São Paulo, Brazil
São Paulo, Brazil

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Brandao F.V.,Federal University of Minas Gerais | De Sa B.C.S.,Fundacao Antonio Prudente | De Sa B.C.S.,Nucleo Of Cancer Of Pele E Dermatologia Do Hospital Ac Camargo | Pinto C.A.L.,University of Sao Paulo | And 3 more authors.
Surgical and Cosmetic Dermatology | Year: 2012

The early detection of melanoma is crucial for improving survival rates. Dermoscopy improves the accuracy of clinical examination, enabling a diagnosis in the early stages. However it has limitations in the diagnosis of incipient melanomas. Full body mapping and digital dermoscopy help diagnose nonspecific lesions and allow the detection of new suspicious lesions. Patients at high risk of developing melanomas benefit the most from this approach. The authors report the case of a high-risk patient whose melanoma diagnosis was only possible with the help of dermoscopy-guided histopathological analysis.


Grant
Agency: European Commission | Branch: FP7 | Program: CP-SICA | Phase: HEALTH-2007-2.4.1-14 | Award Amount: 3.96M | Year: 2009

Colorectal cancer (CRC) is common in both sexes, has relatively poor outcome and has no major avoidable risk factor. Recent studies have shown that common inherited single nucleotide polymorphisms (SNPs) can increase cancer risk. We have shown CRC risk to be associated with SNPs on chromosomes 8q24.21, 15q14 and 8q21. These variants account for <5% of the genetic risk of CRC, but will be very important when their effects are added to those of other, as-yet undetected CRC SNPs. A few genome-wide association studies (GWASs) based on populations of European descent are trying to identify the remaining common CRC genes. Evidence suggests that these studies will not be large enough on their own to detect all CRC SNPs, as: relative risks associated with most SNPs are modest; some disease alleles are rare, at least in Europe; and many variants may lie outside conventional gene boundaries or haplotype blocks. The admixed LA population provides an exciting opportunity to identify new CRC genes that are more tractable to detection in LA, or have been missed by chance in European studies. We shall undertake a combined GWAS and admixture mapping study for CRC predisposition genes in 6,000 LA cases and 6,000 controls. We shall test the disease-associated variants in 3,500 cases and 3,500 controls from Europe. We aim primarily to detect SNPs with effects in both LA and Europe, but also SNPs with effects specific to LA. Eventually, we aim to develop a polymorphism panel for predicting the risk of CRC in the general population, so that those at increased risk can be offered effective measures to prevent cancer. CRC is increasing in frequency in LA and prognosis is poorer than in Europe. We shall use our project as a focus for education about CRC, especially in LA. The study will also provide training for young LA researchers. Our work will provide a direct benefit to medical science and the populations of LA and Europe.


Nagai M.A.,University of Sao Paulo | Gerhard R.,University of Sao Paulo | Fregnani J.H.T.G.,Hospital Of Cancer Of Barretos | Nonogaki S.,Instituto Adolfo Lutz | And 3 more authors.
Breast Cancer Research and Treatment | Year: 2011

An increasing number of studies have shown altered expression of secreted protein acidic and rich in cysteine (SPARC) and N-myc down-regulated gene (NDRG1) in several malignancies, including breast carcinoma; however, the role of these potential biomarkers in tumor development and progression is controversial. In this study, NDRG1 and SPARC protein expression was evaluated by immunohistochemistry on tissue microarrays containing breast tumor specimens from patients with 10 years of follow-up. NDRG1 and SPARC protein expression was determined in 596 patients along with other prognostic markers, such as ER, PR, and HER2. The status of NDRG1 and SPARC protein expression was correlated with prognostic variables and patient clinical outcome. Immunostaining revealed that 272 of the 596 cases (45.6%) were positive for NDRG1 and 431 (72.3%) were positive for SPARC. Statistically significant differences were found between the presence of SPARC and NDRG1 protein expression and standard clinicopathological variables. Kaplan-Meier analysis showed that NDRG1 positivity was directly associated with shorter disease-free survival (DFS, P < 0.001) and overall survival (OS, P < 0.001). In contrast, patients expressing low levels of SPARC protein had worse DFS (P = 0.001) and OS (P = 0.001) compared to those expressing high levels. Combined analysis of the two markers indicated that DFS (P < 0.001) and OS rates (P < 0.001) were lowest for patients with NDRG1-positive and SPARC-negative tumors. Furthermore, NDRG1 over-expression and SPARC down-regulation correlated with poor prognosis in patients with luminal A or triple-negative subtype breast cancer. On multivariate analysis using a Cox proportional hazards model, NDRG1 and SPARC protein expression were independent prognostic factors for both DFS and OS of breast cancer patients. These data indicate that NDRG1 over-expression and SPARC down-regulation could play important roles in breast cancer progression and serve as useful biomarkers to better define breast cancer prognosis. © 2010 Springer Science+Business Media, LLC.


