Sur la seule base de critères cliniques et anatomopathologiques, l’évolution des tumeurs superficielles de la vessie (TSV) est imprévisible. Aucun marqueur ne permet, à ce jour, l’identification des tumeurs à fort potentiel de récidive et d’évolution vers des formes agressives. Dans une première partie, nous avons étudié, chez 127 patients, le polymorphisme des microsatellites dans les cellules urinaires pour la mise en évidence de pertes d'hétérozygotie (LOH, Loss Of Heterozygosity) et 2- en tant que marqueur de suivi. Les résultats ont été comparés à la cytologie urinaire : la sensibilité des LOH est nettement supérieure à celle de la cytologie dans les TSV. La présence de LOH au niveau de TP53 et des marqueurs du chromosome 9p est associée à un risque accru de récidive. Parmi les patients ayant récidivé, l’étude des LOH était positive dans 78% des prélèvements urinaires. Dans 20% des cas, les LOH se sont positivées avant la récidive visible à la cystoscopie. Dans une deuxième partie, nous avons développé une technique urinaire quantitative rapide pour l’étude des profils de méthylation de promoteur de 5 gènes suppresseurs de tumeur. Les résultats prometteurs (sensibilité=62%) de la qPCR-HRM sont corrélés à la technique de référence et pourraient être améliorés en élargissant le panel de gènes étudiés. L’analyse des altérations génétiques et épigénétiques améliore la compréhension des mécanismes de la carcinogenèse dans les carcinomes urothéliaux. Ces altérations pourraient être utilisées comme marqueurs diagnostiques et pronostiques. La biologie moléculaire pourrait trouver toute sa place dans la prise en charge de cette pathologie. / On the basis of clinical and pathological criteria, the evolution of superficial bladder tumours (SBT) is unpredictable. Currently, no marker exists permitting the identification of tumours with high potential for recurrence and progression to more aggressive forms. Firstly, we looked for loss of heterozygosity (LOH) at microsatellite polymorphisms in the bladder cells of 127 patients, with the aim of identifying a marker potentially useful in 1) diagnosis and prognosis and 2) the monitoring of patients following trans-urethral resection. Compared to urine cytology, the sensitivity of LOH detection was significantly higher for SBT. The presence of LOH at TP53 and markers of chromosome 9p was associated with an increased risk of recurrence. Among the patients who relapsed, results of LOH analysis were positive in 78% of urine samples, 20% of which were positive before the relapse was detected by cystoscopy. Secondly, we developed a technique for the rapid and quantitative urinary analysis of patterns of promoter methylation of 5 tumour suppressor genes. The promising results (sensitivity of 62%) of the qPCR-HRM correlate well with the gold standard and could be improved by expanding the panel of genes studied. Analysis of genetic and epigenetic alterations improves the understanding of mechanisms of carcinogenesis in urothelial carcinomas. These alterations could be used as diagnostic and prognostic markers. Molecular biology could therefore prove useful in the management of this pathology.

O câncer de mama é a neoplasia responsável pelo maior número de mortes em mulheres no Brasil, portanto, é importante encontrar novos marcadores específicos e de diagnóstico precoce, utilizando procedimentos simples e rápidos. A via de sinalização Wnt regula importantes funções celulares como proliferação, sobrevida e adesão. Esta via está associada com os processos de iniciação e progressão em muitos tipos tumorais, como câncer de cólon familiar, melanoma e pulmão; sendo que mutações em β-Catenina (CTNNb1) explicam só 30% dos casos de sinalização aberrante encontrada no câncer de mama, indicando que existem outros componentes e/ou reguladores da via que possam estar envolvidos. O objetivo deste trabalho foi avaliar as variantes genéticas e epigenéticas nos genes do complexo de degradação de β-Catenina num grupo de pacientes com câncer de mama e num grupo controle; e determinar os perfis de transcrição dos componentes da via de sinalização Wnt e da molécula de expressão exclusiva do epitélio mamário, a Mamaglobina Humana (MGA), assim como associar estes resultados com as características clínicas, histológicas e patológicas do tumor. Para atingir este objetivo foram coletadas amostras de sangue periférico de 102 mulheres com câncer de mama e 102 mulheres sadias como grupo controle. A avaliação das variantes rs465899 do gene APC, rs2240308 e rs151279728 do gene AXIN2, rs5030625 do gene CDH1 e rs334558 do gene GSK3, foi realizada por meio de PCR-RFLPs e sequenciamento, a análise dos perfis de metilação dos promotores pela MS-PCR. A RT-qPCR foi usada para determinar os níveis de expressão dos componentes da via e a MGA. As variantes rs2240308 e rs151279728 do gene AXIN2 mostraram uma forte associação com o risco de desenvolver o câncer de mama. Um aumento significativo foi observado no nível de expressão de AXIN2 no grupo de mulheres com câncer de mama. Análises adicionais mostraram perfis de expressão diferencial