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Doctoral Thesis
DOI
10.11606/T.5.2008.tde-25032009-101012
Document
Author
Full name
Eduardo Moreira de Queiroga
E-mail
Institute/School/College
Knowledge Area
Date of Defense
Published
São Paulo, 2008
Supervisor
Committee
Bacchi, Carlos Eduardo (President)
Araujo, Iguaracyra Barreto de Oliveira
Bernardi, Fabiola Del Carlo
Morais, José Carlos Oliveira de
Sotto, Mirian Nacagami
Title in Portuguese
Linfoma de Burkitt: características clinicopatológicas, imunoistoquímicas e associação com o vírus de Epstein-Barr (EBV) em populações adulta e pediátrica em diferentes regiões geográficas no Brasil
Keywords in Portuguese
Brasil
Herpesvírus humano 4
Herpesvírus humano 8
Hibridização in situ
Imunoistoquímica
Linfoma de Burkitt
Abstract in Portuguese
O linfoma de Burkitt (LB) é neoplasia linfóide de células B de alto grau que apresenta translocação constante envolvendo o proto-oncogene C-MYC. A associação com o vírus de Epstein-Barr (EBV) varia de acordo com a forma clinicopatológica. O presente estudo tem por objetivo analisar as características clinicopatológicas, imunoistoquímicas, incluindo a expressão do fator de transcrição MUM1/IRF4 e das proteínas p53 e p63, e investigar a associação com infecção pelo Herpesvírus humano 8 (HHV-8) e EBV, através de hibridização in situ e PCR, em 234 casos bem caracterizados de LB no Brasil, provenientes das 5 regiões geográficas em pacientes pediátricos e adultos, incluindo casos associados ao HIV. As características clínicas do LB no Brasil, de maneira geral, foram semelhantes às observadas na forma esporádica do LB ocorrendo nos países desenvolvidos. A infecção pelo EBV foi observada em 52,5% dos casos. A maior associação com EBV foi verificada nas regiões Norte e Nordeste e a menor na região Sul. Através de PCR, demonstrou-se predomínio de EBV do tipo A, sendo exceção a região Centro-Oeste. O fator de transcrição MUM1/IRF4 foi expresso em 39,2% dos tumores e apresentou correlação inversa com infecção pelo EBV. A expressão das proteínas p53 e p63 foi observada em 16,2% e 3,8% dos casos, respectivamente. Não se identificou infecção pelo HHV-8. O LB no Brasil apresenta características clinicopatológicas variáveis entre as regiões geográficas. A associação com infecção pelo EBV é intermediária entre a forma endêmica de LB e a forma esporádica ocorrendo em países desenvolvidos, sendo maior em regiões com indicadores sociais menos favoráveis.
Title in English
Burkitt lymphoma: clinicopathologic, immunohistochemical and association with Epstein-Barr virus (EBV) in adult and pediatric population in different geographical regions of Brazil
Keywords in English
Brazil
Burkitt lymphoma
Human herpesvirus 4
Human herpesvirus 8
Immunohistochemistry
In situ hybridization
Abstract in English
Burkitt lymphoma (BL) is a high grade B cell lymphoma with a consistent translocation involving the proto-oncogene C-MYC. The association with the Epstein-Barr virus (EBV) varies depending on the clinicopathological form. This study aims to analyze the clinicopathologic, immunohistochemical features, including the expression of transcription factor MUM1/IRF4 and p53 and p63 proteins, and investigate the association with infection by human herpesvirus-8 (HHV-8) and EBV, by in situ hybridization and PCR, in 234 well-characterized cases of BL in Brazil from the 5 different geographic regions, in adult and pediatric patients, including HIV associated cases. The clinical characteristics of BL in Brazil, in general, were similar to those observed in the sporadic form of BL occurring in developed countries. EBV infection was seen in 52.5% of cases. The strongest association with EBV was found in the North and Northeast and the lowest in the South. PCR study demonstrated predominance of EBV type A, except in the Central-West region. The transcription factor MUM1/IRF4 was expressed in 39.2% of the tumors and showed inverse correlation with EBV infection. The expression of p53 and p63 proteins was observed in 16.2% and 3.8% of cases, respectively. No evidence of HHV-8 infection was found. The BL in Brazil is clinicopathologic diverse and regionally distinct. The association with EBV infection is intermediate between the endemic form of BL and sporadic form occurring in developed countries and is higher in regions with the less favorable social indicators
 
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Doutorado.pdf (4.23 Mbytes)
Publishing Date
2009-04-06
 
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