Orientador: Reginaldo Palazzo Júnior / Dissertação (mestrado) - Universidade Estadual de Campinas, Faculdade de Engenharia Elétrica e de Computação / Made available in DSpace on 2018-08-26T03:06:58Z (GMT). No. of bitstreams: 1 Pereira_DiogoGuilherme_M.pdf: 2278721 bytes, checksum: d52e9ddea8e27d992073c5cf8ba3674f (MD5) Previous issue date: 2014 / Resumo: É evidente os benefícios proporcionados pela aplicação da teoria da informação nas análises dos processos de codificação genética. Este trabalho propõe o desenvolvimento de algoritmos, e sua implementação computacional, para a realização de análises em sequências de DNA por meio dos códigos BCH. O primeiro programa irá calcular diversos polinômios geradores que serão utilizados pelos outros programas. O segundo programa se utiliza destes polinômios geradores para realizar análises em sequências de DNA e identificar palavras-código na forma de novas sequências de DNA. Já o terceiro programa, de iniciativa inédita, se utiliza tanto dos polinômios geradores quanto as palavras-código e realiza um processo de decodificação com o intuito de rastrear as mutações passiveis de ocorrer em sequências de DNA / Abstract: The benefits provided by the application of information theory in the analyses of genetic coding processes are evident. In this work the development of algorithms and their computational implementations are proposed, with the aim at performing analyses of DNA sequences by use of BCH codes. The first program calculates several generator polynomials which are used by other programs. The second program uses generator polynomials to perform DNA sequence analyses and to identify the codewords in the form of new DNA sequences. The third program by using both the generator polynomials as well as the codewords to perform a decoding process in order to predict mutations that may occur in DNA sequences / Mestrado / Telecomunicações e Telemática / Mestre em Engenharia Elétrica

Les cellules cancéreuses sont caractérisées par des altérations de l'ADN causées par des facteurs exogènes, comme l'exposition à des agents environnementaux tels que le tabac ou les UV, ou par des mécanismes endogènes tels que les erreurs de polymérase lors de la réplication de l'ADN. L'analyse des causes et des conséquences de ces altérations permet de mieux comprendre les facteurs et mécanismes à l'origine du développement d'un cancer. Les technologies de séquençages à haut débit offrent l'opportunité d'étudier la nature précise de ces altérations à l'échelle du génome et permettent de révéler des signatures mutationnelles distinctes et spécifiques de cancérigènes, fournissant ainsi des hypothèses sur l'étiologie des cancers.L'objectif de ma thèse a consisté à développer des méthodes et des outils bioinformatiques accessibles et conviviaux permettant de faciliter l'analyse et l'interprétation des signatures mutationnelles à partir de données de séquençage à haut débit. L'application de ces outils et méthodes à des séries originales de tumeurs humaines et de systèmes expérimentaux de mutagénèse et carcinogénèse a permis de mieux caractériser la signature mutationnelle de l'acide aristolochique (AA) ainsi que d'autres cancérigènes d'intérêt / Cellular genomes accumulate alterations following exposures to exogenous factors, like environmental agents such as tobacco smoking or UV, or to endogenous mechanisms such as DNA replication errors. Analysing the causes and consequences of these changes allows a better understanding of the mechanisms underlying cancer development and progression. Next-generation sequencing (NGS) technologies provide the opportunity tostudy the nature of the resulting alterations on a genome-wide scale and started to reveal distinct mutational signatures specific to past carcinogenic exposures providing clues on cancer aetiology.The aim of my thesis was to develop user-friendly bioinformatic tools and methods for facilitating the analysis and interpretation of carcinogen-specific mutational signatures from NGS data. Applying these tools and methods to human tumours and experimental models of mutagenesis led to a better characterisation the mutational signature of aristolochic acid (AA), as well as other carcinogens of interest

