Repurposing strategies for Chagas disease therapy: the effect of imatinib and derivatives against Trypanosoma cruzi.

Chagas disease (CD) is a neglected parasitic condition endemic in the Americas caused by Trypanosoma cruzi. Patients present an acute phase that may or not be symptomatic, followed by lifelong chronic stage, mostly indeterminate, or with cardiac and/or digestive progressive lesions. Benznidazole (BZ) and nifurtimox are the only drugs approved for treatment but not effective in the late chronic phase and many strains of the parasite are naturally resistant. New alternative therapy is required to address this serious public health issue. Repositioning and combination represent faster, and cheaper trial strategies encouraged for neglected diseases. The effect of imatinib (IMB), a tyrosine kinase inhibitor designed for use in neoplasias, was assessed in vitro on T. cruzi and mammalian host cells. In comparison with BZ, IMB was moderately active against different strains and forms of the parasite. The combination IMB + BZ in fixed-ratio proportions was additive. Novel 14 derivatives of IMB were screened and a 3,2-difluoro-2-phenylacetamide (3e) was as potent as BZ on T. cruzi but had low selectivity index. The results demonstrate the importance of phenotypic assays, encourage the improvement of IMB derivatives to reach selectivity and testify to the use of repurposing and combination in drug screening for CD.

Influence of clinical use on physical-structural surface properties and electrochemical potential of NiTi endodontic instruments.

AIM: To investigate the surface morphology and electrochemical potential of superelastic (SE), M-Wire (MW) and shape memory technology (SMT) NiTi instruments before and after single clinical use in vivo. METHODOLOGY: A total of 60 ProTaper Universal F2 (PTU-SE), ProTaper Next X2 (PTN-MW), Typhoon (TYP), Hyflex (HF) and Vortex Blue (VB), the last three SMT, and size 25, .06 taper (n = 6 of each type) files were examined. Scanning electron microscopy (SEM), X-ray energy-dispersive spectroscopy (EDS) and electrochemical potential analysis were employed before and after clinical use. Statistical analysis was performed with one-way analysis of variance and Bonferroni's post hoc test. Significance was determined at the 95% confidence level for both tests. RESULTS: SEM observations of new instruments indicated the presence of marks left by the machining process during manufacturing and EDS revealed the existence of an oxide coating on shape memory instruments. After clinical use, the five types were associated with propagation of transverse cracks 3 mm from the tip. The surface oxide layer of TYP, HF and VB instruments had microcracks in multiple directions, whilst TYP and HF had fragmentation in chip form of the oxide layer. EDS analysis demonstrated a significant reduction of the oxide layer in shape memory instruments, except for VB. Electrochemical potentials were higher for shape memory instruments than for M-Wire and superelastic NiTi instruments, respectively (P < 0.05). CONCLUSIONS: It appears that shape memory technology NiTi instruments have a dysfunctional oxide layer after clinical use. Additionally, they featured higher electrochemical potential relative to NiTi instruments manufactured from M-Wire, and conventional superelastic NiTi alloy.

Drug repurposing strategy against Trypanosoma cruzi infection: In vitro and in vivo assessment of the activity of metronidazole in mono- and combined therapy.

Metronidazole (Mtz) is a commercial broad-spectrum nitroimidazolic derivative with relevant antimicrobial activity and relative safety profile. Therefore, it is fair to consider Mtz a candidate for drug repurposing for other neglected conditions such as Chagas disease (CD), a parasitic pathology caused by Trypanosoma cruzi. CD is treated only with benznidazole (Bz) and nifurtimox, both introduced in clinics decades ago despite important limitations, including low efficacy on the later disease stage (chronic form) and severe side effects. New cheap and fast alternative treatments for CD are needed, thus the repurposing of Mtz was assessed in vitro and in vivo in mono- and combined therapy. In vitro assays demonstrated EC50>200µM for Mtz, while for Bz the values ranged from 2.51µM (intracellular forms) to 11.5µM (bloodstream trypomastigotes). When both drugs were combined in fixed-ratio proportions, Mtz promoted Bz potency (lower EC50 values). In vivo toxicity assays for Mtz in mice showed no adverse effects neither histopathological alterations up to 2000mg/kg. Regarding experimental T. cruzi infection, Bz 100mg/kg suppressed parasitemia while Mtz (up to 1000mg/kg) in monotherapy did not, but prolonged animal survival at 250 and 500 regimen doses. The combination of both drugs (Bz 10+Mtz 250) prevented mortality (70%) besides protected against electric cardiac alterations triggered by the parasite infection. Although not able to reduce parasite load, the combination therapy prevented animal mortality; this was possibly due to a protection of the electric cardiac physiology that is normally altered in experimental infection of T. cruzi. It also suggested that the interaction with Mtz could have improved the pharmacokinetics of Bz. Our study emphasizes the importance of drug repurposing and combined therapy for CD to contribute to alternative therapies for this neglected and silent pathology.

