http://repositorio.ufc.br/handle/riufc/405 Wed, 10 Jun 2026 15:58:37 GMT 2026-06-10T15:58:37Z http://repositorio.ufc.br/handle/riufc/86109 Título: Alterações moleculares em gliomas: perfil imuno-histoquímico, biomarcadores tumorais e potenciais alvos terapêuticos Autor(es): Gerson, Gunter Abstract: Gliomas are the most common primary malignant tumours of the central nervous system, presenting several molecular alterations that account for the mechanisms of gliomagenesis. This study is a retrospective cross-sectional analysis of 241 adult patients with cerebral gliomas, presented between 2013 and 2023 at a reference hospital in Brazil. The research aimed to evaluate the biomarkers EGFR, Pan-TRK, IDH1, PD-L1, H3K27M, ATRX, P53, HER2, and Ki-67 in patients with specific gliomas and their correlations with epidemiological, clinical, radiological, histopathological aspects, overall and progression-free survival, as well as the relationship between these gliomagenic pathways, highlighting their therapeutic potential. The selected cases underwent tissue microarray (TMA) and immunohistochemical study. Immunological detection of H3K27M, Pan-TRK, ATRX mutations, IDH1, and the non-mutated p53 pattern confirmed them as good prognostic markers. The H3K27M biomarker exhibited lower tumour grade, predominance of low-grade morphological characteristics, IDH1 mutation, and a non-mutated p53 pattern, in addition to better survival curves. Pan-TRK immunodetection was related to less infiltration of structures, IDH1 mutation, absence of PD-L1 immunodetection, lower Ki-67 index, and a non-mutated p53 pattern, as well as better survival curves and a reduced risk of tumour recurrence. The ATRX mutation is associated with the absence of micro vascularization. IDH1 showed a relationship with the population up to 50 years old, immunodetection of H3K27M, Pan-TRK, and PD-L1, in addition to lower Ki-67 indices, absence of EGFR immunodetection, and better survival curves. The non-mutated p53 pattern exhibits a lower need for adjuvant therapy. The biomarkers EGFR, PD-L1, and the mutated p53 pattern were confirmed as markers of worse prognosis. PD-L1 immunodetection was associated with higher mitotic activity and worse survival curves. EGFR positivity showed higher detection in GBMs and a relationship with wild-type IDH tumours. The mutated p53 pattern was associated with higher detection in patients over 50 years of age. The immunoreaction for the HER2 marker was excluded in only one patient, with no statistically significant results. Molecular characterization in routine tumour management is gaining increasing importance, providing therapeutic guidance and prognosis. Tipo: Tese Thu, 01 Jan 2026 00:00:00 GMT http://repositorio.ufc.br/handle/riufc/86109 2026-01-01T00:00:00Z http://repositorio.ufc.br/handle/riufc/81497 Título: Impacto da pandemia de Covid-19 no diagnóstico de neoplasias pulmonares Autor(es): Caminha, Iusta Abstract: Introduction: Lung cancer has a high incidence and is the most lethal neoplasm. Currently, adenocarcinoma is the predominant histological type, with survival closely related to the disease stage at diagnosis. The Covid-19 pandemic forced urgent adaptations in healthcare services, resulting in a challenging scenario for the prevention, screening, and diagnosis of lung neoplasms. Consequently, a drop in incidence rates and an increase in preventable deaths from the disease were recorded. Simultaneously, the large number of chest computed tomography (CT) scans performed to assess pulmonary involvement by SARS-CoV- 2 enabled the screening of a portion of the population for pulmonary tumors. Objective: To evaluate the impact of the Covid-19 pandemic on the diagnosis of lung neoplasms in Ceará, Brazil, at both population and individual levels. Methods: Histopathological reports, hospitalizations, and diagnostic tests performed during the pandemic at a reference hospital for pulmonary diseases in Ceará were assessed and compared with procedures carried out in previous years. Additionally, pulmonary nodules incidentally diagnosed via CT scans performed for Covid-19 evaluation and referred to the state’s thoracic surgery reference center were characterized according to sociodemographic, clinical, and tumor profiles, including detailed evaluation of PD-L1 immunomodulator expression. Results: The number of surgical pathology reports significantly declined in 2020 and 2021 compared to the annual volumes from 2015 to 2019 (p = 0,0006). However, the positivity rate remained stable (48,4%). A negative correlation was observed between the number of histopathological reports and the number of Covid-19 cases and deaths (p = 0,012 e 0,002 respectively). Thirty-nine patients with incidental pulmonary nodules detected on CT scans for Covid-19 evaluation were referred to the thoracic surgery department. Of these, 14 adenocarcinomas and one squamous cell carcinoma were confirmed. Patients diagnosed with cancer were older, had a higher smoking prevalence, and presented with larger nodules than the 24 patients who remained under clinical and radiological follow-up. Of these, 8 were followed for three years, and only one required surgery after a follow-up CT, with a benign tumor diagnosed. More than half of the neoplasms were in early stages. Only 3 of the 39 patients (7.7%) met the United States Preventive Services Task Force criteria for lung cancer screening, all of whom belonged to the group diagnosed with cancer. Immunohistochemical profiling of