Submitted by Luciana Ferreira (lucgeral@gmail.com) on 2016-09-15T13:30:32Z No. of bitstreams: 2 Dissertação - Larisse Silva Dalla Libera - 2016.pdf: 2593854 bytes, checksum: 6b47c9f7567c45f8cd463c53b5b7b129 (MD5) license_rdf: 0 bytes, checksum: d41d8cd98f00b204e9800998ecf8427e (MD5) / Approved for entry into archive by Luciana Ferreira (lucgeral@gmail.com) on 2016-09-15T13:31:04Z (GMT) No. of bitstreams: 2 Dissertação - Larisse Silva Dalla Libera - 2016.pdf: 2593854 bytes, checksum: 6b47c9f7567c45f8cd463c53b5b7b129 (MD5) license_rdf: 0 bytes, checksum: d41d8cd98f00b204e9800998ecf8427e (MD5) / Made available in DSpace on 2016-09-15T13:31:04Z (GMT). No. of bitstreams: 2 Dissertação - Larisse Silva Dalla Libera - 2016.pdf: 2593854 bytes, checksum: 6b47c9f7567c45f8cd463c53b5b7b129 (MD5) license_rdf: 0 bytes, checksum: d41d8cd98f00b204e9800998ecf8427e (MD5) Previous issue date: 2016-03-29 / Coordenação de Aperfeiçoamento de Pessoal de Nível Superior - CAPES / Anal cancer incidence is increasing significantly, especially when associated with the Human papillomavirus (HPV). The objective of this study was to evaluate the clinicopathological aspects of anal cancers and their association with HPV detection and genotypic distribution. It was a retrospective epidemiological study, with the use of the clinicopathological secondary data and molecular analyses of specimens of anal cancers embedded in paraffin blocks, diagnosed in a reference institution in the treatment of cancer at the Centro-Oeste region in a period of ten years (2000-2010). It was initially consulted a list of 140 cases of anal cancers but only 81 were included in the study. Molecular analysis included the amplification and detection of a viral genome fragment, by using PCR (polymerase chain reaction), and genotyping by reverse hybridization, using the commercial kit INNO LiPA. Data analysis was performed by descriptive statistics, univariate analysis and survival. According to the cases evaluated (n 81), 53.1% were more than 61 years of age, and the majority (63%) were females; 51.9% (n 42) presented squamous cells carcinoma (SCC). Lymph node metastases were described in 25.9%, distant metastases in 8.6% being the liver and the lung the most affected organs, the death was recorded in 45 cases (55.6%). HPV DNA was positive in 69% of cases. In the analysis by histologic type, 88.1% of squamous cell carcinomas (SCC), and 43.8% of adenocarcinomas was positive for viral DNA. The ECC was associated with HPV (p 0.0001) as well as females (p 0.01). Multiple infections were detected in 14.3% of the cases. The most prevalent genotypes were HPV16, HPV33 and HPV18. HPV 16 was found in 100% of multiple infections. After five years, overall survival was 44.3% for the group, the prognostic factors worse were female sex (p 0.008), squamous cell carcinoma (p 0.01) and the presence of distant metastasis (p 0. 01). Survival was not influenced by the presence of HPV (p 0.54). The aggressiveness of anal cancer described in this study reinforces the need of prevention strategies for this type of disease, including the HPV vaccine. / A incidência do câncer anal vem aumentando significativamente, principalmente quando associado ao Papilomavírus humano (HPV). O objetivo deste estudo foi avaliar os aspectos clínicopatológicos dos cânceres anais e suas associações com a detecção e distribuição genotípica do HPV. Trata-se de um estudo epidemiológico transversal retrospectivo, com a utilização dos dados clínicopatológicos secundários e análises moleculares de espécimes de cânceres anais