As proteínas MDM2, P53, P21 e pAKT estão entre as muitas já identificadas que visam, por meio do equilíbrio direto e indireto entre si, manter o balanço entre morte e proliferação celular. Existe um leque aberto de hipóteses sobre a via de atuação dessas proteínas na tumorigênese de glândulas salivares, porém não há dados conclusivos. O objetivo deste estudo foi avaliar a expressão das proteínas MDM2, P53, P21 e pAkt em carcinoma adenóide cístico e adenocarcinoma não-específico de glândula salivar, através das técnicas de imunoistoquímica, em casos fixados em parafina; e imunofluorescência e western-blotting, em linhagens celulares provenientes dessas lesões. Os estudos imunoistoquímicos mostraram expressão de MDM2 e pAKT na maioria dos carcinomas adenóides císticos (CAC) avaliados e nos 3 casos de adenocarcinoma não-específicos (ANE). As linhagens Cac2 (proveniente de carcinoma adenóide cístico) e HSG (derivada de adenocarcinoma não-específico) também exibiram expressão das proteínas MDM2 e pAKT tanto no núcleo quanto no citoplasma celular. A proteína P53 mostrou expressão variável entre os diferentes CAC analisados e os 3 casos de ANE estudados mostraram marcação positiva para a proteína P53. Com relação às linhagens celulares, a Cac2 não expressou a proteína P53, enquanto a HSG apresentou expressão nuclear e citoplasmática dessa proteína. As glândulas salivares normais não exibiram marcação imunoistoquímica para as proteínas MDM2, P53, P21 e pAKT. Os resultados deste estudo sugerem que as proteínas pAKT e MDM2 estão envolvidas na tumorigênese e/ou progressão tumoral de carcinoma adenóide cístico e adenocarcinoma não especifico. / MDM2, P53, P21 and pAKT are proteins co-related to the balance between cell death and survival. There are many hypothesis on the role of these proteins in salivary gland tumorigenesis, however, no conclusive data have been published. Theaim of this study was to evaluate the expression of MDM2, P53, P21 and pAKT proteins on adenoid cystic carcinomas (ACC) and adenocarcinoma not otherwise specified (ANOS) through immunohistochemistry, immunofluorescence and westernblotting techniques. The immunostaining studies showed MDM2 and pAKT expression in most cases of adenoid cystic carcinoma and in all adenocarcinoma not-otherwise specified. The cell lines CAC2 (derived from adenoid cystic carcinoma) and HSG (derived from adenocarcinoma not otherwise specified) also showed nuclear and cytoplasmic expression of MDM2 and pAKT. The expression of P53 was variable in the different ACCs analyzed and was absent on CAC2 cells. However, P53 was strongly positive in all ANOS, and HSG cells also showed nuclear and cytoplasmic staining. No MDM2, P53, P21 and pAKT expression was found in normal salivary glands. Therefore, MDM2 and pAKT may participate in the tumorigenesis and/or progression of adenoid cystic carcinoma and adenocarcinoma not otherwise specified.

As proteínas MDM2, P53, P21 e pAKT estão entre as muitas já identificadas que visam, por meio do equilíbrio direto e indireto entre si, manter o balanço entre morte e proliferação celular. Existe um leque aberto de hipóteses sobre a via de atuação dessas proteínas na tumorigênese de glândulas salivares, porém não há dados conclusivos. O objetivo deste estudo foi avaliar a expressão das proteínas MDM2, P53, P21 e pAkt em carcinoma adenóide cístico e adenocarcinoma não-específico de glândula salivar, através das técnicas de imunoistoquímica, em casos fixados em parafina; e imunofluorescência e western-blotting, em linhagens celulares provenientes dessas lesões. Os estudos imunoistoquímicos mostraram expressão de MDM2 e pAKT na maioria dos carcinomas adenóides císticos (CAC) avaliados e nos 3 casos de adenocarcinoma não-específicos (ANE). As linhagens Cac2 (proveniente de carcinoma adenóide cístico) e HSG (derivada de adenocarcinoma não-específico) também exibiram expressão das proteínas MDM2 e pAKT tanto no núcleo quanto no citoplasma celular. A proteína P53 mostrou expressão variável entre os diferentes CAC analisados e os 3 casos de ANE estudados mostraram marcação positiva para a proteína P53. Com relação às linhagens celulares, a Cac2 não expressou a proteína P53, enquanto a HSG apresentou expressão nuclear e citoplasmática dessa proteína. As glândulas salivares normais não exibiram marcação imunoistoquímica para as proteínas MDM2, P53, P21 e pAKT. Os resultados deste estudo sugerem que as proteínas pAKT e MDM2 estão envolvidas na tumorigênese e/ou progressão tumoral de carcinoma adenóide cístico e adenocarcinoma não especifico. / MDM2, P53, P21 and pAKT are proteins co-related to the balance between cell death and survival. There are many hypothesis on the role of these proteins in salivary gland tumorigenesis, however, no conclusive data have been published. Theaim of this study was to evaluate the expression of MDM2, P53, P21 and pAKT proteins on adenoid cystic carcinomas (ACC) and adenocarcinoma not otherwise specified (ANOS) through immunohistochemistry, immunofluorescence and westernblotting techniques. The immunostaining studies showed MDM2 and pAKT expression in most cases of adenoid cystic carcinoma and in all adenocarcinoma not-otherwise specified. The cell lines CAC2 (derived from adenoid cystic carcinoma) and HSG (derived from adenocarcinoma not otherwise specified) also showed nuclear and cytoplasmic expression of MDM2 and pAKT. The expression of P53 was variable in the different ACCs analyzed and was absent on CAC2 cells. However, P53 was strongly positive in all ANOS, and HSG cells also showed nuclear and cytoplasmic staining. No MDM2, P53, P21 and pAKT expression was found in normal salivary glands. Therefore, MDM2 and pAKT may participate in the tumorigenesis and/or progression of adenoid cystic carcinoma and adenocarcinoma not otherwise specified.

