Potential role of the Eph/ephrin system in colorectal cancer: emerging druggable molecular targets

The Eph/ephrin system regulates many developmental processes and adult tissue homeostasis. In colorectal cancer (CRC), it is involved in different processes including tumorigenesis, tumor angiogenesis, metastasis development, and cancer stem cell regeneration. However, conflicting data regarding Eph receptors in CRC, especially in its putative role as an oncogene or a suppressor gene, make the precise role of Eph-ephrin interaction confusing in CRC development. In this review, we provide an overview of the literature and highlight evidence that collaborates with these ambiguous roles of the Eph/ephrin system in CRC, as well as the molecular findings that represent promising therapeutic targets.

Dynamic Role of miRNAs in Salivary Gland Carcinomas: From Biomarkers to Therapeutic Targets

BACKGROUND

Salivary gland carcinomas (SGCs) are a rare group of malignant neoplasms of the head and neck region. MicroRNAs (miRNAs) are a class of small non-coding RNAs that have been associated with the control biological process and oncogenic mechanism by the regulation of gene expression at the post-transcriptional level. Recent evidence has suggested that miRNA expression may play a role in the tumorigenesis and carcinogenesis process in SGCs.

METHODS

This review provides a comprehensive literature review of the role of miRNAs expression in SGCs focusing on the diagnostic, prognostic, and therapeutic applications.

RESULTS

In this review, numerous dysregulated miRNAs have demonstrated an oncogenic and suppressor role in SGCs.

CONCLUSION

In the future, these miRNAs may eventually constitute useful diagnostic and prognostic biomarkers that may lead to a better understanding of SGCs oncogenesis. Additionally, the development of therapeutic agents based on miRNAs may be a promising target in SGC treatment.

Clinical and epidemiological profile of burning mouth syndrome patients following the International Headache Society classification: a systematic review and meta-analysis

OBJECTIVE

This systematic review aimed to determine the clinical and epidemiologic profile of patients with burning mouth syndrome (BMS) following the current classification of the International Headache Society (IHS)-the International Classification of Headache Disorders (ICHD-3) and the International Classification of Orofacial Pain (ICOP).

STUDY DESIGN

This review followed the Preferred Reporting Items for Systematic Reviews and Meta-Analyses checklist and involved a comprehensive search on PubMed, Scopus, EMBASE, Web of Science, LILACS, and the gray literature.

RESULTS

Of the 4,252 studies identified, 41 were included. In general, there were no differences between the clinical and epidemiologic profiles of patients with BMS classified based on ICHD-3 or ICOP. Studies were pooled in meta-analyses and showed a significant prevalence of female patients between the sixth and seventh decade of life. The burning sensation and the tongue were the most prevalent descriptors and affected location. Significant associations were demonstrated between BMS and anxiety (P = .0006), depression (P = .004), and poor oral hygiene (P = .00001).

CONCLUSIONS

Under the existing contemporary classification systems, patients with BMS were found to be mostly females in the sixth and seventh decade of life with a burning sensation on the tongue. Experiencing depression and anxiety was a commonly existing comorbidity.

Reported physical examination methods for screening of oral cancer and oral potentially malignant disorders: a systematic review

OBJECTIVE

This systematic review aimed to describe the method followed during physical examination and the anatomical structures of the head and neck assessed in screening for oral cancer and oral potentially malignant disorders (OPMDs).

STUDY DESIGN

An extensive literature search was carried out using MEDLINE/PubMed, EMBASE, Scopus, LILACS, Web of Science, Cochrane databases, and gray literature. The risk of bias was available in all papers included.

RESULTS

Of 9,688 records identified, 27 were included in this review, reporting data from 356,250 individuals screened and distributed across 11 countries. Most of these (n = 19) were based on 1 round of screening conducted by a dental professional or other health care workers. Most screening programs included visual inspection and palpation of the lips, oral cavity, and the most visible oropharyngeal sites, but the descriptions reported were imprecise. Additional inspection and palpation of the neck (submental, submandibular, cervical, and supraclavicular regions) to assess for the presence of swellings and any palpable neck nodes were also performed in 15 programs.

