MMed, Otorhinolaryngology, Faculty of Health Sciences, University of the Witwatersrand / This study is a six year retrospective review of the histopathology of nasopharyngeal masses in adult patients who underwent a biopsy in theatre at the Charlotte Maxeke Johannesburg Academic Hospital (CMJAH) from 1st January 2003 to 31st December 2008. Eighty one patients were included in this study. They comprised of 54 males (67%) and 27 females (33%) aged between 18 and 82 years. There was no statistical difference between the two genders in terms of their ages (p= 0.39). Fifty two patients (64%) had benign disease and 29 patients (36%) had malignant disease (ratio 1.8:1). Thirty four males (65%) and 18 females (35%) had benign disease. Twenty males and 9 females had malignant disease. There was no significant correlation between gender and malignancy (r= -0.04, p=0.75). The independent predictors of the nature of the tumour were: nasal congestion, epistaxis, hearing loss, otalgia and Human Immunodeficiency Virus (HIV) status. The statistically significant positive predictors of malignancy were the presence of nasal congestion, epistaxis and otalgia. The presence of at least one or more of these symptoms was associated with an odds ratio of 3.06 for malignant disease. (CI= 1.17-8.01). The presence of hearing loss was independently associated with benign disease (p=0.031). The HIV status was known in 41 of the 81 patients. Of the 41 patients whose HIV status was known, 25 were male and 16 were female. The HIV positive patients comprised of 19 males (76% of all males) and 9 females (56% of all females). The presence of HIV infection was independently associated with benign disease. The absence of HIV infection was in fact associated with malignant disease, with an odds ratio of 4.00 and 95% confidence intervals of 1.04 to 15.43.

No description available.

No description available.

yes / Coinciding with advances in whole-slide imaging scanners, it is become essential to automate the conventional image-processing techniques to assist pathologists with some tasks such as mitotic-cells detection. In histopathological images analysing, the mitotic-cells counting is a significant biomarker in the prognosis of the breast cancer grade and its aggressiveness. However, counting task of mitotic-cells is tiresome, tedious and time-consuming due to difficulty distinguishing between mitotic cells and normal cells. To tackle this challenge, several deep learning-based approaches of Computer-Aided Diagnosis (CAD) have been lately advanced to perform counting task of mitotic-cells in the histopathological images. Such CAD systems achieve outstanding performance, hence histopathologists can utilise them as a second-opinion system. However, improvement of CAD systems is an important with the progress of deep learning networks architectures. In this work, we investigate deep YOLO (You Only Look Once) v2 network for mitotic-cells detection on ICPR (International Conference on Pattern Recognition) 2012 dataset of breast cancer histopathology. The obtained results showed that proposed architecture achieves good result of 0.839 F1-measure.

Accelerated tumor cell repopulation during radiation therapy is one of the leading causes for low survival rates of head-and-neck cancer patients. The therapeutic effectiveness of radiotherapy could be improved by selectively targeting proliferating tumor subvolumes with higher doses of radiation. Positron emission tomography (PET) imaging with 3´-deoxy-3´-[18F]-fluorothymidine (FLT) has shown great potential as a non-invasive approach to characterizing the proliferation status of tumors. This thesis focuses on histopathological validation of FLT PET imaging specifically for image-guidance applications in biologically adaptive radiotherapy. The lack of experimental data supporting the use of FLT PET imaging for radiotherapy guidance is addressed by developing a novel methodology for histopathological validation of PET imaging. Using this new approach, the spatial concordance between the intratumoral pattern of FLT uptake and the spatial distribution of cell proliferation is demonstrated in animal tumors. First, a two-dimensional analysis is conducted comparing the microscopic FLT uptake as imaged with autoradiography and the distribution of active cell proliferation markers imaged with immunofluorescent microscopy. It was observed that when tumors present a pattern of cell proliferation that is highly dispersed throughout the tumor, even high-resolution imaging modalities such as autoradiography could not accurately determine the extent and spatial distribution of proliferative tumor subvolumes. While microscopic spatial coincidence between high FLT uptake regions and actively proliferative subvolumes was demonstrated in tumors with highly compartmentalized/aggregated features of cell proliferation, there were no conclusive results across the entire set of utilized tumor specimens. This emphasized the need for addressing the limited resolution of FLT PET when imaging microscopic patterns of cell proliferation. This issue was emphasized in the second part of the thesis where the spatial concordance between volumes segmented on FLT simulated FLT PET images and the three dimensional spatial distribution of cell proliferation markers was analyzed.

