N.M. Forones

Universidade Federal de São Paulo

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Katia Barão

Universidade Federal de São Paulo

Aledson Vitor Felipe

Universidade Federal de Campina Grande

Célia Aparecida Marques Pimenta

Universidade Federal de São Paulo

Celina T. F. Oshima

Universidade Federal de São Paulo

Raphael L. C. Araújo

Universidade Federal de São Paulo

Diego Miguel

Escola Bahiana de Medicina e Saúde Pública

Fernanda Capareli

Hospital Sírio-Libanês

Gustavo Spadaccia dos Santos Fernandes

Hospital Sírio-Libanês

Maria Lúcia Gomes Ferraz

Universidade Católica de Pernambuco

Raphael P Di Paula Filho

Cooperative Institutions

Universidade Federal de São Paulo

Universidade de São Paulo

Instituto do Câncer do Estado de São Paulo

AC Camargo Hospital

Hospital São Paulo

Fundação de Apoio à Universidade Federal de São Paulo

Hospital Sírio-Libanês

Hospital das Clínicas da Faculdade de Medicina da Universidade de São Paulo

Hospital Israelita Albert Einstein

Sociedade Brasileira de Oncologia Clínica

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What are the Most Effective Methods for Assessment of Nutritional Status in Outpatients with Gastric and Colorectal Cancer?

Annals of Oncology (2013)

Mariana Abe Vicente Katia Barão Tiago da Silva N.M. Forones

Gold standard (test)

10.1093/annonc/mdt203.228

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Citations (48)

P-0232 Colorectal Cancer Screening by Human DNA Stool Quantification

Annals of Oncology (2012)

Jacqueline de Lima Yolanda Teixeira Célia Aparecida Marques Pimenta Aledson Vitor Felipe Tiago da Silva

Colorectal cancer screening

10.1016/s0923-7534(20)30159-9

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Citations (1)

Laminin concentration in ascites of patients with hepatic cirrhosis and peritoneal carcinomatosis

Brazilian Journal of Medical and Biological Research (2005)

Regina Maria Catarino José Daniel Lopes N.M. Forones Edison Roberto Parise

Laminin levels in ascitic fluid have been proposed as a marker for neoplastic ascites. We compared the concentration of laminin in serum and in ascitic fluid from patients with hepatic cirrhosis and peritoneal carcinomatosis and assessed the diagnostic value of serum laminin levels in differentiating neoplastic from benign ascites. Laminin concentrations were determined by ELISA with antibodies against laminin extracted from the human placenta, in patients with ascites due to peritoneal carcinomatosis (N = 20) and hepatic cirrhosis (N = 33). Patients with infected or hemorrhagic ascites were excluded. The receiver operating characteristic curve was used to determine the sensitivity and specificity of serum laminin for the diagnosis of neoplastic ascites. When compared to the group with cirrhosis, the carcinomatosis group presented significantly higher mean laminin levels in serum (3.3 +/- 0.5 vs 2.1 +/- 0.4 microg/ml, mean +/- SD, P < 0.05) and ascites (2.8 +/- 0.5 vs 1.6 +/- 0.4 microg/ml, P < 0.05). Although laminin concentration was higher in serum than in ascites, the laminin serum/ascites ratio and serum-ascites gradient did not differ between the studied groups. A significant correlation (r = 0.93, P < 0.0001) was observed between the serum and ascites laminin values. Serum laminin levels >2.25 microg/ml showed 100% sensitivity and 73% specificity for the diagnosis of neoplastic ascites. Serum concentration seems to be the main determinant of laminin levels in ascitic fluid and its values can be used as a diagnostic parameter in the study of neoplastic ascites.

10.1590/s0100-879x2005000200016

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Citations (4)

503P Effect of probiotics on gut microbiota diversity during chemotherapy treatment in patients with gastrointestinal cancer

Annals of Oncology (2024)

N.M. Forones G. C. de Souza Ana Paula Ribeiro Paiotti H.B. Araujo Filo Cleyton Zanardo de Oliveira

Gastrointestinal cancer

10.1016/j.annonc.2024.05.418

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Association between the C3435T single-nucleotide polymorphism of multidrug resistance 1 gene and risk of gastric cancer

Molecular Medicine Reports (2012)

Juliana de Oliveira Aledson Vitor Felipe Paula Yun Joo Chang Célia Aparecida Marques Pimenta TIAGO D. SILVA

