Leucoplasia verrucosa proliferativa, análise de biomarcadores presentes na progressão da lesão

Abstract

lesões em mucosa jugal, rebordo alveolar e língua confirmando ainda seu perfil evolutivo em face às múltiplas lesões com alto potencial recidivante e latente insurgir do carcinoma espinocelular, este podendo ainda ser embasado por expressiva marcação de pmTOR, pAkt e MCM3.Palavras-chave: Leucoplasia verrucosa proliferativa, carcinogênese, pmTOR, pAkt, MCM3. ABSTRACTGimenez LCO. Proliferative verrucous leukoplakia, analysis of biomarkers present in lesion progression [thesis]. São Paulo: Universidade de São Paulo, Faculdade de Odontologia; 2018. Versão Corrigida. Multiple oral lesions that progress in a slow irreversible course by expansion of affected areas, in the sense of a worse prognosis, characterize proliferative verrucous leukoplakia. The said lesion presents an aggressive profile, with an indeterminate number of recurrences and a high potential for neoplastic transformation. To this fact, it is attributed to frequent incidence in verrucous carcinoma as well as invasive and potentially metastatic invasive mouth squamous cell carcinoma, inserting itself in indices of higher prevalence when compared to verrucous carcinoma in patients with proliferative verrucous leukoplakia. It is linked to the aforementioned context, the involvement of cell signaling pathways, causing the disruption of a complex system which encompasses oncogenes activity, inhibition of tumor suppressor genes and alteration of DNA repair system regulators, ending in several factors favorable to carcinogenesis, in which negative regulation of proapoptotic cascades and stimulation to disordered cell proliferation. To this process one may relate the dissatisfaction of the PI3K / Akt / mTOR pathway and a member of the pre-replication complex, MCM3. Thus, the detailed analysis of the evolutionary lesion profile through the role of previous diagnoses and the cross-referencing of epidemiological data, as well as the characterization of malignant neoplasms from proliferative verrucous leukoplakia by the expression of the biomarkers pAkt, pmTOR and MCM3, come to clarify aspects that have not yet been studied in this intriguing clinicopathological entity. Thus, the present study analyzed the historical diagnosis of 28 patients with proliferative verrucous leukoplakia submitting to immunohistochemical analysis for the aforementioned proteins, the amount of 34 samples from the same patients, comprising 28 of proliferative verrucous leukoplakia, 4 of verrucous carcinoma and 2 of squamous cell carcinoma. From the results obtained, it was possible to detect the prevalence of lesions in the buccal mucosa, alveolar ridge and tongue, and the confirmation of its evolutionary profile in the face of the multiple lesions with high recurrent and latent insurgent potential of squamous cell carcinoma, which may be supported by a significant mark of pmTOR, pAkt and MCM3.