Objetivo: As moléculas de adesão celular (MAC) são essenciais para a manutenção do fenótipo epitelial. Alguns estudos têm relatado associação entre as alterações de sua expressão e a carcinogênese, mas o seu papel no câncer de próstata não é claro. Nosso objetivo foi estudar o perfil de expressão de E-caderina, cateninas e integrinas em espécimes cirúrgicos de câncer de próstata e associar as suas expressões com a evolução do tumor. Avaliamos também o perfil de expressão em metástases ósseas e linfonodais, a fim de compreender a influência destes marcadores na progressão do câncer de próstata. Materiais e Métodos: Foram selecionados 111 pacientes com câncer de próstata localizado tratados com prostatectomia radical pelo mesmo cirurgião. Sessenta pacientes não apresentaram recidiva tumoral após acompanhamento médio de 123 meses. A expressão das MAC foi avaliada por imuno-histoquímica (IH) em microarranjo tecidual (TMA), contendo duas amostras de cada tumor. Empregamos análise semiquantitativa para avaliação da expressão e determinamos a associação entre a expressão de cada MAC com a recorrência do tumor após a cirurgia. Avaliamos também a expressão das MAC por IH em TMA contendo espécimes de 28 metástases ósseas e em outro TMA contendo 19 metástases linfonodais com seus 19 tumores primários correspondentes. Resultados: Nos tumores primários a análise multivariada mostrou que a expressão das integrinas 3 e 3 1 relaciona-se com recidiva da doença. Quando a expressão de 3 foi forte e a expressão de 3 1 foi positiva, as chances de recorrência foram de 3,0 e 2,5 vezes maior. Apenas 19% e 28% dos pacientes estavam livres de recidiva após seguimento médio de 123 meses, quando os tumores apresentavam forte imunoexpressão de 3 ou positiva para 3 1 respectivamente. Outras integrinas apresentaram expressão reduzida, exceto 6 que foi expressa pela maioria dos tumores primário e metástases. A E-Caderina e as cateninas não mostraram associação com o prognóstico no tumor de próstata localizado. No sítio metastático, houve perda global de expressão das MAC. Encontramos ganho de expressão com a progressão do câncer de próstata somente para a integrina 3 que mostrou forte expressão em metade das metástases ósseas e linfonodais. Encontramos forte expressão de e -catenina foi em 94% dos linfonodos e 45% Conclusões: Nossos experimentos demonstram que a expressão das integrinas 3 e 3 1 está independentemente associada à recidiva de câncer de próstata após prostatectomia radical, e que a perda das moléculas de adesão celular pode ser considerada uma característica da progressão desta neoplasia / Purpose: Cell adhesion molecules (CAM) are essential for the maintenance of epithelial phenotype. Some studies have reported correlations between abnormalities in their expression and carcinogenesis, but their role in prostate cancer is unclear. Our aim was to study the expression profile of E-cadherin, catenins and integrins in surgical specimens of prostate cancer and associate their expression with outcome. We also assessed these expressions in bone and lymph node metastases in order to understand their influence in the progression of prostate cancer. Materials and Methods: We selected 111 patients with localized prostate cancer who underwent radical prostatectomy performed by the same surgeon. Sixty patients had no tumor recurrence after a median follow-up of 123 months. The CAM expression was evaluated by immunohistochemistry in a tissue microarray (TMA) containing two samples of each tumor. A semiquantitative analysis was employed and we measured the association between the expression of CAM and tumor recurrence. We also evaluated CAM expression by immunohistochemistry in a TMA containing 28 bone metastases and in other TMA containing 19 lymph node metastases with their corresponding 19 primary tumors. Results: In primary tumors, multivariate analysis showed that expression of 3 and 31 integrins was related to worse outcome. When 3 expression was strong and 31 expression was positive,the odds of recurrence were 3.0 and 2.5 fold higher. Only 19% and 28% of patients were recurrence-free in a mean follow up period of 123 months, when tumors showed strong 3 or positive 31 immuno-expression respectively. Other integrins have shown reduced expression, except 6 , which was expressed in most primary and metastatic cases. E-cadherin and catenins expressions were not associated with primary tumor outcome. At the metastatic setting, there was a global loss of CAM expression. We observed reliable gain of expression with prostate cancer progression only for integrin 3 that showed strong expression in half of bone and lymph node metastases. Interestingly, strong expression of and -catenin was observed in 94% of lymph node and 45% of bone metastases. Conclusions: We have demonstrated that the expression of integrins 3 and 31 was independently associated with recurrence after radical prostatectomy. In addition, we have shown that the loss of cell adhesion molecules can be considered a characteristic of prostate cancer progression