contidos em blocos de parafina, diagnosticados em uma instituição de referência no tratamento de câncer na região Centro-Oeste em um período de dez anos (2000-2010). Inicialmente foi consultada uma lista com 140 casos de cânceres anais mas apenas 81 cumpriram os critérios de inclusão e exclusão e foram incluídos no estudo. A análise molecular incluiu a amplificação de um fragmento do genoma viral por PCR (reação em cadeia da polimerase) e hibridização reversa, com o uso do kit comercial INNO LiPA. A análise dos dados foi feita por estatística descritiva, análise univariada e de sobrevida. Do número de casos avaliados (n 81), 53,1% tinham mais que 61 anos de idade e a maior parte (63%) foram mulheres; 51,9%(n 42) apresentavam câncer anal de células escamosas (CCE). Metástases linfonodais foram descritas em 25,9%, metástases a distância em 8,6% sendo o fígado e o pulmão os órgãos mais acometidos e o óbito foi registrado em 45 casos (55,6%). A detecção de DNA do HPV foi positiva em 69% dos casos. Na ánalise por tipo histológico, 88,1% dos carcinomas de células escamosas (CCE) e 43,8% dos adenocarcinomas foram positivos para o DNA viral. O CCE foi associado ao HPV (p 0,0001) assim como o sexo feminino (p 0,01). Infecções múltiplas foram detectadas em 14,3% dos casos. Os genótipos mais prevalentes foram o HPV16, 33 e 18. O HPV 16 esteve presente em 100% das infecções múltiplas. A sobrevida global em 60 meses foi de 44,3%, os fatores de pior prognósticos foram o sexo feminino (p 0,008), o carcinoma de células escamosas (p 0,01) e a presença de metástase à distância (p 0,01). A sobrevida não foi influenciada pela presença do HPV (p 0,54). A agressividade dos cânceres anais descritos neste trabalho reforça a necessidade de estratégias de prevenção para esses cânceres, incluindo a vacina contra HPV.

by Chan Pui Chung, Denise. / Thesis (M.Phil.)--Chinese University of Hong Kong, 2000. / Includes bibliographical references (leaves 119-135). / Abstracts in English and Chinese. / ACKNOWLEDGEMENTS --- p.i / ABSTRACT --- p.iii / ABSTRACT (CHINESE VERSION) --- p.v / TABLE OF CONTENTS --- p.vi / LIST OF TABLES --- p.x / LIST OF FIGURES --- p.xii / LIST OF ABBREVIATIONS --- p.xiv / Chapter CHAPTER 1 --- INTRODUCTION --- p.1 / Chapter 1.1 --- Biology of Human Papillomaviruses --- p.2 / Chapter 1.1.1 --- Taxonomy --- p.2 / Chapter 1.1.2 --- Genomic organisation --- p.2 / Chapter 1.1.3 --- "Types, subtypes and variants" --- p.4 / Chapter 1.2 --- Epidemiology of cervical cancers --- p.6 / Chapter 1.2.1 --- Incidence --- p.8 / Chapter 1.2.2 --- Cervical cancers screening programme --- p.10 / Chapter 1.3 --- Association between human papillomavirus and cervical cancers --- p.11 / Chapter 1.3.1 --- Infection --- p.11 / Chapter 1.3.2 --- Multistep pathogenesis of cervical cancers --- p.13 / Chapter 1.3.3 --- Geographical distribution --- p.14 / Chapter 1.3.4 --- Age distribution of HPV infection --- p.15 / Chapter 1.3.5 --- Oncogenic property of HPV --- p.15 / Chapter 1.3.6 --- Sequence variation --- p.20 / Chapter 1.4 --- Project design --- p.23 / Chapter CHAPTER 2 --- MATERIALS AND METHODS --- p.25 / Chapter 2.1 --- Evaluation of HPV DNA extraction methods for paraffin-embedded tissues --- p.26 / Chapter 2.1.1 --- Study population --- p.26 / Chapter 2.1.2 --- Paraffin-embedded tissue collection --- p.26 / Chapter 2.1.3 --- DNA extraction --- p.26 / Chapter 2.1.3.1 --- Phenol-chloroform extraction --- p.27 / Chapter 2.1.3.2 --- Microwave extraction --- p.28 / Chapter 2.1.3.3 --- QIAGEN spin column extraction --- p.28 / Chapter 2.1.4 --- PCR amplification --- p.29 / Chapter 2.1.4.1 --- PCR amplification for human beta-globin gene --- p.29 / Chapter 2.1.4.2 --- PCR amplification for HPV DNA --- p.30 / Chapter 2.1.5 --- Optimisation of PCRs --- p.30 / Chapter 2.1.5.1 --- Optimisation of beta-globin PCRs --- p.30 / Chapter 2.1.5.2 --- Optimisation of HPV PCRs --- p.31 / Chapter 2.1.5.3 --- Analytical sensitivity of PCRs --- p.31 / Chapter 2.1.5.3.1 --- Analytical sensitivity of beta-globin PCRs --- p.31 / Chapter 2.1.5.3.2 --- Analytical sensitivity of HPV PCRs --- p.32 / Chapter 2.1.5.4 --- Detection of PCR products --- p.32 / Chapter 2.1.6 --- PCR evaluation of DNA extraction methods --- p.33 / Chapter 2.1.6.1 --- Beta-globin PCRs --- p.33 / Chapter 2.1.6.2 --- HPV PCRs --- p.33 / Chapter 2.1.6.2.1 --- MY09/MY11 PCR --- p.33 / Chapter 2.1.6.2.2 --- GP5+/GP6+ PCR --- p.34 / Chapter 2.1.6.3 --- Detection of PCR products --- p.34 / Chapter 2.2 --- Prevalence and genotype distribution of HPV --- p.35 / Chapter 2.2.1 --- Study populations --- p.35 / Chapter 2.2.1.1 --- Women with normal cervices --- p.35 / Chapter 2.2.1.2 --- Women with abnormal cervical cytologies --- p.35 / Chapter 2.2.1.3 --- Women with cervical cancer --- p.35 / Chapter 2.2.2 --- Disease classification --- p.36 / Chapter 2.2.3 --- Specimen collection and preparation --- p.36 / Chapter 2.2.3.1 --- Cervical scrape collection --- p.36 / Chapter 2.2.3.1.1 --- DNA extraction --- p.37 / Chapter 2.2.4 --- HPV DNA detection --- p.37 / Chapter 2.2.4.1 --- MY09/MY11 PCR --- p.38 / Chapter 2.2.4.2 --- GP5+/GP6+ PCR --- p.38 / Chapter 2.2.4.3 --- Detection of PCR products --- p.38 / Chapter 2.2.5 --- HPV genotyping --- p.39 / Chapter 2.3 --- Sequence variation of HPV 16 E7 gene --- p.39 / Chapter 2.3.1 --- Study population --- p.39 / Chapter 2.3.2 --- Optimisation of HPV 16 E7 nested PCR --- p.40 / Chapter 2.3.3 --- HPV 16 E7 nested PCR --- p.41 / Chapter 2.3.3.1 --- Detection of PCR products --- p.42 / Chapter 2.3.4 --- Purification of nested PCR products --- p.42 / Chapter 2.3.5 --- Direct cycle sequencing --- p.42 / Chapter 2.3.5.1 --- Cycle sequencing reaction --- p.42 / Chapter 2.3.5.2 --- Purification of cycle sequencing products --- p.43 / Chapter 2.3.5.3 --- Electrophoresis on DNA sequencer --- p.43 / Chapter 2.3.6 --- Data analysis --- p.44 / Chapter 2.4 --- Statistical methods --- p.44 / Chapter CHAPTER 3 --- RESULTS --- p.45 / Chapter 3.1 --- Evaluation of HPV DNA extraction methods for paraffin-embedded tissues --- p.46 / Chapter 3.1.1 --- Optimised conditions for beta-globin PCRs --- p.46 / Chapter 3.1.2 --- Optimised conditions for HPV PCRs --- p.47 / Chapter 3.1.3 --- Analytical sensitivity of beta-globin and HPV PCRs --- p.48 / Chapter 3.1.4 --- PCR evaluation of DNA extraction methods --- p.48 / Chapter 3.1.4.1 --- PC03/PC07 PCRs --- p.48 / Chapter 3.1.4.2 --- Beta-GPl/Beta-GP2 PCRs --- p.49 / Chapter 3.1.4.3 --- HPV PCRs --- p.49 / Chapter 3.2 --- Prevalence and genotype distribution of HPV --- p.50 / Chapter 3.2.1 --- HPV detection --- p.50 / Chapter 3.2.2 --- HPV typing --- p.50 / Chapter 3.2.3 --- Women with normal cervices --- p.51 / Chapter 3.2.4 --- Women with abnormal cervical cytologies --- p.51 / Chapter 3.2.5 --- Women with cervical cancer --- p.53 / Chapter 3.3 --- Sequence variation of HPV 16 E7 gene --- p.54 / Chapter 3.3.1 --- Optimised conditions for HPV 16 E7 nested PCR --- p.54 / Chapter 3.3.2 --- HPV 16 E7 sequencing --- p.55 / Chapter 3.3.3 --- HPV 16 E7 variants --- p.55 / Chapter 3.3.4 --- Distribution of HPV 16 E7 variants --- p.56 / Chapter CHAPTER 4 --- DISCUSSION --- p.58 / Chapter 4.1 --- Evaluation of HPV DNA extraction methods for paraffin-embedded tissues --- p.59 / Chapter 4.1.1 --- PCR evaluation of DNA extraction methods --- p.59 / Chapter 4.2 --- Prevalence and genotype distribution of HPV --- p.61 / Chapter 4.2.1 --- Women with normal cervices --- p.61 / Chapter 4.2.2 --- Women with abnormal cervical cytologies --- p.62 / Chapter 4.2.3 --- Women with cervical cancer --- p.64 / Chapter 4.3 --- Sequence variation of HPV 16 E7 gene --- p.64 / Chapter CHAPTER 5 --- CONCLUSION --- p.69 / REFERENCES --- p.119

Submitted by Isac Macêdo (isac@ioc.fiocruz.br) on 2013-09-22T19:29:05Z No. of bitstreams: 1 MP 2008 - Lucia Maria Pereira de Oliveira.pdf: 3934700 bytes, checksum: a9cb1d03ea59b424193a37a792775cba (MD5) / Made available in DSpace on 2013-09-22T19:29:05Z (GMT). No. of bitstreams: 1 MP 2008 - Lucia Maria Pereira de Oliveira.pdf: 3934700 bytes, checksum: a9cb1d03ea59b424193a37a792775cba (MD5) / Fundação Oswaldo Cruz. Instituto Oswaldo Cruz. Rio de Janeiro, RJ, Brasil. / A carência de cultura científica, e de espaços educacionais apropriados para incrementá-la, parecem contribuir à morbimortalidade do câncer uterino pelo vírus do papiloma humano (HPV) em mulheres de baixo grau de escolaridade. Com base na abordagem da pesquisa qualitativa de cunho etnográfico, nosso trabalho procurou demonstrar que, devido à interação das mulheres entre si e delas com a equipe de saúde, as clientes parecem conviver melhor com seus conflitos biopsicossociais. Observamos que a efetividade dos tratamentos está também relacionada à escuta interessada das clientes com papilomavirose, estando sujeitas a agravos em conseqüência de práticas curativas e automatizadas, cotidianamente exercidas por profissionais do sistema público de saúde. Assim sendo, realizamos com base em Freire, o desenvolvimento de um processo socioeducativo que suscitou, como produto, a criação de uma sala de espera interativa no Setor de Ginecologia de um hospital universitário. O principal objetivo foi converter um espaço de espera em uma sala com a preocupação não só de acolhimento, com também de um constante processo de construção compartilhada de saberes. Ao mesmo tempo, práticas ligadas à promoção da saúde e à prevenção do câncer são desenvolvidas, conforme reivindica a atual Política Nacional de Humanização da Saúde. / The lack of scientific culture, and educational activities appropriate to increase it, seem to contribute to morbidity and mortality of cervical cancer by human papillomavirus (HPV) in women of low educational level. Based on the approach of qualitative ethnographic research, our study sought to demonstrate that, due to the interaction of women among themselves and with their health care team, clients seem to live better with their conflicts biopsicossociais. We found that the effectiveness of treatment is also related to hearing from interested customers with papilomavirose, and subject to damages as a result of healing practices, automated daily performed by professional public health system. Therefore, we based on Freire, the development of a process which led childcare as a product, creating a waiting room in the interactive industry of Gynecology of a university hospital. The main objective was to convert a room waiting in a room with a concern not only the host, with also a constant process of shared construction of knowledge. At the same time, practices related to health promotion and cancer prevention are developed, as claims the current National Policy of Humanization of Health.