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Guimarães Ribeiro A, Ferlay J, Vaccarella S, Dias de Oliveira Latorre MDR, Tavares Guerreiro Fregnani JH, Bray F. Ethnic disparities in cancer mortality in the capital and northeast of the State of São Paulo, Brazil 2001-17. Cancer Causes Control 2024; 35:523-529. [PMID: 37917366 DOI: 10.1007/s10552-023-01812-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/21/2023] [Accepted: 10/04/2023] [Indexed: 11/04/2023]
Abstract
PURPOSE There is a paucity of studies investigating cancer disparities in groups defined by ethnicity in transitioning economies. We examined the influence of ethnicity on mortality for the leading cancer types in São Paulo, Brazil, comparing patterns in the capital and the northeast of the state. METHODS Cancer deaths were obtained from a Brazilian public government database for the Barretos region (2003-2017) and the municipality of São Paulo (2001-2015). Age-standardized rates (ASR) per 100,000 persons-years, by cancer type and sex, for five self-declared racial classifications (white, black, eastern origin (Asian), mixed ethnicity (pardo), and indigenous Brazilians), were calculated using the world standard population. RESULTS Black Brazilians had higher mortality rates for most common cancer types in Barretos, whereas in São Paulo, white Brazilians had higher rates of mortality from breast, colorectal, and lung cancer. In both regions, lung cancer was the leading cause of cancer death among white, black, and pardo Brazilians, with colorectal cancer deaths leading among Asian Brazilians. Black and pardo Brazilians had higher cervical cancer mortality rates than white Brazilians. CONCLUSION There are substantial disparities in mortality from different cancers in São Paulo according to ethnicity, pointing to inequities in access to health care services.
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Affiliation(s)
- Adeylson Guimarães Ribeiro
- Cancer Surveillance Branch, International Agency for Research On Cancer, 25 Avenue Tony Garnier, CS 90627, 69366, Lyon Cedex 07, France.
- Educational and Research Institute, Barretos Cancer Hospital, Barretos, Brazil.
| | - Jacques Ferlay
- Cancer Surveillance Branch, International Agency for Research On Cancer, 25 Avenue Tony Garnier, CS 90627, 69366, Lyon Cedex 07, France
| | - Salvatore Vaccarella
- Cancer Surveillance Branch, International Agency for Research On Cancer, 25 Avenue Tony Garnier, CS 90627, 69366, Lyon Cedex 07, France
| | | | | | - Freddie Bray
- Cancer Surveillance Branch, International Agency for Research On Cancer, 25 Avenue Tony Garnier, CS 90627, 69366, Lyon Cedex 07, France
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Ribeiro AG, Mafra da Costa A, Pereira TF, Guimarães DP, Fregnani JHTG. Colorectal cancer spatial pattern in the northeast region of São Paulo, Brazil. Glob Epidemiol 2023; 5:100097. [PMID: 37638369 PMCID: PMC10446010 DOI: 10.1016/j.gloepi.2022.100097] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/18/2022] [Revised: 12/09/2022] [Accepted: 12/09/2022] [Indexed: 12/14/2022] Open
Abstract
Background This study examined the spatial pattern of the colorectal cancer (CRC) in the 18 municipalities that compose the Regional Health Department of Barretos (RHD-V), which is in the northeast of the state of São Paulo, Brazil. Methods All incident cases and deaths from CRC between 2002 and 2016 were included. Age-standardized rates (ASR) for incidence and mortality per 100,000 person-years were used to evaluate the spatial distribution for the total and five-year periods. The lethality rates were also assessed. Excess risk maps compared the observed and expected events. Age-standardized net survival was used to evaluate CRC survival. Results For CRC incidence, the ASR value for the general population over the entire period (2002-2016) was 17.7 (95% CI: 16.7, 18.6), ranging from 16.7 (95% CI: 14.9, 18.4) (2002-2006) to 20.0 (95% CI: 18.3, 21.7) (2012-2016) per 100,000. When males and females were compared, the ASR was 20.1 (95% CI: 18.6, 21.6) and 15.7 (95% CI: 14.5, 17.0) per 100,000, respectively. For CRC mortality (2002-2016), the ASR was 8.2 (95% CI: 7.6, 8.9), ranging from 9.0 (95% CI: 7.8, 10.3) (2002-2006) to 8.2 (95% CI: 7.2, 9.3) (2012-2016) per 100,000. Overall, the excess risk up to 2.0 was more frequent. In terms of survival, municipalities with large port populations had lower survival in comparison with medium port. Conclusions This study showed a variation in CRC incidence and mortality, with differences considering five-year periods and gender, being the incidence higher in males than females in the entire period, with mortality equivalent to half the incidence. The survival was lower in municipalities with large port populations in comparison with medium port. Knowing spatial patterns of incidence, mortality, lethality, and survival can be necessary to support policymakers to advance or implement effective cancer control programs.
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Affiliation(s)
- Adeylson Guimarães Ribeiro
- Educational and Research Institute, Barretos Cancer Hospital, Rua Antenor Duarte Viléla, 1331, Dr. Paulo Prata, Barretos 14784-400, SP, Brazil
| | - Allini Mafra da Costa
- Educational and Research Institute, Barretos Cancer Hospital, Rua Antenor Duarte Viléla, 1331, Dr. Paulo Prata, Barretos 14784-400, SP, Brazil
| | - Talita Fernanda Pereira
- Educational and Research Institute, Barretos Cancer Hospital, Rua Antenor Duarte Viléla, 1331, Dr. Paulo Prata, Barretos 14784-400, SP, Brazil
| | - Denise Peixoto Guimarães
- Educational and Research Institute, Barretos Cancer Hospital, Rua Antenor Duarte Viléla, 1331, Dr. Paulo Prata, Barretos 14784-400, SP, Brazil
| | - José Humberto Tavares Guerreiro Fregnani
- Educational and Research Institute, Barretos Cancer Hospital, Rua Antenor Duarte Viléla, 1331, Dr. Paulo Prata, Barretos 14784-400, SP, Brazil
- A.C. Camargo Cancer Center, Rua Tamandaré, 753, Liberdade, São Paulo 01525-001, SP, Brazil
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Ribeiro AG, Ferlay J, Vaccarella S, Latorre MDRDDO, Fregnani JHTG, Bray F. Thyroid Cancer Incidence and Mortality by Socioeconomic Level in the State of São Paulo, Brazil 2001-2017. Endocr Pract 2023; 29:770-778. [PMID: 37536501 DOI: 10.1016/j.eprac.2023.07.028] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/10/2023] [Revised: 07/03/2023] [Accepted: 07/25/2023] [Indexed: 08/05/2023]
Abstract
OBJECTIVE Thyroid cancer is rising largely due to greater detection of indolent or slow-growing tumors; we sought to compare the incidence and mortality profiles of thyroid cancer in the State of São Paulo by socioeconomic status (SES). METHODS Data on thyroid cancer cases diagnosed from 2003 to 2017 in the Barretos Region and from 2001 to 2015 in the municipality of São Paulo were obtained from the respective cancer registries. Corresponding death data were obtained from a Brazilian public government database. Age-standardized rates were calculated and presented as thematic maps. The rates were also calculated by SES and spatial autocorrelation was assessed by global and local indices. RESULTS There were 419 cases of thyroid cancer and 21 deaths in Barretos, contrasting with the highly populated São Paulo, with 30 489 cases and 673 deaths. The overall incidence rates in São Paulo (15.9) were three times higher than in Barretos (5.7), while incidence rates in women were close to five times higher in Barretos and four times higher in São Paulo than in men. Mortality rates were, in relative terms, very low in both regions. A clear stepwise gradient of increasing thyroid cancer incidence with increasing SES was observed in São Paulo, with rates in very high SES districts four times those of low SES (31.6 vs 8.1). In contrast, the incidence rates in Barretos presented little variation across SES levels. CONCLUSION Thyroid cancer incidence varied markedly by SES in São Paulo, with incidence rates rising with increasing socioeconomic index. Overdiagnosis is likely to account for a large proportion of the thyroid cancer burden in the capital.
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Affiliation(s)
- Adeylson Guimarães Ribeiro
- Cancer Surveillance Branch, International Agency for Research on Cancer, Lyon, France; Educational and Research Institute, Barretos Cancer Hospital, Barretos, Brazil.
| | - Jacques Ferlay
- Cancer Surveillance Branch, International Agency for Research on Cancer, Lyon, France
| | - Salvatore Vaccarella
- Cancer Surveillance Branch, International Agency for Research on Cancer, Lyon, France
| | | | | | - Freddie Bray
- Cancer Surveillance Branch, International Agency for Research on Cancer, Lyon, France
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Guimarães Ribeiro A, Ferlay J, Piñeros M, Dias de Oliveira Latorre MDR, Tavares Guerreiro Fregnani JH, Bray F. Geographic variations in cancer incidence and mortality in the State of São Paulo, Brazil 2001-17. Cancer Epidemiol 2023; 85:102403. [PMID: 37390700 PMCID: PMC10432824 DOI: 10.1016/j.canep.2023.102403] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/15/2023] [Revised: 06/07/2023] [Accepted: 06/16/2023] [Indexed: 07/02/2023]
Abstract
BACKGROUND Cancer is a leading cause of morbidity and mortality in Brazil and the burden is rising. To better inform tailored cancer actions, we compare incidence and mortality profiles according to small areas in the capital and northeast region of the State of São Paulo for the leading cancer types. METHODS New cancer cases were obtained from cancer registries covering the department of Barretos (2003-2017) and the municipality of São Paulo (2001-2015). Cancer deaths for the same period were obtained from a Brazilian public government database. Age-standardized rates per 100,000 persons-years by cancer and sex are presented as thematic maps, by municipality for Barretos region, and by district for São Paulo. RESULTS Prostate and breast cancer were the leading forms of cancer incidence in Barretos, with lung cancer leading in terms of cancer mortality in both regions. The highest incidence and mortality rates were seen in municipalities from the northeast of Barretos region in both sexes, while elevated incidence rates were mainly found in São Paulo districts with high and very high socioeconomic status (SES), with mortality rates more dispersed. Breast cancer incidence rates in São Paulo were 30 % higher than Barretos, notably in high and very high SES districts, while corresponding rates of cervical cancer conveyed the opposite profile, with elevated rates in low and medium SES districts. CONCLUSIONS There is substantial diversity in the cancer profiles in the two regions, by cancer type and sex, with a clear relation between the cancer incidence and mortality patterns observed at the district level and corresponding SES in the capital.
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Affiliation(s)
- Adeylson Guimarães Ribeiro
- Cancer Surveillance Branch, International Agency for Research on Cancer, Lyon, France; Educational and Research Institute, Barretos Cancer Hospital, Barretos, Brazil.
| | - Jacques Ferlay
- Cancer Surveillance Branch, International Agency for Research on Cancer, Lyon, France.
| | - Marion Piñeros
- Cancer Surveillance Branch, International Agency for Research on Cancer, Lyon, France.
| | | | | | - Freddie Bray
- Cancer Surveillance Branch, International Agency for Research on Cancer, Lyon, France.
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Ribeiro AG, Ferlay J, Vaccarella S, Latorre MDRDDO, Fregnani JHTG, Bray F. Cancer inequalities in incidence and mortality in the State of São Paulo, Brazil 2001-17. Cancer Med 2023; 12:16615-16625. [PMID: 37345901 PMCID: PMC10469722 DOI: 10.1002/cam4.6259] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/21/2023] [Revised: 06/02/2023] [Accepted: 06/05/2023] [Indexed: 06/23/2023] Open
Abstract
BACKGROUND Cancer disparities exist between and within countries; we sought to compare cancer-specific incidence and mortality according to area-level socioeconomic status (SES) in the State of São Paulo, Brazil. METHODS Cancer cases diagnosed 2003-2017 in the Barretos region and 2001-2015 in the municipality of São Paulo were obtained from the respective cancer registries. Corresponding cancer deaths were obtained from a Brazilian public government database. Age-standardized rates for all cancer combined and the six most common cancers were calculated by SES quartiles. RESULTS There were 14,628 cancer cases and 7513 cancer deaths in Barretos, and 472,712 corresponding cases and 194,705 deaths in São Paulo. A clear SES-cancer gradient was seen in São Paulo, with rates varying from 188.4 to 333.1 in low to high SES areas, respectively. There was a lesser social gradient for mortality, with rates in low to high SES areas ranging from 86.4 to 98.0 in Barretos, and from 99.2 to 100.1 in São Paulo. The magnitude of the incidence rates rose markedly with increasing SES in São Paulo city for colorectal, lung, female breast, and prostate cancer. Conversely, both cervical cancer incidence and mortality rose with lower levels of SES in both regions. CONCLUSIONS A clear SES association was seen for cancers of the prostate, female breast, colorectum, and lung for São Paulo. This study offers a better understanding of the cancer incidence and mortality profile according to SES within a highly populated Brazilian state.
