Made available in DSpace on 2014-12-17T15:32:33Z (GMT). No. of bitstreams: 1 AntonioLAP.pdf: 801979 bytes, checksum: bfcf5910a257b5978efceb008f0c1016 (MD5) Previous issue date: 2006-09-28 / Coordena??o de Aperfei?oamento de Pessoal de N?vel Superior / The unpredictable biologic behavior of the oral squamous cells carcinoma has determined extensive research on the evolution of such tumor. Due to the existing relation between the outer cell matrix and the tumor cells, the integrins have been used as markers in the predictive study of the cell behavior. This study aims to analyze immunohistochemically the expression of the integrin ?2?1, ?3?1, and ?5?1 connections for the collagen, the laminin and the fibronectin respectively in 15 cases of squamous cells carcinoma from the lower lip and 15 from the tongue, with different scores of malignance grading. A predominantly diffuse, cytoplasm and granular immunological marking was observed in the majority of the analyzed cases. According to the marking intensity, integrin ?2?1 appeared positive in 80% of the lip and in 93,3% of the tongue cases. The immunological reactivity of integrin ?3?1 was classified as positive in 60% of both the tongue and lip cases. For this integrin, 20% and 33.3% of the tongue and lip cases, respectively, were negative. In relation to integrin ?5?1 the intensity was classified as positive in 53,3% of the cases and strongly positive in 46,7% of those located in the lip. In the tongue carcinomas, the intensity was positive in 46,7% of the cases and strongly positive in 53,3%. The statistic analysis did not show any significant differences or correlation of expression between these integrins nor between the anatomical sites or between different scores of malignancy grading. The expressive immunological marking of the integrins, ?2?1, ?3?1, and ?5?1 in the studied cases of squamous cell carcinomas leads us to think of a great participation of these proteins in oral carcinogenesis; however, our results do not allow us to correlate its expression as an indicator of variations in the biological behavior of this neoplasia / A imprevisibilidade do comportamento biol?gico do carcinoma epiderm?ide oral vem justificando um grande n?mero de pesquisas utilizando biomarcadores que possam contribuir para um melhor entendimento do curso evolutivo dessa neoplasia. Por estarem envolvidas em rela??es entre as c?lulas tumorais e constituintes da matriz extracelular, as integrinas v?m sendo estudadas como poss?veis marcadores preditivos desse comportamento. Este estudo se prop?s a analisar, atrav?s do m?todo da imunohistoqu?mica, a express?o das integrinas ?2?1, ?3?1 e ?5?1, ligantes para o col?geno, laminina e fibronectina respectivamente, em 15 casos de carcinoma epiderm?ide de l?bio inferior e 15 de l?ngua, com diferentes escores de malignidade histol?gica. Observou-se uma imunomarca??o predominantemente difusa, citoplasm?tica e granular na maioria dos casos analisados. Quanto ? intensidade de marca??o, a integrina ?2?1 mostrou-se de forma positiva em 80% dos casos de l?bio e em 93,3% dos de l?ngua. A imunorreatividade da integrina ?3?1 foi classificada como positiva em 60% dos casos de l?bio e de l?ngua. Para esta integrina, 20% e 33,3% dos casos de l?bio e l?ngua, respectivamente, mostraram-se negativos. J? com rela??o ? integrina ?5?1a intensidade foi classificada como positiva em 53,3% dos casos e fortemente positiva em 46,7% daqueles localizados em l?bio. Nos carcinomas de l?ngua, a intensidade mostrou-se positiva em 46,7% dos casos e fortemente positiva em 53,3%. A an?lise estat?stica n?o demonstrou diferen?as nem correla??es significativas da express?o dessas integrinas nem entre os s?tios anat?micos, nem entre diferentes escores de grada??o histol?gica de malignidade. A expressiva imunomarca??o das integrinas ?2?1, ?3?1e ?5?1 nos casos de carcinomas epiderm?ides estudados nos leva a sugerir uma ampla participa??o dessas prote?nas na carcinog?nese oral; no entanto, nossos resultados n?o nos permitem correlacionar sua express?o como indicador de varia??es no comportamento biol?gico desta neoplasia

