Tesis sobre el tema "Actinic keratosis"
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Stritt, Andrea Christina. "Photodynamic therapy in the treatment of actinic keratosis /". Bern : [s.n.], 2008. http://www.ub.unibe.ch/content/bibliotheken_sammlungen/sondersammlungen/dissen_bestellformular/index_ger.html.
Texto completoHaque, T. "Development of novel pyrrolobenzodiazepines for treatment of skin cancer and actinic keratosis". Thesis, University College London (University of London), 2015. http://discovery.ucl.ac.uk/1464117/.
Texto completoAzimi, Ali. "PROTEOMIC ANALYSIS OF ACTINIC KERATOSIS, BOWEN’S DISEASE AND CUTANEOUS SQUAMOUS CELL CARCINOMA". Thesis, The University of Sydney, 2018. http://hdl.handle.net/2123/20449.
Texto completoSáenz, Sardà Xavier. "Progression pathways of squamous cell carcinoma associated with actinic damage: From cancer field to actinic keratosis and invasive squamous cell carcinoma". Doctoral thesis, Universitat Autònoma de Barcelona, 2019. http://hdl.handle.net/10803/667918.
Texto completoIt was thought that the progression of an actinic keratosis (AK) to invasive squamous cell carcinoma (SCC) occurred as long as the intra-epidermal neoplasm occupied the entire thickness of the epidermis as in the classical pathway (PC) described in cervix cancer. However, cutaneous infiltrative squamous carcinoma can appear directly from a dysplasia that only occupies the lower third of the epidermis (AK I, differentiated pathweay or DP). This second pathway of progression has been described in SCC of the vulva and oral cavity, whose biological behavior is more aggressive. This thesis began by reviewing all cases corresponding to surgical biopsies, obtained through the BioBanco of the Germans Trias and Pujol Hospital, for three consecutive years corresponding to the period 2004-2007. We selected 503 cases of cutaneous SCC, of which we finally studied 196. Most showed AK I on the surface (63.8%) or on the edges (77.9%), thus concluding that the direct invasion from AK I (DP) is the most frequent form of progression to cutaneous SCC. This study was the first one that was proposed to investigate the prevalence of CP and DP in the transformation of AK into infiltrating SCC, providing evidence of its existence. These findings were published in J Eur Acad Dermatol Venereol. 2014 Oct; 29 (5): 991-7.). The next stage of the study consisted in the realization of a tissue microarrays (TMA) of the biopsies already studied and the cases with SCC were segregated between those originated by DP and those originated by CP. In total, eight TMAs were performed, which involved 756 cores to be evaluated. Through the use of immunohistochemical techniques it was demonstrated that the epithelial-mesenchymal transition participates in the transformation of AK I into SCC (DP) while a greater proliferative capacity facilitates the intra-epidermal extension in the classical pathway and significant differences were found in to the expression of CD31 (angiogenesis) and MMP (metalloproteinases), these markers being elevated in tumors that progress through DP, which together with the epithelium-mesenchymal transition could facilitate local progression. A part of these results have been published in the journal J Eur Acad Dermatol Venereol. 2018 Apr; 32 (4): 581-586). We also proceeded to the use of CISH techniques for the study of miRNA, finding that tumors arising from DP express higher levels of miRNA31 both in their intensity and in their extension. In the next stage the extension of the keratinocyte atypia among adnexal structures was studied, being present in 25.9% of the cases and, of them, the infiltration of the squamous carcinoma directly adjacent to the follicular basal was present in 58% of the cases. Consequently, it would be highly advisable to indicate the depth of follicular extension in the histological diagnosis of incisional biopsies, given the risk of recurrence and infiltration that this implies, as well as the therapeutic derivatives that it entails. The findings have been published in the journal J Eur Acad Dermatol Venereol. 2018 Oct; 32 (10): 1657-1661). We consider that the series of studies that make up this thesis provide new knowledge about the pathways of cutaneous SCC progression and its precursor lesions. It has been established that there are at least two pathways of progression from SCC to AK, the concept of PD has been introduced in cutaneous carcinogenesis, molecular bases have been found that explain the progression through both pathways and the risk of follicular extension in the AK. All these studies have led to a paradigm shift in some areas and are relevant both in the diagnosis and treatment of AKs.
Werner, Ricardo Niklas [Verfasser]. "Systematic review of the natural course of actinic keratosis and their relation to squamous cell carcinoma / Ricardo Niklas Werner". Berlin : Medizinische Fakultät Charité - Universitätsmedizin Berlin, 2014. http://d-nb.info/1057869708/34.
Texto completoBuinauskaitė, Evelina. "AKTININĖS KERATOZĖS FOTODINAMINIO GYDYMO SKIRTINGOMIS RAUDONOSIOS ŠVIESOS DOZĖMIS VEIKSMINGUMAS". Doctoral thesis, Lithuanian Academic Libraries Network (LABT), 2014. http://vddb.library.lt/obj/LT-eLABa-0001:E.02~2014~D_20140618_233345-93532.
Texto completoThe aim of this study was to evaluate clinical characteristics of actinic keratosis and the efficacy of photodynamic treatment with different red light doses. The diagnosis of AK is based upon its typical clinical aspects. However, there are data stating that diagnosing single AKs clinically is not precise and that there are even interobserver disagreements between dermatologists and dermatopathologists. In this study we assessed the clinical peculiarities of AK and its correlation with histological characteristics. We assessed the sensitivity and specificity of AK clinical diagnosis based on histopathological analysis. In 0.025% to 20% cases AK transforms into squamous cell carcinoma. It is impossible to predict which AK will spread from the epithelium into the deeper layers of the skin. Therefore, treatment of actinic keratosis is recommended in all cases. Topical photodynamic treatment is safe and effective therapy for AK but pain is the limitation of the procedure. We performed a prospective within-patient study and evaluated the clinical pecularities of actinic keratosis after photodynamic treatment. We assessed the factors that influence pain during the treatment. We assessed the efficacy of photodynamic treatment with different red light doses for actinic keratosis after two-years follow-up. Factors that influence the recurrence of AK were evaluated. Follow-up data for two years was used to formulate the practical recommendations of the study.
Ashton, Kevin John. "Genetic Aberrations in Non-Melanoma Skin Cancer". Thesis, Griffith University, 2002. http://hdl.handle.net/10072/367012.
Texto completoThesis (PhD Doctorate)
Doctor of Philosophy (PhD)
School of Health Sciences
Full Text
Costa, Sabrina dos Santos [UNESP]. "Proliferação celular e expressão da cicloxigenase-2 como parâmetros prognósticos na ceratose actínica e no carcinoma de células escamosas cutâneo em cães". Universidade Estadual Paulista (UNESP), 2009. http://hdl.handle.net/11449/89218.
