neural networks model for survival prediction that uses volume, midline invasion and N-stage to determine prognosis. This model can be used to determine individualized probabilities of 2-year survival. The lateral extrinsic muscles of the tongue lie just beneath the surface of the lateral tongue, yet their invasion is a criterion for T4 classification using the TNM staging system. In this work, the Visible Human Female is used to conduct an anatomic study of the extrinsic muscles of the tongue. Linear measurement is used to quantify the distance from the surface mucosa to the most superficial muscle fibres of the styloglossus and genioglossus. Further, the lateral extrinsic muscles are poorly demonstrated on MRI. An anatomic atlas of the tongue is fused with MRI images of oral carcinoma to demonstrate lateral muscle invasion. The results demonstrate that the styloglossus and hyoglossus lie very close to the surface of the lateral tongue, in some cases passing within 1 mm of the surface mucosa. These extrinsic muscles are readily invaded by even small tumours of the lateral tongue. Strict application of the TNM T4a criteria leads to unnecessary upstaging as these carcinomas do not warrant the prognosis and aggressive treatment of Stage IV disease. Extrinsic muscle invasion should be removed as a T4a criterion for the oral cavity. A separate category, T4a (oral tongue) specifying invasion of the genioglossus is also recommended. This work presented in this thesis is an original contribution to the field of oral cavity cancer research and has determined that there is capacity for improvement in current efforts to determine the natural history and prognosis of oral cavity squamous cell carcinoma. This thesis is the first to examine the role of statistical methodology in oral carcinoma depth of invasion cut-point variability. Further, this work presents an original approach to the prediction of regional metastasis and survival using advanced multivariate modeling techniques. No other work explored MRI-measured volume using the substantial sample size gathered in this thesis. Finally, this work is the first to demonstrate that lateral extrinsic muscle invasion is an unnecessary component of the T4a (oral cavity) classification criteria and should be reconsidered.

Oral cancer drugs are branded and expensive medications that generally do not have generics available. The restrictions of the Medicare Part D program, including the coverage gap and high cost-sharing, and the high cost of oral chemotherapy may lead to patients’ non-adherence to medication. Few studies have examined the cost and utilization of oral anti-cancer medications. This study will be the first to examine the costs associated with the use of oral anti-cancer medications and the impact of cost-sharing and type of prescription drug subsidy on medication discontinuation in the Medicare Part D elderly population. Objectives: To determine the usage and costs of oral cancer treatment in elderly Medicare Part D beneficiaries and to examine the relationship between out of pocket costs and medication discontinuation or delay. Methods: A cross-sectional study of the spending and usage of oral cancer drugs in the Medicare Part D population was conducted. A 5% random sample of 2008 Medicare beneficiaries was used. The study sample included all members of this group who: 1) were 65 years of age and older and 2) filled at least one prescription for imatinib, erlotinib, anastrozole, letrozole, or thalidomide. We examined the average costs patients paid per day, the cost that the Part D plan paid per day, and the total cost that patients paid for the entire year for each drug. The demographic characteristics and type of prescription drug subsidy of Part D beneficiaries who used oral cancer drugs were reported in frequency counts and percentages. We also determined the percentage of enrollees who entered the Part D coverage gap, the time and duration that they fell into the coverage gap, the number of beneficiaries who discontinued treatment and the association between OOP costs and medication discontinuation or delay, controlling for polypharmacy, prescription coverage and socio-demographic factors. Results: Prescription drug subsidy was categorized in four groups: 1) Dual Eligible (DE), 2) full Low Income Subsidy (LIS), 3) partial LIS, and 4) no subsidy. Mean out-of-pocket (OOP) costs per day were between $0.03 and $0.09 for DE beneficiaries, between $0.04 and $0.23 for full LIS beneficiaries, between $1.17 and $6.34 for partial LIS beneficiaries and between $2.93 and $36.84 for beneficiaries who did not receive a subsidy. On average, the beneficiaries who used oral cancer medications were between 75 and 76 years of age. Over half of oral cancer medication users were Caucasian and female. Over two-thirds of oral cancer medication users received no subsidies for their prescription