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Rebeca De Souza Azevedo - One of the best experts on this subject based on the ideXlab platform.
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time resolved fluorescence spectroscopy for clinical diagnosis of Actinic Cheilitis
Biomedical Optics Express, 2016Co-Authors: Alessandro Cosci, Marcelo Saito Nogueira, Ademar Takahama, Sebastiao Pratavieira, Rebeca De Souza Azevedo, Cristina KurachiAbstract:Actinic Cheilitis is a potentially malignant disorder of the lips. Its first cause is believed to be UV sun radiation. The lesion is highly heterogeneous, making the choice of area to be biopsied difficult. This study exploits the capabilities of time-resolved fluorescence spectroscopy for the identification of the most representative area to be biopsied. A preliminary study was performed on fourteen patients. A classification algorithm was used on data acquired on nine different biopsies. The algorithm discriminated between absent, mild, and moderate dysplasia with a sensitivity of 92.9%, 90.0%, and 80.0%, respectively. The false positive rate for healthy tissue (specificity) was 88.8%.
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a comparative study using who and binary oral epithelial dysplasia grading systems in Actinic Cheilitis
Oral Diseases, 2016Co-Authors: Priscilla Rodrigues Câmara, S N Dutra, A Takahama, Kbfc Fontes, Rebeca De Souza AzevedoAbstract:OBJECTIVE: To evaluate comparatively the influence of histopathological features on epithelial dysplasia (ED) and the effectiveness in usage of WHO and binary grading systems in Actinic Cheilitis (AC). MATERIAL AND METHODS: Cytological and architectural alterations established by WHO for ED were evaluated in 107 cases of AC. Epithelial dysplasia was graded using WHO and binary systems. The comparisons were performed using kappa, chi-square, and phi coefficient tests (P < 0.05). RESULTS: Most cases were classified as mild ED (44.5%) in the WHO system and as low risk for malignant transformation (64.5%) in the binary system. There was a positive correlation between WHO and binary systems (k = 0.33; P < 0.0002). Loss of basal cell polarity (P < 0.001) was associated with severity of ED grade in the WHO system. Anisonucleosis (P < 0.0001), nuclear pleomorphism (P < 0.0001), anisocytosis (P = 0.03), cell pleomorphism (P = 0.002) increased nuclear/cytoplasm ratio (P < 0.0001), increased nuclear size (P < 0.0001), increased number of mitotic figures (P = 0.0006), and dyskeratosis (P = 0.008) were associated with severity of ED grade in the binary system. CONCLUSIONS: It seems that usage of binary ED grading system in AC may be more precise because there is correlation between many of cytological and some of architectural microscopic alterations with increased grade of ED.
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usefulness of tissue autofluorescence imaging in Actinic Cheilitis diagnosis
Journal of Biomedical Optics, 2013Co-Authors: Ademar Takahama, Alessandro Cosci, Cristina Kurachi, Isabel Schausltz Pereira Faustino, Danielle Resende Camisasca, Karla Bianca Fernandes Da Costa Fontes, Fabio Ramoa Pires, Rebeca De Souza AzevedoAbstract:Actinic Cheilitis (AC) is a potentially malignant disorder of the lips. Because of its heterogeneous clinical aspect, it is difficult to indicate representative biopsy area. The purpose of this study was to evaluate the usefulness of tissue autofluorescence in AC diagnosis. The system was composed of a 405-nm light-emitting diode, sent to the sample by a dichroic, that allows the fluorescence signal to reach a camera directly plugged in the system. Fifty- seven patients with clinical diagnosis of AC and 45 normal volunteers were selected. According to clinical and fluorescence features, one or more areas were selected for biopsies in the AC group and epithelial dysplasia (ED) grades were established. The autofluorescence images were processed by a clustering algorithm for AC automated diagnosis. The tissue autofluorescence image revealed a heterogeneous pattern of loss and increase of fluorescence in patients with AC. ED was found in 93% of the cases, and most of the areas graded as moderate or severe ED were chosen with the aid of autofluorescence. The processed autofluorescence images from AC patients showed a higher number of spots in an irregular pattern. Tissue autofluorescence image system is a useful technique in association with clinical examination for AC diagnosis. © 2013 Society of Photo-Optical Instrumentation Engineers (SPIE) (DOI: 10.1117/1.JBO.18.7 .076023)
Filipe Modolo - One of the best experts on this subject based on the ideXlab platform.
