Presente estudo teve como objetivo avaliar a utilização da tecnologia de banda estreita com filtros ópticos (TBE) no rastreamento do carcinoma espinocelular do esôfago (CEC), utilizando como método comparativo a cromoscopia com a solução de Lugol. Trata-se de um estudo prospectivo de teste de diagnóstico, para o qual foram avaliados 129 pacientes do Hospital das Clínicas da Faculdade de Medicina da Universidade de São Paulo (HC-FMUSP), com diagnóstico de carcinoma epidermóide de cabeça e pescoço, em programa de rastreamento de tumores secundários, no período de agosto de 2006 a fevereiro de 2007. Os exames de endoscopia convencional, TBE e a cromoscopia com Lugol foram realizados consecutivamente em um mesmo procedimento, e as lesões encontradas foram registradas e submetidas a biópsias. Foram calculados para cada método valores da sensibilidade, especificidade, acurácia, valores preditivos positivos e negativos, valores de verossimilhança positivo e negativo. Foram diagnosticados nove carcinomas superficiais (7%), sendo cinco carcinomas in situ e quatro carcinomas intramucosos, todos detectados pelo TBE e pelo Lugol, porém apenas seis foram diagnosticados pelo exame convencional e destes, nenhum foi menor ou igual a 10 mm. A tecnologia de bandas estreitas com filtros ópticos (TBE) sem magnificação de imagem apresentou resultados superponíveis a cromoscopia com Lugol, método atualmente de escolha para rastreamento do CEC esofágico em grupos de pacientes de alto risco, portadores de tumores de cabeça e pescoço / Background and study aims: The aim of this study was to compare narrow band imaging (NBI) without magnification and chromoendoscopy with Lugols solution for detecting superficial esophageal squamous cell carcinoma in patients with head and neck cancer. Patients and methods: This is a prospective observational study of 129 patients with primary head and neck tumors consecutively referred to the Gastrointestinal Endoscopy Unit of Hospital das Clínicas, São Paulo University Medical School (FMUSP), Brazil, between August 2006 and February 2007. Conventional examinations, NBI and Lugol chromoendoscopy were consecutively performed, and the detected lesions were mapped, recorded and sent for biopsy. The results of the three methods were compared regarding sensitivity, specificity, accuracy, positive predictive value, negative predictive value, positive likelihood value and negative likelihood value. Results: Of the 129 patients, nine (7%) were diagnosed with carcinomas, five of which were in situ and four intramucosal. All carcinomas were detected through NBI and Lugol chromoendoscopy. Only six lesions were diagnosed by conventional examination, all of which were larger than 10 mm. Conclusions: Narrow-band imaging technology with optical filters has high sensitivity and high negative predictive value for detecting superficial esophageal squamous cell carcinomas and produces results comparable to those obtained with 2.0% Lugol chromoendoscopy in patients with head and neck cancer

Unilateral cortisol producing adenoma (CPA) is the most common cause of ACTH-independent Cushing’s syndrome and is surgically curable. On the other hand, adrenocortical carcinomas (ACCs) are rare and aggressive tumours. Although the overall survival of the patients with ACC is very poor, the outcome can be heterogeneous and vary significantly between the patients. This thesis comprises studies showing genetic and genomic events occurring in CPAs and ACCs, their functional impact and clinical correlations. The Wnt/β-catenin and cAMP/PKA signalling pathways are crucial in adrenal homeostasis and frequent mutations in members of these pathways (CTNNB1, GNAS, and PRKACA) are found in CPAs. Mutational analysis revealed that ~60% of the CPAs harboured mutations in either of these genes. Transcriptome signature exhibited increased expression of genes involved in steroidogenesis in PRKACA/GNAS mutated (Cluster1) tumours in comparison to CTNNB1 mutated /wildtype (Cluster2) tumours. In addition we have also observed that gain of chromosome arm 9q was the most frequent arm level copy number variation (CNV) occurring in CPAs and were exclusively present in Cluster2 tumours. We also discovered novel PRKACA mutations occurring in ACCs, causing activation of cAMP/signalling pathway.    Comprehensive analysis of Wnt/β-catenin signalling pathway in ACCs revealed novel interstitial deletions occurring in CTNNB1 leading to deletion of the N-terminus of β-catenin. This is a novel and yet another frequent event leading to activated Wnt/β-catenin signalling and downstream targets in ACCs. Both, mutations occurring in CTNNB1 and nuclear expression of its protein were associated with poor overall survival. Through multiregional sampling approach we discovered intra-tumour heterogeneity in ACC tumours. Although all the multiregions within a tumour showed presence of shared basal CNVs, they encompassed private CNVs, different ploidy levels and private mutations in known driver genes. We found intra-tumour heterogeneity in CTNNB1, PRKACA, TERT promoter and TP53 mutations as well as ZNRF3 and CDKN2A/2B homozygous deletions.