A thesis on Head and neck cancer focusing on dose planning, salivary gland carcinoma and Single nucleotide polymorphism. For dose planning PET/CT (Positron emissions tomography/computed tomography) with tracer gave more precise information in comparison dose planning with CT. More primary tumours and metastases were found with the acetate tracer than with glucose tracer. Acetate PET/CT also showed larger volume of tumours attributed to lipid metabolism. In a retrospective study salivary gland cancer 5-year overall survival (OS) was 53 %. Salivary gland carcinoma consists of many histopathological groups, the two largest groups being mucoepidermoid carcinoma (MEC) and adenoid cystic carcinoma (ASCC). For ACC, having the best 5-year OS, it was 70 percent. Facial palsy, advanced stage disease, lymph node metastases worsened prognosis. ACC and polymorphous low grade carcinoma (PLGA) expressed c-myc and cyclin D1 to a larger extent than MEC. In squamous cell carcinoma of the head and neck we examined the occurrence of Single Nucleotide polymorphism, SNP. We found that the SNPs in male and female patients differed from each other. In male patients the SNPs were associated with immune response while in female patients the association was to SNPs concerning inflammation. This means that different pathways were engaged in cancer development for men and women. We also found that the SNPs in patients were different from those expressed in the healthy controls.

Ο καρκίνος εκ του επιθηλίου επιφανείας των ωοθηκών είναι η 5η πιο κοινή αιτία θανάτου σε γυναίκες στο Δυτικό κόσμο και είναι υπεύθυνος για τους περισσότερους θανάτους από ότι όλες οι γυναικολογικές κακοήθειες μαζί. Τόσο ο μηχανισμός του νεοπλαστικού μετασχηματισμού όσο και τα μοριακά μονοπάτια που οδηγούν στο ωοθηκικό επιθηλιακό καρκίνωμα δεν έχουν εξακριβωθεί πλήρως. Ένα πρόσφατα αναγνωρισμένο γονίδιο, η μετατχερίνη (MTDH), γνωστή και ως AEG-1 ή LYRIC ενοχοποιείται ως πιθανός σημαντικός διαμεσολαβητής κατά την καρκινογένεση, την μετάσταση και την αντίσταση στις χημειοθεραπείες. Ωστόσο, η κλινική σημασία και ο βιολογικός ρόλος της μετατχερίνης (MTDH), στο επιθηλιακό καρκίνωμα των ωοθηκών δεν έχουν γίνει αποσαφηνισθεί πλήρως. Η υπερέκφραση της MTDH/AEG-1 μπορεί να ενεργοποιήσει πολλά σηματοδοτικά μονοπάτια, όπως για παράδειγμα το NF-κΒ σηματοδοτικό μονοπάτι σε διάφορους καρκινικούς τύπους. Ο NF-κΒ έχει πρόσφατα συσχετισθεί με την ανάπτυξη και την εξέλιξη των όγκων και επιπλέον τα διμερή του NF-κΒ ενισχύουν την έκφραση ποικίλων γονιδίων που αφορούν την κυτταρική αύξηση, τη διαφοροποίηση, τις φλεγμονώδεις αντιδράσεις και τη ρύθμιση της απόπτωσης. Η παρούσα μελέτη σχεδιάστηκε προκειμένου να διερευνηθεί η έκφραση των πρωτεϊνών MTDH και NF-kB (p65/p50) σε επιθηλιακά ωοθηκικά καρκινώματα (καλοήθεις, οριακής κακοήθειας και διηθητικά καρκινώματα). Για το σκοπό αυτό μελετήθηκαν τμήματα επιθηλιακών νεοπλασμάτων ωοθηκών από 76 ασθενείς (15/46 οριακής κακοήθειας όγκοι, 30/46 διηθητικά αδενοκαρκινώματα και 31/76 κυσταδενώματα), μονιμοποιημένα σε ουδέτερη φορμόλη και εγκλεισμένα σε παραφίνη με τη μέθοδο της ανοσοϊστοχημείας για την έκφραση των πρωτεϊνών MTDH και NF-κB (p50/p65). Επίσης εκτιμήθηκε η σχέση της MTDH/AEG-1 με τον NF-κB και με κλινικοπαθολογοανατομικές παραμέτρους όπως ο βαθμός κακοήθειας του όγκου, το στάδιο, η μέγιστη διάμετρος του όγκου και η ηλικία της ασθενούς. Τα αποτελέσματα της ανοσοϊστοχημείας αναλύθηκαν με τη χρήση του στατιστικού πακέτου SPSS. Ο φυσιολογικός ωοθηκικός ιστός και τα κυσταδενώματα ήταν κυρίως αρνητικά για τις πρωτεΐνες MTDH/AEG-1 και NF-κB (p50, p65). Η έκφραση των MTDH/AEG-1 και NF-kappa B/ p50, πρωτεϊνών ήταν σημαντικά αυξημένες στα αδενοκαρκινώματα σε σχέση