José Carlos de Oliveira

Multiple ADH genes are associated with upper aerodigestive cancers

Alcohol is an important risk factor for upper aerodigestive cancers and is principally metabolized by alcohol dehydrogenase (ADH) enzymes. We have investigated six ADH genetic variants in over 3,800 aerodigestive cancer cases and 5,200 controls from three individual studies. Gene variants rs1229984 (ADH1B) and rs1573496 (ADH7) were significantly protective against aerodigestive cancer in each individual study and overall (P = 10−10 and 10−9, respectively). These effects became more apparent with increasing alcohol consumption (P for trend = 0.0002 and 0.065, respectively). Both gene effects were independent of each other, implying that multiple ADH genes may be involved in upper aerodigestive cancer etiology.

End results of a prospective trial on elective lateral neck dissection vs type III modified radical neck dissection in the management of supraglottic and transglottic carcinomas

Either modified type III radical neck dissection (MRND) or lateral neck dissections (LNDs) are considered valid treatments for patients with laryngeal carcinoma with clinically negative neck findings (N0). The object of this prospective study was to compare complications, neck recurrences, and survival results of elective MRND and LND on the management of laryngeal cancer patients.

Tumor-associated macrophages and the profile of inflammatory cytokines in oral squamous cell carcinoma

OBJECTIVEnTo evaluate and characterize macrophage populations (M1/M2) in the tumor microenvironment of oral cavity squamous cell carcinoma (OCSCC). The relationship between macrophages and clinicopathological factors, such as survival data, lymph node metastasis, tumoral proliferation, and WHO histological grading are also analyzed.nnnMATERIALS AND METHODSnThe samples consisted of surgically excised specimens from patients with non-metastatic and metastatic OCSCC and normal oral mucosa (control). Immunohistochemistry, flow cytometry, and qRT-PCR were used to evaluate macrophage populations and the expression of pro- (IL-12, IL-23, and INF-γ) and anti-inflammatory (IL-10 and TGF-β) cytokines. The level required for statistical significance was defined as p<0.05.nnnRESULTSnThe data showed a predominance of M2 phenotype (high percentage of IL-10(+)TGF-β(+)) macrophages in the tumor microenvironment of OCSCC. A higher percentage of macrophages expressing TGF-β was seen in the OCSCC group when compared with healthy individuals. The assessment of mRNA expression also presented a greater expression of anti-inflammatory cytokines TGFβ and IL10 in OCSCC when compared with the control group. The percentage of macrophages, demonstrated by immunohistochemistry, was significantly higher in the metastatic OCSCC group than in the non-metastatic and control groups. The log-rank test also showed that the mean survival time for patients with high levels of macrophages was less (44 months) when compared with patients with a low percentage of such cells (93 months).nnnCONCLUSIONnA predominance of the M2 phenotype in the tumor microenvironment of OCSCC could contribute to local immunosuppression, via TGF-β production, and consequently greater lymph node involvement and reduced patient survival time.

Temporal evolution of breast cancer stages in a population-based cancer registry in the Brazilian central region

PURPOSEnTo analyze the temporal changes of breast cancer staging at diagnosis among women living in Goiânia, Goiás, Brazil, between 1989 and 2003.nnnMETHODSnRetrospective and descriptive study in which the cases were identified from the Population-Based Cancer Registry of Goiânia for the period from 1989 to 2003. The variables studied were age, diagnostic method, topographic sublocation, morphology and breast cancer staging. Frequency analyses were carried out on the variables and means, and the medians for the age were determined. The SPSS(R) 15.0 software was used for statistical analyses.nnnRESULTSnA total of 3,204 breast cancer cases were collected. The mean age was 56 years (sd+/-16 years). With regard to clinical staging, 45.6% of the cases were found to be localized in the breast, with an increased rate of 19.25% between the first and the third five-year period (p<0.001; CI 95%=0.14-0.23) and 10.2% of cases were with distant metastases. However, a reduction of 17.74% for metastatic cases in the same interval (p<0.001 e CI 95%=0.14-21) was observed. The in situ case rate was 0.2% in 1989-1993 and increased to 6.2% in 1999-2003 (p<0.001, IC95%=4.9-7.4).nnnCONCLUSIONnThe diagnostic profile of breast cancer in the city of Goiânia is changing. Substantial increases in the number of early breast cancer cases are being found in relation to the number of advanced cases.

