ROSSANA VERONICA MENDOZA LOPEZ
Projetos de Pesquisa
Unidades Organizacionais
Instituto do Câncer do Estado de São Paulo, Hospital das Clínicas, Faculdade de Medicina
LIM/24 - Laboratório de Oncologia Experimental, Hospital das Clínicas, Faculdade de Medicina
LIM/24 - Laboratório de Oncologia Experimental, Hospital das Clínicas, Faculdade de Medicina
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- Co-infection of sexually transmitted pathogens and Human Papillomavirus in cervical samples of women of Brazil(2017) AMORIM, Aline Teixeira; MARQUES, Lucas Miranda; CAMPOS, Guilherme Barreto; LOBAO, Tassia Neves; LINO, Vanesca de Souza; CINTRA, Ricardo Cesar; ANDREOLI, Maria Antonieta; VILLA, Luisa Lina; BOCCARDO, Enrique; BRAGA JUNIOR, Antonio Carlos Ricardo; LOPEZ, Rossana Veronica Mendoza; SANTOS, Djanilson Barbosa dos; SOUZA, Gerson Maciel de; ROMANO, Carla Cristina; TIMENETSKY, JorgeBackground: Some sexually transmitted infectious agents, such as Chlamydia trachomatis and Herpes simplex, cause local inflammation, and could contribute to Human Papillomavirus (HPV) and cervical lesion progression. Thus, the aim of this study was to determine any association between the presence of microorganisms of gynecological importance, sexual behavior, clinical and demographical variables to the development and progress of cervical lesions. Methods: One hundred and thirty-two women between 14 and 78 years and living at Vitoria da Conquista, Bahia, Brazil, were included (62 individuals with cervical lesions and 70 without lesions). They answered a questionnaire to provide data for a socioeconomic and sexual activity profile. Samples of cervical swabs were collected and analyzed by PCR to detect genital microorganisms and HPV. Quantitative PCR was used to detect and quantify Ureaplasma urealyticum and Ureaplasma parvum. Univariate and multiple logistic regression were performed to measure the association with the cervical lesions, and an odds ratio (OR) with 95% confidence intervals (95% CI) were calculated. The Mann-Whitney U test was also used to compare the microorganism load in the case and control groups. The significance level was 5% in all hypotheses tested. Results: Cervical lesions were associated with: women in a stable sexual relationship (OR = 14.21, 95% CI = 3.67-55.018), positive PCR for HPV (OR = 16.81, 95% CI = 4.19-67.42), Trichomonas vaginalis (OR = 8.566, 95% CI = 2.04-35.94) and Gardnerella vaginalis (OR = 6.13, 95% CI = 1.53-24.61), adjusted by age and qPCR for U. parvum. U. parvum load showed a statistical difference between the case and control groups (p-value = 0.002). Conclusion: Variables such as stable relationship, HPV, T. vaginalis, G. vaginalis were associated with cervical lesions in epidemiological studies. U. parvum load was higher in woman with cervical lesions compared with women without lesions. Additional studies are needed to better understand the role of these factors in cervical lesion development.
- Palliative cancer care: costs in a Brazilian quaternary hospital(2022) ROZMAN, Luciana Martins; CAMPOLINA, Alessandro Goncalves; LOPEZ, Rossana Mendoza; CHIBA, Toshio; SOAREZ, Patricia Coelho DePalliative care (PC) improves the quality of life of patients with diseases such as cancer, and several studies have shown a reduction in costs among patients who use PC services when compared with those receiving standard oncological treatments. Most studies on PC costs are carried out in high-income countries. There is a lack of these types of studies in middle-income and low-income countries and of better evidence about this intervention. Objective To describe resource utilisation and costs among patients with cancer in a Brazilian quaternary hospital by cancer localisation and per month of treatment before death. Methods This study is a description of retrospective costs to estimate the costs of formal healthcare sector associated with PCs, from the perspective of a public quaternary cancer hospital. Unit costs were estimated using microcosting and macrocosting approaches. Setting/Participants Patients older than 18 years old who died from 2010 to 2013 and who had at least two visits in PC and/or made use of hospice care. Results Among the 2985 patients included in the study, the average cost per patient was US$12 335, ranging from US$8269 for patients with pancreatic cancer to US$19 395 for patients with brain cancer. The main costing item was hospital admission (47.6% of the total cost), followed by hospice care (29.5%) and medical and other supplies (11.1%). Conclusions The study clarified the direct medical costs and the profile and use of resources of patients with cancer who need PC, and can help in the planning and allocation of resources in cancer care.