Made available in DSpace on 2014-12-17T15:32:18Z (GMT). No. of bitstreams: 1 CyntiaCPC.pdf: 2470782 bytes, checksum: 4619c7ffcab85bffa54a732d30786d99 (MD5) Previous issue date: 2010-02-24 / Conselho Nacional de Desenvolvimento Cient?fico e Tecnol?gico / Currently, bone morphogenetic proteins (BMPs) have effective participation in the growth of malignancies. Knowing that there are few studies involving BMPs and oral squamous cell carcinoma, this work constitutes an immunohistochemical study of BMP-2, BMPR IA and BMPR II in squamous cell carcinomas (SCC) of the lower lip relating to the clinical and pathological aspects of this lesion. The sample consisted of 40 cases of SCC of the lower lip, being 20 cases of SCC of the lower lip with regional metastasis and 20 cases without metastasis. We evaluated the intensity of expression (score 1 to mark absent / weak, score 2 for high ) and was found the percentage of labeled cells, where the score was 1 cases with 0 to 50% of positive cells, score 2 with 51 to 75% of positive cells, and score 3 more than 75% of positive cells. The sample comprised 72.5% of men with a mean age of 65.8 years, there was a predominance of stage II and 52.5% of the carcinomas were classified as low grade, being carcinoma with metastasis presenting most cases (70%) as carcinomas of high malignancy grade (p = 0.004). The largest number of cases of SCC of the lower lip that were in stages I / II (61, 9%) were classified as carcinomas of low grade malignancy and carcinomas in stages III / IV were classified as high-grade tumors (p = 0, 024). The BMP-2 showed strong intensity of immunostaining in 82.5%, BMPR-IA showed 55% of cases with an intensity of immunostaining absent / weak and BMPR-II showed 85% of cases with an intensity of immunostaining absent / weak. Only the protein BMPR-IA were significantly associated with all clinic-pathological parameters studied, metastasis (p <0.001), TNM (p <0.001) and histological grade of malignancy with (p = 0.028). The percentage of positive cells, all markers showed the highest number of cases with more than 75% of positive cells (score 3) and only BMPR-II showed statistical difference when related to the presence and absence of metastasis (p = 0.049 ). We conclude that there is disturbance in the BMP signaling pathway in EC-mediated lower lip and that high expression of BMP-2 associated with the expression of BMPR-IA and BMPR-II are associated with metastasis in carcinoma / Atualmente as prote?nas morfogen?ticas do osso (BMPs) t?m efetiva participa??o no crescimento de neoplasias malignas. Sabendo que s?o escassos os trabalhos envolvendo BMPs e o carcinoma epiderm?ide oral, este trabalho realizou um estudo imunoistoqu?mico da BMP-2, BMPR IA e BMPR II em carcinomas epiderm?ides (CE) de l?bio inferior relacionando com os aspectos clinico-patol?gicos desta les?o. A amostra constou de 40 casos de CE de l?bio inferior, sendo 20 casos de CE de l?bio inferior com met?stase linfonodal regional e 20 casos sem met?stase. A grada??o histol?gica de malignidade foi realizada no front invasivo da les?o. Foi avaliada a intensidade de express?o (escore 1 para marca??o ausente/ fraca e escore 2 para marca??o forte), bem como foi verificado a porcentagem de c?lulas positivas, onde o escore 1 era os casos com 0 a 50% das c?lulas positivas; escore 2 com 51 a 75% das c?lulas positivas; e escore 3 com mais de 75% das c?lulas positivas. A amostra foi composta por 72,5% de homens com a m?dia de idade de 65,8 anos, houve um predom?nio do est?gio II e 52,5% dos carcinomas foram classificados como de baixo grau, sendo os carcinomas com met?stase regional apresentando a maioria dos casos (70%) como carcinomas de alto grau de malignidade (p =0,004). O maior n?mero de casos de CE de l?bio inferior que estavam nos est?gios I/ II (61, 9%) foi classificado em carcinomas de baixo grau de malignidade e os carcinomas nos est?gios III/ IV foram classificados em alto grau de malignidade (p =0, 024). A BMP-2 apresentou intensidade da imunomarca??o forte em 82,5%, BMPR-IA observou-se 55% dos casos com intensidade de imunomarca??o ausente/ fraca e a BMPR-II revelou 85% dos casos com intensidade de imunomarca??o ausente/ fraca. Apenas a prote?na BMPR-IA apresentou associa??o estatisticamente significante com todos os par?metros clinico-patol?gicos estudados, met?stase (p<0,001), TNM (p<0,001) e grada??o histol?gica de malignidade com ( p=0,028). Quanto ? porcentagem de c?lulas positivas, todos os marcadores apresentaram o maior n?mero de casos com mais de 75% das c?lulas positivas (escore 3) e apenas a BMPR-II apresentou diferen?a estat?stica quando relacionada com a presen?a e aus?ncia de met?stase (p=0,049). Conclui-se que existe dist?rbio na via de sinaliza??o BMP-mediada no CE de l?bio inferior e que a alta express?o da BMP-2 associada com a express?o da BMPR-IA e BMPR-II est?o relacionadas com a met?stase neste carcinoma

