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Microdissection of well defined cell populations for RNA isolation in the analysis of normal human skin and basal cell carcinomaEdlund, Karolina January 2005 (has links)
The human skin provides us with an excellent protective barrier and possesses a remarkable ability of constant renewal. Basal cell carcinoma is the most common type of skin cancer. The aim of this project was to verify results from an earlier study investigating the molecular differences between basal cell carcinoma (BCC) and basal cells of normal human epidermis. In that study microdissection of cell populations from BCC and basal cells of normal epidermis respectively was performed in five cases of confirmed BCC. Following RNA extraction and amplification, a gene expression analysis was performed using a 46 k human cDNA microarray. Comparison of expression profiles showed a differential expression of approximately 300 genes in BCC. An upregulation of signaling pathways previously known to be of importance in BCC development could be observed, as well as a downregulation of differentiation markers, MHC class II molecules, and proteins active in scavenging of oxygen radicals. We wanted to confirm these findings for a number of selected genes, using real time PCR. The focal point of this project was microdissection of cells from BCC and subsequent isolation of RNA. Microdissection based methods offer a possibility of selecting well defined cell populations for further analysis by using a focused laser beam. Initially tests in order to optimize the method were also performed, concerning the dehydration process and choice of slides used in microdissection. Isolation of RNA may, as we experienced, be associated with problems due to destruction of RNA by degrading enzymes.
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Effects of sonic hedgehog inhibition on behavior and metabolism of basal cell carcinoma cells and fibroblastsKasraie, Sima 23 February 2021 (has links)
Cancers of the human skin are divided into melanoma and non-melanoma. Being among the most commonly diagnosed cancer cases globally, non-melanoma skin cancers are comprised of basal and squamous cell carcinomas. In dermato-pathology, basal cell carcinomas (BCCs) are a frequently encountered diagnosis of skin cancer, and most cases are treated with surgical excisions. While sporadic BCC tumors appear primarily due to aging and ultra-violet exposure, the development of numerous BCCs from a young age is one of the main clinical signs in Gorlin syndrome patients. The critical driver of BCC tumor formation is the sonic hedgehog (SHH) pathway, a pivotal developmental signaling pathway that regulates organ development, cell proliferation, and tissue repair. The majority of all sporadic and syndromic BCCs exhibit mutations in two key components in this pathway, the tumor suppressor gene patched 1 (PTCH1) or the proto-oncogene smoothened (SMO), which result in aberrant pathway activation and continued transcription of SHH-dependent genes. In the last decade, SHH inhibitors have emerged as a novel treatment for advanced and metastatic BCCs. Systemic treatment with vismodegib, a potent SMO inhibitor, can effectively reduce BCC tumor burden in adult Gorlin syndrome patients. However, it is associated with chemotherapy-related adverse events, and treatment cessation results in cancer recurrence and formation of a subset of drug resistant BCCs. While aberrant SHH signaling is key, mechanisms that underlie epithelial–stromal crosstalk and reprograming of tumor metabolism can potentially converge with this pathway and promote BCC tumor development. In this study, we investigated the effects vismodegib on the morphology, behavior, and energy metabolism of human BCC cells and human dermal fibroblasts, in individual cultures as well as in co-cultures, that enabled the crosstalk between these two cell types. Computer-assisted bright-field microscopy was used to characterize cell morphology and behavior. Nuclear magnetic resonance (NMR) and metabolomics were used to determine the metabolic activity of these cells. We found that continuous crosstalk between the cells and different concentrations of vismodegib led to distinct changes in cell morphology and growth, as well as consumption of glucose, pyruvate, and glutamine and secretion of acetate, lactate, and glutamate by these cells. Deciphering tumor driver mechanisms that converge with SHH pathway and contribute to changes within the tumor microenvironment are important not only for better understanding of BCC pathobiology, but also for the development of new mechanism-based BCC therapies with improved clinical outcomes. / 2023-02-22T00:00:00Z
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Pparg Drives Luminal Differentiation and Luminal Tumor Formation in the UrotheliumTate, Tiffany January 2021 (has links)
The urothelium is a crucial stratified epithelial barrier that protects the urinary tract. It consists of basal cells in the lower layers and intermediate and superficial cells in the luminal layer. These urothelial cells can be identified by their distinct gene expression patterns. Superficial cells are terminally differentiated, binucleated, post-mitotic cells that are responsible for the barrier function of the urothelium via the production of uroplakin proteins. Intermediate cells act as the progenitor cells for superficial cells during development, homeostasis, and after acute injury. Basal cells consist of two populations, K14-basal cells and K5-basal cells. K14- basal cells have been shown to be progenitors that can repopulate the urothelium after chronic injury and are the cells of origin that produce bladder cancer. Bladder cancer can be classified as basal subtype or luminal subtype. The basal subtype is generally immune infiltrated, aggressive, and invasive with a poor prognosis. The luminal subtype is generally immune poor, less aggressive, and non-invasive with a better prognosis compared to basal tumors.
