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Advisor(s)
Abstract(s)
Introdução:
Atualmente o cancro é uma das maiores causas de morbilidade e mortalidade mundial.
É imperativo o estudo aprofundado da doença oncológica de forma a obter-se um diagnóstico mais precoce, tratamentos mais eficazes e prognóstico mais fiável.
O cancro colorretal (CCR) é o terceiro mais comum a nível mundial e é o terceiro mais mortal tanto em mulheres como em homens.
Nas passadas décadas, a taxa global de sobrevivência do CCR não evoluiu favoravelmente e os fatores de prognóstico até à data são insuficientes (estadiamento TNM, a presença/ausência de doença residual pós-cirurgia, classificação histológica, presença/ausência de invasão ganglionar e/ou metástases à distância).
No sentido de melhorar a previsão da evolução clínica e determinar a abordagem terapêutica mais adequada, torna-se crucial investigar a existência de novos marcadores moleculares que sirvam como fatores de prognóstico isolados ou em combinação com os dados clínico-histopatológicos.
A oncoproteína p53 regula vários processos metabólicos como a apoptose, a reparação do ADN e o ciclo celular. A perda desta proteína em 50% dos cancros sugere um papel importante na carcinogénese.
Este marcador molecular tem sido alvo de exploração e investigação científica com o intuito de se perceber o seu papel na carcinogénese e estabelecimento como fator de prognóstico independente para diversos tipos de cancro. No entanto, no que concerne ao adenocarcinoma colorretal (ACR), a literatura existente revela resultados controversos quanto ao seu valor prognóstico.
Objetivos:
1) Detetar através do método de coloração imunohistoquímica a expressão da oncoproteína p53. 2) Analisar a expressão imunohistoquímica da oncoproteína p53 e dos parâmetros clinico-histopatológicos em estudo.
3) Determinar o valor prognóstico da expressão da proteína p53 em pacientes com ACR e a sua correlação com os parâmetros clínico-histopatológicos: grau de diferenciação, localização, prognóstico dos pacientes.
Métodos:
Estudo clínico-patológico retrospectivo realizado nas peças cirúrgicas de 32 doentes com mais de 50 anos que foram submetidos a (uma) resseção cirúrgica do cancro do cólon e reto no Serviço de Cirurgia do Centro Hospitalar da Cova da Beira (CHCB) na Covilhã entre 2002-2005.
As amostras foram processadas histologicamente no serviço de Anatomia Patológica do CHCB. Foram de seguida classificadas de acordo com o tipo histológico, grau de diferenciação e TMN. Posteriormente, foram consideradas de acordo com a intensidade e percentagem de células marcadas imunohistoquímicamente pela oncoproteína p53.
Os dados foram analisados estatisticamente considerando-se um valor p<0,05 como estatisticamente significativo.
Resultados:
Foi encontrada uma correlação estatisticamente significativa (p<0,05) entre a expressão imunohistoquímica de células marcadas pela oncoproteína p53 e o prognóstico dos pacientes.
Não se verificaram resultados estatisticamente significativos entre a “expressão imunohistoquímica de células marcadas pela oncoproteína p53” e a “localização do tumor” e o “grau de diferenciação histológico”. Ao fim de 10 anos a mortalidade foi de 59,4%.