Orientadores: Carla Beatriz Collares Buzato, Maria Tereza Cartaxo Muniz / Tese (doutorado) - Universidade Estadual de Campinas, Instituto de Biologia / Made available in DSpace on 2018-08-26T04:14:27Z (GMT). No. of bitstreams: 1 Falcao_VivianeTannuriFerreiraLima_D.pdf: 4019842 bytes, checksum: b5e69f5076caaaff42a597448cba843c (MD5) Previous issue date: 2014 / Resumo: As junções intercelulares (JIs) e suas proteínas estruturais estão envolvidas em vários processos celulares tais como adesão e comunicação celular, diferenciação, proliferação e homeostase celular em diversos órgãos. No pâncreas endócrino, JIs parecem estar envolvidas na regulação da citoarquitetura das ilhotas pancreáticas, bem como na biossíntese e secreção de insulina. O objetivo desta tese foi investigar o possível papel do contato intercelular mediado pelas junções intercelulares e suas proteínas estruturais na disfunção das células beta pancreáticas na patogênese do Diabetes mellitus tipo 2 (DMT2). Para tanto, investigamos a distribuição e expressão celular de proteínas juncionais (a saber, E-, N-, VE-caderinas, ZO-1, ?- e ? - cateninas) no pâncreas endócrino de camundongos C57BL/6/JUnib alimentados com uma dieta rica em gorduras (dHL) durante 8 meses. Inicialmente, foi feita uma caracterização metabólica dos animais e uma análise estrutural e morfométrica do pâncreas endócrino, já que estudos avaliando o efeito da administração de dHL por tempo prolongado são escassos. Os animais do grupo dHL (alimentados com ração contendo 21%g lipídios por 8 meses) tornaram-se obesos, mostrando importante aumento do ganho de peso (170%) em relação ao grupo controle (que receberam ração padrão com 4,5%g lipídios pelo mesmo período de tempo). Ainda, os camundongos obesos exibiram distúrbios metabólicos característicos e indicativos dos estágios iniciais do estabelecimento da DMT2, como resistência periférica a insulina, com um aumento (de 27,34%, p=0,0005) da área sob a curva de ITT, bem como marcada hiperglicemia em jejum (52%, p<0,0001) e hiperinsulinemia pós-prandial (88%, p=0,0058) em relação ao grupo Ct. Ilhotas pancreáticas isoladas de camundongos alimentados com dHL mostraram uma deficiência significativa da secreção de insulina estimulada por glicose (p<0,05), associada a um aumento da expressão do gene da insulina (isoformas 1 e 2), analisado por qPCR. A histologia do pâncreas endócrino não revelou alterações marcantes na morfologia e citoarquitetura das ilhotas entre os grupos de animais. Entretanto, os animais dHL apresentaram um aumento significativo do volume relativo de células ? por pâncreas total (aumento de 57,1%, p<0,036) e da área relativa de células ? por ilhota em relação ao grupo controle (p<0,003), indicando uma expansão compensatória da massa de célula beta, associada com uma significativa diminuição (p<0,003) da área ocupada pelas células alfa em relação à área total da ilhota (30%, p<0,003). Com relação à distribuição celular das proteínas juncionais nas ilhotas pancreáticas, a N-caderina, E-caderina, ZO-1 e cateninas estão distribuídas na região de contato intercelular das células endócrinas pancreáticas, enquanto que a VE-caderina está limitada ao endotélio. Verificou-se, por imunoistoquímica, uma diminuição na marcação intercelular das células ? para N-caderina (p<0,0001), E-caderina (p<0,0001) e ?-catenina (p<0,0001) e um aumento na imunoreação para VE-caderina (p<0,004) nas ilhotas de camundongos diabéticos em relação ao grupo Ct. No caso particular da imunofluorescência para N-caderina, verificou-se um aumento na marcação difusa do interior das células ?, indicando uma redistribuição dessa proteína da região de contato intercelular para o citoplasma. Entretanto, não observamos diferenças significativas no grau do conteúdo celular dessas proteínas juncionais em homogeneizados de ilhotas isoladas entre os grupos experimentais, analisado por Western Blot. Conforme revelado por qPCR, um aumento na expressão gênica da VE- e N-caderinas, bem como de ZO-1, foi observado em ilhotas isoladas de camundongos diabéticos em comparação com os controles. Em conclusão, as proteínas juncionais estudadas são expressas por células endócrinas e endoteliais das ilhotas pancreáticas e, em particular, a distribuição/expressão de N-, E- e VE-caderinas, bem como ?