Diss. (sammanfattning) Stockholm : Karol. inst. / Härtill 5 uppsatser.

Orientadores: Luciana Rodrigues de Meirelles, Athanase Billis / Dissertação (mestrado) - Universidade Estadual de Campinas, Faculdade de Ciências Médicas / Made available in DSpace on 2018-08-17T03:17:56Z (GMT). No. of bitstreams: 1 Noronha_MarceloRamos_M.pdf: 4236927 bytes, checksum: 8e1d5407a5771801d828a3660c398949 (MD5) Previous issue date: 2010 / Resumo: O adenocarcinoma de próstata é a segunda neoplasia maligna que afeta homens, sendo precedida somente pelo cancer de pele. A prostatectomia radical continua sendo a mais aceita estratégia terapêutica para os casos confinado a próstata. Alguns achados clinicopatológicos em pacientes submetidos a prostatectomia radical são controvertidos como tendo valor preditivo de progressão bioquímica pós-cirurgia. O monitoramento da progressão da moléstia pós-prostatectomia radical é feito através de dosagem do PSA sérico cujo aumento pode significar recidiva local e/ou metástases. O valor de corte do PSA sérico indicando progressão é variável entre os autores. Há uma recomendação recente da Associação Americana de Urologia para que este valor seja ?0,2ng/mL com um segundo valor >0,2ng/mL. Não está estabelecido se pacientes mais jovens ou de raça negra mostram taxa de recidiva bioquímica maior. O PSA pré-operatório é um dado de grande importância preditiva, mas não está estabelecido a validade da estratificação dos valores em 3 categorias: 4-10ng/mL, 10-20ng/mL e >20ng/mL. Margens cirúrgicas comprometidas no espécime cirúrgico estão na categoria I (valor preditivo comprovado). É controvertido se a contagem final de Gleason 3+4=7 é semelhante ou não a 4+3=7 como fator preditivo de progressão bioquímica pós-prostatectomia radical. O estudo foi retrospectivo e os dados foram coletados dos prontuários médicos de 300 pacientes submetidos consecutivamente à prostatectomia radical no Hospital de Clínicas da Universidade Estadual de Campinas, no período de janeiro de 1997 a maio de 2007. O objetivo principal do trabalho foi avaliar a progressão bioquímica (PSA) pós prostatectomia radical de acordo com: raça, idade, margens cirúrgicas comprometidas, invasão microscópica do colo vesical, contagem final de Gleason, extensão do tumor, estádio patológico e PSA pré-operatório. Os dados obtidos foram analisados estatisticamente utilizando-se o teste de Mann-Whitney, o produto limite de Kaplan-Meier utilizando-se o teste do log-rank para comparação entre os grupos e o método de Cox para avaliar risco do tempo de progressão bioquímica (PSA) pós-prostatectomia radical. O nível de significância considerado para rejeição da hipótese nula foi p<0,05 bicaudal. Os resultados mais importantes neste trabalho foram: diferença estatisticamente significante quanto ao tempo de progressão bioquímica de pacientes com PSA pré-operatório ?10ng/mL, margens cirúrgicas comprometidas, invasão microscópica do colo vesical, Gleason 4+3=7, tumores mais extensos e tumores não confinados à próstata. Não houve associação da idade e raça com progressão bioquímica. Em análise univariada, os fatores preditivos significantes do tempo e risco de progressão pós-prostatectomia radical foram o PSA pré-operatório, as margens cirúrgicas positivas, a invasão das vesículas seminais, a invasão microscópica do colo vesical e o Gleason 4+3=7. Em análise multivariada, somente PSA pré-operatório, margens positivas e invasão das vesículas seminais mostraram-se fatores preditivos independentes do tempo e risco de progressão bioquímica pós-prostatectomia radical / Abstract: Adenocarcinoma of the prostate is the second malignancy that affects men, being preceded only by skin cancer. Radical prostatectomy remains the most widely accepted treatment strategy for cases confined to the prostate. Some clinical and pathological findings in patients undergoing radical prostatectomy are at issue as having predictive value of biochemical progression after surgery. The monitoring of disease progression after radical prostatectomy is done by measuring concentrations of PSA which can mean increased local recurrence and/or metastases. The cutoff of PSA indicating progression varies among authors. There is a recent recommendation of the American Urological Association that this value is ?0.2ng/mL with a second value >0.2ng/mL. It has not been established whether younger or black patients show higher rate of biochemical recurrence. The preoperative PSA is an important predictive factor for biochemical recurrence, but it has not been established the validity of the stratification of values in three categories: 4-10ng/mL, 10-20ng/mL, and >20ng/mL. Positive surgical margins in the surgical specimen are in category I (proven predictive value). It is controversial whether the final Gleason score 3+4=7 is similar or not to 4+3=7 as a predictor of biochemical progression after radical prostatectomy. The study was based on 300 whole-mount consecutive radical prostatectomies. The aim of this study was to analyse the risk and time for biochemical progression after surgery, according to race, age, positive surgical margins, bladder neck invasion, Gleason score, tumor extension, pathological stage and serum PSA preoperative levels. Time to biochemical progression-free outcome was compared using the Kaplan-Meier product-limit analysis using the log-rank to compare the groups. To assess individual variables for risk and time to biochemical progression, we created a univariate Cox proportional hazards model, and to assess the influence of several variables simultaneously, we developed a final multivariate Cox proportional hazards model of the statistically significant covariates. The most important results were: There was a significant association to time of progression of patients with preoperative PSA ?10ng/mL, positive surgical margins, microscopic invasion of the bladder neck, Gleason 4+3=7, more extensive tumors and non confined tumors. No association of race and age to biochemical progression following radical prostatectomy. On univariate analysis, the significant predictive variables for risk and time to biochemical progression were: preoperative PSA, positive surgical margins, seminal vesicle invasion, microscopic invasion of the bladder neck, and Gleason 4+3=7. On multivariate analysis, only positive surgical margins and seminal vesicle invasion were independent predictive variables / Mestrado / Anatomia Patologica / Mestre em Ciências Médicas