dos genes APC, AXIN2, CTNNB1, GSK3 e CSNK1A1 associado ao status dos receptores hormonais e histogênese tumoral. MGA foi identificado exclusivamente em 38% dos pacientes com câncer de mama e foi associada com a progressão da doença. Este é o primeiro estudo que relaciona uma variante do gene AXIN2 com o câncer de mama na população brasileira. As variantes avaliadas do gene AXIN2 são marcadores promissores de susceptibilidade ao câncer de mama na população estudada, sendo importante, a avaliação desta variante genética na população e determinar o seu real efeito no processo de iniciação e/ou progressão do câncer de mama. / Background: Wnt/β-catenin signaling pathway is an important regulator of cellular functions such as proliferation, survival and cell adhesion. This pathway is associated with tumor initiation and progression; -catenin (CTNNB1) mutations explains only 30% of aberrant signaling found in breast cancer, indicating that other components and/or regulating of the Wnt/β-catenin pathway may be involved. Objective: The objective of the study was to evaluate the APC rs465899, AXIN2 rs2240308 and rs151279728, CDH1 rs5030625 and GSK3 rs334558 polymorphisms, APC, AXIN2, CDH1 and GSK3 promoter methylation status and expression profile of -Catenin destruction complex genes and MGA in peripheral blood of breast cancer patients. Methods: We collected peripheral blood samples from 102 breast cancer and 102 healthy subjects. The identification of the mutation was performed using PCR-RFLPs and DNA sequencing. MSP and HRM-MS was used to measure promoter methylation and RT-qPCR to determine expression profile. Results: We found significant association of AXIN2 rs2240308 polymorphism with breast cancer. Increased risk was observed even after stratification based on clinicpathological characteristics. AXIN2 rs151279728 polymorphism was found only in 9 breast cancer patients, but none in control group subject. APC and CDH1 polymorphisms were not associated with breast cancer. GSK3 polymorphism was weak associated with breast cancer and heterozygous status was associated with breast cancer protection after group stratification. APC and CDH1 promoter methylation in breast cancer patients was found. Significant increase was observed in AXIN2, CTNNB1 and GSK3 level expression in breast cancer patients. APC was down-regulated in breast cancer patients. Further analyses, showed APC, AXIN2, CTNNB1, GSK3 and CSKN1A1 gene expression associated to receptor status and histological type. MGA was found only in breast cancer patients and was associated with cancer progression. Conclusion: The present study reports, for the first time, that AXIN2 genetic defect and -catenin destruction complex expression disturbance may be found in breast cancer patients, providing additional support to the role of Wnt/-catenin pathway dysfunction in breast cancer tumorigenesis. However, the functional consequence of this genetic alteration remains to be determined. In another hand MGA was determined like a good biomarker for diagnosis and prognosis outcome.

O câncer de mama é a neoplasia responsável pelo maior número de mortes em mulheres no Brasil, portanto, é importante encontrar novos marcadores específicos e de diagnóstico precoce, utilizando procedimentos simples e rápidos. A via de sinalização Wnt regula importantes funções celulares como proliferação, sobrevida e adesão. Esta via está associada com os processos de iniciação e progressão em muitos tipos tumorais, como câncer de cólon familiar, melanoma e pulmão; sendo que mutações em β-Catenina (CTNNb1) explicam só 30% dos casos de sinalização aberrante encontrada no câncer de mama, indicando que existem outros componentes e/ou reguladores da via que possam estar envolvidos. O objetivo deste trabalho foi avaliar as variantes genéticas e epigenéticas nos genes do complexo de degradação de β-Catenina num grupo de pacientes com câncer de mama e num grupo controle; e determinar os perfis de transcrição dos componentes da via de sinalização Wnt e da molécula de expressão exclusiva do epitélio mamário, a Mamaglobina Humana (MGA), assim como associar estes resultados com as características clínicas, histológicas e patológicas do tumor. Para atingir este objetivo foram coletadas amostras de sangue periférico de 102 mulheres com câncer de mama e 102 mulheres sadias como grupo controle. A avaliação das variantes rs465899 do gene APC, rs2240308 e rs151279728 do gene AXIN2, rs5030625 do gene CDH1 e rs334558 do gene GSK3, foi realizada por meio de PCR-RFLPs e sequenciamento, a análise dos perfis de metilação dos promotores pela MS-PCR. A RT-qPCR foi usada para determinar os níveis de expressão dos componentes da via e a MGA. As variantes rs2240308 e rs151279728 do gene AXIN2 mostraram uma forte associação com o risco de desenvolver o câncer de mama. Um aumento significativo foi observado no nível de expressão de AXIN2 no grupo de mulheres com câncer de mama. Análises adicionais mostraram perfis de expressão diferencial dos genes APC, AXIN2, CTNNB1, GSK3 e CSNK1A1 associado ao status dos receptores hormonais e