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Aukšto laipsnio prostatos intraepitelinė neoplazija (ALPIN, angl. – HGPIN – high grade prostatic intraepithelial neoplasia ) priskiriama prie priešvėžinių būklių ( arba prostatos vėžio prekursorių) ir susijusi su padidėjusia kartu esamo vėžio diagnozavimo rizika arba vėlesne jos progresija iki vėžio. Manoma, kad pacientai, kuriems nustatyta ALPIN prostatos biopsinėje medžiagoje, yra tinkami kandidatai chemoprevencijai. Šio darbo tikslas buvo nustatyti 5-alfa reduktazės inhibitoriaus dutasterido reikšmę prostatos vėžio prevencijai esant didelei šios ligos rizikai. Darbo uždaviniai : 1. Nustatyti prostatos vėžio dažnį esant didelei šios ligos rizikai (biopsinėje medžiagoje nustatyta aukšto laipsnio prostatos intraepitelinė neoplazija). 2. Įvertinti pakartotinių biopsijų reikšmę prostatos vėžio diagnozavimo dažniui. 3. Įvertinti tiriamojo vaisto reikšmę prostatos vėžio prevencijai (ar sumažina prostatos vėžio diagozavimo dažnį) esant didelei šios ligos rizikai. 4. Palyginti diagnozuoto prostatos vėžio diferenciacijos skirtumus tiriamosiose grupėse. / A high grade prostatic intraepithelial neoplasia (HPIN) is traditionally ascribed to pre-cancerous conditions or prostate cancer (PC) precursors, and associated with an increased risk of concomitant cancer or its later progression to malignant disease. After evaluation of the data indicating HPIN as a pre–cancerous condition, it is thought that the patients having HPIN in the prostate biopsy material are suitable candidates for chemoprevention.The aim of the study was to find out the significance of dutasteride, a 5–alpha reductase inhibitor, for the prevention of development of prostate cancer in case of a high risk for the disease. Objectives of the study: 1. To determine the rate of prostate cancer in case of a high risk for the disease (when a high grade prostatic intraepithelial neoplasia is found in biopsy material). 2. To find out the significance of repeat biopsies for the detection rate of prostate cancer. 3. To find out the significance of the investigatory medication for the prevention of development of prostate cancer in case of a high risk for the disease. 4. To compare the differences in the differentiation of diagnosed prostate cancer between the study groups.

Thesis (Ph.D. in Toxicology) -- University of Colorado Denver, 2008. / Typescript. Includes bibliographical references (leaves 144-170). Free to UCD Anschutz Medical Campus. Online version available via ProQuest Digital Dissertations;

Orientador: Hélio Amante Miot / Resumo: Fundamentos: Campo de cancerização cutâneo representa uma área com alterações genômicas induzidas pela radiação ultravioleta, cujo sinal de atividade são as queratoses actínicas (QA). Tratamentos que visem sua estabilização podem reduzir a incidência de QA e de tumores cutâneos não melanoma. Estudos em terapia fotodinâmica com metil aminolevulinato (TFD-MAL) no tratamento do campo de cancerização cutâneo mostram redução de até 89% na contagem de QA, já com colchicina tópica, há redução de até 78%. Até o momento, não há estudos comparando colchicina com TFD-MAL. Esse trabalho objetiva avaliar eficácia e segurança de colchicina 0,5% creme versus TFD-MAL no tratamento do campo de cancerização dos antebraços.Casuística e métodos: Ensaio clínico aberto, controlado, randomizado, envolvendo 36 pacientes do ambulatório de Dermatologia da UNESP-Botucatu, com 3-10 QAs em cada antebraço, tratados (cada antebraço) com creme de colchicina 0,5% (2x/dia por 10 dias) ou uma sessão de TFD-MAL; reavaliados após 60 dias. A avaliação clínica foi realizada pela contagem de QAs, seus subtipos clínicos, sua escala de gravidade e escala de fotoenvelhecimento dos antebraços. Avaliação histopatológica foi realizada pelo escore KIN (Keratinocyte Intraepithelial Neoplasia), atrofia epitelial e imunohistoquímica de p53 e Ki67. Todos os pacientes incluídos no estudo e randomizados fizeram parte da população ITT (intention to treat). Os dados do único dropout foram imputados como LOCF (last observed car... (Resumo completo, clicar acesso eletrônico abaixo) / Mestre

