ANA CAROLINA PRADO RIBEIRO E SILVA
Projetos de Pesquisa
Unidades Organizacionais
Instituto do Câncer do Estado de São Paulo, Hospital das Clínicas, Faculdade de Medicina
69 resultados
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- Stromal myofibroblasts in squamous cell carcinoma of the tongue in young patients - a multicenter collaborative study(2014) FONSECA, Felipe Paiva; COLETTA, Ricardo Della; AZEVEDO, Marina Barbosa; RIBEIRO, Ana Carolina Prado; SOUBHIA, Ana Maria Pires; MIYAHARA, Glauco Issamu; CARLOS, Roman; FARTHING, Paula; HUNTER, Keith D.; SPEIGHT, Paul M.; VARGAS, Pablo Agustin; ALMEIDA, Oslei Paes; LOPES, Marcio Ajudarte; SANTOS-SILVA, Alan RogerObjective. The purpose of this study was to evaluate the presence of myofibroblasts, frequently associated with a more aggressive neoplastic behavior, in oral tongue squamous cell carcinoma (TSCC) of young patients and to compare with the distribution observed in older patients. Study Design. Tumor samples from 29 patients younger than 40 years old affected by TSCC were retrieved and investigated for the presence of stromal myofibroblasts by immunohistochemical reactions against a smooth muscle actin, and the results obtained were compared to TSCC cases affecting older patients. Results. No positive reaction could be found in the stromal areas devoid of neoplastic tissue, whereas myofibroblasts were present in 58.6% of the lesions in young patients and in 75.9% of the older ones. No significant difference was found when comparing the invasive front and the overall stroma of both groups, and no correlation could be obtained with stromal a smooth muscle actin expression, higher tumor grades or clinical stage (P > .05). Conclusion. There was no significant difference between the presence of stromal myofibroblasts of TSCC affecting young and old individuals.
- HIV-positive patients with oral Kaposi's sarcoma: An overall survival analysis of 31 patients(2021) GUEDES, Pablyanne Tereza Louzada; PONTES, Flavia Sirotheau Correa; PRADO-RIBEIRO, Ana Carolina; RODRIGUES-OLIVEIRA, Leticia; BRANDAO, Thais Bianca; SOUZA, Lucas Lacerda de; ALVES, Barbara Waleria Goncalves; LOPES, Marcio Ajudarte; SANTOS-SILVA, Alan Roger; MONTEIRO, Julius Caesar Mendes Soares; ALMEIDA, Oslei Paes de; PONTES, Helder Antonio RebeloObjective. The aim of this study was to evaluate the influence of viral load and lymphocyte count on survival of patients who presented with human immunodeficiency virus (HIV)-associated oral Kaposi's sarcoma. Study Design. Thirty-one cases (from January 2010 to December 2019) of oral Kaposi's sarcoma in patients with HIV from 2 oral pathology centers in Brazil were reviewed, considering clinical data and correlation of viral load and lymphocyte count with overall survival. Overall survival rates were estimated by a Kaplan-Meier analysis and compared using a log-rank test. The factors introduced stepwise into a Cox proportional hazard model to identify the independent predictors of survival. A P value <.05 was considered significant. Result. Most of the patients were males (90.3%) with a mean age of 32.4 years (range, 19-58). Hard palate, soft palate, and tongue were the most affected sites. Treatment, viral load >999 copies/mL, CD4(+) level <= 200 cells/mm(3), CD4(+)/CD8(+) level <= 0.39 cells/mm(3), and CD4(+) nadir level <50 cells/mm(3) were related to overall survival. Conclusions. Survival of patients affected by oral HIV-associated Kaposi's sarcoma is influenced by treatment, viral load, CD4(+), CD4(+)/CD8(+), and CD4(+) nadir count.
