Faria Karina Morais, Brandão Thais Bianca, Ribeiro Ana Carolina Prado, Vasconcellos Adriele Ferreira Gouvêa, de Carvalho Icaro Thiago, de Arruda Fernando Freire, Castro Junior Gilberto, Gross Vanessa Cristina, Almeida Oslei Paes, Lopes Marcio Ajudarte, Santos-Silva Alan Roger
Oral Diagnosis Department, Semiology and Pathology Areas, Piracicaba Dental School, University of Campinas (UNICAMP), Piracicaba, Sao Paulo, Brazil.
Dental Oncology Service, Instituto do Câncer do Estado de São Paulo (ICESP), Faculdade de Medicina da Universidade de São Paulo, São Paulo, Brazil.
J Endod. 2014 Oct;40(10):1553-9. doi: 10.1016/j.joen.2014.07.006. Epub 2014 Aug 20.
Teeth are often included in the radiation field during head and neck radiotherapy, and recent clinical evidence suggests that dental pulp is negatively affected by the direct effects of radiation, leading to impaired sensitivity of the dental pulp. Therefore, this study aimed to investigate the direct effects of radiation on the microvasculature, innervation, and extracellular matrix of the dental pulp of patients who have undergone head and neck radiotherapy.
Twenty-three samples of dental pulp from patients who finished head and neck radiotherapy were analyzed. Samples were histologically processed and stained with hematoxylin-eosin for morphologic evaluation of the microvasculature, innervation, and extracellular matrix. Subsequently, immunohistochemical analysis of proteins related to vascularization (CD34 and smooth muscle actin), innervation (S-100, NCAM/CD56, and neurofilament), and extracellular matrix (vimentin) of the dental pulp was performed.
The morphologic study identified preservation of the microvasculature, nerve bundles, and components of the extracellular matrix in all studied samples. The immunohistochemical analysis confirmed the morphologic findings and showed a normal pattern of expression for the studied proteins in all samples.
Direct effects of radiotherapy are not able to generate morphologic changes in the microvasculature, innervation, and extracellular matrix components of the dental pulp in head and neck cancer patients.
在头颈部放疗期间,牙齿常被纳入辐射野,近期临床证据表明牙髓会受到辐射直接效应的负面影响,导致牙髓敏感性受损。因此,本研究旨在调查放疗对接受过头颈部放疗患者牙髓的微血管系统、神经支配和细胞外基质的直接影响。
对23例完成头颈部放疗患者的牙髓样本进行分析。样本经组织学处理,并用苏木精-伊红染色,以对微血管系统、神经支配和细胞外基质进行形态学评估。随后,对牙髓中与血管生成相关的蛋白(CD34和平滑肌肌动蛋白)、神经支配相关的蛋白(S-100、神经细胞黏附分子/CD56和神经丝)以及细胞外基质相关的蛋白(波形蛋白)进行免疫组织化学分析。
形态学研究发现,所有研究样本中的微血管系统、神经束和细胞外基质成分均得以保留。免疫组织化学分析证实了形态学研究结果,并显示所有样本中所研究蛋白的表达模式正常。
放疗的直接效应不会对头颈部癌症患者牙髓的微血管系统、神经支配和细胞外基质成分产生形态学改变。