MARIANNY NAZARETH SULBARAN NAVA
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conferenceObject KI-67 EXPRESSION CAN BE A MARKER OF AGRESSIVENESS OF DUODENAL DISEASE IN FAMILIAL ADENOMATOUS POLYPOSIS(2020) SULBARAN, Marianny; CAMPOS, Fabio G.; PAES, Vitor R.; ALVES, Venancio A.; KISHI, Humberto; MOURA, Eduardo G. de; BUSTAMANTE-LOPEZ, Leonardo A.; NAHAS, Sergio C.; RIBEIRO, Ulysses; COUDRY, Renata; SAFATLE, Adriana V.- Systematic review and meta-analysis of colon capsule endoscopy accuracy for colorectal cancer screening. An alternative during the Covid-19 pandemic?(2022) SULBARAN, Marianny; BUSTAMANTE-LOPEZ, Leonardo; BERNARDO, Wanderley; SAKAI, Christiano M.; SAKAI, Paulo; NAHAS, Sergio; MOURA, Eduardo G. H. deAim To determine the diagnostic accuracy of colon capsule endoscopy for colorectal cancer screening. Methods Studies that compared the diagnostic performance of colonoscopy and second-generation colon capsule endoscopy (CCE-2) for screening of asymptomatic patients aged 50-75 years were included. The primary outcomes were sensitivity, specificity, and positive and negative likelihood ratios for polyps and adenomas measuring at least 6 mm or 10 mm. Results Eight full-text studies that evaluated 1602 patients were included for systematic review. Of these, 840 (52.43%) patients participated in an opportunistic screening program. The pooled outcomes of CCE-2 for polyps at least 6 mm / 10 mm were (CI = confidence interval): sensitivity: 88% (95% CI: 0.84-0.91) / 88% (95% CI: 0.82-0.93), specificity: 94% (95% CI: 0.92-0.95) / 95.5% (95% CI: 0.94-0.97); positive likelihood ratio: 11.86 (95% CI: 5.53-25.46) / 23.07 (95% CI: 6.163-86.36); negative likelihood ratio: 0.14 (95% CI: 0.1-0.21) / 0.14 (95% CI: 0.09-0.21). The area under the summary receiver operating characteristic curve for polyps at least 6 and 10 mm was 96.3% and 96.7%, respectively. The only cancer missed by complete CCE-2 was shown at multiple frames in the unblinded review. In total, 125 (7.8%) patients presented mild adverse events mostly related to bowel preparation. Conclusion CCE-2 is demonstrated to be an effective and safe alternative method for colorectal cancer screening. Diagnostic performance of CCE-2 for polyps of at least 6 and 10 mm was similar. Completion rates still need to be improved.
conferenceObject SYSTEMATIC REVIEW AND META-ANALYSIS OF COLON CAPSULE ENDOSCOPY ACCURACY FOR COLORECTAL CANCER SCREENING. AN ALTERNATIVE DURING THE COVID ERA?(2021) SULBARAN, Marianny; BERNARDO, Wanderley M.; BUSTAMANTE-LOPEZ, Leonardo A.; SAKAI, Christiano M.; SAKAI, Paulo; NAHAS, Sergio C.; MOURA, Eduardo G. De- Diagnostic meta-analysis: Case study in oncology(2018) MARIANNY, S.; AFONSO, S.; LEONARDO, B.-L.Cancer represents a major public health problem worldwide. Although there have been significative advances against cancer in the last two decades, incidence and death rates are increasing for several cancer types, including liver and pancreas. Continued clinical and basic researches are needed to further improve clinical quality care and diminish mortality caused by malignancies. In this context meta-analysis of diagnostic test accuracy studies represents a reliable methodological tool that facilitates structured high-quality evidence for efficient evidence summary and optimized decision-making regarding oncologic diagnosis and prognosis. However, the relative unfamiliarity of diagnostic test accuracy methods and its interpretation represent a challenge to the clinician that must be overcome. Additionally, previous studies have highlighted a limited quality of the literature regarding assessment of reporting systematic reviews of oncologic diagnostic test accuracy studies. Improvement on the execution and reporting of systematic reviews of diagnostic studies is needed. In this chapter we will summarize specific strategies to simplify the methodological complex system for reporting and interpreting case studies in oncology that will clearly have a positive impact on the quality of systematic reviews and meta-analysis of oncologic diagnostic test accuracy studies. © Springer International Publishing AG, part of Springer Nature 2018.