-catenina nas ilhotas é significativamente alterada em camundongos obesos e diabéticos, o que pode ter repercussão no desenvolvimento da DMT2 / Abstract: Intercellular junctions (IJs) and their CAMs participate in important cellular processes such as adhesion, growth/death and signaling. In the endocrine pancreas, IJs play a role in regulating islet cytoarchitecture, insulin biosynthesis and secretion. In this PhD thesis, we investigate the islet histology and cellular distribution and content of CAMs (E-, N-, VE-cadherins, ZO-1, ?- and ?-catenins) in the endocrine pancreas of C57BL/6/JUnib mice fed a high fat (HF) diet for a prolonged time period (8 months). After HF diet exposure, mice became obese and displayed marked metabolic disturbances indicative of type 2 diabetes mellitus, such as marked peripheral insulin resistance and hyperglycemia, and moderate hyperinsulinemia. Isolated pancreatic islets of HF-fed mice showed a significant impairment of glucose-stimulated insulin secretion associated with an increase in insulin (isoforms 1 and 2) gene expression as revealed by qPCR. Histology of the endocrine pancreas revealed no marked changes in islet morphology and cytoarchitecture between animal groups, although HF-fed mice showed a 57% increase in the relative beta cell volume (per total pancreas) in comparison with controls. As shown by immunohistochemistry, ZO-1, E-, N-cadherin and catenins, were expressed at the intercellular contact site of endocrine cells while VE-cadherin was restricted to the islet vascular compartment. A cellular redistribution of N- and E-cadherin and ?-catenin (from the contact region to the cytoplasm in endocrine cells) and an increase in VE-cadherin islet content were seen in diabetic mice as compared to controls. No significant differences in islet immunoreaction for the other CAMs were observed between the animal groups. As revealed by qPCR, an increase in gene expression of VE- and N-cadherins as well as of ZO-1, not accompanied by significant changes in islet protein content, was observed in isolated islets of diabetic mice as compared to the controls. In conclusion, CAMs are expressed by endocrine and endothelial cells of pancreatic islets and, in particular, the islet distribution/content of N-, E- and VE-cadherins as well as ?-catenin are significantly altered in obese and diabetic mice / Doutorado / Biologia Celular / Doutora em Biologia Celular e Estrutural

Abstract Epithelial cell-cell adhesions have a critical role in morphogenesis, establishment and maintenance of tissue architecture, cell-cell communication, normal cell growth and differentiation. These adhesions are disrupted during malignant transformation and tumour cell invasion. Several kinases, phosphatases and small GTPases regulate cell-cell contacts. In the present work we investigated the dynamics of cell-cell adhesion structures after microinjection of fluorophore tagged vinculin, during transformation caused by an active Src tyrosine kinase and during Helicobacter pylori infection. The regulatory role of Rac GTPase as well as the behaviour of actin and cadherin were analysed in all these conditions. Microinjection of vinculin into bovine kidney epithelial MDBK cells induced release of actin, cadherin and plakoglobin to cytoplasm of the cells, caused disruption of protein complexes at adherens and tight junctions that finally led to formation of polykaryons. Activated Rac GTPase, in turn, enhanced accumulation of cadherin to membranes and thereby diminished the formation of polykaryons, whereas inactive Rac removed cadherin from membranes. Incorporation of vinculin to lateral membranes took place also in acidifying and depolarising conditions where cell fusions were prevented. Thus, the membrane potential seemed to control fusion ability. In src-MDCK cells, activation of Src kinase led to disintegration of adherens junctions. Clusters of junctional components and bundles of actin were seen at the basal surface already within 30 min after Src activation. p120ctn was the only component of adherens junction whose relocation correlated to its phosphorylation. Inhibition of Src by a specific inhibitor PP2 restored the cubic morphology of the cells and accumulated cadherin back to lateral walls. Still p120ctn remained in cytoplasm and thereby was not responsible for the epithelial phenotype. Activation of Rac GTPase by Tiam1 also increased the amount of cadherin at lateral membranes and maintained the morphology of src-MDCK cells practically normal after activation of Src kinase. In the same way, actin cytoskeleton was reorganised in gastric carcinoma cells in response to infection with H. pylori via activation of Rac signalling pathway. Hence, Rac and cadherin seem to be the major players in the maintenance of epithelial cell morphology.

