Made available in DSpace on 2015-04-22T22:17:33Z (GMT). No. of bitstreams: 1 Nina.pdf: 824521 bytes, checksum: 14507b5c2edaefea645d63b84c66d030 (MD5) Previous issue date: 2008-07-14 / Coordenação de Aperfeiçoamento de Pessoal de Nível Superior / Several studies have shown a close relationship between genetic predisposition, environmental factors, lifestyle and carcinogenesis. It is known that 80% to 90% of cancers are linked to environmental factors. Among the environmental factors to diet stands out as a predominant factor in the emergence of stomach cancer. In this context, the objective of this study was to evaluate the food consumption and possible factors related to cancer of stomach, holders of adults with primary gastric cancer, attended the Foundation Centre for Control of Amazons Oncology - FCECON. To obtain data profile of food and socio-economic population of 25 patients were used: Survey of Consumer Food Frequency-QFCA, Social Survey - Economic-demographic - ISED and for the classification of nutritional status was used Body Mass Index - BMI current and preceding the diagnosis of the disease as well as weight, height and age. We used the program EPI INFO - version 3.4.3 where they calculated the absolute frequencies for simple and qualitative data on the average, median and standard deviation (SD), for the quantitative data. When to the average weight difference between the current and previous disease, was used t-Student test in significance level of 5%. In this study, the gender with greater predominance was the male with 80% of cases. It was observed low consumption of foods considered to be at risk as canned, sausage, smoked, barbecue and no artificial sweetener. High tendency to daily consumption of chips (40%), manioc flour (84%), beef (44%), coffee (96%), fresh vegetables - smell of pepper (48%) and fruits - bananas (56% ), And low consumption of protectors foods like yogurt (8%), oil (0%), whole foods (0%).With regard to harmful vices (72%) patients reported that smoke or have smoked and 88% reported consumption of alcoholic drink, preferably beer and rum. Among the professions found, the majority (52%) was of farmers and workers of the construction that could be in environments that exposed to toxicity and radioactivity. The results suggest that the traditional dish of the Amazon, consisting of fried beef, white rice, manioc flour, beans, vegetables and fruits, moderate amounts of coffee and milk habits are identified, also as the standard diet Brazilian, with specific regional and the wasteful consumption of manioc flour with a large intake of glycosides. From a nutritional concluded that the diet is inadequate and unprotected for cancer, because despite not contain smoked foods, canned, salted and embedded, is rich in fats, red meat, low in fiber and monounsaturated fats. / Diversos estudos têm evidenciado uma estreita relação entre a predisposição genética, os fatores ambientais de estilo de vida e a carcinogênese. Sabe-se que 80% a 90% dos cânceres estão associados a fatores ambientais. Dentre os fatores ambientais a dieta destaca-se como um fator preponderante no aparecimento do câncer de estômago. Nesse contexto, o objetivo do presente estudo foi avaliar o consumo alimentar e possíveis fatores relacionados ao câncer de estômago, de portadores adultos com a neoplasia gástrica primária, atendidos na Fundação Centro de Controle Oncológico do Amazonas - FCECON. Para a obtenção dos dados do perfil alimentar e sócio econômico-demográfico de 25 pacientes foram utilizados: Questionário de Freqüência de Consumo Alimentar-QFCA, Inquérito Sócio Econômico Demográfico - ISED e para a classificação do estado nutricional foi utilizado o Índice de Massa Corporal - IMC atual e anterior ao diagnóstico da doença, assim como peso, altura e idade. Foi utilizado o programa EPI INFO versão 3.4.3 onde se calculou as freqüências absolutas simples e relativas para os dados quantitativos e a média, mediana e desvio padrão (DP) para os dados quantitativos. Na análise da média da diferença entre peso atual e anterior à doença utilizou-se o teste t-Student no nível de significância de 5 %.Neste estudo, o gênero com maior predominância foi o masculino com 80% dos casos. Foi observado baixo consumo de alimentos considerados de risco como enlatados, embutidos, defumados, churrasco e nenhum adoçante artificial. Alta tendência a consumo diário de frituras (40%), farinha de mandioca (84%), carne bovina (44%), café (96%), vegetais frescos - pimenta de cheiro (48%) e frutas banana (56%), e baixo consumo de alimentos protetores como iogurtes (8%), azeite (0%), alimentos integrais (0%). Com relação aos vícios nocivos (72%) dos pacientes relataram que fumam ou já fumaram e 88% indicaram consumo de bebida alcoólica, preferencialmente cerveja e cachaça. As profissões de agricultores e trabalhadores da construção civil foram as mais encontradas (52%) por estarem em ambientes propícios, expostos a toxidade e radioatividades. Os resultados sugerem que o prato tradicional do amazonense, composto de carne frita arroz branco, farinha de mandioca, feijão, vegetal e frutas, quantidades moderadas de café e leite são hábitos identificados também como padrão da dieta alimentar brasileira, com particularidades regionais como o consumo exagerado da farinha de mandioca conferindo uma importante ingestão de glicídios. Do ponto de vista nutricional conclui-se que a dieta está inadequada e desprotegida para o câncer, pois apesar de não conter alimentos defumados, enlatados, embutidos e salgados, é rica em gorduras, carne vermelha, pobre em fibras e gorduras monoinsaturadas.