CONCLUSION

In conclusion, there was considerable heterogeneity in the method of physical examination in screening programs for oral cancer and OPMDs among the included studies.

Hematopoietic colony-stimulating factors in head and neck cancers: Recent advances and therapeutic challenges

Colony-stimulating factors (CSFs) are key cytokines responsible for the production, maturation, and mobilization of the granulocytic and macrophage lineages from the bone marrow, which have been gaining attention for playing pro- and/or anti-tumorigenic roles in cancer. Head and neck cancers (HNCs) represent a group of heterogeneous neoplasms with high morbidity and mortality worldwide. Treatment for HNCs is still limited even with the advancements in cancer immunotherapy. Novel treatments for patients with recurrent and metastatic HNCs are urgently needed. This article provides an in-depth review of the role of hematopoietic cytokines such as granulocyte colony-stimulating factor (G-CSF), granulocyte-macrophage colony-stimulating factor (GM-CSF), macrophage colony-stimulating factor (M-CSF), and interleukin-3 (IL-3; also known as multi-CSF) in the HNCs tumor microenvironment. We have reviewed current results from clinical trials using CSFs as adjuvant therapy to treat HNCs patients, and also clinical findings reported to date on the therapeutic application of CSFs toxicities arising from chemoradiotherapy.

Oral Teratoma with Hairy Polyp-Like Features: A Brief Report of a Rare Presentation

We present a 21-day-old female child presenting with a large oral epithelialized tumor implanted at the rhinopharynx and ethmoid plate through a cleft palate, associated with feeding and respiratory difficulties. The histopathological exam showed mature central adipose tissue, hair follicles, sebaceous glands, and neurovascular structures, lined by keratinized stratified squamous epithelium. Proliferative cartilaginous, glandular, lymphatic, bony, and immature myxoid tissue was seen at the posterior region and insertion. Despite the characterization of the tumor as a teratoma containing structures derived from the three embryonic leaflets, the anterior portion presented a microscopic bigeminal pattern fully compatible with hairy polyp.

Clinicopathological profile of sclerosing polycystic adenoma/adenosis: A systematic review

In this systematic review, we aimed to evaluate the clinicopathological profile of sclerosing polycystic adenoma (SPA). PubMed, Scopus, EMBASE, Lilacs, Web of Science, and gray literature were searched to access cases of SPA in salivary glands. One hundred and thirty cases of SPA were found across 61 selected articles. SPA affected mainly the parotid gland of adults with a mean age of 44.6 years old, with a slight preference for females. The lesion was usually presented as a painless firm mass with a long period of evolution. Histologically, they are well-delimitated lesions composed of acinar and ductal elements with a variety of cytomorphologic features surrounded by a densely collagenized stroma. PI3K was the most common gene mutation related to SPA. SPA is a benign condition that mainly affects the parotid gland of female patients and it is usually treated by surgical resection with a good prognosis.

Discovery proteomics reveals potential protein signature associated with malignant phenotype acquisition in pleomorphic adenoma

OBJECTIVE

To analyze the proteomic profile of salivary pleomorphic adenoma (PA) and carcinoma ex pleomorphic adenoma (CXPA) samples and correlate them with the malignant transformation of the PA.

MATERIALS AND METHODS

Thirty samples (10 PA, 16 CXPA, and 4 residual PA) were microdissected and submitted to liquid chromatography-tandem mass spectrometry (LC-MS/MS). The proteomic data and protein identification were analyzed through LC-MS/MS spectra using the MaxQuant software.

RESULTS

The proteomic analysis identified and quantified a total of 240 proteins in which 135 were found in PA, residual PA, and CXPA. The shared proteins were divided into six subgroups, and the proteins that showed statistically significant differences (p > 0.05) and fold-change > or <2.5 in one subgroup to another subgroup were included. Seven proteins (Apolipoprotein A-I-APOA1, haptoglobin-HP, protein of the synaptonemal complex 1-SYCP1, anion transport protein of band 3-SLC4A1, subunit μ1 of AP-1 complex-AP1M1, beta subunit of hemoglobin-HBB, and dermcidin-DCD) were classified as potential protein signatures, being HP, AP1M1, and HBB with higher abundance for PA to residual PA, APOA1 with higher abundance for PA to CXPA, SLC4A1 with lower abundance in the PA to CXPA, SYCP1with lower abundance for residual PA to CXPA, and DCD with higher abundance in the CXPA with epithelial differentiation to myoepithelial differentiation.