coverage. About 99% of users of the more expensive drugs - imatinib, erlotinib and thalidomide - entered the coverage gap and the majority of these entered the coverage gap at the time of their first fill. In contrast, beneficiaries who filled the less expensive drugs - anastrozole and letrozole - entered the coverage gap later. Less than 7% entered the coverage gap at the time of the first fill of their prescriptions. Beneficiaries who used imatinib, erlotinib, or thalidomide spent approximately a month in the coverage gap. Over the course of a year, the majority of their time was spent in the catastrophic phase. Approximately 33-60% of total oral cancer drug users discontinued their therapies. About 50% of these discontinued during the coverage gap for anastrozole and letrozole and about 80% discontinued during the catastrophic phase for imatinib, erloinib and thalidomide. OOP costs were associated with medication discontinuation for all five oral cancer drugs. The odds of discontinuation and delay increased 101%, 170%, and 264% for each $100 increase in OOP spending for imatinib, erlotinib and thalidomide users, respectively. The odds of discontinuation and delay increased 9%-10%, and 6-8% for every $10 increase in OOP spending for anastrozole and letrozole users, respectively. Conclusions: About 33-60% of all users discontinued their therapies. Beneficiaries receiving subsidies had low OOP costs, averaging between $0.03 and $6.34 per day. Beneficiaries on the more expensive drugs and not having subsidies had high OOP costs, averaging between $15.66 and 36.84 per day. Higher OOP costs were associated with an increased likelihood of discontinuation or delay.

A proteína moesina, uma das proteínas do complexo ERM (ezrina, radixina e moesina), participa do processo de migração de células tumorais controlando a ligação entre o citoesqueleto de actina e os receptores transmembrana. As proteínas ERM vêm sendo investigadas como ligantes de outras glicoproteínas, como a podoplanina, cuja expressão é encontrada em células malignas de diversas neoplasias, incluindo o carcinoma espinocelular (CEC) de boca. O objetivo desse estudo foi avaliar as expressões imuno-histoquímicas da moesina e da podoplanina pelas células malignas no front de invasão de 84 pacientes com CEC de boca e suas associações com a evolução clínica e com o prognóstico dos pacientes. A associação entre a expressão imuno-histoquímica da moesina e da podoplanina pelas células malignas e as variáveis demográficas, clínicas e microscópicas foi avaliada pelo teste qui-quadrado ou teste exato de Fisher. As análises de sobrevida global e livre de doença em 5 e 10 anos foram calculadas pelo estimulador produto-limite de Kaplan-Meier e a comparação das curvas de sobrevida realizada pelo teste de log-rank. Os resultados mostraram que houve expressão da moesina pelas células malignas na região do front de invasão tumoral, entretanto, nenhuma associação estatisticamente significativa foi encontrada entre esta proteína e as características clínicas, demográficas e microscópicas. A expressão da podoplanina, pelas células malignas, foi significativamente associada à radioterapia (p=0,004), à invasão muscular (p=0,006) e ao comprometimento linfonodal (p=0,013). Não houve associação significativa entre a expressão das duas proteínas nos CECs de boca (p=0,460). A forte expressão da moesina pelas células malignas constituiu um fator de prognóstico desfavorável para os pacientes com CEC de boca e estadiamento clínico II e III. O comprometimento linfonodal histopatológico também se mostrou fator de prognóstico significativo para a recidiva da doença (p=0,018). Estes resultados sugerem que a expressão de moesina, pelas células malignas juntamente com o comprometimento linfonodal pode contribuir para determinar os pacientes com CEC de boca que apresentam um pior prognóstico. Além disso, verificamos que as proteínas moesina e podoplanina se expressam pelas células neoplásicas nos CEC de boca mas não parecem estar associadas no processo de invasão tumoral. / The moesin protein, one of the proteins of the ERM complex (ezrin, radixin and moesin) takes part in the migration of tumor cells process by controlling the relation between actin cytoskeleton and transmembrane receptors. The ERM proteins have been investigated as ligants of other glycoproteins, such as podoplanin, which are found in malignant cells of malignant, including oral squamous cell carcinoma (OSCC). The aim of this study was to evaluate the immunohistochemical expressions of moesin and podoplanin by malignant cells in the invasive front of 84 patients with oral squamous carcinoma and its association with clinical outcome and patients\' prognosis. Chi- square or Fisher\'s exact test was used to analyze the association between the moesin and podoplanin expressions by malignant cells and demographic, clinical and microscopic