Made available in DSpace on 2016-07-18T17:53:08Z (GMT). No. of bitstreams: 1 DISSERTACAO_ Magda - 21-08-2011- corrigido.pdf: 2313731 bytes, checksum: 7e4161e3e3a18ed9159672a8d9d78833 (MD5) Previous issue date: 2011-06-30 / The aim of this study was to evaluate the effectiveness of the linseed oil (OL) in different preparations (oral, topically, oral and topically combined) in the treatment of the kerato-conjunctivitis sicca (KCS) experimentally induced in rabbits. Twenty white male rabbits of the New Zeland race were used. They were divided in 4 groups of 5 animals each: Group C (Control); Group OLO (OL oral); Group OLT (OL topically); and Group OLOT (OL oral and topically). The rabbits were evaluated weekly by the Shirmer Tear Test (TLS), Flourescein Test (TF) and the Rose-Bengal Test (TRB), and a ocular impression cytology exam was done once a month, and at the end of the experiment the rabbits were sacrificed to a histopathological analysis. There was a significant improvement in the parameters analysed (TLS,TF and TRB) in all the groups that used OL, but there was differences in the performance of each group. In the TLS the groups OLO and OLT showed larger values than the OLOT group from the 7th week to the end of the experiment. In TF the group OLT reverted the incidence of corneal ulcers earlier than the other groups starting on the 5th week. In TRB, the group OLO and also the OLT showed normal values starting on the 9th week, while the group OLOT only on the last week. In the cytological findings the group OLT showed a more advanced stage of inflammation on the 4th and 8th week and also on the hispathological findings of this group showed a more advanced stage of edema, degeneration and necrosis than the other groups. It wasn´t observed any collateral damage due the use of OL. The results analyzed showed that the OL, topically or oral, was efficient on the treatment of CCS experimentally induced in rabbits and can be and excellent adjuvant, natural and safe, in the treatment of this illness / O objetivo deste estudo foi avaliar a eficácia do óleo de semente de linhaça (OL) em várias preparações (oral, tópica, oral e tópica associadas) no tratamento da ceratoconjuntivite seca (CCS) induzida experimentalmente em coelhos. Foram utilizados vinte coelhos brancos machos da raça Nova Zelândia. Os animais foram divididos em 4 grupos com 5 animais cada: Grupo C (controle) animais hígidos; Grupo OLO (OL via oral); Grupo OLT (OL por via tópica) e Grupo OLOT (OL via oral e tópica). Os coelhos foram avaliados semanalmente pelo Teste de Lágrima de Schirmer (TLS), Teste de Fluoresceína (TF) e Teste de Rosa Bengala (TRB), uma vez por mês pelo exame de citologia de impressão ocular, e ao final do experimento foram sacrificados para análise histopatológica. Houve melhora clínica significativa nos parâmetros analisados (TLS, TF e TRB) em todos os grupos que usaram OL, porém, houve diferenças no desempenho de cada grupo. Os Grupos OLO e OLT apresentaram valores superiores do TLS, quando comparado com o Grupo OLOT a partir da 7ª semana até o final da observação. No TF o grupo OLT reverteu mais precocemente, a partir da 5ª semana, a incidência de úlceras na córnea, do que os demais grupos. Os Grupos OLO e OLT apresentaram TRB negativos para CCS a partir da 9ª semana, enquanto o grupo OLOT somente na última semana. Nos achados citológicos o grupo OLT apresentou um maior grau de inflamação na 4ª e 8ª semana e também nos achados histopatológicos esse grupo apresentou um maior grau de edema, degeneração e necrose do que os demais grupos. Não foi observado nenhum efeito colateral com o uso do OL. Os resultados analisados demonstraram que o OL, tanto por via oral como tópica, foi eficaz no tratamento de CCS induzida experimentalmente em coelhos e pode ser um adjuvante, natural, no tratamento desta enfermidade.