Overall survival of the metastatic forms of epithelial derived cancers, especially head and neck squamous cell carcinomas (HNSCC), has not significantly improved even with the application of aggressive combined modality approaches incorporating radiation and chemotherapy. Cumulative evidence implicates the epidermal growth factor receptor (EGFR) as an important therapeutic target in HNSCC. We have previously demonstrated that the combination of lovastatin, a potent inhibitor of the mevalonate pathway, with EGFR tyrosine kinase inhibitors induced robust synergistic cytotoxicity. However, the use of high dose statins in our clinical trial was associated with significant toxicities including higher than anticipated rate of muscle pathologies. Our goal was to uncover novel downstream targets of the mevalonate pathway that may enhance the efficacy or limit toxicities of this novel combination therapeutic approach. In this study we have demonstrated that GGTI-298, an inhibitor of protein geranylgeranylation, through its ability to disrupt the actin cytoskeleton, inhibits EGFR dimerization and cellular trafficking. This novel mechanism targeting the EGFR has clinical implications as GGTI-298 in combination with tarceva, a clinically relevant EGFR inhibitor, showed enhanced cytotoxicity and inhibitory effects on EGFR activation and its downstream signaling.

Distant brain metastases from oral squamous cell carcinomas (OSCC) are extremely rare. Here we describe a case of a 53-year-old man with a primary OSCC who referred to the neurosurgical department because of epileptic seizures. MR imaging revealed an enhancing lesion in the right parietal lobe. A craniotomy with tumor removing was performed. Histopathological examination verified an invasive, minimally differentiated metastasis of the primary OSCC. The patient refused whole brain radiation therapy and died from pulmonary metastatic disease 10 months after the neurosurgical intervention without any cerebral recurrence. To the authors’ knowledge, only two similar cases have been previously reported.

Hereditary Colorectal Carcinomas – Reflection on Preventive Surgery Hereditary Nonpolyposis Colorectal Cancer (HNPCC) accounts for about 5% of all colorectal cancers and is the most frequent familial form; familial adenomatous polyposis coli accounts for about 1%. Prerequisitive for individually tailored surveillance is the identification of the pathogenic germline mutation. In classical FAP, surgical standard is a restorative proctocolectomy while in HNPCC there is no surgical standard other than standard oncological resection due to missing evidence. In HNPCC, prophylactic colectomy before the onset of the first colorectal cancer is not recommended. Main arguments for the extension of the resection in the case of the first colorectal carcinoma in HNPCC are the rate of metachronous colorectal carcinomas of 40–45% in a 10-year interval and rapid tumor progression. In HNPCC, in the case of first colon cancer a subtotal colectomy seems to be indicated. A proctocolectomy or, if indicated, a restorative proctocolectomy may be considered in the case of carcinomas in the lower rectum. These considerations should be evaluated in a prospective clinical trial. Counselling, molecular diagnosis and surgery in patients with hereditary colorectal cancers should only be performed in interdisciplinary centers. / Das «Hereditary Nonpolyposis Colorectal Cancer» (HNPCC)-Syndrom bildet mit zirka 5% aller kolorektalen Karzinome die größte Gruppe der familiären Formen; die familiäre adenomatöse Polyposis coli (FAP) macht zirka 1% aus. Voraussetzung für die Indikationsstellung zu individuellen Vorsorgeprogrammen ist die Identifizierung der pathogenen Keimbahnmutation. Bei der klassischen FAP ist die Durchführung einer restaurativen Proktokolektomie die Therapie der Wahl, beim HNPCC-Syndrom gibt es aufgrund fehlender Daten klinischer Studien noch keinen Operationsstandard, der über eine Resektion entsprechend den onkologischen Resektionsprinzipien hinausgeht. Eine prophylaktische Kolektomie vor Manifestation eines kolorektalen Karzinoms bei HNPCC kann bei der gegenwärtigen Datenlage nicht empfohlen