Pparg is a nuclear hormone receptor that has been described as a master regulator of adipogenesis and cellular differentiation that also carries out important anti-inflammatory functions (in part by antagonizing the NFKB pathway). Pparg is downregulated in basal subtype muscle invasive bladder cancer and amplified in luminal subtype bladder cancer. In vivo we find that Pparg is a master regulator of cell specification during urothelial development, homeostasis, regeneration, and cancer. When Pparg is ablated in the entire urothelium, Pparg KO mutants lack mature superficial cells and undergo squamous differentiation, with an expansion of the K14-basal cell population. These Pparg KO mutants also display persistent inflammation and squamous metaplasia after injury by urinary tract infection (UTI), due to unregulated NFKB signaling. However, the squamous differentiation in the Pparg KO mutants did not progress to bladder cancer.
Constitutive activation of Pparg in basal cells using a novel VP16;Pparg transgenic mouse line crossed to an Krt5CreERT2 driver induces basal cells to undergo a luminal differentiation program towards post-mitotic S-cells during homeostasis. Not surprisingly, these cells did not progress to form bladder cancer on their own. Interestingly, expression of VP16;Pparg in basal cells only drives tumor formation when the basal cells are in an “activated state,” induced by 1 month of BBN treatment. In a BBN mouse model which produces basal subtype bladder cancer in wild type animals, expression of the VP16;Pparg transgene in activated basal cells drives the formation of luminal tumors with papillary morphology, suggesting that this transcription factor is a master regulator of urothelial luminal differentiation, as has been suggested from previous in vitro studies. Like their human counterparts, these VP16;Pparg luminal tumors are immune cold. Additionally, these VP16;Pparg luminal tumors have different domains; a top domain that is “luminal,” and a bottom domain that is “basal”, suggesting the luminal tumors produced by activation of Pparg are not homogenous and undergo a phenotypic shift that mimics what has previously been reported in patient-derived organoids. Understanding the molecular mechanism that drives luminal bladder cancer provides critical information in bettering our approach in diagnosing and treating MIBCs.
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A comparative retrospective study of Mohs micrographic surgery and vismodegib chemotherapy for the treatment of advanced basal cell carcinomaBunnell, Charles F. 03 November 2023 (has links)
Basal cell carcinoma is the most common form of human malignancy, and as such there are varied methods for treating its various forms. Its more advanced and aggressive forms have required both the use of and advent of therapies which offer differing safety profiles, cost, and efficacy. Two therapies which differ substantially in these respects but have overlap in their recommended use are Mohs micrographic surgery and the pharmaceutical drug vismodegib. Few studies have sought to compare the two methods using these criteria, and as vismodegib has only received FDA approval in the past ten years, it is worthwhile to explore the limitations and advantages of each therapy. In exploring previous clinical trials and retrospective studies, the two therapies are put side by side to contrast their results with their shared intended use. The general findings were that Mohs micrographic surgery remains the gold standard for the treatment of locally advanced basal cell carcinoma, and there are few demonstrable instances in which vismodegib could be deemed a more appropriate therapy. The future of vismodegib appears to be in its use as a neoadjuvant therapy for locally advanced basal cell carcinomas for which a decrease in size by vismodegib would allow for better treatment outcomes.
