Gustavo Davi Rabelo1,2, Claudia Coutinho-Camillo3, Luiz Paulo Kowalski4, Nathalie Portero-Muzy5, Jean-Paul Roux5, Pascale Chavassieux5, Fabio Abreu Alves6,7. 1. Stomatology Department, A.C.Camargo Cancer Center, Professor Antônio Prudente St 211, São Paulo, SP, 01509-900, Brazil. drgustavorabelo@yahoo.com.br. 2. Department of Osteology and Biomechanics, University Medical Center Hamburg-Eppendorf, Lottestr. 55a, 22529, Hamburg, Germany. drgustavorabelo@yahoo.com.br. 3. International Research Center, A.C.Camargo Cancer Center, Professor Antônio Prudente St 211, São Paulo, SP, 01509-900, Brazil. 4. Department of Head and Neck Surgery and Otorhinolaryngology, A.C.Camargo Cancer Center, Professor Antônio Prudente St 211, São Paulo, SP, 01509-900, Brazil. 5. INSERM UMR 1033, Université de Lyon, UFR de Médecine Lyon-Est-Domaine Laennec, 7-11 Rue Guillaume Paradin, 69372, Lyon Cedex 08, France. 6. Stomatology Department, A.C.Camargo Cancer Center, Professor Antônio Prudente St 211, São Paulo, SP, 01509-900, Brazil. 7. Stomatology Department, Faculty of Dentistry, University of São Paulo, Av. Prof. Lineu Prestes, 2227/05508-000, Cidade Universitária, São Paulo, SP, Brazil.
Abstract
OBJECTIVES: The aim of the study was to evaluate the mandible cortical bone changes in patients with oral squamous cell carcinoma (OSCC). PATIENTS AND METHODS: Twenty patients who underwent some mandibular bone removal as part of the treatment of OSCC had bone samples collected in two parts: in the proximity of the tumor (BPT) and in the surgical margin (BEP). Cortical microarchitecture was analyzed trough micro-computed tomography, together with texture analysis, followed by microcrack evaluation in histological sections and gene expression of RANK, RANKL, OPG, and sclerostin by quantitative polymerase chain reaction. RESULTS: Bone surface was higher in BPT (0.005 ± 0.002 vs 0.004 ± 0.002, p = 0.01) compared with BEP. In BPT, the subset of patients without bone invasion presented higher anisotropy (0.83 ± 0.07) compared with the ones with bone invasion (0.70 ± 0.14) (p = 0.04). RANK, RANKL, OPG, and sclerostin were found to be downregulated in the majority of cases in both parts. There were significant correlations between the parameters of microarchitecture and gene expression analysis (p < 0.001 to p < 0.05), most of them related with OPG levels. CONCLUSION: The cortex in the mandible in the proximity of the tumor reveals more bone surface than the bone in the surgical margin, and the tumor invasion causes a decrease in anisotropy. RANK, RANKL, OPG, and sclerostin are downregulated in mandible, in both parts analyzed. Correlation tests revealed the association between cortical thickness, bone surface, anisotropy, porosity, bone mineral density, and OPG levels. CLINICAL RELEVANCE: The mandible cortical bone microarchitecture changes in the proximity of the squamous cell carcinoma lesion.
OBJECTIVES: The aim of the study was to evaluate the mandible cortical bone changes in patients with oral squamous cell carcinoma (OSCC). PATIENTS AND METHODS: Twenty patients who underwent some mandibular bone removal as part of the treatment of OSCC had bone samples collected in two parts: in the proximity of the tumor (BPT) and in the surgical margin (BEP). Cortical microarchitecture was analyzed trough micro-computed tomography, together with texture analysis, followed by microcrack evaluation in histological sections and gene expression of RANK, RANKL, OPG, and sclerostin by quantitative polymerase chain reaction. RESULTS: Bone surface was higher in BPT (0.005 ± 0.002 vs 0.004 ± 0.002, p = 0.01) compared with BEP. In BPT, the subset of patients without bone invasion presented higher anisotropy (0.83 ± 0.07) compared with the ones with bone invasion (0.70 ± 0.14) (p = 0.04). RANK, RANKL, OPG, and sclerostin were found to be downregulated in the majority of cases in both parts. There were significant correlations between the parameters of microarchitecture and gene expression analysis (p < 0.001 to p < 0.05), most of them related with OPG levels. CONCLUSION: The cortex in the mandible in the proximity of the tumor reveals more bone surface than the bone in the surgical margin, and the tumor invasion causes a decrease in anisotropy. RANK, RANKL, OPG, and sclerostin are downregulated in mandible, in both parts analyzed. Correlation tests revealed the association between cortical thickness, bone surface, anisotropy, porosity, bone mineral density, and OPG levels. CLINICAL RELEVANCE: The mandible cortical bone microarchitecture changes in the proximity of the squamous cell carcinoma lesion.
Entities:
Keywords:
Anisotropy; Bone; Bone biomarkers; Oral squamous cell carcinoma; micro-CT
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