Perfil clínico, histopatológico, imuno-histoquímico e de infecção por HPV de carcinoma de células escamosas de pênis usuais com áreas de aspecto basaloide
Ano de defesa: | 2022 |
---|---|
Autor(a) principal: | |
Orientador(a): | |
Banca de defesa: | , , , |
Tipo de documento: | Dissertação |
Tipo de acesso: | Acesso aberto |
Idioma: | por |
Instituição de defesa: |
Universidade Federal do Maranhão
|
Programa de Pós-Graduação: |
PROGRAMA DE PÓS-GRADUAÇÃO EM SAÚDE DO ADULTO E DA CRIANÇA/CCBS
|
Departamento: |
DEPARTAMENTO DE MEDICINA II/CCBS
|
País: |
Brasil
|
Palavras-chave em Português: | |
Palavras-chave em Inglês: | |
Área do conhecimento CNPq: | |
Link de acesso: | https://tedebc.ufma.br/jspui/handle/tede/tede/3537 |
Resumo: | Introduction: Penile cancer is a rare disease with high morbidity and mortality, affecting preferentially lower socioeconomic regions. The diagnosis and its prognostic profile is defined through morphological examinations and surgery is still the main treatment. Objective: To characterize the clinical-histopathological, immunohistochemical and human papillomavirus infection profile in patients from the state of Maranhão, Brazil, diagnosed with squamous cell carcinoma of the penis (SCC), the usual subtype with areas of basaloid aspect and to show its relationship with tumor aggressiveness. Methods: Retrospective study, with 96 cases of Squamous cell carcinoma of the penis diagnosed in the state of Maranhão,Brazil, in the period between 2007 and 2021, separated into two groups, the group without areas of basaloid aspect (N=68) and the usual with areas of basaloid aspect (n=28), represented by groups of rounded cells, with higher nucleus-cytoplasm ratio, without necrosis and that did not involve > 20% of the tumor surface. Their clinical-epidemiological, histological and immunohistochemical (Ki67, p16 and p53) and HPV infection characteristics were observed. Considered significant the result with p<0.05. Results: Comparing the usual groups with and without areas of basaloid appearance, similarity was observed in the sociodemographic variables related to age over 60 years, origin of rural residence and northern region of the state, brown skin colour and married marital status, as well as no or low education and occupation farmer. There were no statistically significant differences between the two groups in relation to lifestyle and habits of life, nor to the symptoms reported, such as smoking, alcoholism, history of sexually transmitted infections (STIs) and age at first sexual intercourse less than 18 years. Most of the population presented HPV detection, absence of angio lymphatic invasion and involvement of corpora cavernosa and tunica albuginea, as well as presence of perineural invasion, involvement of corpus spongiosum and urethra, presence of peri-tumoral lymphocytic infiltrate and association with carcinoma in situ. The usual group with basaloid aspect areas showed differences with statistical significance in the degree of differentiation (p =0.001) and applied staging (p=0.0042), with predominance of stage II and III. This group also presented more cases with the presence of angio lymphatic and perineural invasion, involvement of corpora cavernosa and tunica albuginea, association with carcinoma in situ and lymph node involvement. The range of disease-free time, in cases that could be followed up, was shorter in the usual group with basaloid areas than in the usual group without basaloid areas, from 0 to 31 months and from 0 to 62 months, respectively. Conclusion: the usual SCCs, unlike the other subtypes of SCCs, have a variable predictive prognostic profile and need to gather a lot of information to better manage the patient's follow up. The basaloid aspect did not bring results with statistical significance in our population, despite having shown higher percentage of socio-demographic risk factors and positivity for histological criteria said to be more aggressive, such as invasion of corpora cavernosa and tunica albuginea, presence of angio-lymphatic and perineural invasion, lymph node involvement. New researches are necessary in the search for predictive criteria of this high morbidity and mortality disease. |