Krebserkrankungen sind das Resultat komplexer Vorgänge und Veränderungen. Eine wichtige Variable in der Initialisierung ist die Interaktion zwischen Genotyp und Umwelt. Da Magenkarzinome zu den wenigen Krebserkrankungen gehören, bei denen im letzten Jahrhundert ein deutlicher Rückgang in der Inzidenz beobachtet werden konnte (Becker 2006), stellt sich die Frage, ob es Unterschiede in der genetischen Ausstattung von historischen Tumorgenomen im Vergleich zu rezenten gibt. Als typisches Zielgen für Tumormutationen wurde das Tumorsuppressorgen p53 untersucht. Au¬ßerdem wurde Helicobacter pylori (H. pylori) als Risikofaktor für die Entstehung von Magenkarzinomen in den historischen Proben identifiziert. Insgesamt standen 51 Gewebeproben von Magenkarzinompatienten aus den Medizinhistori¬schen Museen Berlin und Zürich, dem Pathologisch-anatomischen Bundesmuseum Wien sowie der anatomischen Sammlung der Universität Tartu zur Verfügung. Bei 47 Proben handelte es sich nach histologischer Diagnose um Magenkarzinome. Die Proben sind zwischen 50 und 180 Jahre alt und wurden in Konservierungsflüssigkeiten unbekannter Zusammensetzung gelagert. Von 45% der Proben konnten vollständige Sequenzen der Exons 5 bis 8 des p53-Gens generiert werden. Es konnten Veränderungen im Mutationsspektrum und in der Lokalisation der Mutationen in den historischen Proben im Vergleich zu rezenten Tumormutationen festgestellt werden. Die Mutationsfrequenz betrug 52%. Insgesamt wurden zehn verschiedene Mutationsereignisse in p53 bei elf verschiedenen Proben detektiert, wobei drei Proben von zwei Mutationen betroffen waren. Zwei Mutationen führen direkt (Q144X) bzw. indirekt (S166fs) zu der Entstehung von Stoppcodons. Zu einem Verlust des p53-Proteins bei gleichzeitiger Akquirierung onkogener Funktionen kommt es durch die Hotspot-Mutation R248W (Wang & El-Deiry 2007). Zu einer Zunahme der Funktionsfähigkeit (gain-of-function) kommt es außerdem durch die Mutation K291E. Die Mutation E271K ist an einer splice site lokalisiert, so dass das Exon nicht in die mRNA übernommen werden kann. Die Konsequenzen der anderen Mutationsereignisse sind nicht eindeutig belegt, scheinen aber einen geringeren Einfluss auf die Funktionalität von p53 zu haben. Abweichend zu rezenten Magenkarzinomen konnte die Mutation M246K als Hotspot der historischen Proben identifiziert werden. Insgesamt waren nur vier historische Mutationen bisher aus rezentem Magenkarzinomgewebe beschrieben, davon die Mehrheit in Studien mit asiatischen Patienten. Die veränderten Mutationen der historischen Magenkarzinome können als Hinweis auf Veränderungen in den karzinogen wirkenden Einflussfaktoren dienen, etwa eine veränderte Lebens- und Ernährungsweise durch die Einführung von Kühlmöglichkeiten für Lebensmittel. Der Risikofaktor H. pylori konnte in 70% der Gewebeproben sicher nachgewiesen werden. Der Anteil der Träger des Virulenzfaktors cag betrug 44%. 73% der Proben mit p53-Mutation waren nachweislich mit H. pylori und davon wiederum 63% mit einem cag-positiven Stamm infiziert. Die Infektion ermöglicht eine Teilerklärung für die untypische Lokalisation der Mutationen, da H. pylori-induzierte Mutationen seltener an Magenkarzinom-Hotspots vorkommen (Murakami et al. 1999). Es konnten keine resistenztypischen Mutationen gegen das Antibiotikum Clarithromycin in den historischen Geweben identifiziert werden. Die vorliegende Arbeit konnte p53-Mutationen und das Bakterium H. pylori in den historischen Gewebeproben identifizieren. Ein verändertes Mutationsspektrum und die veränderte Lokalisation der Mutationen geben den Hinweis, dass sich die Einflüsse auf die Entstehung der Magenkarzinome im letzten Jahrhundert verändert haben.