Binder-based assays are employed throughout the life sciences. Powerful signal amplification techniques have enabled detection of very rare molecule species diluted in simple buffers. Unspecific binding of primary binders leads to increased background in more complex samples. By requiring two recognition events, ligation-based molecular analyses provide highly specific detection of biomolecules in complex samples. We developed a highly multiplexed padlock-ligation assay targeting signature sequences in the hemagglutinin and neuraminidase genes. From a panel of 77 avian influenza isolates of all major serotypes, 97% were genotyped correctly in accordance with previous classifications by classical diagnostic methods (Paper I). Alternative splicing is an important mechanism expanding the proteome. Current analysis techniques fail to provide sequences of complete transcripts beyond the read length of sequencing instruments. We devised and implemented a strategy to compress the sequence information contained in the splicing pattern of a transcript into the presence or absence of sequence-blocks. We demonstrate that this assay yields information about the splicing patterns in thousands of transcripts from cellular cDNA (Paper II). Expression changes of mucin proteins and glycosylation structures are frequently observed from the early stages of cancer development. Expression of mucin 2 and sialyl-Tn are common features of intestinal metaplasia and gastric cancer, and are known to co-locate. Here we have developed an in situ proximity ligation assay (PLA) directed against mucin 2 and sialyl-Tn. Our study on intestinal metaplasia and gastric cancer tissue sections identified mucin 2 as a major carrier of sialyl-Tn in these conditions, and demonstrated how conveniently glycosylation of proteins can be studied by in situ PLA (Paper III). This thesis shows how the dual recognition requirement of ligation-based assays can be employed to detect target molecules with high specificity, to analyze several sequence features of nucleic acids or to study the proximity of two antigens in situ.

Introdução: O Fator de Crescimento Endotelial Vascular - A (VEGF) é um dos principais promotores da angiogênese e demonstra relação com prognóstico no câncer gástrico (CG). Objetivos: Correlacionar a expressão imunoistoquímica do VEGF com o estadiamento e sobrevida no câncer gástrico. Métodos: 45 espécimes de adenocarcinomas foram avaliados para expressão imunoistoquímica do VEGF. O estadiamento patológico (pTNM), características histológicas e sobrevida foram avaliados empregando os testes ANOVA, análise multivariada e curva de Kaplan-Meier. Resultados: Foi observada maior expressão do VEGF na comparação entre os estadiamentos IA e IB vs II,III e IV (p<0,001). O VEGF menos expresso estava relacionado com maior penetração do tumor na parede gástrica (p<0,003) e presença de comprometimento linfonodal (p<0,001). Pacientes apresentando tumores com maior expressão de VEGF tiveram maior sobrevida (HR 0,37; IC 95%: 0,17-0,79). Conclusão: Houve associação inversa na expressão do VEGF com o estadiamento dos tumores gástricos. A análise multivariada demonstra a expressão do VEGF como fator prognóstico independente na sobrevida dos pacientes com câncer gástrico. / Background: Vascular endothelial growth factor A (VEGF) is one of the main promoters of angiogenesis and correlates with gastric cancer (GC) prognosis. Aims: To evaluate the correlation between immunohistochemical VEGF expression and the gastric cancer stage and survival rate. Methods: VEGF expression was evaluated by immunohistochemistry in 45 adenocarcinoma specimens. Pathologic staging (pTNM), histological characteristics and survival were assessed using an ANOVA test, a multivariate analysis and the Kaplan-Meier method. Results: A higher VEGF expression level was observed in stages IA and IB compared with II, III and IV (p<0.001). A lower VEGF expression level correlated with a greater tumor penetration level in the gastric wall (p<0.003) and the extent of tumor spread to the lymph nodes (p<0.001). Higher VEGF scores correlated with a longer survival time (HR 0.37; 95% CI: 0.17 - 0.79). Conclusion: An inverse correlation was observed between VEGF expression and gastric tumor stage. A multivariate analysis demonstrates that VEGF expression is an independent prognostic factor for survival in gastric cancer.