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Actinic Cheilitis and lip squamous cell carcinoma literature review and new data from brazil
Journal of Clinical and Experimental Dentistry, 2019Co-Authors: Fernandaweber Mello, Filipe Modolo, Gilberto Melo, Elenarietcorrea RiveroAbstract:Background To investigate the prevalence of malignant and potentially malignant lesions of the lip in an oral pathology service and to compare these data with a literature review. Material and methods A total of 3173 biopsy reports and histopathological records were analyzed. Cases with a histological diagnosis of Actinic Cheilitis (AC) with or without epithelial dysplasia, in situ carcinoma, or lip squamous cell carcinoma (LSCC) were included. A comprehensive literature review was conducted to investigate the prevalence of AC and/or LSCC. Results 124 cases (3.91%) were included, 75 (60.5%) had some degree of epithelial dysplasia and 31 (25.0%) were LSCC. Clinically, most of the lesions were diagnosed as AC (50.8%); however, eight cases clinically reported as AC were histologically diagnosed as LSCC. Regarding clinical characteristics, most individuals were fair-skinned male, with mean age of 54.3±12.3 years, and with a history of long-term solar exposure. Furthermore, 18 articles were selected from the literature, showing that the lower lip was predominantly affected and that most individuals were males, fair-skinned, and older than 40 years. Conclusions Since most of the cases diagnosed clinically as AC presented some degree of epithelial dysplasia, it is important to emphasize the value of biopsy and the histological evaluation of this lesion. Key words:Actinic Cheilitis, Precancerous conditions, In situ carcinoma, Oral diagnosis, Mouth neoplasms.
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Immunoexpression of HDAC1, HDAC2, and HAT1 in Actinic Cheilitis and lip squamous cell carcinoma.
Oral diseases, 2017Co-Authors: Emanuely Da Silva Chrun, Filipe Modolo, Dsc Vieira, Áls Borges-júnior, Renata Goulart Castro, Filipe Ivan DanielAbstract:Background Acetylation/deacetylation are the most studied covalent histone modifications resulting in transcriptional regulation with histone deacetylases (HDAC) and histone acetyltransferases (HAT) as the main associated enzymes. These enzymes overexpression induces abnormal transcription of key genes that regulate important cellular functions, such as proliferation, cell cycle regulation, and apoptosis. Thus, the expression of different HATs and HDACs has been evaluated in various cancers. OBJECTIVE: to investigate HDAC1, HDAC2 and HAT1 expression in lip squamous cell carcinoma (LSCC) and Actinic Cheilitis (AC) and to demonstrate their correlation with DNA metyltransferases (DNMTs). Material And Methods Thirty cases of lip squamous cell carcinoma (LSCC), thirty cases of Actinic Cheilitis (AC), and 28 cases of non-neoplastic epithelium as control, were selected for immunohistochemical investigation. RESULTS: Nuclear HDAC2 immunopositivity was significantly higher in AC (75.07%±29.70) when compared with LSCC (51.06%±39.02). HDAC1 and HAT1 nuclear immunostaining were higher in AC, with no statistical significance. When comparing data with our previous study, we found a positive correlation between HDAC1 X DNMT1/DNMT3b, HDAC2 X DNMT3b, and HAT1 X DNMT1/DNMT3b for certain studied groups. Conclusion This study showed higher levels of nuclear HDAC2 immunopositivity in AC, possibly indicating that this enzyme plays a key role in lip photocarcinogenesis early stages. This article is protected by copyright. All rights reserved.