Purpose: Previous clinical studies have suggested a positive effect of low-frequency pulsed electromagnetic fields (PEMF) on wound healing and inflammation in the eye. We tried to test the value of PEMF treatment in a hyphema animal model with well-defined conditions. Methods: After injection of citrated autologous blood for the production of hyphema, 16 rabbit eyes were treated with 10 or 20 mT for 60 min on 4 days within the postoperative week. Two control groups with hyphema alone (n = 8) and PEMF irradiation without hyphema (n = 4) were also included. The rate of resorption was recorded daily. Histopathologic evaluation was performed. Results: The incidence of endothelial cell damage and fibrotic clots was markedly reduced in the 10-mT group while the resorption time of 8 days was identical with the control group. In the 20-mT group, the complication rate and the resorption time was increased versus the control group. Conclusions: The use of PEMF treatment is of some, however, limited value as it did not reduce the resorption time of hyphema but displayed a dose-dependent, beneficial influence on some serious side effects. Future clinical studies with low-dose PEMF irradiation are justified and should determine the optimal dosage and suitable indications of PEMFs as an adjunctive treatment in ocular inflammation or trauma. / Dieser Beitrag ist mit Zustimmung des Rechteinhabers aufgrund einer (DFG-geförderten) Allianz- bzw. Nationallizenz frei zugänglich.

L'un des problèmes les plus complexes dans l'analyse des images histologiques est l'évaluation de l¿organisation spatiale des structures histologiques dans le tissu. En fait, les sections histologiques peuvent contenir un très grand nombre de cellules de différents types et irrégulièrement réparties dans le tissu, ce qui rend leur contenu spatial indescriptible d'une manière simple. Les méthodes fondées sur la théorie des graphes ont été largement explorées dans cette direction, car elles sont des outils de représentation efficaces ayant la capacité expressive de décrire les caractéristiques spatiales et les relations de voisinage qui sont interprétées visuellement par le pathologiste. On peut distinguer trois familles principales de méthodes des graphes utilisées à cette fin: analyse de structure syntaxique, analyse de réseau et analyse spectrale. Cependant, un autre ensemble distinctif de méthodes basées sur la morphologie mathématique sur les graphes peut être développé et adapté pour ce problème. L'objectif principal de cette thèse est le développement d'un outil capable de fournir une évaluation quantitative des arrangements spatiaux des structures histologiques en utilisant la morphologie mathématique basée sur les graphes. / One of the most challenging problems in histological image analysis is the evaluation of the spatial organizations of histological structures in the tissue. In fact, histological sections may contain a very large number of cells of different types and irregularly distributed, which makes their spatial content indescribable in a simple manner. Graph-based methods have been widely explored in this direction, as they are effective representation tools having the expressive ability to describe spatial characteristics and neighborhood relationships that are visually interpreted by the pathologist. We can distinguish three main families of graph-based methods used for this purpose: syntactic structure analysis, network analysis and spectral analysis. However, another distinctive set of methods based on mathematical morphology on graphs can be additionally developed for this issue. The main goal of this dissertation is the development of a framework able to provide quantitative evaluation of the spatial arrangements of histological structures using graph-based mathematical morphology.