werden. Hauptargumente für die Erweiterung des Eingriffs bei manifestem kolorektalem Karzinom bei HNPCC-Patienten sind das Risiko metachroner kolorektaler Karzinome von 40–45% in einem Zeitraum von 10 Jahren und die rasche Tumorprogression. Bei Erstmanifestation eines Kolonkarzinoms erscheint die Durchführung einer subtotalen Kolektomie indiziert. Bei Erstmanifestation des Karzinoms im unteren Rektumdrittel ist die Durchführung einer Proktokolektomie bzw. unter entsprechenden onkologischen und funktionellen Voraussetzungen eine Kolektomie mit Proktomukosektomie und Ileum-Pouch zu erwägen. Die Evaluierung dieser Überlegungen sollte im Rahmen einer prospektiven klinischen Studie erfolgen. Die Beratung, molekulare Diagnostik und chirurgische Therapie von Patienten mit hereditären kolorektalen Karzinomen sollte zunächst nur entsprechenden interdisziplinären Zentren vorbehalten bleiben. / Dieser Beitrag ist mit Zustimmung des Rechteinhabers aufgrund einer (DFG-geförderten) Allianz- bzw. Nationallizenz frei zugänglich.

Introduction HNF-1β is a transcription factor that plays a crucial role in the ontogenesis, regulates expression of multiple genes involved in cell cycle modulation and seems to be involved in cancerogenesis of various tumors. HNF-1β protein is coded by the HNF1B gene. Genetic and epigenetic changes of HNF1B play role in tumorigenesis and these changes can be accompanied by loss of expression or increased protein expression as detected by immunohistochemistry. In gynecopathology, expression of HNF-1β was considered as specific marker of clear cell carcinomas of the ovary and endometrium. However, more recent studies described HNF-1β expression also in tumors of other histogenesis. Aims: Our study focused on the immunohistochemical and molecular analysis of HNF1B in the normal tissue, various types of tumors and non-neoplastic lesions of the female genital tract. The goals of our study were: 1. Analysis of HNF-1β expression in cervical carcinomas. 2 Analysis of HNF-1β expression in endometrial carcinomas and non-neoplastic tissues of the female genital tract. 3. Analysis of epigenetic and genetic changes of HNF1B in endometrioid carcinomas and ovarian clear cell carcinomas. 4. Comprehensive analysis of atypical polypoid adenomyomas. Material and methods: A total of 574 samples including 399...

Antibodies are Y-shaped proteins. In the human body, antibodies areproduced by plasma cells, mainly T and B cells which are included inthe adaptive immune system. The production of antibodies is stimulatedby antigens. The binding between an antigen-specific antibody and itsantigen can be like the interconnect between a lock and a key.Therefore, antibodies are widely used as diagnostic tools for avariety of diseases but most importantly cancer. Some rapid diagnostictests are completely dependent on the specificity and reactivity ofantibodies such as UBC® Rapid produced by IDL Biotech AB. Therefore,the quality of these antibodies is important. This master thesis at IDL Biotech aimed to validate six anticytokeratinantibodies that are currently used in several rapid cancerdiagnostic tests produced by IDL. Antibody validation is a processwhere specificity, selectivity and reproductivity of an antibody isdemonstrated through specific laboratory investigations. During thisthesis, two laboratory methods were used to validate antibodies,namely, isoelectric focusing electrophoresis and the Attana QuartzCrystal Microbalance based biosensor. Isoelectric focusing electrophoresis (IEF) is a method that determinesproteins pI-values which can then reveal information about posttranslationalmodifications and protein sustainability during storage.IEF revealed changes in pI-values in two antibodies: AB2 and AB4. Attana biosensor analysis on AB1-5 showed that all antibodies havehigh specificity, reactivity and relatively high affinity to theircytokeratin targets. It also revealed that 4 antibodies (AB1 and AB3-5) have lower cross-reactivity with other cytokeratins than theirtarget cytokeratins compared to AB2. Keywords: Antibody validation, Isoelectric focusing, QCM, Attanabiosensor, biosensors, rapid diagnostics, epithelial carcinomas.

