RESUMO
BACKGROUND: Lip, oral cavity, and oropharyngeal squamous cell carcinoma (SCC) represent a major health problem in the global scenario. In South America, the highest incidence rates are seen in Brazil. Therefore, the epidemiological and clinical profile and survival outcomes of lip, oral cavity, and oropharyngeal SCC was studied in São Paulo State, Brazil. MATERIAL AND METHODS: The clinicopathological data of 12,099 patients with lip, oral cavity, and oropharyngeal SCC were obtained from hospital cancer registries of the Fundação Oncocentro de São Paulo, Brazil (2010-2015). Survival rates and other analyses were performed using SPSS software. RESULTS: A clear male predominance was observed, particularly for patients with oropharyngeal SCC (88.3%). The average age of patients was higher for lip cases (65 ± 13.5 years) compared to other sites. The schooling level was low for most patients, especially in lip cases (87.9%). Most of the patients with oral cavity (71.8%) and oropharyngeal (86.3%) SCC had advanced-stage (III-IV) disease. However, the majority of lip cases (83.3%) were at an early stage (I-II). Surgical excision was the main treatment for lip (72%) and oral cavity SCC (23.5%), and chemoradiotherapy was the main treatment for oropharyngeal SCC (40.2%). The 5-year overall survival (OS) for patients with lip, oral cavity, and oropharyngeal SCC were 66.3, 30.9, and 22.6%, respectively. Multivariate analysis revealed that the determinants of OS were different for lip, oral cavity, and oropharyngeal SCC, except for those at the clinical stage, which was an independent predictor for all sites. CONCLUSIONS: OS-independent determinants varied according to the affected site. Oral cavity and oropharyngeal SCC presented worse survival rates than those for lip SCC.
Assuntos
Carcinoma de Células Escamosas , Neoplasias de Cabeça e Pescoço , Neoplasias Bucais , Neoplasias Orofaríngeas , Idoso , Brasil/epidemiologia , Carcinoma de Células Escamosas/epidemiologia , Carcinoma de Células Escamosas/terapia , Feminino , Humanos , Lábio/patologia , Masculino , Pessoa de Meia-Idade , Neoplasias Bucais/epidemiologia , Neoplasias Bucais/terapia , Neoplasias Orofaríngeas/epidemiologia , Neoplasias Orofaríngeas/terapia , Carcinoma de Células Escamosas de Cabeça e Pescoço/epidemiologia , Carcinoma de Células Escamosas de Cabeça e Pescoço/terapiaAssuntos
Neoplasias do Ânus/diagnóstico , COVID-19 , Neoplasias Colorretais/diagnóstico , Detecção Precoce de Câncer/tendências , Acessibilidade aos Serviços de Saúde/tendências , Adulto , Idoso , Idoso de 80 Anos ou mais , Neoplasias do Ânus/economia , Neoplasias do Ânus/epidemiologia , Neoplasias do Ânus/patologia , Brasil/epidemiologia , Neoplasias Colorretais/economia , Neoplasias Colorretais/epidemiologia , Neoplasias Colorretais/patologia , Estudos Transversais , Detecção Precoce de Câncer/economia , Feminino , Acessibilidade aos Serviços de Saúde/economia , Humanos , Masculino , Pessoas sem Cobertura de Seguro de Saúde/estatística & dados numéricos , Pessoa de Meia-Idade , Estadiamento de Neoplasias , Encaminhamento e Consulta/economia , Encaminhamento e Consulta/tendênciasRESUMO
We investigated the association between an aggrecan gene (ACAN) polymorphism and lumbar disc herniation (LDH). This was a case-control study with quinquennial age and gender groups. The study comprised 119 men and women aged between 20 and 60 from Goiânia (Brazil). Of these, 39 were allocated to the case group (Ca) and 80 to the control group (Ct). We gathered sociodemographic and clinical data, and peripheral blood samples. DNA was isolated for genotyping the ACAN variable number tandem repeat (VNTR) via conventional polymerase chain reaction (PCR). Data were statistically analyzed using the chi-square test, multiple comparison analysis, the Student t-test, and odds ratios, with a level of significance set at 5% (P ≤ 0.05). The groups were homogenous in terms of sociodemographic, anthropometric, and life style variables. The allele score for the ACAN VNTR was significantly lower in volunteers with LDH; the A22 allele was significantly more prevalent in this same group; the Ca group presented greater frequency of short alleles A13-A25, whereas the Ct group presented a higher frequency of long alleles. However, this difference was not statistically significant. In both groups, the most common alleles were A28, A27, and A29, and the A26/A26 genotype was significantly more common in the Ca group. The results showed an association between short alleles and LDH among the investigated adults (Ca), corroborating the hypothesis that aggrecan with shorter repeat lengths can lead to a reduction in the physiological proteoglycan function of intervertebral disc hydration and, consequently, increased individual susceptibility to LDH.