Tumour Mutational Burden is a promising biomarker to predict response to immunotherapy. In this thesis, statistical methods of supervised learning were used to predict TMB: GLM, Decision Trees and SVM. Predictions were based on data from targeted DNA sequencing, using variants found in the exonic, intronic, UTR and intergenic regions of the human DNA. This project was of an exploratory nature, performed in a pan-cancer setting. Both regression and classification were considered. The purpose was to investigate whether variants found in these regions of the DNA sequence are useful when predicting TMB. Poisson regression and Negative binomial regression were used within the framework of GLM. The results indicated deficiencies in the model assumptions and that the use of GLM for the application is questionable. The single regression tree did not yield satisfactory prediction accuracy. However, performance was improved by using variance reducing methods such as bagging and random forests. The use of boosted regression trees did not yield any significant improvement in prediction accuracy. In the classification setting, binary as well as multiple classes were considered. The distinction between classes was based on commonly used thresholds in clinical care to achieve immunotherapy. SVM and classification trees yielded high prediction accuracy for the binary case: a misclassification rate of 0.0242 and 0 respectively for the independent test set. In the multiple classification setting, bagging and random forests were implemented, yet, did not improve performance over the single classification tree. SVM produced a misclassification rate of 0.103, and the corresponding number for the single classification tree was 0.109. It was concluded that SVM and Decision trees are suitable methods for predicting TMB based on targeted gene panels. However, to obtain reliable predictions, there is a need to move from a pan-cancer setting to a diagnosis-based setting. Furthermore, parameters affecting TMB, like pre-analytical factors need to be included in the statistical analysis. / Denna uppsats undersöker tre metoder inom statistisk inlärning: GLM, Decision Trees och SVM, med avsikt att förutsäga mutationsbörda, TMB, för cancerpatienter. Metoderna har applicerats både inom regression och klassificering. Förutsägelser gjordes baserat på data från panel-baserad DNA-sekvensering som innehåller varianter från kodande, introniska UTR och intergeniska regioner av mänskligt DNA. Projektet ämnar att undersöka om varianter från dessa regioner av DNA-sekvensen kan vara användbara för att förutsäga mutationsbördan för en patient. Poisson-regression och Negativ Binomial-regression undersöktes inom GLM. Resultaten indikerade på brister i modellerna och att GLM inte är lämplig för denna tillämpning. Regressionsträden gav inte tillräckligt noggranna förutsägelser, men implementering av bagging och random forests förbättrade modellernas prestanda. Boosting förbättrade inte resultaten. Inom klassificering användes både binära klasser och multipla klasser. Avgränsningen mellan klasser baserades på kända gränser för TMB inom vården för att få immunoterapi. SVM och decision trees gav god prestanda för binär klassificering, med ett klassificeringsfel på 0.024 för SVM och 0 för decision trees. Bagging och random forests implementerades för det multipla fallet inom decision trees, men förbättrade inte prestandan. För multipla klasser gav SVM ett klassificeringnsfel på 0.103 och decision trees 0.109. Både SVM och decision trees visade sig vara lämpliga metoder för för att förutse värdet på TMB. Däremot, för att förutsägelserna ska vara tillförlitliga finns det ett behov av att göra denna typ av analys för varje enskild cancerdiagnos. Dessutom finns det ett behov av att inkludera parametrar från den bioinformatiska processen i den statistiska analysen.