Regulated cell death (RCD) is indispensable for homeostasis and plays a crucial role in the pathophysiology of numerous diseases. Adrenocortical carcinomas (ACCs) represent a rare and highly malignant type of cancer. Currently, the most common therapeutic options include the complete surgical removal of the adrenal gland and/or the administration of mitotane, a derivative of the pesticide DDT. Yet patient survival remains poor and the mechanism of action of mitotane remains elusive. In this thesis it is demonstrated that the human ACC cell line NCI-H295R is sensitive to mitotane-induced cell death. In the first part, the involvement of three different RCD pathways, namely apoptosis, necroptosis and ferroptosis, in mitotane induced necrosis was investigated. To this end, different inhibitors were used, which were not able to block mitotane-induced cell death. When the medium was supplemented with insulin, transferrin, sodium selenite and linoleic acid (ITS+1) no cell death of the ACC cells was observed. This phenomenon was attributed to the presence of linoleic acid, since ITS supplementation lacking this component was not able to reverse mitotane-induced necrosis. Identification of new drug targets for alternative options of ACC treatment led to the investigation of key molecules involved in the pathways of necroptosis and ferroptosis. The receptor-interacting protein kinase 1 and 3 (RIPK1 and 3) and the mixed lineage kinase domain-like protein (MLKL) were considered as interesting targets given their crucial role in the execution of necroptosis. A western blot analysis of those molecules revealed the presence only of RIPK1, suggesting that the necroptosis machinery is not present in the NCI-H295R cells. Of interest, evaluation of the expression levels of glutathione peroxidase four (GPX4), one of the main inhibitory molecules of ferroptosis, showed a much higher expression in the ACC cells compared to the standard cell line used for studying ferroptosis, the human fibrosarcoma HT1080 cells. A hypothesis that the NCI-H295R cells are susceptible to ferroptosis induction was formed based on this finding. Compounds representative of all the four classes of ferroptosis inducers (FINs) were tested. Direct inhibition of GPX4 using the small compound RSL3, a type II FIN, led to high necrotic populations. Co-treatment with the ferroptosis inhibitor ferrostatin-1 (Fer-1) completely reversed RSL3-induced ferroptosis. Type IV FIN FINO2, that causes indirect loss of the enzymatic activity of GPX4, lead also to high necrotic populations, while Fer-1 prevented FINO2-induced ferroptosis. Data from public databases concerning gene methylation or mutation status of ACC tissues and normal human adrenal tissues was used to investigate potential key players of ferroptosis that might be either mutated or silenced in ACCs. Of note, glutathione peroxidases 3 and 5 (GPX3 and 5) were highly methylated, while the enzyme cystathionine gamma-lyase (CSE) involved in the transsulfuration pathway via the break down of cystathionine into cysteine and α-ketobutyrate and ammonia was found to be highly mutated. Collectively, these data point towards a high sensitivity of ACCs to ferroptosis induction. This could provide a new chapter for the therapeutic approaches of ACCs. Additionally, these findings provide a better understanding of the biology of this type of cancer that highly mutates or silences ferroptosis-related genes. The second part of this thesis focuses on the involvement of RCD in spontaneous cell death in isolated murine tubules. Existing literature points towards an involvement of necroptosis and ferroptosis pathways in the kidney in models of acute kidney injury (AKI). Acute tubular necrosis (ATN) represents a hallmark of AKI. While the work in the Linkermann lab has shown that isolated tubules perfused with type I FIN erastin undergo cell death in a “wave-of-death” manner, no deeper