RESUMEN

Introdução: O grande omento vem sendo utilizado como estrutura de reparo desde o século XIX e a partir do século XX tem sido descrito, em meio extraperitoneal, para o tratamento de diversas afecções em várias especialidades cirúrgicas. Apesar de amplamente estudado a partir da década de 1960, não há descrição de estudos comparativos sobre o seu retalho em meio extra peritoneal. O objetivo do presente estudo foi analisar as características adaptativas do grande omento em meio extra peritoneal para identificar a real aplicabilidade cirúrgica desta estrutura. Métodos: Estudo experimental comparativo, pareado e controlado de 20 amostras teciduais de ratos (Rattus norvegicus) fêmeas obesas, irmãs da linhagem Sprague- Dawley. De cada animal foram analisados e comparados, macroscopicamente e microscopicamente, através das técnicas de Hematoxilina-eosina (HE) amostras de: (1) omento sem manipulação, (2) omento manipulado intraperitoneal, (3) omento manipulado extraperitoneal e (4) tecido adiposo subcutâneo. Resultados: omento extraperitoneal, macroscopicamente, apresentou uma coloração amarelado mais intenso, semelhante à gordura subcutânea adjacente, com alto grau de contração se comparado ao omento intraperitoneal de controle. Pela técnica de HE, foi identificado alto grau de fibrose e tamanho médio dos adipócitos semelhante ao omento de controle e inferior ao do subcutâneo (p<0,001). Conclusão: O omento extraperitoneal não se mostra capaz de promover regeneração tecidual, uma vez que não foi observado metaplasia à histologia do retalho translocado. Entretanto, pode servir para a correção de pequenas deformidades, para o tratamento de áreas isquêmicas, como estrutura carreadora para a reconstrução cirúrgica e como plataforma germinadora para o desenvolvimento de novos órgãos.

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Introduction: The greater omentum was initially used in the repair of gastrointestinal defects in the 19th century; during the 20th century, it has been used extraperitoneally in the treatment of various disorders, in several surgical specialties. Despite the fact that the greater omentum was studies in detail in the 1960s, there are no reported comparative studies concerning the use of omental flaps extraperitoneally. The present study analyzed the adaptive features of the greater omentum in the extraperitoneal space, with the aim of identifying its surgical applicability. Methods: A paired, controlled comparative study was conducted using 20 tissue samples from 5 obese female Sprague-Dawley rats (Rattus norvegicus). The following specimens from each animal were analyzed and compared, macroscopically and microscopically, using the hematoxylin-eosin (HE) technique: (1) omentum without manipulation; (2) intraperitoneally manipulated omentum; (3) extraperitoneally manipulated omentum; and (4) subcutaneous adipose tissue. Results: Macroscopically, the extraperitoneal omentum exhibited a more intense yellowish color and a higher degree of contraction than the control (intraperitoneal) omentum. The extraperitoneal omentum was similar in color to the adjacent subcutaneous adipose tissue. HE staining revealed a high degree of fibrosis and an average adipocyte size, similar to that in the control omentum, but lower than that in subcutaneous adipose tissue (p< 0.001). Conclusion: The results of this study indicate that the extraperitoneal omentum was not able to promote tissue regeneration, as metaplasia of the translocated flap was not observed in the histological analysis. However, this structure may be used to correct small deformities, in the treatment of ischemic areas, as a carrier structure for surgical reconstruction and as a germination platform for the development of new organs.

Asunto(s)

Animales , Ratas , Epiplón , Enfermedades Peritoneales , Peritoneo , Ratas , Procedimientos Quirúrgicos Operativos , Trasplante Autólogo , Estudio Comparativo , Ensayo Clínico , Estudio de Evaluación , Modelos Animales , Experimentación Animal , Grasas , Metaplasia , Epiplón/cirugía , Epiplón/patología , Enfermedades Peritoneales/cirugía , Peritoneo/cirugía , Ratas/anatomía & histología , Ratas/fisiología , Procedimientos Quirúrgicos Operativos/métodos , Trasplante Autólogo/métodos , Experimentación Animal/normas , Grasas/análisis , Grasas/uso terapéutico , Metaplasia/cirugía , Metaplasia/patología