Introduction: Nowadays, cancer is one of the biggest causes of mortality and morbidity worldwide. It is imperative to deepen the knowledge about cancer in order to get a better and precocious diagnostic, more effective treatments and more reliable prognostics. Colorectal cancer is the third most common worldwide and it is the third most deadly in women and men. In the past decade, the global survival rate of the CRC didn´t evolve favourably and the prognostic factors until today aren’t sufficient (TNM staging system, presence/absence of post-surgery residual disease, histologic classification, presence/absence of lymph nodes invasion and distant metastases). With the intention of improving prognosis prediction and reaching abetter therapeutic approach, it is crucial to search for new molecular markers that can be used as prognostic factors, isolated or in combination with the clinical-histopathological data. The oncoprotein p53 regulates several metabolic processes such as apoptosis, DNA repair and cellular cycle. The loss of this protein in 50% of cancers suggests an important role in carcinogenesis. This molecular marker has been target of research with the objective of discovering its role in carcinogenesis and to establish it as an independent prognostic factor of various cancers. However, for colorectal adenocarcinoma, the prevailing literature reveals controversial results as to its value as prognostic factor. Objectives: 1) Detect the oncoprotein p53 expression through immunohistochemical staining. 2) Analyse the immunohistochemical staining of the oncoprotein p53 and the clinical-histopathological parameters of this study. 3) Determine the prognostic value of p53 expression in patients with colorectal adenocarcinoma and its correlations with clinical-histopathological parameters: histological differentiation degree, location and prognostic. Methods: Retrospective study accomplished in the surgical samples of 32 patients older than 50 years that were submitted to surgical resection of colorectal cancer in the Department of Surgery of Centro Hospitalar Cova da Beira in Covilhã (CHCB) between 2002-2005. The samples were histologically processed in the Department of Pathologic Anatomy of CHCB. They were then categorized according to the histological type, differentiation degree and TNM staging system. Posteriorly, they were analysed according to the intensity and proportion of immunohistochemical staining by oncoprotein p53. The data were statistically analysed by taking in consideration a p-value <0,05 as statistically significant. Results: A significant statistic correlation (p<0,05) between the expression of immunohistochemical cells stained by the oncoprotein p53 and the prognostic of patients was found. We did not verify any other significant results between the expression of immunohistochemical cells stained by the oncoprotein p53 , location of the tumor and the histological differentiation degree. the mortality rate was 59,4% after 10 years.
Introduction: Nowadays, cancer is one of the biggest causes of mortality and morbidity worldwide. It is imperative to deepen the knowledge about cancer in order to get a better and precocious diagnostic, more effective treatments and more reliable prognostics. Colorectal cancer is the third most common worldwide and it is the third most deadly in women and men. In the past decade, the global survival rate of the CRC didn´t evolve favourably and the prognostic factors until today aren’t sufficient (TNM staging system, presence/absence of post-surgery residual disease, histologic classification, presence/absence of lymph nodes invasion and distant metastases). With the intention of improving prognosis prediction and reaching abetter therapeutic approach, it is crucial to search for new molecular markers that can be used as prognostic factors, isolated or in combination with the clinical-histopathological data. The oncoprotein p53 regulates several metabolic processes such as apoptosis, DNA repair and cellular cycle. The loss of this protein in 50% of cancers suggests an important role in carcinogenesis. This molecular marker has been target of research with the objective of discovering its role in carcinogenesis and to establish it as an independent prognostic factor of various cancers. However, for colorectal adenocarcinoma, the prevailing literature reveals controversial results as to its value as prognostic factor. Objectives: 1) Detect the oncoprotein p53 expression through immunohistochemical staining. 2) Analyse the immunohistochemical staining of the oncoprotein p53 and the clinical-histopathological parameters of this study. 3) Determine the prognostic value of p53 expression in patients with colorectal adenocarcinoma and its correlations with clinical-histopathological parameters: histological differentiation degree, location and prognostic. Methods: Retrospective study accomplished in the surgical samples of 32 patients older than 50 years that were submitted to surgical resection of colorectal cancer in the Department of Surgery of Centro Hospitalar Cova da Beira in Covilhã (CHCB) between 2002-2005. The samples were histologically processed in the Department of Pathologic Anatomy of CHCB. They were then categorized according to the histological type, differentiation degree and TNM staging system. Posteriorly, they were analysed according to the intensity and proportion of immunohistochemical staining by oncoprotein p53. The data were statistically analysed by taking in consideration a p-value <0,05 as statistically significant. Results: A significant statistic correlation (p<0,05) between the expression of immunohistochemical cells stained by the oncoprotein p53 and the prognostic of patients was found. We did not verify any other significant results between the expression of immunohistochemical cells stained by the oncoprotein p53 , location of the tumor and the histological differentiation degree. the mortality rate was 59,4% after 10 years.
Description
Keywords
Adenocarcinoma Colorretal Grau de Diferenciação Histológica Ihq Localização P53 Prognóstico