Qin, Jing. / Thesis (M.Phil.)--Chinese University of Hong Kong, 2009. / Includes bibliographical references (leaves 162-218). / Abstract also in Chinese. / Acknowledgment --- p.i / Abstract --- p.ii / 摘要 --- p.iv / Table of Content --- p.vi / List of Figures --- p.x / List of Tables --- p.xv / Abbreviations --- p.xvii / Chapter Chapter 1 --- Introduction --- p.1 / Chapter 1.1 --- Ganoderma spp --- p.1 / Chapter 1.1.1 --- Introduction of Ganoderma spp --- p.1 / Chapter 1.1.2 --- Bioactivities of Ganoderma spp --- p.3 / Chapter 1.1.3 --- Endocrine system and breast cancer --- p.11 / Chapter 1.1.3.1 --- Estrogen --- p.11 / Chapter 1.1.3.2 --- Estrogen receptors --- p.12 / Chapter 1.1.3.3 --- Estrogen responsive genes --- p.15 / Chapter 1.1.3.3.1 --- pS2 --- p.15 / Chapter 1.1.3.3.2 --- Progesterone receptor --- p.18 / Chapter 1.1.3.4 --- Androgen --- p.21 / Chapter 1.1.3.5 --- Androgen receptor --- p.23 / Chapter 1.1.3.6 --- Androgen responsive gene --- p.24 / Chapter 1.1.3.6.1 --- Transmembrane prostate androgen-induced RNA --- p.24 / Chapter 1.1.3.6.2 --- Uridine diphosphate glucose dehydrogenase --- p.26 / Chapter 1.1.3.7 --- Breast cancer --- p.26 / Chapter 1.2 --- "Endocrine Disruption of p,p '-DDE" --- p.28 / Chapter 1.2.1 --- Introduction of p´ةp '-DDE --- p.28 / Chapter 1.2.2 --- "p,p '-DDE in environments" --- p.29 / Chapter 1.2.3 --- "p,p '-DDE in human body" --- p.32 / Chapter 1.2.4 --- "p,p '-DDE and reproductive system" --- p.33 / Chapter 1.2.5 --- Endocrine disruptor --- p.35 / Chapter 1.2.6 --- "Action mechanism of p,p '-DDE on endocrine system" --- p.37 / Chapter 1.2.7 --- Apoptosis --- p.39 / Chapter 1.3 --- Food therapy against endocrine disruption --- p.41 / Chapter 1.3.1 --- Food therapy and functional food --- p.41 / Chapter 1.3.2 --- Ganoderma as a Functional food --- p.47 / Chapter 1.3.3 --- Cancer prevention by dietary agents --- p.47 / Chapter 1.3.4 --- Hormone therapy --- p.48 / Chapter 1.3.5 --- Hormone-related properties of Ganoderma spp --- p.50 / Chapter 1.4 --- The aim of the study --- p.51 / Chapter Chapter 2 --- Materials and Methods --- p.52 / Chapter 2.1 --- Ganoderma samples --- p.52 / Chapter 2.2 --- Artificial cultivation of Ganoderma spp --- p.54 / Chapter 2.3 --- Molecular identification of Ganoderma spp --- p.55 / Chapter 2.3.1 --- Extraction of genomic DNA --- p.55 / Chapter 2.3.2 --- Gene-specific polymerase chain reaction (PCR) --- p.56 / Chapter 2.3.3 --- Gel electrophoresis --- p.56 / Chapter 2.3.4 --- Purification of PCR amplified product for sequencing --- p.57 / Chapter 2.3.5 --- Cycle-sequencing --- p.57 / Chapter 2.3.6 --- Sequencing --- p.58 / Chapter 2.3.7 --- Sequence analysis --- p.58 / Chapter 2.4 --- Chemical analyses of Ganoderma spp --- p.59 / Chapter 2.4.1 --- Polysaccharide preparations --- p.59 / Chapter 2.4.2 --- Terpene profile --- p.60 / Chapter 2.4.3 --- Fatty acid profile --- p.60 / Chapter 2.5 --- Anti-oxidation activities --- p.61 / Chapter 2.5.1 --- Superoxide radical scavenging assay --- p.61 / Chapter 2.5.2 --- DPPH radical scavenging assay --- p.62 / Chapter 2.6 --- Anti-proliferation effect on human breast cancer cells --- p.62 / Chapter 2.7 --- Hormone-like effects --- p.63 / Chapter 2.7.1 --- E-screen test --- p.63 / Chapter 2.7.2 --- In vitro estrogen receptors (ERs) competitor binding assays --- p.64 / Chapter 2.7.3 --- "Recombinant yeast cell based ER-, AR- and PGR-responsible promoter assays" --- p.65 / Chapter 2.7.3.1 --- Recombinant yeasts --- p.65 / Chapter 2.7.3.2 --- Growth medium for recombinant yeasts --- p.66 / Chapter 2.7.3.3 --- "ER, AR and PGR assays" --- p.67 / Chapter 