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Genetic Epidemiology of Radiation Sensitivity and Basal Cell Carcinoma in Childhood Cancer SurvivorsHauser, Jennifer E., M.S. January 2015 (has links)
No description available.
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Análise da correlação entre tipos histológicos de carcinoma basocelular encontrados nas biópsias pré-operatórias e respectivas peças cirúrgicas / Correlation between histological types of basal cell carcinoma found in preoperative biopsies and respective surgical specimensMessina, Maria Cristina de Lorenzo 11 May 2005 (has links)
O carcinoma basocelular (CBC) é tumor constituído por diferentes tipos histológicos, que demonstram diverso potencial de agressividade. Sabe-se que a correlação entre os tipos histológicos de CBC encontrados no material de biópsia pré-operatória e no material da peça cirúrgica excisional não é total. Na literatura esta correlação varia de 42,7 a 80,0% quando analisados os tipos histológicos predominantes (THP). No presente estudo foi feita análise retrospectiva de 70 casos de CBC primário submetidos a biópsia préoperatória e cirurgia excisional. A amostra foi analisada estatisticamente quanto ao gênero e idade dos doentes e localização anatômica dos CBC, demonstrando ser comparável aos demais estudos da literatura. Também foram avaliados o tamanho médio tumoral e o tipo de reconstrução utilizado. A média do maior eixo dos CBC foi de 20 mm e 54% dos casos necessitaram reconstrução complexa, como retalhos e enxertos, mostrando ser amostra representativa de tumores de médio a grande porte. A avaliação histológica foi feita de modo padronizado, determinando tanto o THP quanto os tipos histológicos acessórios (THA) encontrados no material das biópsias pré-operatórias e nas peças cirúrgicas excisionais. Houve 78,3% de correlação entre THP da biópsia e peça cirúrgica, 87,0% de correlação entre THP e/ou THA da biópsia e THP da peça cirúrgica e 92,7% de correlação entre tipos agressivos ou não agressivos. Conclui-se que a biópsia préoperatória é útil para predizer o THP de CBC da peça cirúrgica excisional na maioria dos casos. No entanto, é importante ressaltar que, quando descrito apenas o THP encontrado na biópsia, ocorre 21,7% de falha no diagnóstico. Quando descritos THP e THA encontrados na biópsia a falha diagnóstica cai para 13%. Quando a intenção da biópsia for a determinação da presença de tipos de CBC agressivos ou não, a falha no diagnóstico é de apenas 7,3% / Basal cell carcinoma (BCC) is a tumor presenting many histological types, each one possessing a specific aggressivity potential. It\'s known that correlation between histological types found in preoperative biopsy specimens and excisional surgery specimens is not total. When correlation between predominant histological types (PHT) is analyzed, concordance value varies from 42,7 to 80,0% in the literature. In the present study 70 primary BCC submitted to preoperative biopsy and excisional surgery were retrospectively analyzed. The sample was statistically analyzed in terms of patients\' gender and age and anatomical location of the tumour and was found to be similar to other reports in the literature. Average size of tumors and type of surgical reconstruction employed were also evaluated. Average size of the largest tumour axis was 20 mm and 54% of the cases needed complex reconstructions, such as flaps and grafts, demonstrating that the sample was represented by medium to large sized tumors. Histological evaluation was made in a patterned way, determining PHT and accessory histological types (AHT) in both preoperative biopsies and excisional surgery specimens. Results obtained were: 78.3% correlation between biopsy PHT and excisional surgery PHT, 87.0% correlation between biopsy PHT and/or AHT and excisional surgery PHT and 92.7% correlation when BCC were classified as \"aggressive\" or \"non aggressive\" . Conclusion: preoperative biopsy is useful to predict BCC\'s PHT of excisional surgery specimen in most cases. However, it\'s important to note that when biopsy findings are limited to the description of the PHT , there is a 21.7% diagnostic failure. When both PHT and AHT found in biopsy are described, diagnostic failure falls to 13%. When the intention is determining the presence of aggressive or non aggressive types of BCC, diagnostic failure is only 7.3%
