O adenocarcinoma de ducto pancreático é reconhecido mundialmente como uma doença extremamente agressiva a qual apresenta um prognóstico desfavorável para pacientes sem cirurgia de ressecção. Portanto, é fundamental ampliar o conhecimento sobre os mecanismos biológicos envolvidos no câncer pancreático a fim de permitir a identificação de marcadores moleculares e alvos terapêuticos com o intuito de melhorar o diagnóstico precoce e tratamento. Os fatores de transcrição, reconhecidos por serem os efetores finais de vias de sinalização, regulam diversas funções celulares e, alterações na expressão transcricional destes podem contribuir para a transformação celular bem como para a progressão tumoral. Assim, o objetivo do presente estudo foi identificar os reguladores mestres da transcrição, possivelmente envolvidos no câncer pancreático. Para tanto, utilizamos dados de microarranjos para associar os reguladores mestres com o fenótipo tumoral. As análises foram realizadas no ambiente estatístico R utilizando os pacotes RTN, Limma e Survival. O gene TULP3 foi identificado como um regulador mestre da transcrição em amostras de câncer pancreático. O valor prognóstico de TULP3 foi verificado através de análises de sobrevivência em três coortes independentes. Estas análises revelaram que pacientes com adenocarcinoma pancreático, exibindo altos níveis de expressão do gene TULP3, apresentam uma sobrevida global desfavorável. Os altos níveis transcricionais de TULP3 podem desempenhar um papel fundamental na progressão do adenocarcinoma pancreático e conduzir a um resultado clínico desfavorável. Contudo, este estudo destaca a potencial aplicação de TULP3 como um biomarcador de prognóstico clínico para pacientes com adenocarcinoma pancreático. / Pancreatic ductal adenocarcinoma is world-wide recognized as an aggressive disease with poor prognosis in patients who did not undergo resection. Efforts to better comprehend the biological mechanisms of pancreatic cancer are needed to enable the identification of novel molecular markers and therapeutic targets for improving early diagnosis and treatment. Transcription factors are the final effectors of signaling pathways and regulate a number of cellular functions. Changes in expression of transcription factors may contribute to cellular transformation and tumor progression. Thus, the aim of the present study was to identify transcriptional master regulators potentially involved in pancreatic cancer disease. To achieve this goal, we utilized microarray data to associate master regulators with tumor phenotype. Analyses were performed with RTN, Limma, and Survival packages at R environment. We identified TULP3 as a master regulator of transcription in pancreatic cancer samples. TULP3 prognostic value was accessed in three independent cohort analyses. Our data demonstrate that patients with pancreatic cancer, exhibiting high TULP3 transcriptional levels, show a poor overall survival. High levels of TULP3 expression may play an essential role in pancreatic cancer progression and lead to poor clinical outcome. Our results highlight the potential use of TULP3 as a clinical prognostic biomarker for pancreatic adenocarcinoma.

Small molecules are important not only for treating human diseases but also for studying disease-related biological processes. This dissertation focuses on the effects of small molecules on pancreatic ductal adenocarcinoma cells. Here, I describe the discovery of two small-molecule tool compounds and their applications for interrogating the biological processes related to two distinct diseases in the human pancreas. First, BRD4770 was identified as a histone methyltransferase inhibitor through a target-based biochemical approach, and was used as a probe to study the function of methyltransferases in cancer cells. Second, BRD7552 was discovered as an inducer of Pdx1 using a cell-based phenotypic screening approach, and was used to induce the expression of Pdx1, a master regulatory transcription factor required for \(\beta\)-cell transdifferentiation. This compound is particularly interesting for the study of type-1 diabetes (T1D). The histone methyltransferase G9a catalyzes methylation of lysine 9 on histone H3, a modification linked to aberrant silencing of tumor-suppressor genes. The second chapter describes the collaborative effort leading to the identification of BRD4770 as a probe to study the function of G9a in human pancreatic cancer cells. BRD4770 induces cellular senescence and inhibits both anchorage-dependent and -independent proliferation in PANC-1 cell