Made available in DSpace on 2014-12-17T14:13:50Z (GMT). No. of bitstreams: 1 ElielS_DISSERT_partes_autorizadas.pdf: 70324 bytes, checksum: 39ba330935bd00fb14cab6f93f0af7ab (MD5) Previous issue date: 2010-10-17 / OBJECTIVE: Evaluating the kit-Bh performance in carrying out of breast biopsies. METHODS: They were randomly selected a sample of 30 patients with breast cancer undergoing mastectomy, based on the results of a pilot study from February 2008 to April 2010. They were excluded women with had not palpable, stone-hard consistency tumors, previous surgical manipulation or that contains liquid. Using the helicoid biopsy Kit (kit Bh) and an equipment Core biopsy with cannula and needle and 14 gauge respectively, it was collected a fragment of sound equipment in the area and in tumors in each specimen, totaling 120 fragments for histological study. For data analysis, it was defined a 95% confidence level and used the SPSS-13 version, the Kappa index and the parametric Student t test. RESULTS: Mean age of patients was 51.6 years (? 11.1 years). The infiltrating ductal carcinoma showed a higher incidence, 26 cases (86.7%). The Core biopsy had a sensitivity of 93.3%, specificity of 100% and accuracy 96.7%, while the helicoid biopsy had a sensitivity of 96.7%, specificity of 100% and accuracy 98.3%. By comparing the histology of tumors and the fragments of biopsies, there was high degree of agreement in diagnoses (kappa of 0.93 with p <0.05) CONCLUSION: Both devices provided the histological diagnosis of lesions with high accuracy. Results of this study showed that the helicoid biopsy is a reliable alternative in 22 the preoperative diagnosis of breast lesions. Further studies in vivo better will define the role of Kit Bh in the diagnosis of these lesions / OBJETIVO: avaliar o desempenho do Kit Bh na realiza??o de biopsias mam?rias. M?TODOS: de fevereiro de 2008 a abril de 2010, com base nos resultados de um estudo piloto, selecionou-se aleatoriamente uma amostra composta de 30 pacientes portadoras de c?ncer de mama submetidas a mastectomia. Exclu?ram-se as mulheres portadoras de tumor que tivesse consist?ncia p?trea, n?o palp?vel, com manipula??o cir?rgica pr?via ou que contivesse l?quido. Utilizando-se o Kit de biopsia helic?ide ( Kit Bh ) e um equipamentos de Core biopsy com c?nula e agulha de 14 gauge respectivamente, coletou-se um fragmento por equipamento em ?rea s? e nos tumores, em cada pe?a cir?rgica, totalizando 120 fragmentos para estudo histol?gico. Para a an?lise dos dados definiu-se um n?vel de confian?a de 95% e utilizou-se o software SPSS-vers?o 13, o ?ndice de concord?ncia Kappa e o teste param?trico t de Student. RESULTADOS: a m?dia das idades das pacientes foi de 51,6 anos (? 11,1 anos). O Carcinoma ductal infiltrante apresentou maior incid?ncia, 26 casos (86,7%). A Core biopsy apresentou sensibilidade de 93,3%, especificidade de 100% e acur?cia de 96,7%, enquanto a Biopsia helic?ide teve sensibilidade de 96,7%, especificidade de 100% e acur?cia de 98,3%. Na compara??o entre a histologia dos tumores e dos fragmentos de biopsias houve alto grau de concord?ncia nos diagn?sticos ( Kappa igual a 0,93 com p<0,05) CONCLUS?ES: ambos os equipamentos proporcionaram o diagn?stico histol?gico das les?es com alta acur?cia.Os resultados deste estudo demonstraram que a biopsia helic?ide ? uma alternativa confi?vel no diagnostico pr?-operat?rio de les?es mam?rias. Estudos mais aprofundados in vivo, definir?o melhor o papel do Kit Bh no diagn?stico dessas les?es