RESUMEN

We assessed associations between steroid receptors including: estrogen-alpha, estrogen-beta, androgen receptor, progesterone receptor, the HER2 status and triple-negative epithelial ovarian cancer (ERα-/PR-/HER2-; TNEOC) status and survival in women with epithelial ovarian cancer. The study included 152 women with primary epithelial ovarian cancer. The status of steroid receptor and HER2 was determined by immunohistochemistry. Disease-free and overall survival were calculated and compared with steroid receptor and HER2 status as well as clinicopathological features using the Cox Proportional Hazards model. A mean follow-up period of 43.6 months (interquartile range=41.4 months) was achieved where 44% of patients had serous tumor, followed by mucinous (23%), endometrioid (9%), mixed (9%), undifferentiated (8.5%) and clear cell tumors (5.3%). ER-alpha staining was associated with grade II-III tumors. Progesterone receptor staining was positively associated with a Body Mass Index≥25. Androgen receptor positivity was higher in serous tumors. In stand-alone analysis of receptor contribution to survival, estrogen-alpha positivity was associated with greater disease-free survival. However, there was no significant association between steroid receptor expression, HER2 status, or TNEOC status, and overall survival. Although estrogen-alpha, androgen receptor, progesterone receptor and the HER2 status were associated with key clinical features of the women and pathological characteristics of the tumors, these associations were not implicated in survival. Interestingly, women with TNEOC seem to fare the same way as their counterparts with non-TNEOC.

Asunto(s)

Neoplasias Glandulares y Epiteliales/metabolismo , Neoplasias Ováricas/metabolismo , Receptor ErbB-2/metabolismo , Adulto , Anciano , Carcinoma Epitelial de Ovario , Supervivencia sin Enfermedad , Receptor alfa de Estrógeno/metabolismo , Receptor beta de Estrógeno/metabolismo , Femenino , Humanos , Persona de Mediana Edad , Neoplasias Glandulares y Epiteliales/mortalidad , Neoplasias Glandulares y Epiteliales/patología , Neoplasias Ováricas/mortalidad , Neoplasias Ováricas/patología , Receptores Androgénicos/metabolismo , Receptores de Progesterona/metabolismo

RESUMEN

OBJECTIVE: To examine the patterns of estrogen receptor (ER) and progesterone receptor (PR) expression in borderline ovarian tumors (BOTs) and ovarian carcinomas. We also assessed the disease-free survival (DFS) and overall survival (OS) in women with ovarian carcinoma, in relation to ER and/or PR expression. METHODS: We examined ER/PR expression in 38 BOTs and 172 ovarian carcinomas removed from patients treated at the State University of Campinas-UNICAMP (Brazil), from 1993 to 2008 and followed for up to 60 months using tissue microarray-based immunohistochemistry. RESULTS: Twenty-eight (73.7%) mucinous and 10 (26.3%) serous BOTs were included. Ovarian carcinomas consisted mainly of 79 (46.0%) serous, 44 (25.5%) mucinous, 17 (9.8%) endometrioid, 10 (5.8%) clear-cell types. There was no significant difference of the ER/PR expression between BOT and ovarian carcinoma (p=0.55 for ER alone, 0.90 for PR alone, and 0.12 for combined expression). The level of ER/PR expression in BOTs was significantly higher in serous than in mucinous tumors (p<0.01). In carcinomas, ER/PR was higher in serous tumors than in mucinous (p<0.01) and clear cell tumors (p=0.02), and higher in endometrioid tumors than in mucinous tumors (p<0.01). DFS was affected neither by the clinical characteristics nor by combined steroid receptor status. OS was found to be significantly worse (p<0.01) only in women with stages II-IV tumors and those with residual disease after surgery (p<0.01). CONCLUSION: Overall, serous and endometrioid tumors were predominantly ER/PR positive, whereas mucinous and clear-cell tumors were preponderantly ER/PR negative. DFS and OS were not affected by ER/PR expression.

