Epidemiological and molecular evaluation of BRAF, KRAS, NRAS genes and MSI in the development of colorectal cancer.

BACKGROUND AND OBJECTIVES: KRAS, NRAS, BRAF mutations and microsatellite instability (MSI) can be associated with Colorectal Cancer (CRC) development. MATERIAL AND METHODS: We evaluated 828 medical records of CRC patients from a school hospital from January/2016 to December/2020. Variables such as age, gender, ethnicity, literacy level, smoking, alcoholism, primary anatomical site, tumor staging, presence of BRAFV600E, KRAS, NRAS mutations and MSI , survival and metastasis were identified. The statistical analyses were performed (p < 0.05 was considered significant). RESULTS: There was a predominance of males (51.93%), whites (90.70%), low education (72.34%), smokers (73.79%), and non-alcoholics (79.10%). Rectum was the most affected site (42.14%), advanced tumor stage was most prevalent (62.07%), and metastasis occurred in (64.61%). Of the enrolled patients; 204 were investigated for BRAF mutation and detected in (2.94%); 216 for KRAS gene and detected in (26.08%); 210 for NRAS gene, and detected in (25.36%); 370 for MSI and detected in (44.68%). A significant association of CRC with NRAS mutation and alcohol habit (p = 0.043) was observed. The presence of MSI was associated with primary site proximal colon (p < 0.000), distal colon (p = 0.001) and rectum (p = 0.010). CONCLUSION: Patients with CRC are male, over 64 years old, white, with low education, smokers and non-alcoholics. The most affected primary site is rectum in advanced stage with metastasis. CRC is associated with NRAS mutation and alcohol habit, there is increased risk for primary site of proximal colon and MSI; decreased risk for distal colon and rectum in the presence of MSI.

Synthesis and Physiological Remodeling of CD34 Cells in the Skin following the Reversal of Fibrosis through Intensive Treatment for Lower Limb Lymphedema: A Case Report.

A novel type of cell underwent identification between 2005 and 2008 and was denominated the "telocyte" in 2010. In 2012, transmission electron microscopy revealed the presence of telocytes in the dermis. The aim of the present study was to report important changes in immunostained CD34 cells following the treatment of lower limb lymphedema using a specific lymphatic therapy technique. A clinical trial involving the evaluation of changes in immunostained CD34 cells in the epidermis and dermis (10 randomly selected histological fields) of a patient before and after intensive treatment for clinical stage II lymphedema was conducted using the Godoy Method, which was adapted to the treatment of skin fibrosis. The evaluation involved the use of the Weibel multi-point morphometric method. Comparisons were performed using the t-test with a 95% significance level. An important increase in CD34 cells was found with redistribution occurring following treatment. The treatment of primary lymphedema of the lower limbs resulted in the clinical reversal of fibrosis and an increase in the number of immunomarked CD34 cells.

Apresentação atípica de osteossarcoma femoral em paciente de 63 anos: relato de caso / Atypical presentation of femoral osteosarcoma in a 63-year-old patient: case report / Presentación atípica del osteosarcoma de fémur en un paciente de 63 años: informe de un caso

Introdução: O osteossarcoma consiste na neoplasia maligna mais comum do tecido ósseo. Possui seu pico de incidência em pacientes jovens, na segunda década de vida, sendo pouco frequentes os casos em pacientes mais idosos. O tumor se caracteriza por ser produtor de matriz óssea e derivado de células-tronco mesenquimais. A histopatologia da lesão é complementada pela imuno-histoquímica, através da expressão de marcadores como SATB2 e Ki-67. Objetivo: Relatar um caso clínico de paciente em idade atípica de acometimento por osteossarcoma e correlacionar com os dados préexistentes na literatura sobre o tema. Material e Método: Trata-se de relato de caso baseado em levantamento de prontuário de paciente com osteossarcoma. Resultados: Paciente do sexo masculino, 63 anos, apresentando dor e massa palpável em região de joelho direito. Realizados exames de imagem que evidenciaram lesão agressiva, com componentes líticos e escleróticos. Biópsia da lesão mostrou-se sugestiva de osteossarcoma. Após diagnóstico, foi realizada desarticulação coxofemoral de membro inferior direito. O estudo anatomopatológico revelou lesão, medindo 13,0 x 8,0 cm, compatível com osteossarcoma de alto grau, apresentando invasão linfovascular e estadiamento patológico pT3. Conclusão: Osteossarcomas em pacientes idosos configuram uma rara apresentação da neoplasia, sendo de fundamental importância a divulgação de casos na literatura para estabelecimento de condutas entre equipes. (AU)