με τους οριακής κακοήθειας όγκους. Σε αντίθεση η έκφραση της NF-kappa B/ p65 πρωτεΐνης δεν έδειξε σημαντικές διαφορές μεταξύ των οριακής κακοήθειας όγκων και των αδενοκαρκινωμάτων. Σημαντική στατιστική συσχέτιση παρατηρήθηκε στην έκφραση των πρωτεϊνών MTDH/AEG-1, NF-kappa B/p50 και NF-kappaB/p65 στα αδενοκαρκινώματα. Καμία στατιστική συσχέτιση δεν παρατηρήθηκε στην έκφραση μεταξύ του NF-κB, της MTDH πρωτεΐνης και κλινικοπαθολογοανατομικών παραμέτρων. Συμπερασματικά, τα αποτελέσματα μας υποδεικνύουν ότι η MTDH/AEG-1 ίσως παίζει ένα σημαντικό ρόλο στην παθογένεια του ανθρώπινου ωοθηκικού καρκίνου, πιθανώς μέσω της ενεργοποίησης του σηματοδοτικού μονοπατιού του πυρηνικού μεταγραφικού παράγοντα NF-κB. Επειδή η MTDH συσχετίζεται σημαντικά με την αντίσταση στη χημειοθεραπεία, θα μπορούσε ενδεχομένως να αποτελέσει σημαντικό στόχο για θεραπεία, ενισχύοντας την αποτελεσματικότητα της χημειοθεραπείας στον επιθηλιακό ωοθηκικό καρκίνο. / Epithelial ovarian cancer is the fifth most common cause of cancer death in women in the Western world and the leading cause of death from gynaecological malignancies. Little is known about the mechanism of neoplastic transformation and the molecular events leading to epithelial ovarian cancer are poorly understood. A recently discovered gene, metadherin (MTDH, also known as AEG-1 or LYRIC) has emerged as a potentially crucial mediator of tumor progression, metastasis, and resistance to chemotherapies. The clinical significance and biological role of metadherin (MTDH), in epithelial ovarian carcinoma however, remains unclear. Overexpression of MTDH/AEG-1 can activate several downstream pathways, including the NFκB pathway in various types of cancer cells. Recently, NF-kB has been related to cancer development and progression and NF-kB dimers (p50/p65) could induce the expression of various genes regarding cell growth, differentiation, inflammatory responses and the regulation of apoptosis. This study was designed in order to determine the expression of the MTDH and NF-kB (p65/p50) proteins in epithelial ovarian tumors (benign, borderline and malignant). Formalin-fixed and paraffin embedded tissue blocks from 76 patients with epithelial ovarian neoplasms (15/46 borderline tumors, 30/46 invasive adenocarcinomas and 31/76 cystadenomas) were studied. Expressions of MTDH/AEG-1, NF-κB (p50, p65) were investigated immunohistochemically. The relationship of MTDH/AEG-1 with NF-κB and clinicopathological parameters such as tumor grade, stage, tumor maximal diameter and patient age were evaluated. The results of immunohistochemistry were analyzed with the SPSS statistic analyze protocol. Normal ovarian tissue and benign ovarian cystadenomas were mostly MTDH/AEG-1, NF-κB (p50, p65) negative. The expression of MTDH/AEG-1 and NF-kappaB p50, proteins were significantly higher in adenocarcinoma tissue in comparison with borderline tumors. In contast NF-kappaB p65 expession shows no significant differences between borderline tumors and adenocarcinomas. A statistical significant correlation was observed between MTDH/AEG-1 and NF-kappaB p50, p65 protein expression in adenocarcinomas. No statistical correlation was observed between the NF-Kb and MTDH protein expression and clinicopathological parameters. In conclusion our data indicate that the upregulation of MTDH/AEG-1 may play an important role in the pathogenesis of human ovarian cancer possibly through activation of Nuclear factor-κB signalling pathway. Since MTDH has also a significant correlation with chemoresistance could be an important therapeutic target enhancing chemotherapy efficacy in ovarian epithelial cancer.

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