Correlação do marcador tumoral c-myc com a agressividade nos adenocarcinomas gástrico e colorretal
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Tipo
TCC
Data de publicação
2023-11-27
Periódico
Citações (Scopus)
Autores
Oliveira, Agne Guedes
Santos, Erika Frizzo
Santos, Erika Frizzo
Orientador
Junior, Carlos Roberto Naufel
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Introdução: O câncer é o conjunto de doenças que têm em comum o crescimento desordenado de células. O Brasil poderá registrar 704 mil novos casos de câncer ao ano até 2025. Os cânceres gástricos e colorretais são, respectivamente, a quinta e quarta neoplasia mais comuns e a terceira e segunda em causa de óbitos relacionados a câncer em homens e mulheres no mundo. O câncer gástrico é, em sua maioria, adenocarcinomas e podem ocorrer em qualquer parte do estômago. A dieta parece ser um fator importante, bem como a infecção por Helicobacter pylori. Já em relação ao câncer colorretal (CCR), é o sítio mais frequente de neoplasia primária do que qualquer outro órgão. O CCR se inicia geralmente pelas células mucosas, podendo chegar a órgãos linfonodais e estruturas locais. O câncer é uma doença silenciosa e o diagnóstico precoce constitui uma estratégia essencial para o tratamento. Nesse ponto, o desenvolvimento de bons biomarcadores para a identificação da doença é crucial. Assim, o estudo da relação do marcador tumoral c-MYC se faz necessário pela possibilidade de diagnóstico e prognóstico de agressividade precoce, possibilitando melhor direcionamento de tratamento e consequentemente melhor prognóstico. É esperado que o marcador citado seja indicador positivo de maior agressividade em adenocarcinomas gástrico e colorretal.
Objetivos: Analisar a expressão do marcador c-MYC nas amostras de tecido tumoral de pacientes com adenocarcinomas gástrico e colorretal e correlacionar com a agressividade. Metodologia: Foram incluídos 150 pacientes com adenocarcinoma colorretal e 110 com adenocarcinoma gástrico de ambos os sexos. Foi realizada imunohistoquímica para o biomarcador c-MYC. Dados clínicos retrospectivos foram coletados. As informações clínico epidemiológicas foram cruzadas com o resultado obtido pela imunomarcação e sua análise estatística. A expressão do c-MYC foi utilizada para verificar correlação com a agressividade. Resultados: A média de idade do adenocarcinoma gástrico e colorretal foi próxima, sendo 63,8 e 64,7 anos respectivamente, ambos predomindando no sexo masculino. A maioria do adenocarcinoma colorretal foi moderadamente diferenciado e no gástrico pouco diferenciado. Houve predomínio da lesão localizada no antro gástrico (54,5%), pouco diferenciada (49,1%), com 30% de células em anel de sinete e cólon esquerdo (46,7%) moderadamente diferenciada (85,3%). Metástase a distância em 42,7% no gástrico e 44,7% no colorretal principalmente no fígado em ambos (61,7% e 41,8%). O c-MYC foi positivo no colorretal, em 50% dos pacientes e 99,1% dos pacientes com câncer gástrico foi negativo. A progressão da doença ocorreu na minoria dos pacientes com adenocarcinoma colorretal, naqueles que progrediu, houve presença do marcador (77,3%). Conclusão: Não foi observada expressão imunoistoquímica do c-MYC no adenocarcinoma gástrico, portanto esse biomarcador não apresentou associação com a agressividade tumoral nesse câncer. A respeito do adenocarcinoma colorretal, não é possível afirmar que sozinho, o c-MYC seja preditor de agressividade, sendo necessário mais dados para confirmar a hipótese.