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Affiliation(s)
- Adeylson Guimarães Ribeiro
- Cancer Surveillance BranchInternational Agency for Research on CancerLyonFrance
- Educational and Research InstituteBarretos Cancer HospitalBarretosBrazil
| | - Jacques Ferlay
- Cancer Surveillance BranchInternational Agency for Research on CancerLyonFrance
| | | | | | | | - Freddie Bray
- Cancer Surveillance BranchInternational Agency for Research on CancerLyonFrance
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Causin RL, Sussuchi da Silva L, Leal LF, Possati-Resende JC, Evangelista AF, Matsushita GM, Scapulatempo-Neto C, Tavares Guerreiro Fregnani JH, Antônio de Oliveira M, Musselwhite LW, Chiquitelli Marques MM, Reis RM. The digital expression profile of BMP7, CDKN2C, HIST1H3G, and PKMYT1 genes improves high-grade cervical lesion detection in liquid-based cytology. Cancer Cytopathol 2023. [PMID: 37069588 DOI: 10.1002/cncy.22704] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/01/2022] [Revised: 03/03/2023] [Accepted: 03/07/2023] [Indexed: 04/19/2023]
Abstract
BACKGROUND Some studies reported that differential gene expression could be used as a biomarker for high-grade cervical lesion identification. The aim was to evaluate the gene expression profile of cervical intraepithelial neoplasia (CIN) to identify a gene expression signature of CIN2+ in liquid-based cytology (LBC) samples. METHODS LBC samples (n = 85) obtained from women who underwent colposcopy were included with benign (n = 13), CIN1 (n = 26), CIN2 (n = 16), and CIN3 (n = 30) diagnoses. After RNA isolation, gene expression profiling was performed using the nCounter PanCancer Pathways, which consists of 730 cancer-related genes. The genes identified were in silico expression evaluated using the UALCAN database. An accurate prediction model to discriminate CIN2+ from <CIN2 lesions was determined. Immunohistochemistry was performed to assess the expression of p16 and Ki67 proteins. RESULTS This study identified a gene expression profile that significantly differentiates CIN2+ cases from <CIN2. The gene signature comprised 18 genes, two genes downregulated and 16 upregulated. In silico analysis corroborated the differential expression of 11 of those genes. Further observed was that high expression of BMP7 (odds ratio [OR], 4.202), CDKN2C (OR, 5.326), HIST1H3G (OR, 3.522), PKMYT1 (OR, 4.247), and menarche age (OR, 1.608) were age-adjusted and associated with CIN2+. This model demonstrates a probability of 43% leading to an area under the curve (of .979; sensitivity of 94.9%, and specificity of 91.2% for CIN2+ prediction. It was observed that p16 expression was significantly associated with CDKN2A mRNA overexpression (p = .0015). CONCLUSION A gene expression profile that may be helpful in the identification of patients with CIN2+ was identified. This approach could be used together with currently used LBC in a clinical setting, allowing the identification of patients with high risk of CIN2+.
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Affiliation(s)
| | | | - Leticia Ferro Leal
- Molecular Oncology Research Center, Barretos Cancer Hospital, Barretos, Brazil
- Barretos School of Health Sciences, Dr. Paulo Prata-FACISB, Barretos, São Paulo, Brazil
| | | | - Adriane Feijó Evangelista
- Molecular Oncology Research Center, Barretos Cancer Hospital, Barretos, Brazil
- Sergio Arouca National School of Public Health, Oswaldo Cruz Foundation, Rio de Janeiro, Brazil
| | | | | | | | | | | | | | - Rui Manuel Reis
- Molecular Oncology Research Center, Barretos Cancer Hospital, Barretos, Brazil
- Life and Health Sciences Research Institute (ICVS), Medical School, University of Minho, Braga, Portugal
- ICVS/3B's-PT Government Associate Laboratory, Braga, Portugal
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Mafra A, Bardot A, Charvat H, Weiderpass E, Soerjomataram I, Fregnani JHTG. Cancer survival in the northwestern of São Paulo State, Brazil: A population-based study. Cancer Epidemiol 2023; 83:102339. [PMID: 36863216 DOI: 10.1016/j.canep.2023.102339] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/03/2022] [Revised: 12/26/2022] [Accepted: 02/10/2023] [Indexed: 03/04/2023]
Abstract
BACKGROUND Population-based cancer registry (PBCR) data provide crucial information for evaluating the effectiveness of cancer services and reflect prospects for cure by estimating population-based cancer survival. This study provides long-term trends in survival among patients diagnosed with cancer in the Barretos region (São Paulo State, Brazil). METHODS In this population-based study, we estimated the one- and five-year age-standardized net survival rates of 13,246 patients diagnosed with 24 different cancer types in Barretos region between 2000 and 2018. The results were presented by sex, time since diagnosis, disease stage, and period of diagnosis. RESULTS Marked differences in the one- and five-year age-standardized net survival rates were observed across the cancer sites. Pancreatic cancer had the lowest 5-year net survival (5.5 %, 95 %CI: 2.9-9.4) followed by oesophageal cancer (5.6 %, 95 %CI: 3.0-9.4), while prostate cancer ranked the best (92.1 %, 95 %CI: 87.8-94.9), followed by thyroid cancer (87.4 %, 95 %CI: 69.9-95.1) and female breast cancer (78.3 %, 95 %CI: 74.5-81.6). The survival rates differed substantially according to sex and clinical stage. Comparing the first (2000-2005) and last (2012-2018) periods, cancer survival improved, especially for thyroid, leukemia, and pharyngeal cancers, with differences of 34.4 %, 29.0 %, and 28.7 %, respectively. CONCLUSION To our knowledge, this is the first study to evaluate long-term cancer survival in the Barretos region, showing an overall improvement over the last two decades. Survival varied by site, indicating the need for multiple cancer control actions in the future with a lower burden of cancer.
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Affiliation(s)
- Allini Mafra
- Population-based Cancer Registry of Barretos Region, Barretos Cancer Hospital, Pio XII Foundation, Barretos, 14784-400 Sao Paulo, Brazil; Cancer Surveillance Branch, International Agency for Research on Cancer, 25 Avenue Tony Garnier, 69007 Lyon, France.
| | - Aude Bardot
- Cancer Surveillance Branch, International Agency for Research on Cancer, 25 Avenue Tony Garnier, 69007 Lyon, France.
| | - Hadrien Charvat
- Cancer Surveillance Branch, International Agency for Research on Cancer, 25 Avenue Tony Garnier, 69007 Lyon, France.
| | - Elisabete Weiderpass
- Director's Office, International Agency for Research on Cancer, 25 Avenue Tony Garnier, 69007 Lyon, France.
| | - Isabelle Soerjomataram
- Cancer Surveillance Branch, International Agency for Research on Cancer, 25 Avenue Tony Garnier, 69007 Lyon, France.
| | - José Humberto Tavares Guerreiro Fregnani
- Population-based Cancer Registry of Barretos Region, Barretos Cancer Hospital, Pio XII Foundation, Barretos, 14784-400 Sao Paulo, Brazil; Superintendence of Education and Research, A.C. Camargo Cancer Center, São Paulo 01525-001, Brazil.
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Pereira TF, Aranha VJ, Waldvogel BC, da Costa AM, Tavares Guerreiro Fregnani JH. Deterministic linkage for improving follow-up time in a Brazilian population-based cancer registry. Sci Rep 2023; 13:4816. [PMID: 36964184 PMCID: PMC10039007 DOI: 10.1038/s41598-023-31303-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/26/2022] [Accepted: 03/09/2023] [Indexed: 03/26/2023] Open
Abstract
Population-based cancer registries (PBCR) are the primary source of cancer incidence and survival statistics. The loss to follow-up of these patients is concerning since it reduces the reliability of any statistical analysis. The linkage techniques have been increasingly used to improve data quality in various information systems. The linkage was performed between the databases of the PBCR-Barretos and the mortality database of the state of São Paulo. To evaluate the improvement in the follow-up time of patients, the comparability of the two databases, pre- and post linkage, was made. Three analyses were performed: a comparative analysis of the absolute number of deaths, a comparative analysis of the follow-up time of patients and the survival analysis. After linkage, there was an increase of 813 deaths. The follow-up time of patients was extended and observed in most types of tumours. The comparability of the survival analyses at both time points also showed a decrease in survival probabilities for all tumour types. Deterministic linkage is effective in updating the vital status of registered patients, improving patient follow-up time, and maintaining good quality data from PBCRs, consequently producing more reliable rates, as seen for the survival analyses.
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Affiliation(s)
- Talita Fernanda Pereira
- Post Graduate Program of the Education and Research Institute, Barretos Cancer Hospital, Pio XII Foundation, Barretos, São Paulo, 14784-400, Brazil.
- Based-Population Cancer Registry of Barretos Region, Barretos Cancer Hospital, Pio XII Foundation, Barretos, São Paulo, 14784-400, Brazil.
| | | | | | - Allini Mafra da Costa
- Post Graduate Program of the Education and Research Institute, Barretos Cancer Hospital, Pio XII Foundation, Barretos, São Paulo, 14784-400, Brazil
- Based-Population Cancer Registry of Barretos Region, Barretos Cancer Hospital, Pio XII Foundation, Barretos, São Paulo, 14784-400, Brazil
- Department of Precision Health, Luxembourg Institute of Health, 1445, Strassen, Luxembourg
| | - José Humberto Tavares Guerreiro Fregnani
- Post Graduate Program of the Education and Research Institute, Barretos Cancer Hospital, Pio XII Foundation, Barretos, São Paulo, 14784-400, Brazil
- A.C. Camargo Cancer Center, São Paulo, 01525-001, Brazil
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Mafra da Costa A, Hernandes ICP, Weiderpass E, Soerjomataram I, Fregnani JHTG. Cancer Statistics over Time in Northwestern São Paulo State, Brazil: Incidence and Mortality. Cancer Epidemiol Biomarkers Prev 2022; 31:707-714. [PMID: 35131883 DOI: 10.1158/1055-9965.epi-21-0842] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/21/2021] [Revised: 10/27/2021] [Accepted: 01/25/2022] [Indexed: 12/24/2022] Open
Abstract
BACKGROUND Population studies can serve as an essential source of information on cancer's etiology, and assessments of cancer trends over time can detect changes. This study aimed to provide statistics over time on cancer incidence and mortality in the Barretos Region, Brazil. METHODS Cancer incidence data were obtained from the population-based cancer registry of the Barretos Region, and mortality data were obtained from the Official Federal Database from 2002 to 2016. Age-standardized rates for incidence and mortality were calculated. Joinpoint Regression software was used to estimate the average annual percentage changes (AAPC). RESULTS Age-standardized rates of incidence increased significantly for colon cancer (AAPC: 2.2), rectum and rectosigmoid (AAPC: 2.4), liver (AAPC: 4.7), female breast (AAPC: 2.2), and thyroid cancer (AAPC: 3.8) but decreased for esophageal (AAPC: -3.2), stomach (AAPC: -4.2), lung (AAPC: -2.0), and ovarian cancer (AAPC: -5.6). The mortality increased for liver cancer (AAPC: 2.3) and decreased for pharyngeal cancer (AAPC: -5.8), stomach cancer (AAPC: -6.6), cervical uterine cancer (AAPC: -5.9), prostate cancer (AAPC: -2.4), and ovarian cancer (AAPC: -3.3). CONCLUSIONS We observed decreases in some cancers related to tobacco smoking and cervical and stomach cancers related to infectious agents, showing strong regional and national prevention programs' successes. But, we also observed rises in many cancer sites linked to lifestyle factors, such as breast or colorectal cancer, without a sign of declining mortality. IMPACT These results can impact and support cancer control program implementation and improvement at the community level and extrapolate to the state level and/or the whole country.
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Affiliation(s)
- Allini Mafra da Costa
- Population-Based Cancer Registry of Barretos Region, Barretos Cancer Hospital, Pio XII Foundation, Barretos, São Paulo, Brazil
- Cancer Surveillance Branch, International Agency for Research on Cancer, Lyon, France
| | | | | | | | - José Humberto Tavares Guerreiro Fregnani
- Population-Based Cancer Registry of Barretos Region, Barretos Cancer Hospital, Pio XII Foundation, Barretos, São Paulo, Brazil
- A.C. Camargo Cancer Center, São Paulo, Brazil
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Castro RDPR, Casagrande Tavoloni Braga J, Petaccia de Macedo M, Lopes Pinto CA, Tavares Guerreiro Fregnani JH, Gargantini Rezze G. Hotspot analysis by confocal microscopy can help to differentiate challenging melanocytic skin lesions. PLoS One 2022; 17:e0263819. [PMID: 35157706 PMCID: PMC8843198 DOI: 10.1371/journal.pone.0263819] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/07/2021] [Accepted: 01/27/2022] [Indexed: 11/30/2022] Open
Abstract
Some melanocytic lesions do not present enough clinical and dermoscopic features to allow ruling out a possible melanoma diagnosis. These “doubtful melanocytic lesions” pose a very common and challenging scenario in clinical practice and were selected at this study for reflectance confocal microscopy evaluation and subsequent surgical excision for histopathological diagnosis. The study included 110 lesions and three confocal features were statistically able to distinguish benign melanocytic lesions from melanomas: “peripheral hotspot at dermo-epidermal junction”, “nucleated roundish cells at the dermo-epidermal junction” and “sheet of cells”. The finding of a peripheral hotspot (atypical cells in 1mm2) at the DEJ is highlighted because has not been previously reported in the literature as a confocal feature related to melanomas.
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Hunt B, Fregnani JHTG, Brenes D, Schwarz RA, Salcedo MP, Possati-Resende JC, Antoniazzi M, de Oliveira Fonseca B, Santana IVV, de Macêdo Matsushita G, Castle PE, Schmeler KM, Richards-Kortum R. Cervical lesion assessment using real-time microendoscopy image analysis in Brazil: The CLARA study. Int J Cancer 2021; 149:431-441. [PMID: 33811763 PMCID: PMC8815862 DOI: 10.1002/ijc.33543] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/28/2020] [Revised: 02/05/2021] [Accepted: 02/12/2021] [Indexed: 01/28/2023]
Abstract
We conducted a prospective evaluation of the diagnostic performance of high-resolution microendoscopy (HRME) to detect cervical intraepithelial neoplasia (CIN) in women with abnormal screening tests. Study participants underwent colposcopy, HRME and cervical biopsy. The prospective diagnostic performance of HRME using an automated morphologic image analysis algorithm was compared to that of colposcopy using histopathologic detection of CIN as the gold standard. To assess the potential to further improve performance of HRME image analysis, we also conducted a retrospective analysis assessing performance of a multi-task convolutional neural network to segment and classify HRME images. One thousand four hundred eighty-six subjects completed the study; 435 (29%) subjects had CIN Grade 2 or more severe (CIN2+) diagnosis. HRME with morphologic image analysis for detection of CIN Grade 3 or more severe diagnoses (CIN3+) was similarly sensitive (95.6% vs 96.2%, P = .81) and specific (56.6% vs 58.7%, P = .18) as colposcopy. HRME with morphologic image analysis for detection of CIN2+ was slightly less sensitive (91.7% vs 95.6%, P < .01) and specific (59.7% vs 63.4%, P = .02) than colposcopy. Images from 870 subjects were used to train a multi-task convolutional neural network-based algorithm and images from the remaining 616 were used to validate its performance. There were no significant differences in the sensitivity and specificity of HRME with neural network analysis vs colposcopy for detection of CIN2+ or CIN3+. Using a neural network-based algorithm, HRME has comparable sensitivity and specificity to colposcopy for detection of CIN2+. HRME could provide a low-cost, point-of-care alternative to colposcopy and biopsy in the prevention of cervical cancer.