No description available.

No description available.

No description available.

No description available.

It has been suggested that membrane characteristics associated with carcinomas could be related to an altered molecular structure of lipids inplasma membrane. The microsomal and soluble fractions of the cell are major sites of de novo synthesis and elongation/desaturation of fatty acids. It was the purpose of this study to compare the fatty acid composition of microsomal and soluble fractions isolated from mammary adenocarcinomas with that of normal mammary tissue and to determine if deviations found in the plasma membrane isolated from tumors could be observed at these subcellular levels.Microsomal and soluble fractions were isolated by differential centrifugation from mammary adenocarcinomas and from normal mammary tissue of Strain A female mice. Activities of nicotinamide adenine dinucleotide, reduced (NADH) dependent cytochrome c reductase andnicotinamide adenine dinucleotide phosphate, reduced (NADPH) dependent cytochrome c reductase in these fractions were determined. The fatty acids were extracted, methylated, and methyl esters identified and quantified using gas liquid chromatography. Polar and non-polar GLC columns, silver nitrate thin layer chromatography, hydrogenation, and spiking was used to confirm the identity of some fatty acids.Fatty acid composition of the microsomal and soluble fractions was similar in tumor and normal tissue. There was a greater percentage of C24:1 in tumors. A reversal of the oleic to stearic acid ratio, an increase in the level of palmitic acid, and a tendency toward long chain polyenoic fatty acids, as reported in studies on the plasma membrane isolated from tumors, was not evident in either the microsomal or soluble fractions. There was evidence of greater utilization of NADPH in the reduction of cytochrome c reductase in tumors. This may result in a decreased availability of NADPH for fatty acid synthetase and lipogenesis.Results of this study do not demonstrate support for a shift in the biosynthetic pathway for the synthesis of fatty acids in carcinomas. It is possible that changes in the lipid composition in the plasma membrane of tumor cells occur after initial incorporation or a shift in biosynthesis could occur in the mitochondria, another site of de novo synthesis and elongation/desaturation of fatty acids.

Genomic sequencing of pancreatic ductal adenocarcinoma (PDAC) tumours has highlighted the existence of wide genetic diversity alongside frequent mutations in KRAS, TP53 and SMAD4. Within this heterogeneity many components of the epigenetic machinery are mutated, including the histone H3 lysine 4 methyltransferases KMT2C and KMT2D, which are frequently subject to mutation and can identify patients with a more favorable prognosis. In this thesis low expression of KMT2C and KMT2D were shown to also define better outcome groups, with median survivals of 15.9 vs 9.2 months (p = 0.029), and 19.9 vs 11.8 months (p = 0.001) respectively. Experiments across eight human pancreatic cell lines following their depletion suggest that this improved outcome may be due to attenuated cell proliferation, with decreased progression of cells from G0/G1 observed upon KMT2D loss. Whole transcriptome analysis of PDAC cell lines following KMT2C or KMT2D knockdown identified 31 and 124 differentially expressed genes respectively, with 19 common to both. Gene set enrichment analysis revealed a significant downregulation of genes relating to cell-cycle pathways, confirmed by interrogation of the International Cancer Genome Consortium and The Cancer Genome Atlas PDAC data series. Furthermore, these experiments highlighted a potential role for NCAPD3, a subunit of the condensin II complex, as a PDAC outcome predictor across four patient gene expression series. Alongside this, Kmt2d depletion in cells derived from murine models of pancreatic cancer led to an increase in their response to the antimetabolites 5-fluorouracil and gemcitabine. Taken together, the studies herein suggest that lower levels of this methyltransferase may mediate the sensitivity of PDAC patients to particular treatments. Altogether, these data suggest a potential therapeutic benefit in targeting these methyltransferases within PDAC, especially in those patients that demonstrate higher KTM2C/D expression.

Resumo não disponível

Thesis (Ph. D.)--University of Hong Kong, 2007. / Title proper from title frame. Also available in printed format.