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Análise da correlação entre tipos histológicos de carcinoma basocelular encontrados nas biópsias pré-operatórias e respectivas peças cirúrgicas / Correlation between histological types of basal cell carcinoma found in preoperative biopsies and respective surgical specimensMaria Cristina de Lorenzo Messina 11 May 2005 (has links)
O carcinoma basocelular (CBC) é tumor constituído por diferentes tipos histológicos, que demonstram diverso potencial de agressividade. Sabe-se que a correlação entre os tipos histológicos de CBC encontrados no material de biópsia pré-operatória e no material da peça cirúrgica excisional não é total. Na literatura esta correlação varia de 42,7 a 80,0% quando analisados os tipos histológicos predominantes (THP). No presente estudo foi feita análise retrospectiva de 70 casos de CBC primário submetidos a biópsia préoperatória e cirurgia excisional. A amostra foi analisada estatisticamente quanto ao gênero e idade dos doentes e localização anatômica dos CBC, demonstrando ser comparável aos demais estudos da literatura. Também foram avaliados o tamanho médio tumoral e o tipo de reconstrução utilizado. A média do maior eixo dos CBC foi de 20 mm e 54% dos casos necessitaram reconstrução complexa, como retalhos e enxertos, mostrando ser amostra representativa de tumores de médio a grande porte. A avaliação histológica foi feita de modo padronizado, determinando tanto o THP quanto os tipos histológicos acessórios (THA) encontrados no material das biópsias pré-operatórias e nas peças cirúrgicas excisionais. Houve 78,3% de correlação entre THP da biópsia e peça cirúrgica, 87,0% de correlação entre THP e/ou THA da biópsia e THP da peça cirúrgica e 92,7% de correlação entre tipos agressivos ou não agressivos. Conclui-se que a biópsia préoperatória é útil para predizer o THP de CBC da peça cirúrgica excisional na maioria dos casos. No entanto, é importante ressaltar que, quando descrito apenas o THP encontrado na biópsia, ocorre 21,7% de falha no diagnóstico. Quando descritos THP e THA encontrados na biópsia a falha diagnóstica cai para 13%. Quando a intenção da biópsia for a determinação da presença de tipos de CBC agressivos ou não, a falha no diagnóstico é de apenas 7,3% / Basal cell carcinoma (BCC) is a tumor presenting many histological types, each one possessing a specific aggressivity potential. It\'s known that correlation between histological types found in preoperative biopsy specimens and excisional surgery specimens is not total. When correlation between predominant histological types (PHT) is analyzed, concordance value varies from 42,7 to 80,0% in the literature. In the present study 70 primary BCC submitted to preoperative biopsy and excisional surgery were retrospectively analyzed. The sample was statistically analyzed in terms of patients\' gender and age and anatomical location of the tumour and was found to be similar to other reports in the literature. Average size of tumors and type of surgical reconstruction employed were also evaluated. Average size of the largest tumour axis was 20 mm and 54% of the cases needed complex reconstructions, such as flaps and grafts, demonstrating that the sample was represented by medium to large sized tumors. Histological evaluation was made in