Made available in DSpace on 2014-12-17T15:32:22Z (GMT). No. of bitstreams: 1 KaruzaMAP.pdf: 544780 bytes, checksum: e0fadeed7d2d1ec7568970935306d05c (MD5) Previous issue date: 2006-02-22 / Coordena??o de Aperfei?oamento de Pessoal de N?vel Superior / The Human Papillomavirus (HPV) has been strongly implicated on development of some cases of oral squamous cell carcinoma (OSCC). However, the immunological system somehow reacts against the presence of this virus. Among the cells involved on such mechanism of defense detaches the Langerhans cells (LC), which are responsible for processing and presenting antigens. The purpose of this study was to evaluate the immunohistochemical reactivity for Langerhans cells between HPV positive and HPV negative OSCC, as well as, the relation of the immunoreactivity for this cells and the histological grading of malignancy proposed by Bryne (1998) and modified by Miranda (2002). Additionally, HPV infection was evaluated in relation to sex, age, lesion localization and histological grading of malignancy. In the total, 27 cases of OSSC were evaluated, 09 of them HPV positive and 18 HPV negative. Anti S-100 antibody was utilized for the immunohistochemical labelling, followed by the counting of LCs in 5 highpower fields (400x). No statistically significant difference was verified between the variables sex, age, lesion localization, histological grading of malignancy and HPV presence in OSSC. There was neither association between the immunohistochemical labeling for LCs (S-100+) and HPV infection nor correlation between the quantity of LCs labeled and the histological grading of malignancy of OSSC. The results suggest that despite the absence of statistically significant difference, the presence of HPV in such cases of OSCC can alter the immunological system, particularly the Langerhans cells / O Papilomav?rus Humano (HPV) tem sido implicado fortemente no desenvolvimento de alguns carcinomas epiderm?ides orais (CEOs). Contudo, o sistema imunol?gico reage de alguma forma ? presen?a desse v?rus. Dentre as c?lulas envolvidas nesse mecanismo de defesa, destaca-se a c?lula de Langerhans (CL), por serem c?lulas processadoras e apresentadoras de ant?genos. O objetivo desse estudo foi avaliar a marca??o imuno-histoqu?mica das c?lulas de Langerhans entre os casos de CEOs HPV positivos e negativos, bem como a rela??o da imunomarca??o dessas c?lulas e a grada??o histol?gica de malignidade proposta por Bryne (1998) e modificada por Miranda (2002). Adicionalmente, a infec??o pelo HPV foi estudada com rela??o ao sexo, idade, localiza??o da les?o e a grada??o histol?gica de malignidade. Foram analisados 27 casos de CEOs, sendo 09 destes HPV positivos e 18 casos negativos. Para a marca??o imuno-histoqu?mica utilizou-se o anticorpo anti S-100, sendo as CLs quantificadas em 5 campos de maior aumento (400x). A an?lise estat?stica revelou n?o existir rela??o das vari?veis, sexo, idade, localiza??o da les?o e grada??o histol?gica, com a presen?a do HPV nos CEOs estudados. N?o existiu associa??o entre a marca??o imuno-histoqu?mica das CLs(S-100+) e a infec??o pelo HPV, e tamb?m n?o houve correla??o entre as CLs imunomarcadas e a grada??o histol?gica nos casos de CEOs analisados. Diante desses resultados, pode-se sugerir que mesmo n?o havendo diferen?a significativa, a presen?a do HPV nos casos de carcinoma epiderm?ide oral pode alterar o sistema imune, particularmente as c?lulas de Langerhans

Made available in DSpace on 2014-12-17T15:32:24Z (GMT). No. of bitstreams: 1 JoaoAVGF.pdf: 1413564 bytes, checksum: f5d8ea2da8907cd551169a4091430007 (MD5) Previous issue date: 2006-02-17 / Coordena??o de Aperfei?oamento de Pessoal de N?vel Superior / Squamous cell carcinoma is the most common malignant neoplasm in the oral cavity, accounting for more than 90% of all malignancies in this location. Cyclooxygenases (COX s) are key enzymes on arachidonic acid metabolism and prostaglandin synthesis, being expressed basically in two forms: the constitutive (COX-1) and the inducible (COX-2). Increased levels on the expression of COX-2 have been implicated in the pathogenesis tumor progression of various forms of human cancer, including oral squamous cell carcinoma, some of what suggesting a possible interaction between COX-2 and the protein expressed by the tumor suppressor gene p53, mutated in more than 50% of all human cancers. The mean of the present research consisted in analyze the correlation between the expression of COX-2 and p53, at the protein level, as well as evaluate the difference on the expression of these two proteins with the histological grading of malignancy. 