O uso dos marcadores moleculares (p16, Ki-67 e E-Caderina) em biópsias uterinas cervicais
Autor(a) principal: | |
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Data de Publicação: | 2009 |
Tipo de documento: | Dissertação |
Idioma: | por |
Título da fonte: | Biblioteca Digital de Teses e Dissertações da FAMERP |
Texto Completo: | http://bdtd.famerp.br/handle/tede/525 |
Resumo: | Cervical cancer is related to the Human Papillomavirus (HPV). The E7 viral DNA sequence induces the start of DNA synthesis pf infected cell, releasing protein p16. The sequence E6 inhibits apoptosis, with prolonged survival of cells heavily damaged and changed, with inhibition of p53 protein and increasing of protein Ki-67. The E-cadherin is lost in injured cells, increasing motility cell and invade the ajacent. Objectives - to study the immunoistochemical expression of p16 protein, Ki-67 and E-cadherin in benign lesions, pre-invasive carcinoma of the cervix; to correlate the expression of these markers together in cases of difficult interpretarion, assisting in the diagnosis and prognosis of cervical lesions and asses the relationship between the expression of these markers and the persistence or not of the cervical lesion. Patients and methods: 54 uterine cervix biopsies were selected and submitted to immunohistochemical study, with biomarkers p16, Ki-67 and E-cadherin. Results: 1-CIN I (27.9%) and CIN II (47.9%) had lower expression of p16 than in CIN III (73.5%) and invasive carcinoma (72.7%) (p<0.0005). For Ki-67 There was only statistically significant difference between the median for the normal group (6.6%) with the neoplastic lesions (p=0.005). Invasive carcinoma (57.8%), was highly positive for Ki-67 when compared to CIN I (35.6%), CIN II (51.9%) and CIN III (40.9%) but the was no statistically significant difference between them. E-cadherin expression in invasive carcinoma (46.2%) was lower than in CIN III (56.0%), CIN II (77.4%) and CIN I (82.2%) (p<0.0005) and, normal epithelium had the greatest E-cadherin expression (89.1%). In persistente and no persistent CIN there was no difference in the expression of the biomarkers, with p16 presenting p=0.50, Ki-67, p=0.91 and the E-cadherin a p=0.43 value. Conclusions: there is an increased expression of p16 according to the increase in the degree of lesions. No expression in normal tissue; the Ki-67, there was greater expression of protein in cases of invasive carcinoma in the normal epithelium. However, no significant difference in expression when comparing the invasive carcinoma with CIN I, II and III and lesions of normal tissue from the cervix and CIN I showed expression of E-cadherin more pronounced, which decreases with greater severity of injury. However. there is only difference compared the expression of invasive carcinoma with CIN I and CIN II. The use of p16. Ki-67 and E-cadherin biomarkers in cervical biopsies of difficult diagnosis may help in early diagnosis of malignant lesions and support the apropriate treatment. The use of biomarkers is not useful to distinguish between persistente and non-persistente CIN. |