a patterned way, determining PHT and accessory histological types (AHT) in both preoperative biopsies and excisional surgery specimens. Results obtained were: 78.3% correlation between biopsy PHT and excisional surgery PHT, 87.0% correlation between biopsy PHT and/or AHT and excisional surgery PHT and 92.7% correlation when BCC were classified as \"aggressive\" or \"non aggressive\" . Conclusion: preoperative biopsy is useful to predict BCC\'s PHT of excisional surgery specimen in most cases. However, it\'s important to note that when biopsy findings are limited to the description of the PHT , there is a 21.7% diagnostic failure. When both PHT and AHT found in biopsy are described, diagnostic failure falls to 13%. When the intention is determining the presence of aggressive or non aggressive types of BCC, diagnostic failure is only 7.3%
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Marcadores preditivos do comprometimento das margens cirúrgicas do carcinoma basocelular / Predictive markers of surgical margins commitment in basal cell carcinomaBueno Filho, Roberto 04 November 2015 (has links)
O carcinoma basocelular (CBC) é malignidade de incidência elevada e crescente na população caucasiana, e sua expressiva prevalência nos serviços de saúde remete à necessidade de avaliação dos índices de cura. O presente estudo analisou marcadores clínicos preditivos do comprometimento das margens cirúrgicas do CBC, em conjunto com um painel de marcadores imuno-histoquímicos (IHQ). Analisou-se 1294 laudos histopatológicos de CBC, emitidos durante 2011, e incluídos 674 casos de excisão cirúrgica completa realizada por diferentes especialidades em hospital terciário. Foram selecionados 40 casos dos diferentes subtipos histológicos para realização de IHQ para os marcadores Ber-EP4, MNF116, E-Caderina e VEGF, analisados por sistema digital de captação de imagens e programa de computador. Na amostra, houve predomínio de homens (60,4%) com idade média de 68 anos, da localização cefálica (71%) e do subtipo nodular (61%); da ulceração (p= 0,003) e do diâmetro médio superior dos CBC nos homens (307,41 mm2 x 190,74 mm2; p< 0,001); do subtipo superficial de localização no tronco (p< 0,001) e em mais jovens (<73 anos; p= 0,001); do subtipo nodular (p< 0,001) e ulcerado (p= 0,05) no segmento cefálico. A especialidade Dermatologia foi responsável pela maioria das cirurgias (78%), cuja dimensão média e índice de margens cirúrgicas livres dos CBC excisados foram respectivamente 274 mm2 e 95%, seguida por 279 mm2 e 89% na Cirurgia Plástica, 218 mm2 e 60% na Cirurgia de Cabeça e Pescoço (CCP), 87 mm2 e 49% na Oftalmologia. O risco para desfecho em margens cirúrgicas comprometidas foi determinado para: subtipo micronodular (OR 3,41; IC 95% 1,71 6,80; p= 0,001); localização cefálica (OR 8,33 IC 95% 1,05 50; p= 0,045); excisões realizadas pelas especialidades Oftalmologia (OR 10,12; IC 95% 4,40 23,27; p= 0,001) e CCP (OR 9,67; IC 95% 5,14 18,21; p= 0,001). A imunomarcação pelo Ber-EP4, MNF116 e ECaderina foi homogênea e de intensidade moderada a acentuada nas células neoplásicas em todos os subtipos; os valores de intensidade da marcação, percentual de área e escore para o MNF116 discriminaram os CBC agressivos (esclerodermiforme e micronodular) daqueles não agressivos (nodular e superficial); e foram superiores para ECaderina no subtipo superficial; o percentual de células marcadas pelo VEGF foi superior nos tumores agressivos (p< 0,001). O segmento cefálico e o subtipo micronodular, seguido do esclerodermiforme, implicam em riscos elevados para o comprometimento das margens e merecem atenção quanto ao manuseio cirúrgico. A imunomarcação por Ber-EP4, MNF116 e E-Caderina pode auxiliar na identificação de ninhos tumorais multifocais no subtipo superficial, ou em meio ao processo inflamatório nos subtipos agressivos. A