variables in oral squamous cell carcinoma patients. The 5 and 10 years survival rates were calculated by Kaplan-Meier method and the comparison of survival curves were performed using log-rank test. The results showed that there was moesin expression by malignant cells in the invasive front, however, no statistically significant association was found between this protein and demographic, clinical and microscopic features. The expression of podoplanin by malignant cells was significantly associated with radiotherapy (p=0.004), with muscular invasion (p=0.006) and lymph node involvement (p=0.013). There was no significant association between the expression of two proteins in OSCC (p=0.460). The strong expression of moesin by malignant cells was a factor of unfavorable prognosis for patients with OSCC and clinical stage II and III. The histopathological lymph node involvement was also significant prognostic factor for disease recurrence (p=0.018). These results suggest that the expression of moesin by malignant cells and lymph node involvement may help to determine patients with squamous cell carcinoma who have a poor prognosis. Furthermore, we found that moesin and podoplanin proteins are expressed by neoplastic cells in oral squamous cell carcinoma but not appear to be associated in the process of tumor invasion.

Os hormônios produzidos durante o estresse e seus receptores específicos têm sido amplamente envolvidos com a progressão do câncer. O objetivo deste estudo foi avaliar a expressão dos receptores β2 adrenérgicos pelas células malignas de carcinomas espinocelulares de boca (CEC) e sua correlação com as a características clínicas, evolução e o prognóstico dos pacientes. Um total de 106 pacientes portadores de CEC de boca em estádios clínicos II, III e IV, tratados no Departamento de Cirurgia de Cabeça e Pescoço e Otorrinolaringologia do Hospital de Câncer A.C. Camargo, São Paulo, Brasil, no período de 1970 a 2000, foram analisados quanto aos dados demográficos, história clínica, localização e extensão do tumor, classificação pelo sistema TNM-UICC, tratamento e evolução tumoral. Analisaram-se também as características histopatológicas, índice de malignidade tumoral e a expressão imuno-histoquímica do receptor β2 adrenérgico pelas células malignas no front de invasão tumoral. A associação da expressão do receptor β2 adrenérgico e as variáveis clínicas ou microscópicas foi calculada pelo teste do qui quadrado ou teste exato de Fisher. As probabilidades de sobrevida global e específica por câncer em 5 e 10 anos foram calculadas pelo estimador produto-limite de Kaplan-Meier, comparadas pelo test de long-rank e pelo modelo de regressão múltiplo de Cox. A expressão do receptor β2 adrenérgico foi detectada na membrana e no citoplasma das células malignas da maioria dos CECs de boca (72,6%) e, significativamente associada ao etilismo (p=0,021), tabagismo e etilismo simultâneo (p=0,014) e estadiamento T (p=0,07). Os pacientes cujos tumores demonstraram expressão positiva do receptor β2 adrenérgico apresentaram maiores taxas de sobrevida global (p=0,001) e específica por câncer (p=0,004), quando comparadas aquelas dos pacientes com tumores com ausência da expressão desta proteína. Esses resultados sugerem que a expressão do receptor β2 adrenérgico nas células malignas da região do front de invasão tumoral constitui um fator prognóstico favorável em pacientes com carcinoma espinocelular de boca e pode ser utilizada como alvo de novas estratégias farmacológicas antineoplásicas. / The stress related hormones and their specific receptors have been widely involved with cancer progression. The aim of this study was to evaluate the expression of β2 adrenergic receptor by malignant cells in oral squamous cell carcinoma (OSCC) and its correlation with clinical characteristics, outcome and patients prognosis. A total of 106 patients with OSCC in clinical stages II, III and IV submitted to surgical treatment at the Head and Neck Surgery and Otorhinolaryngology Department, of the Cancer Hospital A.C. Camargo, São Paulo, Brazil, from 1970 to 2000, were analyzed for demographics data, clinical history, location, tumor extension, stage by the TNM-UICC, treatment and tumor outcome. In addition, we investigated the morphologic features, the histopathological malignant index and the immunohistochemical expression of β2 adrenergic receptor by malignant cells of the invasive front of tumor. Chi-square test or Fishers exact test was used to analyze the association among β2 adrenergic receptor expression and the clinical or morphologic variables. The probability of overall and cancer specific survival in 5 and 10 years were calculated by Kaplan-Meier method and the prognostic value of the clinical and morphologic variables was obtained by Cox regression model. Most of OSCCs (72,6%) showed the β2 adrenergic receptor expression in cytoplasm and cell membrane of malignant cells. In OSCC, positive β2 adrenergic receptor expression was significantly associated with alcoholism (p=0.021), simultaneous consumption of alcohol and tobacco (p=0.014) and T stage (p=0.07). OSCC patients with positive expression of β2 adrenergic receptor showed higher rates of overall survival (p=0.001) and cancer specific (p=0.004) than those patients with tumors without expression of this protein. These results suggest that the β2 adrenergic receptor expression by malignant cells in the invasive front of tumor is a favorable prognostic factor in patients with OSCC and can be used as a target for new anti-neoplastic pharmacological strategies.