Introduction: Osteosarcoma is the most common malignant neoplasm of bone tissue. It has its peak incidence in young patients in the second decade of life, and cases in older patients are infrequent. The tumor is characterized by being a producer of bone matrix and derived from mesenchymal stem cells. The histopathology of the lesion is complemented by immunohistochemistry, through the expression of markers such as SATB2 and Ki-67. Objective: To report a clinical case of a patient at atypical age of involvement by osteosarcoma and correlate with pre-existing data in the literature on the subject. Material and Method: This is a case report based on medical records of patients with osteosarcoma. Results: Male patient, 63 years old, presenting pain and palpable mass in the right knee region. Imaging tests were performed that showed aggressive lesion, with lytic and sclerotic components. Biopsy of the lesion was shown to be suggestive of osteosarcoma. After diagnosis, hip dysfunction of the right lower limb was performed. The anatomopathological study revealed lesion, measuring 13.0 x 8.0 cm, compatible with highgrade osteosarcoma, presenting lymphovascular invasion and pathological staging pT3. Conclusion: Osteosarcomas in elderly patients constitute a rare presentation of the neoplasm, being of fundamental importance the disclosure of cases in the literature to establish conducts between teams. (AU)

Introducción: El osteosarcoma es la neoplasia maligna más frecuente del tejido óseo. Tiene su máxima incidencia en pacientes jóvenes en la segunda década de la vida, con casos poco frecuentes en pacientes de mayor edad. El tumor se caracteriza por ser productor de matriz ósea y derivar de células madre mesenquimales. La histopatología de la lesión se complementa con la inmunohistoquímica, mediante la expresión de marcadores como SATB2 y Ki-67. Objetivo: Relatar un caso clínico de paciente en edad atípica de acometimiento por osteosarcoma y correlacionarlo con los datos preexistentes en la literatura sobre el tema. Material y Método: Se trata de un informe de caso basado en la historia clínica de un paciente con osteosarcoma. Resultados: Paciente varón de 63 años que presenta dolor y masa palpable en la región de la rodilla derecha. Los exámenes de imagen mostraron una lesión agresiva con componentes líticos y escleróticos. La biopsia de la lesión fue sugestiva de osteosarcoma. Tras el diagnóstico, se realizó una desarticulación coxofemoral del miembro inferior derecho. El estudio anatomopatológico reveló una lesión de 13,0 x 8,0 cm, compatible con un osteosarcoma de alto grado, que presentaba invasión linfovascular y una estadificación patológica pT3. Conclusión: Los osteosarcomas en pacientes idosos configuran una rara presentación de la neoplasia, siendo de fundamental importancia la divulgación de casos en la literatura para el establecimiento de conductas entre equipos. (AU)

Perfil imuno-histoquímico dos casos de carcinomas mamários da microrregião de catanduva-sp / Immunohistochemical profile of breast carcinoma cases from the microregion of catanduva-sp / Perfil inmunohistoquímico de los casos de carcinomas de mama en la microrregión de catanduva-sp