Tesis por compendio / [ES] El melanoma es el tipo de cáncer de piel más mortífero y peligroso, ya que tumores de pequeño tamaño pueden generar metástasis. Hasta la fecha, se ha tratado de clasificar desde el punto de vista clínico, epidemiológico y molecular, empleándose actualmente el nivel de exposición solar y la localización del tumor como criterios principales para dividir en distintos grupos a los pacientes de melanoma. En 1998, David Whiteman y colaboradores propusieron un "modelo de vías divergentes" para el desarrollo del melanoma. Este presentaba dos vías: una vinculada a la proliferación melanocítica (nevogénica) y otra relacionada con la exposición solar crónica (CSD). Corroborado desde el punto de vista clínico y epidemiológico, todavía no se ha aportado una caracterización molecular en profundidad. A nivel general se habían identificado genes cuyas mutaciones eran relevantes para el desarrollo del melanoma, como por ejemplo KIT. Sin embargo, todavía se había de estudiar con más detalle la distribución de estas mutaciones entre los distintos subgrupos de melanoma, así como su posible valor pronóstico. En esta tesis se han empleado técnicas de secuenciación - masiva y tradicional - para caracterizar los perfiles mutacionales de las poblaciones del modelo de vías divergentes. Encontramos diferencias tanto en el número de mutaciones como en los genes afectados. También hemos visto cómo los melanomas con mutaciones en KIT parecen desarrollarse por una vía independiente de la etiopatogenia conocida, careciendo el estatus mutacional de este gen de valor pronóstico para la supervivencia de los pacientes. / [CA] El melanoma és el tipus de càncer de pell més mortífer i perillós, ja que fins els tumors de menor mida poden acabar generant metàstasi. Al llarg dels anys, s'ha tractat de classificar des del punt de vista clínic, epidemiològic i molecular. Les classificacions actuals utilitzen el nivell d'exposició solar i la localització tumoral per dividir en diferents grups als pacients de melanoma. Al 1998, David Whiteman i col·laboradors proposaren un model de desenvolupament del melanoma que anomenaren "model de vies divergents". Aquest presentava dos vies per la melanomagènesi: una vinculada a la proliferació melanocítica (nevogènica) i l'altra relacionada amb l'exposició solar crònica (CSD). Malgrat aquest model fou corroborat des del punt de vista clínic i epidemiològic, encara no s'ha aportat una caracterització molecular en profunditat. A nivell general s'havien identificat gens les mutacions dels quals eren rellevants per al desenvolupament del melanoma, com el gen KIT. Però, encara s'havia d'estudiar amb més cura la distribució d'estes mutacions entre els distints subgrups de melanoma, així com el seu possible valor pronòstic. En aquesta tesi s'han emprat tècniques de seqüenciació -massiva i tradicional- per caracteritzar els perfils mutacionals de les dues poblacions proposades pel model de vies divergents, trobant diferències tant al nombre de mutacions com als gens afectats. També hem vist com els melanomes mutats en KIT semblen desenvolupar-se per una via independent de l'etiopatogènia coneguda, mancant l'estatus mutacional d'aquest gen de valor pronòstic per la supervivència dels pacients. / [EN] Melanoma is the deadliest and most dangerous type of skin cancer, given that a small tumor can spread and result in metastasis. Over the years, classifications have been made either from a clinical, epidemiological or molecular point of view. Current classifications use the degree of solar exposure and tumoral location to divide into different melanoma groups. In 1998, David Whiteman and collaborators proposed the divergent pathway model for melanoma development. This presented two pathways to melanomagenesis: one related to melanocytic proliferation (nevogenic) and the other related to chronic sun exposure (CSD). Despite corroborations of this model from the clinic and epidemiology, it is yet to be molecularly characterized in depth. At a general level, different genes had been identified with relevant mutations for the development of melanoma, as is the gene KIT. However, there was a lack of knowledge on how these mutations were distributed among different melanoma subgroups, as well as the potential prognostic value. In this thesis we have implemented sequencing techniques - both massive and traditional - to characterize the mutational profile of the two populations proposed by the divergent pathways model. We found differences both in the number of mutations and in the genes carrying the mutations. We have also seen how melanomas harboring KIT mutations seem to develop in a way which is independent from the known etiology, and how the mutational status of this gene lacks prognostic value on the outcome of the patients. / Millán Esteban, D. (2022). Next-Generation Sequencing in the Identification of Biomarkers in Cutaneous Melanoma According to the Etiopathogenic Development Pathway and their Potential Clinical Relevance [Tesis doctoral]. Universitat Politècnica de València. https://doi.org/10.4995/Thesis/10251/182977 / Compendio