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SILVA, Gyl Eanes Barroshttp://lattes.cnpq.br/8383692989202276SILVA, Gyl Eanes Barroshttp://lattes.cnpq.br/8383692989202276CALIXTO, José de Ribamar Rodrigueshttp://lattes.cnpq.br/5052011357112870MELLO, George Castro Figueira dehttp://lattes.cnpq.br/7456159369152104ANDRADE, Marcelo Souza dehttp://lattes.cnpq.br/6267637354657076http://lattes.cnpq.br/7853770335571201MELO, Syomara Pereira da Costa2022-04-27T16:20:55Z2022-03-29MELO, Syomara Pereira da Costa. Perfil clínico, histopatológico, imuno-histoquímico e de infecção por HPV de carcinoma de células escamosas de pênis usuais com áreas de aspecto basaloide. 2022. 89 f. Dissertação (Programa de Pós-Graduação em Saúde do Adulto e da Criança/CCBS) - Universidade Federal do Maranhão, São Luís, 2022.https://tedebc.ufma.br/jspui/handle/tede/tede/3537Introduction: Penile cancer is a rare disease with high morbidity and mortality, affecting preferentially lower socioeconomic regions. The diagnosis and its prognostic profile is defined through morphological examinations and surgery is still the main treatment. Objective: To characterize the clinical-histopathological, immunohistochemical and human papillomavirus infection profile in patients from the state of Maranhão, Brazil, diagnosed with squamous cell carcinoma of the penis (SCC), the usual subtype with areas of basaloid aspect and to show its relationship with tumor aggressiveness. Methods: Retrospective study, with 96 cases of Squamous cell carcinoma of the penis diagnosed in the state of Maranhão,Brazil, in the period between 2007 and 2021, separated into two groups, the group without areas of basaloid aspect (N=68) and the usual with areas of basaloid aspect (n=28), represented by groups of rounded cells, with higher nucleus-cytoplasm ratio, without necrosis and that did not involve > 20% of the tumor surface. Their clinical-epidemiological, histological and immunohistochemical (Ki67, p16 and p53) and HPV infection characteristics were observed. Considered significant the result with p<0.05. Results: Comparing the usual groups with and without areas of basaloid appearance, similarity was observed in the sociodemographic variables related to age over 60 years, origin of rural residence and northern region of the state, brown skin colour and married marital status, as well as no or low education and occupation farmer. There were no statistically significant differences between the two groups in relation to lifestyle and habits of life, nor to the symptoms reported, such as smoking, alcoholism, history of sexually transmitted infections (STIs) and age at first sexual intercourse less than 18 years. Most of the population presented HPV detection, absence of angio lymphatic invasion and involvement of corpora cavernosa and tunica albuginea, as well as presence of perineural invasion, involvement of corpus spongiosum and urethra, presence of peri-tumoral lymphocytic infiltrate and association with carcinoma in situ. The usual group with basaloid aspect areas showed differences with statistical significance in the degree of differentiation (p =0.001) and applied staging (p=0.0042), with predominance of stage II and III. This group also presented more cases with the presence of angio lymphatic and perineural invasion, involvement of corpora cavernosa and tunica albuginea, association with carcinoma in situ and lymph node involvement. The range of disease-free time, in cases that could be followed up, was shorter in the usual group with basaloid areas than in the usual group without basaloid areas, from 0 to 31 months and from 0 to 62 months, respectively. Conclusion: the usual SCCs, unlike the other subtypes of SCCs, have a variable predictive prognostic profile and need to gather a lot of information to better manage the patient's follow up. The basaloid aspect did not bring results with statistical significance in our population, despite having shown higher percentage of socio-demographic risk factors and positivity for histological criteria said to be more aggressive, such as invasion of corpora cavernosa and tunica albuginea, presence of angio-lymphatic and perineural invasion, lymph node involvement. New researches are necessary in the search for predictive criteria of this high morbidity and mortality disease.Introdução: O câncer de pênis é uma doença rara e com elevada morbi-mortalidade, atingindo preferencialmente regiões socioeconômicas menos favorecidas. O diagnóstico e seu perfil prognóstico é definido através de exames morfológicos e a cirurgia ainda é o principal tratamento. Objetivo: Caracterizar o perfil clínico-histopatológico, imunohistoquímico e de infecção pelo papilomavírus humano em pacientes do estado do Maranhão/Brasil diagnosticados com Carcinoma de pênis tipo escamocelular (CEC), subtipo usual com áreas de aspecto basaloide e mostrar sua relação com agressividade tumoral. Métodos: Pesquisa retrospectiva, com 96 casos de Carcinoma escamocelular subtipo usual de pênis, diagnosticados no estado do Maranhão/Brasil, no período entre 2007 e 2021, separado em dois grupos, o usual com áreas de aspecto basaloide (n=28), representado por grupamentos de células arredondadas, com maior razão núcleo-citoplasma, sem necrose e que não comprometessem > 20% da superfície tumoral. E o grupo sem áreas de aspecto basaloide (N=68). Observado suas características clínico-epidemiológicas, histológicas/imuno-histoquímicas (Ki67, p16 e p53) e de infecção pelo HPV, sendo considerado significante o resultado com p<0,05. Resultados: Comparando-se os grupos usual com e sem áreas de aspecto basaloide, observou-se semelhança nas variáveis sociodemográficas relacionadas a idade maior que 60 anos, procedência de residência rural e região norte do estado, cor da pele parda e estado civil casado, assim como nenhuma ou baixa escolaridade e profissão lavrador. Não houve diferenças estatisticamente significativas entre os dois grupos em relação ao estilo e hábitos de vida, nem aos sintomas referidos, como tabagismo, etilismo, histórico de infecções sexualmente transmissíveis (ISTs) e idade da primeira relação sexual inferior a 18 anos. Majoritariamente, a população apresentou detecção do HPV, ausência de invasão angio-linfática e de comprometimento de corpos cavernosos e da túnica albugínea, bem como presença de invasão perineural, comprometimento de corpo esponjoso e uretra, presença do infiltrado linfocitário peri-tumoral e associação com carcinoma in situ. O grupo usual com áreas de aspecto basaloide apresentou diferenças com significância estatística no grau de diferenciação (p =0,001) e estadiamento aplicado (p=0,0042), com predomínio do estágio II e III. Esse grupo também apresentou mais casos com presença de invasão angio-linfática e perineural, de comprometimento de corpos cavernosos e da túnica albugínea, associação com carcinoma in situ e comprometimento linfonodal. A amplitude do tempo livre da doença, nos casos possíveis de serem acompanhados, foi menor no grupo usual com áreas de aspecto basaloide que no grupo usual sem áreas de aspecto basaloide, de 0 a 31 meses e de 0 a 62 meses, respectivamente. Conclusão: os CECs usuais, diferentemente dos outros subtipos de CEC, apresentam perfil preditivo-prognóstico variável e precisam reunir muitas informações para melhor administrar o seguimento do paciente. O aspecto basaloide não trouxe resultados com significância estatística na nossa população, apesar de ter mostrado maior percentual fatores de risco sociodemográficos e positividade para critérios histológicos ditos de maior agressividade, como invasão de corpos cavernosos e da túnica da albugínea, presença de invasão angio-linfática e perineural, comprometimento linfonodal. Novas pesquisas são necessárias na busca de critérios preditores dessa doença de elevada morbidade e mortalidade.Submitted by Jonathan Sousa de Almeida (jonathan.sousa@ufma.br) on 2022-04-27T16:20:55Z No. of bitstreams: 1 SyomaraPereiradaCostaMelo.pdf: 1407887 bytes, checksum: 9c54e0192ab9969b56f11ac06a02dea5 (MD5)Made available in DSpace on 2022-04-27T16:20:55Z (GMT). No. of bitstreams: 1 SyomaraPereiradaCostaMelo.pdf: 1407887 bytes, checksum: 9c54e0192ab9969b56f11ac06a02dea5 (MD5) Previous issue date: 2022-03-29application/pdfporUniversidade Federal do MaranhãoPROGRAMA DE PÓS-GRADUAÇÃO EM SAÚDE DO ADULTO E DA CRIANÇA/CCBSUFMABrasilDEPARTAMENTO DE MEDICINA II/CCBScâncer de pênis;infecção por HPV;histologia;imuno-histoquímica.penile cancer;HPV infection;histology;immunohistochemistry.CancerologiaMedicinaCiências da SaúdePerfil clínico, histopatológico, imuno-histoquímico e de infecção por HPV de carcinoma de células escamosas de pênis usuais com áreas de aspecto basaloideClinical, histopathological, immunohistochemical and HPV infection profile of usual squamous cell carcinoma of the penis with areas of basaloid appearanceinfo:eu-repo/semantics/publishedVersioninfo:eu-repo/semantics/masterThesisinfo:eu-repo/semantics/openAccessreponame:Biblioteca Digital de Teses