Submitted by Marlene Santos (marlene.bc.ufg@gmail.com) on 2014-10-01T14:53:33Z No. of bitstreams: 2 Tese - Luciana Ximenes Salustiano - 2013.pdf: 3049558 bytes, checksum: b1f84cfd9b4978f7ecf5dd1b5da12e3d (MD5) license_rdf: 23148 bytes, checksum: 9da0b6dfac957114c6a7714714b86306 (MD5) / Approved for entry into archive by Luciana Ferreira (lucgeral@gmail.com) on 2014-10-01T15:33:57Z (GMT) No. of bitstreams: 2 Tese - Luciana Ximenes Salustiano - 2013.pdf: 3049558 bytes, checksum: b1f84cfd9b4978f7ecf5dd1b5da12e3d (MD5) license_rdf: 23148 bytes, checksum: 9da0b6dfac957114c6a7714714b86306 (MD5) / Made available in DSpace on 2014-10-01T15:33:57Z (GMT). No. of bitstreams: 2 Tese - Luciana Ximenes Salustiano - 2013.pdf: 3049558 bytes, checksum: b1f84cfd9b4978f7ecf5dd1b5da12e3d (MD5) license_rdf: 23148 bytes, checksum: 9da0b6dfac957114c6a7714714b86306 (MD5) Previous issue date: 2013-12-17 / Retinoblastoma (RB) is the malignant neoplasm of embryonic neural retinal cells and is the most common intraocular tumor of childhood. Early diagnosis associated with modern methods of treatment resulted in increased survival rate of patients with retinoblastoma. However, in those cases whose diagnosis is delayed and in untreated cases, the disease is invariably fatal. The knowledge of the molecular and histopathological features of retinoblastomas can influence the choice of treatment and benefit the prognosis of these tumors. Thus, the objectives of this study are to evaluate the main histopathological and molecular characteristics of retinoblastomas, including the evaluation of p16, Ki67 and VEGF protein expression, as well as the potential role of such molecules as prognostic markers in the retinoblastomas. Fifty-seven cases of RB were evaluated in enucleated eyes at Hospital Araújo Jorge, in Goiânia, in the period of 1998 to 2011. Clinical data were collected from the respective medical files and the cases were reviewed for analysis of histopathological aspects. The expression of Ki67, p16 and VEGF was assessed by immunohistochemistry, using specific antibodies and a detection system associated with polymers. The results were analyzed by descriptive statistics and categorical variables by chi-square test and Fisher exact test, when necessary. Ki67 overexpression was observed in 28% of cases, characterizing the retinoblastomas with high rate of cellular proliferation, while the p16 overexpression was observed in 42% of retinoblastomas evaluated. Significant associations were observed between the overexpression of these proteins and histopathological characteristics of worse prognosis, including invasion of the optic nerve, choroid, sclera and anterior chamber of the eye, as well as to a lower degree of cellular differentiation. VEGF expression was extensively observed in all retinoblastoma cases, independent of the histopathological aspects of the tumors. The associations observed in this study between tumor aggressive histopathological aspects and Ki67 and p16 overexpression, indicate the use of these markers in determining the prognosis of retinoblastomas. On the other hand, the high angiogenic potential of retinoblastomas, translated by diffuse VEGF expression in all cases analyzed in this study, raises new investigations on the use of anti-angiogenic drugs in the treatment of retinoblastomas. / O retinoblastoma (RB) é o tumor maligno das células neurais embrionárias da retina e consiste no tumor intraocular mais comum da infância. O diagnóstico precoce associado a modernos métodos de tratamento resultou em aumento da taxa da sobrevida de pacientes com retinoblastoma. No entanto, nos casos cujo diagnóstico é tardio e nos casos não tratados, a doença é invariavelmente fatal. O conhecimento das características histopatológicas e moleculares dos retinoblastomas pode direcionar a escolha do tratamento e