L’acétylation des résidus de glucosamine terminaux par la N-acétyltransférase lysosomale (HGSNAT) est une étape essentielle de la dégradation catabolique de l’héparan sulfate. Des défauts dans cette réaction causent une maladie de surcharge lysosomale autosomale récessive rare : le désordre de Sanfilippo type C (SFC). À ce jour, 54 mutations ont été rapportées chez des patients SFC, incluant 13 mutations des sites d’épissage, 11 insertions et délétions, 8 mutations non-sens, 18 mutations faux-sens et 4 polymorphismes, avec différentes manifestations phénotypiques. Nous avons identifié 10 d’entre elles et effectué une étude exhaustive portant sur l’éventail des mutations SFC, leur distribution dans la population de patients, ainsi que leur impact potentiel sur la structure de la HGSNAT. Les erreurs d’épissage, les mutations non-sens, les insertions et les délétions devraient toutes entraîner un ARN non fonctionnel qui est rapidement dégradé par des mécanismes de contrôle qualité cellulaire. Les 4 polymorphismes identifiés sont des changements d'acides aminés qui ne modifient pas l'activité enzymatique, la glycosylation ou la localisation et n'ont donc pas de signification au niveau clinique. Au niveau des enzymes, les polymorphismes sont des changements d’acides aminés qui n’affectent pas la fonction, mais dans un contexte d’acides nucléiques ils peuvent être considérés comme des mutations faux-sens. Les dix-huit mutations faux-sens qui ont été exprimées ont produit des protéines inactives, en raison d'erreurs dans leur repliement. Ceci expliquerait donc la progression sévère de la maladie chez les personnes porteuses de ces mutations. Les protéines mutantes mal repliées sont anormalement glycosylées et conservées dans le réticulum endoplasmique. La thérapie par amélioration de l’activité enzymatique par des chaperonnes est une option thérapeutique potentielle, spécifiquement conçue pour exploiter l'activité enzymatique résiduelle de mutants mal repliés, afin d’éliminer les substrats stockés. Nous avons démontré que le traitement de plusieurs lignées de fibroblastes de patients SFC avec le chlorhydrate de glucosamine, un inhibiteur spécifique de la HGSNAT, a partiellement restauré l’activité de l'enzyme mutante, fournissant une preuve de l’utilité future de la thérapie par des chaperonnes dans le traitement de la maladie de SFC. / The acetylation of terminal glucosamine residues by lysosomal N-acetyltransferase (HGSNAT) is an essential part of the catabolic breakdown of heparan sulfate. Defects in this reaction result in the rare autosomal recessive lysosomal storage disorder Sanfilippo syndrome type C (SFC). To date 54 mutations in SFC patients have been reported including 13 splice-site mutations, 11 insertions and deletions, 8 nonsense, 18 missense and 4 polymorphisms, with different phenotypic manifestations. We have identified 10 of them and conducted a comprehensive review discussing the spectrum of Sanfilippo C mutations, their distribution within the patient population as well as how the mutations could potentially affect the structure of HGSNAT. Splicing errors, nonsense mutations, insertions and deletions were all predicted to result in non-functional RNA which is rapidly degraded by cellular quality control mechanisms. The 4 identified polymorphisms resulted in amino acid changes which did not affect the enzyme activity, glycosylation or targeting and were therefore not clinically significant. Polymorphisms, in the context of enzymes are amino acid changes not affecting function, but in the context of nucleic acids can still be considered as missense mutations. Eighteen missense mutations were expressed and shown be inactive due to errors in protein folding providing an explanation for the severe disease progression seen in individuals with these mutations. Misfolded mutants were abnormally glycosylated and retained in the endoplasmic reticulum. Enzyme enhancement/chaperone therapy is a potential treatment option specifically designed to exploit the residual enzyme activity of misfolded mutants in order to clear stored substrates. We demonstrated that treatment of several fibroblast lines of SFC patients with a specific inhibitor of HGSNAT; glucosamine-hydrochloride partially rescued mutant enzyme activity providing a proof of principle for the future use of chaperone therapeutics in the treatment of SFC.