Promoter hypermethylation in primary squamous cell carcinoma of the oral cavity and oropharynx: a study of a Brazilian cohort

Epigenetic silencing of cancer-related genes plays an important role in oral/oropharyngeal squamous cell carcinoma (OSCC). We evaluated promoter hypermethylation of 4 cancer-related genes in OSCCs of a Brazilian cohort and determined its relationship with exposure to alcohol, tobacco, HPV infection and clinicopathological parameters. CDKN2A (cyclin-dependent kinase inhibitor 2A or p16), SFN (stratifin or 14-3-3 σ), EDNRB (endothelin receptor B) and RUNX3 (runt-related transcript factor-3) had their methylation patterns evaluated by MSP analysis in OSCC tumors (nxa0=xa045). HPV detection was carried out by PCR/RFLP. Aberrant methylation was detected in 44/45 (97.8xa0%) OSCC; 24.4xa0% at CDKN2A, 77.8xa0% at EDNRB, 17.8xa0% at RUNX3 and 97.8xa0% at SFN gene. There was no significant association between methylation patterns and clinical parameters. HPV (subtype 16) was detected in 3 out of 45 patients (6xa0%). Our findings indicate that HPV infection is uncommon and methylation is frequent in Brazilian OSCCs, however, EDNRB and SFN gene methylation are not suitable OSCC biomarkers due to indistinct methylation in tumoral and normal samples. In contrast, CDKN2A and RUNX3 genes could be considered differentially methylated genes and potential tumor markers in OSCCs.

Estudo descritivo dos casos de câncer de mama em Goiânia, entre 1989 e 2003

OBJETIVO: Descrever os casos de câncer de mama nas mulheres residentes em Goiânia no periodo 1989-2003. METODOS: Estudo retrospectivo, descritivo, que incluiu todos os casos de câncer de mama ocorridos nas moradoras de Goiânia, identificados pelo Registro de Câncer de Base Populacional de Goiânia (RCBPGO), no periodo de 1989 a 2003. As variaveis estudadas foram: idade, metodo de diagnostico, localizacao topografica, morfologia e extensao do câncer de mama. Foram utilizadas frequencias e taxas percentuais, alem da regressao de Poisson para determinacao da mudanca percentual anual (MPA). RESULTADOS: Foram identificados 3204 casos de câncer de mama. A localizacao topografica mais frequente foi o quadrante superior lateral (53,7%). O carcinoma ductal infiltrante (CDI) foi o mais frequente, com 2582 casos (80,6%), seguido pelo carcinoma lobular infiltrante (CLI), com 155 casos (4,8%). Houve aumento significante tanto do CDI quanto do CLI, sendo a MPA de 11,0 % e de 15,4%, respectivamente. A proporcao entre CDI e CLI nao foi influenciada pela idade (p=0,98). Quanto a extensao do tumor ao diagnostico, 45,6% dos casos eram localizados na mama, sendo que a MPA foi de 16,1% (IC= 12,4 a 20,0; p<0,001). Houve tendencia de reducao da MPA dos casos metastaticos (-3,8; IC= -8,6 a 1,2; p=0,12). CONCLUSAO: A localizacao topografica e o tipo histologico do câncer de mama, na cidade de Goiânia, seguem o padrao de outros paises. Os principais tipos morfologicos nao foram influenciados pela idade. Houve grande aumento de casos iniciais.

TOTAL THYROIDECTOMY WITH ULTRASONIC SCALPEL: A MULTICENTER, RANDOMIZED CONTROLLED TRIAL

The ultrasonic scalpel is a recently introduced device in head and neck surgery. Total thyroidectomy is the most common endocrine procedure performed by surgeons.

