Análise dos fatores epidemiológicos, clínico-patológicos e expressão das proteínas OCT4 e NANOG em amostras de melanoma cutâneo

• Ano de defesa: 2016
• Autor(a) principal: Silva, Constanza Thaise Xavier
• Orientador(a): Guillo, Lidia Andreu
• Banca de defesa: Guillo, Lidia Andreu , Saddi, Vera Aparecida , Costa, Cesar Augusto Sam Tiago Vila Nova, Carneiro, Lilian Carla, Arruda, Jalsi Tacon
• Tipo de documento: Tese
• Tipo de acesso: Acesso aberto
• dARK ID: ark:/38995/0013000001snv
• Idioma: por
• Instituição de defesa: Universidade Federal de Goiás
• Programa de Pós-Graduação: Programa de Pós-graduação em Ciências da Saúde (FM)
• Departamento: Faculdade de Medicina - FM (RG)
• País: Brasil
• Palavras-chave em Português: Melanoma; Células-tronco tumorais; Imunohistoquímica; NANOG e OCT4
• Palavras-chave em Inglês: Melanoma; Cancer stem cells; Immunohistochemistry; NANOG and OCT4
• Área do conhecimento CNPq: MEDICINA::ANATOMIA PATOLOGICA E PATOLOGIA CLINICA
• Link de acesso: http://repositorio.bc.ufg.br/tede/handle/tede/6620

Cutaneous melanoma is a type of skin cancer that originates in melanocytes, predominantly affecting young and middle-aged adults. Several evidence suggests that cancer stem cells exist for melanoma. The POU5F1 / OCT4, NANOG genes have been studied as cancer stem markers. OCT4 and NANOG are involved in the maintenance of pluripotency and self-renewal of undifferentiated embryonic stem cells. This study aims to evaluate the epidemiological, clinical-pathological and expression of the OCT4 and NANOG proteins in cutaneous melanoma samples. We selected 102 cases for the epidemiological, clinical and pathological study, diagnosed between the years 2004 to 2008. For survival study, patients with a followup of up to 60 months were selected, with a recorded death. Of the 102 cases evaluated, 62.7% were female and 37.3% male; With mean age of 57.2 years and 63.1 years respectively (p= 0.0026). The most prevalent age at diagnosis of melanoma was between 51 and 70 years (44.1% p= 0.023). In this study, there was a predominance of lesions located in the trunk (32.3%). Histopathological examination of the type of tumor growth showed a predominance of the superficial extensive type in 52.9% of the cases. According to the Breslow index, lesions with ≤1.0 mm predominated in 39.2% of the individuals, followed by lesions> 4.0 mm in 23.5% of the cases. According to the Clark level 29.4% of the cases were classified in level IV; Followed by 25.5% cases with level V; Clark II in 23.5%; Clark III in 20.6%; And Clark I in only 1 case (1.0%). There were metastases in 47% of the cases and the main localization sites were: lymph nodes, brain, skin and lung. Regarding the clinical evolution of the patients, there were 26 cases of deaths due to melanoma (25.5%). The survival curve calculated at the 60-month follow-up was 73.0%. Univariate analysis revealed significant associations between nuclear overexpression of OCT4 and the following variables: Breslow index with thickness > 2.1 mm (p = 0.021, OR: 2.64, 95% CI: 1.15-6.05 ); Levels of Clark, IV and V (p = 0.001, OR: 4.11, 95% CI: 1.79-9.46); ulceration present (p≤0.0001; OR: 459.0; 95% CI: 51.67-4077.27); Presence of metastases (p <0.0001, OR: 40.25, 95% CI: 12.90- 125.62), and death from cutaneous melanoma (p <0.0001). The significant associations between cytoplasmic hyperexpression of OCT4 and the following variables were: present ulceration (p = 0.015, OR: 2.73, 95% CI: 1.21-6.16); Presence of metastases (p = 0.004, OR: 3.34, 95% CI: 1.47 - 7.62) and death from cutaneous melanoma (p = 0.039, OR 2.67, 95% CI 1.05 - 6,77). And the significant associations between the cytoplasmic hyperexpression of NANOG and the following variables were: present ulceration (p≤ 0.0001); Presence of metastases (p ≤ 0.0001) and death due to cutaneous melanoma (p = 0.030). Our study demonstrated a strong association of the OCT4