line, presumably mediated through ATM-pathway activation. Chapter three describes the study of a natural product gossypol, which significantly enhances the BRD4770 cytotoxicity in p53-mutant cells through autophagic cell death. The up-regulation of BNIP3 might be responsible for the synergistic cell death, suggesting that G9a inhibition may help overcome drug resistance in certain cancer cells. Ectopic overexpression of Pdx1, Ngn3, and MafA can reprogram pancreatic exocrine cells to insulin-producing cells in mice, which sheds light on a new avenue for treating T1D. The fourth chapter focuses on a gene expression-based assay using quantitative real-time PCR technique to screen >60,000 compounds for induction of one or more of these three transcription factors. A novel compound BRD7552 which up-regulated Pdx1 mRNA and protein levels in PANC-1 cells was identified. BRD7552 induces changes of the epigenetic markers within the Pdx1 promoter region consistent with transcriptional activation. Furthermore, BRD7552 partially complements Pdx1 in cell culture, enhancing the expression of insulin induced by the introduction of the three genes in PANC-1 cells. In summary, the central theme of my dissertation is to identify novel bioactive small molecules using different screening approaches, as well as to explore their effects in pancreatic ductal cells. / Chemistry and Chemical Biology

O adenocarcinoma de ducto pancreático é reconhecido mundialmente como uma doença extremamente agressiva a qual apresenta um prognóstico desfavorável para pacientes sem cirurgia de ressecção. Portanto, é fundamental ampliar o conhecimento sobre os mecanismos biológicos envolvidos no câncer pancreático a fim de permitir a identificação de marcadores moleculares e alvos terapêuticos com o intuito de melhorar o diagnóstico precoce e tratamento. Os fatores de transcrição, reconhecidos por serem os efetores finais de vias de sinalização, regulam diversas funções celulares e, alterações na expressão transcricional destes podem contribuir para a transformação celular bem como para a progressão tumoral. Assim, o objetivo do presente estudo foi identificar os reguladores mestres da transcrição, possivelmente envolvidos no câncer pancreático. Para tanto, utilizamos dados de microarranjos para associar os reguladores mestres com o fenótipo tumoral. As análises foram realizadas no ambiente estatístico R utilizando os pacotes RTN, Limma e Survival. O gene TULP3 foi identificado como um regulador mestre da transcrição em amostras de câncer pancreático. O valor prognóstico de TULP3 foi verificado através de análises de sobrevivência em três coortes independentes. Estas análises revelaram que pacientes com adenocarcinoma pancreático, exibindo altos níveis de expressão do gene TULP3, apresentam uma sobrevida global desfavorável. Os altos níveis transcricionais de TULP3 podem desempenhar um papel fundamental na progressão do adenocarcinoma pancreático e conduzir a um resultado clínico desfavorável. Contudo, este estudo destaca a potencial aplicação de TULP3 como um biomarcador de prognóstico clínico para pacientes com adenocarcinoma pancreático. / Pancreatic ductal adenocarcinoma is world-wide recognized as an aggressive disease with poor prognosis in patients who did not undergo resection. Efforts to better comprehend the biological mechanisms of pancreatic cancer are needed to enable the identification of novel molecular markers and therapeutic targets for improving early diagnosis and treatment. Transcription factors are the final effectors of signaling pathways and regulate a number of cellular functions. Changes in expression of transcription factors may contribute to cellular transformation and tumor progression. Thus, the aim of the present study was to identify transcriptional master regulators potentially involved in pancreatic cancer disease. To achieve this goal, we utilized microarray data to associate master regulators with tumor phenotype. Analyses were performed with RTN, Limma, and Survival packages at R environment. We identified TULP3 as a master regulator of transcription in pancreatic cancer samples. TULP3 prognostic value was accessed in three independent cohort analyses. Our data demonstrate that patients with pancreatic cancer, exhibiting high TULP3 transcriptional levels, show a poor overall survival. High levels of TULP3 expression may play an essential role in pancreatic cancer progression and lead to poor clinical outcome. Our results highlight the potential use of TULP3 as a clinical prognostic biomarker for pancreatic adenocarcinoma.