e Dissertações da UFMAinstname:Universidade Federal do Maranhão (UFMA)instacron:UFMAORIGINALSyomaraPereiradaCostaMelo.pdfSyomaraPereiradaCostaMelo.pdfapplication/pdf1407887http://tedebc.ufma.br:8080/bitstream/tede/3537/2/SyomaraPereiradaCostaMelo.pdf9c54e0192ab9969b56f11ac06a02dea5MD52LICENSElicense.txtlicense.txttext/plain; charset=utf-82255http://tedebc.ufma.br:8080/bitstream/tede/3537/1/license.txt97eeade1fce43278e63fe063657f8083MD51tede/35372023-05-15 15:46:49.333oai:tede2:tede/3537Biblioteca Digital de Teses e Dissertaçõeshttps://tedebc.ufma.br/jspui/PUBhttp://tedebc.ufma.br:8080/oai/requestrepositorio@ufma.br||repositorio@ufma.bropendoar:21312023-05-15T18:46:49Biblioteca Digital de Teses e Dissertações da UFMA - Universidade Federal do Maranhão (UFMA)false |
dc.title.por.fl_str_mv |
Perfil clínico, histopatológico, imuno-histoquímico e de infecção por HPV de carcinoma de células escamosas de pênis usuais com áreas de aspecto basaloide |
dc.title.alternative.eng.fl_str_mv |
Clinical, histopathological, immunohistochemical and HPV infection profile of usual squamous cell carcinoma of the penis with areas of basaloid appearance |
title |
Perfil clínico, histopatológico, imuno-histoquímico e de infecção por HPV de carcinoma de células escamosas de pênis usuais com áreas de aspecto basaloide |
spellingShingle |
Perfil clínico, histopatológico, imuno-histoquímico e de infecção por HPV de carcinoma de células escamosas de pênis usuais com áreas de aspecto basaloide MELO, Syomara Pereira da Costa câncer de pênis; infecção por HPV; histologia; imuno-histoquímica. penile cancer; HPV infection; histology; immunohistochemistry. Cancerologia Medicina Ciências da Saúde |
title_short |
Perfil clínico, histopatológico, imuno-histoquímico e de infecção por HPV de carcinoma de células escamosas de pênis usuais com áreas de aspecto basaloide |
title_full |
Perfil clínico, histopatológico, imuno-histoquímico e de infecção por HPV de carcinoma de células escamosas de pênis usuais com áreas de aspecto basaloide |
title_fullStr |
Perfil clínico, histopatológico, imuno-histoquímico e de infecção por HPV de carcinoma de células escamosas de pênis usuais com áreas de aspecto basaloide |
title_full_unstemmed |
Perfil clínico, histopatológico, imuno-histoquímico e de infecção por HPV de carcinoma de células escamosas de pênis usuais com áreas de aspecto basaloide |
title_sort |
Perfil clínico, histopatológico, imuno-histoquímico e de infecção por HPV de carcinoma de células escamosas de pênis usuais com áreas de aspecto basaloide |
author |
MELO, Syomara Pereira da Costa |
author_facet |
MELO, Syomara Pereira da Costa |
author_role |
author |
dc.contributor.advisor1.fl_str_mv |
SILVA, Gyl Eanes Barros |
dc.contributor.advisor1Lattes.fl_str_mv |
http://lattes.cnpq.br/8383692989202276 |
dc.contributor.referee1.fl_str_mv |
SILVA, Gyl Eanes Barros |
dc.contributor.referee1Lattes.fl_str_mv |
http://lattes.cnpq.br/8383692989202276 |
dc.contributor.referee2.fl_str_mv |
CALIXTO, José de Ribamar Rodrigues |
dc.contributor.referee2Lattes.fl_str_mv |
http://lattes.cnpq.br/5052011357112870 |
dc.contributor.referee3.fl_str_mv |
MELLO, George Castro Figueira de |
dc.contributor.referee3Lattes.fl_str_mv |
http://lattes.cnpq.br/7456159369152104 |
dc.contributor.referee4.fl_str_mv |
ANDRADE, Marcelo Souza de |
dc.contributor.referee4Lattes.fl_str_mv |
http://lattes.cnpq.br/6267637354657076 |
dc.contributor.authorLattes.fl_str_mv |
http://lattes.cnpq.br/7853770335571201 |
dc.contributor.author.fl_str_mv |
MELO, Syomara Pereira da Costa |
contributor_str_mv |
SILVA, Gyl Eanes Barros SILVA, Gyl Eanes Barros CALIXTO, José de Ribamar Rodrigues MELLO, George Castro Figueira de ANDRADE, Marcelo Souza de |
dc.subject.por.fl_str_mv |
câncer de pênis; infecção por HPV; histologia; imuno-histoquímica. |
topic |
câncer de pênis; infecção por HPV; histologia; imuno-histoquímica. penile cancer; HPV infection; histology; immunohistochemistry. Cancerologia Medicina Ciências da Saúde |
dc.subject.eng.fl_str_mv |
penile cancer; HPV infection; histology; immunohistochemistry. |
dc.subject.cnpq.fl_str_mv |
Cancerologia Medicina Ciências da Saúde |
description |