Assuntos
Agrecanas/genética , Degeneração do Disco Intervertebral/genética , Deslocamento do Disco Intervertebral/genética , Repetições Minissatélites , Adulto , Povo Asiático/genética , Estudos de Casos e Controles , Feminino , Predisposição Genética para Doença , Humanos , Masculino , Pessoa de Meia-Idade , Adulto JovemRESUMO
PURPOSE: The aim of this study is to analyze mortality trends of HPV-related cancers in Spain by gender, during the period 1996-2010, and make predictions until the year 2025. METHODS: All deaths registered as cervical cancer were registered (ICD-10 code: C53), as well as vulvar and vaginal (C51 and C52), anal (C21), penile (C60), and oropharyngeal (C02, C09, C10). Adjusted rate calculations for each year were used to study the trends through the regression program Joinpoint. Predictions were made using the Nordpred program, utilizing the age-period-cohort model. RESULTS: In men, a statistically significant increase was observed in mortality by anal cancer, a reduction was observed in oropharyngeal cancer mortality and penile cancer rates were stable. In women, a statistically significant decreasing trend was observed for cervical, vulvar and vaginal cancers. In the predictions, the annual change relative to risk or population changes (size and structure) revealed a reduction in death risk by oropharyngeal cancer in men, and a reduction in death risk by anal cancer in women, although stable adjusted rates were verified for anal cancer in women. CONCLUSIONS: Although an increase was identified in the number of deaths for both genders, rates indicate gender differences in the trends, with increased rates for anal cancer and reduced rates for oropharyngeal cancer in men. Women presented reduced rates for cervical, vulvar, and vaginal cancers. For penile cancer and anal cancer in women, stable trends were verified.
Assuntos
Neoplasias/mortalidade , Neoplasias/virologia , Infecções por Papillomavirus/complicações , Infecções por Papillomavirus/mortalidade , Adolescente , Adulto , Idoso , Idoso de 80 Anos ou mais , Criança , Pré-Escolar , Efeitos Psicossociais da Doença , Feminino , Previsões , Humanos , Lactente , Recém-Nascido , Masculino , Pessoa de Meia-Idade , Mortalidade/tendências , Sistema de Registros , Espanha/epidemiologia , Adulto JovemRESUMO
The association of education, tobacco smoking, alcohol consumption, and interleukin-2 (IL-2 +114 and -384) and -6 (IL-6 -174) DNA polymorphisms with head and neck squamous cell carcinoma (HNSCC) was investigated in a cohort study of 445 subjects. IL-2 and IL-6 genotypes were determined by real-time PCR. Cox regression was used to estimate hazard ratios (HR) and 95 percent confidence intervals (95 percentCI) of disease-specific survival according to anatomical sites of the head and neck. Mean age was 56 years and most patients were males (87.6 percent). Subjects with 5 or more years of schooling had better survival in larynx cancer. Smoking had no effect on HNSCC survival, but alcohol consumption had a statistically significant effect on larynx cancer. IL-2 gene +114 G/T (HR = 0.52; 95 percentCI = 0.15-1.81) and T/T (HR = 0.22; 95 percentCI = 0.02-3.19) genotypes were associated with better survival in hypopharynx cancer. IL-2 +114 G/T was a predictor of poor survival in oral cavity/oropharynx cancer and larynx cancer (HR = 1.32; 95 percentCI = 0.61-2.85). IL-2 -384 G/T was associated with better survival in oral cavity/oropharynx cancer (HR = 0.80; 95 percentCI = 0.45-1.42) and hypopharynx cancer (HR = 0.68; 95 percentCI = 0.21-2.20), but an inverse relationship was observed for larynx cancer. IL-6 -174 G/C was associated with better survival in hypopharynx cancer (HR = 0.68; 95 percentCI = 0.26-1.78) and larynx cancer (HR = 0.93; 95 percentCI = 0.42-2.07), and C/C reduced mortality in larynx cancer. In general, our results are similar to previous reports on the value of education, smoking, alcohol consumption, and IL-2 and IL-6 genetic polymorphisms for the prognosis of HNSCC, but the risks due to these variables are small and estimates imprecise.