L'adénocarcinome canalaire pancréatique (ADKp) possède une architecture compacte, où les cellules tumorales forment des glandes emprisonnées dans un bouclier fibrotique, composé à 50% de collagènes. Ce bouclier empêche la vascularisation, limite l'apport en nutriments et oxygène. Beaucoup de cellules meurent, mais certaines survivent, en reprogrammant en particulier leur métabolisme. Ula plus étudiée est l'utilisation constitutive de la glycolyse, indépendamment de la présence d'oxygène (Effet Warburg). Nous montrons que la population hypoxique de l'ADKp dépend aussi de la dégradation de la glutamine, et que l'activité concomitante de la glycolyse et de la glutaminolyse entraîne la réactivation de la biosynthèse des hexosamines. Ces composés participent à la prolifération tumorale en stabilisant les transporteurs au glucose, ou des oncogènes. L'activité glycolytique intense des cellules hypoxiques permet la synthèse de lactate qui sert de ressource nutritive aux cellules oxygénées adjacentes aux cellules hypoxiques. Nous montrons que certaines cellules oxygénées sont capables de survivre au stress nutritif en dégradant le collagène (écophagie), en utilisant la proline qu'il contient. Les cellules tumorales captent et dégradent les fragments de collagènes pour survivre. Des traçages isotopiques de collagène marqué permettent d'appuyer que la proline internalisée provient du collagène matriciel. Cette proline est transformée en glutamate et fournit le cycle de Krebs pour favoriser la survie tumorale. Ces travaux montrent l'importance de l'étude de la reprogrammation métabolique dans l'ADKp, et le rôle de l'hypoxie ou du collagène dans la progression tumorale. / Pancreatic ductal adenocarcinoma (PDAC) has a compact architecture wherein the tumor cells are organized in glands and trapped in a fibrotic shield (stroma) made of up to 50% of collagen. This shield prevents blood supply, limits nutrients and oxygen intake. Many cells die, but some survive, and proliferate particularly by reprogramming their metabolism. The most studied metabolic reprogramming remains tumor cells addiction to glucose and the constitutive use of glycolysis, regardless of the presence of oxygen (Warburg effect). We show that the hypoxic population of PDAC also depends on glutamine degradation, and the concomitant activity of both glycolysis and glutaminolysis reactivates the hexosamine biosynthetic pathway. These compounds contribute to tumor proliferation by stabilizing glucose transporters, or oncogenes. The intense glycolytic activity of hypoxic cells allows the synthesis of lactate. Excreted in the microenvironment, it serves as a nutritive resource to oxygenic cells adjacent to the hypoxic population and enables their proliferation. We show that some oxygenated cells are also able to survive under nutrient stress by degrading collagen (ecophagy) and use proline it contains. Tumor cells intake and degrade collagen fragments to survive. Isotopic tracer experiments using labeled collagen support the idea that proline comes from the extracellular collagen. This proline is degraded and converted into glutamate, fueling the Krebs cycle for anaplerosis and promotes tumor survival. These studies therefore show the importance to study the metabolic reprogramming of PDAC, and the role of hypoxia or collagen matrix in tumor progression.

O adenocarcinoma de ducto pancreático é reconhecido mundialmente como uma doença extremamente agressiva a qual apresenta um prognóstico desfavorável para pacientes sem cirurgia de ressecção. Portanto, é fundamental ampliar o conhecimento sobre os mecanismos biológicos envolvidos no câncer pancreático a fim de permitir a identificação de marcadores moleculares e alvos terapêuticos com o intuito de melhorar o diagnóstico precoce e tratamento. Os fatores de transcrição, reconhecidos por serem os efetores finais de vias de sinalização, regulam diversas funções celulares e, alterações na expressão transcricional destes podem contribuir para a transformação celular bem como para a progressão tumoral. Assim, o objetivo do presente estudo foi identificar os reguladores mestres da transcrição, possivelmente envolvidos no câncer pancreático. Para tanto, utilizamos dados de microarranjos para associar os reguladores mestres com o fenótipo tumoral. As análises foram realizadas no ambiente estatístico R utilizando os pacotes RTN, Limma e Survival. O gene TULP3 foi identificado como um regulador mestre da transcrição em amostras de câncer pancreático. O valor prognóstico de TULP3 foi verificado através de análises de sobrevivência em três coortes independentes. Estas análises revelaram que pacientes com adenocarcinoma pancreático, exibindo altos níveis de expressão do gene TULP3, apresentam uma sobrevida global desfavorável. Os altos níveis transcricionais de TULP3 podem desempenhar um papel fundamental na progressão do adenocarcinoma pancreático e conduzir a um resultado clínico desfavorável. Contudo, este estudo destaca a potencial aplicação de TULP3 como um biomarcador de prognóstico clínico para pacientes com adenocarcinoma pancreático. / Pancreatic ductal adenocarcinoma is world-wide recognized as an aggressive disease with poor prognosis in patients who did not undergo resection. Efforts to better comprehend the biological mechanisms of pancreatic cancer are needed to enable the identification of novel molecular markers and therapeutic targets for improving early diagnosis and treatment. Transcription factors are the final effectors of signaling pathways and regulate a number of cellular functions. Changes in expression of transcription factors may contribute to cellular transformation and tumor progression. Thus, the aim of the present study was to identify transcriptional master regulators potentially involved in pancreatic cancer disease. To achieve this goal, we utilized microarray data to associate master regulators with tumor phenotype. Analyses were performed with RTN, Limma, and Survival packages at R environment. We identified TULP3 as a master regulator of transcription in pancreatic cancer samples. TULP3 prognostic value was accessed in three independent cohort analyses. Our data demonstrate that patients with pancreatic cancer, exhibiting high TULP3 transcriptional levels, show a poor overall survival. High levels of TULP3 expression may play an essential role in pancreatic cancer progression and lead to poor clinical outcome. Our results highlight the potential use of TULP3 as a clinical prognostic biomarker for pancreatic adenocarcinoma.