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immunohistochemical expression of matrix metalloproteinase 1 matrix metalloproteinase 2 and matrix metalloproteinase 9 myofibroblasts and ki 67 in Actinic Cheilitis and lip squamous cell carcinoma
International Journal of Experimental Pathology, 2015Co-Authors: Bianca Carla Bianco, Renata Goulart Castro, Fernanda Marcello Scotti, Daniella Serafin Couto Vieira, Michelle Tillmann Biz, Filipe ModoloAbstract:Matrix metalloproteinases (MMPs), myofibroblasts (MFs) and epithelial proliferation have key roles in neoplastic progression. In this study immunoexpression of MMP-1, MMP-2 and MMP-9, presence of MFs and the epithelial proliferation index were investigated in Actinic Cheilitis (AC), lip squamous cell carcinoma (LSCC) and mucocele (MUC). Thirty cases of AC, thirty cases of LSCC and twenty cases of MUC were selected for immunohistochemical investigation of the proteins MMP-1, MMP-2, MMP-9, α-smooth muscle actin (α-SMA) and Ki-67. The MMP-1 expression in the epithelial component was higher in the AC than the MUC and LSCC. In the connective tissue, the expression was higher in the LSCC. MMP-2 showed lower epithelial and stromal immunostaining in the LSCC when compared to the AC and MUC. The epithelial staining for MMP-9 was higher in the AC when compared to the LSCC. However, in the connective tissue, the expression was lower in the AC compared to other lesions. The cell proliferation rate was increased in proportion to the severity of dysplasia in the AC, while in the LSCC it was higher in well-differentiated lesions compared to moderately differentiated. There were no statistically significant differences in number of MFs present in the lesions studied. The results suggest that MMPs could affect the biological behaviour of ACs and LSCCs inasmuch as they could participate in the development and progression from premalignant lesions to malignant lesions.
Alejandra Martinez - One of the best experts on this subject based on the ideXlab platform.
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increased fibroblast density in Actinic Cheilitis association with tryptase positive mast cells Actinic elastosis and epithelial p53 and cox 2 expression
Journal of Oral Pathology & Medicine, 2012Co-Authors: I G Rojas, Yadira V Boza, M L Spencer, Maritza Flores, Alejandra MartinezAbstract:J Oral Pathol Med (2012) 41: 27–33 Background: Actinic Cheilitis (AC) is characterized by epithelial and connective tissue alterations caused by ultraviolet sunlight overexposure known as photodamage. Fibroblasts have been linked to photodamage and tumor progression during skin carcinogenesis; however, their role in early lip carcinogenesis remains unknown. The aim of this study was to assess the density of fibroblasts in AC and normal lip (NL) samples and determine their association with markers of lip photodamage. Methods: Fibroblasts, mast cells, p53, COX-2, and elastin were detected in NL (n = 20) and AC (n = 28) biopsies using immunohistochemistry/histochemistry. Mast cell and fibroblast density and epithelial p53 and COX-2 expression scores were then obtained. Elastosis was scored 1–4 according to elastin fiber density and tortuosity. Results: Fibroblasts, mast cells, p53, COX-2, and elastosis were increased in AC as compared to NL (P < 0.001). Multivariate analysis showed an association between fibroblast and mast cell density at the papillary and reticular areas of AC and NL (P < 0.05). Papillary fibroblast density was also associated with epithelial p53 and COX-2 expression (P < 0.05). Increased fibroblast density, both papillary and reticular, was found in the high elastosis group (scores 3–4) as compared to the low elastosis group (scores 1–2) (P < 0.01). Increased reticular mast cell density was detected only in the high elastosis group (P < 0.01). Conclusions: Fibroblasts are increased in AC, and they are associated with mast cell density, epithelial p53 and COX-2 expression, and Actinic elastosis. Therefore, fibroblasts may contribute to lip photodamage and could be considered useful markers of early lip carcinogenesis.