No description available.

No presente estudo, foram selecionados 33 pacientes infectados com HCV genótipo 3a, tratados com IFN e Ribavirina, incluindo pacientes cirróticos (C) e não-cirróticos (NC), respondedores (R) e não-respondedores (NR). Foi realizado o seqüenciamento das regiões E2 e NS5A do genoma do HCV. As seqüências geradas foram analisadas quanto a presença de mutações para correlacionarmos com a resposta virológica sustentada ao tratamento e com a presença de cirrose. Na análise estatística as mutações na região E2 não apresentaram diferença significante. As mutações conservadoras encontradas nas regiões NLS e V3 da NS5A apresentaram diferença significante. Estudos funcionais envolvendo a proteína NS5A são necessários para que possamos avaliar o valor preditivo das mutações conservadoras e não-conservadoras encontradas na NS5A / The aim of this study was to analyse the sequences of fragments of E2 and NS5A regions from 33 outpatients infected with HCV genotype 3, including cirrhotic (C) and non-cirrhotic (NC) patients that have responded (R) or not (NR) to treatment. In the E2 region, we did observe few amino acids changes between patients without statistical significance. In the NLS region and in V3 domain, we found conservatives mutations with statistical significance. In conclusion, our results confirm that the ISDR domain is not predictive for treatment success in patients infected with HCV genotype 3. The carboxy-terminal region and especifically V3 domain region showed most of variations. Structure-function studies are required to identify precisely how NS5A and IFN interact

Les génomes du cancer présentent une mosaïque de types de mutations. Trente signatures mutationnelles ont été identifiées à partir d'un grand nombre de tumeurs humaines primaires. Déchiffrer l'origine de ces signatures mutationnelles pourrait aider à identifier les causes du cancer humain. Environ 40% des signatures décrites sont d'origine inconnue, soulignant la nécessité de modèles expérimentaux contrôlés pour étudier l'origine de ces signatures. Au cours de mon travail de doctorat, j'ai caractérisé et utilisé des modèles in vitro et in vivo d'exposition aux cancérogènes, caractériser les signatures mutationnelles au niveau de génome entier de plusieurs composés cancérogènes pour lesquels le spectre de mutations n'était pas connu ou controversé. Tout d'abord, les conditions de cytotoxicités et genotoxicités pour chaque composé ont été établies et la formation d'adduits d'ADN a été évaluée. Suite au séquençage du gène TP53, on a effectué un séquençage au niveau du génome des clones MEF immortalisés dérivés de l'exposition à l'acrylamide, au glycidamide et à l'ochratoxine A. Le travail suggère une nouvelle signature mutationnelle unique pour l'acrylamide et médiée par son métabolite actif, le glycidamide. En fait, le motif des mutations de glycidamide, correspondant au profil de sa signature mutationnelle, a récapitulé les types de mutations attendus en fonction de l'analyse des adduits d'ADN. En outre, une analyse intégrée utilisant des modèles in vitro et in vivo suggère un manque de mutagénicité directe pour l'OTA avec une contribution potentielle d'un mode d'action lié à la production des radicaux libres à la signature mutationnelle OTA dans les MEF. Cette stratégie expérimentale simple et puissante peut faciliter l'interprétation des empreintes de mutations identifiées dans les tumeurs humaines, élucider l'étiologie du cancer et finalement soutenir la classification des cancers du CIRC en fournissant des preuves mécanistes / Cancer genomes harbour a mosaic of mutation patterns from which thirty mutational signatures have been identified, each attributable to a particular known or yet undetermined causal process. Deciphering the origins of these global mutational signatures in full could help identify the causes of human cancer, especially for about 40% of those