insights into the propagation of tubular necrotic injury exist. A protocol for isolation of murine kidney tubules was established, providing an ex-vivo model for investigation of tubular death. The absence of potentially confounding blood cells as well as immune cells was ensured by extensive washing steps as well as the use of collagenase. Visual observation and staining of isolated tubules with the nucleic acid stain SYTOX green revealed a spontaneous cell death in a “wave-of-death” manner. This wave was running in parallel with a calcium concentration change, indicating its involvement in the spontaneous necrosis. To investigate the potential involvement of mitochondria in this process, electron microscopy images were obtained from parts of the tubules with different levels of damage which revealed highly damaged and ballooned mitochondria. These data provided with a phenotypic characterisation of the spontaneous tubular necrosis. Aiming to approach this type of death genetically, necroptosis and pyroptosis deficient mice (MLKL/GSDMDDKO) were used. Comparison of the LDH release, used as a measure of necrosis, from isolated kidney tubules of the MLKL/GSDMDDKO mice and wild type (WT) mice showed no difference. This indicated that neither necroptosis nor pyroptosis are involved in the tubular necrosis. Therefore, the next step was to investigate the effects of Fer-1 at the levels of LDH of isolated tubules from WT mice. A significantly lower LDH release was observed in tubules treated with Fer-1 compared to the ones treated with vehicle. However, this reduction in the LDH release was not complete, suggesting that ferroptosis is only partially responsible for the spontaneous death of isolated tubules. The difference of male and female mice towards AKI sensitivity has been noted in the literature in that female mice are less susceptible compared to the male mice. Therefore, the next step was to investigate whether this protection of females can be observed at the level of isolated tubules. Indeed, the LDH release from tubules isolated from female mice was significantly less compared to the LDH release of tubules isolated from male mice. Based on the data obtained from isolated tubules from WT male mice treated with Fer-1, a similar experiment was performed with tubules isolated from WT female mice. No difference in the LDH release was observed between the Fer-1-treated tubules and the vehicle-treated ones, indicating that another cell death pathway might be involved. The most obvious difference between male and female organisms is the sex hormones. Whether testosterone or β-estradiol are responsible for the higher susceptibility or protection against cell death has been a debate over the last years. To test this hypothesis, three different cell lines were utilised. A pre-treatment of 16 h with either testosterone or β-estradiol was performed. Treatment with either type I FIN erastin or type II FIN RSL3 followed, and cells were analysed via flow cytometry. Data revealed protective effects of β-estradiol against ferroptosis induction. Next, the effects of β-estradiol in a simultaneous treatment with RSL3 were investigated. Interestingly the protective effects of the hormone were still observed. Among the metabolites of β-estradiol, 2-hydroxyestradiol (2-OHE2) has been reported to exert antioxidant effects. Therefore, 2-OHE2 was used in a simultaneous treatment with RSL3, and the obtained data showed that it was a much more potent inhibitor of necrotic cell death than β-estradiol even at lower concentrations. Collectively these data indicate that the lower susceptibility of female organisms towards cell death might be explained by the presence of β-estradiol and its more potent antioxidant metabolites. Such findings could change the way the two sexes are approached scientifically, while providing new insights on different therapeutic strategies between male and female organisms.