In vitro assessment of the genotoxic and cytotoxic effects of boiled juice (tucupi) from Manihot esculenta Crantz roots.

The population of Pará (a state in Brazil) has a very characteristic food culture, as a majority of the carbohydrates consumed are obtained from cassava (Manihot esculenta Crantz) derivatives. Tucupi is the boiled juice of cassava roots that plays a major role in the culinary footprint of Pará. Before boiling, this juice is known as manipueira and contains linamarin, a toxic glycoside that can decompose to hydrogen cyanide. In this study, the cytotoxic and genotoxic effects of tucupi on cultured human lymphocytes were assessed using the comet assay and detection of apoptosis and necrosis by differential fluorescent staining with acridine orange-ethidium bromide. Tucupi concentrations (v/v) were determined using the methylthiazole tetrazolium biochemical test. Concentrations of tucupi that presented no genotoxic effects (2, 4, 8, and 16%) were used in our experiments. The results showed that under our study conditions, tucupi exerted no genotoxic effects; however, cytotoxic effects were observed with cell death mainly induced by necrosis. These effects may be related to the presence of hydrogen cyanide in the juice.

Phenotypic Screening In Vitro of Novel Aromatic Amidines against Trypanosoma cruzi.

The current treatment of Chagas disease (CD), based on nifurtimox and benznidazole (Bz), is unsatisfactory. In this context, we performed the phenotypic in vitro screening of novel mono- and diamidines and drug interaction assays with selected compounds. Ten novel amidines were tested for their activities against bloodstream trypomastigote (BT) and amastigote forms of Trypanosoma cruzi (Y and Tulahuen strains) and their toxicities for mammalian host cells (L929 cells and cardiac cells). Seven of 10 molecules were more active than Bz against BT, with the most active compound being the diamidine DB2267 (50% effective concentration [EC50] = 0.23 µM; selectivity index = 417), which was 28-fold more active and about 3 times more selective than the standard drug. Five of the six monoamidines were also more active than Bz. The combination of DB2267 and DB2236 in fixed-ratio proportions showed an additive effect (sum of fractional inhibitory concentrations < 4) on BT. Interestingly, when intracellular forms were exposed to DB2267, its activity was dependent on the parasite strain, being effective (EC50 = 0.87 ± 0.05 µM) against a discrete typing unit (DTU) II strain (strain Y) but not against a representative DTU VI strain (strain Tulahuen) even when different vehicles (ß-cyclodextrin and dimethyl sulfoxide) were used. The intrinsic fluorescence of several diamidines allowed their uptake to be studied. Testing of the uptake of DB2236 (inactive) and DB2267 (active) by amastigotes of the Y strain showed that the two compounds were localized intracellularly in different compartments: DB2236 in the cytoplasm and DB2267 in the nucleus. Our present data encourage further studies regarding the activities of amidines and provide information which will help with the identification of novel agents for the treatment of CD.

Impairment of Interleukin-17A Expression in Canine Visceral Leishmaniosis is Correlated with Reduced Interferon-γ and Inducible Nitric Oxide Synthase Expression.

Dogs are the primary urban reservoir of Leishmania infantum and play a crucial role in the transmission of this parasite to man via sandflies. The spleen and liver are the main target organs of L. infantum infection, but few studies have evaluated the immune response to this infection in the canine liver. To identify the immunological mediators involved in resistance and/or susceptibility to canine visceral leishmaniosis (CVL), we selected 21 dogs naturally infected by L. infantum and classified as asymptomatic or symptomatic. Immunological parameters were analysed and correlations with clinical signs were determined. Symptomatic dogs showed higher numbers of parasites and less leucocyte infiltration in the liver compared with asymptomatic dogs. The progression of this disease was characterized not only by the down regulation of T helper (Th) 1-related cytokines, such as interferon (IFN)-γ and tumour necrosis factor (TNF)-α, but also by the down regulation of genes encoding interleukin (IL)-17A, inducible nitric oxide synthase (iNOS) and IL-10 in the spleen and liver in symptomatic dogs compared with asymptomatic dogs. Importantly, IL-17A gene transcription level was positively correlated with mRNA expression for iNOS and IFN-γ. Th1- and Th17-related cytokines therefore appear to play a role in restricting parasite growth via iNOS activation and decrease susceptibility of dogs to CVL.