A podoplanina humana consiste em uma proteína associada ao processo de invasão das células epiteliais neoplásicas, sendo sua alta expressão correlacionada com um pior prognóstico para os pacientes com câncer de cabeça e pescoço. A porção citoplasmática da podoplanina pode se ligar a ezrin, uma proteína que vem sendo associada com a ocorrência de metástases e menor sobrevida para os pacientes com neoplasias malignas. O objetivo do presente estudo foi avaliar em 48 carcinomas espinocelulares de lábio inferior a expressão imuno-histoquímica da podoplanina e da ezrin, nas células do front de invasão tumoral, e verificar a correlação entre a expressão das duas proteínas nas células epiteliais neoplásicas. A expressão membranosa e citoplasmática da podoplanina e da ezrin foi avaliada nas células neoplásicas periféricas e centrais das ilhotas tumorais, por meio de um método semi-quantitativo de escores. A associação entre a expressão membranosa e citoplasmática da podoplanina e da ezrin nos tumores foi feita pelo teste de qui-quadrado, com nível de significância de 5% e a correlação entre a expressão das duas proteínas foi realizada pelo teste de correlação de Spearman. Os resultados demonstraram uma forte expressão membranosa e citoplasmática da podoplanina nas células periféricas do front de invasão tumoral com ausência desta expressão na região central das ilhotas tumorais. A imunomarcação da ezrin foi homogênea nos tumores e predominantemente citoplasmática. Uma diferença estatisticamente significativa foi encontrada entre a expressão da podoplanina nas células neoplásicas periféricas e centrais (p<0,001), como também entre a expressão da ezrin membranosa e citoplasmática (p<0,001) nos carcinomas espinocelulares de lábio. Houve uma correlação positiva, porém sem significância estatística, entre a expressão da podoplanina membranosa e da ezrin membranosa ou citoplasmática nas células neoplásicas periféricas. Estes resultados comprovam que a podoplanina e ezrin são fortemente expressas pelas células neoplásicas do front de invasão tumoral e sugerem que ambas proteínas podem estar participando do processo de invasão dos carcinomas espinocelulares de lábio. / The human podoplanin consists in a protein associated to the invasion process of the epithelial malignant cells, being your high expression correlated with poor prognosis in patients with head and neck cancer. The cytoplasmic tail of the podoplanin can bind to ezrin, a protein that have been associated with metastasis and lower survival rate in patients with malignant neoplasms. The aim of this study was evaluate in 48 squamous cell carcinomas of the lower lip, the immunohistochemical expression of podoplanin and ezrin, in the invasive front, and verify correlation between the expression of both proteins by epithelial neoplastic cells. The membranous and cytoplasmic expression of podoplanin and ezrin was evaluated in peripheral and central areas of the tumor islets, using a semi-quantitative score method. The association between the membranous and cytoplasmic expression of podoplanin and ezrin in the tumors was performed by chi-square test, using a significance level of 5% and the correlation between the expression of both proteins was performed by Spearman correlation test. The results showed a high membranous and cytoplasmic podoplanin expression in the peripheral cells of the invasive front, with no expression of this protein in the central cells. The ezrin immunostaining was homogeneous and observed mainly in the cytoplasm of malignant cells. A statistically significant difference was found between the expression of podoplanin in peripheral and central tumor cells (p<0,001), as well between the membranous and cytoplasmic expression of ezrin (p<0.001) in squamous cell carcinoma of the lip. There was a positive correlation, but without statistical significance, between the expression of membranous podoplanin and membranous or cytoplasmic ezrin in the peripheral tumor cells. These results prove that podoplanin and ezrin are strongly expressed by malignant cells of the invasive front tumor and suggest that both proteins may be participating in the invasive process of the squamous cell carcinoma of the lip.

