SUEMI MARUI
Projetos de Pesquisa
Unidades Organizacionais
Instituto Central, Hospital das Clínicas, Faculdade de Medicina - Médico
LIM/25 - Laboratório de Endocrinologia Celular e Molecular, Hospital das Clínicas, Faculdade de Medicina - Líder
LIM/25 - Laboratório de Endocrinologia Celular e Molecular, Hospital das Clínicas, Faculdade de Medicina - Líder
12 resultados
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- 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 Molecular Investigation of PTEN and DREAM Genes in Patients with Multinodular Goiter(2014) SHINZATO, Amanda; LERARIO, Antonio M.; DANILOVIC, Debora Lucia Seguro; LIN, Chin Jia; MARUI, Suemi; TRARBACH, Ericka Barbosa- Oncogenic mutations in KEAP1 disturbing inhibitory Nrf2-Keap1 interaction: Activation of antioxidative pathway in papillary thyroid carcinoma(2018) DANILOVIC, Debora Lucia Seguro; MELLO, Evandro Sobroza de; FRAZZATO, Eliana Salgado Turri; WAKAMATSU, Alda; JORGE, Alexander Augusto de Lima; HOFF, Ana Oliveira; MARUI, SuemiBackgroundNuclear factor erythroid 2-like 2 (NFE2L2) encodes Nrf2, transcription factor of antioxidative genes. In the presence of reactive oxygen species, Keap1 (Kelch-ECH-associating protein-1) inhibitor complex undergoes conformational changes disrupting Keap1-Nrf2 binding and Nrf2 translocates into nucleus. We evaluated the presence of mutations in NFE2L2 and KEAP1 in papillary thyroid carcinomas (PTCs) and correlated them with clinical presentation. MethodsCoding regions of NFE2L2 and KEAP1 were sequenced in 131 patients with PTC. Clinical and histopathological features were analyzed. Immunohistochemical analysis of Nrf2 expression was performed in mutated carcinomas. ResultsAlthough no mutations were found in NFE2L2, missense mutations in KEAP1 were observed in 6 patients with PTC (4.6%). Immunohistochemistry showed increased Nrf2 expression in nuclei of all mutated carcinomas, which presented poor prognostic features in histopathology. ConclusionWe identified mutations in KEAP1 associated with Nrf2 overexpression in PTC. Mutations favored disruption of inhibitory interaction Nrf2-Keap1 to enable increased antioxidant Nrf2 activity, possibly with prognostic consequences.
- Rapid Control of T3 Thyrotoxicosis in Patients with Metastatic Follicular Thyroid Cancer Treated with Lenvatinib(2015) DANILOVIC, Debora Lucia Seguro; CAMARGO, Rosalinda Yossie Asato de; CASTRO JR., Gilberto; PAPADIA, Carla; MARUI, Suemi; HOFF, Ana Oliveira
- Thymic hyperplasia in Graves' disease(2011) DANILOVIC, Debora Lucia Seguro; MARTIN, Regina Matsunaga; CARUSO, Pedro; MARUI, Suemi
- Thyroid hormonal disturbances related to treatment of hepatitis C with interferon-alpha and ribavirin(2011) DANILOVIC, Debora Lucia Seguro; MENDES-CORREA, Maria Cassia; CHAMMAS, Maria Cristina; ZAMBRINI, Heverton; MARUI, SuemiOBJECTIVE: To characterize thyroid disturbances induced by interferon-alpha and ribavirin therapy in patients with chronic hepatitis C. INTRODUCTION: Interferon-alpha is used to treat chronic hepatitis C infections. This compound commonly induces both autoimmune and non-autoimmune thyroiditis. METHODS: We prospectively selected 26 patients with chronic hepatitis C infections. Clinical examinations, hormonal evaluations, and color-flow Doppler ultrasonography of the thyroid were performed before and during antiviral therapy. RESULTS: Of the patients in our study, 54% had no thyroid disorders associated with the interferon-alpha therapy but showed reduced levels of total T3 along with a decrease in serum alanine aminotransferase. Total T4 levels were also reduced at 3 and 12 months, but free T4 and thyroid stimulating hormone (TSH) levels remained stable. A total of 19% of the subjects had autoimmune interferon-induced thyroiditis, which is characterized by an emerge of antithyroid antibodies or overt hypothyroidism. Additionally, 16% had non-autoimmune thyroiditis, which presents as destructive thyroiditis or subclinical hypothyroidism, and 11% remained in a state of euthyroidism despite the prior existence of antithyroidal antibodies. Thyrotoxicosis with destructive thyroiditis was diagnosed within three months of therapy, and ultrasonography of these patients revealed thyroid shrinkage and discordant change in the vascular patterns. DISCUSSION: Decreases in the total T3 and total T4 levels may be related to improvements in the hepatocellular lesions or inflammatory changes similar to those associated with nonthyroidal illnesses. The immune mechanisms and direct effects of interferon-alpha can be associated with thyroiditis. CONCLUSION: Interferon-alpha and ribavirin induce autoimmune and non-autoimmune thyroiditis and hormonal changes (such as decreased total T3 and total T4 levels), which occur despite stable free T4 and TSH levels. A thyroid hormonal evaluation, including the analysis of the free T4, TSH, and antithyroid antibody levels, should be mandatory before therapy, and an early re-evaluation within three months of treatment is necessary as an appropriate follow-up.
- 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.
conferenceObject Molecular Investigation of PTEN and DREAM Genes in Patients with Multinodular Goiter(2014) SHINZATO, Amanda; LERARIO, Antonio M.; DANILOVIC, Debora Lucia Seguro; LIN, Chin Jia; MARUI, Suemi; TRARBACH, Ericka Barbosa- 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.
bookPart Tumores da Tireoide(2016) DANILOVIC, Debora Lucia Seguro; CAMARGO, Rosalinda Y. Asato de; MARUI, Suemi