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Actinic Cheilitis epithelial expression of cox 2 and its association with mast cell tryptase and par 2
Oral Oncology, 2009Co-Authors: Gina I Rojas, Alejandra Martinez, Ursula Brethauer, Patricia Grez, Roger Yefi, Sandra Luza, Francisco J MarchesaniAbstract:Summary Cyclooxygenase-2 (COX-2) is overexpressed in various types of human malignancies, including oral cancers. Recent studies have shown that mast cell-derived protease tryptase can induce COX-2 expression by the cleavage of proteinase-activated receptor-2 (PAR-2). Actinic Cheilitis (AC) is a premalignant form of lip cancer characterized by an increased density of tryptase-positive mast cells. To investigate the possible contribution of tryptase to COX-2 overexpression during early lip carcinogenesis, normal lip ( n = 24) and AC ( n = 45) biopsies were processed for COX-2, PAR-2 and tryptase detection, using RT-PCR and immunohistochemistry. Expression scores were obtained for each marker and tested for statistical significance using Mann–Whitney and Spearmann’s correlation tests as well as multivariate logistic regression analysis. Increased epithelial co-expression of COX-2 and PAR-2, as well as, elevated subepithelial density of tryptase-positive mast cells were found in AC as compared to normal lip ( P P P
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epithelial expression of p53 mdm 2 and p21 in normal lip and Actinic Cheilitis
Oral Oncology, 2008Co-Authors: Alejandra Martinez, Ursula Brethauer, Jaime Borlando, Loreto M Spencer, Gina I RojasAbstract:Summary The p53 pathway is commonly altered during oral and skin carcinogenesis. The lip is a transition tissue between skin and oral mucosa, which in response to UVB exposure also exhibits alterations in the expression of p53 and p53-related genes that could lead to malignant transformation. To assess if the p53-regulated proteins murine-double-minute (mdm)-2 and p21 are altered during early lip carcinogenesis, biopsies from normal lip ( n = 16) and the premalignant lip lesion, Actinic Cheilitis (AC) ( n = 26) were processed for the immunohistochemical detection of p53, p21 and mdm-2 in serial co-localized sections. Epithelial co-expression of p53 and mdm-2 was significantly increased in AC as compared to normal lip ( P
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expression of apoptotic and cell proliferation regulatory proteins in Actinic Cheilitis
Journal of Oral Pathology & Medicine, 2005Co-Authors: Alejandra Martinez, M L Spencer, Isolde G Rojas, Ursula Brethauer, F Mucientes, J Borlando, M I RudolphAbstract:BACKGROUND: Actinic Cheilitis (AC) is a pre-malignant lesion caused by ultraviolet (UV) radiation. The apoptotic proteins p53, bax, bcl-2, and the proliferation marker Ki-67, are known to play an important role in UV-exposed skin and carcinomas, therefore, these markers were assessed in AC and compared with normal lip and oral mucosa. METHODS: AC (n = 13), normal lip (n = 7) and oral mucosa (n = 6) biopsies were stained immunohistochemically for p53, bax, bcl-2 and Ki-67, to determine their expression and distribution. RESULTS: p53 was over-expressed in AC as compared with normal lip and oral mucosa (P < 0.003). Although bcl-2 expression was higher in AC than in oral mucosa (P < 0.002), it was significantly reduced as compared with normal lip (P < 0.04). Bax expression remained unchanged, and Ki-67 was significantly increased in AC and normal lip as compared with oral mucosa (P < 0.05). CONCLUSION: The results suggest that DNA-damaged cells by UV radiation in AC are eliminated by apoptosis.