2.7.3.4 --- β-Galactosidase assay --- p.67 / Chapter 2.7.4 --- Real time PCR --- p.68 / Chapter 2.8 --- Flow cytometry --- p.71 / Chapter 2.9 --- Comet assay --- p.71 / Chapter 2.10 --- DNA microarray --- p.73 / Chapter 2.10.1 --- Total RNA isolation --- p.73 / Chapter 2.10.2 --- cDNA synthesis --- p.73 / Chapter 2.10.3 --- Preparation of labelled cDNA --- p.74 / Chapter 2.10.4 --- cDNA purification --- p.74 / Chapter 2.10.5 --- Oligo GEArray hybridization --- p.75 / Chapter 2.10.6 --- Chemiluminescent detection --- p.76 / Chapter 2.10.7 --- Data analysis --- p.77 / Chapter Chapter 3 --- Results --- p.78 / Chapter 3.1 --- Analysis of Ganderma spp --- p.78 / Chapter 3.1.1 --- Mycelia and fruiting bodies --- p.78 / Chapter 3.1.2 --- Identification of Ganoderma spp --- p.79 / Chapter 3.1.3 --- Chemical properties of samples --- p.80 / Chapter 3.1.4 --- Anti-oxidation activities --- p.90 / Chapter 3.1.5 --- Anti-proliferation effect on human breast cancer cells --- p.90 / Chapter 3.1.6 --- Hormone-like bioactivities --- p.93 / Chapter 3.1.6.1 --- E-screen test --- p.93 / Chapter 3.1.6.2 --- In vitro estrogen receptors (ERs) competitor binding assays --- p.94 / Chapter 3.1.6.3 --- "Recombinant yeast cell-based ER-, AR- and PGR-responsible promoter assays" --- p.95 / Chapter 3.1.6.4 --- ER- and AR-pathway gene expression by real time PCR --- p.97 / Chapter 3.2 --- "Action mechanism of p,p' -DDE" --- p.99 / Chapter 3.2.1 --- E-screen --- p.99 / Chapter 3.2.2 --- In vitro estrogen receptors (ERs) competitor binding assays --- p.101 / Chapter 3.2.3 --- Recombinant yeast cell based ER- and AR-responsible promoter assays --- p.103 / Chapter 3.2.4 --- ER- and AR-pathway gene expression by real time PCR --- p.106 / Chapter 3.3 --- Ganoderma tsugae mycelia extract against p.p' -DDE --- p.109 / Chapter 3.3.1 --- E-screen test --- p.109 / Chapter 3.3.2 --- ER- and AR-pathway gene expression by real time PCR --- p.110 / Chapter 3.3.3 --- Analysis of cell cycle --- p.112 / Chapter 3.3.4 --- Analysis of DNA damage --- p.114 / Chapter 3.3.5 --- Analysis of sub-G1 peak --- p.117 / Chapter 3.3.6 --- DNA damage and apoptosis relative gene expression by real time PCR --- p.120 / Chapter 3.3.7 --- DNA microarray --- p.121 / Chapter Chapter 4 --- Discussion --- p.131 / Chapter 4.1 --- Analysis of Ganoderma spp --- p.131 / Chapter 4.2 --- Effects of p.p´ة-DDE --- p.144 / Chapter 4.3 --- Protective effects of G. tsugae against p.p' -DDE --- p.151 / Chapter 4.4 --- Further investigation --- p.159 / Chapter 4.5 --- Conclusion --- p.160 / References --- p.162

Orientador: Hélio Amante Miot / Resumo: O tratamento do campo de cancerização tem o intuito de evitar a progressão das lesões pré-malignas ou desenvolvimento de lesões subclínicas, como forma de prevenção da carcinogênese. Existem diversas propostas de tratamento, porém, há poucos estudos com nicotinamida oral, nenhum comparando a eficácia entre 5-fluorouracil (5FU) tópico com fotoproteção, ou na sua associação com a nicotinamida oral. Objetivos: Avaliação da eficácia da nicotinamida oral, versus 5FU tópico intermitente, e fotoproteção, no tratamento do campo de cancerização cutâneo e queratoses actínicas (QA). Casuística e métodos: Desenho: ensaio clínico randomizado (em blocos), controlado (intrasujeito), duplo cego, fatorial. Participantes: pacientes imunocompetentes, que continham entre três e dez QA cada antebraço, selecionados durante os atendimentos do ambulatório oncológico do serviço de dermatologia da Faculdade de Medicina de Botucatu – UNESP no período de março a setembro de 2016. Houve randomização em blocos e alocação em grupos dos pacientes e antebraços. Intervenção: um grupo recebeu nicotinamida 500mg, via oral, cada 12h, e o outro, placebo. Um dos antebraços recebeu 5FU 5% creme, noturno, 3x por semana, e ambos, filtro solar (FPS 30) diurno. A duração dos tratamentos foi de 120 