RESUMEN
Diagnoses based on the screening of cervical smears show low interobserver reproducibility and are frequently discordant with the final histological diagnosis. The aim of this study was to identify which of the cytomorphologic criteria used in the screening of cervical smears were most predictive of the histopathological grades of cervical intraepithelial neoplasia. The abnormal cervical smears of 206 women were reviewed blindly according to 22 pre-established cytomorphological criteria. Colposcopic evaluation was carried out in all cases. The marked presence of several nuclear criteria frequently found together in the same smear was associated with high grade intraepithelial neoplasia regardless of the presence of any other criteria. On the other hand, when the nuclear criteria were less evident, the cluster of criteria related to metaplastic cells was predictive of a diagnosis of high-grade intraepithelial neoplasia. Focusing on selected cytological criteria can aggregate predictive value to cervical smear diagnoses.
Asunto(s)
Adenocarcinoma/patología , Células Epiteliales/patología , Displasia del Cuello del Útero/patología , Neoplasias del Cuello Uterino/patología , Adolescente , Adulto , Anciano , Femenino , Humanos , Tamizaje Masivo , Metaplasia , Persona de Mediana Edad , Valor Predictivo de las Pruebas , Frotis VaginalRESUMEN
We have performed association studies between a novel coding single nucleotide polymorphism (D104N) in endostatin, one of the most potent inhibitors of angiogenesis, and prostate cancer. We observed that heterozygous N104 individuals have a 2.5 times increased chance of developing prostate cancer as compared with homozygous D104 subjects (odds ratio, 2.4; 95% confidence interval, 1.4-4.16). Modeling of the endostatin mutant showed that the N104 protein is stable. These results together with the observation that residue 104 is evolutionary conserved lead us to propose that: (a) the DNA segment containing this residue might contain a novel interaction site to a yet unknown receptor; and (b) the presence of N104 impairs the function of endostatin.
Asunto(s)
Adenocarcinoma/genética , Inhibidores de la Angiogénesis/genética , Colágeno/genética , Fragmentos de Péptidos/genética , Polimorfismo Genético , Neoplasias de la Próstata/genética , Anciano , Inhibidores de la Angiogénesis/química , Inhibidores de la Angiogénesis/fisiología , Colágeno/química , Colágeno/fisiología , Endostatinas , Predisposición Genética a la Enfermedad , Humanos , Masculino , Persona de Mediana Edad , Modelos Moleculares , Fragmentos de Péptidos/química , Fragmentos de Péptidos/fisiología , Electricidad Estática , Propiedades de SuperficieRESUMEN
Os autores avaliaram a concordância diagnóstica cito-histológica de lesöes de colo uterino e discutiram as eventuais discrepâncias. OBJETIVO. Averiguar o nível de concordância cito-histológica nos casos da Divisäo de Patologia do Instituto Adolfo Lutz (IAL) e aprimorar a estratégia de garantia de qualidade na instituiçäo. MATERIAL E MÉTODO. Estudaram 157 casos consecutivos dos arquivos do IAL em que foram enviadas citologia cérvico-vaginal e biópsia. RESULTADO. Houve concordância absoluta em 119 (75,8 por cento) casos; nos demais, a citologia superestimou 11 lesöes (7,0 por cento) e subestimou 27 (17,2 por cento). Observou-se que em 5 casos, inicialmente diagnosticados como inflamatório pela citologia, dois foram, à revisäo, considerados como NIC 1; os demais foram ratificados como inflamatórios, apesar de suas respectivas biópsias terem diagnóstico de neoplasia intra-epitelial cervical. CONCLUSÄO. Tais resultados demonstram a importância da correlaçäo cito-histológica para o sistema de garantia de qualidade em diagnóstico citológico e apontam para a colheita como um dos fatores determinantes nas discrepâncias diagnósticas.
