FERNANDO NALESSO AGUIAR
Projetos de Pesquisa
Unidades Organizacionais
Instituto do Câncer do Estado de São Paulo, Hospital das Clínicas, Faculdade de Medicina - Médico
20 resultados
Resultados de Busca
Agora exibindo 1 - 10 de 20
- Association Between GATA3 and Histopathological and Immunohistochemical Parameters in Early-Infiltrating Breast Carcinomas(2022) SOUZA, Priscila de Medeiros; CARVALHO, Filomena Marino; AGUIAR, Fernando N.; GAGLIATO, Debora; BARROS, Alfredo Carlos Simoes Dornellas deObjective: This study evaluated the frequency of GATA-binding protein 3 (GATA3) expression in early breast cancer and its relationship with histopathological and immunohistochemical parameters. Materials and Methods: GATA3 was analysed by immunohistochemistry in histological sections of rumors from 105 female patients, with histological diagnosis of invasive breast carcinoma (BC), at clinical stages I, II and IIIA, who underwent primary surgical treatment. GATA3 nuclear expression was determined as the percentage of positive tumor cells and further categorized as high (positive expression in more than 95% of cells) or non-high (negative or low positive expression in up to 95% of rumor cells). GATA3 expression was analysed according to the patient age, tumor and node pathological stage, histological type, histological and nuclear grade, lymphovascular invasion, and estrogen receptor (ER), progesterone receptor (PR), androgen receptor (AR), human epidermal growth factor 2 (HERZ) status, and Ki-67 expression. Results: GATA3 expression was positive in 103 cases (98.1%). High expression was significantly associated with low histological and nuclear grade, positive hormonal receptors, and less proliferative activity based on Ki-67 expression. A prominent feature was that 94.7% of the ER-posirive/HER2-negative cases presented high-GATA3 expression, as 94.0% of the rumors showing high-GATA3 were ER-positive. In ER-negative/HER2-positive or ER-negative/HER2- negative, high-GATA3 was present in 25% while 75% were non-high-GATA3 compared with ER-positive/HER2- negative (4.1%) and ER-positive/HER2-positive (20%). Proliferative activity in triple-negative breast cancer tended to be higher among rumors with low-GKIA3, irrespective of AR expression. In the group of ER-positive/HER2-negative tumors only three cases were low-GATA3 (85% and 80%), both with high proliferative activity. Conclusion: High GATA3 expression is associated with favorable histopathologic and immunohistochemical BC prognostic factors.
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.- L1 Cell Adhesion Molecule (L1CAM) expression in endometrioid endometrial carcinomas: A possible pre-operative surrogate of lymph vascular space invasion(2018) FREITAS, Daniela de; AGUIAR, Fernando Nalesso; ANTON, Cristina; BACCHI, Carlos Eduardo; CARVALHO, Jesus Paula; CARVALHO, Filomena MarinoBackground Risk stratification of endometrial carcinomas is primarily based on surgical staging that requires extensive retroperitoneal lymph node dissection. One of the most powerful predictor of lymph node involvement is the lymph vascular space invasion (LVSI). The objective of this study was to determine the potential of L1 Cell Adhesion Molecule (L1CAM) to predict LVSI and its association with other risk factors in endometrioid endometrial carcinomas. Materials and methods We studied 47 consecutive patients aged 37-88 (61.34 +/- 10.52). Twenty-three patients (48.9%) were submitted to complete surgical staging. Nine patients (19.1%) underwent surgical staging without para-aortic dissection. Seven (14.9%) were submitted to hysterectomy with no lymph node dissection. Eight patients (17.0%) only had the biopsy material for analysis. The 32 patients submitted to lymphadenectomy were staged according to the FIGO system and classified among the risk categories of the ESMO-ESGO-ESTRO guidelines. The following histological characteristics were analyzed: tumor size (mm), depth of myometrial infiltration, presence of microcystic, elongated, and fragmented (MELF) pattern of myoinvasion, and lymph vascular space invasion (LVSI). Immunohistochemical analyses of mismatch repair (MMR) proteins MLH1, MSH2, MSH6, and PMS2, p53, and L1CAM were performed in formalin-fixed paraffin embedded whole tumor tissue sections. Results LVSI was identified in 26/41 (63,4%) of the cases. L1CAM was positive in 8/47 (17%) cases, all of them positive for LVSI and within the high-risk category of ESMO-ESGO-ESTRO. L1CAM-positive cases were associated with high histological grade and p53 aberrant immunohistochemical profile. Besides, it showed a trend to larger tumors, greater depth of myometrial infiltration, and with a higher frequency of the MELF pattern of myoinvasion. LVSI was also associated with FIGO stage, tumor size, depth of myometrial infiltration, and tumor grade. Conclusions L1CAM is highly associated with LVSI and could be used as a pre-operative predictor of lymph node involvement in endometrioid endometrial carcinomas.