Modulation of expressivity in PDGFRB-related infantile myofibromatosis: a role for PTPRG?

Infantile myofibromatosis is a rare genetic disorder characterized by the development of benign tumors in the skin, muscle, bone, and viscera. The molecular pathogenesis is still incompletely known. An autosomal dominant form had been reported as causally related with mutations in the gene for platelet-derived growth factor receptor beta (PDGFRB). We report here two siblings with infantile myofibromatosis and with a PDGFRB mutation identified by exome sequence analysis. However, the unaffected mother also had the same PDGFRB mutation. We showed that both children had also inherited from their healthy father a heterozygous mutation in the gene for receptor protein tyrosine phosphatase gamma (PTPRG), an enzyme known to dephosphorylate PDGFRB. We suggest that in this family, the additional mutation in PTPRG may explain the full phenotypic penetrance in the siblings affected, in comparison with the unaffected mother.

Flexibility and torsional behaviour of rotary nickel-titanium PathFile, RaCe ISO 10, Scout RaCe and stainless steel K-File hand instruments.

AIM: To assess and compare the flexibility and torsional resistance of PathFile, RaCe ISO 10 and Scout RaCe instruments in relation to stainless steel K-File hand instruments. METHODOLOGY: Rotary PathFile (sizes 13, 16 and 19; .02 taper), Race ISO 10 (size 10; 0.02, 0.04 and 0.06 tapers), Scout RaCe (sizes 10, 15 and 20; 0.02 taper) and hand K-File (sizes 10, 15 and 20; 0.02 taper) instruments were evaluated. Alloy chemical composition, phases present and transformation temperatures were determined for the NiTi instruments. For all instruments, diameters at each millimetre from the tip as well as cross-sectional areas at 3 mm from the tip were measured based on ANSI/ADA Specification No. 101 using image analysis software. Resistance to bending and torsional resistance were determined according to specification ISO 3630-1. Vickers microhardness measurements were also taken in all instruments to assess their strength. Data were analysed using analysis of variance (α = 0.05). RESULTS: The alloys used in the manufacture of the three types of NiTi instruments had approximately the same chemical composition, but the PathFile instruments had a higher Af transformation temperature and contained a small amount of B19' martensite. All instruments had diameter values within the standard tolerance. The bending and torsional resistance values were significantly increased relative to the instrument diameter and cross-sectional area. CONCLUSIONS: PathFile instruments were the most flexible and the least torque resistant, whilst the stainless steel instruments were the least flexible although they were more torque resistant than the NiTi instruments.

Cellular responses induced in vitro by pestheic acid, a fungal metabolite, in a gastric adenocarcinoma cell line (PG100).

There is a constant search for new cancer treatments that are less aggressive and economically affordable. In this context, natural products extracted from plants, fungi, and microorganisms are of great interest. Pestheic acid, or dihidromaldoxin, is a chlorinated diphenylic ether extracted from the phytopathogenic fungus Pestalotiopsis guepinii (Amphisphaeriaceae). We assessed the cytotoxic, cytostatic, and genotoxic effects of pestheic acid in a gastric adenocarcinoma cell line (PG100). A decrease in clonogenic survival was observed. Pestheic acid also induced significant increases in both micronucleus and nucleoplasmic bridge frequency. However, we did not observe changes in cell cycle kinetics or apoptosis induction. Reactive oxygen species induced by diphenylic ethers may explain the genotoxicity and mutagenicity of pestheic acid. The absence of repair checkpoints that we observed is probably due to the fact that the PG100 cell line lacks the TP53 gene, which is common in gastric cancers. Even though pestheic acid has had a clear cytotoxic effect, the minimal inhibitory concentration was high, which shows that pestheic acid is not an active anticancer compound under these conditions.