histogênese tumoral. MGA foi identificado exclusivamente em 38% dos pacientes com câncer de mama e foi associada com a progressão da doença. Este é o primeiro estudo que relaciona uma variante do gene AXIN2 com o câncer de mama na população brasileira. As variantes avaliadas do gene AXIN2 são marcadores promissores de susceptibilidade ao câncer de mama na população estudada, sendo importante, a avaliação desta variante genética na população e determinar o seu real efeito no processo de iniciação e/ou progressão do câncer de mama. / Background: Wnt/β-catenin signaling pathway is an important regulator of cellular functions such as proliferation, survival and cell adhesion. This pathway is associated with tumor initiation and progression; -catenin (CTNNB1) mutations explains only 30% of aberrant signaling found in breast cancer, indicating that other components and/or regulating of the Wnt/β-catenin pathway may be involved. Objective: The objective of the study was to evaluate the APC rs465899, AXIN2 rs2240308 and rs151279728, CDH1 rs5030625 and GSK3 rs334558 polymorphisms, APC, AXIN2, CDH1 and GSK3 promoter methylation status and expression profile of -Catenin destruction complex genes and MGA in peripheral blood of breast cancer patients. Methods: We collected peripheral blood samples from 102 breast cancer and 102 healthy subjects. The identification of the mutation was performed using PCR-RFLPs and DNA sequencing. MSP and HRM-MS was used to measure promoter methylation and RT-qPCR to determine expression profile. Results: We found significant association of AXIN2 rs2240308 polymorphism with breast cancer. Increased risk was observed even after stratification based on clinicpathological characteristics. AXIN2 rs151279728 polymorphism was found only in 9 breast cancer patients, but none in control group subject. APC and CDH1 polymorphisms were not associated with breast cancer. GSK3 polymorphism was weak associated with breast cancer and heterozygous status was associated with breast cancer protection after group stratification. APC and CDH1 promoter methylation in breast cancer patients was found. Significant increase was observed in AXIN2, CTNNB1 and GSK3 level expression in breast cancer patients. APC was down-regulated in breast cancer patients. Further analyses, showed APC, AXIN2, CTNNB1, GSK3 and CSKN1A1 gene expression associated to receptor status and histological type. MGA was found only in breast cancer patients and was associated with cancer progression. Conclusion: The present study reports, for the first time, that AXIN2 genetic defect and -catenin destruction complex expression disturbance may be found in breast cancer patients, providing additional support to the role of Wnt/-catenin pathway dysfunction in breast cancer tumorigenesis. However, the functional consequence of this genetic alteration remains to be determined. In another hand MGA was determined like a good biomarker for diagnosis and prognosis outcome.

Im Rahmen der Untersuchung wurde bei 27 Patienten, die klinische Zeichen der Karies, aber keine pulpitischen Symptome zeigten, kariöses Dentin mit Hilfe eines sterilen Exkavators entnommen. Das durchschnittliche Alter der Patienten beträgt 41 Jahre und der Durchschnittswert des DMF-T-Index 12,5. Die Untersuchungsgruppe bestand zu 55,5 % aus männlichen Probanden sowie zu 44 % aus Rauchern. Nach Isolierung von 107 Reinkulturen aus den Patientenproben erfolgte die Identifizierung der oralen Streptokokken mittels eines mikrobiologischen Standardtests (RapidID-32Strep der Firma BioMérieux) und MALDI-TOF-MS-Analyse. Parallel wurden speziesspezifische PCRs der Dentinproben für S. sanguinis, S. constellatus, S. intermedius, S. anginosus, S. mutans, S. salivarius, S. oralis, S. mitis, S. gordonii und S. parasanguinis durchgeführt. Mittels MALDI-TOF-MS-Analyse konnten insgesamt sechs verschiedene Spezies oraler Streptokokken in den Dentinproben nachgewiesen werden. Am häufigsten kamen Vertreter der Mitis-Gruppe vor (in 89 % der Dentinproben), gefolgt von S. gordonii und S. sanguinis (zu 52 % und 26 % vertreten). Die MALDI-TOF-MS-Methode erwies sich als geeignetere der mit Kultivierung verbundenen Nachweismethoden. Ihre Ergebnisse wurden durch selektive PCRs einzelner Subkulturen und DNA-Sequenzierung bestätigt. Mittels der speziesspezifischen PCRs der Dentinspäne wurden zehn verschiedene Spezies oraler Streptokokken identifiziert. Vertreter der Mutans-Gruppe wurden so zu durchschnittlich 44 %, S. salivarius zu 37 % nachgewiesen. Es zeigte sich ein signifikantes Vorkommen von S. anginosus in Proben, die ebenfalls S. mutans enthielten (p= 0,00213). Alle drei Verfahren sind zur Untersuchung klinischer Proben geeignet, wobei die MALDI-TOF-MS-Analyse die genaueste Differenzierung auf Speziesebene ermöglicht. Die Non-Mutans-Streptokokken S. oralis, S. gordonii und S. anginosus scheinen die Mikroflora von kariösem Dentin zu dominieren. Sie übertrafen in der vorliegenden Arbeit in ihrem Vorkommen S. mutans in mehr als der Hälfte der untersuchten Proben. Diese Beobachtung stützt die erweiterte ökologische Plaquehypothese.