The multidrug resistance 1 (MDR1) gene encodes P-glycoprotein, which confers resistance to antineoplastic drugs, but also affects the kinetic disposition of certain drugs and carcinogens. The C3435T polymorphism of the MDR1 gene may influence the transport and excretion of carcinogens, increasing the risk of cancer. The aim of this study was to evaluate the association between this polymorphism and the risk of gastric cancer (GC). Ninety-eight patients with non-cardia GC and 203 healthy subjects participated in the study. DNA was extracted from leukocytes and the MDR1 polymorphism was analyzed using PCR-RFLP. Serology was performed by ELISA for the investigation of infection with Helicobacter pylori. No significant difference in the genotype (p=0.668) or allele (p=0.745) frequency of the C3435T polymorphism was observed between the GC and control groups. There was no association between the genotypes studied and the risk of GC in patients infected with H. pylori (p=0.662). Patient survival was not correlated with the genotypes studied (p=0.454). No correlation was observed between the C3435T polymorphism of the MDR1 gene and GC risk or prognosis in the population studied.

10.3892/mmr.2012.926

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Citations (8)

CEA and CA 19-9 as prognostic indexes in colorectal cancer.

PubMed (1999)

N.M. Forones Masao Tanaka

Carcinoembryonic Antigen (CEA) and CA 19-9 are tumor markers expressed by colorectal cancers (CR), particularly in advanced cases. The aim of this study was to evaluate the prognostic value of pre-operative elevated CEA and/or CA 19-9 levels for patients with CR. Blood samples were collected from 74 patients. CEA and CA 19-9 were determined by ELISA (normal range: 0-3 ng/ml for CEA and 0-37 U/ml for CA 19-9). All patients were followed-up for at least 30 months or until death. At the time of diagnosis, 42% of the patients had elevated serum levels of CEA and 35% of CA 19-9. Relapse was observed in 33 patients, 73% of whom had elevated CEA and/or CA 19-9 levels. Among patients without relapse, 68% and 73% had normal values of CEA and CA 19-9, respectively. Ninety-three percent of patients, who had CR recurrence during the first year, had an elevated CEA and/or CA 19-9 level, while 67% of the patients with CR after 1 year, had normal tumor markers. Elevated pre-operative serum CEA and CA 19-9 levels were each predictive of increased cancer mortality (p = 0.001 for CEA, p = 0.01 for CA 19-9). Raised CEA and CA 19-9 levels identify patients at high risk for CR and death and may be useful in selecting patients for adjuvant therapy.

Carcinoembryonic antigen

CA19-9

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Citations (48)

The role of minimally invasive hepatectomy for hilar and intrahepatic cholangiocarcinoma: A systematic review of the literature

Journal of Surgical Oncology (2020)

Daniel Kitayama Shiraiwa Parisina Fraga Dutra Cabral de Carvalho Carlos Maeda Luciana C. Silva N.M. Forones

Abstract Despite the fact laparoscopic liver resections (LLR) for cholangiocarcinoma is still limited, this systematic review addressed surgical and oncological outcomes of LLR to treat both perihilar cholangiocarcinoma (pCCA) and intrahepatic cholangiocarcinoma (iCCA). Five comparative and 20 noncomparative studies were found. Regarding iCCA, LLR had lower blood loss and less need for Pringle maneuver. However, open liver resections (OLR) were performed more for major hepatectomies, with better lymphadenectomy rates and higher number of harvested lymph nodes. High heterogeneity and selection bias were suggested for iCCA studies.

Intrahepatic Cholangiocarcinoma

Lymphadenectomy

10.1002/jso.25821

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Citations (37)

Immunoexpression of cyclooxygenase-1 and -2 in ulcerative colitis

Brazilian Journal of Medical and Biological Research (2007)

Ana Paula Ribeiro Paiotti Ricardo Artigiani Neto N.M. Forones Celina T. F. Oshima Sender Jankiel Miszputen