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Affiliation(s)
- Brady Hunt
- Rice University, Department of Bioengineering, Houston, Texas
| | | | - David Brenes
- Rice University, Department of Bioengineering, Houston, Texas
| | | | - Mila P. Salcedo
- Federal University of Health Sciences of Porto Alegre (UFCSPA)/Santa Casa Hospital of Porto Alegre, Brazil
- Division of Cancer Epidemiology and Genetics, National Cancer Institute, National Institutes of Health, Rockville, MD
| | | | | | | | | | | | - Philip E. Castle
- Division of Cancer Prevention, National Cancer Institute, National Institutes of Health, Rockville, MD
- Division of Cancer Epidemiology and Genetics, National Cancer Institute, National Institutes of Health, Rockville, MD
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12
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Pedrão PG, de Carvalho AC, Possati-Resende JC, de Paula Cury F, Campanella NC, de Oliveira CM, Tavares Guerreiro Fregnani JH. DNA Recovery Using Ethanol-Based Liquid Medium from FTA Card-Stored Samples for HPV Detection. Acta Cytol 2021; 65:264-271. [PMID: 33951624 DOI: 10.1159/000515913] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/09/2020] [Accepted: 03/09/2021] [Indexed: 01/22/2023]
Abstract
INTRODUCTION Alternative methods of dry storage and transportation may be a viable alternative to the use of liquid storage medium for cervical samples, especially for screening programs in places with few resources. OBJECTIVE The objective of this study is to verify the viability and efficacy of human papillomavirus DNA (HPV-DNA) detection in cervical cell samples collected and stored on a Flinders Technology Associates (FTA) card (Whatman Indicating FTA® Elute Micro Card) and subsequently recovered in ethanol-based liquid medium and to compare the results to those obtained using samples stored directly in ethanol-based liquid medium. STUDY DESIGN Thirty-four women submitted to ETZ (excision of the transformation zone of the cervix) were included in this study. Before ETZ, 2 samples of exfoliated cervical cells were collected from each woman by a doctor and stored in ethanol-based liquid medium and on an FTA card. DNA recovery from FTA samples was performed using ethanol-based liquid medium. Detection of HPV-DNA in the samples was performed using the Cobas® 4800 HPV Test Platform. RESULTS AND CONCLUSIONS The HPV-DNA detection positivity rates were 70.6% for the samples collected directly in liquid medium and 64.7% for the samples stored on the FTA card, with high detection accuracy in the DNA samples recovered from the FTA card (area under the curve = 0.958; 95% confidence interval = 0.890-1.000). The concordance between the results obtained using the 2 storage media was 94.1% (Kappa = 0.866). These preliminary results suggest that collection of cervical material on an FTA card may be an alternative to storage in liquid medium since the liquid medium has some limitations. In addition, DNA recovery from the card using ethanol-based liquid medium streamlines the workflow in the laboratory and reduces the cost associated with reagents, thereby facilitating access to the HPV test in places with few resources and potentially improving cervical cancer screening.
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Affiliation(s)
- Priscila Grecca Pedrão
- Molecular Oncology Research Center, Barretos Cancer Hospital, Barretos, São Paulo, Brazil
| | | | | | | | - Nathália C Campanella
- Molecular Oncology Research Center, Barretos Cancer Hospital, Barretos, São Paulo, Brazil
| | - Cristina Mendes de Oliveira
- Molecular Oncology Research Center, Barretos Cancer Hospital, Barretos, São Paulo, Brazil
- DASA Laboratories, São Paulo, Brazil
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13
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Campanholi LL, Baiocchi JMT, Batista BN, Bergmann A, Fregnani JHTG, Duprat Neto JP. Agreement Between Optoelectronic Volumetry and Circumferential Girth Measurements to Diagnose Lymphedema in Patients Submitted to Axillary Radical Lymphadenectomy for Treatment of Cutaneous Melanoma. Lymphat Res Biol 2021; 19:568-572. [PMID: 33555979 DOI: 10.1089/lrb.2017.0081] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Aim: To assess the agreement between indirect and optoelectronic volumetries to diagnose lymphedema based on arm volume difference in patients with axillary lymph node dissection (ALND) for cutaneous melanoma. Methods and Results: Patients were assessed by circumferential girth measurements (truncated cone formula) to determine the upper limb volumes (indirect volumetry) and by optoelectronic volumetry (Perometer®) of affected and control limbs. A diagnosis of lymphedema on each measuring method was defined as an absolute volume difference >200 mL or a relative volume >10%. Forty-six patients with ALND were included. There were no significant differences between the volume means or the mean absolute or relative differences measured by each method. Good correlation was observed between the volume of upper limbs for both the left (r = 0.998) and right (r = 0.985) arms. As for the diagnosis of lymphedema, an absolute volume difference >200 mL determined a prevalence of 28% (13/46) of lymphedema by indirect volumetry and 35% (16/46) by optoelectronics volumetry. The crude diagnostic agreement was 93% with a kappa = 85% (agreement adjusted by chance) between methods. If a 10% increase in the relative volume difference between the arms was used as the diagnostic criterion, prevalence was 20% (9/46) and 22% (10/46), respectively. Conclusion: There is good agreement between perometry and circumferential girth measurements when classifying patients as having a difference between arm volumes >200 mL or 10%, the most frequently used cutoffs to diagnose lymphedema.
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Affiliation(s)
| | | | | | - Anke Bergmann
- Molecular Carcinogenesis Program, Instituto Nacional do Câncer-INCA/MS, Rio de Janeiro, Brazil
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14
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Costa RFA, Longatto-Filho A, de Lima Vazquez F, Pinheiro C, Zeferino LC, Fregnani JHTG. The Quality of Pap Smears from the Brazilian Cervical Cancer Screening Program According to the Human Development Index. Cancer Prev Res (Phila) 2019; 13:299-308. [PMID: 31836602 DOI: 10.1158/1940-6207.capr-19-0306] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/14/2019] [Revised: 10/13/2019] [Accepted: 12/06/2019] [Indexed: 12/24/2022]
Abstract
Brazil is a country with strong socioeconomic disparities, which may explain the different rates of cervical cancer incidence and mortality and influence the quality of cervical cancer screening tests. The aim of this study was to perform a trend analysis of some quality indicators of Pap smears according to the Municipal Human Development Index (MHDI). Information about cytopathological exams (approximately 65,000,000) performed from 2006 to 2014 in women ages 25 to 64 years was obtained from the Cervical Cancer Information System (SISCOLO). The average annual percentage change (AAPC) for each indicator was calculated using the Joinpoint Regression Program, according to MHDI levels. Very low frequencies of unsatisfactory cases (<5%) were observed at different MHDI levels. Although the positivity index in the low- and medium-MHDI groups has increased, the values remained below international recommendations (3%-10%). The HSIL (high-grade squamous intraepithelial lesion) percentage remained stationary at all levels of the MHDI. In the low- and medium-MHDI groups, most quality indicators were below the recommendations by Brazilian National Cancer Institute INCA, with no improvement trend; in the high-MHDI group, the majority of the indicators also presented no improvement, although they show slightly better quality indicators. The MHDI should be considered in the definition of the policies of the screening program for cervical cancer in Brazil, and the current program may require adjustments to achieve improved efficiency.
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Affiliation(s)
- Ricardo Filipe Alves Costa
- Graduate Program on Oncology, Barretos Cancer Hospital, Barretos, São Paulo, Brazil. .,Barretos School of Health Sciences Dr. Paulo Prata-FACISB, Barretos, São Paulo, Brazil
| | - Adhemar Longatto-Filho
- Molecular Oncology Research Center, Barretos Cancer Hospital, Barretos, São Paulo, Brazil.,Laboratory of Medical Investigation (LIM 14), Faculty of Medicine, São Paulo University, FMUSP, São Paulo, Brazil.,Life and Health Sciences Research Institute, ICVS, School of Health Sciences, Minho University, Braga, Portugal.,ICVS/3B's-PT Government Associate Laboratory, Braga/Guimarães, Portugal
| | | | - Céline Pinheiro
- Barretos School of Health Sciences Dr. Paulo Prata-FACISB, Barretos, São Paulo, Brazil.,Molecular Oncology Research Center, Barretos Cancer Hospital, Barretos, São Paulo, Brazil
| | - Luiz Carlos Zeferino
- School of Medical Sciences, Women's Hospital CAISM, Unicamp, Campinas, São Paulo, Brazil
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15
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Rodrigo Zanon J, Cardoso MS, Mimica MJ, Faria EF, Baiocchi G, Guerreiro Fregnani JHT. Retrospective Analysis of the Role of Antibiotic Prophylaxis in the Placement and Replacement of Percutaneous Nephrostomy Catheters in Patients with Malignant Ureteral Obstruction. J Palliat Med 2019; 23:686-691. [PMID: 31800348 DOI: 10.1089/jpm.2019.0289] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
Background: Antibiotic prophylaxis is usually adopted to prevent urinary tract infection (UTI) after nephrostomy catheter placement and replacement. This prophylaxis has been little studied in cancer patients, and its efficacy is uncertain. Objective: To determine the rate of UTI associated with percutaneous nephrostomy catheters placement and replacement and associated risk factors. Methods: This retrospective study collected data from the available medical records. Catheter-related UTI was defined as any diagnosis of UTI based on clinical symptoms recorded in antibiotic prescription charts, and on the results of urine culture collected up to 7 days after percutaneous nephrostomy catheter. The associations between categorical variables were analyzed using Fisher's exact test. The risk factors for UTI were assessed using logistic regression. Results: In the univariate analyses, there was no significant difference in the rate of urinary infection between patients receiving and not receiving antibiotic prophylaxis before percutaneous nephrostomy and after replacement. Conclusion: The results of the present study suggest that the use of antibiotic prophylaxis for managing urinary tract obstruction by percutaneous nephrostomy is not recommended in cancer patients. In contrast, for catheter replacement, antibiotic prophylaxis appears to have a protective effect for UTI.
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Affiliation(s)
- Jeferson Rodrigo Zanon
- Department of Palliative Care and Nephrology, Jales Cancer Hospital (Pio XII Foundation), Jales, Brazil
| | - Mateus Saldanha Cardoso
- Department of Interventional Radiology, Barretos Cancer Hospital (Pio XII Foundation), Barretos, Brazil
| | - Marcelo Jenné Mimica
- Microbiology Department, Department of Pathological Sciences, Santa Casa de São Paulo Medical School, São Paulo, Brazil.,Department of Pediatrics, Santa Casa de Misericórdia, São Paulo, Brazil
| | - Eliney Ferreira Faria
- Uro-Oncology Department and Graduation Program in Oncology of Barretos Cancer Hospital (Pio XII Foundation), Barretos, Brazil
| | - Glauco Baiocchi
- Department of Gynecology-Oncology, Laparoscopy and Robotic Surgery at the A.C. Camargo Cancer Center (Antônio Prudente Foundation), São Paulo, Brazil
| | - José Humberto Tavares Guerreiro Fregnani
- Graduate Program at the Cancer Hospital of Barretos, Barretos, Brazil.,Director of Teaching and Learning, A.C. Camargo Cancer Center, Antônio Prudente Foundation, São Paulo, Brazil
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16
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Causin RL, Pessôa-Pereira D, Souza KCB, Evangelista AF, Reis RMV, Fregnani JHTG, Marques MMC. Identification and performance evaluation of housekeeping genes for microRNA expression normalization by reverse transcription-quantitative PCR using liquid-based cervical cytology samples. Oncol Lett 2019; 18:4753-4761. [PMID: 31611985 PMCID: PMC6781752 DOI: 10.3892/ol.2019.10824] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/01/2019] [Accepted: 07/02/2019] [Indexed: 12/14/2022] Open
Abstract
Screening for cervical cancer by cytology has been effective in reducing the worldwide incidence and mortality rates of this disease. However, a number of studies have demonstrated that the sensitivity of conventional cervical cytology may be too low for detection of cervical intraepithelial neoplasias (CIN). Therefore, it is important to incorporate more sensitive molecular diagnostic tests that could substantially improve the detection rates and accuracy for identifying CIN lesions. MicroRNAs (miRNAs) are a class of small non-coding RNAs with the potential to provide robust non-invasive cancer biomarkers for detecting CIN lesions in liquid-based cervical cytology (LBC) samples. At present, there is no consensus on which are the best housekeeping genes for miRNA normalization in LBC. The present study aimed to identify housekeeping genes with consistent and reproducible performance for normalization of reverse transcription-quantitative PCR (RT-qPCR) expression analysis of miRNA using LBC samples. The present study firstly selected six potential candidate housekeeping genes based on a systematic literature evaluation. Subsequently, the expression levels of microRNAs U6, RNU-44, RNU-47, RNU-48, RNU-49 and hsa-miR-16 were measured in 40 LBC samples using RT-qPCR. The stability of each potential housekeeping gene was assessed using the NormFinder algorithm. The results revealed that U6 and RNU-49 were the most stable genes among all candidates requiring fewer amplification cycles and smaller variation across the sample set. However, RNU-44, RNU-47, RNU-48 and hsa-miR-16 stability exceeded the recommended housekeeping value suitable for normalization. The findings revealed that U6 may be a reliable housekeeping gene for normalization of miRNA RT-qPCR expression analysis using LBC samples.