Cellular responses induced in vitro by iron (Fe) in a central nervous system cell line (U343MGa).

Iron is the most important metallic chemical element on Earth. Poisoning caused by excessive iron in humans has been associated with pulmonary diseases including neoplasms caused by inhalation of iron oxides. The involvement of iron in neurodegenerative processes has already been described. DNA alterations are induced by iron and other chemical compounds containing this metal; however, the data are controversial and the mechanism by which iron induces mutagenesis remains unknown. This study assessed in vitro iron-induced cytotoxic and genotoxic responses in an astrocytic cell line. Short- and long-term cytotoxicity and genotoxicity were evaluated with the Cell Proliferation Kit II and micronucleus test, respectively. Results indicated that the highest concentration of iron sulfate tested was cytotoxic in long-term cytotoxic assays and increased micronucleus frequency in comparison to controls. The significant cytotoxicity observed here might be due to the intrinsic ability of iron to induce apoptosis and possible changes in cell cycle kinetics; the genotoxic effects are probably due to the oxidant properties of iron itself. This was the first study to investigate the induction of micronuclei by iron in central nervous system cells.

The influence of simulated clinical use on the flexibility of rotary ProTaper Universal, K3 and EndoSequence nickel-titanium instruments.

AIM: To investigate the influence of cyclic flexural and torsional loading on the flexibility of ProTaper Universal, K3 and EndoSequence nickel-titanium instruments, in view of the hypothesis that these types of loading would decrease the flexibility of the selected NiTi rotary files. METHODOLOGY: The instruments evaluated were S2 and F1 ProTaper Universal, sizes 20 and 25, .06 taper K3, and sizes 20 and 25, .06 taper EndoSequence. Flexibility was determined by 45° bending tests according to ISO 3630-1 specification. Values of the bending moment (MB ) obtained with new instruments were considered as the control group (CG). Bending tests were then conducted in instruments previously fatigued to one-fourth and three-fourths of their average fatigue life (fatigue groups, FG» and FG¾), as well as after cyclic torsional loading (torsional group, TG). Fatigue tests were carried out in a bench device that allowed the files to rotate freely inside an artificial canal with an angle of curvature of 45° and a radius of 5 mm. Cyclic torsional loading tests were performed that entailed rotating the instrument from zero angular deflection to 180° and then returning to zero applied torque in 20 cycles. Data were analysed using one-way analysis of variance at a significance level of 5%. RESULTS: Simulated clinical use by means of flexural fatigue tests did not affect the flexibility of the instruments, except for a significant increase in flexibility observed in a few instruments (P < 0.05). In addition, comparative statistical analyses between the values of MB measured in new instruments and after cyclic torsional loading showed no significant differences between them (P > 0.05). CONCLUSIONS: The flexibility of rotary ProTaper Universal, K3 and EndoSequence NiTi instruments, measured in bending tests, was not adversely affected by simulated clinical use in curved root canals.

Physical and mechanical properties of twisted or ground nickel-titanium instruments.

AIM: To compare the flexibility, torsional resistance and structural and dimensional characteristics of instruments produced by twisting with those of a geometrically similar nickel-titanium (NiTi) system produced by a grinding process. METHODOLOGY: The mean diameters along the flute and the pitch length of size 25, .04 taper, size 25, .06 taper, and size 25, .08 taper Twisted File (TF) (SybronEndo, Orange, CA, USA), and size 25, .04 taper, and size 25, .06 taper RaCe instruments (FKG, La Chaux-de-Fonds, Switzerland) (n = 10 each) were measured according to ANSI/ADA specification No. 101. Two pairs of instruments were found to have similar diameters at 3 mm from the tip: TF size 25, .06 taper and RaCe size 25, .04 taper, and TF size 25, .08 taper and RaCe size 25, .06 taper. The cross-sectional areas at 3 mm from the tip were determined. These instruments were then submitted to energy-dispersive X-ray spectroscopy, X-ray diffraction, differential scanning calorimetry (DSC), and Vickers microhardness measurements. Bending moment at 45° and maximum torque at fracture were measured (n = 10) according to specification ISO 3630-1. Data were analysed using analysis of variance (α = 0.05). RESULTS: The two types of instruments had approximately the same chemical composition, phase constitution, and austenite finishing temperatures. TF instruments had significantly (P ≤ 0.001) lower Vickers microhardness values and were more flexible than RaCe instruments (P = 0.016), but had similar (TF size 25, .08 taper and RaCe size 25, .06 taper, P = 0.916) or significantly higher (TF size 25, .06 taper and RaCe size 25, .04 taper, P ≤ 0.001) torsional resistance. CONCLUSIONS: Comparison of TF and RaCe instruments of similar measured dimensions revealed that the different manufacturing methods employed for producing these instruments gave rise to different mechanical behaviours.