Les cancers gastro-intestinaux, en particulier les cancers colorectaux (CCR) et les cancers gastriques (CG), sont des pathologies agressives avec des taux de mortalité élevés dans le monde. Ces cancers sont caractérisés par la dérégulation de voies de signalisation cellulaire telles que les voies Wnt, Notch et Hippo qui jouent un rôle très important dans la tumorigenèse gastro-intestinale. L’activité des différents facteurs de transcription impliqués dans ces voies de signalisation nucléaire est contrôlée par de nombreux corégulateurs transcriptionnels. Ces travaux de thèse ont porté sur deux corégulateurs transcriptionnels initialement identifiés comme des partenaires des récepteurs nucléaires, à savoir RIP140 et LCoR. L’objectif a été d’explorer l’expression de ces deux facteurs de transcription dans les cancers gastro-intestinaux ainsi que leur rôle dans les cancers gastriques principalement au travers du dialogue avec la voie de signalisation Hippo. L’analyse par immunohistochimie de l'expression de RIP140 et LCoR dans les cancers colorectaux et gastriques a montré que les niveaux d’expression de ces deux corégulateurs transcriptionnels sont fortement corrélés. Dans les CCRs, leur expression tend à diminuer dans le tissu tumoral par rapport au tissu normal adjacent, alors que dans les CGs, les niveaux d’expression de RIP140 et LCoR sont significativement plus élevés dans la tumeur que dans l’épithélium sain. Des corrélations significatives ont été observées avec les paramètres clinicopathologiques des patients (stade TNM et différenciation tumorale) ainsi qu’avec d’autres protéines clés impliquées dans la progression et l'invasion tumorale (incluant E-cadhérine et Cox-2). L'analyse de la survie a montré que les patients atteints de CCR avec des tumeurs LCoRlow/RIP140high ont une durée de survie plus longue. Dans le CG, l'expression élevée de RIP140 ou de LCoR a été identifiée comme un marqueur de mauvais pronostic suggérant un rôle clé de ces deux gènes dans cette malignité.Pour mieux cerner le rôle de RIP140 dans le CG, nous avons utilisé les lignées cellulaires MKN45 et MKN74 de cancer de l’estomac humain avec une surexpression ectopique du gène RIP140 ou au contraire avec une diminution de son expression. Nos résultats ont montré que l'expression de RIP140 est associée à un effet anti-prolifératif à travers une régulation positive de l'expression du gène p21WAF1/CIP1. Nous avons également démontré que RIP140 réduit la migration des cellules MKN45 et MKN74 et augmente l'expression du gène E-cadhérine au niveau transcriptionnel. D’une manière intéressante, nos résultats suggèrent aussi que RIP140 régule la voie de signalisation Hippo à travers l’activation de TEAD.Dans l'ensemble, ces résultats suggèrent que les gènes RIP140 et LCoR participent à la régulation de la tumorigenèse gastro-intestinale et que leurs niveaux d'expression ont une valeur pronostique dans ces cancers et pourraient servir de nouveaux biomarqueurs dans la caractérisation moléculaire de ces tumeurs. / Gastrointestinal cancers, particularly colorectal cancer (CRC) and gastric cancer (GC), are aggressive pathologies with a high mortality rate worldwide. These cancers are characterized by the deregulation of cellular signaling pathways such as the Wnt, Notch and Hippo pathways which play a very important role in gastrointestinal tumorigenesis. Moreover, it’s well established that the activity of the transcriptionnel factors involved in these nuclear signaling pathways is controlled by many transcriptionnel coregulators. This work focused on two transcriptional coregulators initially identified as partners of nuclear receptors, namely RIP140 and LCoR. The objective was to explore the expression of these two transcription factors in gastrointestinal cancers and their role in gastric cancers mainly through the dialogue