the 13 surgically resected tumors revealed considerable variability in the distribution of CD8+ lymphocytes and macrophages. PD-L1 expression showed concordance between tissue microarray (TMA) cores and the surgical specimen. Conclusion: Although the Covid-19 pandemic negatively affected the diagnosis of lung cancer at the population level, it individually benefited some patients by enabling incidental diagnosis of early-stage pulmonary neoplasms. Adenocarcinoma was the predominant histological type among incidental tumors, and immunohistochemical profiling should be cautiously interpreted when using TMAs, due to variability compared to the surgical specimen. Tipo: Tese Wed, 01 Jan 2025 00:00:00 GMT http://repositorio.ufc.br/handle/riufc/81497 2025-01-01T00:00:00Z http://repositorio.ufc.br/handle/riufc/81319 Título: BCG como plataforma vacinal: da imunidade treinada à análise in sílico de peptídeos do SARS-CoV-2 Autor(es): Campelo, Thales Alves Abstract: First identified in 2019, the SARS-CoV-2 is a Betacoronavirus that triggered a global pandemic, resulting in millions of cases and deaths. Characterized by high transmissibility and the ability to evade the acquired immunity, it infects human cells through the interaction between the Spike protein and the ACE2 receptor, initiating complex immune responses. Given the need for alternative vaccines, the Bacillus Calmette-Guérin (BCG) vaccine, widely used against tuberculosis, stands out for its potential to induce innate/trained and adaptive immunities, as well as its application in heterologous protection against viral infections. In this context, this study conducted an in silico analysis to identify and evaluate SARS-CoV-2- immunogenic peptides, with potential for incorporation into a future recombinant BCG (rBCG) to induce a specific and robust immune response against covid-19. Additionally, the immune mechanisms associated with the trained immunity conferred by BCG were revisited, highlighting its ability to reprogram monocytic cells and induce amplified responses to subsequent infections. The results highlighted the identification of immunogenic peptides derived from SARS-CoV-2, with broad population coverage and the ability to stimulate specific immune responses. Furthermore, it was demonstrated that BCG can reprogram innate immune cells through trained immunity, offering cross-protection against viral infections. The rBCG platform was identified as a viable strategy for the development of multivalent vaccines, combining innate/trained and adaptive immunities to induce effective immune responses. Despite challenges such as genetic stability and variability between strains, the findings reinforce the potential of rBCG in combating emerging diseases and pandemics. Tipo: Tese Wed, 01 Jan 2025 00:00:00 GMT http://repositorio.ufc.br/handle/riufc/81319 2025-01-01T00:00:00Z http://repositorio.ufc.br/handle/riufc/79194 Título: Autópsia Minimamente Invasiva (AMI) no serviço de verificação de óbitos do Ceará: possibilidades e avanços Autor(es): Melo, Deborah Nunes de Abstract: Introduction: minimally invasive autopsy (MIA) is a viable alternative to conventional autopsy, considered the gold standard for determining the causes of death, in the various situations in which there is no possibility of opening the body after death. Arboviruses remain a serious public health problem in Brazil, with an increase in the number of deaths each year. However, there is limited capacity to investigate these deaths, even in places with technical resources to perform autopsies, such as death verification services, due to families' rejection of the procedure. Objective: To evaluate the potential use of Minimally Invasive Autopsy (AMI) for death surveillance in the state of Ceará. Methods: a partnership between the Ministry of Health, the Universities of São Paulo, the Federal University of Ceará and Barcelona, in addition to the Ceará Health Department and the Christus University Center, facilitated a practical theoretical course at the Ceará Death Verification Service where they were trained service pathologists. After this training, it was possible to propose, evaluate and validate a flow for implementing AMI in the SVO. Results: after training and reviewing the available literature, we showed the feasibility of performing AMI in the SVO in Ceará. A flow was established, and criteria were defined for the collection, identification, transport and storage of samples according to the diagnostic methodology to be used. Over a three-month period, 43 bodies underwent AMI at SVO. Of these, 21 (48.8%) were referred with a diagnostic hypothesis of an arbovirus and, in seven (16.3%) the diagnosis was confirmed (six of chikungunya; one of dengue); cases of covid-19 (n = 9), tuberculosis (n = 5), meningitis (n = 4), cryptococcosis (n = 1), Creutzfeldt-Jakob disease (n = 1), breast neoplasia (n = 1) were also confirmed. n = 1) and human rabies (n = 1). Finally, we report the confirmation of a pediatric death due to severe dengue that was possible due to the performance of AMI at the SVO in Ceará. Conclusion: the flow created and implemented allowed the capture of deaths suspected of arboviruses, in addition to the confirmation of other pathologies of interest to epidemiological surveillance. The technique appears to be promising for use in cases where conventional autopsy is not permitted by the family. Tipo: Tese Mon, 01 Jan 2024 00:00:00 GMT http://repositorio.ufc.br/handle/riufc/79194 2024-01-01T00:00:00Z