34 cases of oral squamous cell carcinoma were selected and graded according to the histological grading system proposed by Bryne (1998) and the labeling indexes (LI s) for COX-2 and p53 evaluated using immunohistochemistry method. The results revealed that COX-2 was expressed in increased levels in most of the specimens, although there was no statistic significant correlation between LI s from COX-2 and p53 (p>0.05), and there were no statistical differences on the expression of these proteins between tumors of high and low grade of malignancy (p>0.05). Interestingly, the expression of COX-2 and p53 was detected in fragments of dysplastic oral epithelium adjacent to tumor areas, on basal and suprabasal layers. The absence of statistical correlation between the expression of COX-2 and p53 proteins do not rule ot the existence of a relation between them, were it may reflect the diversity of regulatory pathways between both, different direct and indirect inhibitory effects of COX-2 over p53, as well as the wide range of activation macheenisms for COX-2 and mutational status of the p53 gene Another conclusion point that the increased expression of COX-2 observed in oral squamous cell carcinomas suggest a role for this protein in the processes of pathogenesis and tumoral evolution of this malignant neoplasm / O carcinoma epiderm?ide ? a neoplasia maligna mais comum na cavidade oral, representando mais de 90% das malignidades nesta localiza??o. As cicloxigenases (COX s) s?o enzimas chave no metabolismo do ?cido aracd?nico e s?ntese de prostaglandinas, sendo expressas basicamente sob duas formas: uma constitutiva (COX-1) e uma induzida (COX-2). N?veis elevados na express?o da COX-2 t?m sido implicados na patog?nese e progress?o tumoral em diversos tipos de c?ncer em humanos, incluindo o carcinoma epiderm?ide oral, alguns dos quais sugerindo uma poss?vel intera??o entre a COX-2 e a prote?na expressa pelo gene supressor tumoral p53, mutado em mais de 50% de todos c?nceres humanos. O prop?sito da presente pesquisa consistiu em analisar a correla??o entre a express?o de COX-2 e p53, em n?vel de prote?na, bem como avaliar a diferen?a na express?o destas duas prote?nas em rela??o ao grau histol?gico de malignidade. Para tal, foram selecionados 34 casos de carcinoma epiderm?ide oral, os quais foram classificados de acordo com o sistema de grada??o histol?gica de malignidade proposto por Bryne (1998) e cujos ?ndices de positividade para COX-2 e p53 foram avaliados atrav?s da t?cnica imuno-histoqu?mica. O resultados revelaram que a COX-2 esteve expressa em n?veis elevados na maior parte dos esp?cimes analisados, embora n?o se tenha verificado correla??o estatisticamente significativa entre os IP s da COX-2 e da p53 (p>0,05), tampouco diferen?a estatisticamente significativa entre a express?o destas prote?nas entre tumores de alto e baixo grau de malignidade (p>0,05). Interessantemente, foi detectada a express?o da COX-2 e da p53 em fragmentos de epit?lio oral displ?sico, nas camadas basal e parabasal, adjacentes ao tumor. A aus?ncia de correla??o estat?stica entre a express?o das prote?nas COX-2 e p53 n?o descarta a exist?ncia de uma rela??o entre as mesmas, podendo refletir a diversidade de vias regulat?rias entre ambas, os diferentes efeitos inibit?rios diretos e indiretos da COX-2 sobre a p53, bem como os in?meros mecanismos de ativa??o da COX-2 e o estado mutacional do gene p53. Conclui-se ainda que a elevada express?o da COX-2 observada em carcinomas epiderm?ides orais sugere um papel desta prote?na dentro dos processos de patog?nese e evolu??o tumoral desta neoplasia maligna