beneficiar o prognóstico desses tumores. Este estudo objetiva avaliar as principais características histopatológicas e moleculares dos retinoblastomas, incluindo a avaliação da expressão das proteínas p16, Ki67 e VEGF e o potencial papel prognóstico desses marcadores que são anticorpos envolvidos na carcinogênese, angiogênese e proliferação celular. Cinquenta e sete casos de RB foram avaliados em olhos enucleados no Hospital Araújo Jorge, em Goiânia, no período de 1998 a 2011. Os dados clínicos foram coletados dos respectivos prontuários e todos os casos foram revistos para análise dos aspectos histopatológicos. A expressão de Ki67, p16 e VEGF foi avaliada por imunoistoquímica, utilizando anticorpos específicos e sistema de detecção associado a polímeros. Os resultados foram analisados por estatística descritiva e as variáveis categóricas pelo teste do qui-quadrado e teste exato de Fisher, quando necessário. A superexpressão de Ki67 foi observada em 28% dos casos, caracterizando os retinoblastomas com alto índice de proliferação celular, enquanto a superexpressão de p16 foi observada em 42% dos retinoblastomas avaliados. Associações significativas foram detectadas entre a superexpressão dessas proteínas e as características histopatológicas de pior prognóstico, incluindo invasão do nervo óptico, esclera, coroide e câmara anterior do olho, bem como ao menor grau de diferenciação celular. A expressão de VEGF foi observada de forma difusa em todos os casos analisados, independente dos aspectos histopatológicos dos tumores. As associações observadas neste estudo, entre os aspectos histopatológicos de maior agressividade tumoral e a superexpressão de Ki67 e p16, indicam que o uso destes marcadores pode influir na determinação do prognóstico dos retinoblastomas. Por outro lado, o alto potencial angiogênico dos retinoblastomas, traduzido pela expressão difusa do VEGF em todos os casos analisados neste estudo, suscita novas investigações sobre o uso de medicamentos anti-angiogênicos no tratamento dos retinoblastomas.

Carcinoma verrucoso e leucoplasia verrucosa proliferativa, estão entre as lesões que apresentam difícil diagnóstico diferencial devido às semelhanças histopatológicas que ocorrem em determinada fase de evolução. Existe, para tanto, a necessidade de somar dados clínico-epidemiológicos ao histopatológico a fim de se estabelecer o diagnóstico final. A leucoplasia verrucosa proliferativa caracteriza-se por seu acometimento multifocal, grande potencial de recidiva e perfil progressivo que resulta em alto risco de transformação maligna. Por outro lado, o carcinoma verrucoso, variante de baixo grau do carcinoma epidermoide, é unifocal e dificilmente recidiva. A importância de novos estudos acerca das suas duas lesões mencionadas vem a agregar conhecimento de modo a facilitar um correto diagnóstico e, consequentemente, um apurado prognóstico. A leucoplasia verrucosa proliferativa, por se tratar de lesão com alto potencial de transformação maligna, pode evoluir para carcinoma epidermoide invasivo, menos diferenciado e mais agressivo com consequente prognostico obscuro, ao passo que, o carcinoma verrucoso não incorre em metástases e apresenta um prognóstico mais favorável. Isso posto, com o objetivo de aumentar a precisão diagnóstica, o presente trabalho propôs identificar e quantificar em porcentagem os critérios histopatológicos encontrados na leucoplasia verrucosa proliferativa e no carcinoma verrucoso visando diferenciar morfologicamente as lesões dos dois grupos. Também buscamos comparar os dados epidemiológicos referentes aos casos inseridos no estudo, dentre eles vinte e dois casos de leucoplasia verrucosa proliferativa, dezoito casos de carcinoma verrucoso e dois casos apresentando tanto leucoplasia verrucosa proliferativa quanto carcinoma verrucoso, casos esses com diagnósticos estabelecidos