Assuntos
Idoso , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Carcinoma de Células Escamosas/mortalidade , Neoplasias de Cabeça e Pescoço/mortalidade , /genética , /genética , Polimorfismo Genético/genética , Consumo de Bebidas Alcoólicas/efeitos adversos , Estudos de Coortes , Carcinoma de Células Escamosas/etiologia , Intervalo Livre de Doença , Escolaridade , Genótipo , Neoplasias de Cabeça e Pescoço/etiologia , Prognóstico , Fatores de Risco , Fumar/efeitos adversosRESUMO
The association of education, tobacco smoking, alcohol consumption, and interleukin-2 (IL-2 +114 and -384) and -6 (IL-6 -174) DNA polymorphisms with head and neck squamous cell carcinoma (HNSCC) was investigated in a cohort study of 445 subjects. IL-2 and IL-6 genotypes were determined by real-time PCR. Cox regression was used to estimate hazard ratios (HR) and 95% confidence intervals (95%CI) of disease-specific survival according to anatomical sites of the head and neck. Mean age was 56 years and most patients were males (87.6%). Subjects with 5 or more years of schooling had better survival in larynx cancer. Smoking had no effect on HNSCC survival, but alcohol consumption had a statistically significant effect on larynx cancer. IL-2 gene +114 G/T (HR = 0.52; 95%CI = 0.15-1.81) and T/T (HR = 0.22; 95%CI = 0.02-3.19) genotypes were associated with better survival in hypopharynx cancer. IL-2 +114 G/T was a predictor of poor survival in oral cavity/oropharynx cancer and larynx cancer (HR = 1.32; 95%CI = 0.61-2.85). IL-2 -384 G/T was associated with better survival in oral cavity/oropharynx cancer (HR = 0.80; 95%CI = 0.45-1.42) and hypopharynx cancer (HR = 0.68; 95%CI = 0.21-2.20), but an inverse relationship was observed for larynx cancer. IL-6 -174 G/C was associated with better survival in hypopharynx cancer (HR = 0.68; 95%CI = 0.26-1.78) and larynx cancer (HR = 0.93; 95%CI = 0.42-2.07), and C/C reduced mortality in larynx cancer. In general, our results are similar to previous reports on the value of education, smoking, alcohol consumption, and IL-2 and IL-6 genetic polymorphisms for the prognosis of HNSCC, but the risks due to these variables are small and estimates imprecise.
Assuntos
Carcinoma de Células Escamosas/mortalidade , Neoplasias de Cabeça e Pescoço/mortalidade , Interleucina-2/genética , Interleucina-6/genética , Polimorfismo Genético/genética , Idoso , Consumo de Bebidas Alcoólicas/efeitos adversos , Carcinoma de Células Escamosas/etiologia , Estudos de Coortes , Intervalo Livre de Doença , Escolaridade , Feminino , Genótipo , Neoplasias de Cabeça e Pescoço/etiologia , Humanos , Masculino , Pessoa de Meia-Idade , Prognóstico , Fatores de Risco , Fumar/efeitos adversos , Carcinoma de Células Escamosas de Cabeça e PescoçoRESUMO
Specific genotypes appear to be related to the development of thyroid disease. We examined whether polymorphisms of the genes CYP1A1, GSTM1, GSTT1, and TP53 at codon 72 are associated with increased risk for thyroid nodules. Blood samples were obtained from 122 thyroid patients with nodules and from 134 healthy control individuals from Goiânia city, GO, Brazil. We found no significant association of CYP1A1m1 and CYP1A1m2 genotypes with thyroid diseases (P > 0.05). The null genotypes of GSTM1 and GSTT1 genes were predominant in patients with nodules, indicating that individuals that possess these genotypes have a predisposition for thyroid disease. The genotype p53Arg Arg was associated with a low risk for thyroid cancer (OR = 0.15; P < 0.0001), indicating that the arginine allele in homozygosis could have a protective effect against carcinogenesis. On the other hand, the p53ArgPro genotype was significantly associated with malignant neoplastic nodules (OR = 3.65; P = 0.001). Interindividual variation in susceptibility to thyroid diseases could provide new perspectives for early diagnosis, prognosis and treatment, indicating which patients with thyroid nodules will benefit from treatment, depending on specific polymorphic profiles.
Assuntos
Citocromo P-450 CYP1A1/genética , Glutationa Transferase/genética , Polimorfismo Genético , Nódulo da Glândula Tireoide/genética , Adolescente , Adulto , Idoso , Idoso de 80 Anos ou mais , Sequência de Bases , Estudos de Casos e Controles , Primers do DNA , Genótipo , Humanos , Pessoa de Meia-Idade , Adulto JovemRESUMO
Cancers of the upper aerodigestive tract [(UADT): oral cavity, pharynx, larynx and oesophagus] have high incidence rates in some parts of South America. Alterations in the TP53 gene are common in these cancers. In our study, we have estimated the prevalence and patterns of TP53 mutations (exons 4-10) in 236 UADT tumours from South America in relation to lifestyle risk factors, such as tobacco smoking and alcohol drinking. Moreover, we have conducted a pilot study of EGFR mutations (exons 18-21) in 45 tumours from the same population. TP53 mutation prevalence was high: 59% of tumours were found to carry mutant TP53. We found an association between TP53 mutations and tobacco smoking and alcohol drinking. The mutation rate increased from 38% in never-smokers to 66% in current smokers (P-value for trend = 0.09). G:C>T:A transversions were found only in smokers (15%). Alcohol drinkers carried more G:C>A:T transitions (P = 0.08). Non-exposed individuals were more probable to carry G:C>A:T transitions at CpG sites (P = 0.01 for never-smokers and P < 0.001 for never-drinkers). EGFR mutations were found in 4% of cases. Inactivation of TP53 by mutations is a crucial molecular event in the UADT carcinogenesis and it is closely related to exposure to lifestyle risk factors. EGFR mutations do not appear to be a common event in UADT carcinogenesis in this population.