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Affiliation(s)
- Rhafaela Lima Causin
- Molecular Oncology Research Center, Barretos Cancer Hospital, Barretos, São Paulo 14784-400, Brazil
| | - Danielle Pessôa-Pereira
- Molecular Oncology Research Center, Barretos Cancer Hospital, Barretos, São Paulo 14784-400, Brazil
| | | | | | - Rui Manuel Vieira Reis
- Molecular Oncology Research Center, Barretos Cancer Hospital, Barretos, São Paulo 14784-400, Brazil
| | | | - Márcia Maria Chiquitelli Marques
- Molecular Oncology Research Center, Barretos Cancer Hospital, Barretos, São Paulo 14784-400, Brazil.,Barretos School of Health Sciences-FACISB, Barretos, São Paulo 14785-002, Brazil
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17
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da Costa AM, Hashim D, Fregnani JHTG, Weiderpass E. Overall survival and time trends in breast and cervical cancer incidence and mortality in the Regional Health District (RHD) of Barretos, São Paulo, Brazil. BMC Cancer 2018; 18:1079. [PMID: 30404614 PMCID: PMC6223073 DOI: 10.1186/s12885-018-4956-7] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/15/2018] [Accepted: 10/15/2018] [Indexed: 02/05/2023] Open
Abstract
BACKGROUND Breast and cervical cancers represent a significant cause of morbidity and mortality among women. The purpose of this study was to analyse the survival and time trends in two of the most common female cancers in the Regional Health District (RHD) of Barretos, São Paulo, Brazil. METHODS From 2000 through 2015, we calculated the breast and cervical cancer incidence and mortality rates per 100,000 women who were age-standardized to the world population. We obtained the time trends using the Joinpoint Regression software. We estimated the overall survival rates using the Kaplan-Meier methods. RESULTS The age-standardized rates (ASR) for incidence of breast cancer increased annually, with an average annual percentage change (AAPC) of 4.3 (95% Confidence Interval (CI): 2.4 to 6.3) for invasive breast cancer and 10.2 (95% CI: 6.1 to 14.5) for in situ breast cancer. The mortality rates for invasive breast cancer decreased with an AAPC of 0.2 (95% CI: -1.9 to 2.4). The ASR incidence of invasive cervical cancer showed an AAPC of - 1.9 (95% CI: -4.7 to 0.9). For in situ cases, the ASR showed an AAPC of 9.3 (95% CI: 3.3 to 15.7). The ASR mortality for cervical cancer showed an AAPC of - 5.3 (95% CI: -9.5 to - 0.8). The Kaplan-Meier analysis indicated 5-year overall survival rates of 74.3% for breast cancer and 70.7% for cervical cancer. CONCLUSIONS The incidence of in situ and invasive breast cancer is increasing, while the mortality rates remain stable. We observed an increase in the incidence of in situ cervical cancer and a decrease in invasive incidence rates during the study period, and we noted that the cervical cancer mortality significantly declined during the study period.
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Affiliation(s)
- Allini Mafra da Costa
- Hospital-Based Cancer Registry, Barretos Cancer Hospital, Rua Antenor Duarte Vilela, 1331, Dr. Paulo Prata, Barretos, São Paulo 14784-400 Brazil
- Population-Based Cancer Registry of Barretos Cancer Hospital, Barretos, São Paulo 14784-400 Brazil
- Institute of Education and Research, Barretos Cancer Hospital, Barretos, São Paulo 14784-400 Brazil
| | - Dana Hashim
- Department of Research, Cancer Registry of Norway, Institute of Population-Based Cancer Research, Oslo, Norway
| | | | - Elisabete Weiderpass
- Department of Research, Cancer Registry of Norway, Institute of Population-Based Cancer Research, Oslo, Norway
- Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Sweden
- Department of Community Medicine, Faculty of Health Sciences, University of Tromsø, The Arctic University of Norway, Tromsø, Norway
- Genetic Epidemiology Group, Folkhälsan Research Center, Helsinki, Finland
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18
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Rogeri CD, Silveira HCS, Causin RL, Villa LL, Stein MD, de Carvalho AC, Arantes LMRB, Scapulatempo-Neto C, Possati-Resende JC, Antoniazzi M, Longatto-Filho A, Fregnani JHTG. Methylation of the hsa-miR-124, SOX1, TERT, and LMX1A genes as biomarkers for precursor lesions in cervical cancer. Gynecol Oncol 2018; 150:545-551. [DOI: 10.1016/j.ygyno.2018.06.014] [Citation(s) in RCA: 28] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/27/2017] [Revised: 05/30/2018] [Accepted: 06/10/2018] [Indexed: 12/22/2022]
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19
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Palhares DMF, Marconi DG, Azevedo TLD, Hess CB, Fregnani JHTG, Affonso RJ, Veneziani ACLC, Canton HP, Gadia R, Spadim MD, Rossini RR, Kamrava M. Predicting the necessity of adding catheters to intracavitary brachytherapy for women undergoing definitive chemoradiation for locally advanced cervical cancer. Brachytherapy 2018; 17:935-943. [PMID: 30100273 DOI: 10.1016/j.brachy.2018.07.003] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/21/2018] [Revised: 06/17/2018] [Accepted: 07/03/2018] [Indexed: 01/26/2023]
Abstract
PURPOSE To identify if baseline patient or magnetic resonance imaging (MRI) features can predict which women are at risk for inadequate tumor coverage with only intracavitary tandem and ovoid (T + O) brachytherapy and to correlate tumor coverage with clinical outcomes. METHODS AND MATERIALS We performed a retrospective study of 50 women with cervical cancer treated with chemoradiation at a single institution between January 2014 and December 2015. All patients had a 3T-MRI performed at baseline (MRI1) and at the completion of external beam radiation therapy (MRI2). Gross tumor volume initial (GTV-Tinit) was measured on MRI1 and high-risk clinical tissue volume (CTVHR) on MRI2. CTVHR extending beyond point A was classified as too large for adequate coverage with T + O and requiring interstitial needles. Multivariate analysis was performed to determine predictive factors of inadequate coverage. Kaplan-Meier and Cox Regression were performed to correlate inadequate coverage with outcomes. RESULTS Mean patient age was 49.2 ± 13.2 years, and 84% had Federation of Gynecology and Obstetrics IIB/IIIB disease. Forty-two percent of women were estimated to have inadequate tumor coverage with T + O brachytherapy. The GTV-Tinit volume and dimensions (superior-inferior, left-right, anterior-posterior) on MRI1 were all important predictive factors of inadequate coverage on multivariate analysis. Receiver operating characteristics curves identified optimal thresholds of superior-inferior ≥ 4.5 cm (area under the curve [AUC] = 0.718), left-right ≥ 4.5 cm (AUC = 0.745), anterior-posterior ≥ 5.0 cm (AUC = 0.767), and GTV-Tinit ≥ 85 cm3 (AUC = 0.842). Patients with inadequate coverage had worse clinical outcomes. CONCLUSIONS Baseline MRI tumor size may predict inadequate CTVHR coverage at the time of brachytherapy (i.e., the need for interstitial needles). This may help identify a subset of women requiring early referral to adequately resourced centers to improve clinical outcomes.
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Affiliation(s)
| | - Daniel Grossi Marconi
- Department of Radiation Oncology, Hospital de Câncer de Barretos, Barretos, São Paulo, Brazil
| | | | | | | | - Renato José Affonso
- Department of Radiation Oncology, Hospital de Câncer de Barretos, Barretos, São Paulo, Brazil
| | | | - Heloisa Pelisser Canton
- Department of Radiation Oncology, Hospital de Câncer de Barretos, Barretos, São Paulo, Brazil
| | - Rodrigo Gadia
- Department of Radiation Oncology, Hospital de Câncer de Barretos, Barretos, São Paulo, Brazil
| | - Marcelo Dimas Spadim
- Department of Radiology, Hospital de Câncer de Barretos, Barretos, São Paulo, Brazil
| | | | - Mitchell Kamrava
- Department of Radiation Oncology, Cedars Sinai Medical Center, Los Angeles, CA
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20
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Pantano N, Hunt B, Schwarz RA, Parra S, Cherry K, Possati-Resende JC, Longatto-Filho A, Fregnani JHTG, Castle PE, Schmeler K, Richards-Kortum R. Is Proflavine Exposure Associated with Disease Progression in Women with Cervical Dysplasia? A Brief Report. Photochem Photobiol 2018; 94:1308-1313. [PMID: 29981148 PMCID: PMC6282608 DOI: 10.1111/php.12976] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/20/2018] [Accepted: 06/27/2018] [Indexed: 12/13/2022]
Abstract
Proflavine is an acridine dye used with high-resolution microendoscopy for in vivo diagnostic evaluation of cervical epithelial cells. However, there are concerns that even short-term exposure of cervical tissue to dilute proflavine may increase cervical cancer risk. We performed a retrospective analysis of women referred for colposcopy to Barretos Cancer Hospital comparing the risk of cervical disease progression in those whose cervical tissue was (n = 232) or was not exposed (n = 160) to proflavine. Patients in both groups underwent treatment and follow-up based on histopathologic results and per the local standards of care. Progression of disease was evaluated by comparing histopathology from the initial visit to the worst subsequent histopathology result from all follow-up visits. Mean duration of follow-up was 18.7 and 20.1 months for the proflavine-exposed and controls groups, respectively. There were no significant differences in disease progression from normal/CIN1 to CIN2/3 or from any initial diagnosis to invasive cancer between the proflavine exposed and control groups overall. Risks of cervical dysplasia progression observed in this study are in agreement with those of the natural history of cervical cancer. Our results suggest that cervical exposure to dilute proflavine does not increase the risk of cervical precancer and cancer.
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Affiliation(s)
- Naitielle Pantano
- Institute of Education and Research, Barretos Cancer Hospital, Pio XII Foundation, Barretos, São Paulo, Brazil.,Molecular Oncology Center, Department of Cancer Prevention, Barretos Cancer Hospital, Pio XII Foundation, Barretos, São Paulo, Brazil
| | - Brady Hunt
- Department of Bioengineering, Rice University, Houston, TX
| | | | - Sonia Parra
- Department of Bioengineering, Rice University, Houston, TX
| | - Katelin Cherry
- Department of Bioengineering, Rice University, Houston, TX
| | - Júlio César Possati-Resende
- Institute of Education and Research, Barretos Cancer Hospital, Pio XII Foundation, Barretos, São Paulo, Brazil.,Molecular Oncology Center, Department of Cancer Prevention, Barretos Cancer Hospital, Pio XII Foundation, Barretos, São Paulo, Brazil
| | - Adhemar Longatto-Filho
- Molecular Oncology Center, Department of Cancer Prevention, Barretos Cancer Hospital, Pio XII Foundation, Barretos, São Paulo, Brazil.,Faculty of Medicine, Laboratory of Medical Investigation (LIM) 14, FMUSP, São Paulo University, São Paulo, Brazil.,School of Health Sciences, Life and Health Sciences Research Institute, ICVS, Uminho University, Braga, Portugal.,ICVS/3B's - PT Government Associate Laboratory, Braga/Guimarães, Portugal
| | - José Humberto Tavares Guerreiro Fregnani
- Institute of Education and Research, Barretos Cancer Hospital, Pio XII Foundation, Barretos, São Paulo, Brazil.,Molecular Oncology Center, Department of Cancer Prevention, Barretos Cancer Hospital, Pio XII Foundation, Barretos, São Paulo, Brazil
| | - Philip E Castle
- Global Coalition against Cervical Cancer, New York, NY.,Department of Epidemiology and Population Health, Albert Einstein College of Medicine, Bronx, NY
| | - Kathleen Schmeler
- Department of Gynecologic Oncology and Reproductive Medicine, The University of Texas MD Anderson Cancer Center, Houston, TX
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21
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Hunt B, Fregnani JHTG, Schwarz RA, Pantano N, Tesoni S, Possati-Resende JC, Antoniazzi M, de Oliveira Fonseca B, de Macêdo Matsushita G, Scapulatempo-Neto C, Kerr L, Castle PE, Schmeler K, Richards-Kortum R. Diagnosing Cervical Neoplasia in Rural Brazil Using a Mobile Van Equipped with In Vivo Microscopy: A Cluster-Randomized Community Trial. Cancer Prev Res (Phila) 2018; 11:359-370. [PMID: 29618459 PMCID: PMC5984709 DOI: 10.1158/1940-6207.capr-17-0265] [Citation(s) in RCA: 21] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/21/2017] [Revised: 12/06/2017] [Accepted: 03/28/2018] [Indexed: 12/14/2022]
Abstract
Cervical cancer is a leading cause of death in underserved areas of Brazil. This prospective randomized trial involved 200 women in southern/central Brazil with abnormal Papanicolaou tests. Participants were randomized by geographic cluster and referred for diagnostic evaluation either at a mobile van upon its scheduled visit to their local community, or at a central hospital. Participants in both arms underwent colposcopy, in vivo microscopy, and cervical biopsies. We compared rates of diagnostic follow-up completion between study arms, and also evaluated the diagnostic performance of in vivo microscopy compared with colposcopy. There was a 23% absolute and 37% relative increase in diagnostic follow-up completion rates for patients referred to the mobile van (102/117, 87%) compared with the central hospital (53/83, 64%; P = 0.0001; risk ratio = 1.37, 95% CI, 1.14-1.63). In 229 cervical sites in 144 patients, colposcopic examination identified sites diagnosed as cervical intraepithelial neoplasia grade 2 or more severe (CIN2+; 85 sites) with a sensitivity of 94% (95% CI, 87%-98%) and specificity of 50% (95% CI, 42%-58%). In vivo microscopy with real-time automated image analysis identified CIN2+ with a sensitivity of 92% (95% CI, 84%-97%) and specificity of 48% (95% CI, 40%-56%). Women referred to the mobile van were more likely to complete their diagnostic follow-up compared with those referred to a central hospital, without compromise in clinical care. In vivo microscopy in a mobile van provides automated diagnostic imaging with sensitivity and specificity similar to colposcopy. Cancer Prev Res; 11(6); 359-70. ©2018 AACR.
