Controle da neoplasia maligna do colo de útero: a resolutividade na atenção básica

A quantitative, descriptive, cross-sectional and retrospective study, using technical procedures of document consultation from secondary sources and health household survey with application form for face to face inter views, with the assent nº.039/2011 from the Ethics Committee of the Federal University of Rio Grande do Norte. The aim of this study was to analyze the cervix cancer control in the area47 of the Health Family Centre Nova Natal II. The cancer cervix is the second most common cancer among women worldwide. In Brazil screening for early detection and treatment of disease has been poorly done and follow-up to reduce mortality has not been executed. From a total of1170women belonging to area 47, who under went screening by the Pap test in the period from 2005 to 2010,was elected a sample of 38 women with positive cervical changes, over 18 years old. The calculation of frequency analysis of socio demographic and clinical and epidemiological selected variables with the results of cervical changes, using the X2 test and taking as significance level of p<0.05 was not statistically significant. The predominant age range was 25 to 64 years (68.9%), most no white women (60.5%), predominantly with primary education (57.9%), most married (68.4%) and housewives (68.4%) with early age of sexual activity (86.8%), the minority smokers (13.2%), with a sexual partner (36.8%). At the time of interview, 42.1% of the women voiced complaint of discharge, while only 2.6% reported bleeding. In relation to the occurrence of STDs (including HPV), 10.5% of women reported being a carrier. The use of oral contraceptives was 32.3% of women, from 2 to 4 years (44.4%). The result of the last screening test performed, showed prevalence of immature squamous metaplasia (55.3%), followed by intraepithelial low- grade lesion (including the cytopathologic HPV effect and cervical intra epithelial neoplasia grade I) (31.6%); intraepithelial high-grade lesion (including cervical intraepithelial neoplasia grade II and III) (7.9%), atypical squamous non neoplastic cells (5.3%). There was no squamous cell carcinoma and adenocarcinoma. Most women received information about the action that should be done after the last screening test result (55.3%), but how to perform follow, most women did not report having done so (55.3%). The follow-up group of women studied, with varying degrees of cervical abnormalities, should only be completed with the discharge by cure, established inconsecutive negative cytology, a goal that is not being achieved in the area 47 of the Health Family Centre of Nova Natal II

Análise comparativa da imunoexpressão das proteínas hmlh1 e hmsh2 em carcinomas epidermóides de lábio inferior e queilites actínicas com graus variados de displasia

Lip squamous cell carcinoma (SCC) may develop from a premalignant condition, actinic cheilitis (AC) in 95% of the cases. Both premalignant and neoplastic lip diseases are caused mainly by chronic exposure to the ultraviolet component of solar radiation, especially UVB. This exposure causes disruption of the cell cycle and damage to DNA repair systems, like mismatch repair, altering proteins repair as hMLH1 and hMSH2. This research aimed to investigate the immunohistochemical expression of hMLH1 and hMSH2 proteins in lower lip SCCs and ACs, providing additional information about carcinogenesis of the lower lip. The sample consisted 40 cases of ACs and 40 cases of lower lip SCCs. Histological sections of 3 μm were submitted to immunoperoxidase method, for immunohistochemical analysis of lesions were counted in 1000 cells (positive and negative), data were evaluated both in absolute numbers and percentage of immunostained cells, the latter by assigning scores. Associations of the variables and comparative analysis of biomarker expression were performed by Fisher s exact and Pearson s chi-square, "t" student, one-way ANOVA, Mann- Whitney e Kruskal-Wallis tests. The level of significance was 5%. It was found that, in lower lip SCC, the mean of the proteins was higher in female patients (hMLH1= 369,80 + 223,98; hMHS2 = 534,80 + 343,62), less than 50 years old (hMLH1 = 285,50 + 190,65; hMHS2 = 540,00 + 274,79) and classified as low-grade malignancy (hMLH1 = 264,59 + 179,21; hMHS2 = 519,32 + 302,58), in these data only to sex, for hMLH1 protein, was statistically significant (p=0.034). Comparing the different lesions, we observed that for both hMLH1 and hMSH2 protein, the average of positive epithelial cells decreased as the lesion was graded at later stages. The ACs classified without dysplasia or mild dysplasia had the highest average of immunostained cells (hMLH1 = 721.23 + 88.116; hMHS2 = 781.50 + 156.93). The ACs classified as moderate or severe dysplasia had intermediate values (hMLH1 = 532,86 + 197,72; hMHS2 = 611,14 + 172,48) and SSCs of the lower lip had the lowest averages (hMLH1 = 255,03 + 199,47; hMHS2 = 518,38 + 265,68). There was a statistically significant difference between groups (p<0.001). In conclusion, our data support the hypothesis that changes in immunoexpression of these proteins is related to the process of carcinogenesis of the lower lip