RESUMEN

The aim of the study was to evaluate the relationship between clinical and pathological factors and survival in patients with double negative HER2-overexpressing carcinoma and triple negative carcinoma. One hundred and sixty-one (161) patients diagnosed with breast cancer negative for estrogen receptor (ER) and progesterone receptor (PR) were included. Of the total, 58 patients had double negative HER2-overexpressing (ER/PR-negative and HER2-positive) and 103 had triple negative (ER-negative, PR-negative and HER2-negative). ER and PR expression was assessed through immunohistochemistry (IHC) and HER2 expression was measured by immunohistochemistry and Fluorescent in situ Hybridization (FISH) analysis in tissue microarray. More than 80% had stages II and III disease and histologic grade III and nuclear grade 3. Patients with triple negative breast carcinoma had undifferentiated histologic types in 11% of cases and vascular invasion in 14.5%. Both groups had more than 50% visceral metastases. HER2 expression (p=0.42) and vascular invasion (p=0.05) did not interfere with survival. Survival of patients with Stages I-II disease was significantly longer than in those with Stage III disease both for double negative HER2-overexpressing carcinomas (p<0.0001) and triple negative carcinomas (p=0.03). The study shows that hormone receptor-negative breast carcinomas were undifferentiated and diagnosed at advanced stages and that HER2 expression was not associated with overall survival.

Asunto(s)

Neoplasias de la Mama/metabolismo , Carcinoma/metabolismo , Regulación Neoplásica de la Expresión Génica , Receptor ErbB-2/metabolismo , Receptores de Estrógenos/metabolismo , Receptores de Progesterona/metabolismo , Adulto , Anciano , Brasil , Neoplasias de la Mama/etnología , Carcinoma/etnología , Femenino , Humanos , Procesamiento de Imagen Asistido por Computador , Inmunohistoquímica , Hibridación Fluorescente in Situ , Persona de Mediana Edad , Modelos Estadísticos , Invasividad Neoplásica , Metástasis de la Neoplasia , Análisis de Secuencia por Matrices de Oligonucleótidos , Resultado del Tratamiento

RESUMEN

The aim of the study was to assess the relationship between the expression of COX-2 and p53, hormone receptors and HER-2 in the in situ (DCIS) and invasive components of ductal carcinomas (IDC) of the same breast. The expression of COX-2, p53, and hormone receptors was assessed in 87 cases of IDC with contiguous areas of DCIS. Results showed that there was no difference in COX-2 expression comparing the in situ and invasive components of the tumors. In the in situ component, there was a statistically borderline increase in p53 expression in tumors that also expressed COX-2. ER-positive specimens were more common in the group of tumors that expressed COX-2 in the invasive component. From this study we conclude that the expression of COX-2 was similar in the in situ and invasive components of the breast carcinomas. COX-2 positivity was marginally related with the expression of p53 in the in situ components, and with the ER expression in the invasive components.

Asunto(s)

Neoplasias de la Mama/patología , Mama/patología , Carcinoma Ductal/patología , Ciclooxigenasa 2/metabolismo , Proteína p53 Supresora de Tumor/metabolismo , Anciano , Biomarcadores de Tumor/genética , Biomarcadores de Tumor/metabolismo , Mama/metabolismo , Neoplasias de la Mama/genética , Neoplasias de la Mama/metabolismo , Carcinoma Ductal/genética , Carcinoma Ductal/metabolismo , Ciclooxigenasa 2/genética , Femenino , Expresión Génica , Humanos , Inmunohistoquímica , Hibridación Fluorescente in Situ , Persona de Mediana Edad , Invasividad Neoplásica , Receptor ErbB-2/genética , Receptor ErbB-2/metabolismo , Receptores de Estrógenos/genética , Receptores de Estrógenos/metabolismo , Microambiente Tumoral , Proteína p53 Supresora de Tumor/genética

RESUMEN

PURPOSE: to evaluate the expression of erbB-2 and of the estrogen and progesterone (ER/P) hormonal receptors in the transition regions between the in situ and the invasive fractions of ductal breast neoplasia (ISDC and IDC, respectively). METHODS: Eighty-five cases of breast neoplasia, containing contiguous ISDC and IDC areas, were selected. Histological specimens from the ISDC and the IDC areas were obtained through the tissue microarray (TMA) technique. The erbB-2 and the ER/PR expressions were evaluated through conventional immunohistochemistry. The McNemar's test was used for the comparative analysis of the expressions of erbB-2 protein and the ER/PR in the in situ and invasive regions of the tumors. The confidence intervals were set to 5% (p=0.05). Intraclass correlation coefficients (ICC) were calculated to assess the cross-tabulation agreement of the erbB-2 and the ER/PR expression in the ISDC and the IDC areas. RESULTS: the erbB-2 expression has not differed between the ISDC and the IDC areas (p=0.38). Comparing the two areas in each case, there was agreement in the expression of erbB-2 (ICC=0.64), PR (ICC=0.71) and ER (ICC=0.64). Restricting the analysis to tumors with the in situ component harboring necrosis (comedo), the ICC for erbB-2 was 0.4, compared to 0.6 for the whole sample. In this select group, the ICC for PR/ER did not differ substantially from those obtained with the complete dataset: as for the ER, ICC=0.7 (versus 0.7 for the entire sample) and for PR, ICC=0.7 (versus 0.6 for the entire sample). CONCLUSIONS: our findings suggest that the erbB-2 and the ER/PR expressions do not differ in the contiguous in situ and invasive components of breast ductal tumors.