Les jonctions adhérentes sont des jonctions intercellulaires essentielles à la morphogenèse et à la maintenance des tissus. Elles reposent sur l'assemblage de grands complexes multiprotéiques aux contacts intercellulaires, centrés sur des protéines transmembranaires appelées cadhérines. Nous avons découvert deux nouveaux partenaires des cadhérines N, E, M, P, R et 11, les flotillines. Nous avons caractérisé leur interaction avec la N-cadhérine et découvert qu'elle était constitutive à la membrane plasmique et vraisemblablement indirecte. Nous avons démontré que les flotillines sont essentielles à la stabilisation des jonctions adhérentes dans des cellules musculaires et épithéliales, ainsi qu'à des processus cellulaires dépendants des jonctions. Nous montrons qu'en effet, les flotillines sont nécessaires à l'interaction des cadhérines avec la p120-caténine, qui inhibe leur internalisation et leur dégradation. Nos expériences suggèrent que les flotillines seraient impliquées dans la formation d'un microdomaine membranaire particulier au niveau de la jonction en cours de maturation, permettant le recrutement de la p120-caténine. / Cadherins are essential in many fundamental processes such as tissue patterning during development and in the maintenance of adult tissue architecture. At regions of cell-cell contact, cadherins assemble into large macromolecular complexes named adherens junctions. Here we identify flotillin 1 and 2 as new partners of several classical cadherins. The interaction between flotillines and N-cadherin is constitutive at the plasma membrane and seems to require an intermediate partner. Knockdown of flotillins had a dramatic effect on N- and E-cadherin recruitment at the adherens junctions in both mesenchymal and epithelial cell types. At the molecular level, we show that flotillins stabilize cadherins at the PM hence allowing the coupling of 120 catenin, one of their main stabilizing partners. Our results suggest that flotillins might scaffold a membrane microdomaine at maturing junctions, allowing the recruitment of p120-catenin.

L’altération des mécanismes impliqués dans l’homéostasie intestinale peut conduire au développement de cancers colorectaux (CCR). Les CCR se situent au 2nd rang des décès par cancer en France et il est donc nécessaire d’améliorer nos connaissances pour mieux les soigner. L’objectif de ces travaux était de comprendre les mécanismes impliqués dans l’homéostasie intestinale par le biais de la Cadhérine atypique MUCDHL dont l’expression semble diminuée dans les CCR. Les conséquences de cette perte et le mode d’action de MUCDHL restent mal connus. Ainsi, l’étude d’une large cohorte de patients et d’un modèle murin a permis de confirmer que la perte de MUCDHL aggrave la tumorigenèse intestinale. De plus, la caractérisation de l’interaction entre MUCDHL et la β-caténine a montré que le mode d’action de MUCDHL est plus complexe qu’une simple séquestration membranaire de la β-caténine impliquant différentes voies de signalisation. Enfin ces travaux ont permis d’identifier des interactants de MUCDHL. Les résultats montrent pour la première fois le rôle de suppresseur de tumeurs de MUCDHL dans le côlon et apportent des informations sur sa régulation et son mode d’action. / The alteration of mechanisms involved in intestinal homeostasis leads to the development of colorectal cancer (CRC). In France, CRC is the second leading cause of cancer mortality, and it is therefore necessary to improve our knowledge to treat it better. The objective of this project was to understand more precisely mechanisms involved in intestinal homeostasis through the atypical Cadherin MUCDHL whose expression seems decreased in CRC. However, the consequences of this loss, as well as the mode of action and the molecular relays of MUCDHL were largely unknown. Thus, the study of a large cohort of patients and of a murine model confirmed that the loss of MUCDHL enhances intestinal tumorigenesis. In addition, the functional characterization of the interaction between MUCDHL and β-catenin showed that the mode of action of MUCDHL is more complex than a simple membrane sequestration of β-catenin involving different signaling pathways. Finally, new interactants of MUCDHL were identified. The results obtained through this work show, for the first time, the tumor suppressor role of MUCDHL in the colon, and provide informations about its regulation and mode of action.