marcação da E-Caderina pode representar o padrão menos agressivo e de crescimento radial do subtipo superficial; e a do VEGF, nos tumores mais agressivos, ser indicativa do papel desta proteína no comportamento mais invasivo. A especialidade Dermatologia tem expressiva participação institucional e níveis de resolubilidade superiores, representada pelas maiores frequências de excisão de CBC e de margens cirúrgicas livres. O reconhecimento de fatores preditivos para desfecho em margens cirúrgicas comprometidas é de fundamental relevância para o planejamento cirúrgico e obtenção das mais elevadas taxas de cura. / Basal cell carcinoma (BCC) is the most common human malignancy and it is increasing its incidence in the Caucasian population. The significant prevalence of cases in specialized health services indicates the need of assessment of cure rates. The present study analyzed clinical predictive markers of compromised surgical margins in BCC in association with a panel of Immunohistochemistry (IHC) markers. We analyzed 1294 BCC histopathological reports during 2011, and 674 cases of complete surgical excision performed by different specialties in a tertiary hospital were included. From the sample, 40 cases of different histological subtypes were selected to perform IHC markers Ber-EP4, MNF116, E-cadherin and VEGF, which were analyzed by digital image capture system and computer program. There was male predominance (60.4%) with mean age of 68 years, location at cephalic segment (71%) and nodular subtype (61%); ulceration (p= 0.003) and higher average size of CBC in men (307.41 mm2 x 190.74 mm2; p< 0.001); superficial subtype was more frequent on trunk (p< 0.001) and in younger than 73 years (p< 0.001); nodular subtype (p< 0.001) and ulceration (p= 0.05) at cephalic segment. The specialty Dermatology performed the majority of surgeries (78%), and the average size and the index of free surgical margins were 274 mm2 and 95% in Dermatology, 279 mm2 and 89% in Plastic Surgery, 218 mm2 and 60% in Head and Neck Surgery (HNS), 87 mm2 and 49% in Ophthalmology. The risk for compromised surgical margins was determined for: micronodular subtype (OR 3.41; 95% CI 1.71 6.80; p= 0.001); location at cephalic segment (OR 8.33; 95% CI 1.05 50; p= 0.045); excisions performed by Ophthalmology (OR 10.12; 95% CI 4.40 23.27; p= 0.001) and HNS (OR 9.67; 95% CI 5.14-18.21; p= 0.001). Immunostaining by Ber-EP4, MNF116 and E-cadherin was homogeneous and moderate to high intensity within the neoplastic cells in all BCC subtypes; values obtained from staining intensity, percentage of area and score for the MNF116 showed difference between aggressive BCC (morpheaform and micronodular) and non-aggressive (superficial nodular); and were higher for E-cadherin in superficial BCC; the percentage of marked cells by VEGF was higher in aggressive tumors (p< 0.001). The cephalic segment and micronodular subtype, followed by the morpheaform, imply high risks for compromised margins and deserve attention during the surgical treatment by trained experts. The immunohistochemistry markers Ber-EP4, MNF116 and E-cadherin may help the identification of multifocal tumor nests in superficial subtype or amid the inflammatory process in the aggressive subtypes. E-cadherin staining may represent the least aggressive and radial pattern of growth of superficial subtype. VEGF staining in peritumoral inflammatory cells of aggressive tumors may be indicative of the role of this protein in more invasive behavior of these subtypes of the BCC. Dermatology has significant institutional participation with highest resolution, represented by higher frequency of BCC excision and less compromised surgical margins. Knowing the predictive factors for compromised surgical margins is important for planning surgical treatment and obtaining the highest cure rates.