signatures identified thus far that remain without a known etiological factor. Thus, well-controlled experimental exposure models can be used to assign particular mutational signatures to various mutagenic factors.During the time frame of my PhD work, I characterized and employed innovative in vitro and in vivo models of carcinogen exposure, namely, primary Hupki MEF cells, HepaRG and lymphoblastoid cell lines as well as rodent tumors. The cytotoxic and genotoxic conditions for each tested exposure compound were established and DNA adduct formation was assessed in select cases. Following a pre-screen by TP53 gene sequencing, genome-wide sequencing of immortalized Hupki MEF clones derived from exposure to acrylamide, glycidamide and ochratoxin A was performed, alongside whole genome sequencing of ochratoxin A induced rat renal tumors. The results reveal a novel mutational signature of acrylamide mediated by its active metabolite, glycidamide, a pattern that can be explained by the parallel analysis of individual glycidamide-DNA adducts. In addition, an integrative mutation analysis using in vitro and in vivo models suggests a lack of direct mutagenicity for OTA and possible indirect effects due to the ROS-mediated mode-of-action in MEF cells. The presented robust experimental strategy can facilitate the interpretation of mutation fingerprints identified in human tumors, thereby elucidating cancer etiology, elucidating the relationship between mutagenesis and carcinogenesis and ultimately providing mechanistic evidence for IARC’s carcinogen classification

A síndrome de Noonan (SN) é uma doença de herança autossômica, relativamente frequente na população e que apresenta heterogeneidade genética. Caracteriza-se por dismorfismos faciais, baixa estatura, pescoço curto/alado, alterações cardíacas, deformidades esternais e criptorquia. A SN apresenta sobreposição dos achados clínicos com outras síndromes mais raras, denominadas síndromes Noonan-like (SNL): síndrome cardio-facio-cutânea (CFC), síndrome de Costello (SC), neurofibromatose-síndrome de Noonan (NFSN), síndrome de Noonan com manchas lentiginosas/síndrome de LEOPARD (SL), síndrome de Noonan-like com perda de cabelos anágenos (SNL-PCA) e síndrome de Noonan-like com leucemia mielomonocítica juvenil (SNL-LMMJ). As SN e SNL decorrem de mutações em genes pertencentes à via de sinalização RAS/MAPK alguns dos quais são protooncogenes, o que tem despertado o interesse na caracterização do risco de desenvolvimento de neoplasias nessas síndromes. Os objetivos deste estudo visam o sequencimento conjunto dos genes PTPN11, SOS1, RAF1, KRAS, SHOC2, BRAF e HRAS em pacientes com diagnóstico clínico das SN e SNL a fim de: determinar a frequência de mutação; estabelecer uma correlação genótipo-fenótipo; estabelecer um fluxograma para o estudo molecular a partir dos hotspots; e avaliar se a variabilidade fenotípica apresentada nos pacientes com SN pode ser explicada pela presença de mutações em mais de um gene da via RAS/MAPK. Foram avaliados 194 probandos - 152 com SN e 42 com SNL (19 CFC, 15 NFNS, 4 CS e 4 LS). Mutações foram identificadas em 99 pacientes 80 com SN (53%); 19 com SNL. Apenas um paciente com SN apresentou mutação em dois genes da via RAS/MAPK (PTPN11 e SOS1). O estudo molecular na SN mostrou, assim como na literatura, um maior envolvimento do gene PTPN11 (34%), seguido dos genes SOS1 (12%) e RAF1 (7%). A comparação dos achados clínicos, levando em consideração as alterações gênicas, também confirma as correlações já descritas na literatura; entre elas observamos que pacientes com SN e mutação no gene: PTPN11, apresentaram maior frequência de estenose pulmonar valvar (EPV) e baixa estatura; SOS1, apresentaram maior frequência de EPV; RAF1, apresentaram maior frequência de miocardiopatia hipertrófica, e menor frequência de EPV e déficit intelectual; SHOC2, apresentaram anormalidades de cabelo. Na nossa casuística