with the Hippo signaling pathway.Immunohistochemical analysis of RIP140 and LCoR expression in colorectal and gastric cancers showed that the expression levels of these two transcriptional regulators are strongly correlated. In CRCs, their expression tends to decrease in tumor tissue compared to adjacent normal tissue, whereas in GCs, RIP140 and LCoR expression levels are significantly higher in the tumor as compared to normal stomach. Significant correlations were observed with clinicopathological parameters (TNM stage and tumor differentiation) as well as the expression levels of key proteins involved in tumor progression and invasion (E-cadherin and Cox-2). Survival analysis showed that CRC patients with LCoRlow/RIP140high tumors have a significant prolonged OS and DFS. In GC, high RIP140 or LCoR expression was identified as an independent marker of poor prognosis suggesting a key role in this malignancy.Further, we investigated the role of RIP140 in gastric cancer cell lines using human epithelial GC cell lines overexpressing or not RIP140. In both MKN45 and MKN74 cells we showed that RIP140 exerted an anti-proliferative effect through the induction of p21WAF1/CIP1 gene expression. We also demonstrated that RIP140 reduced GC cell migration and increased E-cadherin expression at the transcriptional level. Interestingly, our results also suggest that RIP140 regulates the Hippo signaling pathway through TEAD activation.In conclusion, our findings suggest that RIP140 and LCoR genes contribute to the regulation of gastrointestinal cancers and that their expression levels have a prognostic value in these pathologies. Moreover, both RIP140 and LCoR transcriptional coregulaters could serve as novel biomarkers in the molecular characterization of colorectal and gastric cancers.

Made available in DSpace on 2015-04-01T14:16:01Z (GMT). No. of bitstreams: 1 ArquivoTotal.pdf: 1987821 bytes, checksum: 0557f7c6083cf4200e6fc6542c383ea7 (MD5) Previous issue date: 2013-05-16 / Coordenação de Aperfeiçoamento de Pessoal de Nível Superior - CAPES / Cancer is a disease with a high mortality rate in Brazil, including, stomach cancer is currently the fourth most common type of cancer worldwide, responsible for countless deaths. Its etiology is multifactorial, because studies suggest associations to various factors such as dietary habits, environmental factors, genetic and epigenetic factors and gastric infection by Helicobacter pylori. Epigenetic changes such as methylation of the promoter regions of genes involved in cellular homeostasis may contribute to gastric carcinogenesis. To verify the methylation status of THBS1, GPX3 and COX2 genes and to evaluate their association with H. pylori in gastric adenocarcinomas, Methylation-Sensitive Restriction Enzyme PCR (MSRE-PCR) assay was performed in 39 gastric carcinomas (intestinal and diffuse types) and 15 normal stomach tissue samples. The presence of H. pylori was performed by amplification of the fragment of the 16S rRNA. Statistical analysies were performed using Fisher s exact test. The hypermethylation of GPX3, THBS1 and COX2 occurred in 18% (n = 7), 5% (n = 2) 36% (n = 14) of gastric cancer samples, respectively, whereas in normal samples was found in 13%, 7% and 67%. The presence of H. pylori was detected in 67% of gastric cancer samples and 67% in normal gastric samples. No correlation was found between the methylation profile of the studied samples and clinicopathological variables and the presence of H. pylori (P ≥ 0,05). The presence of H. pylori in gastric cancer samples and normal was not associated with clinicopathologic variables analyzed (P> 0.05). / O câncer é uma doença com alta taxa de mortalidade no Brasil, dentre eles, o câncer de estômago constitui atualmente, o quarto tipo de câncer mais comum a nível mundial. No ano de 2012, estimam-se, para