Texto completoCoordenação de Aperfeiçoamento de Pessoal de Nível Superior (CAPES)
Este estudo apresenta uma análise comparativa da taxa de proliferação celular e da expressão da enzima cicloxigenase-2 na pele de cães saudáveis e acometidos por ceratose actínica e carcinoma de células escamosas cutâneo (CCE). O objetivo foi avaliar o prognóstico destes cães utilizando-se a imunorreatividade a COX-2 e o índice de proliferação celular. Foram analisados 20 amostras de pele de cães, sendo 10 casos de ceratose actínica (G1) e 10 de CCE cutâneo (G2). Os dados epidemiológicos e as características clínicas e histopatológicas foram estudados. A taxa de proliferação celular foi avaliada por meio de índice mitótico (IM) e imunomarcação para MIB-1. A expressão da enzima cicloxigenase foi pesquisada por exame imunoistoquímico. Os cães da raça Pit Bull foram os mais acometidos em G1 e G2 e a média de idade foi 4,3 (±0,8) anos e 5,6 (±1,7) anos, respectivamente. Os valores médios do índice mitótico foram 0,4; 4,6 (±3,6) e 4,9 (±2,6) em G0, G1 e G2, respectivamente. Não houve diferença estatística entre G1 e G2, mas sim em relação ao G0. Houve imunomarcação para COX-2 em G1 e G2, a média dos escores foi 8,16 (±3,51) e 8,56 (±1,03), respectivamente. Não houve imunomarcação nas amostras de G0 e não houve diferença estatística entre G1 e G2, mas sim em relação ao G0 (p>0,05). A média da porcentagem de células imunomarcadas para Ki-67 em G0, G1 e G2 foi 0,4; 15,77 (± 8,81) e 17,71 (± 12,21), respectivamente. Não houve diferença entre G1 e G2, mas sim destes em relação ao G0 (p>0,05). A ceratose actínica se comportou como o CCE cutâneo, revelando não ser uma lesão pré-neoplásica, mas sim o estágio inicial da neoplasia propriamente dita.
This research presents a comparative analysis of cell proliferation index and cyclooxigenase-2 expression in skin of healthy and with actinic keratosis and cutaneous squamous cell carcinoma (SCC) dogs. The goal was to evaluate the prognosis of these dogs by COX-2 immunorreactivity and cell proliferation index. Skin sections from 20 dogs were evaluated, which 10 were actinic keratosis (G1) and 10 cutaneous SCC (G2). Epidemiological information, clinical and histopathological aspects were evaluated. Cell proliferation index hás been stimated by mitotic index (MI) and MIB-1 staining. Cyclooxigenase-2 expression has been analyzed by immunohistochemistry study. Pit Bull dogs were the main affected in G1 and G2 and the mean age was 4,3 (±0,8) years old and 5,6 (±1,7) years old, relatively. MI mean values were 0,4; 4,6 (±3,6) and 4,9 (±2,6) in G0, G1 and G2, relatively. There was no statistical difference between G1 and G2, but it did with G0. There was positive staining for COX-2 in G1 and G2, the score mean value was 8,16 (±3,51) and 8,56 (±1,03), relatively. There was no positive staining in G0 samples and neither statistical difference between G1 and G2, but it did with G0 (p>0,05). The positive cells for Ki-67 mean percentage in G0, G1 and G2 was 0,4; 15,77 (± 8,81) and 17,71 (± 12,21), relatively. There was no difference between G1 and G2, but it did with G0 (p>0,05). Actinic keratosis behavior was similar to cutaneous SSC, demonstrating that it is not a pre-neoplastic disease, but, in fact, the initial of neoplasm.
Costa, Sabrina dos Santos. "Proliferação celular e expressão da cicloxigenase-2 como parâmetros prognósticos na ceratose actínica e no carcinoma de células escamosas cutâneo em cães /". Jaboticabal : [s.n.], 2009. http://hdl.handle.net/11449/89218.
Texto completoBanca: Mirela Tinucci Costa
Banca: Andrigo Barboza De Nardi
Resumo: Este estudo apresenta uma análise comparativa da taxa de proliferação celular e da expressão da enzima cicloxigenase-2 na pele de cães saudáveis e acometidos por ceratose actínica e carcinoma de células escamosas cutâneo (CCE). O objetivo foi avaliar o prognóstico destes cães utilizando-se a imunorreatividade a COX-2 e o índice de proliferação celular. Foram analisados 20 amostras de pele de cães, sendo 10 casos de ceratose actínica (G1) e 10 de CCE cutâneo (G2). Os dados epidemiológicos e as características clínicas e histopatológicas foram estudados. A taxa de proliferação celular foi avaliada por meio de índice mitótico (IM) e imunomarcação para MIB-1. A expressão da enzima cicloxigenase foi pesquisada por exame imunoistoquímico. Os cães da raça Pit Bull foram os mais acometidos em G1 e G2 e a média de idade foi 4,3 (±0,8) anos e 5,6 (±1,7) anos, respectivamente. Os valores médios do índice mitótico foram 0,4; 4,6 (±3,6) e 4,9 (±2,6) em G0, G1 e G2, respectivamente. Não houve diferença estatística entre G1 e G2, mas sim em relação ao G0. Houve imunomarcação para COX-2 em G1 e G2, a média dos escores foi 8,16 (±3,51) e 8,56 (±1,03), respectivamente. Não houve imunomarcação nas amostras de G0 e não houve diferença estatística entre G1 e G2, mas sim em relação ao G0 (p>0,05). A média da porcentagem de células imunomarcadas para Ki-67 em G0, G1 e G2 foi 0,4; 15,77 (± 8,81) e 17,71 (± 12,21), respectivamente. Não houve diferença entre G1 e G2, mas sim destes em relação ao G0 (p>0,05). A ceratose actínica se comportou como o CCE cutâneo, revelando não ser uma lesão pré-neoplásica, mas sim o estágio inicial da neoplasia propriamente dita.
Abstract: This research presents a comparative analysis of cell proliferation index and cyclooxigenase-2 expression in skin of healthy and with actinic keratosis and cutaneous squamous cell carcinoma (SCC) dogs. The goal was to evaluate the prognosis of these dogs by COX-2 immunorreactivity and cell proliferation index. Skin sections from 20 dogs were evaluated, which 10 were actinic keratosis (G1) and 10 cutaneous SCC (G2). Epidemiological information, clinical and histopathological aspects were evaluated. Cell proliferation index hás been stimated by mitotic index (MI) and MIB-1 staining. Cyclooxigenase-2 expression has been analyzed by immunohistochemistry study. Pit Bull dogs were the main affected in G1 and G2 and the mean age was 4,3 (±0,8) years old and 5,6 (±1,7) years old, relatively. MI mean values were 0,4; 4,6 (±3,6) and 4,9 (±2,6) in G0, G1 and G2, relatively. There was no statistical difference between G1 and G2, but it did with G0. There was positive staining for COX-2 in G1 and G2, the score mean value was 8,16 (±3,51) and 8,56 (±1,03), relatively. There was no positive staining in G0 samples and neither statistical difference between G1 and G2, but it did with G0 (p>0,05). The positive cells for Ki-67 mean percentage in G0, G1 and G2 was 0,4; 15,77 (± 8,81) and 17,71 (± 12,21), relatively. There was no difference between G1 and G2, but it did with G0 (p>0,05). Actinic keratosis behavior was similar to cutaneous SSC, demonstrating that it is not a pre-neoplastic disease, but, in fact, the initial of neoplasm.
Mestre
Ashton, Kevin John y K. Ashton@griffith edu au. "Genetic Aberrations in Non-Melanoma Skin Cancer". Griffith University. School of Health Science, 2002. http://www4.gu.edu.au:8080/adt-root/public/adt-QGU20030818.122305.
Texto completoChen, Andrew Chih-Chieh. "Effect of oral nicotinamide on non-melanoma skin cancer and skin barrier function". Thesis, The University of Sydney, 2016. http://hdl.handle.net/2123/15831.
Texto completoCeratoses, Sônia Maria Cruz Bastos. "Ceratoses actínicas tratadas com ácido glicólico a 8%". Universidade Federal de Juiz de Fora (UFJF), 2012. https://repositorio.ufjf.br/jspui/handle/ufjf/4571.