também foram observados alguns achados raros: craniosinostose, tumor expansivo em fossa posterior e a primeira descrição de um tumor sólido (schwanomatose) em um paciente com mutação no gene KRAS. A partir deste estudo foi possível estabelecer um fluxograma para investigação molecular devido à correlação genótipo-fenótipo, que embora não seja totalmente precisa, explica parte da grande variabilidade clínica observada em especial quanto ao tipo de cardiopatia. A presença de mutações em diferentes genes da via RAS/MAPK não é frequente, além de não agravar o fenótipo e não explicar a variabilidade fenotípica observada. Embora um grande avanço no conhecimento sobre SN e SNL tenha sido alcançado, vários aspectos precisam ser melhor elucidados, como: caracterização precisa da propensão ao desenvolvimento de neoplasias, estudos que permitam avaliar as consequências biológicas das mutações, identificação de outros genes responsáveis, assim como outros fatores genéticos e/ou ambientais que possam explicar a variabilidade clínica inter e intrafamilial / Noonan syndrome (NS) is a relatively common, autosomal dominant disease that presents a marked genetic heterogeneity. It is characterized by facial dysmorphisms, short stature, webbed/short neck, cardiac abnormalities, esternal anomalies and cryptorchidism. NS shows clinical overlap of some of its findings with other rarer syndromes, known as Noonan-like syndromes (NLS): cardio-facio-cutaneous syndrome (CFC), Costello syndrome (CS), neurofibromatosis-Noonan syndrome (NFNS), Noonan syndrome with lentiginous stains/LEOPARD syndrome (LS), Noonan-like syndrome with loose anagen hair (NLS-LAH) and Noonan-like syndrome with juvenile myelomonocytic leukemia (NLS-JMML). NS and NLS are related to mutations in genes belonging of RAS-MAPK signaling pathway. Some of these genes are classified as proto-oncogenes. This fact also arouses the interest in the characterization of the risk for cancer development in this group of patients. The objectives of this study are to sequence the genes associated with NS and NLS (PTPN11, SOS1, RAF1, KRAS, SHOC2, HRAS and BRAF) in patients that fulfilled clinical diagnostic criteria for NS or NLS to: determine the frequency of the mutations; establish a genotype-phenotype correlation; estabilish a flowchart for molecular study from the hotspots; and evaluate when the phenotypic variability presented in NS patients can be explained by the presence of mutations in more than one gene of the RAS/MAPK pathway. This study evaluated 194 probands 152 with NS e 42 with NLS (19 CFC, 15 NFSN, 4 SC e 4 SL). Mutations were identified in 99 patients 80 with NS (53%), 19 with NLS. Only one patient presented mutation in two different genes of the RAS/MAPK pathway (PTPN11 and SOS1). The molecular analysis showed a predominance of mutations in the PTPN11 gene (34%), followed by the SOS1 (12%) and RAF1 (7%) genes in patients with NS, in accordance with the literature. Patients with NS and mutation in the: PTPN11 gene, presented a higher frequency of valvular pulmonary stenosis (VPS) and short stature; SOS1 gene, showed a higher frequency of VPS; RAF1 gene, showed a higher frequency of hypertrophic cardiomyopathy and lower frequency of VPS and intellectual deficit; and SHOC2 gene, showed more hair abnormalities. This genotype-phenotype correlations is also concordant with the literature. In our study, we also observed some rare finds in some patients: craniosynostosis, expansive tumor in the posterior fossa and the first description of a solid tumor (schwanomatose) in a patient with NS and KRAS gene mutation. Based on this genotype-phenotype correlation, we have proposed a flowchart for molecular investigation. The presence of mutation in more them one gene of the RAS/MAPK pathway was not frequent; additionally, it did not aggravate the phenotype and could not explain the phenotypic variability observed. Although a great advance in the knowledge about SN and SNL has been achieved, several aspects remain to be clarified, as the exact risk for cancer development, functional studies to assess the biological consequences of the mutations and the identification of other genes, as well as other genetic and/or environmental factors that influence the interand intrafamilial clinical variability

