Navegando por Assunto "Metástases linfáticas"
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Item Acesso aberto (Open Access) Estudo da expressão das proteínas Twist1, Kai1 e E-Caderina em amostras de câncer de pênis, de pacientes atendidos em um hospital de referência do estado do Pará(Universidade Federal do Pará, 2015-11-10) BATISTA, Lecildo Lira; KHAYAT, André Salim; http://lattes.cnpq.br/6305099258051586Penile neoplasms are a rare disease in developed nations and occur more in the development areas, which states as a major problem of public health by its mutilating features that may lead to social and psychological problems for the patient. The most important prognosis factor are the lymph node involvement and the presence of distance metastasis. Those patiens who have these features rarely survive for five years. By the other side, the prognosis is good at the initial phases and the cure is obtained in most of the cases. In the search for more reliable prognosis indicators, countless of gens and proteins associated with the penile carcinogenesis have been evaluated for a better understanding of the process, in order to achieve more accurate diagnosis methods to identify patients with aggressive disease, then submit them to a more efficient primarily treatment and a better survive rate. Some groups of epithelial and mesenchymal markers have been used to determinate the transition of mesenchymal epithelium in neoplasm tissues. Those groups include surface proteins like E-cadherin and cytoskeleton markers, as vimentin and β-catenin, and transcription factors, as Snail, Slug and Twist1. With this approach, we did a retrospective study which was analyzed 109 patients from Ophir Loyola Hospital, between January 2012 to November 2014. It was investigated the protein expression of Twist1, Kai1 and E-cadherin in penile tissues with benign and malign lesions to look for evidence of the immunoreactivity pattern and correlate that immunoreactivity pattern with the progression and invasion features of the penile neoplasms and other clinicopathological features of the studied tumor. In relation to E-cadherin, 48,6% of the patients had lower expression of this protein when compared to non-neoplasms tissues, this result showed statistical significance. But the association of the abnormal expression of E-cadherin with others clinicopathoogical factors was not found. The higher expression of Twist1 it was not associated with clinicopathological factors and the KAI1. There was statistical significance when we simultaneously compared the defective expression of E-cadherin and Kai1 and we obtained an inconclusive outcome about the association between them and there was not statistical significance among the analysis of the Twist1 e Kai1 proteins.Item Acesso aberto (Open Access) Papilloma vírus humano: prevalência, distribuição e importância como fator preditivo para metástases linfonodais em carcinoma do pênis(Universidade Federal do Pará, 2013-07-09) FONSECA, Aluizio Gonçalves da; BURBANO, Rommel Mario Rodriguéz; http://lattes.cnpq.br/4362051219348099The etiology of squamous cell carcinoma of the penis (CEP) is related to multiple risk factors such as the presence of foreskin, poor hygiene, chronic dermatitis and smoking. However, the risk factor most extensively studied, is infection by human papilloma virus (HPV). It is well established that this plays an important etiologic role in cancers of the uterine cervix, however, its association with CEP has been the focus of debate, demonstrating viral presence ranging from 15% to 80% of cases, suggesting that only a subset of these tumors is caused by HPV. The prognosis is negatively influenced mainly by the presence of metastases in inguinal lymph nodes. Thus, the surgical aproach of them, is of vital importance in curing the disease. On the other hand, the available methods for staging these nodes are imprecise and lymphadenectomy are accompanied by significant morbidity. A description of other histological markers is scarce because of the rarity of these tumors. The objective of this study is to evaluate the prevalence, distribution and association between HPV and histological parameters of poor prognosis, in order to determine their possible predictive value for inguinal metastases, as well as prognostic factors already described. Paraffin tumor specimens from 82 patients with squamous cell carcinoma of the penis were tested for prevalence and genotype distribution of HPV by PCR. The HPV status was correlated with histopathological factors and metastatic inguinal. It was also evaluated the influence of various histological tumor factors, in lymphonodal disease free survival at 5 years. Follow-up ranged from 1 to 71 months (mean 20 months). HPV DNA was detected in 60.9% of the sample having the most prevalent viral type 11 and 6 (64% and 32%, respectively). There was no significant correlation independent of the histological variables of poor prognosis with HPV status. The probability of lymphonodal disease free survival at 5 years, was not affected by HPV (log rank test = 0.45). The only independent factors for pathological inguinal metastases were T stage ≥ T1b-T4 (p = 0.02), lymphovascular invasion (p = 0.04) and infiltrative invasive front (p=0, 03). The status and distribution of HPV showed no correlation with histological factors of poor prognosis, nor showed significance in predicting lymph node metastases in CEP.