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1.
Artigo em Inglês | MEDLINE | ID: mdl-38750824

RESUMO

BACKGROUND: TRPM4 is a broadly expressed, calcium-activated, monovalent cation channel that regulates immune cell function in mice and cell lines. Clinically, however, partial loss- or gain-of-function mutations in TRPM4 lead to arrhythmia and heart disease, with no documentation of immunologic disorders. OBJECTIVE: To characterize functional cellular mechanisms underlying the immune dysregulation phenotype in a proband with a mutated TRPM4 gene. METHODS: We employed a combination of biochemical, cell biological, imaging, omics analyses, flow cytometry, and gene editing approaches. RESULTS: We report the first human cases to our knowledge with complete loss of the TRPM4 channel, leading to immune dysregulation with frequent bacterial and fungal infections. Single-cell and bulk RNA sequencing point to altered expression of genes affecting cell migration, specifically in monocytes. Inhibition of TRPM4 in T cells and the THP-1 monocyte cell line reduces migration. More importantly, primary T cells and monocytes from TRPM4 patients migrate poorly. Finally, CRISPR knockout of TRPM4 in THP-1 cells greatly reduces their migration potential. CONCLUSION: Our results demonstrate that TRPM4 plays a critical role in regulating immune cell migration, leading to increased susceptibility to infections.

2.
J Exp Clin Cancer Res ; 41(1): 199, 2022 Jun 11.
Artigo em Inglês | MEDLINE | ID: mdl-35690832

RESUMO

BACKGROUND: Large immunogenomic analyses have demonstrated the prognostic role of the functional orientation of the tumor microenvironment in adult solid tumors, this variable has been poorly explored in the pediatric counterpart. METHODS: We performed a systematic analysis of public RNAseq data (TARGET) for five pediatric tumor types (408 patients): Wilms tumor (WLM), neuroblastoma (NBL), osteosarcoma (OS), clear cell sarcoma of the kidney (CCSK) and rhabdoid tumor of the kidney (RT). We assessed the performance of the Immunologic Constant of Rejection (ICR), which captures an active Th1/cytotoxic response. We also performed gene set enrichment analysis (ssGSEA) and clustered more than 100 well characterized immune traits to define immune subtypes and compared their outcome. RESULTS: A higher ICR score was associated with better survival in OS and high risk NBL without MYCN amplification but with poorer survival in WLM. Clustering of immune traits revealed the same five principal modules previously described in adult tumors (TCGA). These modules divided pediatric patients into six immune subtypes (S1-S6) with distinct survival outcomes. The S2 cluster showed the best overall survival, characterized by low enrichment of the wound healing signature, high Th1, and low Th2 infiltration, while the reverse was observed in S4. Upregulation of the WNT/Beta-catenin pathway was associated with unfavorable outcomes and decreased T-cell infiltration in OS. CONCLUSIONS: We demonstrated that extracranial pediatric tumors could be classified according to their immune disposition, unveiling similarities with adults' tumors. Immunological parameters might be explored to refine diagnostic and prognostic biomarkers and to identify potential immune-responsive tumors.


Assuntos
Neoplasias Ósseas , Neuroblastoma , Osteossarcoma , Adulto , Criança , Humanos , Neuroblastoma/genética , Prognóstico , Microambiente Tumoral/genética
3.
Stem Cell Res ; 11(3): 1074-90, 2013 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-23978474

RESUMO

Umbilical cord blood (UCB) is an attractive source of hematopoietic stem cells (HSCs). However, the number of HSCs in UCB is limited, and attempts to amplify them in vitro remain inefficient. Several publications have documented amplification of hematopoietic stem/progenitor cells (HSPCs) on endothelial or mesenchymal cells, but the lack of homogeneity in culture conditions and HSC definition impairs direct comparison of these results. We investigated the ability of different feeder layers, mesenchymal progenitors (MPs) and endothelial cells (ECs), to amplify hematopoietic stem/progenitor cells. Placental derived HSPCs (defined as Lin(-)CD45(-/dim)CD34(+)CD38(-)CD90(+)) were maintained on confluent feeder layers and the number of cells and their marker expression were monitored over 21 days. Although both types of feeder layers supported hematopoietic expansion, only endothelial cells triggered amplification of Lin(-)CD45(-/dim)CD34(+)CD38(-)CD90(+) cells, which peaked at 14 days. The amplified cells differentiated into all cell lineages, as attested by in vitro colony-forming assays, and were capable of engraftment and multi-lineage differentiation in sub-lethally irradiated mice. Mesenchymal progenitors promoted amplification of CD38(+) cells, previously defined as precursors with more limited differentiation potential. A competitive assay demonstrated that hematopoietic stem/progenitor cells had a preference for interacting with endothelial cells in vitro. Cytokine and transcriptomic analysis of both feeder cell types identified differences in gene expression that correlated with propensity of ECs and MPs to support hematopoietic cell amplification and differentiation respectively. Finally, we used RNA sequencing of endothelial cells and HSPCs to uncover relevant networks illustrating the complex interaction between endothelial cells and HSPCs leading to stem/progenitor cell expansion.