dias. Os pacientes foram avaliados nos momentos: T0 e T120 para avaliação clínica (contagem de QA, escore de gravidade de QA e escore de fotoenvelhecimento) e biópsia de pele para avaliação do grau de neoplasia intraepitelial... (Resumo completo, clicar acesso eletrônico abaixo) / Abstract: Background: The treatment of the skin field cancerization is aimed at preventing the progression of premalignant lesions or the development of subclinical lesions as a way of preventing carcinogenesis. There are several treatment proposals, however, there are few studies with oral nicotinamide, none comparing the efficacy of topical 5-fluorouracil (5FU) with photoprotection, or its association with oral nicotinamide. Objectives: To evaluate the efficacy of oral nicotinamide versus intermittent topical 5FU and photoprotection in the treatment of cutaneous cancer and actinic keratoses (AK). Casuistry and methods: Design: randomized (blocks), controlled (intrasubject), double blind, factorial clinical trial. Participants: immunocompetent patients, who had between 3 and 10 AK each forearm, selected during the visits of the oncology outpatient clinic of the dermatology department of Botucatu Medical School - UNESP from March to September, 2016. There was randomization in blocks and allocation in Groups of patients and forearms. Intervention: one group received nicotinamide 500mg, orally every 12h, and the other, placebo. One of the forearms received 5FU 5% cream, overnight, 3x per week, and both, daytime (SPF 30) sunscreen. The duration of the treatments was 120 days. The patients were evaluated at the moments: T0 and T120 for clinical evaluation (AK score, AK severity score and photoaging score) and skin biopsy for evaluation of the levels of keratinocyte intraepithelial neoplasi... (Complete abstract click electronic access below) / Mestre

Submitted by Eliane Roio Ferreira null (eliane_roio@yahoo.com.br) on 2018-07-22T17:04:37Z No. of bitstreams: 1 Dissertacao Eliane 31-07-2017 (Salvo Automaticamente) repositorio.pdf: 1376384 bytes, checksum: fe63f38c9413fbb73b267ecfae5dfb34 (MD5) / Approved for entry into archive by Sulamita Selma C Colnago null (sulamita@btu.unesp.br) on 2018-07-23T13:30:44Z (GMT) No. of bitstreams: 1 ferreira_er_me_bot.pdf: 1376384 bytes, checksum: fe63f38c9413fbb73b267ecfae5dfb34 (MD5) / Made available in DSpace on 2018-07-23T13:30:45Z (GMT). No. of bitstreams: 1 ferreira_er_me_bot.pdf: 1376384 bytes, checksum: fe63f38c9413fbb73b267ecfae5dfb34 (MD5) Previous issue date: 2017-08-24 / O tratamento do campo de cancerização tem o intuito de evitar a progressão das lesões pré-malignas ou desenvolvimento de lesões subclínicas, como forma de prevenção da carcinogênese. Existem diversas propostas de tratamento, porém, há poucos estudos com nicotinamida oral, nenhum comparando a eficácia entre 5-fluorouracil (5FU) tópico com fotoproteção, ou na sua associação com a nicotinamida oral. Objetivos: Avaliação da eficácia da nicotinamida oral, versus 5FU tópico intermitente, e fotoproteção, no tratamento do campo de cancerização cutâneo e queratoses actínicas (QA). Casuística e métodos: Desenho: ensaio clínico randomizado (em blocos), controlado (intrasujeito), duplo cego, fatorial. Participantes: pacientes imunocompetentes, que continham entre três e dez QA cada antebraço, selecionados durante os atendimentos do ambulatório oncológico do serviço de dermatologia da Faculdade de Medicina de Botucatu – UNESP no período de março a setembro de 2016. Houve randomização em blocos e alocação em grupos dos pacientes e antebraços. Intervenção: um grupo recebeu nicotinamida 500mg, via oral, cada 12h, e o outro, placebo. Um dos antebraços recebeu 5FU 5% creme, noturno, 3x por semana, e ambos, filtro solar (FPS 30) diurno. A duração dos tratamentos foi de 120 dias. Os pacientes foram avaliados nos momentos: T0 e T120 para avaliação clínica (contagem de QA, escore de gravidade de QA e escore de fotoenvelhecimento) e biópsia de pele para avaliação do grau de neoplasia intraepitelial dos queratinótitos (KIN), p53 e ki67. Foram avaliados ainda os efeitos adversos no T14. Desfechos: foram analisados por intenção de tratamento (ITT), e os dropouts imputados com os valores da última avaliação disponíveis (LOCF). Os grupos foram comparados por modelo linear generalizado de efeitos mistos. Resultados: Foram incluídos 36 participantes (72 antebraços). A média de idade foi 71,6 (8,6) anos, fototipos I e II prevaleceram (94%) e 61% eram do sexo feminino. Houve redução na contagem de QA para nicotinamida com 5FU (-71%) e com filtro solar (-50%), assim como para placebo e 5FU (-62%) e filtro solar (-60%), 5FU apresentou superioridade ao FPS (p<0,05). O clearance parcial de QA (>50%), apresentou redução para todos os subgrupos (-83%; -50%; -72%; -61%), com superioridade para 5FU (p<0,05). O clearance total de QA não apresentou diferença entre os tratamentos (p=0,72,). Houve redução do escore de gravidade de QA (-74%; -62%; -81%; -64%) e de fotoenvelhecimento (-10%; -6%; -22%; -8%), sem diferença entre os grupos (p>0,2). Os principais efeitos adversos observados foram eritema (50%) e dor local (5%) com uso de 5-FU, epigastralgia e náusea com nicotinamida (5%). Houve redução no escore KIN em todos os grupos (p<0,05), sem diferença entre os subgrupos. Houve redução da atrofia epitelial em todos os tratamentos (p<0,05), com superioridade para 5FU (p<0,05). Houve redução do escore Ki67 em ambos os tratamentos (p<0,05), com maior redução no grupo que recebeu nicotinamida (p<0,05). Para p53 não houve diferença entre os tratamentos (p=0,81). Ocorreram 3 dropouts. Conclusão: 5-FU tópico reduz a atividade do campo de cancerização de forma mais eficaz que o filtro solar quanto à contagem e ao clearance de QA. Nicotinamida oral não promoveu melhora clínica, mas histológica (Ki67), adicional à fotoproteção ou ao uso de 5FU. / Background: The treatment of the skin field cancerization is aimed at preventing the progression of premalignant lesions or the development of subclinical lesions as a way of preventing carcinogenesis. There are several treatment proposals, however, there are few studies with oral nicotinamide, none comparing the efficacy of topical 5-fluorouracil (5FU) with photoprotection, or its association with oral nicotinamide. Objectives: To evaluate the efficacy of oral nicotinamide versus intermittent topical 5FU and photoprotection in the treatment of cutaneous cancer and actinic keratoses (AK). Casuistry and methods: Design: randomized (blocks), controlled (intrasubject), double blind, factorial clinical trial. Participants: immunocompetent patients, who had between 3 and 10 AK each forearm, selected during the visits of the oncology outpatient clinic of the dermatology department of Botucatu Medical School - UNESP from March to September, 2016. There was randomization in blocks and allocation in Groups of patients and forearms. Intervention: one group received nicotinamide 500mg, orally every 12h, and the other, placebo. One of the forearms received 5FU 5% cream, overnight, 3x per week, and both, daytime (SPF 30) sunscreen. The duration of the treatments was 120 days. The patients were evaluated at the moments: T0 and T120 for clinical evaluation (AK score, AK severity score and photoaging score) and skin biopsy for evaluation of the levels of keratinocyte intraepithelial neoplasia (KIN), p53 and ki67. Adverse effects were also evaluated in the T14. Outcomes: were analyzed by intention to treat (ITT), and the imputed dropouts with the values of the last observation carried forward (LOCF). The groups were compared by generalized linear model of mixed effects. Results: 36 participants (72 forearms) were included. The mean age was 71.6 (8.6) years, phototypes I