Made available in DSpace on 2014-12-17T15:32:18Z (GMT). No. of bitstreams: 1 FelipeRM.pdf: 2960586 bytes, checksum: f36dd0983baaaf9fe7c3bb48e095490e (MD5) Previous issue date: 2010-02-12 / Conselho Nacional de Desenvolvimento Cient?fico e Tecnol?gico / Central giant cell lesion (CGCL) and peripheral giant cell lesion (PGCL) of the jaws have a distinct clinical behavior, although they share histopathologic features. It is still unclear whether these clinical differences are supported by a distinct pattern of immunoexpression of markers for multinucleated giant cells (GC) and mononuclear cells (MC). The purpose of this study was to compare the immunohistochemical expression of VEGF, MMP-9 in CG and MC and measure the vascularization by vWF to check whether there are differences in expression of these biomarkers between CGCL and PGCL. Paraffin wax blocks of 20 cases of LCCG and 20 LPCG were retrieved. MMP-9 immunoreactivity was greater in the CM of PGCL compared to VEGF (p<0.05). VEGF expression was greater in the CM of CGCL compared to PGCL (p<0.05) and it was greater in the overall expression of CGCL compared to PGCL (p<0.05). Vascularity was quantified by microvascular counting (MVC). MVC was greater in the PGCL compared CGCL (p<0.05). MMP-9 showed a greater tendency of expression in CGCL, though was not significant (p>0.05). We tested correlation between the proteins studied in each group and found a significant negative correlation between VEGF and vWF in CGCL (p<0.05). These results suggest that there are differences in the expression of VEGF in CM and overall expression between the lesions, although no statistically significant difference in the overall expression of the MMP-9. Then, there was a trend in increased expression of MMP-9 and VEGF in CGCL, possibly by the involvement of both proteins in osteoclastogenesis. Additionally, the results of this study indicate a higher degree of vascularization in PGCL compared to CGCL, fact that can be directly linked to the reactive nature of the PGCL, where the inflammatory process with its rich angiogenesis contributes significantly to these findings. / Les?es centrais (LCCG) e perif?ricas de c?lulas gigantes (LPCG) dos maxilares possuem um comportamento cl?nico distinto, embora compartilhem caracter?sticas histopatol?gicas semelhantes. Ainda ? obscuro se essas diferen?as cl?nicas s?o apoiadas por um padr?o distinto de imunoexpress? o de marcadores para c?lulas gigantes multinucleadas (CG) e mononucleadas (CM). O escopo do presente trabalho foi realizar um estudo imuno-histoqu?mico comparativo, analisando quantitativamente c?lulas gigantes multinucleadas e mononucleadas imunorreativas ? MMP-9 e ao VEGF e mensurar a vasculariza??o atrav?s do FvW para verificar se h? ou n?o diferen?as de express?o desses biomarcadores entre as LCCG e LPCG. Foram selecionados 20 casos de LCCG e 20 de LPCG emblocados em parafina. Constatou-se diferen?a significativa (p<0.05) em rela??o ? imunorreatividade na CM para MMP-9 e VEGF nas LPCG, sendo a MMP-9 mais expressa. O VEGF foi mais expresso nas CM das LCCG em rela??o ?s LPCG (p<0.05), assim como sua express?o global (p<0.05). A MMP-9 apresentou uma tend?ncia maior de express?o nas LCCG, embora n?o significativa estatisticamente (p>0.05). Na mensura??o dos vasos atrav?s da contagem microvascular (MVC), verificou-se maior MVC nas LPCG do que nas LCCG (p<0.05). Testou-se correla??o entre as prote?nas estudadas em cada grupo de les?es e constatou-se uma correla??o negativa significativa entre VEGF e FvW nas LCCG (p<0.05). Diante dos achados deste estudo, observa-se que h? diferen?a na express?o do VEGF nas CM, bem como na express?o global entre as les?es. Observou-se uma tend?ncia na maior express?o da MMP-9 nas LCCG, embora n?o significativa estatisticamente. Dessa forma, sugere-se que a maior express?o de ambas as prote?nas nas LCCG esteja mais relacionada possivelmente com a osteoclastog?nese. Adicionalmente, os resultados do presente estudo apontam um maior grau de vasculariza??o nas LPCG quando comparadas com as LCCG, fato este que pode estar relacionado diretamente com a natureza reacional das primeiras, em que o processo inflamat?rio com sua rica angiog?nese contribui sobremaneira para estes achados.