Assuntos
Células Endoteliais/citologia , Células-Tronco Hematopoéticas/citologia , Placenta/citologia , Transcriptoma , Animais , Antígenos CD34/metabolismo , Comunicação Celular , Diferenciação Celular , Linhagem da Célula , Células Cultivadas , Feminino , Sangue Fetal/citologia , Transplante de Células-Tronco Hematopoéticas , Células-Tronco Hematopoéticas/metabolismo , Humanos , Antígenos Comuns de Leucócito/metabolismo , Camundongos , Gravidez , Transdução de Sinais , Nicho de Células-Tronco
4.
J Proteome Res ; 12(7): 3233-45, 2013 Jul 05.
Artigo em Inglês | MEDLINE | ID: mdl-23734825

RESUMO

Metabolic labeling with stable isotopes is a prominent technique for comparative quantitative proteomics, and stable isotope labeling with amino acids in cell culture (SILAC) is the most commonly used approach. SILAC is, however, traditionally limited to simple tissue culture regimens and only rarely employed in the context of complex culturing conditions as those required for human embryonic stem cells (hESCs). Classic hESC culture is based on the use of mouse embryonic fibroblasts (MEFs) as a feeder layer, and as a result, possible xenogeneic contamination, contribution of unlabeled amino acids by the feeders, interlaboratory variability of MEF preparation, and the overall complexity of the culture system are all of concern in conjunction with SILAC. We demonstrate a feeder-free SILAC culture system based on a customized version of a commonly used, chemically defined hESC medium developed by Ludwig et al. and commercially available as mTeSR1 [mTeSR1 is a trade mark of WiCell (Madison, WI) licensed to STEMCELL Technologies (Vancouver, Canada)]. This medium, together with adjustments to the culturing protocol, facilitates reproducible labeling that is easily scalable to the protein amounts required by proteomic work flows. It greatly enhances the usability of quantitative proteomics as a tool for the study of mechanisms underlying hESCs differentiation and self-renewal. Associated data have been deposited to the ProteomeXchange with the identifier PXD000151.


Assuntos
Técnicas de Cultura de Células/métodos , Células-Tronco Embrionárias/metabolismo , Marcação por Isótopo , Proteômica/métodos , Aminoácidos/química , Animais , Diferenciação Celular , Meios de Cultura/química , Células-Tronco Embrionárias/citologia , Humanos , Camundongos
5.
J Transl Med ; 11: 28, 2013 Jan 31.
Artigo em Inglês | MEDLINE | ID: mdl-23369187

RESUMO

BACKGROUND: The early peritoneal invasion of epithelial ovarian cancer (EOC) by tumoral aggregates presents in ascites is a major concern. The role of the microenvironment seems to be important in this process but the lack of adequate models to study cellular interactions between cancer cells and stromal cells does not allow to uncover the molecular pathways involved. Our goal was to study the interactions between ovarian cancer cells (OCC) and mesenchymal stem cells (MSC) using a 3D model. METHODS: We used millimetric pieces of amniochorionic membrane - referred to as amniotic membrane scaffold (AMS) - to create 3D peritoneal nodules mimicking EOC early invasion. We were able to measure the distribution and the depth of infiltration using confocal microsopy. We extracted MSC from the amniochorionic membrane using the markers CD34-, CD45-, CD73+, CD90+, CD105+ and CD29+ at the Fluorescence Activated Cell Sorting (FACS) analysis. We used transwell and wound healing tests to test OCC migration and invasion in vitro. RESULTS: Here we show that OCC tumors were located in regions rich in MSC (70%). The tumors infiltrated deeper within AMS in regions rich in MSC (p<0.001). In vitro tests revealed that higher IL6 secretion in a context of MSC-OCC co-culture could enhance migration and invasion of OCC. After IL6 receptor antagonism, OCC infiltration was significantly decreased, mostly in regions rich in MSCs, indicating that recruitment and tridimensional invasion of OCC was dependent of IL6 secretion. CONCLUSIONS: The use of tridimensional models using AMS could be a useful tool to decipher early molecular events in ovarian cancer metastasis. Cytokine inhibitors interrupting the cross-talk between OCCs and MSCs such as IL6 should be investigated as a new therapeutic approach in ovarian cancer.