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Ceratoses Actínicas (CA) são lesões de pele frequentes, induzidas primariamente pela luz ultravioleta e que surgem preferencialmente na superfície da pele foto exposta. Representam a manifestação inicial da proliferação de ceratinócitos atípicos intra-epiteliais com um potencial de 0,25% e 20% ao ano de evoluir para o carcinoma espinocelular (CEC) que é metastatizante. São diagnosticadas clinicamente e tratadas ambulatorialmente. Prevalência mundial, com maior distribuição em indivíduos de pele clara fototipo I e II de Fitzpatrick. Existem vários tratamentos (tópicos, cirúrgicos e sistêmicos), sendo a prevenção a modalidade mais importante. O ácido glicólico, primeiro de uma série de alfa hidroxiácidos, quando aplicado topicamente, em baixas concentrações (2% a 12%) nos veículos, cremes, géis ou loções não iônicas, age como epidermolítico e ceratolítico. Isto o torna um excelente ativo no tratamento que propomos. Nosso objetivo foi pesquisar a efetividade ou não de uma nova conduta terapêutica para CA. Avaliar a adesão do paciente ao tratamento. Observar a apresentação de efeitos adversos indesejáveis. O Estudo foi Clínico, Prospectivo, Transversal em pacientes atendidos no Ambulatório de Dermatologia Geriátrica do HU/CAS da UFJF, total de 50 indivíduos. Todos portadores de ceratoses actínicas na face. O resultado mostra que a resolução total das CA não foi observada em todos os pacientes, mas houve adesão completa ao medicamento, não sendo observados efeitos adversos na população em estudo. Concluímos que mesmo não sendo completamente eficaz para o desaparecimento das lesões levou a uma diminuição acentuada do número de lesões e do índice de gravidade das mesmas.
Actinic keratoses (AK) are common skin lesions, primarily induced by ultraviolet light, occurring mainly on the photoexposed skin surface. They represent the initial manifestation of proliferation of atypical intraepithelial keratinocytes with a potential of 0.25% - 20% per year progress to squamous cell carcinoma (SCC), which is metastasizing. They are clinically diagnosed and treated on an outpatient basis. They are prevalent worldwide, with higher distribution in light-skinned individuals of Fitzpatrick phototype I and II. There are several treatments (topical, surgical and systemic), prevention being the most important modality. Glycolic acid, the first of a series of alpha hydroxyacids, when applied topically in low concentrations (2% to 12%) in cream, gels or nonionic lotions, acts as an epidermolytic and keratolytic. This makes it an excellent asset in the treatment that we propose. Our objective was to investigate the effectiveness or otherwise of a new therapeutic approach to AK, assess patient adherence to treatment and observe the appearance of adverse reactions. The study was clinical, prospective, transversal in patients seen at the Geriatric Dermatology Clinic of HU / CAS UFJF, 50 individuals altogether. All patients had actinic keratoses on their face. The result show that total resolution of AK was not observed in all patients, but there was complete adherence to medication, adverse effects not being observed in the study population. We conclude that, although not completely effective for the disappearance of the lesions, it led to a marked decrease in the number of lesions and the severity index of these.
Haddad, Alessandra [UNIFESP]. "Luz intensa pulsada e ácido 5 aminolevulínico no tratamento de queratoses actínicas e fotoenvelhecimento facial". Universidade Federal de São Paulo (UNIFESP), 2010. http://repositorio.unifesp.br/handle/11600/9790.
Texto completoINTRODUÇÃO: Rejuvenescimento fotodinâmico refere-se ao tratamento do fotoenvelhecimento e das queratoses actínicas. OBJETIVO: Avaliar a eficácia da terapia fotodinâmica com ácido aminolevulínico a 20% (ALA) ¾ tópico e luz intensa pulsada no tratamento das queratoses actínicas e do fotoenvelhecimento facial. MÉTODOS: Quarenta e três pacientes com idade média 71,3 anos, fototipos de pele I e IV divididos em: Controle (aplicação LIP/18J); Tratamento-I (ALA incubado por duas horas; ativado por duas passagens de LIP/16J); Tratamento-II (ALA; duas passagens de LIP/18J), foram avaliados por dois observadores, clínica e fotograficamente, no Pré, 48 horas, 8 e 12 semanas após, pela escala de Griffiths. Cinco queratoses actínicas foram marcadas como alvo para contagem no Pós- Tratamento, sendo uma submetida à biopsia antes e depois do tratamento, para avaliação anatomopatológica de atipias e perda de polaridade. RESULTADOS: Testes não-paramétricos mostraram melhora significativa (rugas finas, alterações texturais, pigmentação irregular) nos Grupos-Tratamento-I/II. No Grupo Controle, significância apenas para alterações pigmentares. Queratoses actínicas tiveram redução maior nos Grupos II (68, 4%) e I (51,2%) em relação ao Controle (5%). Houve redução significativa da gravidade das atipias e perda de polaridade nos Grupos-TratamentoI/II em relação ao controle. CONCLUSÃO: A terapia fotodinâmica, com ácido 5aminolevulínico e luz intensa pulsada, mostrou-se efetiva no tratamento do fotoenvelhecimento e das queratoses actínicas faciais. O tratamento das queratoses actínicas foi mais efetivo com uso de maior energia.
BACKGROUND: Photodynamic rejuvenation is the term used to the treatment of actinic keratosis and photodamage with photodynamic therapy. OBJECTIVE: Evaluate the efficacy of photodynamic therapy with aminolevulinic acid and intense pulsed light in the treatment of actinic keratosis and photodamage. METHODS: Fourty three patients mean age 71,3 years, were randomized in three groups: Control (IPL 18J); Treatment I (ALA+ IPL 16J); and Treatment II ( ALA+ IPL 18J) and evaluated clinically an photographically by two observers in Pre, 48hs, 8 weeks and 12 weeks Post-Treatment using Griffth’s Photonumeric Scale. Five actinic keratosis were marked as target in Pre-Treatment and biopsies Pre and Post-Treatment were done in one lesion to evaluate atypias and loss of cellular polarity. RESULTS: Non parametric tests showed marked improvement in mottled pigmentation, texture fine wrinkles in Groups Treatment I and II. In Control Group improvement only in mottled pigmentation. Actinic Keratosis clearance in Groups Treatment I and II were 51,2% and 68,4% respectively, whereas in Group Control it was 5%. In relation to Control Group, Groups Treatment I and II showed significant reduction of atypias and improvement in loss of cellular polarity. CONCLUSIONS: Photodynamic therapy with aminolevulinic acid and intense pulsed light is effective in the treatment of photodamage and actinic keratosis. The resolution of actinic keratosis was better with higher levels of energy.
TEDE
BV UNIFESP: Teses e dissertações
Ferreira, Eliane Roio. "5-fluorouracil 5 por cento intermitente versus nicotinamida no tratamento do campo de cancerização cutâneo ensaio clínico randomizado /". Botucatu, 2017. http://hdl.handle.net/11449/154566.
