Associação entre infecção pelos vírus HPV e EBV e neoplasias malignas de boca: análise histomorfométrica

Made available in DSpace on 2015-07-11T02:06:12Z (GMT). No. of bitstreams: 1 000471993-Texto+Completo-0.pdf: 2126269 bytes, checksum: f86f75c4cb3e97d7b63c12ed82e07361 (MD5) Previous issue date: 2015 === Head and neck cancer represents a group of diseases affecting the face and upper aerodigestive...

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Bibliographic Details
Main Author: Jornada, Vanessa Chidiac
Other Authors: Cherubini, Karen
Language:Portuguese
Published: Pontifícia Universidade Católica do Rio Grande do Sul 2015
Subjects:
Online Access:http://hdl.handle.net/10923/7469
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Summary:Made available in DSpace on 2015-07-11T02:06:12Z (GMT). No. of bitstreams: 1 000471993-Texto+Completo-0.pdf: 2126269 bytes, checksum: f86f75c4cb3e97d7b63c12ed82e07361 (MD5) Previous issue date: 2015 === Head and neck cancer represents a group of diseases affecting the face and upper aerodigestive tract. Early diagnosis of these neoplasms and their etiologic factors is crucial for patient’s survival and treatment. In the last decades, cause-and-effect relationship between some viruses and malignancies has been widely accepted. Recently, the role of Human papillomavirus (HPV) and Epstein-Barr virus (EBV) has been shown in the pathogenesis of oropharyngeal carcinoma, undifferentiated nasopharyngeal carcinoma and lymphomas. Nevertheless, the role of such viral agents in oral squamous cell carcinoma (OSCC) is still controversial. This study aimed to investigate HPV, EBV, p53 and Ki-67 in OSCC and oral lymphoma, considering clinical and histological features. The sample was composed of archived material (medical records and paraffin blocks of biopsied specimens) from patients with OSCC, oral lymphoma, and oral traumatic fibrous hyperplasia. The biopsied specimens and medical records were allocated into five groups: (1) 16 samples from patients with OSCC grade I (well-differentiated); (2) 16 samples from patients with OSCC grade II (moderately-differentiated); (3) 19 samples from patients with OSCC grade III (poorly-differentiated); (4) 14 samples from patients with oral non-Hodgkin lymphoma; and (5) 19 samples from patients with oral traumatic fibrous hyperplasia. Biopsied specimens were analyzed for HPV, EBV, p53 and Ki-67 expression by immunohistochemistry, and clinical data concerning age and gender of the patients, size and duration of the lesion as well as habits and comorbidities were collected. Marker expression was evaluated according to clinical features and histological grade of the tumors. There was no association of HPV and EBV with the tumors analyzed. Ki-67 expression was significantly lower in the fibrous hyperplasia group with no other significant differences. p53 expression was significantly lower in the lymphoma and fibrous hyperplasia groups than the OSCC groups, with no other significant differences. OSCC grade II and III were associated with male gender and tobacco smoking, while grade III was also associated with alcohol consumption. There was no association of the tumors with either chimarrão or comorbidities. Duration of the lesion was inversely correlated to lesion size, which in turn was inversely correlated to HPV. EBV and HPV were positively correlated to each other, as was Ki-67 to lesion size and p53, which was correlated to HPV. === Os tumores malignos da região de cabeça e pescoço constituem um grupo de doenças que afeta a face e o trato aerodigestivo superior. O diagnóstico precoce dessas neoplasias e de seus fatores etiológicos é de extrema importância para a sobrevida e para o tratamento do paciente. Nas últimas décadas, a relação de causa e efeito entre certos vírus e tumores malignos tem sido amplamente aceita. Recentemente, foi relatado o papel do Human papillomavirus (HPV) e do Epstein-Barr virus (EBV) na patogenia do carcinoma espinocelular de orofaringe, no carcinoma indiferenciado de nasofaringe e em linfomas, sendo ainda controverso o papel desses agentes virais no carcinoma de células escamosas oral (CCEO). O presente estudo teve por objetivo investigar, por meio de exame imunoistoquímico, os vírus HPV e EBV, bem como os marcadores Ki-67 e p53 em carcinomas e linfomas orais considerando fatores clínicos e histológicos. Espécimes de biópsia arquivados em blocos de parafina e prontuários de pacientes portadores de lesões orais de CCEO, linfoma e hiperplasia fibroepitelial foram distribuídos em cinco grupos: (1) 16 amostras de CCEO grau I (bem diferenciado); (2) 16 amostras de CCEO grau II (moderadamente diferenciado); (3) 19 amostras de CCEO grau III (pobremente diferenciado); (4) 14 amostras de linfoma não-Hodgkin e (5) 19 amostras de hiperplasia fibroepitelial. Os espécimes de biópsia foram submetidos a processamento imunoistoquímico para HPV, EBV, p53 e Ki-67.Dados clínicos referentes a idade e sexo dos pacientes, tamanho e duração da lesão, comorbidades e hábitos foram coletados dos prontuários. A expressão dos marcadores foi analisada de acordo com os aspectos clínicos e grau histológico dos tumores. Não houve associação entre HPV e EBV com os tumores analisados. A expressão do Ki-67 foi significativamente menor no grupo hiperplasia fibroepitelial, não havendo outras diferenças significativas entre os demais grupos. Os linfomas e as hiperplasias fibroepiteliais exibiram expressão de p53 significativamente menor que os carcinomas, sem outras significâncias. CCEO grau II e III foram associados ao sexo masculino e ao tabagismo, enquanto o CCEO grau III foi também associado ao consumo de álcool. Não houve associação dos tumores avaliados com chimarrão ou comorbidades. Houve correlação negativa entre duração e tamanho da lesão, bem como entre tamanho da lesão e HPV. EBV e HPV exibiram correlação positiva, assim como o Ki-67 foi correlacionado ao tamanho da lesão e à p53, que por sua vez exibiu correlação positiva com o HPV.