Le muscle et l’os coopèrent mécaniquement mais aussi biochimiquement, via les facteurs de croissance et les cytokines. Suite à une lésion de l’os, les cellules souches sont recrutées et induites en différenciation osseuse grâce à la sécrétion de molécules bioactives telles que les facteurs de croissance. L’une des stratégies de l’ingénierie tissulaire de l’os est de combiner des matériaux avec des facteurs de croissance osseux. Les protéines morphogéniques osseuses (ou BMPs), pouvant être présentées aux cellules en solution ou enchâssées dans la matrice, appartiennent à la famille des facteurs de croissance basiques et jouent un rôle très important dans la formation de l’os. Les BMPs induisent non seulement une différenciation osseuse de progéniteurs osseux, mais induisent aussi la transdifférenciation de progéniteurs musculaires vers un phénotype ostéoblastique. L’obtention de la complexité de l’architecture tissulaire osseuse nécessite des interactions continues entre la cellule et son microenvironnement. Ces interactions sont médiées par les récepteurs cellule/matrice (intégrine) et cellule/cellule (cadhérines). Dans cette thèse, nous nous sommes intéressés au rôle du système adhésif dans la réponse à la BMP-2 lors de la transdifférenciation des myoblastes C2C12. Nous avons utilisé un film multicouche à base de hyaluronane et de poly(L-lysine) comme biomatériau pour présenter la BMP-2 par la matrice. A court terme, nous avons mis en évidence une coopération entre l’intégrine 3 et les récepteurs BMP dans l’induction d’un étalement cellulaire et d’une réponse précoce à la BMP-2, via la protéine GSK3. A plus long terme, nous avons montré un switch du répertoire adhésif en réponse à la BMP-2. Enfin, nos résultats suggèrent une coopération entre les intégrines β3 et β5 et les cadhérines N et 11 dans la transdifférenciation induite par la BMP-2. / Muscle and bone cooperate both mechanically and biochemically, through growth factors and cytokines. Following a bone lesion, stem cells are recruited and their differentiation is induced via the secretion of bioactive molecules such as growth factors. One strategy in bone tissue engineering is to combine materials with bone growth factors. Bone Morphogenetic Proteins (BMPs), which can be presented to the cell either in solution or bound to the matrix, belong to the basic growth factor family and play a very important role in bone formation. BMPs induce not only the differentiation of bone progenitors, but also the transdifferentiation of muscle progenitors towards an osteoblastic phenotype. Obtaining the complexity of the bone tissue architecture requires continuous interactions between the cell and its microenvironment. These interactions are mediated by cell/matrix and cell/cell receptors (integrins and cadherins, respectively). In this thesis, we investigated the role of the adhesion system in the context of its response to BMP-2 during the transdifferentiation of C2C12 murine myoblasts. To do so, we used polelectrolyte multilayer films composed of hyaluronan and poly(L-lysine) as a biomaterial to present BMP-2 in a matrix-bound manner. Short term, we revealed a cooperation between the integrin 3 and BMP receptors in the induction of cell spreading and of an early response to BMP-2 via the protein GSK3. In a longer term, we showed a switch in the repertoire of adhesion receptors in response to BMP-2. Finally, our results suggest a cooperation between 3 and 5 integrins and cadherins N and 11 for the BMP-2-induced transdifferentiation.

Chemotherapy is one of the basic therapeutic procedures of breast cancer (BC) which may precede and/or follow the surgical resection of a tumor as a part of neoadjuvant or adjuvant therapy. However, the selective pressure of chemotherapy on tumor cells may change their molecular and expression profile and thus also their chemosensitivity. The aim of our work was to document the expression changes of selected markers in BC after neoadjuvant chemotherapy, which may contribute to the understanding of the role of these proteins and genes in tumor response to chemotherapy and the development of chemoresistance. Immunohistochemical analysis of expression of standard BC markers [estrogen (ER) and progesterone receptors (PR), HER2 and proliferation activity (Ki67)] and intercellular junction proteins (claudin 1, 3 and 4, E- and N-cadherin) before and after neoadjuvant chemotherapy revealed a decrease of PR, Ki67 and claudin 3 expression and an increase of claudin 1 expression. The expression of ER, HER2, claudin 4, E- and N-cadherin proved to be stable. Assessment of standard BC markers is performed routinely during a bioptic investigation as a necessary factor for therapy indication. Our results support the current recommendations for the re-examination before indication of adjuvant chemotherapy. Claudins...

