Surgical treatment of neuroendocrine tumors of pancreas: clinical and immunohistochemical analysis of tumors asymptomatic and identification of molecular markers of prognosis

• Grant number: 19/03584-0
• Support Opportunities: Scholarships in Brazil - Scientific Initiation
• Start date: June 01, 2019
• End date: May 31, 2020
• Field of knowledge: Health Sciences - Medicine - Surgery
• Principal Investigator: Estela Regina Ramos Figueira
• Grantee: Júlia Fray Ribeiro
• Host Institution: Faculdade de Medicina (FM). Universidade de São Paulo (USP). São Paulo , SP, Brazil

Abstract

Pancreatic Neuroendocrine Tumors (PNET) are rare tumors with heterogenic apresentation due to their multiple subtypes which can be joined together in two major groups: nonfunctioning and functioning. Despite the existence of numerous factors that can determine the prognosis, the diagnosis of malignancy is often difficult. Furthermore, it has been discussed more conservative conduct in small non-functioning tumors. However, the treatment of uncertain malignant potential injuries, as well as the correlation between tumor's size and survival, are still controversial. Objective: This study's objective is to evaluate possible prognostic molecular factors in patients with non-functioning neuroendocrine pancreas tumor submitted to surgical treatment. Method: It will be evaluated patients with a diagnosis of NF-PNET submitted to surgical treatment. Medical records from clinical and laboratory evolutions are being analyzed, as the records of the electronic database HCMED and Tazy-ICESP. The immunohistochemical analysis will be performed to quantify possible prognostic indicators, posteriorly, this analysis will be correlated with other clinical and anatomopathological parameters. Specific antibodies will be used for the analysis of DAXX, ATRX, KI67, PTEN, TSC2, CK19, KIT, p53 and Rb. For that, the construction technique of the obtained and storage TMA (Tissue Microarrays) paraffined Cutts, will be used. The immunohistochemical reactions will be conducted by LIM-14 / Hepatic Pathology / FMUSP team. Statistical Analysis: the comparisons between two groups will be performed using Student's T-Test, Mann-Whitney or Chi-square test. Disease-Free Survival (SLD) and Disease-Specific Survival will be estimated at five and ten years calculated using the Kaplan-Meier method and compared with the log-rank test. Univariate and multivariate Cox analyses will be done to identify the factors of prognostic impact of survival.