- Upper gastrointestinal neoplasia in familial adenomatous polyposis: prevalence, endoscopic features and management(2019) CAMPOS, Fabio Guilherme; MARTINEZ, Augusto Real; SULBARAN, Marianny; BUSTAMANTE-LOPEZ, Leonardo Alfonso; SAFADE-RIBEIRO, Adriana VazBackground: To evaluate the prevalence of upper gastrointestinal (GI) polyps in familial adenomatous polyposis (FAP), and to discuss current therapeutic recommendations. Methods: Clinical, endoscopic, histological and treatment data were retrieved from charts of 102 patients [1958-2016]. Duodenal adenomatosis was classified according to Spigelman stages. Results: this series comprised 59 women (57.8%) and 43 men (42.1%) with a median age of 32.3 years. Patients underwent 184 endoscopic procedures, the first at a median age of 35.9 years (range, 13-75 years). Fundic gastric polyps (n=31; 30.4%) prevailed in the stomach. While only 5 adenomas were found in the stomach, 33 patients (32.4%) presented duodenal ones. Advanced lesions (n=13; 12.7%) were detected in the stomach (n=2) and duodenum (n=11). During follow-up, Spigelman stages improved in 6 (12.2%) patients, remained unchanged in 25 (51.0%) and worsened in 18 (36.7%). Carcinomas were diagnosed in the stomach and duodenum (4 lesions each, 3.9%), at median ages of 50.2 and 55.0 years, respectively. Advanced lesions and carcinomas were managed through local or surgical resections. Severe complications occurred in only 2 patients (one death). Enteroscopy in 21 patients revealed jejunal adenomas in 12, 11 of whom also presented duodenal adenomas. Conclusions: There is a high prevalence of upper GI adenomas and cancer in FAP. There were diagnosed fundic gastric polyps (30.4%), duodenal (32.4%) and jejunal adenomas (11.8%), respectively. One third of duodenal polyps progressed slowly throughout the study. The rates of advanced gastroduodenal lesions (12.7%) and cancer (7.8%) raise the need for continuous surveillance during follow-up.
conferenceObject ENDOSCOPIC ASSISTED COLOSTOMY WITH PERCUTANEOUS COLOPEXY: AN EXPERIMENTAL STUDY.(2015) BUSTAMANTE-LOPEZ, L.; SULBARAN, M.; SAKAI, P.; MOURA, E.; NAHAS, C.; MARQUES, C.; SAKAI, C.; CECCONELLO, I.; PINTO, R.; NAHAS, S.- Prevention of esophageal stricture after endoscopic submucosal dissection: a systematic review and meta-analysis(2016) OLIVEIRA, J. F.; MOURA, E. G. H.; BERNARDO, W. M.; IDE, E.; CHENG, S.; SULBARAN, M.; SANTOS, C. M. L.; SAKAI, P.Endoscopic submucosal dissection (ESD) of extensive superficial cancers of the esophagus may progress with high rates of postoperative stenosis, resulting in significantly decreased quality of life. Several therapies are performed to prevent this, but have not yet been compared in a systematic review. A systematic review of the literature and meta-analysis were performed using the MEDLINE, Embase, Cochrane, LILACS, Scopus, and CINAHL databases. Clinical trials and observational studies were searched from March 2014 to February 2015. Search terms included: endoscopy, ESD, esophageal stenosis, and esophageal stricture. Three retrospective and four prospective (three randomized) cohort studies were selected and involved 249 patients with superficial esophageal neoplasia who underwent ESD, at least two-thirds of the circumference. We grouped trials comparing different techniques to prevent esophagus stenosis post-ESD. We conducted different meta-analyses on randomized clinical trials (RCT), non-RCT, and global analysis. In RCT (three studies, n = 85), the preventive therapy decreased the risk of stenosis (risk difference = -0.36, 95 % CI -0.55 to -0.18, P = 0.0001). Two studies (one randomized and one non-randomized, n = 55) showed that preventative therapy lowered the average number of endoscopy dilatations (mean difference = -8.57, 95 % CI -13.88 to -3.25, P < 0.002). There were no significant differences in the three RCT studies (n = 85) in complication rates between patients with preventative therapy and those without (risk difference = 0.02, 95 % CI -0.09 to 0.14, P = 0.68). The use of preventive therapy after extensive ESD of the esophagus reduces the risk of stenosis and the number of endoscopic dilatations for resolution of stenosis without increasing the number of complications.
conferenceObject ADVANCED DUODENAL AND AMPULLARY ADENOMATOSIS IN A BRAZILIAN POPULATION OF FAMILIAL ADENOMATOUS POLYPOSIS: PROSPECTIVE CLINICAL AND MOLECULAR STUDY.(2017) NAVA, M. Sulbaran; CAMPOS, F.; RIBEIRO JUNIOR, U.; COUDRY, R.; MEIRELES, S.; LISBOA, B.; KISHI, H.; SAKAI, P.; MOURA, E. de; BUSTAMANTE-LOPEZ, L.; TOMITAO, M.; NAHAS, S.; RIBEIRO, A. Safatle