o Brasil, 12.670 casos novos de câncer do estômago em homens e 7.420 em mulheres. A sua etiologia é multifatorial, pois estudos sugerem associações a diversos fatores como: hábitos alimentares, fatores ambientais, fatores genéticos e epigenéticos e a infecção gástrica por Helicobacter pylori. Alterações epigenéticas tais como a metilação das regiões promotoras de genes envolvidos na homeostase celular podem contribuir para carcinogênese gástrica. Para verificar o estado de metilação de genes THBS1, GPX3 e COX2 e avaliar a sua associação com a Helicobacter pylori (H. pylori) em adenocarcinomas gástricos, Methylation-Sensitive Restriction Enzyme PCR (MSRE-PCR) foi realizada em 39 carcinomas gástricos (intestinal e tipo difusa) e 15 amostras de tecido normal do estômago. A presença de H. pylori foi realizada por amplificação de um fragmento de rRNA 16S. Analysies estatísticas foram realizadas utilizando o teste exato de Fisher. A hipermetilação de GPX3, THBS1 e COX2 ocorreu em 18% (n = 7), 5% (n = 2) 36% (n = 14) das amostras de câncer gástrico, respectivamente, ao passo que em amostras normais foi encontrada em 13%, 7 % e 67%. A presença de H. pylorifoi detectada em 67% das amostras de câncer gástrico e 67% em amostras gástricas normais. Não foi encontrada correlação entre o perfil de metilação das amostras estudadas com variáveis clínico-patológicas e com presença de H. pylori (P > 0,05). A presença de H. pylori nas amostras de câncer gástrico e normais não foi associada com as variáveis clínico-patológicas analisadas (P > 0.05).

Introdução: O Fator de Crescimento Endotelial Vascular - A (VEGF) é um dos principais promotores da angiogênese e demonstra relação com prognóstico no câncer gástrico (CG). Objetivos: Correlacionar a expressão imunoistoquímica do VEGF com o estadiamento e sobrevida no câncer gástrico. Métodos: 45 espécimes de adenocarcinomas foram avaliados para expressão imunoistoquímica do VEGF. O estadiamento patológico (pTNM), características histológicas e sobrevida foram avaliados empregando os testes ANOVA, análise multivariada e curva de Kaplan-Meier. Resultados: Foi observada maior expressão do VEGF na comparação entre os estadiamentos IA e IB vs II,III e IV (p<0,001). O VEGF menos expresso estava relacionado com maior penetração do tumor na parede gástrica (p<0,003) e presença de comprometimento linfonodal (p<0,001). Pacientes apresentando tumores com maior expressão de VEGF tiveram maior sobrevida (HR 0,37; IC 95%: 0,17-0,79). Conclusão: Houve associação inversa na expressão do VEGF com o estadiamento dos tumores gástricos. A análise multivariada demonstra a expressão do VEGF como fator prognóstico independente na sobrevida dos pacientes com câncer gástrico. / Background: Vascular endothelial growth factor A (VEGF) is one of the main promoters of angiogenesis and correlates with gastric cancer (GC) prognosis. Aims: To evaluate the correlation between immunohistochemical VEGF expression and the gastric cancer stage and survival rate. Methods: VEGF expression was evaluated by immunohistochemistry in 45 adenocarcinoma specimens. Pathologic staging (pTNM), histological characteristics and survival were assessed using an ANOVA test, a multivariate analysis and the Kaplan-Meier method. Results: A higher VEGF expression level was observed in stages IA and IB compared with II, III and IV (p<0.001). A lower VEGF expression level correlated with a greater tumor penetration level in the gastric wall (p<0.003) and the extent of tumor spread to the lymph nodes (p<0.001). Higher VEGF scores correlated with a longer survival time (HR 0.37; 95% CI: 0.17 - 0.79). Conclusion: An inverse correlation was observed between VEGF expression and gastric tumor stage. A multivariate analysis demonstrates that VEGF expression is an independent prognostic factor for survival in gastric cancer.

