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Background Melanoma is an aggressive malignant tumor, rarely observed in the oral cavity. The aim of this study was to describe the clinicopathologic features of a series of oral melanomas. Material and Methods A retrospective descriptive study was performed. A total of 15,482 biopsy records from two oral and maxillofacial pathology services in Brazil were analyzed. All cases of oral melanomas were reviewed, and clinical, demographic, histopathological data, treatment, and follow-up status were collected. In addition, immunohistochemistry stains (pan-cytokeratin AE1/AE3, vimentin, α-SMA, CD45, S-100 protein, HMB-45, Melan A, and Ki-67) were performed. Results The series comprised of 5 males (71.4%) and 2 females (28.6%), with a mean age of 58.0 ± 9.2 years (range: 45-69 years) and a 2.5:1 male-to-female ratio. The gingiva (n = 3, 42.8%) and hard palate (n = 2, 28.6%) were the most common affected sites, presenting clinically as ulcerated swellings with a brown to black color. Cervical lymph node metastasis was detected in three patients during the first examination. Microscopically, 6 cases (85.7%) were melanotic, and one (14.3%) was amelanotic. Most cases (n = 4, 57.1%) presented a predominance of epithelioid cells. S-100 and HMB-45 were positive in all cases (n = 7, 100.0%). In contrast, only 4 cases (57.1%) were positive for Melan-A. The proliferative index with Ki-67 was high, with labeling index ranging from 70.0% to more than 90% of positive cells. Five patients died from complications of the tumors after a mean follow-up period of 7.8 months. Conclusions Melanoma is an aggressive malignant tumor that rarely occurs in the oral cavity. It occurs mainly in adult and elderly patients and often is diagnosed in advanced stages. The current findings were similar to previous studies and reflected the characteristics of the services from where lesions were retrieved. Key words:Head and neck cancer, melanoma, oral melanoma, oral mucosa.

Os papilomavírus humanos (HPVs) pertencem à família Papillomaviridae e seu ciclo de vida é diretamente ligado à diferenciação das células epiteliais do hospedeiro. Possuem seis genes que se expressam precocemente e dois genes que se expressam tardiamente, sendo denominados respectivamente E (early) e L (late). O ácido desoxirribonucleico (DNA) viral dentro da célula do hospedeiro pode assumir duas formas: epissomal e integrada. O HPV tem como alvo as células basais de epitélios escamosos, em particular da área genital, onde está associado ao carcinoma da cérvice uterina. Na boca, o HPV está associado a papiloma escamoso oral, condiloma acuminado, verruga vulgar e hiperplasia epitelial focal. Entretanto, seu papel na carcinogênese oral é ainda controverso, sendo também identificado como agente etiológico de alguns carcinomas de células escamosas de cabeça e pescoço. A infecção pelo HPV pode agir sinergicamente com agentes carcinogênicos, como o tabaco e o álcool. Pelo menos 150 subtipos diferentes de HPV já foram identificados, sendo que 25 têm sido detectados em lesões orais. Considerando a relevância do tema para a melhor compreensão da infecção oral pelo HPV, o objetivo desta atualização é rever os aspectos relevantes da biologia do HPV, com ênfase na relação HPV-ceratinócitos, e a importância dos dados clínicos e histopatológicos na definição diagnóstica das lesões orais possivelmente associadas ao HPV. Papillomaviruses belong to the family Papillomaviridae and their life cycle is directly linked to the differentiation of host epithelial cells. They have six genes that are expressed earlier and two genes that are expressed later in their life cycle, named respectively E (early) and L (late). Host cell viral DNA can take two forms: episomal and integrated. The human papillomavirus (HPV) targets the basal cells of squamous epithelia, particularly from the genital area, which is associated with uterine cervix carcinoma. In the oral area HPV is associated with oral squamous papilloma, condyloma acuminatum, verruca vulgaris, and focal epithelial hyperplasia. However, its role in oral carcinogenesis is still controversial. Moreover, it has identified as an etiological agent of some head and neck squamous cell carcinomas. HPV infection may act synergistically with carcinogens such as tobacco and alcohol. At least 150 different subtypes of HPV have been identified, of which 25 types have been detected in oral lesions. Considering the relevance of the topic for better understanding of HPV oral infection, the objective of this update is to review relevant aspects of HPV biology, with emphasis on HPV-keratinocytes relationship and the importance of clinical and histopathological aspects in the diagnosis of oral lesions possibly associated with HPV.