Assuntos
Âmnio , Córion , Interleucina-6/metabolismo , Células-Tronco Mesenquimais/patologia , Modelos Biológicos , Neoplasias Ovarianas/patologia , Antígenos CD/imunologia , Membrana Celular , Técnicas de Cocultura , Feminino , Citometria de Fluxo , Humanos , Imunofenotipagem , Células-Tronco Mesenquimais/imunologia , Microscopia Confocal , Neoplasias Ovarianas/metabolismo
6.
PLoS One ; 8(1): e54524, 2013.
Artigo em Inglês | MEDLINE | ID: mdl-23342164

RESUMO

Mesenchymal progenitors or stromal cells have shown promise as a therapeutic strategy for a range of diseases including heart failure. In this context, we explored the growth and differentiation potential of mesenchymal progenitors (MPs) derived in vitro from human embryonic stem cells (hESCs). Similar to MPs isolated from bone marrow, hESC derived MPs (hESC-MPs) efficiently differentiated into archetypical mesenchymal derivatives such as chondrocytes and adipocytes. Upon treatment with 5-Azacytidine or TGF-ß1, hESC-MPs modified their morphology and up-regulated expression of key cardiac transcription factors such as NKX2-5, MEF2C, HAND2 and MYOCD. Nevertheless, NKX2-5+ hESC-MP derivatives did not form contractile cardiomyocytes, raising questions concerning the suitability of these cells as a platform for cardiomyocyte replacement therapy. Gene profiling experiments revealed that, although hESC-MP derived cells expressed a suite of cardiac related genes, they lacked the complete repertoire of genes associated with bona fide cardiomyocytes. Our results suggest that whilst agents such as TGF-ß1 and 5-Azacytidine can induce expression of cardiac related genes, but treated cells retain a mesenchymal like phenotype.


Assuntos
Células-Tronco Embrionárias/citologia , Células-Tronco Embrionárias/metabolismo , Células-Tronco Mesenquimais/citologia , Miócitos Cardíacos/citologia , Azacitidina/farmacologia , Humanos , Células-Tronco Mesenquimais/metabolismo , Miócitos Cardíacos/efeitos dos fármacos , Fator de Crescimento Transformador beta1/farmacologia
8.
PLoS One ; 7(5): e38340, 2012.
Artigo em Inglês | MEDLINE | ID: mdl-22666502

RESUMO

Tumor microenvironment is an important actor of ovarian cancer progression but the relations between mesenchymal cells and ovarian cancer cells remain unclear. The objective of this study was to determine the ovarian cancer cells' biological modifications induced by mesenchymal cells. To address this issue, we used two different ovarian cancer cell lines (NIH:OVCAR3 and SKOV3) and co-cultured them with mesenchymal cells. Upon co-culture the different cell populations were sorted to study their transcriptome and biological properties. Transcriptomic analysis revealed three biological-function gene clusters were enriched upon contact with mesenchymal cells. These were related to the increase of metastatic abilities (adhesion, migration and invasion), proliferation and chemoresistance in vitro. Therefore, contact with the mesenchymal cell niche could increase metastatic initiation and expansion through modification of cancer cells. Taken together these findings suggest that pathways involved in hetero-cellular interaction may be targeted to disrupt the acquired pro-metastatic profile.