Ulcerative colitis (UC) is a disease of the colon and rectum characterized by a nonspecific chronic inflammation mediated by the concerted response of cellular and humoral events. Prostaglandins are synthesized by cyclooxygenase (COX)-1 and -2 and exhibit both pro- and anti-inflammatory activity. To evaluate COX-1 and COX-2 immunoexpression in 42 cases of UC and to correlate it with clinicopathological parameters, COX-1 and COX-2 expression was investigated by the immunohistochemistry method. Only patients with all pertinent clinical and evolutive data as well as with adequate biopsy material were included in the study. Fifteen samples of colorectal adenocarcinoma and 14 of large bowel with no histological changes were used for positive and negative controls, respectively. UC patients showed COX-1 immunoreactivity in epithelial cells in 29% of the cases and in inflammatory cells in 43%. COX-2 positivity in epithelial and inflammatory cells was found in 69% of the samples. The comparison between UC and the control groups revealed that the UC group had significantly more positive cases for COX-1 and COX-2 in inflammatory cells. Immunohistochemistry allowed the identification of COX-1 and COX-2 expression in epithelial and inflammatory cells in UC biopsies. No significant difference between COX-1 and COX-2 immunoreactivity in epithelial and inflammatory cells was observed regarding the clinicopathological parameters. COX-2 presented low expression in normal colon and high expression in colorectal adenocarcinoma. COX-2 might play a role in the pathophysiologic processes of inflammatory bowel disease and the development of neoplasia. Treatment with selective COX-2 inhibitors might be an additional option for therapy.

10.1590/s0100-879x2006005000128

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Citations (28)

[Alphafetoprotein in hepatic tumours and benign liver diseases].

PubMed (1995)

N.M. Forones Lds Queiroz Maria Lúcia Gomes Ferraz Edison Roberto Parise

AFP is an oncofetal protein found in increased levels in hepatocellular carcinoma, liver metastasis and other benign liver diseases. PURPOSE--To know the behaviour of this protein in each of these clinical situations would undoubtedly help us to discriminate between hepatocellular carcinoma and benign diseases. PATIENTS--A hundred forty nine patients were divided into 4 groups: 1. acute hepatitis (AH) n = 24, 2. chronic liver disease, viral or alcoholic (CLD) n = 81, 3. hepatic metastasis (HM) n = 29, 4. hepatocellular carcinoma (HCC) n = 15. AFP assays were done by ELISA (Abbott Diagnostica, ref. value: 15ng/mL). RESULTS--The results observed were as follows: AFP < 15ng/mL: AH 75%, CLD 86.4%, HM 79.3%, HCC 6.6%, AFP > 15 e < 100ng/mL: AH 25%, CLD 8.6%, HM 20.6%, HCC 20%, AFP > 100ng/mL: AH zero, CLD 4.9%, HM zero, HCC 49%. It is clear that depending on the cut off level, there is a decrease of sensibility which is paralleled by an increase in specificity. CONCLUSIONS--AFP levels are increased in benign liver diseases (AH, CLD) and HM, how ever levels above 100ng/mL occur much more frequently in HCC. In our sample, 93.3% of the HCC showed high levels of AFP, probably because most of the patients had advanced clinical stages of the disease.

Liver disease

Viral Hepatitis

Alpha-fetoprotein

Chronic liver disease

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Citations (6)

Combined primary neuroendocrine carcinoma and hepatocellular carcinoma of the liver in chronic hepatitis C: Case report and literature review

Gastroenterology Hepatology and Endoscopy (2018)

Flávia Appel N.M. Forones Giuseppe D’Ippolito Valéria Pereira Lanzoni Carla AL de Matos

Primary hepatic neuroendocrine carcinoma (NEC) is uncommon and its coexistence with hepatocellular carcinoma (HCC) is extremely rare.This study reports the case of a 66-year-old male patient without symptoms at presentation in whom hepatitis C and a liver nodule were discovered during routine examination.The physical examination was unremarkable and no organomegaly or palpable mass was detected.The patient had no family history of cancer.Computed tomography of the abdomen showed a liver mass measuring 5.6 cm in diameter in segment VI/VII compatible with HCC.The patient underwent right liver resection.Thereafter, triple therapy (pegylated interferon: 180 µg/week + ribavirin: 1 g/day + telaprevir: 750 mg/tid) was started to treat hepatitis C and the patient achieved a sustained virological response.Two years after the initial diagnosis, a retroperitoneal mass was detected, and histological analysis was compatible with high-grade metastatic neuroendocrine tumor.Based on this new diagnosis, the pathological material of the previous liver resection was re-evaluated, including broad immunohistochemical analysis which demonstrated the presence of primary hepatic NEC combined with HCC in a non-cirrhotic liver.The patient died 6 years after the diagnosis.This study highlights the challenge of diagnosing this rare tumor considering the absence of symptoms, radiological clues, or even histological findings.In addition, rigorous histological examination including broad immunohistochemical analysis should always be performed.Despite the relatively long survival time for such severe illness, an earlier diagnosis of the combined tumor could have changed patient outcome.

Neuroendocrine carcinoma

10.15761/ghe.1000168

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