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Cury, Patricia Malufhttp://lattes.cnpq.br/4507603595734808Bonilha, Jane Lopeshttp://lattes.cnpq.br/7492782019607468Stiepcich, Mônica Maria ÁgataOliani, Denise Cristina Mós Vaz33915231827http://lattes.cnpq.br/4457299685294961Munhoz, Natália Gaspar2019-03-11T18:14:14Z2009-05-29Munhoz, Natália Gaspar. O uso dos marcadores moleculares (p16, Ki-67 e E-Caderina) em biópsias uterinas cervicais. 2009. 30 f. Dissertação (Programa de Pós-Graduação em Ciências da Saúde) - Faculdade de Medicina de São José do Rio Preto, São José do Rio Preto.956http://bdtd.famerp.br/handle/tede/525Cervical cancer is related to the Human Papillomavirus (HPV). The E7 viral DNA sequence induces the start of DNA synthesis pf infected cell, releasing protein p16. The sequence E6 inhibits apoptosis, with prolonged survival of cells heavily damaged and changed, with inhibition of p53 protein and increasing of protein Ki-67. The E-cadherin is lost in injured cells, increasing motility cell and invade the ajacent. Objectives - to study the immunoistochemical expression of p16 protein, Ki-67 and E-cadherin in benign lesions, pre-invasive carcinoma of the cervix; to correlate the expression of these markers together in cases of difficult interpretarion, assisting in the diagnosis and prognosis of cervical lesions and asses the relationship between the expression of these markers and the persistence or not of the cervical lesion. Patients and methods: 54 uterine cervix biopsies were selected and submitted to immunohistochemical study, with biomarkers p16, Ki-67 and E-cadherin. Results: 1-CIN I (27.9%) and CIN II (47.9%) had lower expression of p16 than in CIN III (73.5%) and invasive carcinoma (72.7%) (p<0.0005). For Ki-67 There was only statistically significant difference between the median for the normal group (6.6%) with the neoplastic lesions (p=0.005). Invasive carcinoma (57.8%), was highly positive for Ki-67 when compared to CIN I (35.6%), CIN II (51.9%) and CIN III (40.9%) but the was no statistically significant difference between them. E-cadherin expression in invasive carcinoma (46.2%) was lower than in CIN III (56.0%), CIN II (77.4%) and CIN I (82.2%) (p<0.0005) and, normal epithelium had the greatest E-cadherin expression (89.1%). In persistente and no persistent CIN there was no difference in the expression of the biomarkers, with p16 presenting p=0.50, Ki-67, p=0.91 and the E-cadherin a p=0.43 value. Conclusions: there is an increased expression of p16 according to the increase in the degree of lesions. No expression in normal tissue; the Ki-67, there was greater expression of protein in cases of invasive carcinoma in the normal epithelium. However, no significant difference in expression when comparing the invasive carcinoma with CIN I, II and III and lesions of normal tissue from the cervix and CIN I showed expression of E-cadherin more pronounced, which decreases with greater severity of injury. However. there is only difference compared the expression of invasive carcinoma with CIN I and CIN II. The use of p16. Ki-67 and E-cadherin biomarkers in cervical biopsies of difficult diagnosis may help in early diagnosis of malignant lesions and support the apropriate treatment. The use of biomarkers is not useful to distinguish between persistente and non-persistente CIN.O câncer do colo uterino está relacionado com o Papilomavírus Humano (HPV). A seqüência do DNA de células infectadas, liberando proteína p16. A seqüência E6 inibe a apoptose, prolongado a sobrevida das células modificadas com a inibição da proteína p53 e do aumento da proteína Ki-67. A E-caderina diminui nas células lesadas fazendo com que ocorra uma maior motilidade celular para invadir as adjacentes. Objetivo - Estudar a expressão imunoistoquímica das proteínas p16, Ki-67 e E-caderina em lesões benignas, pré-invasivas e carcinoma invasivo de colo uterino; correlacionar a expressão destes marcadores juntos em casos de difícil interpretação, auxiliando no diagnóstico e