Introdução: O câncer de mama compreende a principal neoplasia maligna que acomete as mulheres brasileiras, com destaque nos índices de mortalidade. O diagnóstico precoce é preconizado através da mamografia, a qual, quando alterada, sugere realizar biópsia para estudo histopatológico e, caso confirmado um carcinoma mamário, acrescenta-se o estudo imuno-histoquímico para determinação de fatores prognósticos e preditivos para o tumor. Objetivos: Levantar os resultados de análise imuno-histoquímica dos carcinomas mamários diagnosticados pelo Serviço de Patologia do Hospital Emílio Carlos (Catanduva-SP) e estabelecer os principais subtipos moleculares do câncer de mama encontrados nessa população. Material e Método: O estudo foi transversal e retrospectivo, a partir dos relatórios de imunohistoquímica dos carcinomas. Foram relatados idade, sexo, subtipo histológico do tumor e positividade imunohistoquímica para receptor de estrogênio, receptor de progesterona, fator de crescimento epidérmico humano 2, índice de proliferação celular e E-caderina. Os casos foram classificados conforme os critérios estabelecidos pelo Consenso de St. Gallen e os dados apresentados por meio de gráficos e tabelas. Resultados: A amostra foi constituída por n=210 casos de carcinomas mamários, com idade média de 58 anos e predominantemente do sexo feminino. O tipo histológico predominante foi o carcinoma mamário invasivo do tipo não especial. A expressão de receptor de estrogênio ocorreu em 92,86%, progesterona 80,48%, HER2 32,38% e Ki67 alto em 70%. O principal subtipo molecular foi o luminal B. Conclusão: Os casos de carcinomas mamários da microrregião de Catanduva apresentam diferenças quando comparados com estudos nacionais, porém similares a outros de caráter regional

Introduction: Breast cancer is the main malignant neoplasm that affects Brazilian women, especially in mortality rates. Early diagnosis is recommended through mammography, which, when altered, suggests biopsy for histopathological study and, if a breast carcinoma is confirmed, the immunohistochemical study is added for determination of prognostic and predictive factors for the tumor. Objectives: To survey the results of immunohistochemical analysis of breast carcinomas diagnosed by the Pathology Service of Hospital Emílio Carlos (Catanduva-SP) and to establish the main molecular subtypes of breast cancer found in this population. Material and Method: The study was cross-sectional and retrospective, from the reports of immunohistochemistry of carcinomas (CEP/UNIFIPA number 4737142). Age, sex, histological subtype of the tumor and immunohistochemical positivity for estrogen receptor, progesterone receptor, human epidermal growth factor 2, cell proliferation index and E-cadherin were reported. The cases were classified according to the criteria established by the St. Gallen Consensus and the data presented by means of graphs and tables. Results: The sample consisted of n=210 cases of breast carcinomas, with a mean age of 58 years and predominantly female. The predominant histological type was invasive breast carcinoma of the non-special type. Estrogen receptor expression occurred in 92.86%, progesterone 80.48%, HER2 32.38% and high Ki67 in 70%. The main molecular subtype was luminal B. Conclusion: The cases of breast carcinomas in the microregion of Catanduva present differences when compared to national studies, but similar to other regional studies

Introduction: Breast cancer comprises the main malignant neoplasm that affects Brazilian women, especially in mortality rates. Early diagnosis is recommended through mammography, which, when altered, suggests biopsy for histopathological study and, if confirmed a breast carcinoma, the immuno-study is addedto determine prognostic and predictive factors for the tumor. Objectives: To collect the results of immunohistochemical analysis of breast carcinomas diagnosed by the Pathology Service of the Emílio Carlos Hospital (Catanduva-SP) and to establish the main molecular subtypes of breast cancer found in this population. Methods: The study was cross-sectional and retrospective, from the reports of immunohistochemistry of carcinomas. Age, sex, tumor histological subtype and immunohistochemical positivity for estrogen receptor, progesterone receptor, human epidermal growth factor 2, cell proliferation index and E-cadherin were reported. The cases were classified according to the criteria established by the St. Gallen Consensus and the data presented through graphs and tables. Results: The sample consisted of n = 210 cases of breast carcinomas, with a mean age of 58 years and predominantly female. The predominant histological type was nonspecial invasive breast carcinoma. The expression of estrogen receptor occurred in 92.86%, progesterone 80.48%, HER2 32.38% and Ki67 high in 70%. The main molecular subtype was luminal B. Conclusion: The cases of breast carcinomas in the Catanduva microregion show differences when compared to national studies, but similar to others of regional character

Stimulation of Synthesis and Lysis of Extracellular Matrix Proteins in Fibrosis Associated with Lymphedema.