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increased mast cell density and protease content in Actinic Cheilitis
Journal of Oral Pathology & Medicine, 2004Co-Authors: Isolde G Rojas, M L Spencer, Alejandra Martinez, A Pineda, M Jimenez, M I RudolphAbstract:Background: Actinic Cheilitis (AC) is a pre-malignant lesion caused by ultraviolet (UV) radiation and characterized by epithelial and connective tissue alterations. Mast cells (MCs), key contributors to solar elastosis in murine UV-irradiated skin, were characterized in order to assess their potential contribution to connective tissue degeneration in AC. Methods: Actinic Cheilitis (n = 15) and normal lip (n = 8) biopsies were stained immunohistochemically for tryptase and enzymehistochemically for chymase to determine MC density and protease content. MC subpopulations (i.e. MCT containing only tryptase, and MCTC containing chymase and tryptase) and their distribution were also determined. Results: Mast cells and their proteases were increased in AC as compared with normal lip (P < 0.0001), and appeared degranulated especially around elastotic areas. MCT predominated over MCTC in AC and normal lip (P < 0.05). However, in AC MCT were increased in the epithelium/connective junction and connective area (P < 0.05), while in normal lip MCT predominated in connective and submucosal areas (P < 0.05). Conclusion: The results suggest that increased MC density and protease content may contribute to elastosis formation in AC. In addition, changes in MCT distribution may favor AC malignization.
Pereiro Ferreirós Manuel - One of the best experts on this subject based on the ideXlab platform.
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Assembling a consensus on Actinic Cheilitis: A Delphi study
'Wiley', 2021Co-Authors: Seoane Lestón, Juan Manuel, Pereiro Ferreirós Manuel, Warnakulasuriya Saman, Bagan Jose, Aguirre Urizar, José Manuel, López Jornet Pía, Hernández Vallejo Gonzalo, González Moles, Miguel Ángel, Seoane Romero Javier, Varela Centelles, Pablo IgnacioAbstract:Aims: To discuss the terminology to define and classify Actinic Cheilitis (AC) and to build a consensus on the diagnostic and therapeutic approaches to AC. Methods: Two-round Delphi study using a questionnaire including 34 closed sentences (9 on terminology and taxonomy, 5 on potential for malignant transformation, 12 on diagnostic aspects, 8 on treatment) and 8 open questions. Experts’ agreement was rated using a Likert scale (1–7). Results: A consensus was reached on 24 out 34 statements (73.5%) and on 5 out of 8 (62.5%) close-ended questions. The response rate was identical in both rounds (attrition of 0%). AC is the term with the highest agreement (median of 7 (strongly agree; IQR: 6–7)) and the lowest dispersion (VC = 21.33). ‘Potentially malignant disorder’ was the preferred classification group for AC (median of 7) and 85.6% of participants showing some level of agreement (CV < 50). Experts (66.75%) consider AC a clinical term (median: 7; IQR: 4–7) and believe definitive diagnosis can be made clinically (median: 6; IQR: 5–7), particularly by inspection and palpation (median: 5; IQR: 4–6). Histopathological confirmation is mandatory for the management of AC (median: 5; IQR: 2.5–7), even for homogeneous lesions (median: 5; IQR: 3.5–6). Consensus was reached on all treatment statements (VC < 50). Conclusions: AC is a potentially malignant disorder with a significant lack of agreement on diagnostic criteria, procedures, biopsy indications and the importance of techniques to assist in biopsy. A consensus was reached on nomenclature and management of this disorderS
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Actinic Cheilitis: analysis of clinical subtypes, risk factors and associated signs of Actinic damage