Assuntos
Comunicação Celular , Células-Tronco Mesenquimais/citologia , Neoplasias Ovarianas/patologia , Adesão Celular/genética , Linhagem Celular Tumoral , Movimento Celular/genética , Proliferação de Células , Técnicas de Cocultura , Resistencia a Medicamentos Antineoplásicos/genética , Feminino , Perfilação da Expressão Gênica , Humanos , Invasividade Neoplásica , Metástase Neoplásica
9.
Int J Cancer ; 128(3): 715-25, 2011 Feb 01.
Artigo em Inglês | MEDLINE | ID: mdl-20725999

RESUMO

Hyperthermic intraperitoneal chemotherapy (HIPEC) has shown promise in treatment of ovarian carcinosis. Despite its efficiency for the treatment of peritoneal carcinosis from digestive tract neoplasia, it has failed to demonstrate significant benefit in ovarian cancers. It is therefore essential to understand the mechanism underlying resistance to HIPEC in ovarian cancers. Mesenchymal stem cells (MSC) play an important role in the development of ovarian cancer metastasis and resistance to treatments. A recent study suggests that MSCs may be cytotoxic for cancer cells upon heat shock. In contrast, we describe the protective role of MSC against hyperthermia. Using cytokine arrays we determined that the tumor associated MSC (TAMC) secrete pro-tumoral cytokines. We studied the effect of hyperthermia in co-culture setting of TAMC or BM-MCS associated with ovarian cancer cell lines (SKOV3 and CaOV3) with polyvariate flow cytometry. We demonstrate that hyperthermia does not challenge survival of TAMC or bone marrow derived MSC (BM-MSC). Both TAMC and BM-MSC displayed strong protective effect inducing thermotolerance in ovarian cancer cells (OCC). Transwell experiments demonstrated the role of secreted factors. We showed that CXCL12 was inducing thermotolerance and that inhibition of CXCL12/CXCR4 interaction restored cytotoxicity of hyperthermia in co-culture experiments. Contrary to the previous published study we demonstrated that TAMC and BM-MSC co-cultured with OCC induced thermotolerance in a CXCL12 dependant manner. Targeting the interaction between stromal and cancer cells through CXCL12 inhibition might restore hyperthermia sensitivity in ovarian cancers, and thus improve HIPEC efficiency.


Assuntos
Células-Tronco Mesenquimais/fisiologia , Neoplasias Ovarianas/patologia , Antineoplásicos/uso terapêutico , Linhagem Celular Tumoral , Sobrevivência Celular , Quimiocina CXCL12/antagonistas & inibidores , Técnicas de Cocultura , Feminino , Citometria de Fluxo , Genes Reporter , Proteínas de Fluorescência Verde/genética , Temperatura Alta , Humanos , Hipertermia Induzida , Células-Tronco Mesenquimais/metabolismo , Células-Tronco Mesenquimais/patologia , Neoplasias Ovarianas/tratamento farmacológico , Neoplasias Ovarianas/mortalidade , Receptores CXCR4/antagonistas & inibidores , Taxa de Sobrevida
10.
Clin Lung Cancer ; 11(3): 187-91, 2010 May.
Artigo em Inglês | MEDLINE | ID: mdl-20439195

RESUMO

BACKGROUND: Recent studies suggest that chemokines are involved in organ-specific metastatic relapse. We evaluated the potential implications of chemokine receptors in the development of adrenal metastasis after complete resections of primary non-small-cell lung cancer. PATIENTS AND METHODS: We studied a unique cohort of 21 primary lung cancers with matched adrenal metastases for the expression of CX3CR1, CXCR4, CCR6, and CCR7, using immunohistochemistry. RESULTS: Although CXCR4, CX3CR1, and CCR7 were independently expressed in primary and corresponding metastases, CCR6 was clearly overexpressed in adrenal metastases, compared with corresponding primary tumors. Moreover, CCL20, the ligand of CCR6, was preferentially expressed in adrenal tissues that developed metastases. CONCLUSION: We report for the first time (to the best of our knowledge) a potential role for the CCR6 receptor in the organ orientation of the development of metastases in lung cancer. We demonstrated a statistically significant overexpression of CCR6 in adrenal metastases compared with primary lung tumors, indicating that the increased production of CCL20 in adrenal glands might contribute to the selective recruitment of CCR6-expressing cancer cells in lung cancer. This study, in concordance with the data obtained in animal models, suggests that the chemokine receptor family constitutes a biologic support of the "seed and soil" theory.