Introdução: A avaliação dos processos inflamatórios em pacientes com tumores de boca é assunto atual na literatura científica. Poucos estudos, entretanto avaliaram a expressão da Proteína Inibidora de Protease Secretada por Leucócito (SLPI), marcador específico de inflamação, em pacientes com câncer de boca Objetivos: 1.Descrever a frequência da concentração de SLPI salivar e sérica em pacientes com câncer bucal. 2. Avaliar a associação dessas concentrações com características clínicas, sociodemográficas e de estilo de vida. Metodologia: Realizou-se a quantificação de SLPI em soro por meio do teste ELISA em pacientes com carcinoma epidermoide da cavidade bucal atendidos no Hospital Heliópolis da Secretaria de Estado da Saúde do Estado de São Paulo no período entre 2011 e 2017. Dados relativos a estadiamento do tumor, características sócio demográficas dos pacientes, hábitos alimentares e estilo de vida foram coletados por meio de prontuários médicos e questionários aplicados aos pacientes. Foram realizados teste de correlação de Spearman e teste qui-quadrado para testar possíveis associações. Resultados: Foram encontradas: correlação positiva entre SLPI em saliva maços-ano de tabagismo (p=0,03) e correlação negativa entre SLPI bochecho para frequência no consumo de carne vermelha (p=0,01). A quantificação de SLPI em soro por quartis apresentou associação com significância estatística para escolaridade (maior proporção de pessoas com ensino médio completo no quartil mais baixo de SLPI), frequência de escovação dentária (maior proporção de pessoas que escovam os dentes mais do que uma vez por dia no quartil com maior SLPI) e estadiamento patológico (2º quartil com maior proporção de estadiamentos 3 e 4). Na avaliação de SLPI em saliva e bochecho, houve associação com o consumo de carne vermelha, havendo indivíduos com consumo mais baixo apenas nos quartis mais superiores de SLPI Conclusão: Este estudo concorda com a hipótese de que o SLPI em pacientes com câncer de boca se relaciona com estilo de vida e estadiamento da lesão. / Introduction: The evaluation of inflammatory processes in patients with oral tumors is a current topic in the scientific literature. Few studies, however, have evaluated the expression of the Leukocyte Secreted Protein Inhibitor Protein (SLPI), a specific marker of inflammation in patients with oral cancer. Objectives: 1. To describe the frequency of salivary and serum SLPI in patients with oral cancer. 2. To evaluate the association of these concentrations with clinical, sociodemographic and lifestyle characteristics. Methodology: Serum SLPI was quantified by ELISA in patients with squamous cell carcinoma of the oral cavity treated at the Hospital Heliópolis of the State Health Department of the State of São Paulo in the period between 2011 and 2017. Data on staging of the tumor, socio-demographic characteristics of patients, eating habits and lifestyle were collected through medical records and questionnaires applied to patients. Spearman\'s correlation test and chi-square test were performed to test possible associations. Results: There was a positive correlation between SLPI in saliva and malnutrition SLPI (p = 0.03). The quantification of SLPI in serum by quartiles was associated with statistical significance for schooling (higher proportion of people with complete secondary education in the lowest quartile of SLPI), frequency of toothbrushing (a higher proportion of people brushing their teeth more than once per day in quartile with higher SLPI) and pathological staging (2nd quartile with a higher proportion of stages 3 and 4). In the evaluation of SLPI in saliva and mouthwash, there was an association with red meat consumption, with individuals with lower consumption only in the higher quartiles of SLPI. Conclusion: This study agrees with the hypothesis that SLPI in patients with oral cancer is related to lifestyle and staging of the lesion.