Introdução: O Fator de Crescimento Endotelial Vascular - A (VEGF) é um dos principais promotores da angiogênese e demonstra relação com prognóstico no câncer gástrico (CG). Objetivos: Correlacionar a expressão imunoistoquímica do VEGF com o estadiamento e sobrevida no câncer gástrico. Métodos: 45 espécimes de adenocarcinomas foram avaliados para expressão imunoistoquímica do VEGF. O estadiamento patológico (pTNM), características histológicas e sobrevida foram avaliados empregando os testes ANOVA, análise multivariada e curva de Kaplan-Meier. Resultados: Foi observada maior expressão do VEGF na comparação entre os estadiamentos IA e IB vs II,III e IV (p<0,001). O VEGF menos expresso estava relacionado com maior penetração do tumor na parede gástrica (p<0,003) e presença de comprometimento linfonodal (p<0,001). Pacientes apresentando tumores com maior expressão de VEGF tiveram maior sobrevida (HR 0,37; IC 95%: 0,17-0,79). Conclusão: Houve associação inversa na expressão do VEGF com o estadiamento dos tumores gástricos. A análise multivariada demonstra a expressão do VEGF como fator prognóstico independente na sobrevida dos pacientes com câncer gástrico. / Background: Vascular endothelial growth factor A (VEGF) is one of the main promoters of angiogenesis and correlates with gastric cancer (GC) prognosis. Aims: To evaluate the correlation between immunohistochemical VEGF expression and the gastric cancer stage and survival rate. Methods: VEGF expression was evaluated by immunohistochemistry in 45 adenocarcinoma specimens. Pathologic staging (pTNM), histological characteristics and survival were assessed using an ANOVA test, a multivariate analysis and the Kaplan-Meier method. Results: A higher VEGF expression level was observed in stages IA and IB compared with II, III and IV (p<0.001). A lower VEGF expression level correlated with a greater tumor penetration level in the gastric wall (p<0.003) and the extent of tumor spread to the lymph nodes (p<0.001). Higher VEGF scores correlated with a longer survival time (HR 0.37; 95% CI: 0.17 - 0.79). Conclusion: An inverse correlation was observed between VEGF expression and gastric tumor stage. A multivariate analysis demonstrates that VEGF expression is an independent prognostic factor for survival in gastric cancer.

Introdução: Além do catabolismo protéico acentuado, o paciente com câncer apresenta alterações no metabolismo lipídico. Objetivo: o objetivo do estudo foi avaliar as concentrações séricas de ácidos graxos (AG) antes, durante e após o tratamento oncológico de pacientes com neoplasia de estômago ou de esôfago. Casuística: O estudo prospectivo longitudinal foi conduzido com 14 pacientes com neoplasia de estômago ou de esôfago [62,1 anos (IC95% 55,6-68,6)], sob tratamento oncológico em unidade especializada. O estudo incluiu também 15 voluntários saudáveis [61,0 anos (IC95% 57,1-65,0)]. Métodos: Foram aplicados os questionários de ingestão alimentar (Recordatórios de 24h) e inquéritos relacionados com efeitos adversos e de toxicidade (CTCAE) que potencialmente interferem na ingestão alimentar e no estado nutricional. Foram feitas as medidas antropométricas, a impedância bioelétrica e coleta de sangue para os exames laboratoriais. Os AG foram determinados por cromatografia gasosa e expressos como porcentagem da área total. No Grupo Câncer, os procedimentos foram feitos antes do início, na metade e ao término do tratamento oncológico; o Grupo Controle foi submetido às mesmas avaliações em apenas uma ocasião. A análise estatística foi feita por meio do software Statistica 8.0, usando testes estatísticos não paramétricos. Resultados: As reações adversas relacionadas ao tratamento oncológico foram redução da ingestão de alimentos, saliva espessa com alteração no paladar e náuseas. Antes do início do tratamento, os pacientes com câncer já haviam perdido 17% do peso em relação ao usual; o peso corporal e o IMC reduziram entre a primeira e a terceira avaliação, mas não houve alteração na composição de massa corporal magra e gorda, na ingestão energética e da maioria dos macronutrientes no decorrer do estudo. Em relação ao Grupo Controle, o ácido nervônico foi maior enquanto que os ácidos gama-linolênico e alfalinolênico foram menores no Grupo Câncer. Na avaliação longitudinal, o ácido lignocérico reduziu durante o tratamento oncológico. Conclusão: os pacientes com câncer de esôfago e de estômago apresentam