Objetivo: Determinar la frecuencia de Helicobacter pylori en muestras histopatológicas gástricas malignas y premalignas del servicio de anatomía patológica del Hospital Regional Lambayeque durante los años 2016 al 2019. Material y métodos. Estudio censal, observacional descriptivo, retrospectivo y transversal. La población de estudio estuvo conformada por los pacientes cuyas muestras histológicas gástricas fueron recibidas y estudiadas en el servicio de anatomía patológica del Hospital Regional Lambayeque. Resultados. Cumplieron con los criterios de selección 566 pacientes. La edad media fue 57,3; rango de 8 a 97 años. Hubo un predominio de pacientes entre la quinta (23.9%), sexta (24%) y séptima (17%) década de la vida. La frecuencia global de Helicobacter Pylori en las muestras seleccionadas fueron de 70.5%, con un predominio en el sexo masculino (71.2%). Los hallazgos anatomopatológicos se distribuyeron de la siguiente manera: 147 pacientes (26%) con gastritis crónica atrófica (GCA), 333 (58.8%) con metaplasia intestinal (MI), 60 (10.6%) con displasia y 26 (4.6%) con cáncer gástrico. Metaplasia intestinal fue el hallazgo más común; el mismo que se encontró en 166 personas (49.85%) con MI completa, 73 (21.92%) con MI incompleta y 94 (28.22%) con MI mixta. Conclusiones La frecuencia de Helicobacter Pylori (HP) fue alta en las lesiones premalignas, mientras que no hubo diferencias en la presencia o ausencia en muestras gástricas malignas. Conforme avanzaba la edad disminuía la frecuencia del HP pero aumentaban la gravedad de las lesiones. / Objective: Determine the frequency of Helicobacter pylori in malignant and premalignant gastric histopathological samples from the pathological anatomy service of the Hospital Regional Lambayeque during the years 2016 to 2019. Material and methods. Census, observational, descriptive, retrospective and cross-sectional study. The study population was made up of patients whose gastric histological samples were received and studied in the pathological anatomy service of the Hospital Regional Lambayeque. Results. 566 patients fulfilled the selection criteria. The mean age was 57.3; range from 8 to 97 years. There was a predominance of patients between the fifth (23.9%), sixth (24%) and seventh (17%) decades of life. The overall frequency of Helicobacter Pylori in the selected samples was 70.5%, with a predominance in the male sex (71.2%). The anatomopathological findings were distributed as follows: 147 patients (26%) with chronic atrophic gastritis (CAG), 333 (58.8%) with intestinal metaplasia (IM), 60 (10.6%) with dysplasia and 26 (4.6%) with gastric cancer. Intestinal metaplasia was the most common finding; the same that was found in 166 people (49.85%) with complete MI, 73 (21.92%) with incomplete MI and 94 (28.22%) with mixed MI. Conclusions The frequency of Helicobacter Pylori (HP) was high in premalignant lesions, while there were no differences in the presence or absence in malignant gastric samples. As age advanced, the frequency of PH decreased but the severity of the lesions increased.

No description available.

A queilite actínica (QA) é uma lesão potencialmente maligna importante para identificar indícios precoces de transformação maligna para o carcinoma epidermoide de lábio (CEL), possibilitando a implementação de um tratamento eficiente e menos invasivo, que promova um melhor prognóstico para os pacientes. Pesquisas recentes indicam que os métodos histopatológicos geralmente são falhos em traçar o risco de malignização de casos de QA, pois além de não demonstrar as alterações genéticas presentes nos queratinócitos, não foram realizados estudos de acompanhamento clínico para avaliar se o grau de displaia epitelial da QA está relacionado ao risco de malignização para CE. Assim, a presente pesquisa teve como objetivo caracterizar, a partir dos casos atendidos no Serviço de Patologia Cirúrgica da FOUSP, qual a diferença de perfil clínico-patológico de pacientes de QA com evolução para CEL, pacientes de QA sem informações e sinais presentes de malignização e pacientes apenas diagnosticados com CEL, e também visou analisar a expressão de Ki67 e pRb nesses três grupos. Para isso, os dados dos pacientes como idade, sexo, cor da pele, aspecto clínico da lesão fundamental, coloração, tamanho e tempo de duração das lesões foram resgatados de 998 casos e distribuídos nessas três categorias. Os resultados da análise clínico-epidemiológica revelaram que o único aspecto clínico estatisticamente significante para diferenciar pacientes apenas