Texto completoResumo: O tratamento do campo de cancerização tem o intuito de evitar a progressão das lesões pré-malignas ou desenvolvimento de lesões subclínicas, como forma de prevenção da carcinogênese. Existem diversas propostas de tratamento, porém, há poucos estudos com nicotinamida oral, nenhum comparando a eficácia entre 5-fluorouracil (5FU) tópico com fotoproteção, ou na sua associação com a nicotinamida oral. Objetivos: Avaliação da eficácia da nicotinamida oral, versus 5FU tópico intermitente, e fotoproteção, no tratamento do campo de cancerização cutâneo e queratoses actínicas (QA). Casuística e métodos: Desenho: ensaio clínico randomizado (em blocos), controlado (intrasujeito), duplo cego, fatorial. Participantes: pacientes imunocompetentes, que continham entre três e dez QA cada antebraço, selecionados durante os atendimentos do ambulatório oncológico do serviço de dermatologia da Faculdade de Medicina de Botucatu – UNESP no período de março a setembro de 2016. Houve randomização em blocos e alocação em grupos dos pacientes e antebraços. Intervenção: um grupo recebeu nicotinamida 500mg, via oral, cada 12h, e o outro, placebo. Um dos antebraços recebeu 5FU 5% creme, noturno, 3x por semana, e ambos, filtro solar (FPS 30) diurno. A duração dos tratamentos foi de 120 dias. Os pacientes foram avaliados nos momentos: T0 e T120 para avaliação clínica (contagem de QA, escore de gravidade de QA e escore de fotoenvelhecimento) e biópsia de pele para avaliação do grau de neoplasia intraepitelial... (Resumo completo, clicar acesso eletrônico abaixo)
Abstract: Background: The treatment of the skin field cancerization is aimed at preventing the progression of premalignant lesions or the development of subclinical lesions as a way of preventing carcinogenesis. There are several treatment proposals, however, there are few studies with oral nicotinamide, none comparing the efficacy of topical 5-fluorouracil (5FU) with photoprotection, or its association with oral nicotinamide. Objectives: To evaluate the efficacy of oral nicotinamide versus intermittent topical 5FU and photoprotection in the treatment of cutaneous cancer and actinic keratoses (AK). Casuistry and methods: Design: randomized (blocks), controlled (intrasubject), double blind, factorial clinical trial. Participants: immunocompetent patients, who had between 3 and 10 AK each forearm, selected during the visits of the oncology outpatient clinic of the dermatology department of Botucatu Medical School - UNESP from March to September, 2016. There was randomization in blocks and allocation in Groups of patients and forearms. Intervention: one group received nicotinamide 500mg, orally every 12h, and the other, placebo. One of the forearms received 5FU 5% cream, overnight, 3x per week, and both, daytime (SPF 30) sunscreen. The duration of the treatments was 120 days. The patients were evaluated at the moments: T0 and T120 for clinical evaluation (AK score, AK severity score and photoaging score) and skin biopsy for evaluation of the levels of keratinocyte intraepithelial neoplasi... (Complete abstract click electronic access below)
Mestre
Arruda, Guilherme de Oliveira. "Características clínicas das ceratoses actínicas e suas correlações histológicas sugestão de uma escala de gravidade clínica /". Botucatu, 2019. http://hdl.handle.net/11449/183361.
Texto completoResumo: FUNDAMENTOS: As queratoses actínicas são lesões pré-malignas com risco de transformação para carcinoma espinocelular invasivo. OBJETIVOS: Correlacionar as características clínicas das queratoses actínicas dos antebraços e dorso das mãos com o grau de atipia do exame histológico (Keratinocyte Intraepidermal Neoplasia) e a expressão lesional e perilesional de p53 e Ki-67; desenvolver e validar uma escala de gravidade clínica que possa inferir o grau histológico das queratoses actínicas. MÉTODOS: Estudo transversal em que foram avaliadas clinicamente 162 queratoses actínicas quanto ao diâmetro, eritema, infiltração, hiperqueratose e exulceração e biopsiadas 34 lesões com diferentes padrões. As características clínicas foram correlacionadas com o grau de atipia histológica e expressão de p53 e Ki-67. RESULTADOS: As características clínicas apresentaram baixa consistência entre si (Cronbach=0,24). Apenas o diâmetro das lesões se correlacionou significativamente com o grau de atipia (p=0,04), e apenas o eritema, a hiperqueratose e o diâmetro se correlacionaram com as marcações imuno-histoquímicas. Foi desenvolvido um escore clínico incluindo o diâmetro, a hiperqueratose e a exulceração, o qual se correlacionou significativamente com o grau de atipia (Rho de Spearman=0,43; p=0,01). LIMITAÇÕES DO ESTUDO: O escore obtido não pode ser extrapolado para áreas que não sejam os antebraços e dorso das mãos; não houve seguimento prospectivo dos pacientes; não incluímos pacientes com genoderm... (Resumo completo, clicar acesso eletrônico abaixo)
Abstract: BACKGROUND: Actinic keratosis are pre-malignant lesions with risk of transformation for invasive squamous cell carcinoma. OBJECTIVES: To correlate the clinical features of actinic keratosis of the forearms and dorsum of the hands with its histological features (Keratinocyte Intraepidermal Neoplasia) and p53 and Ki-67 staining in the lesion and around the lesion; develop and validate a clinical severity scale that can infer the histological grade of actinic keratosis. METHODS: A cross-sectional study in which 162 actinic keratosis were clinically evalueted for diameter, erythema, infiltration, hyperkeratosis and exulceration, and 34 lesions with different patterns were biopsied. Clinical features were associated with degrees of atypia and p53 and Ki-67 staining. RESULTS: Clinical features were low in consistency (Cronbach=0.24). Only the diameter of the lesions was significantly correlated with the degree of atypia (p=0.04), and only erythema, hyperkeratosis and diameter were correlated with immunohistochemical staining. A clinical score including the diameter, hyperkeratosis and exulceration was developed, with significant correlation with the degree of atypia (Spearman's Rho=0.43; p=0.01). LIMITATIONS: The developed score can not be extrapolated to areas other than the forearms and back of the hands; there was no prospective follow-up of the patients; we did not include patients with genodermatosis or immunosuppressed patients. CONCLUSION: Clinical features of actinic kerato... (Complete abstract click electronic access below)
Mestre
Miola, Anna Carolina [UNESP]. "Eficácia e segurança do creme de colchicina 0,5 por cento versus terapia fotodinâmica com aminolevulinato de metila no tratamento do campo de cancerização cutâneo: um ensaio clínico randomizado". Universidade Estadual Paulista (UNESP), 2017. http://hdl.handle.net/11449/152019.
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Fundamentos: Campo de cancerização cutâneo representa uma área com alterações genômicas induzidas pela radiação ultravioleta, cujo sinal de atividade são as queratoses actínicas (QA). Tratamentos que visem sua estabilização podem reduzir a incidência de QA e de tumores cutâneos não melanoma. Estudos em terapia fotodinâmica com metil aminolevulinato (TFD-MAL) no tratamento do campo de cancerização cutâneo mostram redução de até 89% na contagem de QA, já com colchicina tópica, há redução de até 78%. Até o momento, não há estudos comparando colchicina com TFD-MAL. Esse trabalho objetiva avaliar eficácia e segurança de colchicina 0,5% creme versus TFD-MAL no tratamento do campo de cancerização dos antebraços. Casuística e métodos: Ensaio clínico aberto, controlado, randomizado, envolvendo 36 pacientes do ambulatório de Dermatologia da UNESP-Botucatu, com 3-10 QAs em cada antebraço, tratados (cada antebraço) com creme de colchicina 0,5% (2x/dia por 10 dias) ou uma sessão de TFD-MAL; reavaliados após 60 dias. A avaliação clínica foi realizada pela contagem de QAs, seus subtipos clínicos, sua escala de gravidade e escala de fotoenvelhecimento dos antebraços. Avaliação histopatológica foi realizada pelo escore KIN (Keratinocyte Intraepithelial Neoplasia), atrofia epitelial e imunohistoquímica de p53 e Ki67. Todos os pacientes incluídos no estudo e randomizados fizeram parte da população ITT (intention to treat). Os dados do único dropout foram imputados como LOCF (last observed carried forward). Resultados: Foram incluídos 36 participantes: 50% eram do sexo masculino, com idade média (dp) de 70,9 (8,6) anos e predominância de pacientes fototipos I e II (89%). O clearance total de QAs ocorreu em 6 (17%) de COL e 7 (19%) de MAL-PDT (p=0,76), e clearance parcial (> 50%) foi alcançado em 16 (44%) dos antebraços COL e 24 (67%) MAL-PDT (p=0,07). Houve redução significativa no escore da escala de fotoenvelhecimento para COL e TFD-MAL (-6% vs -6%), escore de gravidade de QA (-65% vs -73%), subtipos clínicos das QAs presentes e contagem de QA (-45% vs -40%), após as intervenções (p<0,01), sem diferenças significativas entre os grupos. Houve redução no escore KIN em ambos os grupos (p<0,01), normalizado em 28% dos pacientes MAL-PDT e 20% em COL. Houve redução da atrofia epitelial após 60 dias (p<0,01), sem diferenças entre os tratamentos (p=0,58). Houve redução significativa do escore Ki67 em ambos os tratamentos: 15% em COL e 9% em MAL-PDT, sem diferença entre os grupos (p=0,32). Houve redução do escore de p53 em 27% no grupo COL, porém, um aumento de 4% na MAL-PDT (p<0,05). Efeitos adversos foram relatados em ambos os grupos: 69% em COL e 67% em TFD-MAL. Não houve evento adverso grave. Conclusão: Colchicina 0,5% creme e TFD-MAL são eficazes e seguros no tratamento do campo de cancerização cutâneo.
