Navegando por Palavras-chave "Differentiated Thyroid Carcinoma"

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    Epidemiologia Do Câncer De Tiroide, Impacto Econômico E Tratamento Dos Casos De Baixo Risco De Recorrência: Uma Perspectiva Brasileira
    (Universidade Federal de São Paulo (UNIFESP), 2017-12-20) Janovsky, Carolina Castro Porto Silva [UNIFESP]; Biscolla, Rosa Paula Mello [UNIFESP]; Universidade Federal de São Paulo (UNIFESP)
    Com os artigos apresentamos nesta tese conclui-se que ocorreu uma mudança em alguns aspectos do diagnóstico e tratamento do cancer de tiroide nos últimos anos. Nosso primeiro artigo publicado na revista European Thyroid Journal em novembro de 2015 demonstra que os pacientes com câncer de tiroide com baixo risco de recorrência apresentaram um excelente desfecho com o tratamento cirúrgico, sem necessidade de radioiodoterapia, e que a melhor abordagem para seguimento destes casos é observar a curva da tiroglobulina (Tg trend) acompanhada da US cervical periódica. Já o segundo artigo, submetido à revista BMC Public Health, sobre a epidemia do câncer de tiróide no Brasil e o impacto econômico no SUS, demonstra, através de pesquisa no sistema DATASUS, que houve um aumento importante no número de procedimentos relacionados ao diagnóstico (dosagem de TSH, US de tiroide e PAAF de nódulo tiroidiano) e tratamento (tiroidectomia total, uso de radioiodoterapia). Consequentemente, isso acarretou em aumento significativo nos custos para o sistema de saúde público brasileiro, aproximadamente cinco vezes em relação ao esperado no período de 2008 a 2015. Finalmente, ambos os artigos sugerem que se torna necessário rever as indicações de exames diagnósticos e de seguimento e os tipos de tratamento para os pacientes com câncer de tiroide.
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    Identificação de alterações genéticas associadas à patogênese dos carcinomas da tiroide negativos para genes Driver conhecidos: busca de novos marcadores moleculares e compreensão dos processos biológicos
    (Universidade Federal de São Paulo (UNIFESP), 2021) Bim, Larissa Valdemarin [UNIFESP]; Cerutti, Janete Maria [UNIFESP]; Universidade Federal de São Paulo
    Thyroid cancer is currently among the most prevalent neoplasms in both Brazil as in the world and Differentiated Thyroid Carcinoma is its most frequent (around 90% of cases). Differentiated carcinomas can be divided into Papillary Thyroid Carcinoma (CPT), with a high prevalence of mutation BRAF V600E and fusions involving the RET gene, Follicular Thyroid Carcinoma (CFT), which has mutations in the RAS genes and the PAX8-PPARg fusion and the Hurthle cell carcinoma with low prevalence of RAS mutations and profile practically haploid, with loss of several chromosomes. It has great relevance also the most prevalent subtype of CPT, the Follicular Variant of Carcinoma Thyroid Papillary (VFCPT) which has a mixed histological and molecular profile between CPT and CFT. The increased incidence of thyroid cancer is due, in part, to refinement of diagnostic technologies that identify nodules up to 2mm. One time Once the nodule is identified, an accurate diagnosis is essential. Among the methodologies diagnostics, the Fine Needle Aspiration Puncture (FNAB) has been considered the method of choice. However, one of the biggest clinical problems has been the limitation of FNA when performing differential diagnosis in approximately 20-30% of the nodules. Molecular panels, based on the mutational or expression profile of thyroid tumors, has been used to aid in preoperative diagnosis differential of benign or malignant nodules.However, we do not know all the genetic alterations associated with the pathogenesis of tumors, causing cases negative for the mutations arranged in the panels generate diagnostic difficulties. This work seeks, through the RNAseq technique, to investigate negative tumors for the main changes drives in thyroid tumors and define their profile mutational. 30 cases were sequenced, of which 14 are negative for mutations. BRAF V600E, NRAS, KRAS, HRAS and for RET-PTC1, RET-PTC2, RET-PTC3 mergers, - 12 - ETV6-NTRK3, ATRN-ALK, AGK-BRAF and PAX8-PPARg and 16 mutation positives in BRAF, K/H/NRAS and PAX8-PPARg fusion. In this work we identify potentials driver genes for thyroid cancer that, after validation in larger series, may be included in existing panels and, in this way, increase the accuracy of tests available. In addition, the analysis of the expression profile showed that these can be classified into two expression clusters, separating samples with mutation in RAS and BRAF in different clusters, along with a division of the between these two groups (RL negative (RAS-Like) and BL negative (BRAFLike)). The ERK score showed a greater number of genes in the ERK-MAPK pathway activated in BRAF positive and BL negative samples, confirmed by enrichment of this pathway in the analysis of differential expression between BL negatives and negative RL. In addition, the BL negative samples showed large enrichment for immune system pathways and increased expression of genes from evasion of the immune system. Together, these data can contribute to increase the accuracy of molecular tests, as well as for a better understanding of the biological behavior of thyroid tumors.