:.In our work we wanted to confirm our clinical experience with therapy of biliary and pancreatic duct injuries from the endoscopic retrograde cholangiopancreatography (ERCP) which was done in 267. Children and infants with a variety of biliary tract disorders and traumatic injuries in the area of biliary and pancreatic duct.. Pressure of the bile plays the key role in the therapy of biliary tract injuries Therefore we have measured the pressure in biliary tract and duodenum before and after the sphincterotomy of Oddi sphincter. Thea aim of our study was to confirm the insertion of drainage into the biliary and pancreatic duct in children with injury in this area. Our results showed significant differences between biliary duct pressure and duodenal pressure in the patients before and after sphincterotomy of Oddi sphincter. This results on theoretical basis confirmed, that it is necessary in children after traumatic rupture of biliary duct to provide ERCP and insert a biliary drainage after sphincterotomy. With this procedure the biliary tract injury is healed ad integrum without surgical liver resection. To provide only papilosphincterotomy without biliary drainage is not sufficient. This new miniinvasive procedure plays a fundamental role in the therapy of blunt abdominal injuries in a children and infants...

Le 17 novembre 2016 a eu lieu la 3ème journée mondiale de lutte contre le cancer du pancréas.Cette prise en considération tardive rend compte de la dualité entre une incidence faible et un pronostic redoutable. Sa réputation de cancer rapidement mortel est attestée par un ratio incidence/mortalité proche de 1. Au 10ème rang en termes de localisations de cancers, il se hisse au 4ème rang en termes de mortalité par cancer et devrait devenir, en 2020, la 2ème cause de décès par cancer devant le cancer du côlon et juste après le cancer du poumon. Le taux de survie à 5 ans, tous stades confondus, est de 5% aux USA et en Europe.L’adénocarcinome canalaire pancréatique représente la tumeur la plus fréquente (80% des tumeurs pancréatiques exocrines). Sa localisation dans la glande pancréatique est céphalique dans 2/3 des cas.A ce jour, le traitement chirurgical reste le seul traitement potentiellement curatif. Celui-ci ne s’adresse qu’à une faible proportion de patients. En effet, seul 20% des patients présentant un adénocarcinome pancréatique céphalique sont effectivement résécables permettant d’obtenir un taux de survie globale à 5 ans d'environ 10 à 20% si la résection est suivie de chimiothérapie adjuvante ou non. Ces résultats modestes sont en outre à pondérer par la morbi-mortalité des résections pancréatiques céphaliques. Dans la série de l’Association Française de Chirurgie, reprenant les résections pancréatiques céphaliques réalisées en France entre 2004 et 2010, la mortalité était de 3,8% et la morbidité de 54%. Parmi les complications post-opératoires, la fistule pancréatique représente la principale complication en termes de mortalité (15 à 25%), génératrice de coût important dans les soins et d’une augmentation significative de la durée de séjour. La fistule pancréatique demeure la pierre angulaire de l’amélioration du pronostic des patients.L’objectif de ce travail sur l’adénocarcinome canalaire pancréatique céphalique traité chirurgicalement était d’analyser certains facteurs influençant la morbi-mortalité au trois temps de sa prise en charge :- Avant l’intervention, avec l’étude d’un facteur pronostic préopératoire, sur une cohorte de patients, pouvant influencer la survenue d’une fistule pancréatique et la mortalité- Pendant l’intervention, avec la réalisation d’une méta-analyse sur le type de reconstruction pancréatique et son influence sur la survenue d’une fistule pancréatique- Après l’intervention, avec l’étude de l’influence de la survenue d’une complication sévère sur la survie et la survie sans récidive.Au cours de cette thèse nous avons vu, que la réduction du taux de fistule pancréatique, par le seul biais de techniques peropératoires semble difficilement réalisable au regard de la multiplicité des techniques et de la difficulté à réaliser des études randomisées contrôlées méthodologiquement satisfaisantes. En revanche, la recherche des facteurs liés aux patients, prédisposant à la survenue d’une fistule pancréatique semble l’approche à privilégier. Ceci est d’autant plus primordial dès lors que nous avons mis en