Os insulinomas são os tumores neuroendócrinos pancreáticos funcionantes mais frequentes, entretanto, os aspectos moleculares envolvidos em sua tumorigênese precisam ser melhor esclarecidos. As características morfológicas e histoquímicas dos insulinomas não conseguem predizer completamente seu comportamento biológico, apenas o fenótipo invasivo local e a presença de metástase são as formas confiáveis do diagnóstico maligno. A presente investigação teve por objetivos analisar a expressão gênica por reação em cadeia da polimerase (PCR) em tempo real e a expressão protéica por imuno-histoquímica dos componentes da via de sinalização do fator de crescimento hepatocítico (HGF) e seu receptor (c-MET) em 27 amostras de insulinomas, sendo: 16 tumores benignos grau 1 (G1), seis tumores benignos grau 2 (G2), dois insulinomas malignos grau 3 (G3) e três metástases hepáticas. Além disso, realizou-se a pesquisa de mutações somáticas no gene MET. Observou-se (1) o aumento da expressão dos genes HGF, MET e ST14 (codificante para a matriptase) e a baixa expressão do gene HAI-1 (codificante para a protease inibidora tipo-kunitz do tipo 1) nos insulinomas malignos e metástases quando comparados aos insulinomas benignos G1; (2) uma correlação positiva entre a expressão do mRNA do gene MET e o gene ST14 e índice proliferativo Ki-67, bem como uma correlação inversa entre a expressão do mRNA do gene HAI-1 e os genes MET, HGF, ST14 e o índice mitótico; (3) uma correlação positiva entre a expressão do gene ST14 e a expressão do mRNA do gene HGF; (4) maior expressão protéica de c-MET nos insulinomas malignos G3 em relação aos insulinomas G1/G2 e (5) ausência de mutações nos éxons 2, 10, 14, 16, 17 e 19 do gene MET. Concluiu-se que os genes HGF, MET, ST14 e HAI-1 estão diferencialmente expressos entre insulinomas malignos e benignos, o que pode ter implicações diagnósticas e terapêuticas / In an attempt to better understand the molecular processes involved in the tumourigenesis of islet beta-cells, the present study evaluated the expression of genes belonging to the hepatocyte growth factor and its receptor (HGF/MET) system, namely, MET, HGF; HGFAC and ST14 (encode HGF activator and matriptase, respectively, two serine proteases that catalyze conversion of pro-HGF to active HGF); and SPINT1 and SPINT2 (encode serine peptidase inhibitors Kunitz type 1 and type 2, respectively, two potent inhibitors of HGF activator and of matriptase) in 27 sporadic insulinomas; 16 grade 1 (G1), six grade 2 (G2), two grade 3 (G3) and three hepatic metastases. Quantitative reverse-transcriptase polymerase chain reaction was employed to assess RNA expression of the target genes and immunohistochemical analysis was used to evaluate the expression of MET and SPINT1. Somatic mutations of MET gene were searched by direct sequencing of exons 2, 10, 14, 16, 17 and 19. Overexpression of MET was observed in grouped G3 insulinomas and metastases concomitantly with upregulation of the genes encoding HGF and matriptase and downregulation of SPINT1. Positive correlations were observed between MET RNA expression and Ki-67 proliferation index while a negative correlation was detected between SPINT1 expression and the mitotic index. No somatic mutations were found in MET gene. The final effect of the increased expression of HGF, its activator (matriptase) and its specific receptor (MET) together with a decreased expression of one potent inhibitor of matriptase (SPINT1) is probably a contribution to tumoural progression and malignancy in insulinomas