diagnosticados com CEL dos demais grupos foi o tempo de duração das lesões. A análise do grau de displasia epitelial nos casos de QA na amostra presente revelou que todos os pacientes de QA posteriormente diagnosticados com CEL foram classificados como lesões de alto risco, e ainda exibiram em maior frequência as atipias: aumento do número de figuras de mitose, variação anormal do tamanho do núcleo, variação anormal do tamanho da célula e alteração da relação núcleo/citoplasma, figuras de mitose anormais e aumento do número e tamanho de nucléolos. Tanto a expressão da proteína Ki-67 como da proteína pRb não demonstraram significância estatística na comparação entre os grupos do estudo. Assim, a avaliação de uma ampla série de casos revelou diferença significante no tempo de duração do CEL com relação à QA. Além disso, algumas alterações morfológicas foram observadas com maior frequência em casos de QA com evolução para CEL. No entanto, outros marcadores biológicos devem ser testados em conjunto, para tentar diagnosticar alterações precoces que levem ao desenvolvimento de CEL. / Actinic cheilitis (AC) is a potentially malignant lesion important to identify early signs of malignant transformation into lip squamous cell carcinoma (LSCC), enabling the implementation of an efficient and less invasive treatment to patients. Recent researches pointed that histopatological methods often fail to trace malignization risk in AC cases, because they are unable to identify genetic damage in keratinocytes and do not exist a clinical follow-up studie to assess if the grading of epithelial dysplasia in AC is related with the malignancy risk to LSCC development. Thus, this research aims to characterize, from cases of Surgical Pathology Service of Universidade de São Paulo, the differences in clinical and pathological profile among AC patients which had evolution to LSCC, AC patients without signs and information about malignization and patients diagnosed only with LSCC. This study also analyzed the expression of Ki-67 and pRb proteins in these three groups. To conduct this study, data as age, gender, race, fundamental lesion aspect, color, size and duration time of the lesion were collected from 998 patients. The clinical-epidemiological analysis revealed that duration time of the lesion was the statistically significant clinical feature to differentiate patients diagnosed only with LSCC from other groups. The grading of epithelial dysplasia analysis showed that all AC patients with a posterior diagnosis of LSCC were classified as high risk lesions and these cases also exhibited most frequently atypia figures as: increased number of mitotic features, abnormal variation in nuclear size, abnormal variation in cellular size, increased nuclear/cytoplasmic ratio, abnormal mitotic features and increased number and size of nucleoli. The immunohistochemical expression of both Ki-67 and pRb protein demonstrated lack of significant statistical difference among the groups. We concluded that the evaluation of a large serie of cases revealed differences in duration time of lesion in patiens only diagnoses with LSCC and some morphological criteria were most frequent in AC cases with a posterior diagnosis of LSCC. However, other biological markers must be tested together, to try to identify early steps of LSCC development.

As úlceras venosas representam um grande problema de saúde mundial e elevados custos associados ao tratamento a longo prazo. A terapia ultrassônica tem sido aplicada por décadas a fim de acelerar o processo de cicatrização de feridas crônicas. Muitos autores observaram os efeitos do ultrassom pulsado de baixa intensidade (LIPUS) em úlceras venosas, no entanto não há dados concisos sobre os modos de aplicação. O objetivo deste estudo foi avaliar a eficácia de duas técnicas de aplicação (borda e leito) do LIPUS, comparada à terapia convencional (creme sulfadiazina de prata 1%) na cicatrização de úlceras venosas crônicas. Para tanto, vinte e quatro pacientes com úlceras venosas foram avaliados no Ambulatório de Úlceras da Dermatologia (AUD) do Centro Saúde Escola (CSE) da Faculdade de Medicina de Ribeirão Preto (FMRP) da Universidade de São Paulo (USP) e alocados aleatoriamente nos: Grupo Borda (média da idade 63 anos; 37,5% mulheres; e 62,5% brancas) com 9 úlceras (13,49 \'+ OU -\' 14,41 \'CM POT.2\' inicial) tratadas com LIPUS (1,5 MHz, 30 mW/\'CM POT.2\') na borda; Grupo Leito (média da idade 73 anos; 100% mulheres; e 87,5% brancas) com 8 úlceras (15.61 \'+ OU -\' 13.36 \'CM POT.2\' inicial) tratadas