NATHALIE OLIVEIRA DE SANTANA
Projetos de Pesquisa
Unidades Organizacionais
LIM/25 - Laboratório de Endocrinologia Celular e Molecular, Hospital das Clínicas, Faculdade de Medicina
6 resultados
Resultados de Busca
Agora exibindo 1 - 6 de 6
- Diagnostic performance of thyroid ultrasound in Hurthle cell carcinomas(2019) SANTANA, Nathalie Oliveira; FREITAS, Ricardo Miguel Costa; MARCOS, Vinicius Neves; CHAMMAS, Maria Cristina; CAMARGO, Rosalinda Yossie Asato; SCHMERLING, Claudia Kliemann; VANDERLEI, Felipe Augusto Brasileiro; HOFF, Ana Oliveira; MARUIL, Suemi; DANILOVIC, Debora Lucia SeguroObjective: Hurthle cell carcinomas (HCCs) of the thyroid have been recently reclassified as a separate entity due to their distinct clinical and molecular profiles. Few studies have assessed the ability of preoperative characteristics in differentiating HCCs from Hurthle cell adenomas (HCAs) due to the low prevalence of both lesions. This study aimed to compare the preoperative features of HCCs and HCAs and evaluate the diagnostic performance of ultrasound in distinguishing between both. Subjetcs and methods: Retrospective study including 101 patients (52 HCCs and 49 HCAs) who underwent thyroid surgery from 2000 to 2016. Clinical, ultrasonographic, and histological data were reviewed. Diagnostic performance of suspicious sonographic features was analyzed in 51 cases (24 HCCs and 27 HCAs). Results: Hurthle cell neoplasms were predominant in females. Subjects >= 55 years represented 58% of the cases of HCCs and 53% of those of HCAs. Carcinomas were significantly larger (p < 0.001), and a tumor size >= 4 cm significantly increased the risk of malignancy (odds ratio 3.67). Other clinical, cytologic, and sonographic data were similar between HCCs and HCAs. Among the HCCs, the lesions were purely solid in 54.2%, hypoechoic in 37.5%, and had coarse calcifications in 12.5%, microcalcifications in 8.3%, irregular contours in 4.2%, and a taller-than-wide shape in 16.7%. Predominantly/exclusive intranodular vascularization was observed in 52.6%. Overall, 58% of the HCCs were classified as TI-RADS 4 or 5 compared with 48% of the HCAs. TI-RADS 4 or 5 had a specificity of only 51.8% and a positive likelihood ratio of 1.21. Conclusions: Apart from the lesion size, no other preoperative feature adequately distinguished HCCs from HCAs. Sonographic characteristics raising suspicion for malignancy, which are mostly present in papillary carcinomas, were infrequent in HCCs. New tools must be developed to improve preoperative diagnosis and deferral of surgery in cases of adenomas.
conferenceObject GnRH Analogue's Use in the Diagnostic Approach of Patients with Suspected 46,XX Ovotesticular Disorders of Sex Development(2014) PELAES, Tatiana S.; SANTANA, Nathalie Oliveira; SILVA, Rosana Barbosa; COSTA, Elaine Maria Frade; SIRCILI, Maria Helena Palma; CUNHA, Flavia Siqueira; MENDONCA, Berenice B.; DOMENICE, Sorahia- Pituitary MRI Features in Acromegaly Resulting From Ectopic GHRH Secretion From a Neuroendocrine Tumor: Analysis of 30 Cases(2022) POTORAC, Iulia; BONNEVILLE, Jean-Francois; DALY, Adrian F.; HERDER, Wouter de; FAINSTEIN-DAY, Patricia; CHANSON, Philippe; KORBONITS, Marta; CORDIDO, Fernando; LAMBACK, Elisa Baranski; ABID, Mohamed; RAVEROT, Veronique; RAVEROT, Gerald; APINANIZ, Emma Anda; CARON, Philippe; BOULLAY, Helene Du; BILDINGMAIER, Martin; BOLANOWSKI, Marek; LALOI-MICHELIN, Marie; BORSON-CHAZOT, Francoise; CHABRE, Olivier; CHRISTIN-MAITRE, Sophie; BRIET, Claire; DIAZ-SOTO, Gonzalo; BONNEVILLE, Fabrice; CASTINETTI, Frederic; GADELHA, Monica R.; SANTANA, Nathalie Oliveira; STELMACHOWSKA-BANAS, Maria; GUDBJARTSSON, Tomas; VILLAR-TAIBO, Rocio; ZORNITZKI, Taiba; TSHIBANDA, Luaba; PETROSSIANS, Patrick; BECKERS, AlbertContext Ectopic acromegaly is a consequence of rare neuroendocrine tumors (NETs) that secrete GHRH. This abnormal GHRH secretion drives GH and IGF-1 excess, with a clinical presentation similar to classical pituitary acromegaly. Identifying the underlying cause for the GH hypersecretion in the setting of ectopic GHRH excess is, however, essential for proper management both of acromegaly and the NET. Owing to the rarity of NETs, the imaging characteristics of the pituitary in ectopic acromegaly have not been analyzed in depth in a large series. Objective Characterize pituitary magnetic resonance imaging (MRI) features at baseline and after NET treatment in patients with ectopic acromegaly. Design Multicenter, international, retrospective. Setting Tertiary referral pituitary centers. Patients Thirty ectopic acromegaly patients having GHRH hypersecretion. Intervention None. Main outcome measure MRI characteristics of pituitary gland, particularly T2-weighted signal. Results In 30 patients with ectopic GHRH-induced acromegaly, we found that most patients had hyperplastic pituitaries. Hyperplasia was usually moderate but was occasionally subtle, with only small volume increases compared with normal ranges for age and sex. T2-weighted signal was hypointense in most patients, especially in those with hyperplastic pituitaries. After treatment of the NET, pituitary size diminished and T2-weighted signal tended to normalize. Conclusions This comprehensive study of pituitary MRI characteristics in ectopic acromegaly underlines the utility of performing T2-weighted sequences in the MRI evaluation of patients with acromegaly as an additional tool that can help to establish the correct diagnosis.