- Evaluation of Parotid Salivary Gland Echo Texture by Ultrasound Examinations and Correlation With Whole-Body Scintigraphy After Radioiodine Therapy in Patients With Differentiated Thyroid Carcinoma(2020) LIMA, Graziele Aparecida Simoes; LOPEZ, Rossana Veronica Mendoza; FREITAS, Ricardo Miguel Costa de; WILLEGAIGNON, Jose; SAPIENZA, Marcelo Tatit; CHAMMAS, Maria Christina; COURA-FILHO, George BarberioObjectives This study aimed to evaluate the echo texture of the parotid salivary glands before and after radioiodine therapy (RIT) using ultrasound (US) images in patients with differentiated thyroid cancer and to evaluate the correlations between post-RIT whole-body scintigraphy (WBS) images and US image patterns in salivary and cervical areas. Methods A retrospective study was performed with data on demographic and clinical information, US examinations, and WBS images collected through medical recordings. Results Comparing the US features before and after RIT, significant echo texture heterogeneity was found in 31.3% of all patients evaluated. When evaluated according to the level of iodine 131 (I-131) radioactivity (<5.6, 5.6-<9.3, and >= 9.3 GBq), echo texture heterogeneity was significantly associated with the 5.6-GBq I-131 radioactivity group (P < .001). No association was found for any level of I-131 post-RIT WBS uptake intensity and changes in US feature patterns. Conclusions Ultrasound may be a useful tool for evaluating chronic sialadenitis after RIT, and the I-131 uptake intensity using a routine post-RIT WBS is not associated with US echo texture changes.
- HNdb: an integrated database of gene and protein information on head and neck squamous cell carcinoma(2016) HENRIQUE, Tiago; SILVEIRA, Nelson Jose Freitas da; VOLPATO, Arthur Henrique Cunha; MIOTO, Mayra Mataruco; STEFANINI, Ana Carolina Buzzo; FARES, Adil Bachir; ANDRADE, Joao Gustavo da Silva Castro; MASSON, Carolina; LOPEZ, Rossana Veronica Mendoza; NUNES, Fabio Daumas; KOWALSKI, Luis Paulo; SEVERINO, Patricia; TAJARA, Eloiza HelenaThe total amount of scientific literature has grown rapidly in recent years. Specifically, there are several million citations in the field of cancer. This makes it difficult, if not impossible, to manually retrieve relevant information on the mechanisms that govern tumor behavior or the neoplastic process. Furthermore, cancer is a complex disease or, more accurately, a set of diseases. The heterogeneity that permeates many tumors is particularly evident in head and neck (HN) cancer, one of the most common types of cancer worldwide. In this study, we present HNdb, a free database that aims to provide a unified and comprehensive resource of information on genes and proteins involved in HN squamous cell carcinoma, covering data on genomics, transcriptomics, proteomics, literature citations and also cross-references of external databases. Different literature searches of MEDLINE abstracts were performed using specific Medical Subject Headings (MeSH terms) for oral, oropharyngeal, hypopharyngeal and laryngeal squamous cell carcinomas. A curated gene-to-publication assignment yielded a total of 1370 genes related to HN cancer. The diversity of results allowed identifying novel and mostly unexplored gene associations, revealing, for example, that processes linked to response to steroid hormone stimulus are significantly enriched in genes related to HN carcinomas. Thus, our database expands the possibilities for gene networks investigation, providing potential hypothesis to be tested. Database URL: http://www.gencapo.famerp.br/hndb