com LIPUS no leito; e Grupo Sulfadiazina (média da idade 76 anos; 20% mulheres; e 40% brancas) com 7 úlceras (24,06 \'+ OU -\' 30,10 \'CM POT.2\' inicial) tratadas diariamente com creme sulfadiazina de prata 1%. Durante o tratamento, as úlceras foram fotografadas quinzenalmente e analisadas pelo software ImageJ a fim de se obter a área ulcerada e posterior Índice de Cicatrização da Úlcera (ICU) e Relação Esfácelo/Granulação (REG). No Grupo Leito foi realizada uma análise histopatológica (contagem de fibroblastos, células inflamatórias, vasos sanguíneos e colágeno) a partir de biópsias coletadas no 1º e no 45º dia de tratamento. Os dados foram analisados pelo teste de efeitos mistos e por Poisson a fim de comparar os grupos, com um nível de significância de 95% (p < 0,05). Assim, considerando as discretas diferenças encontradas no ICU e na REG dos dois grupos irradiados somadas às alterações histopatológicas do GL, torna-se evidente a ação positiva do LIPUS no tratamento das úlceras venosas crônicas superior à terapia com sulfadiazina de prata 1%, independente do local de aplicação. / Venous ulcers represent a major health problem in the world and high costs associated with long-term treatment. Ultrasonic therapy has been applied for decades to enhance the process of chronics wound healing. Many authors have assessed the effects of LIPUS on venous ulcers, but there were no data about the different application techniques. This study aimed to assess the effectiveness of two application techniques (edge and bed) of LIPUS, comparing with the conventional therapy (1% silver sulfadiazine cream) on the chronic venous ulcers healing. Therefore, twenty four patients with venous ulcers were evaluated at the Ulcers Outpatient of Dermatology at the Teaching Health Center, Faculty of Medicine of Ribeirão Preto - University of São Paulo (FMRP-USP) and randomly allocated, as follows: Edge Group (mean age 62.9 years, 37.5% women, 62.5% white) with nine ulcers (13,49 \'+ OR -\' 14,41 \'CM POT.2\') treated with LIPUS (1.5 MHz, 30 mW/\'CM POT.2\') at the edge, Bed Group (mean age 72.6 years, 100% women, 87.5% white) with eight ulcers (15.61 \'+ OR -\' 13.36 \'CM POT.2\') treated with the same LIPUS at the bed and Sulfadiazine Group (mean age 75.7 years, 20% women, 40% white) with seven ulcers (24,06 \'+ OR -\' 30,10 \'CM POT.2\') treated daily with 1% silver sulfadiazine cream. During treatment, they were photographed every fifteen days and analyzed with the software ImageJ to obtain the ulcerated area, Wound Healing Index (WHI) and Sphacel and Granulation Ratio (SGR) from all ulcers. At the Bed Group, it was performed a histopathological analysis (fibroblasts, inflammatory cells, blood vessels, and collagen counting) from biopsies collected at the 1st and the 45th treatment day. Data were analyzed by the (mixed effects and Poisson tests) for comparison among groups, with the level of significance set at 95% (p < 0.05). Thus, considering the slight differences found in ICU and REG of irradiated groups and GL histopathological changes, it is evident better effects in chronic venous ulcers with LIPUS treatment than conventional therapy with silver sulfadiazine 1%, independently of application site.

Key words: adenocarcinoma of the esophagus and esophagogastric junction, neoadjuvant chemotherapy, PET/CT, histopathological response, technique of esophagogastric anastomosis, anastomotic leak, anastomotic stricture Previous studies have shown that preoperative chemotherapy of locally advanced AEG is beneficial only for patients with a good histopathological response, the so-called responders. The aim of the first part of the thesis was to prospectively verify whether positron emission tomography (PET/CT) could be used for early identification of histopathological non- responders, who could be spared ineffective neoadjuvant treatment. Our study did not prove that the early metabolic response, expressed as the percentage change of the consumption of glucosis on PET/CT performed before (PET1) and 12 to 22 days after the start of the first cycle of preoperative chemotherapy (PET2) correlated with the histopathological response in the resection specimen in the entire population of 90 patients. In a post hoc explorative analysis we found the correlation between metabolic and histopathological response in a subgroup of patients with PET2 performed ≤16 days after the start of the therapy, but this hypothesis needs to be prospectively validated. Our study suggests that PET/CT performed after the first...