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published_or_final_version / Pathology / Master / Master of Philosophy

Introdução: Câncer gástrico é uma doença multifatorial influenciada por fatores externos e hereditários. Embora a síndrome do câncer gástrico difuso hereditário causada por mutações germinativas no gene CDHl seja uma condição rara, sua influência sobre a incidência de câncer gástrico no Brasil, que é considerado um país de alta incidência desta neoplasia, é desconhecida. Objetivos: Avaliar a frequência de variantes germinativas em CDHl e os hábitos de dieta/estilo de vida em pacientes diagnosticados câncer gástrico com idade precoce «55 anos) no Brasil. Metodologia: De outubro de 2013 a agosto 2015, foram recrutados 88 pacientes consecutivos e não aparentados diagnosticados com câncer gástrico em idade precoce em um hospital público brasileiro. Todos os éxons e regiões intrônicas flanqueadoras do CDHl foram sequenciados. Os hábitos de dieta/estilo de vida dos pacientes com câncer gástrico em idade precoce foram comparados com informações sobre os hábitos da população armazenados em bancos de dados populacionais brasileiros. Resultados: Dos 88 pacientes, 51,1% eram do sexo feminino e a média de idade no momento do diagnóstico do câncer era de 39 anos (variação, 20-55); 23% relataram história familiar de câncer gástrico em parentes de primeiro ou de segundo. A maioria dos tumores era do tipo difuso (74%), pouco diferenciado (74%) e localizava-se no terço médio ou distal do estômago (67%). No total, 24 variantes germinativas foram detectadas: 3 (12.5%) benignas, 17 (70.8%) provavelmente benignas e 4 (16.7%) variantes de significado clínico incerto (VSI). Todas as VSI são mutações missense e nunca foram relatadas previamente na literatura: c.313T> A, c.387G> T, c.1676G> A e c.1806C> A. Os pacientes com câncer gástrico diagnosticados em idade precoce apresentaram maior consumo de carne vermelha (OR: 2.591, IC 95%: 1.371-4.894) e carne processada (OR: 3.093, IC 95%: 1.591- 6.009) em comparação com os hábitos alimentares da população brasileira. Conclusão: De acordo com o nosso conhecimento, esta é a maior série investigando a contribuição de mutações germinativas de CDHl em pacientes diagnosticados com câncer gástrico em idade precoce na América Latina. Para um país considerado de alta incidência, a frequência encontrada de variantes germinativas em CDHl foi maior do que o esperado; 4 novas mutações missense foram identificadas e mais estudos são necessários para confirmar a patogenicidade dessas variantes. Fatores de risco modificáveis, como o consumo de carne vermelha e/ou de carne processada podem ter contribuído para o desenvolvimento de câncer gástrico em idade precoce na população estudada / Introduction: Gastric cancer is a multifactorial disease influenced by inherited and noninherited factors. Although hereditary diffuse gastric cancer syndrome caused by germline mutation in CDHl is arare condition its contribution to gastric cancer burden in Brazil, which is considered a high-incidence country for this neoplasia, is unknown. Objectives: To evaluate the frequency of CDHl germline variants and the dietjlifestyle habits in early-onset gastric cancer (EOGC, < 55 years old) patients in Brazil. Methodology: From October 2013 to August 2015, a total of 88 unrelated and consecutive patients attending a Brazilian public hospital with EOGC were enrolled. Ali CDHl exons and intronic boundaries were sequenced. The dietjlifestyle habits of EOGC patients have been compared to Brazilian population data bases. Results: Of 88 patients, 51.1% were female and the mean age at gastric cancer diagnosis was 39 years (range 20-55); 23% reported family history of gastric cancer in first- or second-degree rei atives. The majority of the tumors were diffuse (74%), poorly differentiated (74%), and located in the middle and distal-third of the stomach (67%). In total, 24 germline variants were detected: 3 (12.5%) benign, 17 (70.8%) likely benign, and 4 (16.7%) variants of unknown significance (VUS). Ali VUS were missense novel mutations: c.313T > A, c.387G > T, c.1676G > A, and c. 1806C > A. EOGC patients had ahigher red (OR: 2.591, 95% CI: 1.371-4.894) and processed (OR: 3.093, 95% CI: 1.591-6.009) meat intake compared to eating habits of the Brazilian population. Conclusion: To our knowledge, this is the largest series investigating the contribution of CDHl germline mutations in EOGC cancer in Latin America. For a high-incidence country, the incidence of CDHl germline variants was higher than expected; 4 novel CDHl missense mutations were identified and further studies are warranted to confirm their pathogenicity. Modifiable risk factors, such as the consumption of red and/or processed meat may have contributed to early- onset gastric cancer development in our studied population