Background: Fibrotic diseases pose a problem for overall health due to their chronic, progressive nature; the lack of a cure; and the fact that such conditions are largely refractory to current medical and surgical treatment practices. Objective: The aim of the present study was to report the physiological stimulation of synthesis and lysis of extracellular matrix proteins during the treatment of primary lymphedema. Material and Methods: A clinical trial was conducted involving the analysis of changes in type I and III collagen fibers and elastic fibers as well as the thickness of the epidermis and dermis in 10 histological fields. Samples were taken from the skin before and after intensive treatment using the Godoy Method® and adapted to the treatment of fibrosis in a patient with a clinical diagnosis of lower limb lymphedema. Slides were stained with orcein, hematoxylin and eosin, picrosirius red, and Gomori's reticulin stains. Weibel's multipoint method was used for the morphometric evaluation. The data were compared using the t-test with a 95% confidence interval. Results: Significant changes were detected in all aspects of interest (thickness of the epidermis and dermis, type I and III collagen fibers, and elastic fibers). Conclusion: The present findings demonstrate the physiological stimulation of synthesis and lysis of the main components of an extracellular matrix, such as type I and III collagen fibers and elastic fibers, as well as a reduction in the thickness of the epidermis and dermis in cases of fibrosis through adequate stimulation of the lymphatic system.

VEGFA and NFE2L2 Gene Expression and Regulation by MicroRNAs in Thyroid Papillary Cancer and Colloid Goiter.

Deregulation of VEGFA (Vascular Endothelial Growth Factor A) and NFE2L2 (Nuclear Factor (Erythroid-derived 2)-Like 2), involved in angiogenesis and oxidative stress, can lead to thyroid cancer progression. MiR-17-5p and miR-612 are possible regulators of these genes and may promote thyroid disorders. In order to evaluate the involvement of VEGFA, NFE2L2, hsa-miR-17-5p, and hsa-miR-612 in thyroid pathology, we examined tissue samples from colloid goiter, papillary thyroid cancer (PTC), and a normal thyroid. We found higher levels of VEGFA and NFE2L2 transcripts and the VEGFA protein in goiter and PTC samples than in normal tissue. In the goiter, miR-612 and miR-17-5p levels were lower than those in PTC. Tumors, despite showing lower VEGFA mRNA expression, presented higher VEGFA protein levels compared to goiter tissue. In addition, NRF2 (Nuclear Related Transcription Factor 2) protein levels in tumors were higher than those in goiter and normal tissues. Inhibition of miR-17-5p resulted in reduced NFE2L2 expression. Overall, both transcript and protein levels of NFE2L2 and VEGFA were elevated in PTC and colloid goiter. Hsa-miR-612 showed differential expression in PTC and colloid goiter, while hsa-miR-17-5p showed differential expression only in colloid goiter, suggesting that hsa-miR-17-5p may be a positive regulator of NFE2L2 expression in PTC.

Differential Expression of Prostaglandin I2 Synthase Associated with Arachidonic Acid Pathway in the Oral Squamous Cell Carcinoma.