Assuntos
Neoplasias das Glândulas Suprarrenais/secundário , Biomarcadores Tumorais/análise , Carcinoma Pulmonar de Células não Pequenas/secundário , Neoplasias Pulmonares/patologia , Receptores CCR6/biossíntese , Neoplasias das Glândulas Suprarrenais/genética , Neoplasias das Glândulas Suprarrenais/metabolismo , Adulto , Idoso , Receptor 1 de Quimiocina CX3C , Carcinoma Pulmonar de Células não Pequenas/genética , Carcinoma Pulmonar de Células não Pequenas/metabolismo , Quimiocina CCL20/biossíntese , Quimiocina CCL20/genética , Feminino , Expressão Gênica , Humanos , Imuno-Histoquímica , Neoplasias Pulmonares/genética , Neoplasias Pulmonares/metabolismo , Masculino , Pessoa de Meia-Idade , Receptores CCR7/biossíntese , Receptores CCR7/genética , Receptores CXCR4/biossíntese , Receptores CXCR4/genética , Receptores de Quimiocinas/biossíntese , Receptores de Quimiocinas/genética
11.
Am J Clin Oncol ; 33(4): 341-5, 2010 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-19884805

RESUMO

OBJECTIVES: Carcinogenesis is a multistep process involving the accumulation of genetic and molecular abnormalities. It has been suggested that there is a relationship between telomere attrition in the early stages of carcinogenesis and activation of the DNA damage response machinery. We explored telomere length modification and damage response pathway activation at 3 steps of breast carcinogenesis. METHODS: We carried out a retrospective immunohistochemical analysis of pathway ataxia telangiectasia mutated (p-ATM) (series 1981) and gamma-H2AX (series 139) levels in normal breast, preneoplastic lesions, and invasive carcinoma. Fluorescent in situ hybridization was used to analyze telomere length at each stage. RESULTS: ATM was activated in 45% of normal tissue samples, 70% of preneoplastic lesions, and 14% of breast carcinomas. The increase in ATM activation, between normal tissues and preneoplasia, was not significant (P = 0.095), whereas, ATM repression between preneoplasia and cancer was significant (P = 0.0023). Telomeres in preneoplastic lesions were more frequently shorter than those in normal tissues (P = 0.0116). Finally, telomere lengths were long in 38.9% and very short in 38.9% of breast carcinomas (P = 0.0087 for comparisons with preneoplastic lesions). CONCLUSIONS: This study suggests that a major defect in DNA repair occurs between preneoplasia and breast cancer. This defect is associated with changes in telomere length between the preneoplastic and the cancer stage.


Assuntos
Neoplasias da Mama/patologia , Mama/citologia , Dano ao DNA , Reparo do DNA , Lesões Pré-Cancerosas/patologia , Telômero/ultraestrutura , Adulto , Idoso , Mama/patologia , Neoplasias da Mama/genética , Feminino , Histonas/genética , Histonas/metabolismo , Humanos , Pessoa de Meia-Idade , Invasividade Neoplásica , Lesões Pré-Cancerosas/genética , Telômero/genética , Telômero/parasitologia
12.
J Thorac Oncol ; 4(10): 1212-20, 2009 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-19687761

RESUMO

INTRODUCTION: The use of biomarkers to evaluate the presence of a target or to select a specific therapy is increasingly advocated. The correlation of biomarker expression between the primary tumor and its corresponding metastasis has not yet been well documented and analyzed in patients with non-small cell lung cancer (NSCLC). METHODS: The expression of epidermal growth factor receptor (EGFR), excision repair cross-complementing (ERCC1), vascular-endothelial growth factor receptor, and Ki-67 was immunohistochemically analyzed in tumor samples of primary NSCLC and one corresponding metastasis in a population of 49 patients. RESULTS: Sixteen cases (33%) displayed clear discordance in the EGFR status between the primary tumor and the metastasis, with a significant trend toward downregulation of EGFR in the metastasis (p = 0.01). The ERCC1 status was discordant in 20 cases (41%), with a trend toward overexpression in brain and adrenal metastases (p = 0.01 and p = 0.08, respectively). The vascular-endothelial growth factor receptor and Ki-67 statuses were discordant in 13 (27%) and 15 (31%) cases, respectively. No difference in expression was observed between synchronous and metachronous metastasis. CONCLUSION: Biomarker expression is discordant between the primary tumor and its corresponding metastasis in about one third of patients with NSCLC. These findings should be considered in the setting of clinical trials and further explored using frozen material and high-throughput techniques.