CONCLUSIONS

In this work, we demonstrated the comparative proteomic profiling of PA, residual PA, and CXPA, and seven were proposed as protein signatures, some of which may be associated with the malignant phenotype acquisition.

Clinicopathological and survival profile of patients with salivary gland myoepithelial carcinoma: A systematic review

OBJECTIVES

In this systematic review, we aimed to evaluate the clinicopathological and prognosis data of patients with salivary gland myoepithelial carcinoma.

MATERIALS AND METHODS

MEDLINE/PubMed, Scopus, and Embase search was performed with the keywords "myoepithelial carcinoma" "malignant myoepithelioma," and "salivary glands." Primary salivary glands myoepithelial carcinoma that fulfilled the World Health Organization diagnostic criteria were included. The Joanna Briggs Institute tool was used to assess the risk of bias.

RESULTS

Forty-three studies (71 patients) met the inclusion criteria. The patients showed a mean age of 56.4 ± 19.6 years with no sex predilection. The parotid was the most affected gland (49.3%). The tumor presented as an asymptomatic (65.1%) mass (84%). The most common histological findings were the presence of clear tumor cells (39.7%) and multinodular growth patterns (60.7%). Multivariate analysis showed plasmacytoid cell type (p = 0.010) and solid growth pattern (p = 0.003) were related to decreased disease-free survival. Surgery alone was the most used treatment (53.5%). Patients with a combination of treatments showed a longer disease-free survival (p = 0.049). The 2-year and 5-year overall survival rates were 67.5% and 46.1%, respectively.

CONCLUSION

Salivary gland myoepithelial carcinoma showed no sex predilection, with a higher incidence in the parotid gland. Cell type, growth pattern, and treatment type may be related to a lower disease-free survival. Overall, salivary gland myoepithelial carcinoma presented low recurrence and metastasis rates. Registration and protocol: This systematic review followed the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) 2020 checklist and registered in the International Prospective Register of Systematic Reviews (PROSPERO) database (CRD42022311512).

Heterogeneity and versatility of the extracellular matrix during the transition from pleomorphic adenoma to carcinoma ex pleomorphic adenoma: cumulative findings from basic research and new insights

Pleomorphic adenoma (PA) is the most common salivary gland tumor, accounting for 50%-60% of these neoplasms. If untreated, 6.2% of PA may undergo malignant transformation to carcinoma ex-pleomorphic adenoma (CXPA). CXPA is a rare and aggressive malignant tumor, whose prevalence represents approximately 3%-6% of all salivary gland tumors. Although the pathogenesis of the PA-CXPA transition remains unclear, CXPA development requires the participation of cellular components and the tumor microenvironment for its progression. The extracellular matrix (ECM) comprises a heterogeneous and versatile network of macromolecules synthesized and secreted by embryonic cells. In the PA-CXPA sequence, ECM is formed by a variety of components including collagen, elastin, fibronectin, laminins, glycosaminoglycans, proteoglycans, and other glycoproteins, mainly secreted by epithelial cells, myoepithelial cells, cancer-associated fibroblasts, immune cells, and endothelial cells. Like in other tumors including breast cancer, ECM changes play an important role in the PA-CXPA sequence. This review summarizes what is currently known about the role of ECM during CXPA development.

Spindle cell carcinoma of the lip: An immunohistochemical study of a challenging case

INTRODUCTION

Spindle cell carcinoma (SpCC) or sarcomatoid carcinoma, is a rare variant of squamous cell carcinoma (SCC) that has a variable proportion of carcinomatous and sarcomatous components. Here, we reported an immunohistochemical study of a spindle cell carcinoma with a challenging morphological diagnosis.