Posttherapeutic cure criteria in Chagas' disease: conventional serology followed by supplementary serological, parasitological, and molecular tests.

We performed a critical study of conventional serology, followed by supplementary serological, parasitological, and molecular tests, to assess the response to etiologic treatment of Chagas' disease. A group of 94 Chagas' disease patients treated with benznidazole at least 10 years earlier were evaluated from the laboratory and clinical points of view. When conventional serology (enzyme-linked immunosorbent assay [ELISA], indirect immunofluorescence [IIF], and indirect hemagglutination [IHA]) and classic criteria (consistent results with any two of the three tests) or more rigorous criteria (consistent results from the three tests) were used, 10.6% and 8.5% of patients were considered treated and cured (TC) by classic and rigorous criteria, respectively. Patients were then evaluated using supplementary (recombinant ELISA and Trypanosoma cruzi excreted-secreted antigen blotting [TESA-blot]), parasitological (hemoculture), and molecular (PCR) tests. The results of recombinant ELISA were similar to those with the rigorous criterion (three consistent test results). The TESA-blot group showed a higher percentage (21.3%) of negative results than the groups defined by either cure criterion. Hemoculture and PCR gave negative results for all treated and cured (TC) patients, regardless of the criterion used. Recombinant ELISA and TESA-blot tests showed negative results for 70% and 87.5% of the patients categorized as TC by the classic and three-test criteria, respectively. For patients with discordant conventional serology, the supplementary serological and molecular tests were the decisive factor in determining therapeutic failure. Clinical evaluation showed that 62.5% of TC patients presented with the indeterminate form of the disease. Additionally, treated patients with negative TESA-blot results should be reevaluated later with all methodologies used here to verify whether TESA-blot is a reliable way to determine early parasitological cure of Chagas' disease.

Physical and mechanical properties of a thermomechanically treated NiTi wire used in the manufacture of rotary endodontic instruments.

AIM: To compare physical and mechanical properties of one conventional and one thermomechanically treated nickel-titanium (NiTi) wire used to manufacture rotary endodontic instruments. METHODOLOGY: Two NiTi wires 1.0 mm in diameter were characterized; one of them, C-wire (CW), was processed in the conventional manner, and the other, termed M-Wire (MW), received an additional heat treatment according to the manufacturer. Chemical composition was determined by energy-dispersive X-ray spectroscopy, phase constitution by XRD and the transformation temperatures by DSC. Tensile loading/unloading tests and Vickers microhardness measurements were performed to assess the mechanical behaviour. Data were analysed using analysis of variance (α = 0.05). RESULTS: The two wires showed approximately the same chemical composition, close to the 1 : 1 atomic ratio, and the ß-phase was the predominant phase present. B19' martensite and the R-phase were found in MW, in agreement with the higher transformation temperatures found in this wire compared with CW, whose transformation temperatures were below room temperature. Average Vickers microhardness values were similar for MW and CW (P = 0.91). The stress at the transformation plateau in the tensile load-unload curves was lower and more uniform in the M-Wire, which also showed the smallest stress hysteresis and apparent elastic modulus. CONCLUSIONS: The M-Wire had physical and mechanical properties that can render endodontic instruments more flexible and fatigue resistant than those made with conventionally processed NiTi wires.

Amblyomma dissimile Koch (Acari: Ixodidae) attacking Primolius maracana Vieillot (Psittaciformes: Psittacidae) in the Amazon region, State of Pará, Brazil.

The tick Amblyomma dissimile Koch feeds preferentially on reptiles (Squamata), although amphibians (Anura) also seem to be important hosts. We report an A. dissimile nymph infesting a blue-winged macaw, Primolius maracana, held in captivity in the Mangal das Garças Park, State of Pará, Brazil. Environmental observations suggest that free-living iguanas (Iguana iguana), which used to walk on the bird enclosure in the park, were the source of the A. dissimile tick that infested the blue-winged macaw. We provide the second world record of a bird host for A. dissimile, and the first bird record for this species in South America.