prognóstico das lesões cervicais e avaliar a relação entre as expressão desses marcadores e a persistência ou não da lesão cervical. Pacientes e Métodos - 54 biópsias de colo uterino foram selecionados e submetidas a estudo imunohistoquímico, com biomarcadores p16, Ki-67 e E-caderina. Resultados - NIC I (27,9%) e NIC II (47,9%) tiveram menor expressão da p16 em NIC de III (73,5%) e carcinoma invasivo (72,7%) (p <0,0005). Para Ki-67, somente houve uma diferença estatística significante entre o grupo normal (6,6%) com lesões neoplásicas (p=0,0005). O carcinoma invasivo (57,8%), teve maior expressão quando comparados com NIC I (35,6%), NIC II (51,9%) e NIC III (40,9%), mais não houve uma diferença estatística significante entre eles. A expressão de E-caderina com carcinoma invasivo (46,2%) foi menor do que na NIC III (56,0%), NIC II (77,4%) e NIC I (82,2%) (p <0,0005), e epitélio normal tinha o maior expressão de E-caderina (89,1%). Em NIC persistentes e não persistentes não houve diferença na expressão dos biomarcadores, com p16 com valores p = 0,50, Ki-67, p = 0,91 e da E-caderina = 0,43. Conclusões - Em relação à proteína p16 vimos que houve um aumento de sua expressão de acordo com o aumento do grau das lesões. Em tecidos normais não houve expressão da mesma; o Ki-67 observou-se uma maior expressão dessa proteína nos casos de carcinoma invasivo em relação ao epitélio normal. Porém, não houve diferença significativa de sua expressão quando comparamos o carcinoma invasivo com NIC I, II e III. As lesões de tecidos normais de colo uterino e NIC I apresentaram expressão da E-caderina mais acentuada, que diminui com a maior gravidade a lesão. Entretanto existe diferença estatística apenas quando comparada a expressão de carcinoma invasivo com NIC I e NIC II. O uso de p16, Ki-67 e E-caderina biomarcadores em biópsias cervicais de difícil diagnóstico poderá ajudar no diagnóstico precoce de lesões malignas e apoiar o tratamento adequado. O uso dos biomarcadores não são úteis para diferenciar entre NIC persistentes e não-persistente.Submitted by Suzana Dias (suzana.dias@famerp.br) on 2019-03-11T18:14:14Z No. of bitstreams: 1 NataliaGasparMunhoz_dissert.pdf: 5641996 bytes, checksum: 434aa435be92f8bebdc51d0456f10850 (MD5)Made available in DSpace on 2019-03-11T18:14:14Z (GMT). No. of bitstreams: 1 NataliaGasparMunhoz_dissert.pdf: 5641996 bytes, checksum: 434aa435be92f8bebdc51d0456f10850 (MD5) Previous issue date: 2009-05-29application/pdfporFaculdade de Medicina de São José do Rio PretoPrograma de Pós-Graduação em Ciências da SaúdeFAMERPBrasilFaculdade 1::Departamento 1PatologiaAntígeno Ki-67Displasia do Colo do ÚteroNeoplasia Intraepitelial CervicalPathologyKi-67 AntigenUterine Cervical DysplasiaCervical Intraepithelial NeoplasiaCIENCIAS DA SAUDE::MEDICINAO uso dos marcadores moleculares (p16, Ki-67 e E-Caderina) em biópsias uterinas cervicaisinfo:eu-repo/semantics/publishedVersioninfo:eu-repo/semantics/masterThesis-6954410853678806574500500600306626487509624506-969369452308786627info:eu-repo/semantics/openAccessreponame:Biblioteca Digital de Teses e Dissertações da FAMERPinstname:Faculdade de Medicina de São José do Rio Preto (FAMERP)instacron:FAMERPORIGINALNataliaGasparMunhoz_dissert.pdfNataliaGasparMunhoz_dissert.pdfapplication/pdf5641996434aa435be92f8bebdc51d0456f10850MD52LICENSElicense.txtlicense.txttext/plain; charset=utf-82165bd3efa91386c1718a7f26a329fdcb468MD51http://bdtd.famerp.br/bitstream/tede/525/2/NataliaGasparMunhoz_dissert.pdfhttp://bdtd.famerp.br/bitstream/tede/525/1/license.txttede/5252019-03-11 15:14:14.859oai:localhost: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Biblioteca Digital de Teses e Dissertaçõeshttp://bdtd.famerp.br/PUBhttps://bdtd.famerp.br/oai/requestsbdc@famerp.br||joao.junior@famerp.bropendoar:47112019-03-11T18:14:14Biblioteca Digital de Teses e Dissertações da FAMERP - Faculdade de Medicina de São José do Rio Preto (FAMERP)false |