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Affiliation(s)
- Brady Hunt
- Rice University, Department of Bioengineering, Houston, Texas
| | | | | | | | | | | | | | | | | | | | - Ligia Kerr
- Barretos Cancer Hospital, Barretos, SP, Brazil
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Boni RADS, Paiva CE, de Oliveira MA, Lucchetti G, Fregnani JHTG, Paiva BSR. Burnout among medical students during the first years of undergraduate school: Prevalence and associated factors. PLoS One 2018. [PMID: 29513668 PMCID: PMC5841647 DOI: 10.1371/journal.pone.0191746] [Citation(s) in RCA: 68] [Impact Index Per Article: 11.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022] Open
Abstract
Objective To evaluate the prevalence and possible factors associated with the development of burnout among medical students in the first years of undergraduate school. Method A cross-sectional study was conducted at the Barretos School of Health Sciences, Dr. Paulo Prata. A total of 330 students in the first four years of medical undergraduate school were invited to participate in responding to the sociodemographic and Maslach Burnout Inventory-Student Survey (MBI-SS) questionnaires. The first-year group consisted of 150 students, followed by the second-, third-, and fourth-year groups, with 60 students each. Results Data from 265 students who answered at least the sociodemographic questionnaire and the MBI-SS were analyzed (response rate = 80.3%). One (n = 1, 0.3%) potential participant viewed the Informed Consent Form but did not agree to participate in the study. A total of 187 students (187/265, 70.6%) presented high levels of emotional exhaustion, 140 (140/265, 52.8%) had high cynicism, and 129 (129/265, 48.7%) had low academic efficacy. The two-dimensional criterion indicated that 119 (44.9%) students experienced burnout. Based on the three-dimensional criterion, 70 students (26.4%) presented with burnout. The year with the highest frequency of affected students for both criteria was the first year (p = 0.001). Personal attributes were able to explain 11% (ΔR = 0.11) of the variability of burnout under the two-dimensional criterion and 14.4% (R2 = 0.144) under the three-dimensional criterion. Conclusion This study showed a high prevalence of burnout among medical students in a private school using active teaching methodologies. In the first years of graduation, students’ personal attributes (optimism and self-perception of health) and school attributes (motivation and routine of the exhaustive study) were associated with higher levels of burnout. These findings reinforce the need to establish preventive measures focused on the personal attributes of first-year students, providing better performance, motivation, optimism, and empathy in the subsequent stages of the course.
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Affiliation(s)
- Robson Aparecido dos Santos Boni
- Barretos School of Health Sciences, Dr. Paulo Prata, Barretos, São Paulo, Brazil
- Research Group on Palliative Care and Health-Related Quality of Life (GPQual) –Barretos Cancer Hospital, Barretos, São Paulo, Brazil
| | - Carlos Eduardo Paiva
- Research Group on Palliative Care and Health-Related Quality of Life (GPQual) –Barretos Cancer Hospital, Barretos, São Paulo, Brazil
- Teaching and Research Institute, Barretos Cancer Hospital, Barretos, São Paulo, Brazil
- Department of Clinical Oncology – Breast and Gynecology Division, Barretos Cancer Hospital, Barretos, São Paulo, Brazil
| | - Marco Antonio de Oliveira
- Research Group on Palliative Care and Health-Related Quality of Life (GPQual) –Barretos Cancer Hospital, Barretos, São Paulo, Brazil
| | - Giancarlo Lucchetti
- Research Group on Palliative Care and Health-Related Quality of Life (GPQual) –Barretos Cancer Hospital, Barretos, São Paulo, Brazil
- School of Medicine, Federal University of Juiz de Fora, Minas Gerais, Brazil
| | - José Humberto Tavares Guerreiro Fregnani
- Research Group on Palliative Care and Health-Related Quality of Life (GPQual) –Barretos Cancer Hospital, Barretos, São Paulo, Brazil
- Teaching and Research Institute, Barretos Cancer Hospital, Barretos, São Paulo, Brazil
| | - Bianca Sakamoto Ribeiro Paiva
- Research Group on Palliative Care and Health-Related Quality of Life (GPQual) –Barretos Cancer Hospital, Barretos, São Paulo, Brazil
- Teaching and Research Institute, Barretos Cancer Hospital, Barretos, São Paulo, Brazil
- * E-mail:
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Costa RFA, Longatto-Filho A, de Lima Vazquez F, Pinheiro C, Zeferino LC, Fregnani JHTG. Trend analysis of the quality indicators for the Brazilian cervical cancer screening programme by region and state from 2006 to 2013. BMC Cancer 2018; 18:126. [PMID: 29394915 PMCID: PMC5797416 DOI: 10.1186/s12885-018-4047-9] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/24/2017] [Accepted: 01/24/2018] [Indexed: 11/21/2022] Open
Abstract
Background Quality indicators for the Brazilian cervical cancer screening programme can provide a perspective on its effectiveness in Brazilian macro-regions and states. The aim of this study was to perform a trend analysis of the cervical cancer screening program’s quality indicators, according to Brazilian regions and states, from 2006 to 2013. Methods Using information from approximately 62,000,000 exams obtained from the Information System of Cervical Cancer Screening (SISCOLO), joinpoint analysis was used to calculate the Annual Percentage Change (APC). Results The estimated number of women in the target age group (25–64 years) who underwent Pap testing over a three-year interval was lower than that recommended by international guidelines in the North, Northeast and Midwest regions, and the trends for this indicator remained stationary over the years in all regions of Brazil. Overall, the index of positivity in Brazilian regions and states is below that preconized by the Brazilian National Cancer Institute (INCA). Additionally, the frequencies of unsatisfactory cases are in line with international guidelines but above those preconized by INCA guidelines. All positive cytological diagnoses were lower than those preconized by INCA. Conclusions The results show that the cervical cancer screening programme is still far from efficient because most of the quality indicators in Brazilian regions and states are outside of the parameters preconized by national and international organizations. Electronic supplementary material The online version of this article (10.1186/s12885-018-4047-9) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- Ricardo Filipe Alves Costa
- Graduate Program on Oncology, Barretos Cancer Hospital, Barretos, São Paulo, 14784-400, Brazil. .,Barretos School of Health Sciences Dr. Paulo Prata - FACISB, Avenida Loja Maçonica Renovadora 68, N° 100, Bairro Aeroporto, Barretos, SP, 14785-002, Brazil.
| | - Adhemar Longatto-Filho
- Molecular Oncology Research Center, Barretos Cancer Hospital, Barretos, São Paulo, 14784-400, Brazil.,Laboratory of Medical Investigation (LIM 14), Faculty of Medicine São Paulo University, FMUSP, São Paulo, 01246-903, Brazil.,Life and Health Sciences Research Institute, ICVS, School of Health Sciences, Uminho University, 4710, Braga, Portugal.,ICVS/3B's - PT Government Associate Laboratory, 4710, Braga/Guimarães, Portugal
| | - Fabiana de Lima Vazquez
- Research and Teaching Institute, Barretos Cancer Hospital, Barretos, São Paulo, 14784-400, Brazil
| | - Céline Pinheiro
- Barretos School of Health Sciences Dr. Paulo Prata - FACISB, Avenida Loja Maçonica Renovadora 68, N° 100, Bairro Aeroporto, Barretos, SP, 14785-002, Brazil.,Molecular Oncology Research Center, Barretos Cancer Hospital, Barretos, São Paulo, 14784-400, Brazil
| | - Luiz Carlos Zeferino
- School of Medical Sciences, Women's Hospital CAISM, Unicamp, Campinas, São Paulo, 13081-940, Brazil
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Possati-Resende JC, Vazquez FDL, Biot ST, Mauad EC, Talarico T, Fregnani JHTG, Longatto-Filho A. Organized Cervical Cancer Screening Program in Barretos, Brazil: Experience in 18 Municipalities of São Paulo State. Acta Cytol 2017; 62:19-27. [PMID: 29069645 DOI: 10.1159/000480446] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/18/2017] [Accepted: 08/18/2017] [Indexed: 11/19/2022]
Abstract
OBJECTIVES The aim of this report is to demonstrate the Barretos Cancer Hospital initiative of organizational, laboratorial, and human resources training in the implementation of an organized cervical screening program in low-resource settings. METHODS We developed a computational program to report all epidemiological, clinical, and laboratorial findings, and to trace all necessary information to recruit women for regular screening or for referral for complementary exams after liquid-based Pap test analyses. RESULTS All Pap tests were collected in liquid medium and in 2014 more than 160,000 tests were analyzed and 2,900 colposcopy examinations were performed. From 2012 to 2015, the percentage of exams collected increased from 54.6% in 2012 to 62.4% in 2013, 68.4% in 2014, and 71% in 2015. Per 1,000 Pap tests, 0.4 cases of invasive cancer were diagnosed; for in situ carcinoma, 1.9 cases were identified. More importantly, between 2011 and 2015, 89.4% of all carcinomas were detected at clinical stage 0 or I (in situ carcinoma), and only 5% at stages III and IV. CONCLUSIONS Since the organized system was implemented, 98% of women have attended their recall for colposcopy. So far, we have not reached the target of 70% of women for this proposal, as recommended by the international standards.
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Fregnani CMS, Fregnani JHTG, Longatto-Filho A. Methodological study to evaluate the psychometric properties of FACIT-CD in a sample of Brazilian women with cervical intraepithelial neoplasia. BMC Cancer 2017; 17:686. [PMID: 29037189 PMCID: PMC5644164 DOI: 10.1186/s12885-017-3676-8] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/06/2016] [Accepted: 10/08/2017] [Indexed: 11/16/2022] Open
Abstract
BACKGROUND The occurrence of cervical intraepithelial neoplasia (CIN) is associated with changes in health-related quality of life, including psychological factors, such as fear and shame, and changes in sexuality and sexual satisfaction, such as decreased sexual desire and frequency of sexual intercourse. Personal relationships are the most affected because CIN is sexually transmitted and many women tend to blame their partner for disease transmission. The aim of this study was to evaluate the psychometric properties of the FACIT-CD questionnaire in Brazilian women diagnosed with CIN. METHODS The properties of the FACIT-CD questionnaire were tested on a sample of 439 women seen at the Department of Prevention of Barretos Cancer Hospital, including 329 patients who were diagnosed with CIN and 110 women who were not diagnosed with the disease. The analysed parameters included internal consistency (Cronbach's alpha), reproducibility (intraclass correlation coefficient), structural validity, convergent validity (correlation with the SF-12 and EORTC QLQ-CX24 questionnaires), discriminant validity (according to disease status, and self-rating of health), sensitivity, and responsiveness. RESULTS The Cronbach alpha values of the FACIT-CD scales were higher than 0.70 with the exception of the relationship scale (0.66). The FACIT-CD reproducibility was satisfactory, with variation in the intraclass correlation coefficients ranging between 0.50 and 0.83, although the 95% confidence interval (CI) was lower than 0.40 (0.33-0.64) on the treatment satisfaction scale. Regarding structural validity, only one item on the physical well-being scale was not kept in the original domain. The expected correlations between the FACIT-CD and SF-12 were not confirmed, whereas the correlations between the FACIT-CD and EORTC QLQ-CX24 were confirmed. The questionnaire was able to discriminate the groups according to disease status and self-rating of health. The sensitivity was low for the relationship scale and moderate for the other scales. The responsiveness of the FACIT-CD questionnaire varied between the groups that denominate the self-perception of health as no change, improvement or worsening. CONCLUSION Our results are encouraging and indicate that the FACIT-CD questionnaire is a promising tool for the analysis of the quality of life of women with CIN.
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Affiliation(s)
- Cristiane Menezes Sirna Fregnani
- Teaching and Research Institute of Barretos Cancer Hospital, Antenor Duarte Villela street, 1331. Barretos, São Paulo, Zip code: 14784-400 Brazil
| | | | - Adhemar Longatto-Filho
- Teaching and Research Institute of Barretos Cancer Hospital, Antenor Duarte Villela street, 1331. Barretos, São Paulo, Zip code: 14784-400 Brazil
- Life and Health Sciences Research Institute (ICVS), School of Health Sciences, University of Minho, 4710-057 Braga, Portugal
- ICVS/3B’s, PT Government Associate Laboratory, Braga, Guimarães Portugal
- Laboratory of Medical Investigation (LIM) 14, FMUSP, São Paulo, Brazil
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Fregnani CMS, Fregnani JHTG, Paiva CE, Barroso EM, Camargos MGD, Tsunoda AT, Longatto-Filho A, Paiva BSR. Translation and cultural adaptation of the Functional Assessment of Chronic Illness Therapy - Cervical Dysplasia (FACIT-CD) to evaluate quality of life in women with cervical intraepithelial neoplasia. Einstein (Sao Paulo) 2017; 15:155-161. [PMID: 28767912 PMCID: PMC5609610 DOI: 10.1590/s1679-45082017ao3910] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/03/2016] [Accepted: 02/18/2017] [Indexed: 11/29/2022] Open
Abstract
Objective To translate and perform the cultural adaptation of the tool Functional Assessment of Chronic Illness Therapy – Cervical Dysplasia (FACIT-CD) to the Portuguese language. Methods A descriptive cross-sectional study, with translation and cultural adaptation of the assessment tool performed according to international guidelines and the Functional Assessment of Chronic Illness Therapy (FACIT) protocol group. It involved eight experts, six from Brazil, one from Portugal and one from the United States. After translation and back-translation of the tool, the semantic analysis process was carried out. We randomly included 20 women aged between 18 and 70 years with altered cervical cytology exam, seen at the Department of Prevention and Gynecologic Oncology - Hospital de Câncer de Barretos. Results The sample consisted of women with low education level. In the first pre-test, ten women participated and half of them considered the questions CD1, CD2 and CD3 as difficult, because they did not understand the meaning of the term “pelvic area”. The question CD5, “I worry about spreading the infection”, was also considered difficult to understand by five women. After the reconsideration of the expert committee and FACIT group, the second pre-test was performed. At this stage, we concluded that the previously raised understanding problems had been solved. Conclusion The translated version of FACIT-CD in universal Portuguese language is equivalent to the original version in English and was easily understood by patients with cervical intraepithelial neoplasia.
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da Costa AM, Fregnani JHTG, Pastrez PRA, Mariano VS, Neto CS, Guimarães DP, de Oliveira KMG, Neto SAZ, Nunes EM, Ferreira S, Sichero L, Villa LL, Syrjanen KJ, Longatto-Filho A. Prevalence of high risk HPV DNA in esophagus is high in Brazil but not related to esophageal squamous cell carcinoma. Histol Histopathol 2017; 33:357-363. [PMID: 28875493 DOI: 10.14670/hh-11-929] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
BACKGROUNDS The first publication that associated Human Papillomavirus (HPV) infection and esophageal cancer was published in 1982. However, data are still contradictory and require further investigation. The aim of this study was to identify high risk HPV DNA in esophageal tissue of patients with and without esophageal squamous cell carcinoma (ESCC) and correlate HPV presence with classical risk factors. METHODS Invited patients signed the informed consent form, and interviews were conducted in order to obtain information about sociodemographic and lifestyle behavior. During endoscopy, esophageal biopsies were collected from case and controls. Multiplex polymerase chain reaction genotyping was conducted on endoscopic biopsies to identify HPV types and HPV-16 was further evaluated by specific PCR real time. RESULTS Among 87 cases, 12 (13.8%) had tumors harboring high risk HPV DNA and among 87 controls, 12 (13.8%) had high risk HPV DNA (OR:1.025 [CI:0.405:2.592]). Variables regarding consumption of alcohol and use of tobacco continued to characterize risk factors even after adjustments by presence or absence of high risk HPV. CONCLUSION HPV was demonstrated to be frequently and similarly associated to normal and malignant esophageal tissues, but not as an independent risk factor to esophageal cancer. IMPACT To contribute to the Brazilian population data on this subject, which is still contradictory.