Background: Skin field cancerization is an area with genomic alterations induced by ultraviolet radiation, and actinic keratosis (AK) is a sign of its activity. Treatments to stabilize it may reduce the incidence of non-melanoma skin cancers and AK. Photodynamic therapy with methyl aminolevulinate (TFD-MAL) in the treatment of skin field cancerization shows a reduction of up to 89% in the AK count, and topical colchicine, up to 78% of reduction. To date, there are no studies comparing colchicine with PDT-MAL. The aim of this study was to evaluate the efficacy and safety of colchicine 0.5% cream versus PDT-MAL in skin field cancerization treatment of the forearms. Patients and methods: A randomized, controlled clinical trial involving 36 patients from the UNESP-Botucatu Dermatology outpatient clinic, with three to 10 AKs in each forearm, treated (each forearm) with colchicine cream (2x / day for 10 days) and one session of PDT-MAL. Reassessed after 60 days. Clinical evaluation was performed by AK count, its clinical subtypes, severity scale and forearm photoaging scale. Histopathological evaluation performed by KIN (Keratinocyte Intraepithelial Neoplasia), epithelial atrophy and immunohistochemistry of p53 and Ki67. All patients included in the study and randomized were part of the ITT population (intention to treat). The only dropout was analyzed through LOCF (last observation carried forward). Results: Thirty-six participants were included: 50% were males, mean age (SD) of 70.9 (8.6) years and predominance of phototype I and II patients (89%). Total clearance of AK occurred in 6 (17%) of COL and 7 (19%) of MAL-PDT (p = 0.76), and partial clearance (> 50%) was achieved in 16 (44%) of COL and 24 (67%) of MAL-PDT (p = 0.07). There was a significant reduction in the photodamage scale for COL and PDT-MAL (-6% vs -6%), AK severity score (-65% vs -73%), clinical subtypes of the present AK and AK (-45% vs -40%) after interventions (p <0.01), with no significant differences between the groups (p> 0.24). There was a reduction in KIN score in both groups (p <0.01), normalized in 28% of MAL-PDT patients and 20% in COL. There was reduction of epithelial atrophy after 60 days (p <0.01), with no differences between treatments (p = 0.58). There was a significant reduction of the Ki67 score in both treatments: 15% in COL and 9% in MAL-PDT, with no difference between groups (p = 0.32). There was a reduction of the p53 score in 27% in the COL group, but a 4% increase in MAL-PDT (p <0.05). Adverse effects were reported in both groups: 69% in COL and 67% in PDT-MAL. There was no serious adverse event. Conclusion: Colchicine 0.5% cream and TFD-MAL are effective and safe in skin field cancerization treatment.
Miola, Anna Carolina. "Eficácia e segurança do creme de colchicina 0,5 por cento versus terapia fotodinâmica com aminolevulinato de metila no tratamento do campo de cancerização cutâneo um ensaio clínico randomizado /". Botucatu, 2017. http://hdl.handle.net/11449/152019.
Texto completoResumo: Fundamentos: Campo de cancerização cutâneo representa uma área com alterações genômicas induzidas pela radiação ultravioleta, cujo sinal de atividade são as queratoses actínicas (QA). Tratamentos que visem sua estabilização podem reduzir a incidência de QA e de tumores cutâneos não melanoma. Estudos em terapia fotodinâmica com metil aminolevulinato (TFD-MAL) no tratamento do campo de cancerização cutâneo mostram redução de até 89% na contagem de QA, já com colchicina tópica, há redução de até 78%. Até o momento, não há estudos comparando colchicina com TFD-MAL. Esse trabalho objetiva avaliar eficácia e segurança de colchicina 0,5% creme versus TFD-MAL no tratamento do campo de cancerização dos antebraços.Casuística e métodos: Ensaio clínico aberto, controlado, randomizado, envolvendo 36 pacientes do ambulatório de Dermatologia da UNESP-Botucatu, com 3-10 QAs em cada antebraço, tratados (cada antebraço) com creme de colchicina 0,5% (2x/dia por 10 dias) ou uma sessão de TFD-MAL; reavaliados após 60 dias. A avaliação clínica foi realizada pela contagem de QAs, seus subtipos clínicos, sua escala de gravidade e escala de fotoenvelhecimento dos antebraços. Avaliação histopatológica foi realizada pelo escore KIN (Keratinocyte Intraepithelial Neoplasia), atrofia epitelial e imunohistoquímica de p53 e Ki67. Todos os pacientes incluídos no estudo e randomizados fizeram parte da população ITT (intention to treat). Os dados do único dropout foram imputados como LOCF (last observed car... (Resumo completo, clicar acesso eletrônico abaixo)
Mestre
Torezan, Luís Antonio Ribeiro. "Estudo da pele do campo cancerizável antes e após a terapia fotodinâmica através dos métodos clínicos, histopatológicos e imunohistoquímicos". Universidade de São Paulo, 2011. http://www.teses.usp.br/teses/disponiveis/5/5133/tde-23022012-161422/.
Texto completoThe field cancerization concept suggests that photodamaged skin has an increased risk for the development of malignant lesions. Topical photodynamic therapy (PDT) is a non-invasive therapeutic method for multiple actinic keratosis (AK), allowing the possibility of treating the entire surface. Twenty-six patients with photodamaged skin and multiple AKs on the face were submitted to three consecutive sessions of PDT with mehtylaminolevulinate 16% (MAL) and red light, one month apart. Biopsies were performed before and three months after the last treatment session, and stained for hematoxilin-eosin and Weigert. Immunohistochemestry study was performed for TP-53, pro-collagen I, Metalloproteinase-1 and Tenascin-C. The global score for photodamage improved considerably in all patients (p < 0.001). The AK clearance rate was 89.5% at the end of the study. Two treatments were similar to three MAL-PDT sessions. A significant decrease in keratinocytes atypia grade and amount was observed (p < 0.001). A significant increase in collagen deposition (p = 0.001) and improvement of solar elastosis (p = 0.002) were noticed. Immunohistochemical study showed decreased TP-53 expression although not statistically significant (p = 0.580), increased pro-collagen I and MMP-1 expressions (p = 0.477 and p = 0.08) again not statistically significant and a increased expression of Tenascin-C (p = 0.024), which was statistically significant. In conclusion, multiple sessions of MAL-PDT induced clinical and histological improvement of field cancerization. The decrease in severity and extension of keratinocytes atypia associated with a decreased expression of TP-53 suggest a reduced carcinogenic potential of the altered field
Travnik, Richard. "Split-Face-Studie zweier Lampensysteme zur topischen photodynamischen Therapie aktinischer Keratosen". kostenfrei, 2008. http://www.opus-bayern.de/uni-regensburg/volltexte/2009/1201/.