Wnt/beta-Catenin-Signalgebung hat große Bedeutung für die Initiation und Progression verschiedener Krebsarten. Unser Labor hat kürzlich ein Mausmodell für Squamöse Speicheldrüsen-Karzinome etabliert, das menschliche Hals-Nasen-Ohren-Karzinome reflektiert, durch kombinierte Mutationen von beta-Catenin und dem Bmp-Rezeptor 1a. Diese Tumore enthielten hohen Level von sich selbst-erneuernden Krebs-Stammzellen. Behandlung mit den Wnt-Inhibitoren ICG-001 blockierte die Selbsterneuerung und induzierte die Differenzierung der Krebs-Stammzellen. In den Krebs-Stammzellen der Maus wurde eine globale Aufregulierung des Histonmarkers H3K4me3 beobachtet, was durch Wnt-Inhibition gehemmt werden konnte. Um die molekularen Mechnismen aufzuklären, wurden die Histon-Methyltransferasen für H3K4me3, d.h., Mitglieder der Mll-Proteinfamilie, in sphären-kultivierten Krebs-Stammzellen durch RT-PCR analysiert: Mll1 war hoch transkribiert, zusammen mit den Hoxa9- und Meis1-Zielgenen. Interessanterweise aktivierte die Expression von Mll1 durch Wnt-Signalgebung die distale Enhancer-Region von Mll1, was durch Luciferase-Reporter-Assays gemessen wurde. Immunopräzipitation zeigte weiter, dass Mll1 im beta-Catenin-Transcriptionsfaktor-Komplex involviert ist: shRNA-Behandlung von Mll1 reduzierte die Sphären-Bildung der Speicheldrüsen-Krebs-Stammzellen der Maus. In doppelt-mutanten Mäusen hat die zusätzliche genetische Ablation von Mll1 die Tumorbildung verhindert und die Selbsterneuerung der Krebs-Stammzellen reduziert. Diese Daten zeigen dass die beta-Catenin-Mll1-Achse die Selbsterneuerung der Stammzellen antreibt und deren Differenzierung verhindert, und zwar via epigenetische Mechanismen. Deshalb wird durch das Targeting von Mll1 und dessen Interaktion mit beta-Catenin und andern Komponenten den gesunden epigenetischen Zustand in den Stammzellen wieder herstellt, was eine neue und vielversprechende Möglichkeit für die Behandlung von Patienten mit Hals-Nasen-Ohren-Tumoren darstellt. / Wnt/beta-catenin signaling has been implicated in the initiation and progression of various human cancers. Our lab has recently established a mouse model of salivary gland squamous cell carcinomas (SCCs), which resembles human head and neck cancer, by combined gain- and loss-of-function mutations of beta-catenin and the Bmp receptor 1a (double mutant tumors). These tumors contained highly self-renewing cancer stem cells (CSCs) that were Wnt-dependent. Treatment with the Wnt inhibitor ICG-001 (interferes with beta-catenin-CBP-Mll1 interaction) blocked the self-renewal and induced differentiation of CSCs. In the mouse salivary gland CSCs, a global up-regulation of the histone mark H3K4me3 was observed, which could be suppressed by Wnt inhibition. To study the potential molecular mechanisms, the H3K4me3 histone methyl-transferases, i.e., members of the Mll protein family were analyzed in freshly isolated, sphere-cultured CSCs by RT-PCR: Mll1 was highly transcribed, together with its target genes Hoxa9 and Meis1. Interestingly, the expression of Mll1 was upregulated by Wnt signaling by activating its distal enhancer regions, which was seen with Luciferase reporter assays. Immuno-precipitation further showed that Mll1 is involved in the beta-catenin/Tcf4 transcription factor complex: shRNA treatment against Mll1 reduced sphere formation of mouse salivary gland CSCs. In double mutant mice, additional genetic ablation of Mll1 (triple mutant tumors) abrogated tumor formation and affected the self-renewal ability of CSCs. Collectively, the data presented in this study show that the beta-catenin-Mll1 axis drives self‐renewal and fends off differentiation of CSCs via epigenetic mechanisms. Therefore, targeting Mll1 or its interaction with beta-catenin and other components may help to restore a healthy epigenetic state in the stem cells, which represent a novel and promising therapeutic approach for the treatment of head and neck SCCs.