- The impact of radiation caries on morbidity and mortality outcomes of head and neck squamous cell carcinoma patients(2024) PALMIER, Natalia Rangel; PRADO-RIBEIRO, Ana Carolina; MARIZ, Bruno Augusto Linhares Almeida; RODRIGUES-OLIVEIRA, Leticia; PAGLIONI, Mariana de Pauli; NAPIMOGA, Juliana Trindade Clemente; PEDROSO, Caique Mariano; MORAIS-FARIA, Karina; OLIVEIRA, Maria Cecilia Querido de; VECHIATO-FILHO, Aljomar Jose; BRANDAO, Thais Bianca; SANTOS-SILVA, Alan RogerAimsRadiation caries (RC) is a highly prevalent and chronic complication of head and neck radiotherapy (HNRT) and presents a challenge for clinicians and patients. The present study aimed to assess the impact of RC on the morbidity and mortality outcomes of head and neck squamous cell carcinoma (HNSCC) patients. Methods and ResultsPatients were divided into three groups: (1) RC (n = 20), (2) control (n = 20), and (3) edentulous (n = 20). Information regarding the number of appointments, dental procedures, osteoradionecrosis (ORN), prescriptions, and hospital admissions were collected. Mortality outcomes were assessed through disease-free survival (DFS) and overall survival (OS) rates. RC patients required more dental appointments (p < .001), restorations (p < .001), extractions (p = .001), and antibiotic and analgesic prescriptions (p < .001). Kaplan-Meier subgroup analyses showed a significantly increased risk of ORN in RC compared to edentulous patients (p = .015). RC patients presented lower DFS rates (43.2 months) than the control and edentulous groups (55.4 and 56.1 months, respectively). ConclusionsRC impacts morbidity outcomes among cancer survivors due to increased demand for medication prescriptions, multiple specialized dental appointments, invasive surgical treatments, increased risk of ORN, and increased need for hospital admissions.
- Oral Management of Cancer Patients After Multimodality Therapy(2023) PRADO-RIBEIRO, A. C.; SANTOS-SILVA, A. R.; FONSECA, F. P.; SCARINI, J. F.; INNOCENTINI, L. M. A. R.; BRANDãO, T. B.No currently available anticancer treatment, whether radiotherapy or chemotherapy, can kill neoplastic cells without affecting normal cells. In this context, the oral mucosa epithelium is susceptible to acute and chronic toxicities of antineoplastic treatment. This chapter offers an update on the main oral toxic effects of radiotherapy and chemotherapy and how to adequate individualize treatment based on the recommendations of preventative and interventional treatments for these patients. © The Editor(s) (if applicable) and The Author(s), under exclusive license to Springer Nature Switzerland AG 2023.
- Clinical outcomes of dental implants in head and neck cancer patients: An overview(2023) MARQUES, Nelson Pereira; PEREZ-DE-OLIVEIRA, Maria Eduarda; NORMANDO, Ana Gabriela Costa; MARQUES, Nadia Carolina Teixeira; EPSTEIN, Joel B.; MIGLIORATI, Cesar A.; MARTELLI JUNIOR, Hercilio; RIBEIRO, Ana Carolina Prado; ROCHA, Andre Caroli; BRANDAO, Thais Bianca; SANCHEZ, Francisco German Villanueva; GUEIROS, Luiz Alcino Monteiro; LOPES, Marcio Ajudarte; SANTOS-SILVA, Alan RogerObjective. The aim of this study was to evaluate the clinical outcomes of dental implants (DIs) in patients with head and neck can-cer (HNC) treated with radiotherapy (RT), isolated chemotherapy, or bone modifying agents (BMAs). Study Design. This study was registered in the Prospective Register of Systematic Reviews (CRD42018102772); conducted via the Preferred Reporting Items for Systematic Reviews and Meta-Analyses checklist; and based on PubMed, Scopus, Embase, Cochrane Library, Web of Science, and gray literature searches. The selection of studies was performed in 2 phases by 2 independent reviewers. The risk of bias (RoB) was assessed by the Measurement Tool to Assess the Methodological Quality of Systematic Reviews 2. Results. Twenty systematic reviews were included in the qualitative analysis. The majority scored as having high RoB (n = 11). Pri-mary DIs placement in the mandible of patients with HNC subjected to RT doses <50 Gy was associated with better survival rates. Conclusions. The placements of DIs could be considered safe in patients with HNC in sites of alveolar bone that received RT (<5000 Gy); however, no conclusions could be made in patients with cancer managed by chemotherapy or BMAs. Due to the heterogeneity of studies included, the recommendation for DIs placement in patients with cancer should be carefully considered. Future better controlled randomized clinical trials are required to provide enhanced clinical guidelines for best patient care. (Oral Surg Oral Med Oral Pathol Oral Radiol 2023;136:42-53)
