Submitted by Caroline Xavier (caroline.xavier@pucrs.br) on 2017-03-23T17:01:21Z No. of bitstreams: 1 TES_ALAN_ARRIEIRA_AZAMBUJA_PARCIAL.pdf: 523244 bytes, checksum: 4c0badea8cde88821a6bea4a43da846d (MD5) / Made available in DSpace on 2017-03-23T17:01:21Z (GMT). No. of bitstreams: 1 TES_ALAN_ARRIEIRA_AZAMBUJA_PARCIAL.pdf: 523244 bytes, checksum: 4c0badea8cde88821a6bea4a43da846d (MD5) Previous issue date: 2016-12-14 / Tumors of testicular germ cells (TGCT) are associated with a high cure rate, and are very sensitive to platinum based chemotherapy. Different mechanisms are related to resistance to chemotherapy and higher recurrence. We evaluate the risk of recurrence related to expression of nuclear factor kappa- B (NF-?B), excision repair cross-complementation group 1 (ERCC1) e transglutaminase 2 (TG2), in patients with TGCT treated with platinum combinations. Seventy-six patients were evaluated with TGCT treated with platinum-based chemotherapy 2001 to 2011 in the Department of Oncology of the HSL/PUCRS. Immunohistochemistry analysis was performed and expression correlated with clinical and laboratory data. Fifty patients were included in the group, mean age was 28.4 (18 to 45), 68% non-seminoma histology. All patients were treated with BEP or EP. Multivariate analysis identified that positive expressions of NF-?B and ERCC1 are independent risk factors for higher recurrence TGCT after chemotherapy (RR 3.16 and 2.96). There was no significance in TG2 cases. In conclusion, expression of ERCC1 and NF-?B give much worse prognosis for relapse to patients with TGCT treated with platinumbased chemotherapy. They may represent markers that predict poor clinical outcome and response to chemotherapy. / Tumores de c?lulas germinativas testiculares (TGCT) est?o associados com uma alta taxa de cura, e s?o muito sens?veis ?s platinas. Diferentes mecanismos s?o relacionados a resist?ncia ? cisplatina. Identificar pacientes platino resistentes poderia permitir uma melhor sele??o do tratamento, evitando toxicidade desnecess?ria. Neste estudo, revisamos na literatura poss?veis marcadores de resposta ?s platinas, bem como avaliamos o risco de recorr?ncia relacionado a express?o de nuclear factor kappa-B (NF-?B), excision repair cross-complementation group 1 (ERCC1) e transglutaminase 2 (TG2), em pacientes com TGCT, tratados com combina??es de platina. Foram analisados 76 pacientes com TGCT tratados com quimioterapia ? base de platina 2001 a 2011 no Departamento de Oncologia do HSL/PUCRS. A an?lise imunohistoqu?mica foi realizada e a express?o correlacionada com dados cl?nicos e laboratoriais. Cinquenta pacientes foram inclu?dos, idade m?dia do grupo foi de 28,4 anos (18 a 45), 68% histologia n?o-seminomatosa. Todos os pacientes foram tratados com bleomicina, etoposide e cisplatina (BEP) ou etoposide e cisplatina (EP). A an?lise multivariada identificou que as express?es positivas de NF-?B e ERCC1 s?o fatores de risco independentes para maior recorr?ncia de TGCT ap?s a quimioterapia (RR 3.16 e 2.96). Resultados com transglutaminase 2 n?o mostraram diferen?a significativa. A express?o de ERCC1 e NF-?B conferem progn?stico pior para recidiva em pacientes com TGCT tratados com quimioterapia baseada em platina. Estes marcadores podem representar fatores que predizem m? evolu??o cl?nica e resposta a quimioterapia.