Assuntos
Receptores ErbB/genética , Neoplasias Esofágicas/epidemiologia , Genes p53 , Neoplasias de Cabeça e Pescoço/epidemiologia , Estilo de Vida , Adulto , Idoso , Estudos de Casos e Controles , Cocarcinogênese , Neoplasias Esofágicas/genética , Feminino , Neoplasias de Cabeça e Pescoço/genética , Humanos , Masculino , Pessoa de Meia-Idade , Projetos Piloto , Fatores de Risco , América do Sul/epidemiologiaRESUMO
A interação do genoma do HPV com o genoma da célula hospedeira ou de proteínas virais com proteínas celulares necessárias ao controle do ciclo celular desencadeia a morte celular ou age como fator de iniciação e progressão de processos malignos. Diversostrabalhos têm sido desenvolvidos no sentido de associar a infecção de HPV aos cânceres de cabeça e pescoço. O objetivo do presente estudo foi comparar a detecção do genoma de HPV em pacientes com CEC da laringe, considerando os ensaios de PCR convencional e em tempo real. O grupo amostral foi constituído de 15 pacientes do Registro de Câncer de Base Populacional da ACCG. Das peças cirúrgicas, foi obtido DNA total, usado na investigação molecular, para detecção do genoma de HPV, utilizando os primers genéricos GP05/06, que detectam todos os tipos de HPV. O genoma de HPV foi amplificado em 30 dos casos por PCR convencional e no ensaio de PCR em tempo real apresentaram amplificação em 46,7 das amostras, evidenciando uma diferença em 40 . Os estudosde associação entre o HPV e os cânceres da laringe são importantes no sentido de ampliar o conhecimento acerca dos mecanismos de infecção, iniciação e promoção tumoral potencializada por estes vírus.
Assuntos
Humanos , Carcinoma de Células Escamosas , Estudo Comparativo , Genes Supressores de Tumor , Neoplasias Laríngeas , Laringe , Técnicas de Diagnóstico Molecular , Infecções por Papillomavirus , Reação em Cadeia da PolimeraseRESUMO
Este estudo propõe-se a uma breve revisão da literatura sobre qualidade de vida (QV) e câncer de cabeça e pescoço, bem como avaliar a reação de enfermos com esta patologia frente a Escala de Qualidade de Vida desenvolvida por Font - 1988 (Costa Neto, 1997). Participaram do estudo 43 pacientes do Serviço de Cirurgia de Cabeça e Pescoço do Hospital Araújo Jorge - ACCG, que foram abordados individualmente na ocasião da consulta médica ou durante a internação hospitalar. Houve o predomínio de casos masculinos (55,8 por cento) sobre os femininos (44,2 por cento), a maioria em tratamento cirúrgico exclusivo (60 por cento), com idade entre 51 e 60 anos (28 por cento), com nenhuma (21 por cento) ou pouca escolarização (36 por cento). Cerca de 44 por cento nao trabalhava devido ao câncer. As neoplasias mais freqüentes eram da boca (25 por cento), e tireóide (19 por cento) e laringe (16 por cento). Na subescala (S-E) Sintomas, predominaram os fatores dor (38 por cento) e naúseas (23 por cento). Na S-E Dificuldades nos Hábitos Cotidianos, as atividades laborais (62 por cento). Na S-E Dificuldades Sociais/Familiares, preocupação com os filhos (60 por cento) e preocupações econômicas (58 por cento). Na S-E Fatores Psicológicos, Insatisfação com o Próprio Corpo (54 por cento) e Medo (49 por cento). No geral, houve uma perda média de 35 por cento na QV dos enfermos. Conclui-se que a Escala de QV de Font é apropriada para sujeitos com câncer de cabeça e pescoço, mas sugere-se associá-la a entrevistas semi-estruturadas, uma vez que as dimensões de significado não são avaliadas por instrumentos mais objetivos.