alteração discreta na concentração dos AG séricos em relação aos controles e o tratamento oncológico teve pouco impacto no perfil de AG circulantes / Introduction: In addition to enhanced protein catabolism, the cancer patient has alterations in lipid metabolism. Objective: The objective of the study was to evaluate serum concentrations of fatty acids (FA) before, during and after cancer treatment of patients with gastric or esophageal cancer. Subjects: The prospective longitudinal study was conducted with 14 patients with gastric or esophageal cancer [62.1 years (95% CI 55.6 to 68.6)], under cancer treatment in a specialized unit. The study also included 15 healthy volunteers [61.0 years (95% CI 57.1 to 65.0)]. Methods: The food intake questionnaires were applied (24-hour Dietary Recall) and inquiries related adverse effects and toxicity (CTCAE) that potentially interfere with food intake and nutritional status. Anthropometric measurements were made, the bioelectrical impedance and blood collection for laboratory tests. Gas chromatography determined the FA that was expressed as a percentage of the total area. In Cancer Group, the procedures were done before the start, the middle and at the end of cancer treatment; the control group underwent the same evaluations on only one occasion. Statistical analysis was performed using Statistica 8.0 software, using non-parametric statistical tests. Results: Adverse reactions related to cancer treatment have been reduced food intake, thick saliva with altered taste and nausea. Before the treatment, the patients with cancer had already lost 17% of weight with respect to the usual. Body weight and BMI reduced between the first and the third evaluation, but there was no change in the composition of lean and fat mass, energy intake and macronutrient most during the study. Compared to the control group, the nervonic acid was higher while the gamma-linolenic and alpha-linolenic acids were lower in the cancer group. In the longitudinal evaluation, the lignoceric acid reduced during cancer treatment. Conclusion: Patients with esophageal and stomach cancer have a mild change in the concentration of serum FA compared to controls and cancer treatment had little impact on the current FA profile

Introdução: Agregação familial é observada em cerca de 10% dos casos de câncer e 1 a 3% é hereditário. O tipo difuso pode estar relacionado à agregação familial e a alterações genéticas no gene CDH1, que codifica a proteína E-caderina. Alterações na imunoexpressão de Beta-catenina e p53 também são observadas. Objetivos: Analisar a imunoexpressão da E-caderina, Beta-catenina e TP53 em adenocarcinomas gástricos de pacientes com câncer gástrico familial e comparar com os dados clinicopatológicos, além dos achados das alterações genéticas destes pacientes, estudadas previamente nesta Instituição. Casuística e Métodos: Vinte e seis casos de adenocarcinoma gástrico em blocos de parafina de pacientes do HC-FMUSP foram submetidos ao estudo imunoistoquímico para detecção e análise do padrão de imunoexpressão da E-caderina, Beta-catenina e TP53 através do método da streptavidina-biotina-peroxidase. A análise da imunoexpressão dos marcadores foi classificada segundo escala de intensidade e distribuição e os testes estatísticos utilizados foram o Teste t de Student e Exato de Fisher. Resultados: A localização predominante do tumor foi no antro (61,5%). 11 (42,3%) casos alterados para a imunoexpressão da E-caderina, sendo todos do tipo difuso; 15 (57,7%) casos normais, sendo 9 do tipo difuso e 6 do tipo intestinal (p=0,02). Em estudo prévio realizado nesta instituição, uma mutação missense no exon 12 do gene CDH1, códon 617, nucleotídeo 1849 G>A foi encontrada no mesmo caso em que foi observada ausência de imunorreatividade da E-caderina. 