VENANCIO AVANCINI FERREIRA ALVES
Projetos de Pesquisa
Unidades Organizacionais
Departamento de Patologia, Faculdade de Medicina - Docente
Instituto Central, Hospital das Clínicas, Faculdade de Medicina
LIM/14 - Laboratório de Investigação em Patologia Hepática, Hospital das Clínicas, Faculdade de Medicina - Líder
Instituto Central, Hospital das Clínicas, Faculdade de Medicina
LIM/14 - Laboratório de Investigação em Patologia Hepática, Hospital das Clínicas, Faculdade de Medicina - Líder
18 resultados
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- Tumour epithelial and stromal characteristics of hepatocellular carcinomas with abundant fibrous stroma: fibrolamellar versus scirrhous hepatocellular carcinoma(2017) KIM, Young-Joo; RHEE, Hyungjin; YOO, Jeong Eun; ALVES, Venancio A. F.; KIM, Gi Jeong; KIM, Hye Min; HERMAN, Paulo; CHAGAS, Aline; KIM, Haeryoung; PARK, Young NyunAimsThe scirrhous variant of hepatocellular carcinoma (S-HCC) and fibrolamellar HCC (FL-HCC) are less common subtypes of HCC that are characterized by abundant fibrous stroma. Here, we aimed to investigate differences in the tumour microenvironment and the tumour epithelial cell characteristics of S-HCC and FL-HCC. Methods and resultsWhole tissue sections of 17 S-HCCs and 9 FL-HCCs were subjected to immunohistochemical stains for keratin 7 (K7), K19, EpCAM, CD56/NCAM, CD163, CD68, pSTAT3, FAP, CCN2 and Ki-67. FL-HCC patients were younger than S-HCC patients (P < 0.001), and chronic liver disease was seen in the background of 88.2% of S-HCC and in none of the FL-HCC. CD68 and CD163-positive tumour-infiltrating macrophages, and FAP-positive cancer-associated fibroblasts (CAFs) were more abundant in the stroma of S-HCCs compared to FL-HCCs (all P < 0.05). Tumour epithelial K19 expression was more frequent in S-HCCs compared to FL-HCCs (P = 0.023). Significant positive correlations were seen between pSTAT3 expression status in tumour epithelial cells and CAFs, the extent of stromal CAF and macrophage infiltration and K19 expression status. No significant differences were seen for K7, EpCAM, CD56/NCAM, CCN2 expression and Ki-67 labelling index between S-HCCs and FL-HCCs. ConclusionS-HCC and FL-HCC are subtypes of HCC with extensive fibrosis, and the nature of the fibrous stroma differs between them. While the stroma of FL-HCC is composed of dense lamellated collagenous bands with sparse cellular components, S-HCC demonstrates more abundant CAF and tumour-infiltrating macrophages and stemness-related marker expression, suggesting the presence of a complex tumour microenvironment that may influence the aggressive behaviour of S-HCCs.
- Re-Transplantation, Higher Creatinine Levels in Hepatitis C Virus Patients, and Donor Age Are Predictors of Mortality in Long-Term Analysis of Late Acute Rejection in Liver Transplantation(2017) NACIF, Lucas Souto; PINHEIRO, Rafael Soares; PECORA, Rafael Antonio de Arruda; TANIGAWA, Ryan Yukimatsu; ROCHA-SANTOS, Vinicius; ANDRAUS, Wellington; ALVES, Venancio Avancini Ferreira; D'ALBUQUERQUE, Luiz CarneiroBackground: Late acute rejection (LAR) differs in its clinical and histological presentation and management from early acute rejection. This clinical entity is not completely understood; thus, we aimed to identify significant prognostic factors that can influence post-transplant survival in LAR patients. The purpose of this study was to evaluate the incidence and post-transplant survival of patients from a single center with a focus on late acute rejection. Material/Methods: From January 2002 to June 2013, all liver biopsies from patients with rejection were scored using the Banff criteria. The groups were compared, and simple and multiple logistic regression and survival curves were created. Results: A total of 779 liver transplants were performed; 585 patients with no rejections and 194 patients with rejections were analyzed. The overall incidence of LAR was 6.7%, and there was a higher prevalence of early acute cellular rejection than LAR. The mean time to LAR was 564 days (median 214 days, range 91-2642). LAR had a more severe grade (35.3%) than early acute rejection (23.5%). The survival rates were similar between both modalities for the long-term period. Worse mortality rates were observed in liver re-transplantation (HR 4.77; p<0.0001); in hepatitis C virus patients with increased creatinine levels (HR 22.48; p=0.016); and in donors > 41 years of age (OR 2.1; p=0.047) in a long-term analysis of LAR. Conclusions: Liver re-transplantation, higher creatinine levels in hepatitis C virus patients, and donor age were predictors of mortality in this long-term analysis of late acute rejection in liver transplantation.