- The performance of digital microscopy for primary diagnosis in human pathology: a systematic review(2019) ARAUJO, Anna Luiza Damaceno; ARBOLEDA, Lady Paola Aristizabal; PALMIER, Natalia Rangel; FONSECA, Jessica Montenegro; PAGLIONI, Mariana de Pauli; GOMES-SILVA, Wagner; RIBEIRO, Ana Carolina Prado; BRANDAO, Thais Bianca; SIMONATO, Luciana Estevam; SPEIGHT, Paul M.; FONSECA, Felipe Paiva; LOPES, Marcio Ajudarte; ALMEIDA, Oslei Paes de; VARGAS, Pablo Agustin; TROCONIS, Cristhian Camilo Madrid; SANTOS-SILVA, Alan RogerValidation studies of whole slide imaging (WSI) systems produce evidence regarding digital microscopy (DM). This systematic review aimed to provide information about the performance of WSI devices by evaluating intraobserver agreement reported in previously published studies as the best evidence to elucidate whether DM is reliable for primary diagnostic purposes. In addition, this review delineates the reasons for the occurrence of discordant diagnoses. Scopus, MEDLINE/PubMed, and Embase were searched electronically. A total of 13 articles were included. The total sample of 2145 had a majority of 695 (32.4%) cases from dermatopathology, followed by 200 (9.3%) cases from gastrointestinal pathology. Intraobserver agreements showed an excellent concordance, with values ranging from 87% to 98.3% ( coefficient range 0.8-0.98). Ten studies (77%) reported a total of 128 disagreements. The remaining three studies (23%) did not report the exact number and nature of disagreements. Borderline/challenging cases were the most frequently reported reason for disagreements (53.8%). Six authors reported limitations of the equipment and/or limited image resolution as reasons for the discordant diagnoses. Within these articles, the reported pitfalls were as follows: difficulties in the identification of eosinophilic granular bodies in brain biopsies; eosinophils and nucleated red blood cells; and mitotic figures, nuclear details, and chromatin patterns in neuropathology specimens. The lack of image clarity was reported to be associated with difficulties in the identification of microorganisms (e.g., Candida albicans, Helicobacter pylori, and Giardia lamblia). However, authors stated that the intraobserver variances do not derive from technical limitations of WSI. A lack of clinical information was reported by four authors as a source for disagreements. Two studies (15.4%) reported poor quality of the biopsies, specifically small size of the biopsy material or inadequate routine laboratory processes as reasons for disagreements. One author (7.7%) indicated the lack of immunohistochemistry and special stains as a source for discordance. Furthermore, nine studies (69.2%) did not consider the performance of the digital methodlimitations of the equipment, insufficient magnification/limited image resolutionas reasons for disagreements. To summarize the pitfalls of digital pathology practice and better address the root cause of the diagnostic discordance, we suggest a Categorization for Digital Pathology Discrepancies to be used in further validations studies. Among 99 discordances, only 37 (37.3%) had preferred diagnosis rendered by means of WSI. The risk of bias and applicability concerns were judged with the QUADAS-2. Two studies (15.4%) presented an unclear risk of bias in the sample selection domain and 2 (15.4%) presented a high risk of bias in the index test domain. Regarding applicability, all studies included were classified as a low concern in all domains. The included studies were optimally designed to validate WSI for general clinical use, providing evidence with confidence. In general, this systematic review showed a high concordance between diagnoses achieved by using WSI and conventional light microscope (CLM), summarizes difficulties related to specific findings of certain areas of pathologyincluding dermatopathology, pediatric pathology, neuropathology, and gastrointestinal pathologyand demonstrated that WSI can be used to render primary diagnoses in several subspecialties of human pathology.