CASE REPORT

A 50-year-old woman with a previous history of nodular melanoma was referred for evaluation of a painful papule in the lower lip. After surgical resection, neoplastic cells showed focal positivity for CK-14, αSMA, p63, and confirmed the strong positivity for S100 and vimentin. Tumor cells were negative for HMB-45, Melan A, SOX-10, AE1/AE3, 34βE12, CK5-6, CAM5.2, EMA, desmin, calponin, CD10, CD34, and CD68. With these findings, a diagnosis of SpCC was rendered. The patient presented lung and dorsal metastases after 12 months and after 3 years of follow-up, the patient died.

CONCLUSION

In summary, a careful correlation of microscopy and immunohistochemical characteristics is required for the proper diagnosis of this lesion.

Metabolic alterations in carcinoma ex pleomorphic adenoma development of lacrimal glands

PURPOSE

To evaluate metabolic alterations along with the carcinoma ex pleomorphic adneoma (CXPA) development of lacrimal glands (LG).

METHODS

Four samples of the normal LG (NLG), 9 of pleomorphic adenoma (PA), 4 of residual PA (rPA), and 4 of CXPA of LG were included. GLUT-1, HIF-1α, FASN, and adipophilin by immunohistochemical stains were performed in the selected cases.

RESULTS

Was observed higher expression of markers associated with glycolytic and lipid metabolism in the tumor tissue samples when compared to the NLG samples. Additionally, GLUT-1, FASN, and Adipophilin were more expressed in CXPA samples while HIF-1α in PA samples.

CONCLUSIONS

In conclusion, our results demonstrate overexpression of FASN and Adipophilin in CXPA which may reflect a metabolic shift toward lipogenesis in cancer cells.

Salivary gland cystadenocarcinoma: Rare neoplasm in buccal mucosa

A 72-year-old female was referred for diagnosis of a lesion located in the right buccal mucosa, with duration unknown. At intraoral examination, the lesion appeared as a well-delimited, mobile, and submucosal nodule. A benign mesenchymal neoplasm was the main hypothesis of diagnosis. Histopathological analysis revealed salivary gland neoplasm formed by atypical cells often arranged in microcystic structures, with frequent intraluminal papillary projections. The tumor cells presented positivity for CK7 and negativity for CK20. Based on these features, the diagnosis of cystadenocarcinoma was established. The patient was submitted to wide surgical resection. No recurrence was observed after 48 months. Although rare, cystadenocarcinoma should be considered in the differential diagnosis of oral submucosal nodules.

Secretory carcinoma ex pleomorphic adenoma of the submandibular gland: An immunohistochemical study

Male patient 60-year-old was referred from another service for expert review of a lesion in the submental region. Pathological review revealed morphological features compatible with salivary gland Secretory carcinoma (SC) in cervical lymph node. The patient underwent removal of the left submandibular gland, left neck dissection and biopsy of left labial commissure region. Anatomopathological examination was observed tumor cells arranged in a solid and ductal/cystic pattern, with abundant droplets of secreted eosinophilic material within these structures and extensive hyalinized area, which presented few cells arranged in a ductal pattern. It was possible to observe the presence of extracapsular extension of neoplastic cells > 6 mm, base on this aspects, Carcinoma ex pleomorphic adenoma was suspected. Immunohistochemical panel showed positivity for mammaglobin, s100, CK7, and adipophilin and negativity for myoepithelial markers and PAS in SC cells. The myoepithelial markers showed positivity for residual cellsin hyalinized area, corresponding to residual Pleomorphic adenoma (PA). In view of these findings, the diagnosis of Secretory carcinoma ex pleomorphic adenoma (SCXPA) was established.

Diagnostic and prognostic value of miRNAs on salivary gland tumors: a systematic review and meta-analysis

PURPOSE

Different levels of miRNA expression have been described in salivary gland tumors as a potential diagnostic marker and predictor of survival. We systematically reviewed the literature to assess the diagnostic and prognostic value of miRNAs on salivary gland tumors.