dc.title.por.fl_str_mv |
O uso dos marcadores moleculares (p16, Ki-67 e E-Caderina) em biópsias uterinas cervicais |
title |
O uso dos marcadores moleculares (p16, Ki-67 e E-Caderina) em biópsias uterinas cervicais |
spellingShingle |
O uso dos marcadores moleculares (p16, Ki-67 e E-Caderina) em biópsias uterinas cervicais Munhoz, Natália Gaspar Patologia Antígeno Ki-67 Displasia do Colo do Útero Neoplasia Intraepitelial Cervical Pathology Ki-67 Antigen Uterine Cervical Dysplasia Cervical Intraepithelial Neoplasia CIENCIAS DA SAUDE::MEDICINA |
title_short |
O uso dos marcadores moleculares (p16, Ki-67 e E-Caderina) em biópsias uterinas cervicais |
title_full |
O uso dos marcadores moleculares (p16, Ki-67 e E-Caderina) em biópsias uterinas cervicais |
title_fullStr |
O uso dos marcadores moleculares (p16, Ki-67 e E-Caderina) em biópsias uterinas cervicais |
title_full_unstemmed |
O uso dos marcadores moleculares (p16, Ki-67 e E-Caderina) em biópsias uterinas cervicais |
title_sort |
O uso dos marcadores moleculares (p16, Ki-67 e E-Caderina) em biópsias uterinas cervicais |
author |
Munhoz, Natália Gaspar |
author_facet |
Munhoz, Natália Gaspar |
author_role |
author |
dc.contributor.advisor1.fl_str_mv |
Cury, Patricia Maluf |
dc.contributor.advisor1Lattes.fl_str_mv |
http://lattes.cnpq.br/4507603595734808 |
dc.contributor.advisor-co1.fl_str_mv |
Bonilha, Jane Lopes |
dc.contributor.advisor-co1Lattes.fl_str_mv |
http://lattes.cnpq.br/7492782019607468 |
dc.contributor.referee1.fl_str_mv |
Stiepcich, Mônica Maria Ágata |
dc.contributor.referee2.fl_str_mv |
Oliani, Denise Cristina Mós Vaz |
dc.contributor.authorID.fl_str_mv |
33915231827 |
dc.contributor.authorLattes.fl_str_mv |
http://lattes.cnpq.br/4457299685294961 |
dc.contributor.author.fl_str_mv |
Munhoz, Natália Gaspar |
contributor_str_mv |
Cury, Patricia Maluf Bonilha, Jane Lopes Stiepcich, Mônica Maria Ágata Oliani, Denise Cristina Mós Vaz |
dc.subject.por.fl_str_mv |
Patologia Antígeno Ki-67 Displasia do Colo do Útero Neoplasia Intraepitelial Cervical |
topic |
Patologia Antígeno Ki-67 Displasia do Colo do Útero Neoplasia Intraepitelial Cervical Pathology Ki-67 Antigen Uterine Cervical Dysplasia Cervical Intraepithelial Neoplasia CIENCIAS DA SAUDE::MEDICINA |
dc.subject.eng.fl_str_mv |
Pathology Ki-67 Antigen Uterine Cervical Dysplasia Cervical Intraepithelial Neoplasia |
dc.subject.cnpq.fl_str_mv |
CIENCIAS DA SAUDE::MEDICINA |
description |
Cervical cancer is related to the Human Papillomavirus (HPV). The E7 viral DNA sequence induces the start of DNA synthesis pf infected cell, releasing protein p16. The sequence E6 inhibits apoptosis, with prolonged survival of cells heavily damaged and changed, with inhibition of p53 protein and increasing of protein Ki-67. The E-cadherin is lost in injured cells, increasing motility cell and invade the ajacent. Objectives - to study the immunoistochemical expression of p16 protein, Ki-67 and E-cadherin in benign lesions, pre-invasive carcinoma of the cervix; to correlate the expression of these markers together in cases of difficult interpretarion, assisting in the diagnosis and prognosis of cervical lesions and asses the relationship between the expression of these markers