- Extranodal NK/T cell lymphoma, nasal type: An updated overview(2021) SANCHEZ-ROMERO, Celeste; BOLOGNA-MOLINA, Ronell; ALMEIDA, Oslei Paes de; SANTOS-SILVA, Alan Roger; PRADO-RIBEIRO, Ana Carolina; BRANDAO, Thais Bianca; CARLOS, RomanExtranodal NK/T-cell lymphoma, nasal type (ENKTCL-NT) is an aggressive malignancy associated with Epstein Barr virus infection, with a geographic and racial predilection for some Asian and Latin American countries. ENKTCL-NT manifests as a necrotic process affecting nasal or upper aerodigestive structures and, rarely, extranasal sites such as skin, and the gastrointestinal tract. ENKTCL-NT was characterized by its poor prognosis irrespective of clinical stage and therapy. However, during the last two decades, advances in its clinicopathologic, genetic and molecular characterization have been achieved, as have changes in the chemotherapy regimens that, in combination with radiotherapy, are significantly improving the survival of these patients, especially in initial stages. For these reasons, we present an overview of the historical background of ENKTCL-NT along with an updated review of its potential etiological factors, clinicopathologic and molecular features, as well as its prognostic models, current treatment protocols, and future directions on potential promising therapeutic approaches.
- Impact of Clustering Oral Symptoms in the Pathogenesis of Radiation Caries: A Systematic Review(2020) VASCONCELLOS, Adriele Ferreira Gouvea; PALMIER, Natalia Rangel; RIBEIRO, Ana Carolina Prado; NORMANDO, Ana Gabriela Costa; MORAIS-FARIA, Karina; GOMES-SILVA, Wagner; VECHIATO FILHO, Aljomar Jose; GOES, Mario Fernando de; LEME, Adriana Franco Paes; BRANDAO, Thais Bianca; LOPES, Marcio Ajudarte; MARSH, Philip D.; SANTOS-SILVA, Alan RogerRadiation-related caries (RRC) is a disease with a high potential for destruction of the dentition, which impairs quality of life in head-and-neck (HN) cancer (HNC) patients who undergo radiotherapy. In light of the recently described ""clustering of oral symptoms theory,"" the present systematic review (PROSPERO CRD42019132709) aims to assess HN and gastrointestinal (GI) symptom clusters among HNC patients and discusses how these indirect effects of cancer therapy play a pivotal role in the pathophysiology of RRC. The search was performed at PubMed, Scopus, and Embase and resulted in 11 studies that met the inclusion criteria. Data extraction was performed with respect to the presence of HN/GI symptom clusters among HNC patients. The methodological data of the studies included were assessed using the MAStARI and GRADE instruments. The most prevalent reported HN symptoms were dysphagia, xerostomia, and pain. Taste alterations and fatigue were also commonly reported by the patients. Loss of appetite and weight loss were regularly reported in the studies, as well as nausea and vomiting. The results of the present study suggest that HNC treatment generates clusters of oral symptoms, leading to dietary changes, impaired oral hygiene, enamel fragility, and a highly cariogenic oral environment, which may impact the risk for RRC. A better understanding of oral symptom clustering could be of considerable clinical significance for the oral health and quality of life of HNC patients. Therefore, contemporary protocols of RRC prevention must take this broader treatment scenario of symptom clusters such as oral side effects into account.