évidence un lien entre la survenue d’une complication sévère et la survie ou la récidive chez les patients réséqués. Ce travail souligne l’importance d’être capable d’identifier, dès la consultation, les patients à haut risque de complications sévères et de fistule post-opératoire d’une part, pour sélectionner les bons candidats à la chirurgie et d’autre part, pour être capable de leur apporter une information franche et loyale indispensable éthiquement au consentement éclairé. / The third World Day on pancreatic cancer took place the 17th November 2016. This late consideration is due to the duality between his relative scarcity and a dreadful prognosis.Its aggressiveness is underlined by a mortality rate equal to its incidence. Ranked 10th on cancer-related localization and 4th on cancer-related mortality, he will become the second cause of cancer-related deaths in 2020 just behind pulmonary cancer and before colorectal cancer. 5-yr survival rate is 5% irrespective of the stage.Pancreatic ductal adenocarcinoma is the most frequent form (80% of exocrine pancreatic tumors). He is localized in cephalic pancreas in 2/3 of cases.Although pancreatic resection provides the only chance of long-term survival, no more than 20% of patients will be eligible for surgery in curative intent leading to a 5-yr survival rate of 10 to 20%. Pancreaticoduodenectomy for pancreatic head, neck and uncinated process is still a challenging procedure. In the study of the French Surgery Association, mortality and morbidity rate were respectively 3.8% and 54%. Postoperative pancreatic fistula is considered as the Achilles’ heel of pancreaticoduodenectomy and is associated with increased post-operative mortality. Postoperative pancreatic fistula generates significant costs and prolonged hospital stay. Thus postoperative pancreatic fistula is the corner stone of patient’s prognosis improvement.The aim of this study on operated pancreatic ductal adenocarcinoma was to analyze several factors influencing morbidity and mortality.- Before surgery, by testing the impact of body surface area in a cohort of patients.- During surgery, by conducting a meta-analysis on reconstruction methods for pancreatic anastomosis.- After surgery, by evaluating the influence of severe complications on survival and recurrence.We show that the use of various surgical refinements, such as type of pancreatic anastomoses, are equivocal to decrease postoperative pancreatic fistula rate and that performing randomized controlled trials will be difficult. In contrast, the search for patient’s factors leading to postoperative pancreatic fistula seems to be the promising approach. This is of major concern as we demonstrated the causal link between the occurrence of severe postoperative complications and survival or recurrence. This work highlights the need for surgeons to distinguish during preoperative consultation high-risk patients in order to select the best candidates suitable for surgery as well as to give them a full and frank information ethically necessary for free and informed consent.

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INTRODUÇÃO: Os microRNAs (miRNAs) são uma classe de pequenas moléculas não codificadoras de proteínas que regulam a expressão gênica durante a etapa de tradução. Esta regulação é feita pelo pareamento de bases com o mRNA-alvo (RNA mensageiro), resultando na supressão da tradução ou na clivagem do mRNA. A depender se os miRNAs têm como alvo genes supressores de tumor ou oncogenes, eles podem atuar como supressores tumorais ou oncogenes. A imunoistoquímica triplo negativa, no câncer de mama, é, comumente, utilizada como substituto clínico para identificação dos tumores basaloides, que se caracterizam pela expressão de genes epiteliais basais, sendo associados a menores taxas de sobrevida livre de doença e sobrevida global. O câncer de mama triplo negativo faz com que seja necessária a descoberta de marcadores moleculares que possam servir de alvos terapêuticos ou, pelo menos, que sirvam como marcadores preditivos da resposta aos quimioterápicos. OBJETIVO: avaliar a expressão de microRNAs, por PCR em tempo real, no carcinoma mamário ductal invasivo (CDI) triplo negativo. MÉTODOS: Foram avaliados materiais em parafina de tumor de 31 pacientes com as seguintes características: carcinoma invasivo de mama, receptores de estrogênio e de progesterona negativos e HER 2 