and II prevailed (94%) and 61% were female. There was a reduction in the counts of AK for nicotinamide with 5FU (-71%) and with sunscreen (-50%), as well as for placebo and 5FU (-62%) and sunscreen (-60%), 5FU presented SPF superiority (P <0.05). The partial clearance of AK (> 50%) presented a reduction for all subgroups (-83%, -50%, -72%, -61%), with a superiority of 5FU (p <0.05). Total clearance of AK did not show any difference between the treatments (p = 0.72,). There was a reduction in the severity score of AK (-74%, -62%, -81%, -64%) and of photoaging (-10%, -6%, -22%, -8%), with no difference between Groups (p> 0.2). The main adverse effects observed were erythema (50%) and local pain (5%) with use of 5-FU, epigastralgia and nausea with nicotinamide (5%). There was a reduction in the KIN score in all groups (p <0.05), with no difference between the subgroups. There was reduction of epithelial atrophy in all treatments (p <0.05), with superiority to 5FU (p <0.05). There was a reduction in the Ki67 score in both treatments (p <0.05), with a larger reduction in the nicotinamide group (p <0.05). For p53 there was no difference between treatments (p = 0.81). There were 3 dropouts: one per death, one refusal because the lesions improved, and one drop due to adverse local effects. Conclusion: Topical 5-FU reduces the activity of the cancerization field more effectively than the sunscreen in the counting and clearance of AK. Oral nicotinamide did not promote clinical improvement, but histological improvement (Ki67), additional to photoprotection or the use of 5FU.

Submitted by ANNA CAROLINA MIOLA (anna_fmrp@yahoo.com.br) on 2017-10-25T13:27:30Z No. of bitstreams: 1 defesa-FINAL-repositorio.pdf: 1407690 bytes, checksum: 620d293167960fc67b1031c581f71462 (MD5) / Approved for entry into archive by Monique Sasaki (sayumi_sasaki@hotmail.com) on 2017-10-31T16:10:30Z (GMT) No. of bitstreams: 1 miola_ac_me_bot.pdf: 1407690 bytes, checksum: 620d293167960fc67b1031c581f71462 (MD5) / Made available in DSpace on 2017-10-31T16:10:30Z (GMT). No. of bitstreams: 1 miola_ac_me_bot.pdf: 1407690 bytes, checksum: 620d293167960fc67b1031c581f71462 (MD5) Previous issue date: 2017-08-24 / Fundamentos: Campo de cancerização cutâneo representa uma área com alterações genômicas induzidas pela radiação ultravioleta, cujo sinal de atividade são as queratoses actínicas (QA). Tratamentos que visem sua estabilização podem reduzir a incidência de QA e de tumores cutâneos não melanoma. Estudos em terapia fotodinâmica com metil aminolevulinato (TFD-MAL) no tratamento do campo de cancerização cutâneo mostram redução de até 89% na contagem de QA, já com colchicina tópica, há redução de até 78%. Até o momento, não há estudos comparando colchicina com TFD-MAL. Esse trabalho objetiva avaliar eficácia e segurança de colchicina 0,5% creme versus TFD-MAL no tratamento do campo de cancerização dos antebraços. Casuística e métodos: Ensaio clínico aberto, controlado, randomizado, envolvendo 36 pacientes do ambulatório de Dermatologia da UNESP-Botucatu, com 3-10 QAs em cada antebraço, tratados (cada antebraço) com creme de colchicina 0,5% (2x/dia por 10 dias) ou uma sessão de TFD-MAL; reavaliados após 60 dias. A avaliação clínica foi realizada pela contagem de QAs, seus subtipos clínicos, sua escala de gravidade e escala de fotoenvelhecimento dos antebraços. Avaliação histopatológica foi realizada pelo escore KIN (Keratinocyte Intraepithelial Neoplasia), atrofia epitelial e imunohistoquímica de p53 e Ki67. Todos os pacientes incluídos no estudo e randomizados fizeram parte da população ITT (intention to treat). Os dados do único dropout foram imputados como LOCF (last observed carried forward). Resultados: Foram incluídos 36 participantes: 50% eram do sexo masculino, com idade média (dp) de 70,9 (8,6) anos e predominância de pacientes fototipos I e II (89%). O