Análise dos fatores epidemiológicos, clínico-patológicos e expressão das proteínas OCT4 e NANOG em amostras de melanoma cutâneo
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2016-12-13
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Universidade Federal de Goiás
Resumo
Cutaneous melanoma is a type of skin cancer that originates in melanocytes,
predominantly affecting young and middle-aged adults. Several evidence suggests
that cancer stem cells exist for melanoma. The POU5F1 / OCT4, NANOG genes
have been studied as cancer stem markers. OCT4 and NANOG are involved in the
maintenance of pluripotency and self-renewal of undifferentiated embryonic stem
cells. This study aims to evaluate the epidemiological, clinical-pathological and
expression of the OCT4 and NANOG proteins in cutaneous melanoma samples. We
selected 102 cases for the epidemiological, clinical and pathological study,
diagnosed between the years 2004 to 2008. For survival study, patients with a followup
of up to 60 months were selected, with a recorded death. Of the 102 cases
evaluated, 62.7% were female and 37.3% male; With mean age of 57.2 years and
63.1 years respectively (p= 0.0026). The most prevalent age at diagnosis of
melanoma was between 51 and 70 years (44.1% p= 0.023). In this study, there was
a predominance of lesions located in the trunk (32.3%). Histopathological
examination of the type of tumor growth showed a predominance of the superficial
extensive type in 52.9% of the cases. According to the Breslow index, lesions with
≤1.0 mm predominated in 39.2% of the individuals, followed by lesions> 4.0 mm in
23.5% of the cases. According to the Clark level 29.4% of the cases were classified
in level IV; Followed by 25.5% cases with level V; Clark II in 23.5%; Clark III in
20.6%; And Clark I in only 1 case (1.0%). There were metastases in 47% of the
cases and the main localization sites were: lymph nodes, brain, skin and lung.
Regarding the clinical evolution of the patients, there were 26 cases of deaths due to
melanoma (25.5%). The survival curve calculated at the 60-month follow-up was
73.0%. Univariate analysis revealed significant associations between nuclear
overexpression of OCT4 and the following variables: Breslow index with thickness >
2.1 mm (p = 0.021, OR: 2.64, 95% CI: 1.15-6.05 ); Levels of Clark, IV and V (p =
0.001, OR: 4.11, 95% CI: 1.79-9.46); ulceration present (p≤0.0001; OR: 459.0; 95%
CI: 51.67-4077.27); Presence of metastases (p <0.0001, OR: 40.25, 95% CI: 12.90-
125.62), and death from cutaneous melanoma (p <0.0001). The significant
associations between cytoplasmic hyperexpression of OCT4 and the following
variables were: present ulceration (p = 0.015, OR: 2.73, 95% CI: 1.21-6.16);
Presence of metastases (p = 0.004, OR: 3.34, 95% CI: 1.47 - 7.62) and death from
cutaneous melanoma (p = 0.039, OR 2.67, 95% CI 1.05 - 6,77). And the significant
associations between the cytoplasmic hyperexpression of NANOG and the following
variables were: present ulceration (p≤ 0.0001); Presence of metastases (p ≤ 0.0001)
and death due to cutaneous melanoma (p = 0.030). Our study demonstrated a strong
association of the OCT4
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SILVA, C. T. X. Análise dos fatores epidemiológicos, clínico-patológicos e expressão das proteínas OCT4 e NANOG em amostras de melanoma cutâneo. 2016. 127 f. Tese (Doutorado em Ciências da Saúde) - Universidade Federal de Goiás, Goiânia, 2016.