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Estudo do macrófago no carcinoma basocelular sólido recidivado após Cirurgia Micrográfica de Mohs / Study of macrophages in solid basal cell carcinoma recurrent after Mohs Micrographic SurgeryPadoveze, Emerson Henrique 28 January 2016 (has links)
INTRODUÇÃO: Os macrófagos associados aos tumores (MAT) sólidos estão relacionados à progressão ou à involução das neoplasias, dependendo da diferenciação em M1 ou M2. No carcinoma basocelular (CBC), as formas mais agressivas apresentam aumento de macrófagos às custas do fenótipo M2, se comparadas às formas não invasivas. O tratamento do CBC sólido pela Cirurgia Micrográfica de Mohs (CMM) proporciona elevados índices de cura, porém recidivas podem ocorrer. OBJETIVOS: Comparar a população total de macrófagos e as subpopulações M1 e M2 nos casos de CBC sólidos recidivados e não recidivados após exérese pela CMM. METODOLOGIA: Cortes histológicos obtidos a partir dos blocos de parafina de nove casos de CBC sólidos recidivados após CMM e de 18 casos de CBC sólido operados pela CMM não recidivados foram marcados imunoistoquimicamente para iNOS, CD204, CD163 e CD68. A expressão desses marcadores foi analisada pelo método de análise de imagens. RESULTADOS: Não foram encontradas diferenças significativas entre os grupos em relação à porcentagem média de células M1 (INOS), células M2 (CD163 e CD204) e total de células (CD68). CONCLUSÃO: A recidiva dos tumores estudados não ocorreu por influência do MAT, mas pode ser decorrente da falha técnica na realização da CMM ou de algum outro mecanismo imunológico desconhecido / INTRODUCTION: The macrophages associated with solid tumors (MAT) are related to the progression or regression of tumors, depending on the differentiation in M1 or M2. In basal cell carcinoma (BCC), the most aggressive forms show an increase in macrophages at the expense of M2 phenotype compared to non-invasive forms. The treatment of BCC solid by Mohs micrographic surgery (MMS) provides high cure rates, but relapses can occur. OBJECTIVES: To compare the total population of macrophages and subpopulations M1 and M2 in cases of recurrent BCC solid and not recurrent after excision by MMS. METHODS: Histological sections obtained from paraffin blocks of 9 cases of recurrent solid CBC after MMS and 18 cases of solid CBC operated by MMS not relapsed were labeled immunohistochemically for iNOS, CD204, CD163 and CD68. The expression of these markers was analyzed by image analysis. RESULTS: No significant differences were found between the groups in relation to the average percentage of M1 cells (INOS), M2 cells (CD163 and CD204) and total cells (CD68). CONCLUSION: The recurrence of the tumors studied did not occur under the influence of MAT, but may be due to technical failure in achieving MMS or some other unknown immune mechanism
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Aspectos epidemiológicos do carcinoma basocelular dos pacientes operados em hospital de referência de câncer no Estado da Paraíba entre os anos 2009 a 2011 / Epidemiological aspects of Basal Cell Carcinoma of the operated patients in Hospital of cancer in the State of Paraíba between 2009 to 2011Andrade, Zuleika Maria Vieira de 24 September 2013 (has links)
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Previous issue date: 2013-09-24 / Basal Cell Carcinoma (BCC) is the most common malignancy in humans corresponds to 75% of epithelial malignant tumors. Its incidence is increasing around the world, generating significant burden to the health care system and configuring it as a public health problem. It lies mainly on the face and fair-skinned individuals, involves those over 40 years of age, with a history of exposure to sunlight. We analyzed medical records of all patients diagnosed with BCC in the pathology laboratory of a cancer referral hospital in the state of Paraiba, during the period of 2009 to 2011, with the purpose of analyzing its distribution according to gender, age, location of the tumor, histological subtype, situation of surgical margins, size of the lesions and the origin of the patients. We carried out descriptive analysis of the main variables included in the study, qui-square test, and logistic regression models to identify possible risk factors. The cases were distributed geographically according to the municipality