Assuntos
Neoplasias das Glândulas Suprarrenais/metabolismo , Biomarcadores Tumorais/metabolismo , Neoplasias Ósseas/metabolismo , Neoplasias Encefálicas/metabolismo , Carcinoma Pulmonar de Células não Pequenas/metabolismo , Neoplasias Pulmonares/metabolismo , Adenocarcinoma/metabolismo , Adenocarcinoma/patologia , Adenocarcinoma Bronquioloalveolar/metabolismo , Adenocarcinoma Bronquioloalveolar/patologia , Neoplasias das Glândulas Suprarrenais/secundário , Adulto , Idoso , Idoso de 80 Anos ou mais , Neoplasias Ósseas/secundário , Neoplasias Encefálicas/secundário , Carcinoma de Células Grandes/metabolismo , Carcinoma de Células Grandes/patologia , Carcinoma Pulmonar de Células não Pequenas/patologia , Carcinoma de Células Escamosas/metabolismo , Carcinoma de Células Escamosas/patologia , Proteínas de Ligação a DNA/metabolismo , Endonucleases/metabolismo , Receptores ErbB/metabolismo , Feminino , Humanos , Técnicas Imunoenzimáticas , Neoplasias Pulmonares/patologia , Masculino , Pessoa de Meia-Idade , Estadiamento de Neoplasias , Prognóstico , Receptores de Fatores de Crescimento do Endotélio Vascular/metabolismo , Taxa de Sobrevida , Fator A de Crescimento do Endotélio Vascular/metabolismo
13.
Lung Cancer ; 65(2): 144-9, 2009 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-19091442

RESUMO

INTRODUCTION: The development of molecular targeted therapies as anti-cancer strategies raises important questions regarding the biological and molecular behavior of the metastatic sites as compared to their corresponding primary tumors. We analysed telomere related markers (telomere length and telomeric proteins) and DNA damage repair (DDR) markers in a cohort of patients with surgically resected primary lung NSCLC and adrenal metastasis. These markers were selected for two reasons: (i) small molecule inhibitors of 'druggable' DDR components as well as telomere-interacting agents are already being developed for clinical use; and (ii) limited data is available comparing the expression of these biomarkers between primary tumors and their metastases. MATERIAL AND METHODS: We studied a single series of 21 patients who had undergone surgery of both their primary lung tumor and its related adrenal gland metastasis in a single Institution. DDR and telomeric proteins were analysed by immunohistochemistry and telomere length was assessed by fluorescent in situ hybridization in 17 paired samples. RESULTS: DDR activation was observed in primary tumors and their corresponding metastasis. However, higher levels of p-Chk2 were observed in metastasis than in primary tumors (p=0.0113). This was not observed for p-ATM and gamma-H2AX. Telomere length was independent from primary or metastatic status (p=0.29). There was no correlation between primary and metastatic sites, although approximately 65% of metastases had shorter telomeres than their corresponding primary tumors. In the same way, telomeric protein expression was independent from primary/metastatic localization. Cluster analysis of each specimen according to its protein's expression levels and telomere length showed that matched primary tumors/adrenal metastasis were mostly separated into different clusters. Overall, our findings suggest that the levels of biomarkers analysed differ substantially between primary lung tumors and corresponding metastases. CONCLUSION: There are clear molecular discrepancies at the telomeric and DDR level between primary tumors and their corresponding metastases. Our results may have important implications for the development of molecular targeted therapies aiming at DNA damage repair and telomeric components. Our findings suggest that primary tumors and their relevant metastases may respond differently to such approaches.


Assuntos
Neoplasias das Glândulas Suprarrenais/metabolismo , Biomarcadores Tumorais/análise , Enzimas Reparadoras do DNA/metabolismo , Reparo do DNA/fisiologia , Neoplasias Pulmonares/metabolismo , Telômero/metabolismo , Neoplasias das Glândulas Suprarrenais/genética , Neoplasias das Glândulas Suprarrenais/secundário , Adulto , Idoso , Carcinoma Pulmonar de Células não Pequenas/genética , Carcinoma Pulmonar de Células não Pequenas/secundário , Análise por Conglomerados , Feminino , Humanos , Imuno-Histoquímica , Hibridização in Situ Fluorescente , Neoplasias Pulmonares/genética , Neoplasias Pulmonares/patologia , Masculino , Pessoa de Meia-Idade , Estadiamento de Neoplasias , Telômero/genética
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