Asunto(s)
Humanos , Femenino , Garantía de la Calidad de Atención de Salud , Cuello del Útero/patología , Citodiagnóstico , Método Simple Ciego , Neoplasias del Cuello Uterino , Estudios RetrospectivosRESUMEN
UNLABELLED: The cytohistologic diagnosis concordance of the cervix-uterine lesions was evaluated and the discordances are discussed. PURPOSE: To evaluate the level of cytohistological diagnosis agreement in the Pathology Division of the Adolfo Lutz Institute and enhance parameters of quality assurance system developed in this institution. METHODS: The authors retrospectively evaluated 157 pairs of cytologyhistology consecutive cases from the files the Adolfo Lutz Institute (Division of Pathology). RESULTS: Agreement was found in 119 cases (75.8%); in the remaining cases cytologic diagnosis were higher than histology in 11 lesions (7.0%) and lower in 27 (17.2%). We also observed that in 5 cases previously diagnosed as inflammatory, 2 of them were reclassified as CIN 1; after revision, the others remained as inflammatory even though they had a histological diagnosis of CIN. CONCLUSION: These results showed the role of cytohistological correlation to the quality assurance system of cytological diagnosis and also stressed the importance of taking the cervical scrapes with accurate care to avoid diagnostic discrepancies.
Asunto(s)
Cuello del Útero/patología , Citodiagnóstico/normas , Garantía de la Calidad de Atención de Salud , Femenino , Humanos , Estudios Retrospectivos , Neoplasias del Cuello Uterino/prevención & controlRESUMEN
OBJECTIVE: To suggest which system of cytologic classification (Bethesda System or World Health Organization [WHO]) of cervical lesions is more adequate for the Public Health Service of São Paulo State, Brazil, based on morphometric study with the Jandel Videoanalysis (JAVA) System. STUDY DESIGN: The study comprised groups of typical smears: cervical intraepithelial neoplasia (CIN 1) separated into two subgroups: cytopathic effects of human papillomavirus associated or not with dyskaryosis, CIN 2 and CIN 3. The JAVA system of image analysis was used to determine the nuclear/cytoplasmic (N/C) ratio in abnormal cells from each group. RESULTS: Significant differences were detected between the three grades of CIN and between the two subgroups of CIN 1. CONCLUSION: Although image analysis is not applicable to large-scale population screening of cervical smears, its use in the present study favored the three-grade cytologic classification (WHO). In addition, the three-grade classification offers the clinician more options for treatment. Considering the clinical-laboratory characteristics of our public health service, the three-grade classification is more adequate.
Asunto(s)
Displasia del Cuello del Útero/clasificación , Displasia del Cuello del Útero/diagnóstico , Neoplasias del Cuello Uterino/clasificación , Neoplasias del Cuello Uterino/diagnóstico , Núcleo Celular/patología , Citoplasma/patología , Femenino , Humanos , Procesamiento de Imagen Asistido por Computador , Papillomaviridae , Infecciones por Papillomavirus/patología , Infecciones Tumorales por Virus/patologíaRESUMEN
The authors describe a case of cerebellar abscess by Nocardia in a patient with the acquired immunodeficiency syndrome (AIDS) that was submitted to a posterior fossa craniectomy for diagnosis and treatment. Pathological and neuroimage findings are discussed as well as the surgical approach taking into account literature data on the subject.
Asunto(s)
Síndrome de Inmunodeficiencia Adquirida/complicaciones , Absceso Encefálico/complicaciones , Nocardiosis/complicaciones , Nocardia asteroides , Adulto , Absceso Encefálico/diagnóstico , Absceso Encefálico/cirugía , Cerebelo/microbiología , Femenino , Humanos , Imagen por Resonancia Magnética , Masculino , Tomografía Computarizada por Rayos XRESUMEN
No setor de criaçäo de coelhos da DTAEP-F. M. USP foi verificada em uma coelha N.Z.W. adulta a eversäo completa da vesícula urinária. Ao exame macroscópico, a superfície mucosa apresentou-se de coloraçäo avermelhada e com formaçöes papilomatosas de 3 a 7 cm irregularmente distribuídas na porçäo distal do órgäo. Cortes histológicos da área papilomatosa demonstraram uma erosäo da mucosa recoberta por crosta de fibrina e hemáceas em alguns pontos. Preparos histológicos em outras regiöes apresentaram quadro semelhante, com áreas focais de infiltrado inflamatório mais intenso. Tais resultados permitiram concluir um quadro de cistite crônica inespecífica