Made available in DSpace on 2014-12-17T15:32:28Z (GMT). No. of bitstreams: 1 MartaRP.pdf: 1904281 bytes, checksum: 2912c6b8ea9a773c553d0776245f93a5 (MD5) Previous issue date: 2009-02-27 / Conselho Nacional de Desenvolvimento Cient?fico e Tecnol?gico / The Oral Epithelial Dysplasia (OED) is the lesion that precedes or co-exists with the Oral Squamous Cell Carcinoma (OSCC), presenting molecular and/or histological similar alterations. The divergences about the malignization potential of OEDs and the role of inflammation in this process make hard the early diagnosis and evaluation of OSCCs aggressiveness. Thus, it became the goal of this study to evaluate the role of inflammation in oral carcinogenesis and tumoral aggressiveness. For this purpose a morphological study was performed in 20 OED cases and 40 OSCC cases to detect the malignization potential of OEDs and the histologic malignancy grading (HMG) of OSCCs, analyzing superficial masses for dismorphism evaluation and the invasive front for evaluation of tumoral growing; and immunohistochemical, using anti-CD8, anti-FOXP3, anti-TGF?, anti-TNF? and anti-NF-?B antibodies, comparing their with the types lesion, histological degree and intensity of the inflammatory infiltrate. The results were statistically significant for the parameters: cell maturity (p=0,0001), masses presence (p=0,038) and dismorphism (p=0,037), when associated to HMG. To compare the expression of the markers with the types lesion, a significantly higher expression of CD8 (p=0,001) and NF-?B (p=0,002) in the OED, and also a smaller expression of the epithelial TGF? in the severe OEDs (p=0,011), without significant expression between OSCC degrees. By relating the expression of the studied markers with the inflammatory infiltrate intensity, a positive relation was observed with: inflammatory TNF?(p=0,003), epithelial TNF? and NF-?B (p=0,051 and p=0,004), in OEDs; and with CD8 (p=0,021) and TNF? (p=0,015) in conjunctive OSCCs; and a negative relation with epithelial TNF? (p=0,034) in OSCCs. No significant relation was found between FOXP3 with any of the studied variables. These findings lead to the conclusion that, the study of the invasive front is as important as the study of superficial masses for the evaluation of tumoral aggressiveness; the intensity of the inflammatory infiltrate has no use as a parameter for prognostic evaluation of OSCC in routine exams, but, the molecular events detected in this study may be necessary to give basis for determining the malignant potential in OEDs and aggressiveness in OSCCs / A Displasia Epitelial Oral (DEO) ? a les?o que precede ou co-existe com o Carcinoma Epiderm?ide Oral (CEO), apresentando altera??es moleculares e/ou histol?gicas semelhantes. As diverg?ncias sobre o potencial de maligniza??o das DEO e o papel da inflama??o nestes processos t?m dificultado o diagn?stico precoce e a avalia??o da agressividade dos CEO. Sendo assim, tornou-se objetivo deste estudo avaliar o papel da inflama??o na carcinog?nese oral e agressividade tumoral. Para isso foi realizado estudo morfol?gico em 20 casos de DEO e 40 casos de CEO para detectar o potencial de maligniza??o das DEO e o Grau Histol?gico de Malignidade (GHM) dos CEO, analisando as massas superficiais para avalia??o do dismorfismo e o front invasivo para avalia??o do crescimento tumoral; e imuno-histoqu?mico, utilizando os anticorpos anti-CD8, anti-FOXP3, anti-TGF?, anti-TNF-? e anti-NF-?B, para comparar a express?o dos mesmos com o tipo de les?o, grau histol?gico e intensidade do infiltrado inflamat?rio. Os resultados foram estatisticamente significantes para os par?metros, maturidade celular (p=0,0001), presen?a de massas (p=0,038) e dismorfismo (p=0,037), quando associados aos GHM. Ao comparar a express?o dos marcadores com o tipo de les?o, encontrou-se uma express?o significativamente maior do CD8 (p=0,001) e do NF-?B (p=0,002) nas DEO, assim como uma menor express?o do TGF? epitelial nas DEO severas (p=0,011), n?o tendo express?o significativa entre os graus dos CEO. Ao relacionar a express?o dos marcadores estudados com a intensidade do infiltrado inflamat?rio, observou-se uma rela??o positiva com o TNF? inflamat?rio (p=0,003), o TNF? e o NF-?B epiteliais (p=0,051 e p=0,004), nas DEO; com o CD8 (p=0,021) e o TNF? (p=0,015) no conjuntivo dos CEO; e uma rela??o negativa com o TNF? (p=0,034) epitelial dos CEO. N?o foi encontrada rela??o significativa da FOXP3 com nenhuma das vari?veis estudadas. Esses achados levaram a concluir que, o estudo do front invasivo ? t?o importante quanto o estudo das massas superficiais para avalia??o da agressividade tumoral; a intensidade do infiltrado inflamat?rio n?o pode ser utilizado como par?metro para avalia??o progn?stica do CEO no exame de rotina; mas os eventos moleculares detectados neste estudo podem ser necess?rios para embasar a determina??o do potencial de malignidade nas DEO e da agressividade nos CEO