clearance total de QAs ocorreu em 6 (17%) de COL e 7 (19%) de MAL-PDT (p=0,76), e clearance parcial (> 50%) foi alcançado em 16 (44%) dos antebraços COL e 24 (67%) MAL-PDT (p=0,07). Houve redução significativa no escore da escala de fotoenvelhecimento para COL e TFD-MAL (-6% vs -6%), escore de gravidade de QA (-65% vs -73%), subtipos clínicos das QAs presentes e contagem de QA (-45% vs -40%), após as intervenções (p<0,01), sem diferenças significativas entre os grupos. Houve redução no escore KIN em ambos os grupos (p<0,01), normalizado em 28% dos pacientes MAL-PDT e 20% em COL. Houve redução da atrofia epitelial após 60 dias (p<0,01), sem diferenças entre os tratamentos (p=0,58). Houve redução significativa do escore Ki67 em ambos os tratamentos: 15% em COL e 9% em MAL-PDT, sem diferença entre os grupos (p=0,32). Houve redução do escore de p53 em 27% no grupo COL, porém, um aumento de 4% na MAL-PDT (p<0,05). Efeitos adversos foram relatados em ambos os grupos: 69% em COL e 67% em TFD-MAL. Não houve evento adverso grave. Conclusão: Colchicina 0,5% creme e TFD-MAL são eficazes e seguros no tratamento do campo de cancerização cutâneo. / Background: Skin field cancerization is an area with genomic alterations induced by ultraviolet radiation, and actinic keratosis (AK) is a sign of its activity. Treatments to stabilize it may reduce the incidence of non-melanoma skin cancers and AK. Photodynamic therapy with methyl aminolevulinate (TFD-MAL) in the treatment of skin field cancerization shows a reduction of up to 89% in the AK count, and topical colchicine, up to 78% of reduction. To date, there are no studies comparing colchicine with PDT-MAL. The aim of this study was to evaluate the efficacy and safety of colchicine 0.5% cream versus PDT-MAL in skin field cancerization treatment of the forearms. Patients and methods: A randomized, controlled clinical trial involving 36 patients from the UNESP-Botucatu Dermatology outpatient clinic, with three to 10 AKs in each forearm, treated (each forearm) with colchicine cream (2x / day for 10 days) and one session of PDT-MAL. Reassessed after 60 days. Clinical evaluation was performed by AK count, its clinical subtypes, severity scale and forearm photoaging scale. Histopathological evaluation performed by KIN (Keratinocyte Intraepithelial Neoplasia), epithelial atrophy and immunohistochemistry of p53 and Ki67. All patients included in the study and randomized were part of the ITT population (intention to treat). The only dropout was analyzed through LOCF (last observation carried forward). Results: Thirty-six participants were included: 50% were males, mean age (SD) of 70.9 (8.6) years and predominance of phototype I and II patients (89%). Total clearance of AK occurred in 6 (17%) of COL and 7 (19%) of MAL-PDT (p = 0.76), and partial clearance (> 50%) was achieved in 16 (44%) of COL and 24 (67%) of MAL-PDT (p = 0.07). There was a significant reduction in the photodamage scale for COL and PDT-MAL (-6% vs -6%), AK severity score (-65% vs -73%), clinical subtypes of the present AK and AK (-45% vs -40%) after interventions (p <0.01), with no significant differences between the groups (p> 0.24). There was a reduction in KIN score in both groups (p <0.01), normalized in 28% of MAL-PDT patients and 20% in COL. There was reduction of epithelial atrophy after 60 days (p <0.01), with no differences between treatments (p = 0.58). There was a significant reduction of the Ki67 score in both treatments: 15% in COL and 9% in MAL-PDT, with no difference between groups (p = 0.32). There was a reduction of the p53 score in 27% in the COL group, but a 4% increase in MAL-PDT (p <0.05). Adverse effects were reported in both groups: 69% in COL and 67% in PDT-MAL. There was no serious adverse event. Conclusion: Colchicine 0.5% cream and TFD-MAL are effective and safe in skin field cancerization treatment.