previamente (baseando-se nos dados epidemiológicos somados ao histopatológico). A utilização de um marcador imuno-histoquímico da atividade proliferativa celular, o Ki67, também permitiu uma análise comparativa entre o comportamento biológico de ambas as lesões através de um ensaio quantitativo e qualitativo. A marcação mostrou-se escassa, mas evidente em células mitóticas da leucoplasia verrucosa proliferativa, mostrando, no entanto, maior número de células positivas no carcinoma verrucoso, estas visíveis nas camadas basal e parabasal. Os resultados do presente trabalho permitiram concluir então que o marcador Ki67 pode auxiliar no diagnóstico diferencial entre leucoplasia verrucosa proliferativa e carcinoma verrucoso. Foi possível depreender também que, histologicamente, o carcinoma verrucoso apresenta maior alteração em sua conformação epitelial, bem como maior número de atipias cito-arquiteturais quando comparado à leucoplasia verrucosa proliferativa, que, apesar de seu aspecto morfológico, evolui no sentido de uma potencial transformação maligna, apresentando, por sua vez, maior freqüência de projeções em gota. / Verrucous carcinoma and proliferative verrucous leukoplakia, are among the injuries presenting difficult differential diagnosis due to histopathological similarities that occur at some stage of evolution. There is a need to add clinical, epidemiological and histopathological data to achieve the final diagnosis. Proliferative verrucous leukoplakia is characterized by its multifocal involvement, great potential for relapse and progressive profile that results in malignant transformation high risk. On the other hand, the verrucous carcinoma, which is considered low-grade variant of squamous cell carcinoma, is unifocal and unlikely to return. The importance of new studies on its two mentioned lesions is to generate knowledge aiming at a correct diagnosis and prognosis. The proliferative verrucous leukoplakia, since it is a lesion with high potential for malignant transformation, can develop into less differentiated and more aggressive invasive squamous cell carcinoma with subsequent poor prognosis, whereas the verrucous carcinoma incurs no metastases and presents a more favorable prognosis. Thus, aimed to increase the diagnostic accuracy, the present work looked for to identify and quantify in percentage the histopathological criteria found on proliferative verrucous leukoplakia and verrucous carcinoma, aiming morphologically differentiate the lesions from both groups. We also seek to compare the epidemiological data related to cases included in the study, including twenty-two cases of proliferative verrucous leukoplakia, eighteen cases of verrucous carcinoma and two cases showing both proliferative verrucous leukoplakia as verrucous carcinoma, cases with these diagnoses established previously (based on epidemiological data added to histopathology data). Using a cell proliferation immunohistochemical marker, Ki67, we made a comparative analysis between the biological behavior of both lesions by quantitative and qualitative assay. We saw a few strongly positive mitotic cells in samples of proliferative verrucous leukoplakia, and numerous positive cells observed in the basal and parabasal layers of verrucous carcinoma samples. This study results indicate, then, that the Ki67 marker may help in the differential diagnosis between proliferative verrucous leukoplakia and verrucous carcinoma. It was also possible to conclude that, histologically, the verrucous carcinoma shows greater change in its epithelial conformation and a higher number of cyto-architectural atypia when compared to proliferative verrucous leukoplakia, which, despite its morphological appearance, evolves towards a potential malignant transformation, presenting, in turn, higher drop-shaped rete ridges frequency.