Submitted by Boris Flegr (boris@uerj.br) on 2021-01-05T19:41:35Z No. of bitstreams: 1 DISSERTACAO_FINAL_Paulo Ornellas de Souza.pdf: 5700098 bytes, checksum: 6b717b2aa67ee5400fb93b10c679c825 (MD5) Made available in DSpace on 2021-01-05T19:41:35Z (GMT). No. of bitstreams: 1 DISSERTACAO_FINAL_Paulo Ornellas de Souza.pdf: 5700098 bytes, checksum: 6b717b2aa67ee5400fb93b10c679c825 (MD5) Previous issue date: 2013-08-28 Coordenação de Aperfeiçoamento de Pessoal de Nível Superior Squamous cell carcinoma of the penis (SSCP) represents 95% of penile cancers. It affects mostly uncircumcised patients and is often associated with lack of adequate local hygiene and phimosis. In Brazil, the incidence is 2.7% but in some areas of the country can reach 17% of diagnosed cases of cancer per year. The tumor can occur in any part of the sexual organ and the type of staging to be used is controversial. The Broders classification is more often used to classify tumors. Studies suggest the relationship between the development of penile carcinoma and HPV infection (Human Papilloma Virus). The evaluation method of inguinal lymph nodes remains controversial and it is difficult to differentiate inflammatory reaction from metastatic lymphadenopathy. Physical examination is not a reliable predictor of lymph node involvement since patients with palpable lymph nodes can not present metastases. There are few publications about the molecular mechanisms involved in the genesis and progression of the SSCP. Although several markers have been evaluated, currently the clinical application of these is limited. Most of the markers studied require invasive procedures for obtaining tumor tissue. There is a need to find through a minimally invasive technique circulating tumor markers able to differentiate SSCP patients with and without metastatic involvement. In this type ofmalignancythediscovery of biomarkers that assessthe prognosisis relevant since physical examination is not a reliable predictor oflymph node involvementand survival. The objectives of this study were: 1) to review and discuss the epidemiology, etiology, different types of surgical approach and controversies in the surgical treatment of penile cancer 2)to investigate via the platform ClinProt / MALDI / TOF presence of plasma markers able to discriminate healthy subjects from patients affected by squamous cell carcinoma of the penis (SCCP) 3) to evaluate the importance of these markers in disease progression. Between June 2010 and June 2011, plasma samples from 36 healthy subjects and 25 patients with penile carcinoma who underwent surgical treatment in the UrologyServicesofNational Cancer InstituteandMarioKröeffHospital were collected and analyzed by the ClinProt/MALDI/TOF platform. Our results found a cluster of 2 peptides (A=m/z 1897.22 +-9 Da and B=m/z 2021.99 +-9 Da that was able to discriminate patients from controls subjects. These peptides were further identified as C3 and C4 A/B fragments from complement system. Cross validation analysis using the whole casuistic showed 62.5% and 86.76% of sensitivity and specificity, respectively with a very high sensitivity (100%) and specificity (97%) for SCCP patients that have died by disease. Moreover, patients with lymph node involvement present a sensitivity and specificity of 80% and 97%, respectively. The results showed that as the disease progresses more under express are the cluster comparing with healthy subjects. These results may be useful as prognostic toll. O carcinoma epidermóide de pênis (CEP) representa 95% das neoplasias penianas e afeta quase sempre pacientes não circuncidados estando muitas vezes associado à falta de higiene local adequada e à fimose. No Brasil a sua incidência é de 2,7 % porém em algumas áreas do país pode chegar a 17% dos casos diagnosticados por ano. O tumor pode ocorrer em qualquer parte do órgão sexual masculino e o tipo de estadiamento empregado é controverso. A classificação de Broders é a mais utilizada. Estudos sugerem a relação entre o desenvolvimento do carcinoma de pênis com a infecção por HPV (Papiloma Vírus Humano). O método de avaliação dos linfonodos inguinais permanece controverso sendo difícil a diferenciação entre linfadenomegalia inflamatória reacional e metastática. O exame físico não é um preditor confiável do comprometimento linfonodal pois pacientes com linfonodos palpáveis podem não apresentar metástases. Há poucas publicações sobre os mecanismos moleculares envolvidos na gênese e progressão do CEP. Apesar de vários marcadores terem sido avaliados, atualmente a aplicação clínica destes é limitada. A maior parte dos marcadores estudados requer procedimentos invasivos para obtenção do tecido tumoral. Existe a necessidade de encontrar através de uma técnica pouco invasiva marcadores tumorais circulantes capazes de diferenciar portadores de CEP com e