- Early Palliative Care and Its Impact on End-of-Life Care for Cancer Patients in Brazil(2018) ROZMAN, Luciana Martins; CAMPOLINA, Alessandro Goncalves; LOPEZ, Rossana Veronica Mendonca; KOBAYASHI, Silvia Takanohashi; CHIBA, Toshio; SOAREZ, Patricia Coelho deBackground: Integrating palliative care into standard oncology care has been recommended for cancer patients. Early palliative care is associated with less aggressive treatment at the end of life. Objective: To describe cancer patients receiving palliative care in Brazil, determining the time from entry into palliative care to death, and investigating whether late referral to palliative care is associated with aggressive end-of-life treatment. Design: This was a cross-sectional study of cancer patients receiving palliative care in Brazil. Setting/Subjects: Subjects were 2985 cancer patients 18 years of age who received at least two palliative care visits at the SAo Paulo State Cancer Institute, in the city of SAo Paulo, Brazil, and died between 2010 and 2013. Measurements: We evaluated the time from the first palliative care consult to death, stratifying cases by the timing of entry into palliative care (3 or <3 months before death). The associations between early palliative care and indicators of aggressive treatment were assessed by Pearson's chi-square test and Fisher's exact test. Results: The overall median time between entry into palliative care and death was 34 days (mean, 72 days) and was significantly shorter in 2013 than in 2010 (p<0.001). The number of emergency department visits was significantly lower among the patients who entered palliative care earlier (p<0.001). Conclusions: Among cancer patients in Brazil, late referral to palliative care is common. Patients who enter palliative care earlier appear to receive less aggressive end-of-life treatment.
- Prognostic value of integrin alpha V expression and localization pattern in invasive breast carcinomas(2022) CERQUEIRA, Otto Luiz Dutra; BOTELHO, Mayara Carolline Silva; FIORE, Ana Paula Zen Petisco; OSORIO, Cynthia Aparecida Bueno de Toledo; TOMASIN, Rebeka; MORAIS, Mauro Cesar Cafundo; LOPEZ, Rossana Veronica Mendoza; CARDOSO, Elaine Cristina; VILELLA-ARIAS, Santiago Andres; REIS, Eduardo Moraes; BRUNI-CARDOSO, AlexandreInvasion of surrounding stroma is an early event in breast cancer metastatic progression, and involves loss of cell polarity, loss of myoepithelial layer, epithelial-mesenchymal transition (EMT) and remodeling of the extracellular matrix (ECM). Integrins are transmembrane receptors responsible for cell-ECM binding, which triggers signals that regulate many aspects of cell behavior and fate. Changes in the expression, localization and pairing of integrins contribute for abnormal responses found in transformed epithelia. We analyzed 345 human breast cancer samples in tissue microarrays (TMA) from cases diagnosed with invasive breast carcinoma to assess the expression and localization pattern of integrin alpha V and correlation with clinical parameters. Patients with lower levels of integrin alpha V staining showed reduced cancer specific survival. A subset of cases presented a peripheral staining of integrin alpha V surrounding tumor cell clusters, possibly matching the remaining myoepithelial layer. Indeed, the majority of ductal carcinoma in situ (DCIS) components found in the TMA presented integrin alpha V at their periphery, whereas this pattern was mostly lost in invasive components, even in the same sample. The lack of peripheral integrin alpha V correlated with decreased cancer specific survival. In addition, we observed that the presence of integrin alpha V in the stroma was an indicative of poor survival and metastatic disease. Consistently, by interrogating publicly available datasets we found that, although patients with higher mRNA levels of integrin alpha V had increased risk of developing metastasis, high co-expression of integrin alpha V and a myoepithelial cell marker (MYH11) mRNA levels correlated with better clinical outcomes. Finally, a 3D cell culture model of non-malignant and malignant cells reproduced the integrin alpha V pattern seen in patient samples. Taken together, our data indicate that both the expression levels of integrin alpha V and its tissue localization in primary tumors have prognostic value, and thus, could be used to help predict patients at higher risk of developing metastasis.& nbsp;