- Impact of tumor site on the prognosis of salivary gland neoplasms: A systematic review and meta-analysis(2021) SANTOS, Erison Santana dos; RODRIGUES-FERNANDES, Carla Isabelly; SPEIGHT, Paul M.; KHURRAM, Syed Ali; ALSANIE, Ibrahim; NORMANDO, Ana Gabriela Costa; PRADO-RIBEIRO, Ana Carolina; BRANDAO, Thais Bianca; KOWALSKI, Luiz Paulo; GUERRA, Eliete Neves Silva; LOPES, Marcio Ajudarte; VARGAS, Pablo Agustin; SANTOS-SILVA, Alan Roger; LEME, Adriana Franco PaesIn numerous types of cancer, the primary tumor site can show a correlation with disease behavior and survival outcomes. In salivary gland tumors (SGTs) this association remains controversial. This study assessed the association between primary sites of SGTs and prognosis. Studies from five databases were assessed and a metaanalysis was performed using studies that presented 95 % confidence interval (95 % CI), hazard ratio (HR) and survival analysis. Gathered information from 46,361 patients showed that site had a prognostic impact on SGTs. Tumors involving minor salivary glands showed worse overall survival (HR = 1.60; 95 % CI = 1.17-2.19; p = 0.003), disease-specific survival (HR=1.63; 95 % CI = 1.12-2.37; p = 0.01), and cause-specific survival (HR=2.10; 95 % CI = 1.72-2.55; p = 0.00001). Tumors from major salivary glands showed better recurrencefree survival (HR=2.31; 95 % CI = 1.77-3.02; p = 0.00001), and locoregional control of disease (HR=2.66; 95 % CI = 1.20-5.91; p = 0.02). Our results showed that the primary site of SGTs has an impact on patient prognosis.
- Combining discovery and targeted proteomics reveals a prognostic signature in oral cancer(2018) CARNIELLI, Carolina Moretto; MACEDO, Carolina Carneiro Soares; ROSSI, Tatiane De; GRANATO, Daniela Campos; RIVERA, Cesar; DOMINGUES, Romenia Ramos; PAULETTI, Bianca Alves; YOKOO, Sami; HEBERLE, Henry; BUSSO-LOPES, Ariane Fidelis; CERVIGNE, Nilva Karla; SAWAZAKI-CALONE, Iris; MEIRELLES, Gabriela Vaz; MARCHI, Fabio Albuquerque; TELLES, Guilherme Pimentel; MINGHIM, Rosane; RIBEIRO, Ana Carolina Prado; BRANDAO, Thais Bianca; CASTRO JR., Gilberto de; GONZALEZ-ARRIAGADA, Wilfredo Alejandro; GOMES, Alexandre; PENTEADO, Fabio; SANTOS-SILVA, Alan Roger; LOPES, Marcio Ajudarte; RODRIGUES, Priscila Campioni; SUNDQUIST, Elias; SALO, Tuula; SILVA, Sabrina Daniela da; ALAOUI-JAMALI, Moulay A.; GRANER, Edgard; FOX, Jay W.; COLETTA, Ricardo Della; LEME, Adriana Franco PaesDifferent regions of oral squamous cell carcinoma (OSCC) have particular histopathological and molecular characteristics limiting the standard tumor-node-metastasis prognosis classification. Therefore, defining biological signatures that allow assessing the prognostic outcomes for OSCC patients would be of great clinical significance. Using histopathology-guided discovery proteomics, we analyze neoplastic islands and stroma from the invasive tumor front (ITF) and inner tumor to identify differentially expressed proteins. Potential signature proteins are prioritized and further investigated by immunohistochemistry (IHC) and targeted proteomics. IHC indicates low expression of cystatin-B in neoplastic islands from the ITF as an independent marker for local recurrence. Targeted proteomics analysis of the prioritized proteins in saliva, combined with machine-learning methods, highlights a peptide-based signature as the most powerful predictor to distinguish patients with and without lymph node metastasis. In summary, we identify a robust signature, which may enhance prognostic decisions in OSCC and better guide treatment to reduce tumor recurrence or lymph node metastasis.