A queilite actínica (QA) é uma lesão potencialmente maligna importante para identificar indícios precoces de transformação maligna para o carcinoma epidermoide de lábio (CEL), possibilitando a implementação de um tratamento eficiente e menos invasivo, que promova um melhor prognóstico para os pacientes. Pesquisas recentes indicam que os métodos histopatológicos geralmente são falhos em traçar o risco de malignização de casos de QA, pois além de não demonstrar as alterações genéticas presentes nos queratinócitos, não foram realizados estudos de acompanhamento clínico para avaliar se o grau de displaia epitelial da QA está relacionado ao risco de malignização para CE. Assim, a presente pesquisa teve como objetivo caracterizar, a partir dos casos atendidos no Serviço de Patologia Cirúrgica da FOUSP, qual a diferença de perfil clínico-patológico de pacientes de QA com evolução para CEL, pacientes de QA sem informações e sinais presentes de malignização e pacientes apenas diagnosticados com CEL, e também visou analisar a expressão de Ki67 e pRb nesses três grupos. Para isso, os dados dos pacientes como idade, sexo, cor da pele, aspecto clínico da lesão fundamental, coloração, tamanho e tempo de duração das lesões foram resgatados de 998 casos e distribuídos nessas três categorias. Os resultados da análise clínico-epidemiológica revelaram que o único aspecto clínico estatisticamente significante para diferenciar pacientes apenas diagnosticados com CEL dos demais grupos foi o tempo de duração das lesões. A análise do grau de displasia epitelial nos casos de QA na amostra presente revelou que todos os pacientes de QA posteriormente diagnosticados com CEL foram classificados como lesões de alto risco, e ainda exibiram em maior frequência as atipias: aumento do número de figuras de mitose, variação anormal do tamanho do núcleo, variação anormal do tamanho da célula e alteração da relação núcleo/citoplasma, figuras de mitose anormais e aumento do número e tamanho de nucléolos. Tanto a expressão da proteína Ki-67 como da proteína pRb não demonstraram significância estatística na comparação entre os grupos do estudo. Assim, a avaliação de uma ampla série de casos revelou diferença significante no tempo de duração do CEL com relação à QA. Além disso, algumas alterações morfológicas foram observadas com maior frequência em casos de QA com evolução para CEL. No entanto, outros marcadores biológicos devem ser testados em conjunto, para tentar diagnosticar alterações precoces que levem ao desenvolvimento de CEL. / Actinic cheilitis (AC) is a potentially malignant lesion important to identify early signs of malignant transformation into lip squamous cell carcinoma (LSCC), enabling the implementation of an efficient and less invasive treatment to patients. Recent researches pointed that histopatological methods often fail to trace malignization risk in AC cases, because they are unable to identify genetic damage in keratinocytes and do not exist a clinical follow-up studie to assess if the grading of epithelial dysplasia in AC is related with the malignancy risk to LSCC development. Thus, this research aims to characterize, from cases of Surgical Pathology Service of Universidade de São Paulo, the differences in clinical and pathological profile among AC patients which had evolution to LSCC, AC patients without signs and information about malignization and patients diagnosed only with LSCC. This study also analyzed the expression of Ki-67 and pRb proteins in these three groups. To conduct this study, data as age, gender, race, fundamental lesion aspect, color, size and duration time of the lesion were collected from 998 patients. The clinical-epidemiological analysis revealed that duration time of the lesion was the statistically significant clinical feature to differentiate patients diagnosed only with LSCC from other groups. The grading of epithelial dysplasia analysis showed that all AC patients with a posterior diagnosis of LSCC were classified as high risk lesions and these cases also exhibited most frequently atypia figures as: increased number of mitotic features, abnormal variation in nuclear size, abnormal variation in cellular size, increased nuclear/cytoplasmic ratio, abnormal mitotic features and increased number and size of nucleoli. The immunohistochemical expression of both Ki-67 and pRb protein demonstrated lack of significant statistical difference among the groups. We concluded that the evaluation of a large serie of cases revealed differences in duration time of lesion in patiens only diagnoses with LSCC and some morphological criteria were most frequent in AC cases with a posterior diagnosis of LSCC. However, other biological markers must be tested together, to try to identify early steps of LSCC development.