of residence. Along the study period, 3,088 patients were identified with BCC, 48.8% female and 51.52% male. Most of the tumors were located in the head/neck (85.1%), followed by the trunk (10.2%), upper (3.01%) and lower limbs (1.04%); 87.6% were located in the photoexposed areas and only 12.4% in not photoexposed areas. In relation to the location on the head, 33.6% were located in the nose, followed by malar region (23.7%). The nodular subtype was the most frequent (69%), followed by surface type (16%), sclerodermiform (6%), Pigmented (4%) and metatypic (2%). The age group most affected was between 70 to 80 years (26%). Most of the injuries were classified as small, with free surgical margins. A total of 56% of the patients was coming from Zona da Mata region. In bivariate logistic regression models, women had 2.4 times higher risk of developing BCC. The higher age group (OR=5.21) and the origin of Borborema mesoregion (OR=3.88) had significantly higher chance. In the multiple regression mode by including variables that showed statistical significance in bivariate model, showed that the variables Borborema mesoregion (OR=4.88), age ¿ 60 years (OR=5.16) and females (OR=1) remained significant. In this study, we found that the BCC was more frequent in males, above 60 years of age, located in the head, nodular histological type, small size, with free surgical margins and coming from Zona da Mata region. More studies are needed to assess risk factors such as skin color, the profession, sun-exposed activities and family history. / O Carcinoma Basocelular (CBC) é a neoplasia maligna mais comum em humanos, corresponde a 75% dos tumores epiteliais malignos, e sua incidência vem aumentando em todo o mundo, gerando significativo ônus ao sistema de saúde e configurando-o como problema de saúde pública. Localiza-se principalmente na face e acomete indivíduos de pele clara, acima de 40 anos, com história de exposição à luz solar. Foi feita uma análise dos prontuários de todos os pacientes com diagnóstico de CBC no Laboratório de Patologia de Hospital de Referência em Câncer na Paraíba, durante o período de 2009 a 2011, com o objetivo de analisar a sua distribuição segundo sexo, idade, localização do tumor, tipo histológico, situação das margens cirúrgicas, tamanho das lesões e a procedência dos pacientes. Realizou-se uma análise descritiva das principais variáveis incluídas no estudo, além de teste de associação e modelos de regressão logística, para identificar possíveis fatores de risco. Os casos foram distribuídos geograficamente, tendo como unidade o município de residência. Foram identificados 3088 pacientes com CBC, sendo 48,8% do sexo feminino e 51,52% do sexo masculino. A maioria dos tumores estava localizada na cabeça/pescoço (85,1%), seguidos pelo tronco (10,2%), membros superiores (3,01%) e membros inferiores (1,04%), 87,6% estavam localizados nas áreas fotoexpostas e apenas 12,4% nas áreas não fotoexpostas. Em relação à localização na cabeça, 33,6% estavam localizados na região nasal, seguida pela região malar (23,7%). O tipo nodular foi o mais frequente (69%), seguido pelo tipo superficial (16%), esclerodermiforme (6%), pigmentado (4%) e metatípico (2%). A faixa etária mais acometida foi entre 70 a 80 anos (26%). A maioria das lesões foi classificada como pequena, com margens cirúrgicas livres. Um total de 56% dos pacientes foi proveniente da Zona da Mata Paraibana. Nos modelos de regressão logística bivariada, o sexo feminino apresentou 2,4 vezes maior chance de desenvolver CBC. As faixas etárias mais altas (OR=5,21) e a procedência da mesorregião Borborema (OR=3,88) tiveram chance significante maior. No modelo de regressão múltipla, ao incluir as variáveis que mostraram significância estatística nos modelos bivariados, evidenciou-se que as variáveis mesorregião Borborema (OR=4,88), faixa etária ¿ 60 anos (OR=5,16) e sexo feminino (OR=1) mantiveram-se significantes. Neste estudo, concluímos que o CBC foi mais frequente no sexo masculino, acima de 60 anos de idade, localizados na cabeça, do tipo histológico nodular, de tamanho pequeno, com margens cirúrgicas livres e provenientes da Zona da Mata paraibana. São necessários mais estudos para avaliar fatores de risco como a cor da pele, a profissão, atividades expostas ao sol e história familiar.
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