conferenceObject Acromegaly Due to Ectopic Secretion of GHRH Mimicking a GH-Secreting Pituitary Adenoma: The Role of Imaging and GHRH Assay(2014) SANTANA, Nathalie Oliveira; JALLAD, Raquel S.; DUARTE, Felipe H. G.; RIECHELMANN, Rachel Simoes Pimenta; RAVEROT, Veronique; TROUILLAS, Jacqueline; RAVEROT, Gerald; BRONSTEIN, Marcello D.- 25-Hydroxyvitamin D and TSH as Risk Factors or Prognostic Markers in Thyroid Carcinoma(2016) DANILOVIC, Debora Lucia Seguro; FERRAZ-DE-SOUZA, Bruno; FABRI, Amanda Wictky; SANTANA, Nathalie Oliveira; KULCSAR, Marco Aurelio; CERNEA, Claudio Roberto; MARUI, Suemi; HOFF, Ana OliveiraObjective The increasing incidence of thyroid nodules demands identification of risk factors for malignant disease. Several studies suggested the association of higher TSH levels with cancer, but influence of 25-hydroxyvitamin D (25OHD) is controversial. This study aimed to identify the relationship of thyroid cancer with higher TSH levels and hypovitaminosis D and to evaluate their influence on prognostic characteristics of papillary thyroid carcinomas (PTC). Methods We retrospectively evaluated 433 patients submitted to thyroidectomy for thyroid nodules. Patients were categorized according to quartiles of TSH and 25OHD levels. Clinicopathological features were analyzed. Results Subjects with thyroid carcinomas were more frequently male and younger compared to those with benign disease. Their median TSH levels were higher and adjusted odds-ratio (OR) for cancer in the highest-quartile of TSH (> 2.4 mUI/mL) was 2.36 (1.36-4.09). Although vitamin D deficiency/insufficiency was prevalent in our cohort (84%), no significant differences in 25OHD levels or quartile distribution were observed between benign and malignant cases. Among 187 patients with PTC, analyses of prognostic features revealed increased risk of lymph nodes metastases for subjects with highest-quartile TSH levels (OR = 3.7, p = 0.029). Decreased 25OHD levels were not overtly associated with poor prognosis in PTC. Conclusions In this cross-sectional cohort, higher TSH levels increased the risk of cancer in thyroid nodules and influenced its prognosis, particularly favoring lymph nodes metastases. On theother hand, no association was found between 25OHD levels and thyroid carcinoma risk or prognosis, suggesting that serum 25OHD determination may not contribute to risk assessment workup of thyroid nodules.
- Molecular profile of Hurthle cell carcinomas: recurrent mutations in the Wnt/beta-caten n pathway(2020) SANTANA, Nathalie Oliveira; LERARIO, Antonio Marcondes; SCHMERLING, Claudia Kliemann; MARUI, Suemi; ALVES, Venancio Avancini Ferreira; HOFF, Ana O.; KOPP, Peter; DANILOVIC, Debora Lucia SeguroObjective: Genomic alterations in Hurthle cell carcinomas (HCC) include chromosomal losses, mitochondria! DNA mutations, and changes in the expression profile of the PI3K-AKT-mTOR and Wnt/beta-catenin pathways. This study aimed at characterizing the mutational profile of HCC. Methods: Next-generation sequencing (NGS) of 40 HCC using a 102-gene panel including, among others, the MAPK, PI3K-AKT-mTOR, Wnt/beta-catenin, and Notch pathways. HCC was widely invasive in 57.5%, and lymph node and distant metastases were diagnosed in 5% and 7.5% of cases. During follow-up, 10% of patients presented with persistent/ recurrent disease, but there were no cancer-related deaths. Results: Genetic alterations were identified in 47.5% of HCC and comprised 190 single-nucleotide variants and 5 insertions/deletions. The Wnt/beta-catenin pathway was most frequently affected (30%), followed by MAPK (27.5%) and PI3K-AKT-mTOR (25%). FAT1 and APC were the most frequently mutated genes and present in 17.5%. RAS mutations were present in 12.5% but no BRAF mutation was found. There was no association between the mutational profile and clinicopathological features. Conclusions: This series of HCC presents a wide range of mutations in the Wnt/beta-catenin, MAPK and PI3K-AKT-mTOR pathways. The recurrent involvement of Wnt/beta-catenin pathway, particularly mutations in APC and FAT1, are of particular interest. The data suggest that mutated FAT1 may represent a potential novel driver in HCC tumorigenesis and that the Wnt/p-catenin pathway plays a critical role in this distinct thyroid malignancy.