- External validation of the AJCC Cancer Staging Manual, 8th edition, in an independent cohort of oral cancer patients(2017) MATOS, Leandro Luongo; DEDIVITIS, Rogerio Aparecido; KULCSAR, Marco Aurelio Vamondes; MELLO, Evandro Sobroza de; ALVES, Venancio Avancini F.; CERNEA, Claudio RobertoObjectives: To evaluate the new American Joint Committee on Cancer (AJCC) cancer staging manual (8th edition) in an independent cohort of patients surgically treated for oral squamous cell carcinoma in order to determine whether the upstaging of pT and pN classification was indicative of a worse prognosis. Methods: A cohort of 298 patients was analyzed retrospectively. Results: Of these patients, 22.8% received an upstaging when the depth of invasion was included into the pT classification. Similarly, 29.2% of them were upstaged when extracapsular extension was added to pN classification. Twenty-eight of 68 patients (41.2%) that received an upstaging of pT classification died, and 23 (33.8%) experienced disease recurrence compared to 98/229 (42.8%) and 68/229 (29.7%), respectively, for those with the same pT during follow-up. With regard to pN classification, 70.6% of upstaged patients (60/85) died, and 50.6% (43/85) developed recurrence of the disease compared to 63/205 (30.7%) and 42/205 (20.5%), respectively, for those with the same pN during follow-up. Patients who were upstaged in pT classification presented a worse DFS (51.1% versus 80.4%, P = 0.007) and OS (31.5% versus 58.6%, P = 0.017). Similarly, those that were upstaged in pN classification presented a worse DFS (17.1% versus 61.2%, P = 0.001) and OS (8.5% versus 37.9%, P < 0.001). Conclusion: The new AJCC cancer staging manual (8th edition) allows a better stratification of oral SCC patients. By including the depth of invasion to the pT classification and extranodal extension to the pN classification, a worse disease-free and overall survival was assessed for these patients.
- Concordance of non-invasive mechanical and serum tests for liver fibrosis evaluation in chronic hepatitis C(2017) PARANAGUA-VEZOZZO, Denise C.; ANDRADE, Adriana; MAZO, Daniel F. C.; NUNES, Vinicius; GUEDES, Ana L.; RAGAZZO, Taisa G.; MOUTINHO, Renata; NACIF, Lucas S.; ONO, Suzane K.; ALVES, Venancio A. F.; CARRILHO, Flair J.AIM To determine the sensitivity and specificity of liver stiffness measurement (LSM) and serum markers (SM) for liver fibrosis evaluation in chronic hepatitis C. METHODS Between 2012 and 2014, 81 consecutive hepatitis C virus (HCV) patients had METAVIR score from liver biopsy compared with concurrent results from LSM [transient elastography (TE) [FibroScan (R)/ARFI technology (Virtual Touch (R))] and SM [FIB-4/aspartate aminotransferase-to-platelet ratio index (APRI)]. The diagnostic performance of these tests was assessed using receiver operating characteristic curves. The optimal cut-off levels of each test were chosen to define fibrosis stages F >= 2, F >= 3 and F = 4. The Kappa index set the concordance analysis. RESULTS Fifty point six percent were female and the median age was 51 years (30-78). Fifty-six patients (70%) were treatment-naive. The optimal cut-off values for predicting F >= 2 stage fibrosis assessed by TE were 6.6 kPa, for acoustic radiation force impulse (ARFI) 1.22 m/s, for APRI 0.75 and for FIB-4 1.47. For F >= 3 TE was 8.9 kPa, ARFI was 1.48 m/s, APRI was 0.75, and FIB-4 was 2. For F = 4, TE was 12.2 kPa, ARFI was 1.77 m/s, APRI was 1.46, and FIB-4 was 3.91. The APRI could not distinguish between F2 and F3, P = 0.92. The negative predictive value for F = 4 for TE and ARFI was 100%. Kappa index values for F >= 3 METAVIR score for TE, ARFI and FIB-4 were 0.687, 0.606 and 0.654, respectively. This demonstrates strong concordance between all three screening methods, and moderate to strong concordance between them and APRI (Kappa index = 0.507). CONCLUSION Given the costs and accessibility of LSM methods, and the similarity with the outcomes of SM, we suggest that FIB-4 as well as TE and ARFI may be useful indicators of the degree of liver fibrosis. This is of particular importance to developing countries.