Texto completoDang-Heine, Chantip. "Genexpressionsprofil und Aktivität humaner Papillomviren in nicht-melanozytären Hauttumoren". Doctoral thesis, Humboldt-Universität zu Berlin, Mathematisch-Naturwissenschaftliche Fakultät I, 2010. http://dx.doi.org/10.18452/16152.
Texto completoDuring development of non-melanoma skin cancer, several risk factors are involved: UV-exposition, pigmentation, age, and potentially human papilloma virus (HPV). The molecular mechanisms underlying tumourgenesis in squamous cell carcinoma (SCC) and its pre-cancerosis actinic keratosis (AK) are not fully understood. In this study, the gene expression profile and HPV-infection status were analysed in SCC from immunocompetent and organ transplanted, immunocompromised patients.By global transcriptome analysis from cutaneous SCC, AK and healthy skin, 118 genes were identified differentially expressed in a cDNA-microarray. The expression of 11 out of 13 selected genes (85%) was investigated by real-time RT-PCR (qPCR) and the expression of three genes remarkably induced in SCC correlated with the progression to AK until SCC. These genes encoded for Metalloproteinase-1, which is involved in the remodelling of extracellular matrix, and the protooncogene RAB31 and Tenascin-C (Tn-C). Tn-C protein is expressed in SCC-tissue at the invasion front in basal cells and in keratinocytes in the Stratum papillare and retikulare, but not in healthy skin. This study, the 2243 bp Tn-C-specific splice-variant has for the first time detected in SCC, but not in normal skin. Thus it might serve as diagnostic marker of SCC progression. The data of the transcriptome analysis indicates that a simultaneous dysregulation of oncogene expression and DNA-repair, cell-cycle and proliferation, proteolysis and adhesion molecules exists in SCC. Additionally, the expression of HPV in SCC and thus the causal relationship between HPV-infection and tumourgenesis of SCC in immunocompromised patients was investigated. The HPV-infection pattern in SCC-tissue and normal skin was assessed by detection of DNA from cutaneous HPV-types. Viral E6/E7-mRNA-transcripts of the cutaneous HPV-types 8, 9, 15 were expressed selectively in AK and SCC. In contrast, no HPV-specific mRNA was present in HPV-DNA positive normal skin. The analysis of the open reading frame from the respective E6-protein genes unravelled one single pointmutation, which is not been characterized so far in terms of e.g. its impact on protein structure. The viral activity of the oncogenes E6 and E7 of cutaneous HPV-types indicates a potential function of HPV in the tumourgenesis of SCC in immunocompromised individuals.
Vicentini, Claire. "Évaluation de dispositifs d’illumination textiles permettant d’améliorer l’efficacité et la tolérance de la Thérapie Photodynamique en Dermatologie : modèle des kératoses actiniques". Thesis, Lille 2, 2019. http://www.theses.fr/2019LIL2S044.
Texto completoBackground: Photodynamic therapy is an effective treatment for actinic keratosis, for patients with large areas of field cancerization. Among the approved protocols in Europe, the most widely used requires illumination with a LED lamp. However, pain during irradiation and the reproductibility are two limiting factors of this protocol. To overcome these limits, a light-emitting fabric-based device was developed. We evaluated these devices and two illumination schemes: Flexitheraligth at a fluence rate of 12.3 mW/cm2 to get a fluence of 37J/cm2 and Pho-Istos at a fluence rate of 1.3 mW/cm2 to get a fluence of 12J/cm2.Objectives: We aim to assess the non-inferiority, in terms of photodynamic therapy efficacy to treat actinic keratosis, of the Flexitheralight and Phos-Istos devices compared with the conventional protocol using the red LED lamp.Methods: Randomized, controlled, phase II clinical studies were performed. We included patients with grade I-II actinic keratosis of the forehead and scalp, treated with methyl aminolevulinate photodynamic therapy in two symmetrical areas. One area was treated with the conventional protocol, whereas the other area was treated with the Flexitheralight or the Phos-Istos protocol, depending on the study. The primary endpoint was the lesion complete response rate at three months (an absolute non-inferiority margin of -10% was used). The secondary endpoints included patient-reported pain at the end of the irradiation.Results: The Flexitheralight study included twenty-five patients treated with the Flexitheralight device on one area (n=154 actinic keratosis) and with the LED lamp on the contralateral area (n=156 actinic keratosis). The lesion complete response rate with the Flexitheralight protocol was non-inferior to that obtained with the LED lamp (66.0% vs. 59.1%, respectively; absolute difference, 6.9%; 95% confidence interval, -0.6% to 14.5%). Patient-reported pain was significantly lower with the Flexitheralight protocol than with the LED lamp (mean ± standard deviation: 0.4 ± 0.6 vs. 5.0 ± 2.6; p<0.0001).The Phos-Istos study included forty-six patients treated with the Phos-Istos device on one area (n=280 lesions) and with the LED lamp on the contralateral area (n=280 lesions). Three months following treatment, the lesion complete response rate of the Phos-Istos device was non-inferior to the LED lamp (79.3% vs. 80.7%, respectively; absolute difference, -1.6%; one-sided 95% confidence interval, -4.5% to infinity). The pain score at the end of illumination was significantly lower for the Phos-Istos device than for the LED lamp (mean±standard deviation: 0.3±0.6 vs. 7.4±2.3; p<0.0001).Conclusions: The light emitting fabrics and the low-irradiance protocols are non-inferior in terms of efficacy and superior in terms of tolerability to the conventional protocol for treating actinic keratoses of the forehead and scalp
Bonilha, Valentina Soffner Jorge [UNESP]. "Tratamento de queratose actínica disseminada através da terapia fotodinâmica". Universidade Estadual Paulista (UNESP), 2011. http://hdl.handle.net/11449/88095.
