FILOMENA MARINO CARVALHO
Projetos de Pesquisa
Unidades Organizacionais
Departamento de Patologia, Faculdade de Medicina - Docente
Instituto Central, Hospital das Clínicas, Faculdade de Medicina - Médico
LIM/14 - Laboratório de Investigação em Patologia Hepática, Hospital das Clínicas, Faculdade de Medicina
Instituto Central, Hospital das Clínicas, Faculdade de Medicina - Médico
LIM/14 - Laboratório de Investigação em Patologia Hepática, Hospital das Clínicas, Faculdade de Medicina
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conferenceObject INFLUENCE OF BODY MASS INDEX ON CLINICOPATHOLOGICAL PRESENTATION OF ENDOMETRIAL CARCINOMAS(2013) CARVALHO, J. P.; ANTON, C.; ARAUJO, M. P.; CARVALHO, F. M.conferenceObject CLINICOPATHOLOGICAL FEATURES OF ENDOMETRIAL CARCINOMA IN YOUNG AND OLD WOMEN(2013) ANTON, C.; CARVALHO, F. M.; CARVALHO, J. P. M.; FAVERO, G. M.; CARVALHO, J. P.conferenceObject LYMPHOVASCULAR SPACE INVASION IS HIGHLY ASSOCIATED WITH LYMPH NODE METASTASIS IN ENDOMETRIAL CANCER(2013) CARVALHO, F. M.; ANTON, C.; SADALLA, J. C.; AGUIAR, F. N.; CARVALHO, J. P.- Localization of metastasis within the sentinel lymph node biopsies: a predictor of additional axillary spread of breast cancer?(2013) ALVARENGA, César Augusto; SANTOS, César Cabello dos; ALVARENGA, Marcelo; PARAVIDINO, Paula Itagyba; MORAIS, Sirlei Siani; BRENELLI, Henrique Benedito; CARVALHO, Filomena Marino dePURPOSE: To explore the relationship between morphological characteristics and histologic localization of metastasis within sentinel lymph nodes (SLN) and axillary spread in women with breast cancer. METHODS: We selected 119 patients with positive SLN submitted to complete axillary lymph node dissection from July 2002 to March 2007. We retrieved the age of patients and the primary tumor size. In the primary tumor, we evaluated histologic and nuclear grade, and peritumoral vascular invasion (PVI). In SLNs we evaluated the size of metastasis, their localization in the lymph node, number of foci, number of involved lymph nodes, and extranodal extension. RESULTS: Fifty-one (42.8%) patients had confirmed additional metastasis in non-sentinel lymph nodes (NLSN). High histologic grade, PVI, intraparenchymatous metastasis, extranodal neoplastic extension and size of metastasis were associated with positive NLSN. SLN metastasis affecting the capsule were associated to low risk incidence of additional metastasis. After multivariate analysis, PVI and metastasis size in the SLN remained as the most important risk factors for additional metastasis. CONCLUSIONS:The risk of additional involvement of NSLN is higher in patients with PVI and it increases progressively according the histologic localization in the lymph node, from capsule, where the afferent lymphatic channel arrives, to the opposite side of capsule promoting the extranodal extension. Size of metastasis greater than 6.0 mm presents higher risk of additional lymph node metastasis.
- Basal cytokeratin as a potential marker of low risk of invasion in ductal carcinoma in situ(2013) AGUIAR, Fernando N.; MENDES, Henrique N.; CIRQUEIRA, Cinthya S.; BACCHI, Carlos E.; CARVALHO, Filomena M.OBJECTIVES: Biological markers that predict the development of invasive breast cancer are needed to improve personalized therapy for patients diagnosed with ductal carcinoma in situ. We investigated the role of basal cytokeratin 5/6 in the risk of invasion in breast ductal carcinoma in situ. METHODS: We constructed tissue microarrays using 236 ductal carcinoma in situ samples: 90 pure samples (group 1) and 146 samples associated with invasive carcinoma (group 2). Both groups had similar nuclear grades and were obtained from patients of similar ages. The groups were compared in terms of estrogen (ER) and progesterone receptor (PR) status, human epidermal growth factor receptor 2 (HER2) expression, cytokeratin 5/6 immunostaining, human epidermal growth factor receptor 1 (EGFR) membrane staining and molecular subtype, as indicated by their immunohistochemistry profiles. RESULTS: ER/PR-negative status was predictive of invasion, whereas HER2 superexpression and cytokeratin 5/6-positive status were negatively associated with invasion. Among the high-grade ductal carcinoma in situ cases, a triple-positive profile (positive for estrogen receptor, progesterone receptor, and HER2) and cytokeratin 5/6 expression by neoplastic cells were negatively associated with invasion. In the low-grade ductal carcinoma in situ subgroup, only cytokeratin 5/6 expression exhibited a negative association with the probability of invasion. CONCLUSION: The immunohistochemical expression of cytokeratin 5/6 by ductal carcinoma in situ epithelial cells may provide clinically useful information regarding the risk of progression to invasive disease.