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Affiliation(s)
- Allini Mafra da Costa
- Teaching and Research Institute, Barretos Cancer Hospital - Pius XII Foundation, Brazil
| | | | | | | | | | | | | | | | - Emily Montosa Nunes
- Molecular Biology Laboratory, Center for Translational Research in Oncology, Instituto do Câncer do Estado de São Paulo - ICESP, São Paulo, Brazil
| | - Silvaneide Ferreira
- Molecular Biology Laboratory, Center for Translational Research in Oncology, Instituto do Câncer do Estado de São Paulo - ICESP, São Paulo, Brazil
| | - Laura Sichero
- Molecular Biology Laboratory, Center for Translational Research in Oncology, Instituto do Câncer do Estado de São Paulo - ICESP, São Paulo, Brazil
| | - Luisa Lina Villa
- Molecular Biology Laboratory, Center for Translational Research in Oncology, Instituto do Câncer do Estado de São Paulo - ICESP, São Paulo, Brazil.,Department of Radiology and Oncology, School of Medicine, University of São Paulo, São Paulo, Brazil
| | - Kari Juhani Syrjanen
- Teaching and Research Institute, Barretos Cancer Hospital - Pius XII Foundation, Brazil.,Department of Clinical Research - Biohit Oyj, Finland
| | - Adhemar Longatto-Filho
- Teaching and Research Institute, Barretos Cancer Hospital - Pius XII Foundation, Brazil.,Medical Laboratory of Medical Investigation (LIM) 14, Department of Pathology, Faculty of Medicine, University of São Paulo, São Paulo, Brazil. .,Research Institute of Life and Health Sciences (ICVS), University of Minho, Braga, Portugal.,ICVS / 3B's - Associated Laboratory to the Government of Portugal, Braga / Guimarães, Portugal
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Thapa A, Soares AC, Soares JC, Awan IT, Volpati D, Melendez ME, Fregnani JHTG, Carvalho AL, Oliveira ON. Carbon Nanotube Matrix for Highly Sensitive Biosensors To Detect Pancreatic Cancer Biomarker CA19-9. ACS Appl Mater Interfaces 2017; 9:25878-25886. [PMID: 28696659 DOI: 10.1021/acsami.7b07384] [Citation(s) in RCA: 54] [Impact Index Per Article: 7.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/12/2023]
Abstract
Biosensors fabricated with nanomaterials promise faster, cheaper, and more efficient alternatives to traditional, often bulky devices for early cancer diagnosis. In this study, we fabricated a thin film sensing unit on interdigitated gold electrodes combining polyethyleneimine and carbon nanotubes in a layer by layer fashion, onto which antibodies anti-CA19-9 were adsorbed with a supporting layer of N-hydroxysuccinimide and 1-ethyl-3-(3-dimethylaminopropyl)carbodiimide solution. By use of impedance spectroscopy, the pancreatic cancer biomarker CA19-9 was detected in a buffer with limit of detection of 0.35 U/mL. This high sensitivity allowed for distinction between samples of blood serum from patients with distinct probabilities to develop pancreatic cancer. The selectivity of the biosensor was confirmed in subsidiary experiments with HT-29 and SW-620 cell lines and possible interferents, e.g., p53 protein, ascorbic acid, and glucose, where significant changes in capacitance could only be measured with HT-29 that contained the CA19-9 biomarker. Chemisorption of CA19-9 molecules onto the layer of anti-CA19-9 antibodies was the mechanism responsible for sensing while electrostatic interactions drove the adsorption of carbon nanotubes, according to polarization-modulated infrared reflection absorption spectroscopy (PM-IRRAS). The adsorption behavior was successfully described by the Langmuir-Freundlich isotherm.
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Affiliation(s)
- Anshu Thapa
- São Carlos Institute of Physics, University of São Paulo , São Carlos 13560-970, Brazil
- Department of Physics, University of Bath , Bath BA2 7AY, United Kingdom
| | | | | | - Iram Taj Awan
- São Carlos Institute of Physics, University of São Paulo , São Carlos 13560-970, Brazil
| | - Diogo Volpati
- Department of Natural Sciences, Mittuniversitetet , Sundsvall 851 70, Sweden
| | - Matias Eliseo Melendez
- Molecular Oncology Research Center, Barretos Cancer Hospital , Barretos 14784-400, Brazil
| | | | - André Lopes Carvalho
- Molecular Oncology Research Center, Barretos Cancer Hospital , Barretos 14784-400, Brazil
| | - Osvaldo N Oliveira
- São Carlos Institute of Physics, University of São Paulo , São Carlos 13560-970, Brazil
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de Melo Kuil L, Lorenzi AT, Stein MD, Resende JCP, Antoniazzi M, Longatto-Filho A, Scapulatempo-Neto C, Fregnani JHTG. The Role of Self-Collection by Vaginal Lavage for the Detection of HPV and High-Grade Intraepithelial Neoplasia. Acta Cytol 2017; 61:425-433. [PMID: 28564641 DOI: 10.1159/000477331] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/20/2016] [Accepted: 05/03/2017] [Indexed: 11/19/2022]
Abstract
OBJECTIVE To compare the results of cervical cytology and high-risk HPV tests using samples obtained using two different collection modalities in a population of Brazilian women: self-collection (vaginal lavage) and cervical Pap testing. METHODS We enrolled 204 women who were aged 18-64 years and had previously obtained abnormal cervical cytology test results; 83.8% of them agreed to participate. The sample was divided into two aliquots: one for the cytological study and one for the molecular analysis of high-risk HPV. RESULTS Fifty-eight percent of the participants preferred to utilize self-collection as an alternative screening method. However, we noticed that the HPV positivity rate was significantly lower in self-collected samples when compared to those obtained using the conventional collection method (p = 0.035). The cytology tests of the samples obtained via self-collection were sensitive and had a positive predictive value and an area under the curve (AUC) that were significantly lower than those of the Pap test. However, the specificity and negative predictive value of these tests were similar. When compared with the HPV test, the self-collected samples demonstrated lower accuracy in predicting high-grade cervical intraepithelial neoplasia or worse, with a significantly lower sensitivity, positive predictive value, and AUC than the cervical Pap test samples. CONCLUSION Self-collection by vaginal lavage is simple and well accepted by women. Due to its limitations, however, self-collection by lavage should be utilized with caution.
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Affiliation(s)
- Larissa de Melo Kuil
- Center for Research Support, Barretos Cancer Hospital, Pius XII Foundation, Barretos, Brazil
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De Lima Vazquez F, Silva TB, Da Costa Vieira RA, Da Costa AM, Scapulatempo C, Fregnani JHTG, Mauad EC, Longatto A, Syrjänen KJ. Retrospective analysis of breast cancer prognosis among young and older women in a Brazilian cohort of 738 patients, 1985-2002. Oncol Lett 2016; 12:4911-4924. [PMID: 28101229 PMCID: PMC5228328 DOI: 10.3892/ol.2016.5360] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/03/2015] [Accepted: 05/16/2016] [Indexed: 12/26/2022] Open
Abstract
Invasive breast cancer (BC) is infrequent among women aged ≤40 years, however, the disease outlook in these younger patients is generally worse than among older women. The present study aimed to compare socio-demographic, clinical and pathological characteristics, and their association with long-term survival, between two random cohorts of young (≤40 years) and older (50–69 years) Brazilian patients with BC. The cohort comprised of 738 randomly selected women who were diagnosed with BC at Barretos Cancer Hospital, Pio XII Foundation (Barretos, Brazil) between January 1985 and December 2002; the patients included young women (n=376) and older women (n=362). The current analysis suggested that BC in young women is associated with numerous pathological features of aggressiveness. Second cancer and bilateral BC were independent predictors of a poor outcome in the younger group. Furthermore, C-erB-2 was positively correlated with poor outcome in the older group, whereas estrogen receptor status and TNM stage were associated with disease prognosis in both groups. The overall survival rates of the two age groups were similar except when analyzed according the treatment period (1997–2002). Although patients aged ≤40 years harbored tumors with more aggressive clinicopathological characteristics, these characteristics were not independent predictors of overall survival. The present study indicates that medical advances associated with prevention of breast cancer may improve screening programs, which may therefore increase early diagnosis and subsequently lower mortality rates.
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Affiliation(s)
- Fabiana De Lima Vazquez
- Department of Prevention, Barretos Cancer Hospital, Pio XII Foundation, Barretos, São Paulo 14784-400, Brazil
| | - Thiago Buosi Silva
- Department of Prevention, Barretos Cancer Hospital, Pio XII Foundation, Barretos, São Paulo 14784-400, Brazil
| | - René Aloísio Da Costa Vieira
- Department of Prevention, Barretos Cancer Hospital, Pio XII Foundation, Barretos, São Paulo 14784-400, Brazil; Department of Prevention, Faculty of Public Health, University of São Paulo, São Paulo 01246-904, Brazil
| | - Allini Mafra Da Costa
- Department of Prevention, Barretos Cancer Hospital, Pio XII Foundation, Barretos, São Paulo 14784-400, Brazil
| | - Cristovam Scapulatempo
- Department of Prevention, Barretos Cancer Hospital, Pio XII Foundation, Barretos, São Paulo 14784-400, Brazil
| | | | - Edmundo Carvalho Mauad
- Department of Prevention, Barretos Cancer Hospital, Pio XII Foundation, Barretos, São Paulo 14784-400, Brazil
| | - Adhemar Longatto
- Laboratory of Medical Investigation 14, Department of Pathology, Medical School of São Paulo University, São Paulo 01246-903, Brazil; 3B's-PT Government Associate Laboratory, Life and Health Sciences Research Institute (ICVS), School of Health Sciences, University of Minho, Guimarães, 4710-057 Braga, Portugal; Molecular Oncology Research Center, Barretos Cancer Hospital, Pio XII Foundation, Barretos, São Paulo 14784-400, Brazil
| | - Kari Juhani Syrjänen
- Department of Prevention, Barretos Cancer Hospital, Pio XII Foundation, Barretos, São Paulo 14784-400, Brazil; Department of Clinical Research, Biohit HealthCare Ltd., 00880 Helsinki, Finland
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Mariano VS, Lorenzi AT, Scapulatempo-Neto C, Stein MD, Resende JCP, Antoniazzi M, Villa LL, Levi JE, Longatto-Filho A, Fregnani JHTG. A Low-Cost HPV Immunochromatographic Assay to Detect High-Grade Cervical Intraepithelial Neoplasia. PLoS One 2016; 11:e0164892. [PMID: 27764154 PMCID: PMC5072685 DOI: 10.1371/journal.pone.0164892] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/28/2016] [Accepted: 10/03/2016] [Indexed: 12/22/2022] Open
Abstract
Objective To evaluate the reproducibility and accuracy of the HPV16/18-E6 test. Methods The study population was comprised of 448 women with a previously abnormal Pap who were referred to the Barretos Cancer Hospital (Brazil) for diagnosis and treatment. Two cervical samples were collected immediately before colposcopy, one for the hr-HPV-DNA test and cytology and the other for the HPV16/18-E6 test using high-affinity monoclonal antibodies (mAb). Women with a histologic diagnosis of cervical intraepithelial neoplasia grade 2 or 3 were considered to be positive cases. Different strategies using a combination of screening methods (HPV-DNA) and triage tests (cytology and HPV16/18-E6) were also examined and compared. Results The HPV16/18-E6 test exhibited a lower positivity rate compared with the HPV-DNA test (19.0% vs. 29.3%, p<0.001) and a moderate/high agreement (kappa = 0.68, 95%CI: 0.60–0.75). It also exhibited a significantly lower sensitivity for CIN2+ and CIN3+ detection compared to the HPV-DNA test and a significantly higher specificity. The HPV16/18-E6 test was no different from cytology in terms of sensitivity, but it exhibited a significantly higher specificity in comparison to ASCH+. A triage test after HPV-DNA detection using the HPV16/18-E6 test exhibited a significantly higher specificity compared with a triage test of ASCH+ to CIN2+ (91.8% vs. 87.4%, p = 0.04) and CIN3+ (88.6% vs. 84.0%, p = 0.05). Conclusion The HPV16/18-E6 test exhibited moderate/high agreement with the HPV-DNA test but lower sensitivity and higher specificity for the detection of CIN2+ and CIN3+. In addition, its performance was quite similar to cytology, but because of the structural design addressed for the detection of HPV16/18-E6 protein, the test can miss some CIN2/3+ lesions caused by other high-risk HPV types.