METHODS

An electronic search was conducted in PubMed, Scopus, Embase, Cochrane, and Web of Science databases. In the meta-analysis, we assumed random-effects model with adjusted hazard ratio (HR) and 95% confidence intervals (95% CI). For prognostic studies, the risk of bias was assessed by Meta-Analysis of Statistics Assessment and Review Instrument (MAStARI) and Quality Assessment Tool for Diagnostic Accuracy Studies-2 (QUADAS-2) was utilized for diagnostic studies.

RESULTS

Gathered data from 1.131 patients in seven studies demonstrated that different levels of miRNA expression presented diagnostic and prognostic in SGTs. The meta-analysis showed that altered miRNA expression were associated with shortened survival (HR, 2.35, 95% CI, 1.77-3.10, P < .00001). For diagnostic meta-analysis, the overall pooled results for specificity and sensibility were 0.87-0.97 (95% CI, 0.72-1) and 0.68-0.91 (95% CI, 0.51-0.96), respectively.

CONCLUSION

MicroRNAs may be useful in prognostication of patients with SGTs; however, the diagnostic value of miRNAs in SGTs is still limited.

M1 macrophages involved in the pathogenesis of placental chronic villitis of unknown etiology

INTRODUCTION

Placental villitis is characterized by the presence of inflammatory infiltrate in the placental villous. The objective of this study was to characterize in villitis of unknown etiology (VUE) of the human placentas the subpopulation of M1, important effector cells, and M2 macrophages, immunoregulatory cells.

METHODS

Sixteen cases of VUE and three control placentas were examined using immunohistochemistry with antibodies for CD3, CD68, CD11c, and CD163.

RESULTS

CD11c appeared predominantly in the inflamed villi when compared to the normal areas (p<.001). These cells corresponded to 41.2% of the macrophage population in the inflamed area and were mainly present inside the villi (36%). With regards to CD163, these cells tended to be in higher amounts in the inflamed villi when compared to CD11c and normal areas.

DISCUSSION

We conclude that the almost exclusive presence of M1 macrophages in the inflamed areas suggests the influence of these cells in the pathogenesis VUE. The greater amount of M2 in villitis and normal areas suggests a possible immunoregulatory mechanism of the inflammatory process in VUE.

Multiple cutaneous fistula after titanium dental implant: A case report

BACKGROUND

Dental implants allow functional and aesthetic reestablishment. Titanium (Ti) implants emerge as the preferred choice because Ti is considered an inert material, highly resistant to corrosion. However, virtually no material can be considered universally biocompatible and this includes titanium.

PURPOSE

To report an unusual presentation of inflammatory reaction after a Ti dental implant.

MATERIALS AND METHODS

The patient presented to a dermatology clinic to evaluate lesions on her face. She reported the placement of dental implants 2 years earlier, one of which evolved with inflammatory signs and instability a few days after the procedure. As anti-inflammatory and antibiotic therapy were fruitless, after 3 months the implant was removed, but the inflammation persisted. On physical examination, painful erythematous-papule-nodular lesions were found on the left mandibular and submandibular region.

RESULTS

Culture tests for microorganisms were negative and histopathological examination revealed a chronic fistula with a foreign body reaction. Using X-ray fluorescence, Ti particles were found along the fistula wall.

CONCLUSIONS

Professionals should be aware of complications arising from dental implants, including Ti implants. Detailed anamnesis and laboratory investigation can assure diagnosis for specific therapeutic approaches.

Two sides of the same coin: Insights into the myoepithelial cells in carcinoma ex pleomorphic adenoma development

The myoepithelial cell seems to play an important role as a tumor suppressor in the development of carcinoma ex pleomorphic adenoma. Nevertheless, interesting aspects concerning the other side of the coin, i.e., the contribution of the myoepithelial cell to cell proliferation, were brought to light. Here we highlighted the studies in which myoepithelial cells were presented as tumor suppressors and promoters in the context of PA malignant transformation. In conclusion, even if in a paracrine way, divergent signals can alter the suppressor role of the myoepithelial cell and induce it to compose a microenvironment propitious to the tumor progression of the malignant cells. This would cause myoepithelial cells to succumb and malignant epithelial cells to initiate progression beyond the basal membrane.