sem envolvimento metastático. Neste tipo de neoplasia, a descoberta de biomarcadores que avaliem o prognóstico é relevante, pois o exame físico não é um indicador confiável do comprometimento linfonodal e da sobrevida.Os objetivos foram 1) revisar e discutir a epidemiologia, a etiologia, os diversos tipos de abordagem cirúrgica e as controvérsias no tratamento cirúrgico do câncer de pênis 2) investigar através da plataforma ClinProt/ MALDI / TOF a presença de marcadores plasmáticos capazes de discriminar indivíduos saudáveis de pacientes afetados por carcinoma epidermóide de pênis (CEP) 3) avaliar a importância destes marcadores na evolução da doença. Foram coletados e analisados pela plataforma ClinProt / MALDI / TOF o plasma de 36 indivíduos saudáveis e 25 pacientes com CEP invasivo, submetidos a tratamento cirúrgico entre junho de 2010 e junho de 2011, nos serviços de urologia do Instituto Nacional de Câncer e do Hospital Mário Kröeff (Rio de Janeiro). Nossos resultados apontaram para um conjunto de dois peptídeos (A = m / z 1897,22 + -9 Da e B = m / z 2021,99 + -9 Da) que foram capazes de diferenciar pacientes com CEP de indivíduos controles. Esses peptídeos foram posteriormente identificados como fragmentos C3 e C4 A/B do sistema complemento. A validação cruzada, utilizando toda casuística apresentou 62,5% e 86,76% de sensibilidade e de especificidade, respectivamente, com uma alta sensibilidade (100%) e especificidade (97%) nos pacientes que morreram pela doença. Além disso, os pacientes com envolvimento ganglionar obtiveram uma sensibilidade e uma especificidade de 80 % e 97%, respectivamente. Ficou demonstrado que à medida que a doença progride mais subexpressos está o conjunto de peptídeos quando comparados com indivíduos saudáveis. Estes resultados podem ser úteis como ferramentas para a avaliação do prognóstico destes pacientes.

Submitted by Boris Flegr (boris@uerj.br) on 2021-01-05T19:43:08Z No. of bitstreams: 1 Mario Lucio Cordeiro Araujo Junior Completa.pdf: 2513788 bytes, checksum: 154c257259bb1c0d02db424f184666ad (MD5) Made available in DSpace on 2021-01-05T19:43:08Z (GMT). No. of bitstreams: 1 Mario Lucio Cordeiro Araujo Junior Completa.pdf: 2513788 bytes, checksum: 154c257259bb1c0d02db424f184666ad (MD5) Previous issue date: 2009-09-18 Systemic Lupus Erythematosus (SLE) is an autoimmune disease with higher prevalence over women. There has been a significant increase in survival time over the years resulting from the improvement of citotoxic and immunosuppressant therapy. This study aims at identifying the prevalence of altered results for cervical smears in this group of patients. 80 patients of the SLE group and 101 patients of the control group were part of the study. The prevalence of alterations in the SLE group was 31.3%, and 5% in the control group (p=0.000). No statistically significant association was found between the presence of alterations in pap smears and the variables STD history, first sexual intercourse at age ≤ 17, multiple partners (≥ 4), previous history of HPV, use of oral contraceptives, tobacco smoking, social class and cancer presence in the family. Statistically significant association was found only in the group variable; patients in the SLE group had a 8.2 higher chance (IC 95% = 2.7 24.9) of showing alterations in the pap smears than those in the control group. These numbers show that SLE patients in immunosuppressant therapy have more alterations in pap smear exams, deserving special attention with regards to cervical cancer prevention. O Lúpus eritematoso sistêmico (LES) é uma doença auto-imune, mais prevalente em mulheres, com marcante aumento da sobrevida nos últimos anos, principalmente relacionado ao avanço do ratamento com terapia imunossupressora / citotóxica. Este estudo visa identificar a prevalência de alterações em esfregaços cervicais nesse grupo de pacientes. Participaram do estudo 80 pacientes do grupo com LES e 101 pacientes do grupo controle. Observou-se que a prevalência de alterações no grupo de paciente com LES foi de 31,3% contra 5,0% do grupo controle (p = 0,000). Não foram encontradas associações estatisticamente significativas entre a presença de alteração no esfregaço cervical e as variáveis: história de DST, sexarca com idade ≤ 17 anos, parceiros múltiplos (≥ 4), história de HPV prévio, uso de ACO, tabagismo, estrato social ou com droga imunossupressora específica. Encontrou-se associação estatisticamente significativa apenas para a variável grupo, tendo paciente pertencente ao grupo LES chance 8,2 vezes maior (IC 95% = 2,7 24,9) de ter alterações no esfregaço cervical que uma paciente do grupo controle. Tais dados demonstram que pacientes com LES em terapia imunossupressora apresentam mais alterações em exames preventivos ginecológicos, merecendo atenção especial quanto à prevenção do câncer de colo do útero.