Texto completoFundação Amaral Carvalho
O câncer de pele é o tipo mais freqüente na população mundial. A sua lesão precursora é a queratose actínica (QA). Um dos grandes problemas associados com a QA é o fato de que as áreas atingidas podem ser extensas, tornando o tratamento demorado, ou no caso de alguns procedimentos químicos, demasiadamente agressivos ao paciente. A terapia fotodinâmica (TFD) tópica surge como uma opção no tratamento das QAs disseminadas. O objetivo do presente estudo foi avaliar in vivo o tempo ideal de oclusão do agente fotossensibilizador ácido 5-aminolevulínico (ALA) a 15% para tratamento das QA disseminadas em membros superiores pelo protótipo Kerato PDT. Foram selecionados 40 pacientes que apresentassem QAs disseminadas nos membros superiores. Estes foram submetidos à aplicação do ALA a 15% nos antebraços e mãos e em seguida a oclusão dos membros foi realizada. A partir disso, os pacientes foram divididos em dois grupos de acordo com tempo de oclusão, no qual os pacientes do grupo 1 (G1) permaneceram por 2 horas em oclusão e no grupo 2 (G2), por 4 horas. Na sessão seguinte, foi retirada a cobertura e realizada a irradiação da área por 40 minutos (40 J/cm2) pelo protótipo Kerato PDT a base de emissores LED. Foi realizada análise visual médica nos períodos de 30 e 90 dias seguindo-se escores de 0 (ausência de melhora) a 10 (melhora total das lesões). Os valores obtidos foram submetidos à análise estatística pelo Teste de Mann-Whitney com p<0,10. Os resultados mostraram que não houve diferença estatisticamente significativa entre os grupos. Pode-se concluir que tanto o tempo de 2 ou 4 horas de oclusão são eficientes para o tratamento das QAs disseminadas; porém o menor tempo permitiu melhor conforto para os pacientes
Skin cancer is the most incident neoplasm in world population. Actinic keratoses (AK) is considered a premalignant lesion. The AKs are often multiple, what can difficult the treatment. Photodynamic therapy (PDT) is an option for the treatment of widespread AK of the limbs. The aim of the present in vivo study was to evaluate the perfect time of occlusion of 5-aminolevulinic acid (ALA) 15% photosensitizing agent to treatment of widespread AKs by Kerato PDT. 40 patients with multiple AK on the upper limbs were selected. They were subjected to the following treatment: the ALA 15% was applied over the entire area (forearm and hand) and then the occlusion of the limbs was performed. After that, patients were divided into two groups according to duration of occlusion, in which patients in group 1 (G1) remained for 2 hours under occlusion and in group 2 (G2), for 4 hours. The next session the patients had their lesions submitted for 40 minutes (40 J/cm2) by prototype-based LED Kerato PDT. Medical visual analysis were performed in periods of 30 and 90 days througth scores from 0 (no improvement) to 10 (total improvement of the lesions). The values were statistically analyzed by Mann-Whitney test with p <0.10. The results showed no statistically significant difference between groups. It can be concluded that both times of occlusion are effective in the treatment of AK disseminated, but the minimum time allowed better comfort for patients
Bonilha, Valentina Soffner Jorge. "Tratamento de queratose actínica disseminada através da terapia fotodinâmica /". Botucatu : [s.n.], 2011. http://hdl.handle.net/11449/88095.
Texto completoAbstract: Skin cancer is the most incident neoplasm in world population. Actinic keratoses (AK) is considered a premalignant lesion. The AKs are often multiple, what can difficult the treatment. Photodynamic therapy (PDT) is an option for the treatment of widespread AK of the limbs. The aim of the present in vivo study was to evaluate the perfect time of occlusion of 5-aminolevulinic acid (ALA) 15% photosensitizing agent to treatment of widespread AKs by Kerato PDT. 40 patients with multiple AK on the upper limbs were selected. They were subjected to the following treatment: the ALA 15% was applied over the entire area (forearm and hand) and then the occlusion of the limbs was performed. After that, patients were divided into two groups according to duration of occlusion, in which patients in group 1 (G1) remained for 2 hours under occlusion and in group 2 (G2), for 4 hours. The next session the patients had their lesions submitted for 40 minutes (40 J/cm2) by prototype-based LED Kerato PDT. Medical visual analysis were performed in periods of 30 and 90 days througth scores from 0 (no improvement) to 10 (total improvement of the lesions). The values were statistically analyzed by Mann-Whitney test with p <0.10. The results showed no statistically significant difference between groups. It can be concluded that both times of occlusion are effective in the treatment of AK disseminated, but the minimum time allowed better comfort for patients
Orientador: Ana Gabriela Sálvio
Coorientador: Vanderlei Salvador Bagnato
Banca: Cristina Kurachi
Banca: Natalia Mayumi Lnada
Mestre
Webber, Analupe. "Estudo comparativo entre terapia fotodinâmica e imiquimod tópico para o tratamento de ceratoses actínicas". reponame:Biblioteca Digital de Teses e Dissertações da UFRGS, 2009. http://hdl.handle.net/10183/31813.
Texto completoBackground: Actinic keratosis (AK) represents an initial process that may lead to in situ or invasive squamous cell carcinoma. The importance of its early diagnosis and treatment is well-established. There are several effective options available for the treatment of actinic keratosis, including topical imiquimod 5% cream and photodynamic therapy (PDT). Objetive: To compare the efficacy and patient preference between topical MAL-PDT and imiquimod 5% cream for the treatment of AK. Methods: Twelve patients, with a total of 245 lesions, underwent treatment with MAL-PDT and imiquimod 5% cream. Randomization was performed to determine the hemiface (right or left) for each therapy. First, patients were submitted to MAL-PDT. After one month, they started to use imiquimod on the opposite side of the face, twice a week, for 16 weeks. Six months after entering the study, both treatments were analyzed by a blinded investigator for their effectiveness, tolerability and cosmetic result. Results: Both treatments showed a good therapeutic response. 72% of the lesions treated with MAL-PDT were completely cleared, and 76% of those treated with imiquimod. The mean size of the residual lesions after the treatments was similar. Ten patients (83%) preferred MAL-PDT rather than imiquimod. (p: 0.03). Conclusions: Both MAL-PDT and imiquimod are effective in clearing AKs. Our results showed similar efficacy and good cosmetic outcomes with both treatments. However, a significant percentage of the subjects preferred MAL – PDT.
Dornelas, Marilho Tadeu. "Expressão de marcadores de proliferação celular e apoptose no carcinoma espinocelular da pele e ceratose actínica". Universidade Federal de Juiz de Fora (UFJF), 2009. https://repositorio.ufjf.br/jspui/handle/ufjf/5501.
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O câncer de pele é o mais frequente tipo de câncer humano e mostra aumento de sua incidência nos últimos anos, o que o torna um crescente problema para a saúde pública mundial. Em muitos casos, antes do surgimento do carcinoma, instala-se uma lesão precursora, - a Ceratose Actínica, que pode evoluir para Carcinoma Espinocelular. Considerando o aumento de novos casos e recidivas frequentes, estudos tem sido intensificados no sentido de determinar os parâmetros com significado prognóstico na predição daqueles tumores que terão comportamento mais agressivo, que poderão recorrer e evoluir com metástases. O objetivo deste estudo foi avaliar a expressão dos marcadores de proliferação celular (PCNA, Ki-67) e apoptose (p53, Bcl-2), em portadores de Carcinoma Espinocelular e Ceratose Actínica. Foram estudadas amostras de 30 pacientes, submetidos à cirurgia reparadora, sendo dez portadores do Carcinoma Espinocelular, dez de Ceratose Actínica e dez indivíduos livres de lesões submetidos à blefaroplastia. A proteína p53 foi expressa em todos os casos estudados, com padrões quantitativos diferentes. O Bcl-2 foi expresso em baixa intensidade em seis casos de Ceratose Actínica, também baixa nas peles de blefaroplastia e negativo nos casos de Carcinoma Espinocelular. O PCNA exibiu expressão intensa em todas as amostras estudadas. O Ki-67 apresentou expressão variável nos casos de carcinoma e de ceratose e negativo na pele de pálpebra. A intensidade da expressão de PCNA, Ki-67, p53 e Bcl-2, associada a outros indicadores, tais como a análise histopatológica e a apresentação clínica, fornece informações sobre a provável progressão, levando a um diagnóstico mais seguro da neoplasia.
The skin cancer is the most frequent type of human cancer and shows an increase in its incidence in recent years, making it an important public health problem worldwide. In many cases before the onset of carcinoma install a precursor lesion, actinic keratosis, which can develop into squamous cell carcinoma. Considering the increase of new cases and relapses frequent, studies have been intensified in order to determine the parameters with prognostic significance in predicting those tumors which have more aggressive behavior, and can develop metastases. The objective was to evaluate the expression of markers of cell proliferation (PCNA, Ki-67) and apoptosis (p53,Bc1-2) in patients with squamous cell carcinoma and actinic keratosis. We studied samples from 30 patients, ten patients of squamous cell carcinoma, ten with actinic keratosis and ten samples free of lesions underwent blepharoplasty. The p53 protein was expressed in all cases with different quantitative patterns. The Bcl-2 was expressed at low intensity in six cases of actinic keratosis in the skins of blepharoplasty and negative in cases of squamous cell carcinoma. The PCNA showed intense expression in all samples. The Ki-67 showed variable expression in cases of keratosis and carcinoma and negative in the skin of eyelid. In conclusion the intensity of expression of PCNA, Ki-67, P53 and Bcl-2, associated with other indicators such as histopathological analysis and clinical presentation, provides information on the likely progression, leading to a more secure diagnosis of malignancy.