- Local and systemic immunomodulatory mechanisms triggered by Human Papillomavirus transformed cells: a potential role for G-CSF and neutrophils(2017) ALVAREZ, Karla Lucia Fernandez; BELDI, Mariana; SARMANHO, Fabiane; ROSSETTI, Renata Ariza Marques; SILVEIRA, Caio Raony Farina; MOTA, Giana Rabello; ANDREOLI, Maria Antonieta; CARUSO, Eliana Dias de Carvalho; KAMILLOS, Marcia Ferreira; SOUZA, Ana Marta; MASTROCALLA, Haydee; CLAVIJO-SALOMON, Maria Alejandra; BARBUTO, Jose Alexandre Marzagao; LORENZI, Noely Paula; LONGATTO-FILHO, Adhemar; BARACAT, Edmund; LOPEZ, Rossana Veronica Mendoza; VILLA, Luisa Lina; TACLA, Maricy; LEPIQUE, Ana PaulaCervical cancer is the last stage of a series of molecular and cellular alterations initiated with Human Papillomavirus (HPV) infection. The process involves immune responses and evasion mechanisms, which culminates with tolerance toward tumor antigens. Our objective was to understand local and systemic changes in the interactions between HPV associated cervical lesions and the immune system as lesions progress to cancer. Locally, we observed higher cervical leukocyte infiltrate, reflected by the increase in the frequency of T lymphocytes, neutrophils and M2 macrophages, in cancer patients. We observed a strong negative correlation between the frequency of neutrophils and T cells in precursor and cancer samples, but not cervicitis. In 3D tumor cell cultures, neutrophils inhibited T cell activity, displayed longer viability and longer CD16 expression half-life than neat neutrophil cultures. Systemically, we observed higher plasma G-CSF concentration, higher frequency of immature low density neutrophils, and tolerogenic monocyte derived dendritic cells, MoDCs, also in cancer patients. Interestingly, there was a negative correlation between T cell activation by MoDCs and G-CSF concentration in the plasma. Our results indicate that neutrophils and G-CSF may be part of the immune escape mechanisms triggered by cervical cancer cells, locally and systemically, respectively.
- Association of Systemic Inflammatory and Immune Indices With Survival in Canine Patients With Oral Melanoma, Treated With Experimental Immunotherapy Alone or Experimental Immunotherapy Plus Metronomic Chemotherapy(2022) GARCIA, Jessica Soares; NOWOSH, Victor; LOPEZ, Rossana Veronica Mendoza; MASSOCO, Cristina de OliveiraAnalysis of the expression of inflammatory markers before starting treatment in human patients with cancer helps to predict outcomes and prognosis; however, there have been few studies on this topic in veterinary medicine. The present study aimed to evaluate inflammatory indices before treatment with autologous antitumor vaccine alone or this vaccine plus metronomic chemotherapy (MC) to predict response and prognosis. The indices included the neutrophil-lymphocyte ratio (NRL), platelet-lymphocyte ratio (PLR), monocyte-lymphocyte ratio (MLR), systemic immune-inflammation index (SII), C-reactive-protein-albumin ratio (CRP/ALB), lactate dehydrogenase level (LDH), frequency of blood lymphocyte subsets (CD4(+), CD8(+), Treg, and CD4/CD8 ratio) and frequency of blood myeloid-derived suppressor cells (MDSCs: monocytic [M]- MDSCs, and granulocytic [PMN]-MDSCs). Blood samples were collected from 25 dogs with oral melanoma treated with the autologous antitumor vaccine and from nine dogs that received MC plus vaccine before surgery. There were no statistically significant differences in the progression-free survival (PFS) or overall survival (OS) between the groups. In addition to the clinical stage, the CRP/ALB ratio and blood circulating Tregs in the univariate analysis showed an association with PFS and OS, and thus were selected for multivariable analysis. The CRP/ALB ratio was associated with PFS [hazard ratio (HR), 1.1; 95% confidence interval (CI), 1.0-1.1; p = 0.017] and OS [HR, 1; 95%CI, 1.0-1.1; p = 0.023]. Similarly, Treg was associated with PFS (HR, 1.6; 95% CI, 1.2-2.1; p = 0.001) and OS (HR, 1.6; 95% CI, 1.2-2.1; p = 0.001). Furthermore, canine patients with a CRP/ALB ratio above the cut-off point of 1.9 (established by receiver operating characteristic curve analysis) had worse PFS and OS, indicating the impact of the preoperative CRP/ALB ratio on the PFS and OS of dogs with oral melanoma. The CRP/ALB ratio and frequency of circulating Tregs are potential prognostic markers in dogs with oral melanoma.