negativo, bem como tecido mamário histologicamente normal. Foram utilizados kit para extração de RNA de amostras fixadas e parafinadas - miRNeasy FFPE; kit para síntese de cDNA - miScript II RT; kit miScript SYBR Green PCR e miScript miRNA PCR Arrays para análise de 84 sequências de miRNA de câncer humano. Foram avaliados dados clínicos, como idade, paridade, amamentação, status menopausal; variáveis histológicas, como tamanho do tumor, status linfonodal, invasão linfática; características imunoistoquímicas, como expressão de Ki-67, EFGR e CK 5/6. O seguimento das pacientes buscou verificar a ocorrência e o tempo de aparecimento de recidiva loco regional, metástase à distância e óbito. Para análise estatística foi utilizado o software miScript miRNA PCR Array Data Analysis, que utiliza o método de quantificação relativa DeltaCt. RESULTADOS: A análise comparativa dos 31 casos de CDI triplo negativo com os 18 casos de parênquima mamário normal definiu microRNAs hiperexpressos, sendo eles: miR-96-5p (fold-regulation(FR) = 9,68, p = 0,000008), miR-21-5p (FR = 4,47, p = 0,00), miR-7-5p (FR = 5,8, p = 0,00137) , miR-182-5p (FR= 7,92, p = 0,000001), miR-210-3p (FR = 11,83, p = 0,000048), miR-18a-5p (FR = 9,51, p = 0,000034), miR-155-5p (FR= 4,40 , p = 0,00019) e miR-93-5p (FR= 4,15, p = 0,000023). Aponta, ainda, microRNAs com hipoexpressão, a saber: miR-204-5p (FR = -10,26, p = 0), miR-205-5p (FR= -4,07, p = 0,019822), miR-125b-5p (FR= -4,29, p=0) e let 7c-5p (FR= -4,91, p=0). CONCLUSÃO: a expressão de microRNAs no carcinoma ductal invasivo triplo negativo permite diferenciá-lo do tecido normal / INTRODUCTION: MicroRNAs (miRNAs) are a class of small non-coding protein molecules that regulate gene expression during the translation stage. This adjustment is made by base pairing with the mRNA (messenger RNA) target resulting in suppression of translation or cleavage of the mRNA. Depending on whether miRNAs target tumor suppressor genes or oncogenes, they can act as tumor suppressors or oncogenes. The triple negative immunohistochemistry in breast cancer is commonly used as a substitute for clinical identification of basaloid tumors, which are characterized by the expression of basal epithelial genes and are associated with lower rates of disease-free survival and overall survival. The triple negative breast cancer makes necessary the discovery of molecular markers that may serve as therapeutic targets or at least as predictive markers of response to chemotherapy. OBJECTIVE: evaluate the expression of microRNAs by RT-PCR in triple negative breast invasive ductal carcinoma (IDC). METHODS: Paraffin embedded tumor material from 31 patients with the following characteristics were evaluated: invasive breast carcinoma, negative estrogen and progesterone receptor, negative HER 2, and histologically normal breast tissue. Were used: Kit for RNA extraction from fixed and paraffin embedded samples - miRNeasy FFPE; cDNA synthesis kit - miScript II RT; miScript SYBR Green PCR Kit and miScript miRNA PCR Arrays for analysis of 84 miRNA sequences of human cancer. Clinical data such as age, parity, breastfeeding, menopausal status; histological variables such as tumor size, lymph node status, lymphatic invasion; immunohistochemical characteristics, such as expression of Ki-67, EFGR and CK 5/6 were evaluated. The follow-up of patients aimed to verify the occurrence and time of appearance of loco regional recurrence, distant metastasis and death. For statistical analysis the miScript miRNA PCR Array Data Analysis software, which uses the method of relative quantification DeltaCt, was used. RESULTS: A comparative analysis of 31 cases of triple negative IDC with 18 cases of normal breast parenchyma defined microRNAs overexpressed, as follows: miR-96-5p (fold-regulation (FR) = 9.68, p = 0.000008), miR -21-5p (FR = 4.47, p = 0.00), 5p, miR-7 (FR = 5.8, p = 0.00137), miR-182-5p (FR = 7.92, p = 0.000001), miR-210-3p (FR = 11.83, p = 0.000048), miR-18a-5p (FR = 9.51, p = 0.000034), miR-155-5p (FR = 4.40, p = 0.00019) and miR-93-5p (FR = 4.15, p = 0.000023). Furthermore, microRNAs with reduced expression, as follows: miR-204-5p (FR = -10.26, p = 0), miR-205-5p (FR = -4.07, p = 0.019822), miR -125b-5p (FR = -4.29, p = 0) and Let-7c 5p (FR = -4.91, p = 0). CONCLUSION: the expression of microRNAs in triple negative invasive ductal carcinoma allows to differentiate it from normal tissue