conferenceObject A STRATEGY FOR THE TREATMENT OF ADVANCED VULVAR CANCER: INGUINO FEMORAL LYMPHADENECTOMY, CHEMORADIOTHERAPY AND VULVECTOMY(2016) DIAS, A. J. Ribeiro; MANCUSI, J. P.; DIAS, M. L. Genta; PIATO, D.; FARIA, M. B. de; MIGLINO, G.; SADALLA, J. C.; AGUIAR, F. N.; CARVALHO, J. P.; BARACAT, E. C.- Pathological macroscopic evaluation of breast density versus mammographic breast density in breast cancer conserving surgery(2023) REIS, Yedda Nunes; MOTA, Bruna Salani; MOTA, Rosa Maria Salani; SHIMIZU, Carlos; RICCI, Marcos Desiderio; AGUIAR, Fernando Nalesso; SOARES-JR, Jose Maria; BARACAT, Edmund Chada; FILASSI, Jose RobertoCorrelation between imaging and anatomopathological breast density has been superficially explored and is heterogeneous in current medical literature. It is possible that mammographic and pathological findings are divergent. The aim of this study is to evaluate the association between breast density classified by mammography and breast density of pathological macroscopic examination in specimens of breast cancer conservative surgeries. Post-hoc, exploratory analysis of a prospective randomized clinical trial of patients with breast cancer candidates for breast conservative surgery. Breast mammographic density (MD) was analyzed according to ACR BI-RADS (R) criteria, and pathologic macroscopic evaluation of breast density (PMBD) was estimated by visually calculating the ratio between stromal and fatty tissue. From 412 patients, MD was A in 291 (70,6%), B in 80 (19,4%) B, C in 35 (8,5%), and D in 6 (1,5%). Ninety-nine percent (201/203) of patients classified as A+B in MD were correspondently classified in PMBD. Conversely, only 18.7% (39/209) of patients with MD C+D were classified correspondently in PMBD (p < 0.001). Binary logistic regression showed age (OR 1.06, 1.01-1.12 95% CI, p 0.013) and nulliparity (OR 0.39, 0.17-0.96 95% CI, p 0.039) as predictors of A+B PMBD.Conclusion: Mammographic and pathologic macroscopic breast density showed no association in our study for breast C or D in breast image. The fatty breast was associated with older patients and the nulliparity decreases the chance of fatty breasts nearby 60%.
- CLINICOPATHOLOGICAL FEATURES ASSOCIATED WITH IMMUNOHISTOCHEMISTRY LOSS OF MISMATCH REPAIR PROTEIN MLH1 IN ENDOMETRIOID ENDOMETRIAL CARCINOMA(2019) FREITAS, D. de; AGUIAR, F. N.; ANTON, C.; BACCHI, C. E.; CARVALHO, J. P.; CARVALHO, F. M.
- Improved frozen section examination of the retroareolar margin for prediction of nipple involvement in breast cancer(2016) PIATO, J. R.; AGUIAR, F. N.; MOTA, B. S.; DORIA, M. T.; ALVES-JALES, R. D.; MESSIAS, A. P.; GONCALVES, R.; MANO, M. S.; SOARES, J. M.; RICCI, M. D.; FILASSI, J. R.; BARACAT, E. C.