Made available in DSpace on 2014-12-17T15:32:29Z (GMT). No. of bitstreams: 1 KaruzaMAP_Tese.pdf: 829792 bytes, checksum: 60cd145c0f060b54f7dfbb5463648200 (MD5) Previous issue date: 2010-02-25 / Coordena??o de Aperfei?oamento de Pessoal de N?vel Superior / The Giant Cell Lesions, both the Central Giant Cells Lesions (CGCL) as the Peripheral Giant Cells Lesions (PGCL), correspond to a group of oral lesions that are histologically similar entities; however they show a variable clinical behaviour. The purpose of this study was to compare the immunohistochemical expression of bone resorption factors RANK (Receptor Activator of Nuclear Factor kappa B), RANKL (Receptor Activator of Nuclear Factor kappa B Ligand) and OPG (Osteoprotegerin) between CGCL and PGCL. Additionally, these bone resorption factors were examined in terms of aggressiveness of these lesions. The sample consisted of 61 cases, 30 cases of PGCL and 31 CGCL (16 non-aggressive and 15 aggressive). The analysis was performed by quantification of mononuclear cells (MO) and giant multinucleated cells (CG) immunopositive to anti-RANK, anti-RANKL and anti-OPG antibodies in 10 fields. Moreover, according to the proportion between the amount of cells positive for RANKL and OPG, the cases were categorized into: RANKL>OPG, OPG>RANKL e RANKL=OPG. CGCL showed a higher amount of MO (p=0.002) and total cells (p=0.003) both positives to RANKL compared with the PGCL. Additionally, the CGCL revealed a significant association with the ratio of RANKL>OPG (p=0.001). Analysis of the bone resorption factors revealed no significant differences between aggressive and non-aggressive CGCL (p>0.05). It was observed a positive correlation between the markers themselves, and a negative correlation between lesion size and quantity of OPG positive MO cells (p=0,004) and total cells (p=0,009). Through these results, we suggest that the greatest CGCL resorptive potential compared to the PGCL, may have occurred to the high expression of RANKL. Furthermore differences in the biological behavior of aggressive and non-aggressive CGCL appear to be related to the expression of these bone resorption factors / As Les?es de C?lulas Gigantes, tanto as Les?es Centrais (LCCG) quanto as Perif?ricas (LPCG), correspondem a um grupo de les?es orais que apresentam-se histologicamente semelhantes, por?m demonstram um comportamento cl?nico vari?vel. O prop?sito deste estudo foi comparar a express?o imuno-histoqu?mica dos fatores de reabsor??o ?ssea RANK (Receptor Ativador do Fator Nuclear kappa B), RANKL (Ligante do Receptor Ativador do Fator Nuclear kappa B) e OPG (Osteoprotegerina) entre LCCG e LPCG. Adicionalmente, esses fatores foram analisados nas LCCG quanto ? agressividade destas. A amostra consistiu de 61 casos, sendo 30 casos de LPCG e 31 de LCCG (16 n?o-agressivos e 15 agressivos). A an?lise foi realizada por meio da quantifica??o das c?lulas mononucleadas (MO) e c?lulas gigantes multinucleadas (CG) imunopositivas aos anticorpos anti-RANK, anti-RANKL e anti-OPG, em 10 campos. Al?m disso, de acordo com a propor??o entre quantidade total de c?lulas positivas para RANKL e para OPG, os casos foram categorizados em: RANKL>OPG, OPG>RANKL e RANKL=OPG. As LCCG apresentaram maior quantidade de MO (p=0,002) e c?lulas totais (p=0,003) positivas para RANKL, em compara??o com as LPCG. As LCCG ainda revelaram uma associa??o significativa com a propor??o de RANKL>OPG (p=0,001). A an?lise dos fatores de reabsor??o ?ssea n?o revelou diferen?as significativas entre LCCG agressivas e n?o-agressivas (p>0,05). Foi constatada correla??o positiva dos marcadores entre si, bem como uma correla??o negativa entre o tamanho das les?es e a quantidade de MO (p=0,004) e c?lulas totais (p=0,009) positivas para OPG. Diante desses resultados, concluise que o maior potencial reabsortivo das LCCG frente ?s LPCG pode ser decorrente da elevada express?o de RANKL. Al?m disso, as diferen?as nos comportamentos biol?gicos de LCCG agressivas e n?o-agressivas parecem n?o estar relacionadas com a express?o desses fatores de reabsor??o ?ssea.