Background: Cancer is a set of diseases that have in common the disordered growth of cells. Brazil could register 704 thousand new cases of cancer per year until 2025. Gastric and colorectal cancers are, respectively, the fifth and fourth most common neoplasms and the third and second causes of cancer-related deaths in men and women in the world. Gastric cancer is mostly adenocarcinomas and can occur anywhere in the stomach. Diet appears to be an important factor, as well as Helicobacter pylori infection. In relation to colorectal cancer (CRC), it is the most frequent site of primary neoplasia than any other organ. CRC generally starts in mucous cells and can reach lymph node organs and local structures. Cancer is a silent disease and early diagnosis is an essential strategy for treatment. At this point, the development of good biomarkers for identifying the disease is crucial. Thus, the study of the relationship between the tumor marker c-MYC is necessary due to the possibility of diagnosis and prognosis of early aggressiveness, enabling better treatment targeting and consequently a better prognosis. The marker is expected to be a positive indicator of greater aggressiveness in gastric and colorectal adenocarcinomas. Aim: To investigate the immunohistochemical expression of c-MYC proteins in gastric and colorectal cancer and to correlate them with the aggressiveness of tumors. Methods: 150 patients with colorectal adenocarcinoma and 110 with gastric adenocarcinoma of both sexes were included. Immunohistochemistry for the c-MYC biomarker was performed. Retrospective clinical data were collected. The clinical epidemiological information was crossed with the results obtained by immunostaining and its statistical analysis. c-MYC expression was used to verify correlation with aggressiveness. Results: The mean age of gastric and colorectal adenocarcinoma was close, being 63.8 and 64.7 years respectively, both predominating in males. The majority of colorectal adenocarcinoma was moderately differentiated, and gastric adenocarcinoma was poorly differentiated. There was a predominance of the lesion located in the gastric antrum (54.5%), poorly differentiated (49.1%), with 30% of signet ring cells and left colon (46.7%) moderately differentiated (85.3%). Distant metastasis in 42.7% in the gastric and 44.7% in the colorectal, mainly in the liver in both (61.7% and 41.8%). The c-MYC was positive in the colorectum in 50% of patients and 99.1% of patients with gastric cancer was negative. Disease progression occurred in a minority of patients with colorectal adenocarcinoma; in those that progressed, the marker was present (77.3%). Conclusion: No immunohistochemical expression of c-MYC was observed in gastric adenocarcinoma, therefore this biomarker was not associated with tumor aggressiveness in this cancer. Regarding colorectal adenocarcinoma, it is not possible to state that c-MYC alone is a predictor of aggressiveness, and more data is needed to confirm the hypothesis.
Background: Cancer is a set of diseases that have in common the disordered growth of cells. Brazil could register 704 thousand new cases of cancer per year until 2025. Gastric and colorectal cancers are, respectively, the fifth and fourth most common neoplasms and the third and second causes of cancer-related deaths in men and women in the world. Gastric cancer is mostly adenocarcinomas and can occur anywhere in the stomach. Diet appears to be an important factor, as well as Helicobacter pylori infection. In relation to colorectal cancer (CRC), it is the most frequent site of primary neoplasia than any other organ. CRC generally starts in mucous cells and can reach lymph node organs and local structures. Cancer is a silent disease and early diagnosis is an essential strategy for treatment. At this point, the development of good biomarkers for identifying the disease is crucial. Thus, the study of the relationship between the tumor marker c-MYC is necessary due to the possibility of diagnosis and prognosis of early aggressiveness, enabling better treatment targeting and consequently a better prognosis. The marker is expected to be a positive indicator of greater aggressiveness in gastric and colorectal adenocarcinomas. Aim: To investigate the immunohistochemical expression of c-MYC proteins in gastric and colorectal cancer and to correlate them with the aggressiveness of tumors. Methods: 150 patients with colorectal adenocarcinoma and 110 with gastric adenocarcinoma of both sexes were included. Immunohistochemistry for the c-MYC biomarker was performed. Retrospective clinical data were collected. The clinical epidemiological information was crossed with the results obtained by immunostaining and its statistical analysis. c-MYC expression was used to verify correlation with aggressiveness. Results: The mean age of gastric and colorectal adenocarcinoma was close, being 63.8 and 64.7 years respectively, both predominating in males. The majority of colorectal adenocarcinoma was moderately differentiated, and gastric adenocarcinoma was poorly differentiated. There was a predominance of the lesion located in the gastric antrum (54.5%), poorly differentiated (49.1%), with 30% of signet ring cells and left colon (46.7%) moderately differentiated (85.3%). Distant metastasis in 42.7% in the gastric and 44.7% in the colorectal, mainly in the liver in both (61.7% and 41.8%). The c-MYC was positive in the colorectum in 50% of patients and 99.1% of patients with gastric cancer was negative. Disease progression occurred in a minority of patients with colorectal adenocarcinoma; in those that progressed, the marker was present (77.3%). Conclusion: No immunohistochemical expression of c-MYC was observed in gastric adenocarcinoma, therefore this biomarker was not associated with tumor aggressiveness in this cancer. Regarding colorectal adenocarcinoma, it is not possible to state that c-MYC alone is a predictor of aggressiveness, and more data is needed to confirm the hypothesis.
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Palavras-chave
imuno-histoquímica , biomarcadores tumorais , adenocarcinoma , proteínas proto-oncogênicas c-myc , câncer colorretal , câncer gástrico , immunohistochemistry , biomarkers tumor , adenocarcinoma , proto-oncogene proteins c-myc , colorectal neoplasms , stomach neoplasms