Made available in DSpace on 2016-01-26T12:51:19Z (GMT). No. of bitstreams: 1 suelisuzigan_tese_parte5.pdf: 78044 bytes, checksum: ede6079670fe7d13ddd7e25ead03f505 (MD5) Previous issue date: 2002-05-03 / Introduction. Tumor growth and metastasis depend greatly on angiogenesis. There are several angiogenic growth factors able to induce new vessels in renal tumors, but the most important are vascular endothelial growth factor (VEGF) and basic fibroblast growth factor (b-FGF). The aim of our study was to investigate expression of b-FGF and to quantify microvessel density (MVD) in oncocytomas and renal cell carcinomas (RCCs) and to relate these parameters of tumor vascularity to other clinicopathological features. Material and Methods. b-FGF and CD31 immunostaining were performed on formalin-fixed paraffin-embedded archival tissues from Larpac Laboratories files, including 36 RCCs (10 conventional, 10 papillary, 8 sarcomatoid, and 8 chromophobe) and 5 oncocytomas. Angiogenesis was quantified microscopically by two independent observers. Results. b-FGF was positive in all five oncocytomas and only in seven of 36 RCCs: 5 of conventional type, 1 papillary, and 1 chromophobe. All sarcomatoid carcinomas were negative. The expression of b-FGF was not related to tumor size, grade, stage, or short survival in either group. MVD mean value was 124.16 ± 50.1 in oncocytomas and 91.54 ± 52.4 in RCCs. The pattern of vascularization observed in oncocytomas was characterized by a fine vascular network around groups of tumor cells although in RCCs the microvessels tended to be more disorganized. When analyzing only carcinomas, patients who died within 12 months after the diagnosis had a tumoral MVD mean value significantly higher (124.12 ± 75.2) than that observed in patients who were still alive one year after diagnosis (80.34 ± 37.8). ix Conclusion. We demonstrate that b-FGF is expressed more often in oncocytomas than in RCCs but MVD is similar in both groups of tumors. The high expression of b-FGF in oncocytomas may reflect the peculiar pattern of vascularization of these tumors. High MVD in rapidly lethal RCCs is an indication that angiogenesis may be correlated with the degree of malignancy of these tumors. / O desenvolvimento dos tumores e das suas metastases dependem em grande parte da angiogenese tumoral. Existem varios fatores de crescimento capazes de induzir à neoformação vascular nas neoplasias renais, porém, os mais importantes são o fator de crescimento do entotélio vascular (vegf) e o fator de crescimento fibroblástico básico (bfgf). O objetivo deste estudo foi o de investigar a expressão do b-fgf e a densidade microvascular (dmv) nos oncocitomas e nos carcinomas de células renais (ccrs) e correlacionar estes parâmetros da vascularização tumoral com outros ascpectos clínico-patológicos. Material e métodos. O estudo imunohidtoquímico para o b-fgf e o cd31 (densidade microvascular) foi realizado em material fixado em formalina e incluído em parafina de 36 casos de ccrs (10 convencionais, 10 papilíferos, 8 sarcomatóides e 8 cromófobos) e 5 oncocitomas, oriundos de exames anátomo-patológicos por dois observadpres independentes. Resultados. Nota de Resumo Foi encontrada positividade para o b-fgf em todos os 5 casos de oncocitomas e em 7 dos 36 casos de ccrs: 5 do tipo convencional, um papilífero, e um cromófobo. Todos os carcinomas sarcomatóides mostraram-se negativos. A expressão tumoral do b-fgf não apresentou correlação com tamanho tumora, grau histológico, estadio patológico, ou sobrevida a curto prazo em nenhum dos grupos. O valor médio da dvm foi de 124,16 +/- 50,1 nos oncocitomas e de 91,54 +/- 52,4 nos ccrs. O padrão de vascularização observado nos oncocitomas era caracterizado por um delicado leito vascular envolvendo grupos de celulas tumorais, enquanto que nos ccrs a microvascularização se apresentou de forma mais organizada. Entre os carcinomas, os tumores que se mostraram letais nos 12 primeiros meses após o diagnóstico, apresentaram um ídice angiogênico significativamente maior (124,12 +/- 75,2) em relação aos pacientes que ainda permaneciam vivos um ano após o diagnóstico (80,34 +/- 37,8). Conclusão. Demostramos que o b-fgf está expresso mais freqüentemente nos oncocitomas do que nos ccrs. Nota de Resumo Apesar de as dmv ser semelhante em ambos os grupos tumorais, observou-se um padrão de vascularização característico nos oncocitomas. Uma dvm mais elevada nos ccrs, rapidamente letais é indicativo de que a angiogenese possa estar correlacionada com grau de malignidade destes tumores.