Pan, Yi y 潘益. "Application of a Three-dimensional Tracking System with Harmonic Generation Microscope for Diagnosing Multiple Actinic Keratosis". Thesis, 2019. http://ndltd.ncl.edu.tw/handle/72724h.
Texto completo國立臺灣大學
光電工程學研究所
107
Actinic keratosis (AK) is a common cutaneous neoplasm consisting of proliferation of atypical epidermal keratinocytes resulting from severe solar damage. AKs are important because of their potential to develop into invasive cutaneous squamous cell carcinoma (SCC) with the highest incidence in the aged population. AK patients usually have multiple AKs. To study the diagnosis of AK, in vivo harmonic generation microscopy (HGM) was proposed as the imaging tool. HGM provides submicron resolution crucial for histopathological examination and causes little optical damage in bio-tissues. With HGM, this thesis is aimed at seeking out the consistent cell morphology in comparison with the H&E stained histopathological images. Five Asian volunteers (2 females and 3 males) aged from 70 to 93 years old with AK were enrolled in this study. It contained 1 ex vivo and 4 in vivo examinations. Due to the clinical demands, we also developed movable HGM system with light guide in this study. HGM and H&E images of AK both show parakeratosis and hyperkeratosis in the stratum corneum (SC), irregular acanthosis, abnormal architecture and pleomorphism of cells and nuclei in the stratum spinosum (SS), crowding of keratinocytes, abnormal architecture and pleomorphism of cells and nuclei in the stratum basale (SB), and solar elastosis in the dermis. Moreover, we also found dendritic-like cells in AK through HGM images. Our case study indicates that noninvasive HGM may become an alternative to invasive biopsy in the diagnosis of AKs and also helps physician to improve follow-up treatment assessment.
Jardim, Ana Sofia Lourenço. "Betula spp na clínica: evidência científica". Master's thesis, 2019. http://hdl.handle.net/10316/89992.
Texto completoIntroduction: Nowadays, medicinal plants are reaching a spotlight, with their biopharmacological properties taking a centre stage in human health. Birch is a tree from the Betulaceae family, which has been used empirically since ancestral times, due to its wide therapeutic actions. Through unceasing investigation, researchers have been able to gather the necessary scientific evidence to prove such therapeutic properties, sustaining current uses. Nevertheless, the latest advances also allowed to unveil new ones. Objective: To write a critical review, aiming to compile and describe the main scientifically sustained biopharmacological properties of birch tree and of its main phytoconstituents: betulin and betulinic acid. Methods: Scientific articles that fulfil the objectives were selected from Pubmed and Embase databases. They were reviewed and the major benefits of birch were organized according to therapeutic properties.Results: The main effects of birch were grouped into: anti-microbiological, nephro-urinary, dermatological, anti-inflammatory, endocrine-metabolic, neuroprotective and oncological. The collected information shows enough scientific evidence to support such properties, reflecting birch’s potential therapeutic application. Conclusion: The state-of-play concerning birch supports its empiric and ancestral use. Moreover, new applications have also been discovered, while the safety and efficacy of this medicinal plant were confirmed. Through biotechnological progress, researchers revealed the underlying mechanisms of action and, at the same time, improved some limitations of these bioactives, specially their decreased bioavailability. Although more studies, particularly in vivo, are still needed to corroborate these findings, today’s scientific evidence allows us to believe that, in the coming years, a clinical application of birch might actually be achieved.
Introdução: No mundo atual, as plantas medicinais têm ganho um crescente destaque, com as suas diversas propriedades biofarmacológicas a assumirem um papel cada vez mais importante. A Bétula é uma árvore pertencente à família Betulaceae, que, dadas as suas vastas ações terapêuticas, era utilizada empiricamente em tempos ancestrais. Com a extensa investigação desenvolvida nesta área e o atual avanço biotecnológico, tais ações vieram a ser sustentadas e outras tantas viriam a ser evidenciadas, motivo pelo qual é ainda hoje utilizada mundialmente. Objetivo: Redigir uma revisão crítica que tem como finalidade indagar e reunir as principais e cientificamente sustentadas atividades biofarmacológicas da Bétula e seus principais fitoconstituintes, nomeadamente a betulina e o ácido betulínico. Métodos: Através de uma pesquisa eletrónica nas bases de dados PubMed e Embase, foram recolhidos artigos que cumprissem os objetivos. Procedeu-se à sua revisão, e à organização dos principais benefícios associados a esta planta por temas. Resultados: Tendo em conta a informação disponível, foi possível agrupar os principais efeitos associados a esta planta em: antimicrobiológicos, nefrourinários, dermatológicos, anti-inflamatórios, endócrino-metabólicos, neuroprotetores e oncoprotetores. A evidência científica revela resultados promissores em todas estas áreas, fazendo desta planta medicinal, e respetivos bioativos, potenciais agentes terapêuticos. Conclusão: A informação científica atual, além de suportar o uso empírico e ancestral desta árvore, e de desvendar outras tantas aplicações, sustenta também o seu bom perfil de segurança e elevada eficácia. A evolução biotecnológica permitiu estudar os mecanismos subjacentes a estes efeitos e melhorar limitações relativas à biodisponibilidade destes bioativos, ambicionando, um dia, a sua aplicação clínica. Contudo, são necessários mais estudos, nomeadamente in vivo que comprovem tais achados.
Στραβοδήμου, Αριστέα. "Μελέτη των Τ-ρυθμιστικών λεμφοκυττάρων στο in situ και διηθητικό καρκίνωμα εκ πλακώδους επιθηλίου του δέρματος και στην ακτινική υπερκεράτωση". Thesis, 2015. http://hdl.handle.net/10889/8717.
Texto completoSquamous cell carcinoma (SCC) of the skin is the second most common skin cancer. It usually develops in a background of actinic keratosis (AK). Neoplastic cells express a variety of antigens, attracting lymphocytes in the tumor microenvironment (Tumor Ιnfiltrating Lymphocytes-TILs). Based on the immunophenotypic profile, the majority of TILs expresses the CD3 molecule, so they are T-lymphocytes. These in turn are divided into CD8+ cytotoxic T-lymphocytes and CD4+ T-lymphocytes. The expression of CD25 enables the separation of CD4+ lymphocytes in two further subgroups, the T-helper (CD4+/CD25-) and T-regulatory (CD4+/CD25+) cells. The most reliable marker for the detection of T-regulatory cells (Tregs) is considered to be the Forkhead box P3 (Foxp3). The increased number of TILs is associated with prognosis and treatment in a variety of tumors, including skin cancers, such as melanoma. The evaluation methology of lymphocytic infiltration, however, is not yet clarified and varies in different types of tumors. In the context of this thesis, the detection of T-lymphocytes was performed by immunohistochemistry using the appropriate antibodies (CD3, CD4, CD8, Foxp3). The presence of the cells was evaluated using light microscopy with two different semiquantitative scoring systems, for all the T-lymphocyte subpopulations, as well as with a third system of quantification of Tregs. The purpose was to compare the methods in order to find the most suitable methodology for the evaluation of the lymphocytic infiltration in squamous cell carcinoma of the skin, to evaluate the number of Tregs in the studied entities using the best method and examine for differences in the density of lymphocyte subpopulations.