Preliminar study of the expression of molecular markers in patients with stomach cancer, in Ceara State

• Main Author: Raquel Carvalho Montenegro
• Other Authors: Manoel Odorico de Moraes Filho
• Format: Others
• Language: Portuguese
• Published: Universidade Federal do Cearà 2003
• Subjects: Neoplasias gÃstricas; Marcadores moleculares; TumorigÃnese; Stomach Neoplasm; Molecular Markers; Tumorigenesis; FARMACOLOGIA BIOQUIMICA E MOLECULAR
• Online Access: http://www.teses.ufc.br/tde_busca/arquivo.php?codArquivo=12

CoordenaÃÃo de AperfeiÃoamento de Pessoal de NÃvel Superior === In search for a better understanding of the biology of tumors, molecular markers related to proliferation, resistance and apoptosis have been intensively studied in the different types of cancer. These markers can help on the elucidation of more specific therapeutic targets for the treatment of various tumors. It was observed that stomach cancer is the second most frequent cause of death in the world. In Brazil, this tumor is among the five major causes of death by cancer and the adenocarcinomas are held responsible for about 95% of all cases. For that matter, the expression of KI-67, PCNA, p53, bcl-2 and c-myc were evaluated independently and in a combined form in stomach adenocarcinomas. Thus, KI-67 and PCNA were confronted in order to determine which one would pose as a better cellular proliferation marker. Finally, a DNA extraction tecnique using CTAB was implemented on tumor tissue as well as the molecular analysis of the p53 gene by SSCP. The positive results were compared with those obtained by the imonohistochemistry analysis. The tumors were collected in surgical procedure, processed and classified histopathologically. The markers were detected by the imunohistochemical method SABP. The DNA was extracted by the CTAB method and the exons 5, 7 and 8/9 of the p53 gene analyzed by SABP. Some of the samples were obtained from biopsy arquives. The age range of the patients was between 61 and 70 years, with 48,1% of the tumors presenting an intestinal origin, 40,7% were diffuse and the other 11,2% were mixed. According to the location, 50% of the tumors were found to be proximal. 41,1% of the tumors were found to be in a low stage (I â IIIA), 44,8% in a high stage (IIIB â IV) and 13,8% were not staged. The imunohistochemical results indicated that KI-67 is the best marker to estimate cellular proliferation in stomach adenocarcinomas. In an independent manner, the tumors showed an 89,3% positivity for KI-67, 62,5% for PCNA, 50% for p53, 60,7% for bcl-2 e 66,7% for c-myc. According to the staging, the difference was significant only to p53 (p = 0,02), with a 66,7% positivity to the tumors in low stage and 16,7% for the ones on a high stage. When evaluated in a combined form, the associations of KI-67+/p53- (p=0,012) (66,67%) and c-myc+/p53- (p=0,02) (63,64%) both for the high stage tumors, were found to be significant. The DNA extraction technique applied to the tumor tissue was found to be satisfactory. For the SSCP analyses, five patients had mutation on the exon 5 (3) and on the exon 7 (2). Based on that, we may conclude that KI-67 is the best marker to access the proliferation of the stomach adenocarcinomas and that there are two proliferation activation pathways: one being dependent and the other independent of the p53 gene. === Na busca de um melhor entendimento da biologia dos tumores, marcadores moleculares relacionados à proliferaÃÃo, resistÃncia e apoptose tÃm sido intensamente pesquisados nos diferentes tipos de cÃncer. Estes marcadores podem auxiliar no estudo de alvos terapÃuticos mais especÃficos para cada tipo de tumor. O cÃncer de estÃmago à a segunda causa de Ãbito mais observado no mundo. No Brasil, este tumor està entre as cinco localizaÃÃes primÃrias mais comuns de Ãbitos por cÃncer, sendo os adenocarcinomas responsÃveis por 95% dos casos. Dessa forma, foi avaliada a expressÃo dos marcadores KI-67, PCNA, p53, bcl-2 e c-myc de forma independente e combinada em adenocarcinomas gÃstricos. TambÃm foi avaliado qual dos marcadores, KI-67 ou PCNA, era mais indicado para acessar a proliferaÃÃo celular. AlÃm disso, foi implantada a tÃcnica de extraÃÃo de DNA de tecido tumoral com CTAB e anÃlise molecular pelo SSCP do gene p53, sendo os resultados positivos comparados com os resultados da imunohistoquÃmica. Os tumores foram coletados em cirurgia, processados e classificados histopatologicamente. Os marcadores foram detectados pelo mÃtodo de imunohistoquÃmica SABP. Foi realizada a extraÃÃo de DNA pelo mÃtodo do CTAB, sendo os Ãxons 5, 7 e 8/9 do gene p53 analisados por SSCP. Algumas amostras foram obtidas de arquivo de biopsia. A faixa etÃria dos pacientes encontrava-se entre 61 e 70 anos de idade, com 48,1% dos tumores do tipo intestinal, 40,7% difusos e 11,2% mistos e com 50% localizados no sÃtio proximal. Em relaÃÃo ao estadiamento, 41,4% dos tumores apresentavam-se no grau baixo (I â IIIA), 44,8% no altorisco (IIIB â IV) e 13,8% sem estadiamento. De acordo com os achados imunohistoquÃmicos, os resultados sugerem que o marcador mais indicado para estimar a proliferaÃÃo celular nos adenocarcinomas gÃstricos à o KI-67. De forma independente os tumores apresentaram positividade em 89,3% para KI-67, 62,5% para PCNA, 50% para p53, 60,7% para bcl-2 e 66,7% e para c-myc. De acordo com o estadiamento, a diferenÃa foi significativa apenas para p53 (p = 0,02), com positividade de 66,7% nos tumores de baixo risco (I â IIIA) e 16,7% nos de altorisco. Quando avaliadas de forma combinada, as associaÃÃes significativas foram entre KI-67+/p53- (p=0,012) nos tumores de alto risco (66,67%) e c-myc+/p53- (p=0,02) tambÃm nos tumores de altorisco (63,64%). A tÃcnica aplicada para a extraÃÃo do DNA do tecido tumoral foi satisfatÃria. Para o SSCP, cinco pacientes apresentaram mutaÃÃo para o Ãxon 5 (3) e Ãxon 7 (2). Com isso, concluÃmos que o marcador mais indicado para acessar a proliferaÃÃo à o KI-67 e que existem duas vias de ativaÃÃo da proliferaÃÃo nos adenocarcinomas gÃstricos: uma dependente de p53 e outra independente de p53.