En oncologie ORL, l'imagerie multiparamétrique est utilisée par un nombre grandissant d'équipes. Parmi les bio-marqueurs, la captation normalisée du fluoro-désoxyglucose (SUV-FDG) en tomoscintigraphie par émission de positons (TEP) et la restriction de la diffusion en IRM (DWI-MRI) sont les plus utilisées.L'IRM couplée à la TEP (TEP/IRM) est une nouveauté qui permet une diminution très significative des doses d'irradiation délivrées par rapport à la TEP/TDM. Nous adressons notre première expérience concernant l'aspect en diffusion et en TEP/IRM dans la surveillance des patients après radio-chimiothérapie. A la question de l'interchangeabilité du FDG-PET et de la DWI-MRI, nous avons tenté d'identifier un lien en imagerie entre la cellularité tumorale et sa consommation glucidique. La cellularité tumorale est approchée en IRM par la mesure du coefficient apparent de diffusion (ADC) et son métabolisme glucidique est approché en TEP en utilisant le 18F-desoxyglucose (FDG) par la mesure de la valeur de fixation normalisée (SUV). Dans une série appariée de 33 patients, nous avons analysé la reproductibilité des mesures de l'ADC et de SUV. Puis nous avons évalué l'indépendance statistique de ces biomarqueurs. Nous avons ensuite voulu comparer les résultats de la TEP obtenus à partir de la TEP/TDM et de la TEP/IRM. Dans une série prospective appariée chez 32 patients explorés en FDG-TEP, nous avons évalué qualitativement les images obtenues par la fusion des images recalées en TEP/IRM et TEP/TDM. Nous avons ensuite comparé la pertinence clinique des deux techniques. Et enfin nous avons comparé les valeurs quantitatives de SUV obtenues du tissu sain et du tissu pathologique. / Multiparametric imaging interest and clinical use is rising for head and neck carcinoma (HNC). Among these modalities, FDG in PET and DWI-MRI are the most studied. PET/MRI is a new modality that allows in a single examination of combined various biologic biomarkers.After an optimization process of PET/MRI, we applied our first experience concerning the aspects of DWI-MRI and PET-MRI after radiation therapy. Thereafter we studied the correlation of SUV and ADC in HNC. In this study SUV and ADC values were independent parameters in HNSCC. Measurements of these two biomarkers were reproducible with almost perfect observer agreements for both methods. Neither SUV nor ADC values were able to predict the histologic grade, although a trend towards higher SUV and lower ADC values was observed in poorly differentiated tumours. Secondly, we we studied detection and quantification of focal uptake in head and neck tumours: 18F-FDG PET/MRI versus PET/CT in 32 consecutive HNSCC who underwent 18F-FDG PET/MRI and PET/CT. Attenuation correction sequence for PET/MRI and CT for PET/CT were used to caculate SUV. In results, PET/MRI coregistration and image fusion was feasible in all patients. There was no statistically significant difference between PET/MRI and PET/CT regarding rating scores for image quality, fusion quality, lesion conspicuity or anatomic location, number of detected lesions and number of patients with and without malignant lesions. A high correlation was observed for SUV measured on PET/MRI and PET/CT. SUV measured on PET/MRI were significantly lower than on PET/CT for malignant tumours, metastatic neck nodes, benign lesions, bone marrow, and liver (p <0.05).