and the persistence or not of the cervical lesion. Patients and methods: 54 uterine cervix biopsies were selected and submitted to immunohistochemical study, with biomarkers p16, Ki-67 and E-cadherin. Results: 1-CIN I (27.9%) and CIN II (47.9%) had lower expression of p16 than in CIN III (73.5%) and invasive carcinoma (72.7%) (p<0.0005). For Ki-67 There was only statistically significant difference between the median for the normal group (6.6%) with the neoplastic lesions (p=0.005). Invasive carcinoma (57.8%), was highly positive for Ki-67 when compared to CIN I (35.6%), CIN II (51.9%) and CIN III (40.9%) but the was no statistically significant difference between them. E-cadherin expression in invasive carcinoma (46.2%) was lower than in CIN III (56.0%), CIN II (77.4%) and CIN I (82.2%) (p<0.0005) and, normal epithelium had the greatest E-cadherin expression (89.1%). In persistente and no persistent CIN there was no difference in the expression of the biomarkers, with p16 presenting p=0.50, Ki-67, p=0.91 and the E-cadherin a p=0.43 value. Conclusions: there is an increased expression of p16 according to the increase in the degree of lesions. No expression in normal tissue; the Ki-67, there was greater expression of protein in cases of invasive carcinoma in the normal epithelium. However, no significant difference in expression when comparing the invasive carcinoma with CIN I, II and III and lesions of normal tissue from the cervix and CIN I showed expression of E-cadherin more pronounced, which decreases with greater severity of injury. However. there is only difference compared the expression of invasive carcinoma with CIN I and CIN II. The use of p16. Ki-67 and E-cadherin biomarkers in cervical biopsies of difficult diagnosis may help in early diagnosis of malignant lesions and support the apropriate treatment. The use of biomarkers is not useful to distinguish between persistente and non-persistente CIN. |
publishDate |
2009 |
dc.date.issued.fl_str_mv |
2009-05-29 |
dc.date.accessioned.fl_str_mv |
2019-03-11T18:14:14Z |
dc.type.status.fl_str_mv |
info:eu-repo/semantics/publishedVersion |
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info:eu-repo/semantics/masterThesis |
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dc.identifier.citation.fl_str_mv |
Munhoz, Natália Gaspar. O uso dos marcadores moleculares (p16, Ki-67 e E-Caderina) em biópsias uterinas cervicais. 2009. 30 f. Dissertação (Programa de Pós-Graduação em Ciências da Saúde) - Faculdade de Medicina de São José do Rio Preto, São José do Rio Preto. |
dc.identifier.uri.fl_str_mv |
http://bdtd.famerp.br/handle/tede/525 |
dc.identifier.doi.por.fl_str_mv |
956 |
identifier_str_mv |
Munhoz, Natália Gaspar. O uso dos marcadores moleculares (p16, Ki-67 e E-Caderina) em biópsias uterinas cervicais. 2009. 30 f. Dissertação (Programa de Pós-Graduação em Ciências da Saúde) - Faculdade de Medicina de São José do Rio Preto, São José do Rio Preto. 956 |
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Faculdade de Medicina de São José do Rio Preto |
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Programa de Pós-Graduação em Ciências da Saúde |
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Faculdade de Medicina de São José do Rio Preto |
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MD5 MD5 |
repository.name.fl_str_mv |
Biblioteca Digital de Teses e Dissertações da FAMERP - Faculdade de Medicina de São José do Rio Preto (FAMERP) |
repository.mail.fl_str_mv |
sbdc@famerp.br||joao.junior@famerp.br |
_version_ |
1800213964076875776 |