- Minor Salivary Gland Transplantation for Severe Dry Eyes(2017) WAKAMATSU, Tais Hitomi; SANT'ANNA, Ana Estela Besteti Pires Ponce; CRISTOVAM, Priscila Cardoso; ALVES, Venancio Avancini Ferreira; WAKAMATSU, Alda; GOMES, Jose Alvaro PereiraDry eye is a multifactorial disease comprising a wide spectrum of ocular surface alterations and symptoms of discomfort. In most patients with aqueous-deficient dry eye, pharmaceutical tear substitutes are used to control symptoms and prevent ocular surface damage. However, in severe dry eye conditions caused by cicatricial disorders, such as Stevens-Johnson syndrome and ocular cicatricial mucous membrane pemphigoid, noninvasive treatments are insufficient, and patients are at risk of developing complications that can lead to blindness. The use of salivary glands as a source of lubrication to treat severe cases of dry eye has been proposed by different authors. The first reports proposed parotid or submandibular gland duct transplantation into the conjunctival fornix. However, complications limited the functional outcomes. Minor salivary gland autotransplantation together with labial mucosa has been used as a complex graft to the conjunctival fornix in severe dry eye with a good outcome. Our group demonstrated significant improvements in best-corrected visual acuity, Schirmer I test score, corneal transparency, and neovascularization after using this technique. A symptoms questionnaire applied to these patients revealed improvements in foreign body sensation, photophobia, and pain. Similar to tears, saliva has a complex final composition comprising electrolytes, immunoglobulins, proteins, enzymes, and mucins. We demonstrated the viability of minor salivary glands transplanted into the fornix of patients with dry eye by performing immunohistochemistry on graft biopsies with antibodies against lactoferrin, lysozyme, MUC1, and MUC16. The findings revealed the presence of functional salivary gland units, indicating local production of proteins, enzymes, and mucins.
- Anti-LeY monoclonal antibody (mAb) hu3S193 as consolidation therapy for patients (pts) with relapsing platinum sensitive ovarian cancer (OC) after achieving a second complete response (2CR).(2017) SMALETZ, Oren; ISMAEL, Gustavo; ESTEVEZ-DIZ, Maria Del Pilar; NASCIMENTO, Ivana Lucia Oliveira; WIERMANN, Ana Luiza Gomes de Morais; CUNHA, Geraldo Felicio; AZEVEDO, Sergio J.; ALVES, Venancio A.; MORO, Ana M.; YEDA, Fernanda Perez; SANTOS, Mariana Lopes dos; MAJUMDER, Indrani; HOFFMAN, Eric W.
conferenceObject Hepatocellular carcinoma in non-alchoolic steatohepatitis (NASH): Clinical, histopathological aspects and immunohistochemical of metabolic and proliferative related-markers(2017) CAMPOS, Priscila B.; OLIVEIRA, Claudia P.; STEFANO, Jose Tadeu; CHAGAS, Aline; HERMAN, Paulo; D'ALBUQUERQUE, Luiz C.; ALVARES-DA-SILVA, Mario R.; LONGATTO-FILHO, Adhemar; BALTAZAR, Ftima; GRANJA, Sara; CARRILHO, Flair J.; ALVES, Venancio Avancini F.conferenceObject Transient Elastography (TE) And Acoustic Radiation Force Impulse Imaging (ARFI) Can Predict Degree Of Advanced Fibrosis For Autoimmune Hepatitis In Biochemical Remission(2017) PARANAGUA-VEZOZZO, Denise; TERRABUIO, Debora R.; MOUTINHO, Renata D.; CANCADO, Eduardo L.; ONO, Suzane; SALAS, Veronica; CARRILHO, Flair; ALVES, Venancio FerreiraconferenceObject Combination of long term N-Acetylcysteine and Ursodeoxycolic Acid in NASH: a multicenter randomized control trial(2017) OLIVEIRA, C. P.; COTRIM, H. P.; CRISTINA, A.; SIQUEIRA, G.; SALGADO, A. L. A.; STEFANO, J. T.; BRIZOLLA, P.; MATTOS, L.; MARTINS, A. H. B.; ANDRADE, A. R.; SCIUTO, R.; FREITAS, L. A.; ALVES, V. A. F.; CARRILHO, F. J.; PARISE, E. R.- Histological Grading of Hepatocellular Carcinoma-A Systematic Review of Literature(2017) MARTINS-FILHO, Sebastiao N.; PAIVA, Caterina; AZEVEDO, Raymundo Soares; ALVES, Venancio Avancini FerreiraBackground: Histological grading typically reflects the biological behavior of solid tumors, thus providing valuable prognostic information. This is also expected in hepatocellular carcinoma (HCC), although limited access to biopsy samples and a lack of standardization might hinder its full predictive value in this cancer. Objectives: In order to better understand the current practices of histological grading in HCC, we examined the latest publications addressing its impact on the outcome of patients following surgical treatment. Methods: We searched the PubMed (MEDLINE) database under the headings ""hepatocellular carcinoma,"" ""grade OR grading,"" and "" prognosis."" Qualitative and quantitative assessment of publications was performed according to the reference they used to grade their tumors (e.g., Edmondson-Steiner, World Health Organization). Results: We reviewed a total of 216 articles: 114 enclosed adequate information and were included herein. Among these, we found divergences and inaccuracies in the histological grade assessment of this cancer, which might have led to a non-standardized grade distribution, with further impact on data analysis. Nevertheless, in most of them, poor tumor differentiation correlated with worse prognosis, expressed by lower overall and/or disease-free survival. Conclusion: While histological grading of HCC has an important prognostic role, there is an unsatisfactory heterogeneity on the microscopic assessment of this tumor, urging for a movement toward standardization.