11 (42,3%) casos alterados para a imunoexpressão de Beta-catenina e 46,2% de imunorreatividade nuclear positiva para TP53. Conclusões: 1) O tipo difuso de Laurén está associado à alteração da imunoexpressão da E-caderina no Câncer Gástrico Familial; 2) Não houve associação entre a imunoexpressão da E-caderina, idade, gênero e localização do tumor; tampouco houve associação entre a imunoexpressão da Beta-catenina e os dados clínico-patológicos; houve associação inversa entre a imunoexpressão da E-caderina e TP53; 3) Nos casos em que foram detectadas alterações na imunoexpressão, parece haver duas rotas distintas de carcinogênese envolvidas no CGF. / Introduction: Familial clustering is observed in about 10% of the gastric cancer cases and 1-3% is hereditary. Diffuse type gastric cancer is related to genetic alterations in CDH1 gene, which translates the E-cadherin protein. The abnormal expression of E-cadherin is characterized by low expression of cytoplasmatic staining, or loss of membranous immunoreactivity. Aim: to analyze the immunoexpression of E-cadherin, Beta-catenin and TP53 in gastric adenocarcinomas in patients with Familial Gastric Cancer and compare with clinical-pathologic data, including the genetic alterations of these patients, found previously on this institution. Methods: 26 cases of paraffin-embedded gastric adenocarcinoma tissue of patients of Hospital das Clinicas - School of Medicine of University of Sao Paulo underwent immunostaining to detect the presence and to analyze the pattern of immunoexpression of E-cadherin, Beta-catenin and TP53 using Streptavidine-Biotine-Peroxidade technique. The immunoexpression evaluation was performed utilizing a semiquantitative scale for intensity and distribution. The statistical analysis was done through Students t test and Fishers Exact test. Results: E-cadherin immunoexpression was negative in 11 cases (42.3%), and all of them were diffuse type of Laurén. 15 cases (57.7%) were positive for E-cadherin, from which 9 were of the diffuse type and 6 of intestinal type (p=0.02). In previous study performed on this institution, one missense mutation in exon 12 of CDH1 gene, codon 617, nucleotide 1849 G>A was found on the same case that absence of E-cadherin immunostaining was observed. 61.5% of the tumors were located in the antrum. Beta-catenin immunoexpression was altered in 43.2% and TP53 nuclear immunoreactivity was positive in 46.2% of the tumors. TP53 was solely detected in 12 (46.2%) of the tumors, while E-cadherin was altered in 10/26 (38.5%) negative TP53 tumors, p=0.01. Conclusions: 1) Diffuse type of Laurén is associated to E-cadherin immunoexpression alteration in Familial Gastric Cancer; 2) There was no association between E-cadherin immunoexpression and age, gender or tumor location, as well as there was no association between Beta-catenin and the clinical-pathologic data; there was an inverse association between immunoexpression of TP53 and E-cadherin; 3) There may be two distinct carcinogenesis pathways on familial gastric cancer cases that imunoexpression alterations were detected.

Os objetivos deste trabalho foram, em indivíduos com câncer de coto gástrico: identificar o padrão de disseminação de linfonodos acometidos, quantificar a invasão tumoral da linha de anastomose, correlacionar a invasão da linha de anastomose com o comprometimento linfonodal e mesenterial, correlacionar o acometimento linfonodal com sobrevivência e correlacionar o acometimento da linha de anastomose com sobrevivência. Foi realizado estudo retrospectivo com revisão de prontuários, peças cirúrgicas e exames anátomo-patológicos de 113 pacientes. O câncer de coto gástrico não tem um padrão de disseminação linfonodal específico; 75% dos pacientes apresentaram invasão tumoral da linha de anastomose; em 66,7% dos casos ocorreu invasão da linha anastomótica e linfonodal concomitantes; menos de 10% dos casos exibiam invasão mesenterial; houve óbito em 86,5% dos casos com invasão linfonodal e 64,7% com invasão da linha de anastomose e em 100% com invasão mesenterial. / The objectives of this study are to identify the metastatic pattern of lymph node for gastric stump cancer; to quantify the invasion of anastomotic site by tumor; to relate the invasion of anastomotic site with metastasis lymph node or mesenterial lymph node and these parameters with the survival of patients with gastric stump cancer. One hundred and thirteen patients with gastric stump cancer were retrospectively analyzed along with their medical records, surgical pieces and histopathologic exam. The metastatic pattern of lymph node isnt specific to gastric stump cancer. 75% of patients had tumoral invasion in the anastomotic site. In 66.7% of the cases there was an invasion of the anastomotic site with metastatic lymph nodes. 9% of patients had mesenterial lymph node invasion by tumor. Fatal cases occurred in 86,5% of the patients with metastatic lymph node, 64,7% with invasion of the anastomotic site and 100% with mesenterial lymph node invasion.