- Altered Expression of CYSLTR1 is Associated With Adverse Clinical Outcome in Triple Negative Breast Tumors: An In Silico Approach(2023) CESPEDES, Andres Galindo; CONCEICAO, Mercia Patricia Ferreira; BASTOS, Daniel Rodrigues de; GRAZIA, Gabriela avila de; LEITE, Jean Michel Rocha Sampaio; NASCIMENTO, Renan Gomes do; FERREIRA, Matthew Thomas; LOPEZ, Rossana MendozaObjective: Triple negative breast cancer (TNBC) has high relapse rates due to dysregulated inflammatory signaling pathways and significant changes in the tumor microenvironment, probably influencing the failure of several therapies. The Cysteinyl Leukotriene Receptor 1 (CYSLTR1), a leukotriene modulator of inflammation, has been shown to play an important role in cancer pathogenesis and survival but few studies have been reported on its role in breast cancer. Materials and Methods: The present work was conducted using publicly available platforms that have omics data to assess the clinical potential of CYSLTR1 expression and its prognostic validation in large cohorts of samples from breast cancer patients. Web platforms containing clinical information, RNA-seq and protein data were selected to perform in silico analyses of the potential marker CYLSTR1. Added together, the platforms included modules for correlation, expression, prognosis, drug interactions, and construction of gene networks.Results: Kaplan-Meier curves revealed that reduced levels of CYSLTR1 corresponded to an unfavorable outcome for overall survival (p<0.005) as well as relapse-free survival (p<0.001) in the basal subtype. Additionally, CYSLTR1 was downregulated in breast tumor samples compared to adjacent healthy tissue (p<0.01) and the basal subtype exhibited the lowest expression of CYSLTR1 relative to the other subtypes (p<0.0001). Furthermore, gene networking analysis showed strong associations of CYSLTR1 with two protein-coding genes (P2RY10 and XCR1) when tested on a TNBC dataset. Conclusion: Our data highlighted the relevance of CYSLTR1 since it may play an important role in TNBC therapy. However, further in vitro and in vivo studies should be directed towards validating our findings in an effort to improve our understanding of TNBC pathology.
- The copy number variation of GSTM1 as a promising prognostic factor of oral squamous cell carcinoma(2022) FIRIGATO, Isabela; LOPEZ, Rossana V. M.; CURIONI, Otavio A.; ANTONIO, Juliana De; GATTAS, Gilka J. F.; GONCALVES, Fernanda de ToledoObjective. The aim of this study was to investigate whether the copy number variation (CNV) of GSTM1 and GSTT1 is related to the occurrence of oral squamous cell carcinoma (OSCC) relapses, along the overall and progression-free survival of patients. Study Design. A total of 234 OSCC patients were recruited from the Heliopolis hospital and they were distributed among 4 groups according to the occurrence of OSCC relapses. Fisher exact test, odds ratio (OR), and 95% CI were determined to investigate the chances of OSCC progression. The overall and progression-free survival were analyzed by the Kaplan-Meier and Cox regression methods. Results. The CNV of GSTM1 analysis showed that one copy of the gene was associated with reduced chances of OSCC recurrences (OR 0.45; 95% CI 0.25-0.81) and decreased the risk of tumor progression (HR 0.50; 95% CI 0.33-0.75). Furthermore, one copy of GSTM1 was related to a better overall survival rate (HR 0.63; 95% CI 0.0.44-0.91). Regarding the CNV of GSTT1, no copies were associated with the chances of OSCC relapses, the overall survival, or the progression-free survival. Conclusions. The CNV of GSTM1 may be applied to predict OSCC relapses and aid the treatment management, which might improve the survival rates of patients.