INTRODUCTION: Differential expression of genes encoding cytochrome P450 (CYP) and other oxygenases enzymes involved in biotransformation mechanisms of endogenous and exogenous compounds can lead to oral tumor development. OBJECTIVE: We aimed to identify the expression profile of these genes, searching for susceptibility biomarkers in oral squamous cell carcinoma. PATIENTS AND METHODS: Sixteen oral squamous cell carcinoma samples were included in this study (eight tumor and eight adjacent non-tumor tissues). Gene expression quantification was performed using TaqMan Array Human CYP450 and other Oxygenases 96-well plate (Applied Biosystems) by real time qPCR. Protein quantification was performed by ELISA and IHC methods. Bioinformatics tools were used to find metabolic pathways related to the enzymes encoded by differentially expressed genes. Results. CYP27B1, CYP27A1, CYP2E1, CYP2R1, CYP2J2, CYP2U1, CYP4F12, CYP4X1, CYP4B1, PTGIS, ALOX12, and MAOB genes presented differential expression in the oral tumors. After correction by multiple tests, only the PTGIS (Prostaglandin I2 Synthase) gene presented significant differential expression (P < 0.05). The PTGIS gene and protein were reduced in oral tumors. CONCLUSION: PTGIS presents downexpression in oral tumors. PTGIS play an important role in the arachidonic acid metabolism. Arachidonic acid and/or metabolites are derived from this pathway, which can influence the regulation of important physiological mechanisms in tumorigenesis process.

Deregulation of annexin-A1 and galectin-1 expression in precancerous gastric lesions: intestinal metaplasia and gastric ulcer.

OBJECTIVE: Annexin-A1 (ANXA1/AnxA1) and galectin-1 (LGALS1/Gal-1) are mediators that play an important role in the inflammatory response and are also associated with carcinogenesis. We investigated mRNA and protein expression in precancerous gastric lesions that participate in the progression cascade to gastric cancer, such as intestinal metaplasia (IM) and gastric ulcer (GU). METHODS: Quantitative real-time PCR (qPCR) and immunohistochemical techniques were used to analyze the relative quantification levels (RQ) of ANXA1 and LGALS1 mRNA and protein expression, respectively. RESULTS: Increased relative expression levels of ANXA1 were found in 100% of cases, both in IM (mean RQ = 6.22 ± 0.06) and in GU (mean RQ = 6.69 ± 0.10). However, the LGALS1 presented basal expression in both groups (IM: mean RQ = 0.35 ± 0.07; GU: mean RQ = 0.69 ± 0.09). Immunohistochemistry revealed significant positive staining for both the AnxA1 and Gal-1 proteins in the epithelial nucleus and cytoplasm as well as in the stroma of the IM and GU groups (P < 0.05) but absence or low immunorectivity in normal mucosa. CONCLUSION: Our results bring an important contribution by evidencing that both the AnxA1 and Gal-1 anti-inflammatory proteins are deregulated in precancerous gastric lesions, suggesting their involvement in the early stages of gastric carcinogenesis, possibly due to an inflammatory process in the gastric mucosa.

Glutathione transferase pi (GSTpi) expression in breast cancer: an immunohistochemical and molecular study.

Breast cancer is the most frequent cancer in women worldwide. Prognostic markers are important for diagnosis, allowing therapeutic strategies to be defined more efficiently. The expression of the glutathione S-transferase pi isoenzyme (GSTpi) in tumor cells has been evaluated as a predictor of prognosis and in response to cytotoxic treatments. Its immunoexpression was assessed in 63 women diagnosed with invasive ductal carcinoma in a retrospective study. The results were statistically correlated with clinicopathological parameters of patients. The results showed that high GSTpi expression was related to p53-positive tumors, grade III histology, large tumor size and death (p<0.05). The 37 patients who received adjuvant treatment, checked separately, showed high expression of GSTpi in relation to local recurrence, metastasis and death (p<0.05). In addition, high levels of GSTpi expression were significantly associated with a shorter overall survival (p<0.05). To confirm this suspicion, GSTpi gene expression was checked by Real-time PCR in neoplastic mammary cells cultured and subjected to treatment with doxorubicin. Our results suggest that high levels of GSTpi may be related to the development of resistance to chemotherapy in these tumors, the response of these tumors to treatment and the clinical course of the patients involved.