Amblyomma dissimile Koch (Acari: Ixodidae) attacking Primolius maracana Vieillot (Psittaciformes: Psittacidae) in the Amazon region, state of Pará, Brazil

The tick Amblyomma dissimile Koch feeds preferentially on reptiles (Squamata), although amphibians (Anura) also seem to be important hosts. We report an A. dissimile nymph infesting a blue-winged macaw, Primolius maracana, held in captivity in the Mangal das Garças Park, State of Pará, Brazil. Environmental observations suggest that free-living iguanas (Iguana iguana), which used to walk on the bird enclosure in the park, were the source of the A. dissimile tick that infested the blue-winged macaw. We provide the second world record of a bird host for A. dissimile, and the first bird record for this species in South America.

Flexibility and torsional resistance of three nickel-titanium retreatment instrument systems.

AIM: To assess the dimensional characteristics, flexibility and torsional behaviour of nickel-titanium retreatment instruments. METHODOLOGY: Using image analysis software and high-resolution digital images, the instrument length, tip angle, diameter at 3 mm from the tip and the distance between the blades (pitch length) of the following eight instruments were measured (n = 12 for each measurement parameter): the ProTaper Universal retreatment (PTU-R) D1, D2 and D3 instruments; the R-Endo R1, R2 and R3 retreatment instruments; and the Mtwo retreatment (Mtwo-R) sizes 25 and 15 retreatment instruments. Maximum torque and the angular deflection at fracture as well as the bending moment at 45° were measured (n = 12) according to the International Standards Organisation (ISO) specification number 3630-1. Data were analysed using the analysis of variance (α = 0.05). RESULTS: The length of the active part of the instruments was found to vary according to the depth of the canal into which they were designed to reach. The pitch length also increased along the active length. The PTU-R D1 and the Mtwo-R instruments had active tips. Measurements of the bending moment at 45° revealed that the Mtwo-R 15 instrument was the most flexible, whereas the PTU-R D1 was the least flexible. The maximum torque tended to increase as the instrument diameter at 3 mm from the tip increased, whereas the angular deflection at fracture varied in the opposite direction. CONCLUSIONS: The geometrical characteristics of the retreatment instruments and their flexibility and torsion behaviour were consistent with their intended clinical application.

Genotoxic effects of aluminum, iron and manganese in human cells and experimental systems: a review of the literature.

There is considerable evidence indicating an increase in neurodegenerative disorders in industrialized countries. The clinical symptoms and the possible mutagenic effects produced by acute poisoning and by chronic exposure to metals are of major interest. This study is a review of the data found concerning the genotoxic potential of three metals: aluminum (Al), iron (Fe) and manganese (Mn), with emphasis on their action on human cells.

Cytogenetic characterization and evaluation of c-MYC gene amplification in PG100, a new Brazilian gastric cancer cell line

Gastric cancer is the fourth most frequent type of cancer and the second cause of cancer mortality worldwide. The genetic alterations described so far for gastric carcinomas include amplifications and mutations of the c-ERBB2, KRAS, MET, TP53, and c-MYC genes. Chromosomal instability described for gastric cancer includes gains and losses of whole chromosomes or parts of them and these events might lead to oncogene overexpression, showing the need for a better understanding of the cytogenetic aspects of this neoplasia. Very few gastric carcinoma cell lines have been isolated. The establishment and characterization of the biological properties of gastric cancer cell lines is a powerful tool to gather information about the evolution of this malignancy, and also to test new therapeutic approaches. The present study characterized cytogenetically PG-100, the first commercially available gastric cancer cell line derived from a Brazilian patient who had a gastric adenocarcinoma, using GTG banding and fluorescent in situ hybridization to determine MYC amplification. Twenty metaphases were karyotyped; 19 (95 percent) of them presented chromosome 8 trisomy, where the MYC gene is located, and 17 (85 percent) presented a deletion in the 17p region, where the TP53 is located. These are common findings for gastric carcinomas, validating PG100 as an experimental model for this neoplasia. Eighty-six percent of 200 cells analyzed by fluorescent in situ hybridization presented MYC overexpression. Less frequent findings, such as 5p deletions and trisomy 16, open new perspectives for the study of this tumor.