Carcinoma verrucoso e leucoplasia verrucosa proliferativa, estão entre as lesões que apresentam difícil diagnóstico diferencial devido às semelhanças histopatológicas que ocorrem em determinada fase de evolução. Existe, para tanto, a necessidade de somar dados clínico-epidemiológicos ao histopatológico a fim de se estabelecer o diagnóstico final. A leucoplasia verrucosa proliferativa caracteriza-se por seu acometimento multifocal, grande potencial de recidiva e perfil progressivo que resulta em alto risco de transformação maligna. Por outro lado, o carcinoma verrucoso, variante de baixo grau do carcinoma epidermoide, é unifocal e dificilmente recidiva. A importância de novos estudos acerca das suas duas lesões mencionadas vem a agregar conhecimento de modo a facilitar um correto diagnóstico e, consequentemente, um apurado prognóstico. A leucoplasia verrucosa proliferativa, por se tratar de lesão com alto potencial de transformação maligna, pode evoluir para carcinoma epidermoide invasivo, menos diferenciado e mais agressivo com consequente prognostico obscuro, ao passo que, o carcinoma verrucoso não incorre em metástases e apresenta um prognóstico mais favorável. Isso posto, com o objetivo de aumentar a precisão diagnóstica, o presente trabalho propôs identificar e quantificar em porcentagem os critérios histopatológicos encontrados na leucoplasia verrucosa proliferativa e no carcinoma verrucoso visando diferenciar morfologicamente as lesões dos dois grupos. Também buscamos comparar os dados epidemiológicos referentes aos casos inseridos no estudo, dentre eles vinte e dois casos de leucoplasia verrucosa proliferativa, dezoito casos de carcinoma verrucoso e dois casos apresentando tanto leucoplasia verrucosa proliferativa quanto carcinoma verrucoso, casos esses com diagnósticos estabelecidos previamente (baseando-se nos dados epidemiológicos somados ao histopatológico). A utilização de um marcador imuno-histoquímico da atividade proliferativa celular, o Ki67, também permitiu uma análise comparativa entre o comportamento biológico de ambas as lesões através de um ensaio quantitativo e qualitativo. A marcação mostrou-se escassa, mas evidente em células mitóticas da leucoplasia verrucosa proliferativa, mostrando, no entanto, maior número de células positivas no carcinoma verrucoso, estas visíveis nas camadas basal e parabasal. Os resultados do presente trabalho permitiram concluir então que o marcador Ki67 pode auxiliar no diagnóstico diferencial entre leucoplasia verrucosa proliferativa e carcinoma verrucoso. Foi possível depreender também que, histologicamente, o carcinoma verrucoso apresenta maior alteração em sua conformação epitelial, bem como maior número de atipias cito-arquiteturais quando comparado à leucoplasia verrucosa proliferativa, que, apesar de seu aspecto morfológico, evolui no sentido de uma potencial transformação maligna, apresentando, por sua vez, maior freqüência de projeções em gota. / Verrucous carcinoma and proliferative verrucous leukoplakia, are among the injuries presenting difficult differential diagnosis due to histopathological similarities that occur at some stage of evolution. There is a need to add clinical, epidemiological and histopathological data to achieve the final diagnosis. Proliferative verrucous leukoplakia is characterized by its multifocal involvement, great potential for relapse and progressive profile that results in malignant transformation high risk. On the other hand, the verrucous carcinoma, which is considered low-grade variant of squamous cell carcinoma, is unifocal and unlikely to return. The importance of new studies on its two mentioned lesions is to generate knowledge aiming at a correct diagnosis and prognosis. The proliferative verrucous leukoplakia, since it is a lesion with high potential for malignant transformation, can develop into less differentiated and more aggressive invasive squamous cell carcinoma with subsequent poor prognosis, whereas the verrucous carcinoma incurs no metastases and presents a more favorable prognosis. Thus, aimed to increase the diagnostic accuracy, the present work looked for to identify and quantify in percentage the histopathological criteria found on proliferative verrucous leukoplakia and verrucous carcinoma, aiming morphologically differentiate the lesions from both groups. We also seek to compare the epidemiological data related to cases included in the study, including twenty-two cases of proliferative verrucous leukoplakia, eighteen cases of verrucous carcinoma and two cases showing both proliferative verrucous leukoplakia as verrucous carcinoma, cases with these diagnoses established previously (based on epidemiological data added to histopathology data). Using a cell proliferation immunohistochemical marker, Ki67, we made a comparative analysis between the biological behavior of both lesions by quantitative and qualitative assay. We saw a few strongly positive mitotic cells in samples of proliferative verrucous leukoplakia, and numerous positive cells observed in the basal and parabasal layers of verrucous carcinoma samples. This study results indicate, then, that the Ki67 marker may help in the differential diagnosis between proliferative verrucous leukoplakia and verrucous carcinoma. It was also possible to conclude that, histologically, the verrucous carcinoma shows greater change in its epithelial conformation and a higher number of cyto-architectural atypia when compared to proliferative verrucous leukoplakia, which, despite its morphological appearance, evolves towards a potential malignant transformation, presenting, in turn, higher drop-shaped rete ridges frequency.