Imunoexpressão de galectinas em queilites actínias e sua relação com características clínicas e gradação histológica

Conselho Nacional de Desenvolvimento Científico e Tecnológico

Actinic keratosis: a clinical and epidemiological revision

Queratoses actínicas são neoplasias benignas intraepiteliais formadas por proliferações atípicas de queratinócitos com potencial de transformação em carcinoma espinocelular. Desenvolvem-se em áreas fotoexpostas da pele, são induzidas principalmente pela radiação ultravioleta e constituem marcadores de exposição solar crônica. Acometem indivíduos adultos e idosos, de fototipos claros, representando o quarto diagnóstico dermatológico mais comum no Brasil. Danos nas vias de apoptose do epitélio fotoexposto favorecem a proliferação celular e manutenção das lesões. Nesta revisão os autores reúnem os principais dados epidemiológicos sobre a doença e defendem que estratégias de identificação de fenótipos de risco, diagnóstico precoce, tratamento adequado, seguimento clínico, incentivo ao autoexame da pele, fotoeducação e fotoproteção devem ser promovidas, a fim de evitar a evolução das lesões, e também prevenir e diagnosticar neoplasias concomitantes também induzidas pela radiação solar.

Avaliação da qualidade de vida em pacientes portadores de câncer de esôfago submetidos à inserção de stent esofágico auto-expansível

Pós-graduação em Bases Gerais da Cirurgia - FMB

Imunoexpressão dos marcadores de apoptose em tumores epiteliais de anexos oculares de cães

Coordenação de Aperfeiçoamento de Pessoal de Nível Superior (CAPES)

Silenciamento epigenético dos genes CRABP2 e MX1 em tumores de cabeça e pescoço

Fundação de Amparo à Pesquisa do Estado de São Paulo (FAPESP)

Identificação de genes diferencialmente expressos em câncer de laringe

Fundação de Amparo à Pesquisa do Estado de São Paulo (FAPESP)

A tecnologia de microarray no estudo do câncer de cabeça e pescoço

(Microarray technology in study of head neck cancer). The microarray technology is a tool for global analysis of gene expression that allows investigating hundreds or thousands of genes in a sample using a hybridization reaction. This technology is based on hybridization between labeled targets derived from biological samples and an array of many DNA probes immobilized on a solid matrix, representing the genes of interest. The simultaneous study of hundreds of genes became the microarray technique a very important tool of global analysis, with applications in several areas, including the study of the development of cancer. Head and neck squamous cell carcinoma (HNSCC) is the fifth most common cancer worldwide, with a global annual incidence of 780,000 new cases. Large-scale studies involving microarrays have identified specific gene expression signatures associated with expression changes in HNSCC samples compared to normal tissue, as well as genes involved in clinical outcome and metastasis. However, the considerable heterogeneity among these studies occurs due to experimental design, number of samples, disease sites and stage, choice of microarray platform and results validation. Thus, there is much to be validated, before the technique has clinical utility. In relation to head and neck neoplasia, the large-scale gene analysis is very important, since the clinical and histopathological methods currently used appear to be insufficient to predict clinical progression and response to treatment. Thus, this approach could result in more effective diagnostic and prognostic and most appropriate therapy for this neoplasia.

Avaliação da diluição do DNA extraido de material parafinado para amplificação em PCR

Introduction: Several reasons may lead to the failure of polymerase chain reaction (PCR) using DNA purified from paraffin-embedded materials: presence of inhibitors and degradation of target DNA. DNA dilution will often reduce the concentration of potential inhibitors and still contain enough DNA to allow PCR amplification. Objective: To evaluate the dilution influence of DNA purified from paraffin-embedded materials on β-globin PCR amplification. Material and Method: Paraffin-embedded blocks from 30 patients with oropharynx squamous cell carcinomas, diagnosed and treated at the Oral Oncology Center were selected. DNA extraction was performed using QIAmp minikit (Quiagen). DNA was quantified and evaluated for purity by spectrophotometer analysis. Two groups were formed with different amounts of DNA: group I had the originally extracted DNA and group II had the same DNA, however diluted with ultrapure water addition. PCR was performed in both groups using oligonucleotides for human β-globin gene. Results: For Group I, amplification of the β-globin gene sequence was successful in 33.33% of the samples and for Group II, in 23.33%. Conclusion: Dilution of the DNA extracted of paraffin-embedded materials did not modify statistically the amount of positive samples β-globin gene amplified in PCR, although the results suggest that this is a way to increase the method for efficacy amplification of PCR.