Risk factors for esophageal cancer in a low-incidence area of Brazil

CONTEXT AND OBJECTIVES Esophageal cancer is the eighth commonest type of cancer worldwide, occupying sixth place in terms of mortality. Smoking and alcohol use are known risk factors for this type of cancer. The aim here was to evaluate the risk factors for esophageal cancer in a low-incidence area. DESIGN AND SETTING Case-control study in Goiânia, with 99 cases of esophageal cancer and 223 controls. METHODS The variables were sociodemographic, dietary, occupational and lifestyle data. The sample was analyzed using the chi-square test, Mann-Whitney test and Mantel-Haenszel approach for multivariate analysis. Odds ratios (OR) were calculated with 5% significance and 95% confidence intervals. RESULTS The risk of esophageal cancer was higher in patients ≥ 55 years (OR = 1.95; P < 0.001). Patients from rural areas were at greater risk of esophageal cancer (OR = 4.9; P < 0.001). Smoking was a risk factor among the cases (OR = 3.8; P < 0.001), as was exposure to woodstoves (OR = 4.42; P < 0.001). The practice of oral sex was not a risk factor (OR = 0.45; P = 0.04). Consumption of apples, pears, vegetables, cruciferous vegetables and fruit juices were protective against esophageal cancer. CONCLUSION In a region in which the incidence of esophageal cancer is low, the most significant risk factors were exposure to woodstoves, smoking and living in rural areas.

High incidence of esophageal cancer in central-western Brazil: a migrant effect?

To determine the incidence and mortality rates of esophageal cancer in central-western Brazil: Goiânia, Brasília, Cuiabá, and Campo Grande, incidence data for Cuiabá (2000–2005) and Brasília (1999–2002) were obtained from the National Cancer Institute, and data from Goiânia (1995–2008) from the Population-Based Cancer Registry of Goiânia. Mortality data for the cities of central-western Brazil were obtained for the period 1980–2008 from the Ministry of Health. Age-standardized incidence and mortality rates were calculated using the world population of Segi. Mortality trends were assessed with the Joinpoint Regression Program and a P value less than 0.05 was defined as significant. The highest incidence of esophageal cancer among men was in Cuiabá (16.0/100 000); the lowest was in Goiânia (6.5/100 000). Among women, the incidence rates were similar in Brasília and Cuiabá, but in Goiânia, the incidence declined. There was a significant increase in mortality among men in Cuiabá (2.4%, P=0.03) and Campo Grande (1.2%, P=0.05), and in women (1.6%, P=0.04) in Goiânia. Mortality by age group increased significantly in Campo Grande by 1.9% for men aged at least 50 years and in Goiânia by 2.7% among women aged at least 50 years; the mortality decreased in Goiânia by 2.2% for women aged less than 50 years. The incidence of esophageal cancer in Brasília and Cuiabá was similar to that of southern Brazil in some periods. There was an increase in mortality trends for men in Cuiabá and Campo Grande, and for women in Goiânia.

Monitoring the profile of cervical cancer in a developing city.

BackgroundMedical records are frequently consulted to verify whether the treatment and guiding principles were correct. Determine incidence and mortality trends of in situ and invasive neoplasms of the uterine cervix, in the period 1988–2004 in Goiânia, Brazil.MethodsThe incident cases were identified through the Population-Based Cancer Registry of Goiânia. Population data were collected from census data of the Brazilian Institute of Geography and Statistics. For mortality analysis, data were extracted from the Mortality Information System. The Poisson Regression was utilized to determine the annual incidence and mortality rates.ResultsA total of 4446 cases of in situ and invasive neoplasms of the uterine cervix were identified. No significant reductions were verified in invasive cervical cancer rates (pu2009=u20090.386) during the study period, while in situ carcinomas presented an annual increasing trend of 13.08% (pu2009<u20090.001). A decreasing trend was observed for mortality (3.02%, pu2009=u20090.017).ConclusionNo reduction was observed for the incidence of invasive cancer of the uterine cervix; however, increasing trends were verified for in situ lesions with a consequent reduction in mortality rates. These increasing trends may be the result of recently-implemented screening programs or due to improvements in the notification system.