Les carcinomes épidermoïdes de la tête et du cou sont souvent de mauvais pronostic, en raison de leur résistance aux traitements suivie de récidives loco-régionales, voire de métastases. Ce travail s'est focalisé sur le rôle des cellules souches cancéreuses (CSC) dans la radiorésistance d'un modèle cellulaire de cancer du larynx, SQ20B, ainsi que sur leur ciblage thérapeutique en association avec la radiothérapie photonique ou par ions carbone. Une sous-population a été isolée à partir de la lignée SQ20B par tris cellulaires successifs selon 3 critères spécifiques des CSC de tumeurs ORL : exclusion du Hoechst 33342, expression de CD44 et activité élevée de l'aldéhyde déshydrogénase (ALDH). Les cellules SQ20B/SP/CD44 high/ALDHhigh présentent bien les caractéristiques de CSC (tumorisphères, tumorigénèse, radiorésistance). La résistance des CSC aux 2 types d'irradiation, par rapport aux cellules « non souche » SQ20B/SP/CD44low/ALDHlow, implique une diminution de la mort par apoptose, une augmentation des capacités prolifératives ainsi qu'une surexpression de la voie de l'autorenouvellement Bmi1. L'effet radiosensibilisant de 3 molécules ciblant les CSC a été démontré : la mort apoptotique induite par l'UCN-01 en inhibant l'arrêt en phase G2/M ; les capacités prolifératives ciblées par l'acide trans-rétinoïque (ATRA) induisant la différenciation ; et la voie de l'autorenouvellement Bmi-1 inhibée par l'artésunate. Seule ou associées (UCN-01 + ATRA), elles agissent en synergie avec une irradiation par photons ou ions carbone. Des études pré-clinique, puis clinique, devraient confirmer l'intérêt du ciblage des CSC dans le contrôle de l'échappement de ces cancers radiorésistants / Head and neck squamous cell carcinomas (HNSCC) have a poor prognosis, due to their resistance to standard treatments. In most cases, locoregional recurrence or metastases occur. This study has focused on the role of cancer stem cells (CSC) in the radioresistance of the SQ20B HNSCC cell line and their therapeutic targeting in association with photon or carbon ions irradiation. A subpopulation of SQ20B-CSC has been isolated by cell sorting based on 3 specific characteristics of HNSCC-CSC : Hoechst 33342 exclusion, CD44 expression and high aldehyde dehydrogenase activity (ALDH). SQ20B/SP/CD44high/ALDHhigh cells show the CSC characteristics (in vitro and in vivo tumorigenesis, high radioresistance). The response of CSC to both types of irradiation was compared to the non-“stem cells” SQ20B/SP/CD44low sub-population. The observed radioresistance involves a decrease in apoptotic cell death, an increase in proliferative capacities and an overexpression of the Bmi1 self-renewing signaling pathway. The radiosensitizing effects of 3 molecules targeting the CSC has been demonstrated : an induction of apoptotic cell death by the inhibition of the G2/M phase arrest after a treatment with UCN01 ; an inhibition of proliferative capacities using the all-trans-retinoic acid (ATRA) which induce their differentiation ; and an inhibition of Bmi1 by artesunate. These treatments, alone or in combination (UCN01+ATRA) have a synergistic effect with photon or carbon ion irradiation to overcome CSC radioresistance. Preclinical and clinical studies should confirm the benefit of targeting CSC and improve the control of tumor escape in patients with radioresistant HNSCC cancers

No description available.

Deregulation of gene expression caused by genetic or epigenetic changes plays an important role in pathogenesis of cancer. The thesis is a commented collection of ten publications dealing with the molecular biology of tumours. The author has significantly contributed to all of them. All the articles contained in the thesis are linked to the topic of assessment of molecules involved in gene expression regulation (microRNAs) or DNA alterations that affect gene expression (promoter methylation, presence of a fusion gene). MicroRNAs are short single-stranded RNA molecules involved in posttranscriptional regulation of gene expression by triggering mRNA degradation or inhibiting translation. It is a basic mechanism with an impact on all cellular processes including the pathogenesis of various diseases. MicroRNAs can either act as oncogenes by decreasing the expression of tumour-suppressor genes or as tumour-suppressor genes by decreasing the expression of oncogenes. However, the network of microRNA - RNA interactions is much more complex. Our published results that are part of this thesis are focused on colorectal carcinoma (CRC), prostate cancer, head and neck squamous cell carcinoma (HNSCC), gastric cancer and non-small cell lung cancer (NSCLC). In patients with CRC, we demonstrated the prognostic...

Deregulation of gene expression caused by genetic or epigenetic changes plays an important role in pathogenesis of cancer. The thesis is a commented collection of ten publications dealing with the molecular biology of tumours. The author has significantly contributed to all of them. All the articles contained in the thesis are linked to the topic of assessment of molecules involved in gene expression regulation (microRNAs) or DNA alterations that affect gene expression (promoter methylation, presence of a fusion gene). MicroRNAs are short single-stranded RNA molecules involved in posttranscriptional regulation of gene expression by triggering mRNA degradation or inhibiting translation. It is a basic mechanism with an impact on all cellular processes including the pathogenesis of various diseases. MicroRNAs can either act as oncogenes by decreasing the expression of tumour-suppressor genes or as tumour-suppressor genes by decreasing the expression of oncogenes. However, the network of microRNA - RNA interactions is much more complex. Our published results that are part of this thesis are focused on colorectal carcinoma (CRC), prostate cancer, head and neck squamous cell carcinoma (HNSCC), gastric cancer and non-small cell lung cancer (NSCLC). In patients with CRC, we demonstrated the prognostic...