Made available in DSpace on 2014-12-17T15:32:18Z (GMT). No. of bitstreams: 1 ThaisGB.pdf: 4320063 bytes, checksum: c97c01facb2aed61dd49fc01568c6ca9 (MD5) Previous issue date: 2010-02-26 / Conselho Nacional de Desenvolvimento Cient?fico e Tecnol?gico / The squamous cell carcinoma (SCC) is the most common malignant neoplasm of epithelial origin in oral cavity and present high capacity to invade adjacent structures. Traditionally, SCC has a predominance of 50 years male patients with long-time use of tobacco and alcohol, and the tongue is the most affected anatomic site. At present, there is an increasing incidence of SCC in patients below 40 years of age, who has been exposed or not to risk factors, mainly for tongue lesions. This study aims to analyze cell proliferation index using Ki-67 antigen in SCC of the tongue for two groups of different age range: until 40 years and older than 50 years. The first group was composed by 16 patients and the second one was composed by 20 patients. Clinicopathological features of the cases were also assessed. There was a male predominance in both groups. Tobacco and alcohol habits were common for patients until 40 years (72,2%), as well as for patients older than 50 years (52,9%). The first group had statistical association with the presence of regional metastases (p = 0,036) and with the most advanced stages of the disease (p = 0,012). Considering the histological malignancy grading, there was higher incidence (56,2%) of high malignancy grade tumors in the group of patients until 40 years old, but no statistical difference has found between groups and histologic malignancy grading. Regarding the immunohistochemical expression of Ki-67, there was no statistically significant difference between the antibody expression of the groups, as well as between other clinical and histopathological parameters. This study identified no significant difference regarding cell proliferation between the analyzed groups / O Carcinoma Epiderm?ide (CE) ? a neoplasia maligna de origem epitelial que mais ocorre na cavidade oral, com alta capacidade de invadir estruturas adjacentes. Classicamente, o CEO ocorre mais em homens com idade acima de 50 anos, que fazem uso de tabaco e ?lcool por longos per?odos de tempo, sendo a l?ngua, o s?tio anat?mico mais frequentemente acometido. Atualmente, vem se percebendo um aumento na incid?ncia dessa les?o em pacientes com idade abaixo dos 40 anos expostos ou n?o a fatores de risco, principalmente as les?es de l?ngua. O objetivo desta pesquisa foi analisar o ?ndice de prolifera??o celular, utilizando o anticorpo Ki-67em CEs de l?ngua em dois grupos de faixas et?rias distintas. Tamb?m, avaliaram-se as caracter?sticas cl?nico-patol?gicas dos casos constantes do estudo. A amostra se constituiu de 16 casos de pacientes com idade at? 40 anos e 20 casos de pacientes com idade acima de 50 anos. Em rela??o ?s caracter?sticas cl?nicopatol?gicas das les?es, o sexo masculino foi o mais acometido para os dois grupos, sendo evidenciado que o h?bito de beber e fumar foi frequente tanto para os pacientes com idade at? 40 anos (72,7%) como para os pacientes com idade acima dos 50 anos (52,9%). Foi poss?vel observar que houve uma associa??o estatisticamente significativa entre o grupo de pacientes com idade at? 40 anos e a presen?a de met?stase regional (p = 0,036), bem como entre o mesmo grupo e os est?gios mais avan?ados da doen?a (p = 0,012). Em rela??o ? grada??o histol?gica de malignidade, houve uma maior frequ?ncia de tumores classificados em alto grau de malignidade no grupo de pacientes com at? 40 anos (56,2%), mas n?o foi evidenciada diferen?a estat?stica entre os grupos e a grada??o histol?gica de malignidade. Quanto ? an?lise da express?o imuno-histoqu?mica pelo Ki-67, n?o houve diferen?a estatisticamente significativa entre a express?o do anticorpo para os grupos et?rios estudados nesta pesquisa, assim como n?o houve associa??o do ?ndice de positividade para o Ki-67 com os par?metros cl?nicos e histomorfol?gicos. Pode-se concluir que a prolifera??o celular n?o foi significativamente diferente entre os grupos que constitu?ram o presente estudo