Eosinofilia tecidual na região do fronte invasivo do carcinoma de células espinocelulares de boca: correlação com parâmetros clínico-patológicos
Tissue eosinophilia in invasive front of oral squamous cell carcinoma: correlation with clinicopathologic parameters
De-Paula, A.M.B.; Cardoso, S.V.; Gomez, R.S.
Rev. odontol. UNESP, vol.35, n3, p.163-169, 2006
Resumo
Introdução Tem sido reconhecido que muitos cânceres são acompanhados por um infiltrado de células inflamatórias de intensidades variáveis. Atenção tem sido direcionada para o possível papel de eosinófilos no comportamento biológico de lesões neoplásicas malignas. Objetivo Avaliar a influência da quantificação de eosinófilos localizados no infiltrado inflamatório da região do fronte invasivo de amostras de carcinoma espinocelular de boca (CEC), categorizados de acordo com o tamanho das lesões primárias; a ocorrência de metástases regionais e com a severidade morfológica da região do fronte de invasão das lesões. Material e método Amostras de 38 espécimes de CEC foram investigadas nesse estudo. O sistema de gradação de malignidades para a região do fronte invasivo empregado no estudo foi idealizado por Bryne et al.9. Para a contagem de eosinófilos, foi utilizada uma lente ocular com um retículo milimetrado de 25 pontos. Doze campos microscópicos corados em H&E foram avaliados de forma aleatória, em um aumento de 400x. Apenas as regiões localizadas no fronte invasivo de cada lesão primária e que apresentavam um evidente componente inflamatório foram selecionadas para análise. A avaliação morfométrica empregada foi baseada no método de Fisher et al.29. Resultado Concordância entre patologistas quanto a gradação da severidade morfológica do fronte de invasão revelou valores de kappa de 0,81 e 0,71 para os exames intra e interobservador, respectivamente. Foi encontrada uma menor quantificação de eosinófilos nas lesões de maiores tamanhos clínicos. Os demais resultados não demonstraram a presença de correlações estatisticamente significativas. Conclusões O tamanho clínico das lesões primárias e a ocorrência de metástases cervicais não parecem ser influenciados pela severidade da gradação morfológica da região do fronte invasivo do CEC. Uma menor quantificação de eosinófilos nas lesões de maiores tamanhos clínicos parece demonstrar uma provável ação inibitória da atividade quimiotática e, conseqüentemente, das atividades antineoplásicas realizadas pelos eosinófilos contra o crescimento de células epiteliais malignas. Estudos futuros sobre a participação de eosinófilos no processo da carcinogênese bucal e de suas citocinas produzidas propiciarão um melhor entendimento sobre o comportamento biológico do CEC.
Palavras-chave
Carcinoma espinocelular, boca, metástase, estadiamento de neoplasias
Abstract
Introduction It has been long recognized that many cancers are accompanied by infiltrates of inflammatory cells of varying intensity. Attention has been directed to the possible role of eosinophils in the biologic behavior of malignant neoplastic lesions. Objective To evaluate the influence of number of eosinophils in samples of oral squamous cell carcinoma (OSCC) with different morphological and clinical parameters. Material and method Tumor tissues of 38 cases of OSCC were investigated in this study. The malignancy grading system of tumour invasive front (Bryne et al.9) was used. An ocular grid in twelve high-power fields in each specimen of primary tumor was used in haematoxylin and eosin stained slides for eosinophils counting. These counting was made in the inflammatory infiltrated in the most invasive areas of the tumour parenchyma. The morphometric analysis employed was based in the method of Fisher et al.29. Result Agreement between pathologists for grading of invasive front showed kappa values of 0.81 and 0.71 for intra and interobserver exams, respectively. Our results did not show a statistically meaningful correlation among the clinical and morphological variables (size of the lesions, cervical metastasis and grading of tumour invasive front). It was found a statiscally meaningful association between the eosinophils counting was statistically associated to the size of the lesions. It was found the smaller number of eosinophils counts in the bigger size lesions (T3/T4). Conclusions Clinical size of the lesions and cervical metastasis of the OSCC do not seem to be directly influenced by morphological grading of the tumour invasive front. A smaller eosinophils counting in bigger size lesions may demonstrate an inhibitory action of the chemotactic activity and/or their antineoplastic activities. Futures advances in the understanding of molecular control of these cells and its citokynes produced may bring a better understanding of biologic behavior of the OSCC.
Keywords
Squamous cell carcinoma, oral cavity, eosinophils, metastasis, neoplasm staging
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