<p dir="ltr">Pancreatic ductal adenocarcinoma (PDAC) remains one of the most deadliest cancer and despite advancements in cancer therapy, remain highly refractory to treatment, largely due to its desmoplastic tumor microenvironment (TME) characterized by complex interactions among cancer cells and stromal components. Particularly, the PDAC associated coagulation system due to leaky tumor vasculatures plays a pivotal role in reshaping the PDAC stroma and its pathogenesis. Understanding the intricate interplay between tumor cells, stromal cells, and the elevated coagulation pathway elements, including tissue factor, thrombin, and fibrin, is essential for developing effective therapeutic strategies. To address these challenges, this research proposes the engineering of a novel PDAC-associated coagulation system using a microfluidic technology, known as coagulation-on-tumor-microenvironment-on-chip (cT-MOC). The study aims to integrate key coagulation pathways in cT-MOC to investigate pivotal interactions in the PDAC stroma: <i>i)</i> thrombin-protease-activated receptors (PARs) mediated promotion of PDAC fibrosis via activation of cancer-fibroblast cross-talk; <i>ii)</i> in-depth analysis of transport and mechanical properties of collagen-fibrin microstructure; <i>iii)</i> inhibited drug delivery in reprogrammed PDAC stroma due to pronounced fibrin deposition on collagen. By leveraging innovative microfluidic technologies and comprehensive experimental approaches, the research endeavors to provide a novel platform that bridges traditional <i>in vitro</i> and <i>in vivo</i> models to overcome the challenges posed by the desmoplastic TME and enhance therapeutic strategies for treatment by targeting the coagulation at the PDAC TME.</p>

Animal testing is still the common method to test the efficacy of new drugs, but tissue engineered in vitro models are becoming more acceptable for replacing and reducing animal testing in anti-cancer drug screening by developing in vitro three-dimensional (3D) tumour models for anti-cancer drug testing. In this study, three-dimensional (3D) culture methods were developed to mimic the tumour microenvironment. 3D culturing is to seed, maintain and expand cultured cells in three-dimensional space, in contrast to the traditional two-dimensional (2D) method in which the cells attach to the bottom of culture containers as monolayers. To mimic the intercellular interplay for tumour study, cell co-culture was applied. In this thesis, perfusion culture showed a better homeostasis for 3D tumour model growth over 17 days, with a more controllable working platform and a more reliable response-dose correlation for data interpretation. In the Matrigel sandwich system, the co-culture of breast cancer cells and endothelial cells demonstrated the morphology featuring a vascular network and tumour structures, with the thickness of the three-dimensional structure around 100µm and tubule length 200-400 µm, and maintained for 10 days. The comparisons studies between Matrigel sandwich and other methods suggest that though not fully characterised, Matrigel is still a valuable scaffold choice for developing co-culture 3D tumour model. Finally, the combination of perfusion and co-culture showed the potential of applying this model in angiogenesis assay, with a drug response profile combining cell viability and morphology to mimic in vivo tumour physiology.

Norrin is a secreted cystine-knot growth factor that plays critical roles in vascular development in the brain, retina, and cochlea, as well as the uterus. Although Norrin is unrelated to the lipid-modified morphogens Wnts, Norrin activates the canonical Wnt/&beta;-catenin pathway by binding to receptor Frizzled4 cysteine-rich domain (Fz4-CRD) and co-receptors of low density lipoprotein receptor related protein 5/6 ectodomain (Lrp5/6-ECD) in conjunction with Tetraspanin-12 (Tspan-12). Like Wnts, Norrin has limited extracellular diffusion properties as a result of associating with heparan sulfate proteoglycans (HSPGs). Mutations lead to inherited disordered retinal vascularization diseases such as Norrie disease, familial exudative vitreoretinopathy and coats' disease. However, the molecular mechanism of how Norrin initiates signalling by engagement with Fz4, Lrp5/6, and HSPGs has remained unresolved. Here, novel strategies for protein production of recombinant human Norrin and Fz4-CRD as well as the complex are developed. The crystal structures of Norrin and its complex with Fz4-CRD, plus complex bound with the heparin mimic sucrose octasulphate, and unliganded structures of Fz4-CRD are presented. These structural data together with biophysical and cellular assays not only reveal the Fz4 and Lrp5/6 binding sites on distinct patches of the Norrin surface, but also indicate the HSPGs binding site on Norrin and Fz4-CRD as well as providing a framework to explain numerous disease-related mutations. Structural comparison with Xenopus Wnt8 in complex with mouse Fz8-CRD provides molecular insights for our understanding of ligand-receptor binding specificity and promiscuity, which has important implications for developing therapeutic strategies against Norrin dependent retinal disorders, and cancers caused by abnormal Wnt signaling.

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