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Affiliation(s)
- Vânia Sammartino Mariano
- Molecular Oncology Research Center, Barretos Cancer Hospital/Pio XII Foundation, Barretos, Sao Paulo, Brazil
| | - Adriana Tarlá Lorenzi
- Molecular Oncology Research Center, Barretos Cancer Hospital/Pio XII Foundation, Barretos, Sao Paulo, Brazil
| | | | - Maíra Degiovani Stein
- Pathology Department, Barretos Cancer Hospital/Pio XII Foundation, Barretos, Sao Paulo, Brazil
| | | | - Márcio Antoniazzi
- Cancer Prevention Department, Barretos Cancer Hospital/Pio XII Foundation, Barretos, Sao Paulo, Brazil
| | - Luisa Lina Villa
- Department of Radiology and Oncology, Faculty of Medicine, University of Sao Paulo, Sao Paulo, Brazil
| | - José Eduardo Levi
- Virology Laboratory, LIM 52.The Institute of Tropical Medicine of the University of Sao Paulo, Sao Paulo, Brazil
| | - Adhemar Longatto-Filho
- Molecular Oncology Research Center, Barretos Cancer Hospital/Pio XII Foundation, Barretos, Sao Paulo, Brazil
- Laboratory of Medical Research Laboratory, LIM 14.Department of Pathology, Faculty of Medicine, University of Sao Paulo, Sao Paulo, Brazil
- Life and Health Sciences Research Institute (ICVS), School of Health Sciences, University of Minho, Braga, Portugal
- ICVS/3B’s–PT Government Associate Laboratory, Braga/Guimaraes, Portugal
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de Oliveira CM, Bravo IG, Santiago e Souza NC, Genta MLND, Fregnani JHTG, Tacla M, Carvalho JP, Longatto-Filho A, Levi JE. High-level of viral genomic diversity in cervical cancers: A Brazilian study on human papillomavirus type 16. Infect Genet Evol 2015; 34:44-51. [PMID: 26160543 DOI: 10.1016/j.meegid.2015.07.002] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/25/2015] [Revised: 07/02/2015] [Accepted: 07/04/2015] [Indexed: 01/31/2023]
Abstract
Invasive cervical cancer (ICC) is the third most frequent cancer among women worldwide and is associated with persistent infection by carcinogenic human papillomaviruses (HPVs). The combination of large populations of viral progeny and decades of sustained infection may allow for the generation of intra-patient diversity, in spite of the assumedly low mutation rates of PVs. While the natural history of chronic HPVs infections has been comprehensively described, within-host viral diversity remains largely unexplored. In this study we have applied next generation sequencing to the analysis of intra-host genetic diversity in ten ICC and one condyloma cases associated to single HPV16 infection. We retrieved from all cases near full-length genomic sequences. All samples analyzed contained polymorphic sites, ranging from 3 to 125 polymorphic positions per genome, and the median probability of a viral genome picked at random to be identical to the consensus sequence in the lesion was only 40%. We have also identified two independent putative duplication events in two samples, spanning the L2 and the L1 gene, respectively. Finally, we have identified with good support a chimera of human and viral DNA. We propose that viral diversity generated during HPVs chronic infection may be fueled by innate and adaptive immune pressures. Further research will be needed to understand the dynamics of viral DNA variability, differentially in benign and malignant lesions, as well as in tissues with differential intensity of immune surveillance. Finally, the impact of intralesion viral diversity on the long-term oncogenic potential may deserve closer attention.
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Affiliation(s)
- Cristina Mendes de Oliveira
- Laboratório de Virologia, Instituto de Medicina Tropical, Universidade de São Paulo, São Paulo, Brazil; Infections and Cancer Laboratory, Catalan Institute of Oncology, Barcelona, Spain.
| | - Ignacio G Bravo
- Infections and Cancer Laboratory, Catalan Institute of Oncology, Barcelona, Spain
| | | | | | | | - Maricy Tacla
- Gynecology Department, Faculdade de Medicina, Universidade de São Paulo, São Paulo, Brazil
| | - Jesus Paula Carvalho
- Instituto do Câncer do Estado de São Paulo (ICESP), Faculdade de Medicina, São Paulo, Brazil
| | - Adhemar Longatto-Filho
- Molecular Oncology Research Center, Hospital de Câncer de Barretos, Barretos, São Paulo, Brazil; Laboratory of Medical Investigation (LIM) 14, Faculty of Medicine, University of São Paulo, São Paulo, Brazil; Life and Health Sciences Research Institute (ICVS), School of Health Sciences, University of Minho, Braga, Portugal; ICVS/3B's - PT Government Associate Laboratory, Braga/Guimarães, Portugal
| | - José Eduardo Levi
- Laboratório de Virologia, Instituto de Medicina Tropical, Universidade de São Paulo, São Paulo, Brazil
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Campanholi LL, Duprat Neto JP, Fregnani JHTG. Evaluation of inter-rater reliability of subjective and objective criteria for diagnosis of lymphedema in upper and lower limbs. J Vasc Bras 2015. [DOI: 10.1590/1677-5449.20140037] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022] Open
Abstract
BACKGROUND: The diagnosis of lymphedema can be obtained objectively by measurement methods, and also by subjective methods, based on the patient's complaint. OBJECTIVE: To evaluate inter-rater reliability of objective and subjective criteria used for diagnosis of lymphedema and to propose a lymphedema cut-off for differences in volume between affected and control limbs. METHODS: We studied 84 patients who had undergone lymphadenectomy for treatment of cutaneous melanoma. Physical measures were obtained by manual perimetry (MP). The subjective criteria analyzed were clinical diagnosis of lymphedema in patients' medical records and self-report of feelings of heaviness and/or increase in volume in the affected limb. RESULTS: For upper limbs, the subjective criteria clinical observation (k 0.754, P<0.001) and heaviness and swelling (k 0.689, P<0.001) both exhibited strong agreement with MP results and there was moderate agreement between MP results and swelling (k 0.483 P<0.001), heaviness (k 0.576, P<0.001) and heaviness or swelling (k 0.412, P=0.001). For lower limbs there was moderate agreement between MP results and clinical observation (k 0.423, P=0.003) and regular agreement between MP and self-report of swelling (k 0.383, P=0.003). Cut-off values for diagnosing lymphedema were defined as a 9.7% difference between an affected upper limb and control upper limb and a 5.7% difference between lower limbs. CONCLUSION: Manual perimetry, medical criteria, and self-report of heaviness and/or swelling exhibited better agreement for upper limbs than for lower limbs for diagnosis of lymphedema.
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Faloppa CC, Baiocchi G, Cunha IW, Fregnani JHTG, Osorio CABT, Fukazawa EM, Kumagai LY, Badiglian-Filho L, Pinto GLS, Soares FA. NF-κB and COX-2 expression in nonmalignant endometrial lesions and cancer. Am J Clin Pathol 2014; 141:196-203. [PMID: 24436266 DOI: 10.1309/ajcpv7u7pghoweqg] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/20/2023] Open
Abstract
OBJECTIVES To examine the immunohistochemical expression of cyclooxygenase-2 (COX-2) and nuclear factor-κB (NF-κB) in benign endometrial polyps (EPs), endometrial hyperplasia (EH), endometrial intraepithelial neoplasia (EIN), and endometrioid endometrial cancer (EC). METHODS The immunohistochemical expression of COX-2 and NF-κB was performed using an Aperio Scanscope XT automated system in 218 patients with endometrioid EC and 107 patients with nonmalignant endometrial lesions: 53 with benign EPs, 37 with EH, and 17 with EIN. RESULTS COX-2 and NF-κB p50 expression were significantly lower in EC compared with nonmalignant lesions. We observed significant decreased NF-κB p65 expression in EC vs EPs (P < .001) and EH (P = .014) as well as in EIN vs. EPs (P = .01). For patients with EC, COX-2 correlated positively with NF-κB p65 and NF-κB p50 (P < .001). Grade 3 tumors had a higher mean expression of NF-κB p65 (P = .03). NF-κB p50, NF-κB p65, and COX-2 expression had no impact on survival. CONCLUSIONS We conclude that COX-2 and NF-κB expression are lower in EC compared with nonmalignant endometrial lesions. COX-2 and NF-κB expression have no prognostic value in EC.
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Affiliation(s)
| | - Glauco Baiocchi
- Departments of Gynecologic Oncology, AC Camargo Cancer Hospital, São Paulo, Brazil
| | | | | | | | - Elza Mieko Fukazawa
- Departments of Gynecologic Oncology, AC Camargo Cancer Hospital, São Paulo, Brazil
| | - Lillian Yuri Kumagai
- Departments of Gynecologic Oncology, AC Camargo Cancer Hospital, São Paulo, Brazil
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Ribeiro FDAQ, Pereira CSB, Chi RJ, Yokomizo PL, Fregnani JHTG, Rocha RM. Comparative assessment between objective and subjective methods in slides stained by immunohistochemistry. Braz J Otorhinolaryngol 2014; 79:704-8. [PMID: 24474481 PMCID: PMC9442420 DOI: 10.5935/1808-8694.20130129] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/01/2013] [Accepted: 07/06/2013] [Indexed: 11/20/2022] Open
Abstract
UNLABELLED Objective methods of assessment are often required in scientific studies. Histological tests with immunohistochemical staining can be assessed by photometry. OBJECTIVE To compare this objective method with the subjective evaluation performed by three independent examiners, using slides of acquired middle ear cholesteatomas. METHOD We selected a total of 54 cholesteatoma images, immunohistochemically stained by anti-TNF-R2 (32 slides) and anti-TGF-α, (22 slides). The secondary antibody used in the two groups was the Max Polymer Detection System (Novo Link Kit, Novocastra®, UK). The samples were processed by a digital slide scanner (ScanScope - Aperio). The selected sites were analyzed by photometry. RESULTS The objective assessment by photometry was compared with the subjective evaluation by three examiners and subjected to statistical analysis. The Statistical analysis revealed moderate reproducibility (K values between 0.41 and 0.60) for both groups. CONCLUSION Our study showed that the irregular characteristics of middle ear cholesteatoma slides stained by immunohistochemistry prevents its proper objective evaluation, while the subjective assessment by experienced examiners was more reliable.
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Fregnani CMS, Fregnani JHTG, Dias de Oliveira Latorre MDR, de Almeida AM. Evaluation of the psychometric properties of the Functional Assessment of Cancer Therapy-Cervix questionnaire in Brazil. PLoS One 2013; 8:e77947. [PMID: 24147102 PMCID: PMC3797824 DOI: 10.1371/journal.pone.0077947] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/13/2013] [Accepted: 09/06/2013] [Indexed: 11/20/2022] Open
Abstract
Background Although cervical cancer is the second most common tumor among Brazilian women, studies that evaluate the quality of life of these women are still scarce. This situation is explained by the lack of specific and validated tools for this purpose in Portuguese (Brazil). The aim of this study was to evaluate the psychometric properties of the Portuguese version of the FACT-CX (Functional Assessment of Cancer Therapy-Cervix) questionnaire in a population of Brazilian women with cervical cancer. Methods The psychometric properties of the FACT-CX questionnaire were tested in a sample of 100 women diagnosed with cervical cancer who were previously treated in the Barretos Cancer Hospital. We analyzed the internal consistency (Cronbach's alpha), reproducibility (intraclass correlation coefficient - ICC), confirmatory factor analysis, convergent validity (correlation with the SF-36 questionnaire), and discriminant validity by disease stage and two questions related to self-perception of health was also performed. Results The scales had Cronbach´s alpha coefficients ranging from 0.61 to 0.80. However, three scales did not have a statistically significant coefficient greater than 0.70. The ICC ranged from 0.68 to 0.82 and all considered satisfactory. Factor analysis did not generate consistent components. The FACT-G and FACT-CX total scores had good internal consistency and reproducibility, and also correlated well with the General Health and Vitality scales of the SF-36. However, only two FACT-CX scales had a significant correlation with SF-36. Discriminant analysis showed that FACT-CX failed to discriminate groups according to clinical stage but was able to divide the women according to the self-perception of health. Conclusion FATC-CX total score had good internal consistency, reproducibility and discriminant validity. In addition, it correlated well with General Health and Vitality scales of SF-36. However, three scales had questionable internal consistency and only two had significant correlation with SF-36.
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Affiliation(s)
- Cristiane Menezes Sirna Fregnani
- Graduation Program in Public Health Nursing, College of Nursing, University of São Paulo, Ribeirão Preto, Brazil
- Research and Teaching Institute, Barretos Cancer Hospital (IEP-HCB), Barretos, Brazil
- * E-mail:
| | | | | | - Ana Maria de Almeida
- Department of Maternal-Infant and Public Health Nursing, College of Nursing, University of São Paulo, Ribeirão Preto, Ribeirão Preto, Brazil
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de Oliveira CM, Fregnani JHTG, Carvalho JP, Longatto-Filho A, Levi JE. Human papillomavirus genotypes distribution in 175 invasive cervical cancer cases from Brazil. BMC Cancer 2013; 13:357. [PMID: 23883423 PMCID: PMC3725167 DOI: 10.1186/1471-2407-13-357] [Citation(s) in RCA: 26] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/18/2012] [Accepted: 07/22/2013] [Indexed: 12/15/2022] Open
Abstract
Background Invasive cervical cancer is the second most common malignant tumor affecting Brazilian women. Knowledge on Human Papillomavirus (HPV) genotypes in invasive cervical cancer cases is crucial to guide the introduction and further evaluate the impact of new preventive strategies based on HPV. We aimed to provide updated comprehensive data about the HPV types’ distribution in patients with invasive cervical cancer. Methods Fresh tumor tissue samples of histologically confirmed invasive cervical cancer were collected from 175 women attending two cancer reference hospitals from São Paulo State: ICESP and Hospital de Câncer de Barretos. HPV detection and genotyping were performed by the Linear Array HPV Genotyping Test (Roche Molecular Diagnostics, Pleasanton,USA). Results 170 out of 172 valid samples (99%) were HPV DNA positive. The most frequent types were HPV16 (77.6%), HPV18 (12.3%), HPV31 (8.8%), HPV33 (7.1%) and HPV35 (5.9%). Most infections (75%) were caused by individual HPV types. Women with adenocarcinoma were not younger than those with squamous cell carcinoma, as well, as women infected with HPV33 were older than those infected by other HPV types. Some differences between results obtained in the two hospitals were observed: higher overall prevalence of HPV16, absence of single infection by HPV31 and HPV45 was verified in HC-Barretos in comparison to ICESP patients. Conclusions To our knowledge, this is one of the largest studies made with fresh tumor tissues of invasive cervical cancer cases in Brazil. This study depicted a distinct HPV genotype distribution between two centers that may reflect the local epidemiology of HPV transmission among these populations. Due to the impact of these findings on cervical cancer preventive strategies, extension of this investigation to routine screening populations is warranted.
