Avaliação de biomarcadores celulares e moleculares na fisiopatologia de craniofaringiomas

Abstract

Craniopharyngiomas are rare and potentially debilitating intracranial tumors that originate in the sellar region and present a challenging clinical course. Although histologically benign, they can exhibit invasive growth, recurrence, and cause significant visual, hormonal, and metabolic dysfunctions. Despite recent advances, the pathophysiology of these tumors remains incompletely understood, and available treatments often result in substantial sequelae. It is hypothesized that the expression of proteins such as Ki-67, β-catenin, and VDAC2 is associated with variations in tumor aggressiveness and treatment response. This study aimed to characterize the clinical, histopathological, and molecular aspects of patients with craniopharyngiomas. The methodology involved the analysis of tumor samples from patients who underwent surgery at HUUFMA. Clinical review, histopathological examination, and immunohistochemical analysis for β-catenin, VDAC2, and Ki-67 were performed, with statistical correlation between clinical, morphological, and molecular findings. All analyzed tumors were of the adamantinomatous type, with a predominance in pediatric patients. Immunostaining for β-catenin revealed nuclear and cytoplasmic accumulation, confirming activation of the Wnt/β-catenin signaling pathway. VDAC2 expression was observed at varying levels and showed a statistically significant positive correlation with the proliferative index Ki-67 and β-catenin expression, suggesting its role as a marker of biological aggressiveness. In conclusion, VDAC2 expression emerges as a potential biomarker of aggressiveness in craniopharyngiomas, representing a possible future therapeutic target. These findings contribute to the advancement of pathophysiological understanding and support the development of more individualized approaches to the management of these complex tumors.