conferenceObject COMPARISON OF CLINICOPATHOLOGICAL CHARACTERISTICS BETWEEN GRADE 3 ENDOMETRIOID AND SEROUS/CLEAR CELLS ENDOMETRIAL ADENOCARCINOMA(2013) CARVALHO, F. M.; ANTON, C.; SILVA, A. Silva e; CARVALHO, J. P. M.; AGUIAR, F. N.; CARVALHO, J. P.- Functional endometrial polyps in infertile asymptomatic patients: a possible evolution of vascular changes secondary to endometritis(2013) CARVALHO, Filomena Marino; AGUIAR, Fernando Nalesso; TOMIOKA, Renato; OLIVEIRA, Ricardo M. de; FRANTZ, Nibo; UENO, JojiObjective: Functional polyps and chronic endometritis are among the most common abnormalities seen in the endometrium of patients with implantation failures and recurrent miscarriages. In this study we describe morphological vascular changes in endometrial samples from asymptomatic infertile patients and their association with chronic endometritis and polyp. Study design: We selected 435 asymptomatic infertility patients submitted to office-based diagnostic hysteroscopy and endometrial biopsy. We described vascular changes and searched for histologic signs of endometritis and functional polyps in the endometrial samples. We explored the associations between these conditions. Results: Signs of endometritis, vascular changes and polyps were identified in 176 (40.5%), 168 (38.6%) and 102 (23.4%) cases, respectively. There was a significant association between endometritis and vascular changes. The more frequent vascular alteration (70%) was the hyaline thickening of vessels, a morphological pattern very similar to the thick-walled vessels of polyps. Polyps were associated with endometritis in 28 (27.4%) cases and with other vascular changes besides the vascular stalk in 14(13.7%). All the polyps with vascular changes had histologic evidence of endometritis. There was a significant association between inflammatory phenomena and vascular changes, even among cases of polyps. Conclusions: Endometrial samples from infertile patients present a broad spectrum of vascular changes, most of them associated with endometritis. This association is also identified in functional polyps. Our results suggest that these alterations may be etiologically related. It is possible that the vessel axis of functional polyps actually may originate from the evolution of the vascular changes associated with endometritis. This would place functional polyps among the spectrum of inflammatory endometrial diseases.
- Immunohistochemistry Applied to the Differential Diagnosis Between Ductal and Lobular Carcinoma of the Breast(2013) MOURA, Rafael de Deus; WLUDARSKI, Sheila C. L.; CARVALHO, Filomena M.; BACCHI, Carlos E.The distinction between classic lobular and ductal carcinoma, both in situ and invasive, has important therapeutic and management implications. Most ductal and lobular carcinomas are distinguished readily on hematoxylin-eosin-stained sections because of distinct histomorphologic features. In cases with ambiguous morphologic features, however, categorization in one or another type can be a challenge. Several immunohistochemical markers, including epithelial cadherin, p120, beta-catenin, and low-molecular-weight and high-molecular-weight cytokeratins among others, have been introduced to help better discriminate between lobular neoplasia and ductal carcinoma. In this critical review of the literature, we comment about the usefulness and the limitations of these markers to improve the accuracy in the differential diagnosis of breast pathology.
- Comparison of nuclear grade and immunohistochemical features in situ and invasive components of ductal carcinoma of breast(2013) AGUIAR, Fernando Nalesso; MENDES, Henrique Nogueira; BACCHI, Carlos E.; CARVALHO, Filomena MarinoPURPOSE:To compare the prognostic and predictive features between in situ and invasive components of ductal breast carcinomas. METHODS:We selected 146 consecutive breast samples with ductal carcinoma in situ (DCIS) associated with adjacent invasive breast carcinoma (IBC). We evaluated nuclear grade and immunohistochemical expression of estrogen receptor (ER), progesterone receptor (PR), human epidermal growth factor receptor 2 (HER2), cytokeratin 5/6 (CK5/6), and epidermal growth factor receptor (EGFR) in both components, in situ and invasive, and the Ki-67 percentage of cells in the invasive part. The DCIS and IBC were classified in molecular surrogate types determined by the immunohistochemical profile as luminal (RE/PR-positive/ HER2-negative), triple-positive (RE/RP/HER2-positive), HER2-enriched (ER/PR-negative/HER2-positive), and triple-negative (RE/RP/HER2-negative). Discrimination between luminal A and luminal B was not performed due to statistical purposes. Correlations between the categories in the two groups were made using the Spearman correlation method. RESULTS:There was a significant correlation between nuclear grade (p<0.0001), expression of RE/RP (p<0.0001), overexpression of HER2 (p<0.0001), expression of EGFR (p<0.0001), and molecular profile (p<0.0001) between components in situ and IBC. CK 5/6 showed different distribution in DCIS and IBC, presenting a significant association with the triple-negative phenotype in IBC, but a negative association among DCIS. CONCLUSIONS: Our results suggest that classical prognostic and predictive features of IBC are already determined in the preinvasive stage of the disease. However the role of CK5/6 in invasive carcinoma may be different from the precursor lesions.
conferenceObject INTRATUMORAL LYMPHOVASCULAR DENSITY IN MUCINOUS OVARIAN CARCINOMAS: LOWER VALUES IN METASTATIC TUMORS(2013) CARVALHO, F.; ALMEIDA, B. G. L.; FERREIRA, C. R.; ANTON, C.; CARVALHO, J. P.