'Acta Dermato-Venereologica', 2019Co-Authors: Rodríguez Blanco Isabel, Paredes Suárez Carmen, Rodríguez Lojo Romina, González Vilas Daniel, Ramírez Santos Aquilina, Paradela Sabela, Suárez Conde Ignacio, Flórez Menéndez, María Ángeles, Pereiro Ferreirós ManuelAbstract:Actinic Cheilitis (AC) is a common condition that mainly involves the lower lip, which is associated with chronic exposure to ultraviolet (UV) radiation. AC is considered a precursor of malignancy (1), but the rate of progression from AC to invasive squamous cell carcinoma (SCC) has not yet been established. An epidemiological study previously described the prevalence of AC and its associated variables in the Galicia region (north-western Spain); the prevalence of AC in a population aged 45 years and over was 31.3%, and multivariate analysis showed that significant and independent risk factors for AC were age ≥60 years, Fitzpatrick skin phototypes I and II, working outdoors for more than 25 years, and a history of non-melanoma skin cancer (NMSC) (2). We report here a subanalysis of the clinical manifestations of AC and the associations of AC with other markers of Actinic damageS
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Actinic Cheilitis prevalence and risk factors: a cross-sectional, multicentre study in a population aged 45 years and over in north-west Spain
'Acta Dermato-Venereologica', 2018Co-Authors: Rodríguez Blanco Isabel, Flórez Ángeles, Paredes Suárez Carmen, Rodríguez Lojo Romina, González Vilas Daniel, Ramírez Santos Aquilina, Paradela Sabela, Suárez Conde Ignacio, Pereiro Ferreirós ManuelAbstract:Actinic Cheilitis is thought to be a premalignant lesion or a superficial squamous cell carcinoma. The prevalence of Actinic Cheilitis in Europe is unknown. The aim of this study was to determine the prevalence of Actinic Cheilitis in the Galicia region (north-west Spain). Secondary objectives were the description of risk factors of Actinic Cheilitis. A cross-sectional multicentre study in patients ≥ 45 years of age was performed in 8 dermatology departments in Galicia region during a 1-year period. The prevalence of Actinic Cheilitis was 31.3%. Significant and independent risk factors of Actinic Cheilitis after multivariate analysis were age ≥ 60 years, Fitzpatrick skin phototype II, outdoor working for more than 25 years, and previous history of non-melanoma skin cancer. This is the first cross-sectional multicentre study of the prevalence of Actinic Cheilitis in Europe. Actinic Cheilitis was present in almost one-third of the screened patients. Lip examination should be performed in all patients with chronic Actinic damageS
Elenarietcorrea Rivero - One of the best experts on this subject based on the ideXlab platform.
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Actinic Cheilitis and lip squamous cell carcinoma literature review and new data from brazil
Journal of Clinical and Experimental Dentistry, 2019Co-Authors: Fernandaweber Mello, Filipe Modolo, Gilberto Melo, Elenarietcorrea RiveroAbstract:Background To investigate the prevalence of malignant and potentially malignant lesions of the lip in an oral pathology service and to compare these data with a literature review. Material and methods A total of 3173 biopsy reports and histopathological records were analyzed. Cases with a histological diagnosis of Actinic Cheilitis (AC) with or without epithelial dysplasia, in situ carcinoma, or lip squamous cell carcinoma (LSCC) were included. A comprehensive literature review was conducted to investigate the prevalence of AC and/or LSCC. Results 124 cases (3.91%) were included, 75 (60.5%) had some degree of epithelial dysplasia and 31 (25.0%) were LSCC. Clinically, most of the lesions were diagnosed as AC (50.8%); however, eight cases clinically reported as AC were histologically diagnosed as LSCC. Regarding clinical characteristics, most individuals were fair-skinned male, with mean age of 54.3±12.3 years, and with a history of long-term solar exposure. Furthermore, 18 articles were selected from the literature, showing that the lower lip was predominantly affected and that most individuals were males, fair-skinned, and older than 40 years. Conclusions Since most of the cases diagnosed clinically as AC presented some degree of epithelial dysplasia, it is important to emphasize the value of biopsy and the histological evaluation of this lesion. Key words:Actinic Cheilitis, Precancerous conditions, In situ carcinoma, Oral diagnosis, Mouth neoplasms.