- SPECT-CT-Guided Thoracoscopic Biopsy of Sentinel Lymph Nodes in the Internal Mammary Chain in Patients With Breast Cancer A Pilot Study(2016) PIATO, Jose Roberto Morales; FILASSI, Jose Roberto; VEGA, Alberto Jorge Monteiro Dela; COURA-FILHO, George Barberio; AGUIAR, Fernando Nalesso; PORCIUNCULA, Ligia Maria Teixeira Pereira; DORIA, Maira Teixeira; SOARES JR., Jose Maria; BARACAT, Edmund ChadaObjective: The objective of this study was to determine the impact of the use of single-photon emission computed tomography fused with computed tomography (SPECT-CT) on thoracoscopic biopsy of sentinel lymph nodes (SLNs) in the internal mammary chain in patients with breast cancer by evaluating resultant changes in staging and their clinical implications. Methods: Between September 2010 and January 2014, we performed lymphoscintigraphy-assisted thoracoscopic biopsy of the internal mammary chain SLN in 20 patients with breast cancer. Single-photon emission computed tomography fused with computed tomography was also used in 13 of these patients. The sentinel nodes were surgically identified with the aid of a gamma probe. Results: Sentinel lymph nodes were identified surgically in 19 of 20 patients. In the 13 patients in whom SPECT-CT was used, it readily identified SLNs, especially when they were located over an intercostal space. Change of staging occurred in three patients (15%), two of whom accordingly received adjuvant radiotherapy to the internal thoracic chain. Conclusions: Compared with lymphoscintigraphy alone, the use of SPECT-CT improves localization of the SLN in the internal mammary chain, allowing more accurate planning of each individual's treatment.
- Nipple-sparing mastectomy for early breast cancer: the importance of intraoperative evaluation of retroareolar margins and intra-nipple duct removal(2020) HEINZEN, Rebeca Neves; BARROS, Alfredo Carlos Simoes Dornellas de; CARVALHO, Filomena Marino; AGUIAR, Fernando Nalesso; NIMIR, Cristiane da Costa Bandeira Abrahao; JACOMO, Alfredo LuizBackground: Nipple-sparing mastectomy (NSM) is increasingly performed for breast cancer (BC) treatment. To ensure local control with this procedure, it is important to obtain clear surgical margins. Here, we aimed to estimate the confidence in intraoperative evaluation of the retroareolar margin (IERM) and the necessity of removing the intra-nipple ducts. Methods: In this retrospective cohort study, we evaluated 224 BC (infiltrating carcinoma 178, ductal carcinoma in situ 46) patients, who underwent NSM. IERM was determined via cytology and frozen sections. Following gland removal, the intra-nipple ducts were excised and embedded in paraffin for analysis. The retroareolar tissue was also paraffin-embedded and reanalyzed for definitive evaluation of retroareolar margins (DERM). The IERM predictive capacity in relation to DERM and the frequency of intra-nipple duct involvement were estimated. Results: IERM classified the sub-nipple areolar complex area as cancer-free in 219 cases (97.8%). The condition of clear retroareolar margin was confirmed by DERM in 216 cases (98.6%). The IERM accuracy was estimated as 98.6%. Ductal carcinoma in situ was detected in intra-nipple ducts using paraffin sections in 1.8% of the cases, despite dear IERM (4/219). Conclusions: In conclusion, IERM affords high accuracy and its results are suitable to manage the nipple-areolar complex. Nevertheless, some patients may retain residual disease in the intra-nipple ducts; thus, these ducts should ideally be removed during NSM.
conferenceObject An uncommon beta catenin gene deletion in a breast desmoid-type fibromatosis(2017) SOARES, I. Cauduro; VASCONCELOS, M. A. Pereira Silva; LIMA, L. G. Cernaglia Aureliano de; BATISTA, R. Pedroso; AGUIAR, F. Nalesso; SHIMIZU, C.; RICCI, M. Desiderio; FILASSI, J. R.