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Fregnani JHTG, Carvalho AL, Eluf-Neto J, Ribeiro KDCB, Kuil LDM, da Silva TA, Rodrigues SL, Mauad EC, Longatto-Filho A, Villa LL. A school-based human papillomavirus vaccination program in barretos, Brazil: final results of a demonstrative study. PLoS One 2013; 8:e62647. [PMID: 23638130 PMCID: PMC3634818 DOI: 10.1371/journal.pone.0062647] [Citation(s) in RCA: 38] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/04/2012] [Accepted: 03/25/2013] [Indexed: 11/30/2022] Open
Abstract
Introduction The implementation of a public HPV vaccination program in several developing countries, especially in Latin America, is a great challenge for health care specialists. Aim To evaluate the uptake and the three-dose completion rates of a school-based HPV vaccination program in Barretos (Brazil). Methods The study included girls who were enrolled in public and private schools and who regularly attended the sixth and seventh grades of elementary school (mean age: 11.9 years). A meeting with the parents or guardians occurred approximately one week before the vaccination in order to explain the project and clarify the doubts. The quadrivalent vaccine was administered using the same schedule as in the product package (0–2–6 months). The school visits for regular vaccination occurred on previously scheduled dates. The vaccine was also made available at Barretos Cancer Hospital for the girls who could not be vaccinated on the day when the team visited the school. Results Among the potential candidates for vaccination (n = 1,574), the parents or guardians of 1,513 girls (96.1%) responded to the invitation to participate in the study. A total of 1,389 parents or guardians agreed to participate in the program (acceptance rate = 91.8%). The main reason for refusing to participate in the vaccination program was fear of adverse events. The vaccine uptake rates for the first, second, and third doses were 87.5%, 86.3% and 85.0%, respectively. The three-dose completion rate was 97.2%. Conclusions This demonstrative study achieved high rates of vaccination uptake and completion of three vaccine doses in children 10–16 years old from Brazil. The feasibility and success of an HPV vaccination program for adolescents in a developing country may depend on the integration between the public health and schooling systems.
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Gurgel JDCE, Pereira CSB, Fregnani JHTG, Ribeiro FDAQ. Method for removal of samples of ear canal and tympanic membrane for histologic and immunhistochemical study. Braz J Otorhinolaryngol 2012; 78:37-42. [PMID: 22392236 PMCID: PMC9443901 DOI: 10.1590/s1808-86942012000100006] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/21/2011] [Accepted: 12/04/2011] [Indexed: 11/24/2022] Open
Abstract
Temporal bones are valuable resources to study ear diseases. Although there are several methods for removing temporal bones from cadavers, such methods are not usually described in enough details in experimental research papers. Objectives To describe a simple and rapid method for ear canal and tympanic membrane removal, and to evaluate its viability for histologic and immunohistochemical studies. Materials and Methods In this experimental study, we obtained 31 ear canal and tympanic membrane samples from cadavers, with a conventional power drill and plug cutter. The material was dissected and samples containing ear canals and tympanic membranes were obtained in blocks. The samples were analyzed by histology and immunohistochemistry. Results Removal of small and good quality samples containing entire ear canals and tympanic membranes. In all the samples, it was possible to perform both histological and immunohistochemical analyses. Conclusion This method was easily achievable, reproducible and yielded good quality samples, both for training purposes and for experimental research. All the samples were viable for histological and immunohistochemical analyses.
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Melani AGF, Fregnani JHTG, Matos D. Treatment of rectal adenocarcinoma by laparoscopy and conventional route: a brazilian comparative study on operative time, postoperative complications, oncological radicality and survival. Rev Col Bras Cir 2012; 38:245-52. [PMID: 21971858 DOI: 10.1590/s0100-69912011000400008] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/15/2010] [Accepted: 08/20/2010] [Indexed: 11/21/2022] Open
Abstract
OBJECTIVE To compare two surgical routes (laparoscopic and conventional) for the treatment of rectal cancer with regard to postoperative complications, oncological radicality and survival. METHODS This is a retrospective study of 84 patients with rectal cancer who were admitted to the Barretos Cancer Hospital between 2000 and 2003. Only individuals who underwent elective operations with curative intent were included. The surgical approach was subjectively chosen rather than by location of the tumor. RESULTS The laparoscopic access was used by 50% of patients. There was no difference (P> 0.05) between the two groups regarding age, sex, topography, staging, neoadjuvant and adjuvant treatment, number of dissected lymph nodes, size of surgical specimen, surgical margins, blood transfusions, postoperative complication rates, hospital stay and overall survival. Surgical time was longer in the laparoscopic group (median: 210x127, 5 min, P <0.001). A reduction in surgical time was noted with the increasing number of laparoscopies performed by the team (rho: -0.387, P = 0.020). CONCLUSION The laparoscopic and conventional routes, for the treatment of rectal cancer, were equivalent with respect to postoperative complications, oncological radicality and survival. However, the operative time was longer in the laparoscopic group.
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Martinho O, Faloppa CC, Neto CS, Longatto-Filho A, Baiocchi G, da Cunha IW, Soares FA, Fregnani JHTG, Reis RM. Loss of RKIP expression during the carcinogenic evolution of endometrial cancer. J Clin Pathol 2011; 65:122-8. [PMID: 22031589 DOI: 10.1136/jclinpath-2011-200358] [Citation(s) in RCA: 21] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
Abstract
AIMS Endometrial cancer is one of the most common cancers in women worldwide, but there is a lack of diagnostic markers for early detection of these tumours. The raf kinase inhibitory protein (RKIP) negatively regulates the Raf/MEK/ERK pathway, and the downregulation of RKIP is associated with tumour progression and metastasis in several human neoplasms. The aim of this study was to assess the expression levels of RKIP in endometrial cancer and determine whether this expression correlates with clinical outcome in these patients. METHODS Tissue microarrays constructed using tissue samples from 209 endometrial adenocarcinomas, 49 endometrial polyps and 48 endometrial hyperplasias were analysed for RKIP expression by immunohistochemistry. RESULTS The authors found that RKIP expression decreases significantly during malignant progression of endometrial cancer; it is highly expressed in non-neoplastic tissues (polyps 79.6%; hyperplasias 87.5%) and expressed at very low levels in endometrioid adenocarcinomas (29.7%). No correlations were observed between RKIP expression, clinicopathological data and survival. CONCLUSION This study demonstrated for the first time that RKIP expression is lost during the carcinogenic evolution of endometrial tumours and that the loss of RKIP expression is associated with a malignant phenotype. Functional studies are needed to address the biological role of RKIP downregulation in endometrial cancer.
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Affiliation(s)
- Olga Martinho
- Life and Health Sciences Research Institute (ICVS), Health Sciences School, University of Minho, Braga, Portugal
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Fregnani JHTG, de Oliveira ATT, de Lima Vazquez V, Viana CR, Longatto-Filho A, Reis RM. Is the gastrointestinal stromal tumor arising in the rectovaginal septum an extragastrointestinal entity? A time for reflection. Int J Colorectal Dis 2011; 26:387-9. [PMID: 20617322 DOI: 10.1007/s00384-010-1002-x] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 06/16/2010] [Indexed: 02/04/2023]
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Rezze GG, Fregnani JHTG, Duprat J, Landman G. Cell adhesion and communication proteins are differentially expressed in melanoma progression model. Hum Pathol 2010; 42:409-18. [PMID: 21193224 DOI: 10.1016/j.humpath.2010.09.004] [Citation(s) in RCA: 35] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/30/2009] [Revised: 09/20/2010] [Accepted: 09/29/2010] [Indexed: 11/30/2022]
Abstract
Cutaneous melanoma is an aggressive cancer derived from skin melanocytes. Tissue microarrays are being used to evaluate the roles of numerous proteins implicated in some of the pathways involved in melanoma pathogenesis. Based on a previous study using a complementary DNA microarray platform, the aim of this study was to evaluate the immunohistochemical expression of the adhesion and communication molecules connexin 43, desmocollin 3, cytokeratin 5, kallikrein 6, and kallikrein 7 in a melanoma progression model. We analyzed 59 common nevi, 22 atypical nevi, and 162 invasive and 29 metastatic melanomas on tissue microarrays using digital microscopy. The expression of desmocollin 3 and connexin 43 was higher in melanomas (P < .001). Kallikrein 6 expression was higher in melanomas than in common nevi (P < .006). The expression of cytokeratin 5 and kallikrein 7 was higher in atypical nevi than in melanomas (P < .001) and was higher in melanomas than in common nevi (P < .001). The expression of desmocollin 3 and connexin 43 in melanomas indicates loss of cell-cell interactions, which starts in the early steps of the melanoma progression model. Keratin expression in melanomas may play a particular role during melanocyte development. The expression of kallikrein 7 and kallikrein 6 in melanomas may be responsible for the loss of cell-cell adhesion.
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Nagai MA, Gerhard R, Salaorni S, Fregnani JHTG, Nonogaki S, Netto MM, Soares FA. Down-regulation of the candidate tumor suppressor gene PAR-4 is associated with poor prognosis in breast cancer. Int J Oncol 2010; 37:41-9. [PMID: 20514395 DOI: 10.3892/ijo_00000651] [Citation(s) in RCA: 31] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022] Open
Abstract
Substantial experimental evidence indicates that PAWR gene (PKC apoptosis WT1 regulator; also named PAR-4, prostate apoptosis response-4) is a central player in cancer cell survival and a potential target for cancer-selective targeted therapeutics. However, little is known about the role of PAR-4 in breast cancer. We investigated the possible role of PAR-4 expression in breast cancer. IHC results on tissue microarrays containing 1,161 primary breast tumor samples showed that 57% (571/995) of analyzable cases were negative for PAR-4 nuclear staining. Down-regulation of nuclear PAR-4 protein expression predicted a poor prognosis for breast cancer patients (OS; P=0.041, log-rank test). PAR-4 down-regulation also correlates with poor survival in the group of patients with luminal A subtype breast cancer (P=0.028). Additionally, in this large series of breast cancer patients, we show that ERBB2/HER2, EGFR and pAKT protein expression are significantly associated with shorter disease-free survival and overall survival, but the prognosis was even worse for HER2-positive, EGFR-positive or pAKT-positive breast cancer patients with tumors negative for nuclear PAR-4 expression. Furthermore, using three-dimensional (3D) cell culture we provide preliminary results showing that PAR-4 is highly expressed in the MCF10A cells inside the acini structure, suggesting that PAR-4 might have a role in the lumen acini formation. Taken together, our results provide, for the first time, evidence that PAR-4 may have a role in the process of the mammary gland morphogenesis and its functional inactivation is associated with tumor aggressive phenotype and might represent an additional prognostic and predictive marker for breast cancer.
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Affiliation(s)
- Maria Aparecida Nagai
- Disciplina de Oncologia, Departamento de Radiologia da Faculdade de Medicina da Universidade de São Paulo, Av. Dr. Arnaldo 455, 4 degrees andar, CEP 01246-903, São Paulo, Brazil.
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Abstract
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.
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Affiliation(s)
- Renê Gerhard
- Departamento de Radiologia, Faculdade de Medicina, Universidade de São Paulo, São Paulo, Brazil.
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Millas I, Liquidato BM, Dolci JEL, Macéa JR, Fregnani JHTG, Meceles LR. Inmunohistochemical Evaluation of Estrogen Receptors Alpha and Beta in Normal Inferior Turbinate Mucosa. INT J MORPHOL 2010. [DOI: 10.4067/s0717-95022010000100020] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
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Fregnani JHTG, de Oliveira Latorre MDRD, Novik PR, Lopes A, de Oliveira JC, Tsunoda AT, Soares FA. Extent of pelvic lymphadenectomy in women with squamous cell carcinoma of the uterine cervix: is there any prognostic value? J Surg Oncol 2009; 100:252-7. [PMID: 19235781 DOI: 10.1002/jso.21252] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
BACKGROUND AND OBJECTIVES Some authors states that the removal of lymph node would only contribute towards assessing the lymph node status and regional disease control, without any benefit for the patients' survival. The aim of this paper was to assess the influence of the number of surgically dissected pelvic lymph nodes (PLN) on disease-free survival. METHODS Retrospective cohort study on 42 women presenting squamous cell carcinoma (SCC) of the uterine cervix, with metastases in PLN treated by radical surgery. The Cox model was used to identify risk factors for recurrence. The model variables were adjusted for treatment-related factors (year of treatment, surgical margins and postoperative radiotherapy). The cutoff value for classifying the lymphadenectomy as comprehensive (15 PLN or more) or non-comprehensive (<15 PLN) was determined from analysis of the ROC curve. RESULTS Fourteen recurrences (32.6%) were recorded: three pelvic, eight distant, two both pelvic and distant, and one at an unknown location. The following risk factors for recurrence were identified: invasion of the deep third of the cervix and number of dissected lymph nodes <15. CONCLUSIONS Deep invasion and non-comprehensive pelvic lymphadenectomy are possible risk factors for recurrence of SCC of the uterine cervix with metastases in PLN.
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Millas I, Liquidato BM, Dolci JEL, Fregnani JHTG, Macéa JR. Histological analysis of the distribution pattern of glandular tissue in normal inferior nasal turbinates. Braz J Otorhinolaryngol 2009. [DOI: 10.1590/s1808-86942009000400007] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022] Open
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Millas I, Maria Liquidato B, Lutaif Dolci JE, Guerreiro Fregnani JHT, Rafael Macéa J. Histological analysis of the distribution pattern of glandular tissue in normal inferior nasal turbinates. Braz J Otorhinolaryngol 2009; 75:507-10. [PMID: 19784418 PMCID: PMC9446069 DOI: 10.1016/s1808-8694(15)30488-2] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/04/2008] [Accepted: 07/29/2008] [Indexed: 11/22/2022] Open
Abstract
Nasal turbinates play an important role in nasal physiology. These functions include the important function of particle filtration by the mucocilliary system. Many nasal mucosal diseases, such as rhinitis and rhinosinusitis, are directly related with structural alterations of the mucosal lining of the turbinates. Aim To study the distribution pattern of the glandular epithelium of the lamina propria in the normal lower nasal turbinate mucosa of the anterior, medium and posterior portions. Material and Method A prospective study in which small linear fragment of the lower nasal turbinate was removed from ten patients undergoing aesthetic nose surgery. The slides were hematoxilineosin stained, examined histologically and photographed. Glandular epithelium was delimited individually, the total area of the lamina propria on the anterior, medium and posterior portions of nasal turbinates was calculated (μm2). Results There was no statistically significant difference in the distribution pattern of the glandular epithelium of the lamina propria. Conclusion This study showed no predominance of glandular epithelium distribution in anterior and posterior portions of lower nasal turbinates in normal subjects.
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