Orientador: Wellerson Rodrigo Scarano / Resumo: A capacidade de progressão do câncer de próstata para uma fase não-responsiva às terapias de privação androgênica traz à luz a importância do estudo de tratamentos adjuvantes. Pesquisas recentes apontam receptores estrogênicos como possíveis alvos terapêuticos em neoplasias, podendo ser modulados por fármacos como o Raloxifeno, atualmente utilizado na prevenção do câncer de mama e tratamento da osteoporose. Nesse contexto, o objetivo deste estudo foi avaliar os potenciais efeitos histoprotetores e antiproliferativos da terapia com Raloxifeno, durante a carcinogênese prostática. Para isso, 34 ratos Fisher 344 machos foram inoculados com o carcinógeno MNU (15 mg/kg) na cápsula dos lobos ventral e dorsolateral e receberam doses subcutâneas de cipionato de testosterona, duas vezes por semana, durante 220 dias, processo aqui denominado de Indução de Carcinogênese. Posteriormente, foram divididos em dois grupos experimentais para o período de Tratamento: grupo Raloxifeno, recebendo 10 mg/kg de peso corpóreo/dia de Raloxifeno diluído em 0,2 ml de óleo de milho durante 30 dias consecutivos; grupo Induzido, recebendo somente 0,2 ml de óleo de milho (veículo) durante 30 dias consecutivos. Outros 10 animais pertencentes ao grupo Controle receberam veículo duas vezes por semana por 220 dias para simular o processo de Indução e, posteriormente, durante 30 dias consecutivos para simular o período de Tratamento. Após a eutanásia, o sangue e as próstatas ventral e dorsolateral foram coletado... (Resumo completo, clicar acesso eletrônico abaixo) / Abstract: Prostate cancer ability to progress to a non-responsive phase to androgen deprivation therapy emphasizes the importance of study on adjuvant treatments. Recent research suggests estrogen receptors as possible therapeutic targets in neoplasias and they can be modulated by drugs such as Raloxifene, currently used in the prevention of breast cancer and treatment of osteoporosis. In this context, this study aimed to evaluate the histoprotective and antiproliferative potential effects of Raloxifene therapy during prostatic carcinogenesis. Thereunto, 34 male Fisher 344 rats were inoculated with the MNU carcinogen (15 mg / kg) in the ventral and dorsolateral lobe capsule and received subcutaneous doses of testosterone cypionate twice a week for 220 days. Subsequently, they were divided into two experimental groups: Raloxifene group, receiving 10 mg/kg of body weight/day of Raloxifene diluted in 0.2 ml of corn oil for 30 consecutive days; Induced group, receiving only 0.2 ml corn oil (vehicle) for 30 consecutive days. Another 10 animals belonging to the Control group received vehicle twice a week for 220 days to simulate the induction process and subsequently for 30 consecutive days to simulate the treatment period. After euthanasia, blood and the ventral and dorsolateral prostate lobes were collected for hormonal dosage, histopathological analysis of the lesions, quantification of mast cells, picrosirius (collagen fibers) and immunostaining for AR (androgen receptor), α-actin and Ki... (Complete abstract click electronic access below) / Doutor

No description available.