Portas J.,Fundacao Antonio Prudente | Socci C.P.,Hospital speech therapist | Scian E.P.,University of Sao Paulo | dos Santos Queija D.,Heliopolis Hospital HOSPHEL | And 3 more authors.
Brazilian Journal of Otorhinolaryngology | Year: 2011

Radiation therapy and radiochemotherapy protocols can cause swallowing difficulties. Aim: To evaluate swallowing in patients undergoing radiation therapy and radiochemotherapy protocol only for the treatment of laryngeal tumors. Methods: A prospective study of 20 patients, with a mean age of 62 years, at the end of oncological therapy. Six patients (30%) underwent radiation therapy, and 14 patients (70%) underwent combined therapy. The mean time between treatment and an evaluation of swallowing was 8.5 months. Videofluoroscopy was done to assess the preparatory, oral and pharyngeal phases of swallowing. Results: All patients had only an oral diet. Normal swallowing was present in only 25% of patients. The swallowing videofluoroscopic examination identified the following changes: bolus formation (85%), bolus ejection (60%), oral cavity stasis (55%), changes in the onset of the pharyngeal phase (100%), decreased laryngeal elevation (65%), and hypopharyngeal stasis (80%). Laryngeal penetration was observed in 25% of the cases; 40% presented tracheal aspiration. The grade of penetration/ aspiration was mild in 60% of cases. Aspiration was silent in 35% of patients. Although 75% of patients had dysphagia, only 25% complained of swallowing difficulties. Conclusion: Patients with laryngeal cancer that underwent radiation therapy/combined treatment can present changes in all swallowing phases, or may be asymptomatic.


Gerhard R.,University of Sao Paulo | Nonogaki S.,Instituto Adolfo Lutz | Fregnani J.H.T.G.,Hospital Of Cancer Of Barretos | Soares F.A.,Fundacao Antonio Prudente | Nagai M.A.,University of Sao Paulo
Clinics | Year: 2010

OBJECTIVES: The aim of this study was to examine the expression of the N-myc downstream-regulated gene 1 protein in benign and malignant lesions of the thyroid gland by immunohistochemistry. INTRODUCTION: N-myc downstream-regulated gene 1 encodes a protein whose expression is induced by various stimuli, including cell differentiation, exposure to heavy metals, hypoxia, and DNA damage. Increased N-myc downstream-regulated gene 1 expression has been detected in various types of tumors, but the role of N-myc downstream-regulated gene 1 expression in thyroid lesions remains to be determined. METHODS: A tissue microarray paraffin block containing 265 tissue fragments corresponding to normal thyroid, nodular goiter, follicular adenoma, papillary thyroid carcinoma (classical pattern and follicular variant), follicular carcinoma, and metastases of papillary and follicular thyroid carcinomas were analyzed by immunohistochemistry using a polyclonal anti- N-myc downstream-regulated gene 1 antibody. RESULTS: The immunohistochemical expression of N-myc downstream-regulated gene 1 was higher in carcinomas compared to normal thyroid glands and nodular goiters, with higher expression in classical papillary thyroid carcinomas and metastases of thyroid carcinomas (P < 0.001). A combined analysis showed higher immunohistochemical expression of NDRG1 in malignant lesions (classical pattern and follicular variant of papillary thyroid carcinomas, follicular carcinomas, and metastases of thyroid carcinomas) compared to benign thyroid lesions (goiter and follicular adenomas) (P = 0.043). In thyroid carcinomas, N-myc downstream-regulated gene 1 expression was significantly correlated with a more advanced TNM stage (P = 0.007) and age, metastasis, tumor extent, and size (AMES) high-risk group (P = 0.012). CONCLUSIONS: Thyroid carcinomas showed increased immunohistochemical N-myc downstream-regulated gene 1 expression compared to normal and benign thyroid lesions and is correlated with more advanced tumor stages. © 2010 Clinics.


Boaventura C.S.,Fundacao Antonio Prudente | Boaventura C.S.,Ac Camargo Cancer Center | Galvao J.L.S.,Nove de Julho University | Soares G.M.B.,Nove de Julho University | And 7 more authors.
Revista da Associacao Medica Brasileira | Year: 2016

Endometrial and cervical cancers are the most prevalent gynecologic neoplasms. While endometrial cancer occurs in older women, cervical cancer is more prevalent in young subjects. The most common clinical manifestation in these two gynecological cancers is vaginal bleeding. In the first case, diagnosis is made based on histological and imaging evaluation of the endometrium, while cervical cancers are diagnosed clinically, according to the International Federation of Gynecology and Obstetrics (FIGO). The authors present a case of synchronous gynecological cancer of the endometrium and cervix diagnosed during staging on MRI and confirmed by histological analysis of the surgical specimen.


PubMed | Ac Camargo Cancer Center, Fundacao Antonio Prudente and Nove de Julho University
Type: Journal Article | Journal: Revista da Associacao Medica Brasileira (1992) | Year: 2016

Endometrial and cervical cancers are the most prevalent gynecologic neoplasms. While endometrial cancer occurs in older women, cervical cancer is more prevalente in young subjects. The most common clinical manifestation in these two gynecological cancers is vaginal bleeding. In the first case, diagnosis is made based on histological and imaging evaluation of the endometrium, while cervical cancers are diagnosed clinically, according to the International Federation of Gynecology and Obstetrics (FIGO). The authors present a case of synchronous gynecological cancer of the endometrium and cervix diagnosed during staging on MRI and confirmed by histological analysis of the surgical specimen.

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