O papel do epstein barr vírus na carcinogênese oral

Introduction: the squamous cell carcinoma (SCC) is the head and neck cancer of higher occurrence, representing about 90% of all these tumors. The SCC has several risk factors as smoking, alcohol and some oncogenic viruses, including the Epstein Barr virus (EBV). The EBV is a member of Herpesviridae family and has tropism for B lymphocytes and also for epithelial cells. Aim: the aim of this study was accomplish a review of the literature about the presence of the EBV in oral carcinomas. Conclusion: EBV is closely related to nasopharyngeal carcinoma, a SCC of high incidence in Southeast Asia, however its role in others oral SCC has not been proved.

Qualidade de vida de pacientes submetidos à radioterapia para tratamento de lesões malignas de cabeça e pescoço

In order to evaluate the quality of life of patients with head and neck cancer, this study analyzed data of 24 patients with squamous cell carcinoma, which indicated therapy was radiotherapy or not be combined with chemotherapy and surgery. The study was conducted in the Unit of Radiotherapy of Megavoltage located in the São José de Rio Preto-SP, in the period August 2007 to January 2008. Then, it was used the questionnaire of quality of life from University of Washington which enabled the identification of different quality of life patterns associated with the different stages of radiotherapy, indicating to be viable the prospect of recognition of prognostic factors of reduction in multiple domains of quality of life. From the data collected and analyzed, it was identified that the areas with the worst score in the begin of radiotherapy were appearance, speech and anxiety; during the treatment were taste, saliva and anxiety; and in the end were taste, saliva and swallowing. Throughout the treatment, it was observed the deterioration of patients' mood. In this regard, emphasizes the importance of dental and psychological follow-up, within the framework of a multidisciplinary care for patients with head and neck cancer during radiotherapy treatment.

O uso da endoscopia para o rastreamento do câncer do trato aerodigestório alto em população de alto risco

Pós-graduação em Bases Gerais da Cirurgia - FMB

O uso da endoscopia para o rastreamento do câncer do trato aerodigestório alto em população de alto risco

Pós-graduação em Bases Gerais da Cirurgia - FMB

Immunohistochemical evaluation of MMP-2, MMP-9 and CD31/microvascular density in squamous cell carcinomas of the floor of the mouth

The aim of this study was to evaluate the immunoexpression of MMP-2, MMP-9 and CD31/microvascular density in squamous cell carcinomas of the floor of the mouth and to correlate the results with demographic, survival, clinical (TNM staging) and histopathological variables (tumor grade, perineural invasion, embolization and bone invasion). Data from medical records and diagnoses of 41 patients were reviewed. Histological sections were subjected to immunostaining using primary antibodies for human MMP-2, MMP-9 and CD31 and streptavidin-biotin-immunoperoxidase system. Histomorphometric analyses quantified positivity for MMPs (20 fields per slide, 100?points grade, ×200) and for CD31 (microvessels <50?µm in the area of the highest vascularization, 5 fields per slide, 100?points grade, ×400). Statistical design was composed by non-parametric Mann-Whitney U test (investigating the association between numerical variables and immunostainings), chi-square frequency test (in contingency tables), Fisher's exact test (when at least one expected frequency was less than 5 in 2×2 tables), Kaplan-Meier method (estimated probabilities of overall survival) and Iogrank test (comparison of survival curves), all with a significance level of 5%. There was a statistically significant correlation between immunostaining for MMP-2 and lymph node metastasis. Factors associated negatively with survival were N stage, histopathological grade, perineural invasion and immunostaining for MMP-9. There was no significant association between immunoexpression of CD31 and the other variables. The intensity of immunostaining for MMP-2 can be indicative of metastasis in lymph nodes and for MMP-9 of a lower probability of survival