Introdução: A avaliação dos processos inflamatórios em pacientes com tumores de boca é assunto atual na literatura científica. Poucos estudos, entretanto avaliaram a expressão da Proteína Inibidora de Protease Secretada por Leucócito (SLPI), marcador específico de inflamação, em pacientes com câncer de boca Objetivos: 1.Descrever a frequência da concentração de SLPI salivar e sérica em pacientes com câncer bucal. 2. Avaliar a associação dessas concentrações com características clínicas, sociodemográficas e de estilo de vida. Metodologia: Realizou-se a quantificação de SLPI em soro por meio do teste ELISA em pacientes com carcinoma epidermoide da cavidade bucal atendidos no Hospital Heliópolis da Secretaria de Estado da Saúde do Estado de São Paulo no período entre 2011 e 2017. Dados relativos a estadiamento do tumor, características sócio demográficas dos pacientes, hábitos alimentares e estilo de vida foram coletados por meio de prontuários médicos e questionários aplicados aos pacientes. Foram realizados teste de correlação de Spearman e teste qui-quadrado para testar possíveis associações. Resultados: Foram encontradas: correlação positiva entre SLPI em saliva maços-ano de tabagismo (p=0,03) e correlação negativa entre SLPI bochecho para frequência no consumo de carne vermelha (p=0,01). A quantificação de SLPI em soro por quartis apresentou associação com significância estatística para escolaridade (maior proporção de pessoas com ensino médio completo no quartil mais baixo de SLPI), frequência de escovação dentária (maior proporção de pessoas que escovam os dentes mais do que uma vez por dia no quartil com maior SLPI) e estadiamento patológico (2º quartil com maior proporção de estadiamentos 3 e 4). Na avaliação de SLPI em saliva e bochecho, houve associação com o consumo de carne vermelha, havendo indivíduos com consumo mais baixo apenas nos quartis mais superiores de SLPI Conclusão: Este estudo concorda com a hipótese de que o SLPI em pacientes com câncer de boca se relaciona com estilo de vida e estadiamento da lesão. / Introduction: The evaluation of inflammatory processes in patients with oral tumors is a current topic in the scientific literature. Few studies, however, have evaluated the expression of the Leukocyte Secreted Protein Inhibitor Protein (SLPI), a specific marker of inflammation in patients with oral cancer. Objectives: 1. To describe the frequency of salivary and serum SLPI in patients with oral cancer. 2. To evaluate the association of these concentrations with clinical, sociodemographic and lifestyle characteristics. Methodology: Serum SLPI was quantified by ELISA in patients with squamous cell carcinoma of the oral cavity treated at the Hospital Heliópolis of the State Health Department of the State of São Paulo in the period between 2011 and 2017. Data on staging of the tumor, socio-demographic characteristics of patients, eating habits and lifestyle were collected through medical records and questionnaires applied to patients. Spearman\'s correlation test and chi-square test were performed to test possible associations. Results: There was a positive correlation between SLPI in saliva and malnutrition SLPI (p = 0.03). The quantification of SLPI in serum by quartiles was associated with statistical significance for schooling (higher proportion of people with complete secondary education in the lowest quartile of SLPI), frequency of toothbrushing (a higher proportion of people brushing their teeth more than once per day in quartile with higher SLPI) and pathological staging (2nd quartile with a higher proportion of stages 3 and 4). In the evaluation of SLPI in saliva and mouthwash, there was an association with red meat consumption, with individuals with lower consumption only in the higher quartiles of SLPI. Conclusion: This study agrees with the hypothesis that SLPI in patients with oral cancer is related to lifestyle and staging of the lesion.