A combinação de agentes quimiopreventivos com diferentes mecanismos de ação tem sido considerada uma estratégia promissora para a prevenção do câncer. Dentre os diversos compostos bioativos em alimentos, destacam-se a tributirina, um pró-fármaco do ácido butírico presente em laticínios e produzido pela fermentação de fibras dietéticas, e o óleo de linhaça, fonte de ácido alfa linolênico. Nesse contexto, foi avaliada a atividade quimiopreventiva de lipídios estruturados obtidos a partir da interesterificação enzimática de tributirina e óleo de linhaça durante a fase de promoção inicial da hepatocarcinogênese experimental. Ratos Wistar machos submetidos ao modelo do hepatócito resistente receberam diariamente, por via intragástrica (i.g), maltodextrina, óleo de linhaça, tributirina, a mistura não esterificada ou lipídios estruturados durante a fase de promoção inicial. O tratamento com lipídios estruturados demonstrou atividade quimiopreventiva comparável à da tributirina, mesmo resultando em menor concentração hepática de ácido butírico. Tanto a tributirina quanto os lipídios estruturados não inibiram a proliferação celular em lesões preneoplásicas, mas induziram a apoptose naquelas em remodelação. Os efeitos inibitórios da tributirina em fases iniciais da hepatocarcinogênese experimental estão relacionados ao aumento da acetilação de histonas e à modulação de processos de translocação nuclear da p53. No presente estudo, foi observado aumento substancial da razão nuclear/citoplasmática de p53 e importina-alfa em fígados de animais submetidos ao modelo e tratados com tributirina, mas não nos tratados com lipídios estruturados. Por outro lado, o tratamento com lipídios estruturados reduziu a expressão dos oncogenes Bcl2, Ccnd2, Pdgfa, Vegfa e aumentou a expressão dos genes supressores de tumor Cdh13, Fhit e Socs3. Assim, embora o potencial quimiopreventivo dos lipídios estruturados seja comparável ao da tributirina, os resultados sugerem que o novo composto não exibe atividade de HDACi, e que seus efeitos inibitórios na hepatocarcinogênese possam ser atribuídos à modulação da expressão de oncogenes e genes supressores de tumor. / Combination of chemopreventive agents with different mechanisms of action has been considered a promising strategy to cancer prevention. Among several bioactive food compounds, tributyrin, a butyric acid prodrug obtained from dairy products and dietetic fiber fermentation, and flax seed oil, a rich source of alpha linolenic acid have shown chemopreventive potential. Here, we evaluated the chemopreventive activity of structured lipids obtained by enzymatic interesterification of tributyrin and flax seed oil during the early promotion phase of experimental hepatocarcinogenesis. Male Wistar rats subjected to the resistant hepatocyte model were treated daily, i.g, with maltodextrin, flax seed oil, tributyrin, non-sterified blend, or structured lipids. Treatment structured lipids showed similar chemopreventive activity compared to tributyrin, even when structured lipids yielded lower concentrations of butyric in the liver. Tributyrin and structured lipids did not inhibit cell proliferation in preneoplastic lesions, but both of them induced apoptosis in remodeling preneoplastic lesions. In addition, histone acetylation and p21 restored expression tributyrin molecular mechanisms were related to modulation of p53 nuclear shuttling mechanisms. In the present study, it was observed a substantial increase in p53 nuclear/cytoplasmic ratio and importin-alpha in preneoplastic livers of tributyrin treated rats, but not in those treated with structured lipids. In contrast, treatment structured lipids downregulated expression of major oncogenes Bcl2, Ccnd2, Pdgfa, and Vegfa; and upregulated expression of critical tumor suppressor genes, Cdh13, Socs3 and Fhit. Hence, although structured lipids and tributyrin show similar chemopreventive potential, the results suggest that the new compound does not exhibit HDACi activity, and that its inhibitory effects may be attributed to the modulation of oncogenes and tumor suppressor genes expression.