Introduction: Penile cancer is a rare disease with high morbidity and mortality, affecting preferentially lower socioeconomic regions. The diagnosis and its prognostic profile is defined through morphological examinations and surgery is still the main treatment. Objective: To characterize the clinical-histopathological, immunohistochemical and human papillomavirus infection profile in patients from the state of Maranhão, Brazil, diagnosed with squamous cell carcinoma of the penis (SCC), the usual subtype with areas of basaloid aspect and to show its relationship with tumor aggressiveness. Methods: Retrospective study, with 96 cases of Squamous cell carcinoma of the penis diagnosed in the state of Maranhão,Brazil, in the period between 2007 and 2021, separated into two groups, the group without areas of basaloid aspect (N=68) and the usual with areas of basaloid aspect (n=28), represented by groups of rounded cells, with higher nucleus-cytoplasm ratio, without necrosis and that did not involve > 20% of the tumor surface. Their clinical-epidemiological, histological and immunohistochemical (Ki67, p16 and p53) and HPV infection characteristics were observed. Considered significant the result with p<0.05. Results: Comparing the usual groups with and without areas of basaloid appearance, similarity was observed in the sociodemographic variables related to age over 60 years, origin of rural residence and northern region of the state, brown skin colour and married marital status, as well as no or low education and occupation farmer. There were no statistically significant differences between the two groups in relation to lifestyle and habits of life, nor to the symptoms reported, such as smoking, alcoholism, history of sexually transmitted infections (STIs) and age at first sexual intercourse less than 18 years. Most of the population presented HPV detection, absence of angio lymphatic invasion and involvement of corpora cavernosa and tunica albuginea, as well as presence of perineural invasion, involvement of corpus spongiosum and urethra, presence of peri-tumoral lymphocytic infiltrate and association with carcinoma in situ. The usual group with basaloid aspect areas showed differences with statistical significance in the degree of differentiation (p =0.001) and applied staging (p=0.0042), with predominance of stage II and III. This group also presented more cases with the presence of angio lymphatic and perineural invasion, involvement of corpora cavernosa and tunica albuginea, association with carcinoma in situ and lymph node involvement. The range of disease-free time, in cases that could be followed up, was shorter in the usual group with basaloid areas than in the usual group without basaloid areas, from 0 to 31 months and from 0 to 62 months, respectively. Conclusion: the usual SCCs, unlike the other subtypes of SCCs, have a variable predictive prognostic profile and need to gather a lot of information to better manage the patient's follow up. The basaloid aspect did not bring results with statistical significance in our population, despite having shown higher percentage of socio-demographic risk factors and positivity for histological criteria said to be more aggressive, such as invasion of corpora cavernosa and tunica albuginea, presence of angio-lymphatic and perineural invasion, lymph node involvement. New researches are necessary in the search for predictive criteria of this high morbidity and mortality disease. |
publishDate |
2022 |
dc.date.accessioned.fl_str_mv |
2022-04-27T16:20:55Z |
dc.date.issued.fl_str_mv |
2022-03-29 |
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MELO, Syomara Pereira da Costa. Perfil clínico, histopatológico, imuno-histoquímico e de infecção por HPV de carcinoma de células escamosas de pênis usuais com áreas de aspecto basaloide. 2022. 89 f. Dissertação (Programa de Pós-Graduação em Saúde do Adulto e da Criança/CCBS) - Universidade Federal do Maranhão, São Luís, 2022. |
dc.identifier.uri.fl_str_mv |
https://tedebc.ufma.br/jspui/handle/tede/tede/3537 |
identifier_str_mv |
MELO, Syomara Pereira da Costa. Perfil clínico, histopatológico, imuno-histoquímico e de infecção por HPV de carcinoma de células escamosas de pênis usuais com áreas de aspecto basaloide. 2022. 89 f. Dissertação (Programa de Pós-Graduação em Saúde do Adulto e da Criança/CCBS) - Universidade Federal do Maranhão, São Luís, 2022. |
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https://tedebc.ufma.br/jspui/handle/tede/tede/3537 |
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Universidade Federal do Maranhão |
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