Asunto(s)

Neoplasias de la Mama/metabolismo , Carcinoma Ductal de Mama/metabolismo , Carcinoma Intraductal no Infiltrante/metabolismo , Receptor ErbB-2/biosíntesis , Receptores de Estrógenos/biosíntesis , Receptores de Progesterona/biosíntesis , Neoplasias de la Mama/química , Neoplasias de la Mama/patología , Carcinoma Ductal de Mama/química , Carcinoma Ductal de Mama/patología , Carcinoma Intraductal no Infiltrante/química , Carcinoma Intraductal no Infiltrante/patología , Estudios Transversales , Femenino , Humanos , Persona de Mediana Edad , Receptor ErbB-2/análisis , Receptores de Estrógenos/análisis , Receptores de Progesterona/análisis

RESUMEN

OBJETIVOS: avaliar a expressão de erbB-2 e dos receptores hormonais para estrógeno e progesterona (RE/RP) nas regiões de transição entre as frações in situ e invasoras de neoplasias ductais da mama (CDIS e CDI, respectivamente). MÉTODOS: oitenta e cinco casos de neoplasias mamárias, contendo regiões contíguas de CDIS e CDI, foram selecionados. Espécimes histológicos das áreas de CDIS e de CDI foram obtidos através da técnica de tissue microarray (TMA). As expressões da erbB-2 e dos RE/RP foram avaliadas por meio de imunoistoquímica convencional. A comparação da expressão da erbB-2 e dos RE/RP nas frações in situ e invasoras da mama foi realizada com emprego do teste de McNemar. Os intervalos de confiança foram determinados em 5 por cento (p=0,05). Foram calculados coeficientes de correlação intraclasse (ICC) para avaliar a concordância na tabulação cruzada da expressão de erbB-2 e RE/RP nas frações de CDIS e CDI. RESULTADOS: a expressão da erbB-2 não diferiu entre as áreas de CDIS e CDI (p=0,38). Comparando caso a caso suas áreas de CDIS e CDI, houve boa concordância na expressão da erbB-2 (coeficiente de correlação intraclasse, ICC=0,64), dos RP (ICC = 0,71) e dos RE (ICC = 0,64). Considerando apenas tumores cujo componente in situ apresentasse áreas de necrose (comedo), o ICC para erbB-2 foi de 0,4, comparado a 0,6 no conjunto completo de casos. Os ICC não diferiram substancialmente daqueles obtidos com o conjunto completo de espécimes em relação aos RE/RP: para RE, ICC=0,7 (versus 0,7 no conjunto completo), e para RP, ICC=0,7 (versus 0,6 no conjunto completo). CONCLUSÕES: nossos achados sugerem que as expressões de erbB-2 e RE/RP não diferem nos componentes contíguos in situ e invasivo em tumores ductais da mama.

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PURPOSE: to evaluate the expression of erbB-2 and of the estrogen and progesterone (ER/P) hormonal receptors in the transition regions between the in situ and the invasive fractions of ductal breast neoplasia (ISDC and IDC, respectively). METHODS: Eighty-five cases of breast neoplasia, containing contiguous ISDC and IDC areas, were selected. Histological specimens from the ISDC and the IDC areas were obtained through the tissue microarray (TMA) technique. The erbB-2 and the ER/PR expressions were evaluated through conventional immunohistochemistry. The McNemar's test was used for the comparative analysis of the expressions of erbB-2 protein and the ER/PR in the in situ and invasive regions of the tumors. The confidence intervals were set to 5 percent (p=0.05). Intraclass correlation coefficients (ICC) were calculated to assess the cross-tabulation agreement of the erbB-2 and the ER/PR expression in the ISDC and the IDC areas. RESULTS: the erbB-2 expression has not differed between the ISDC and the IDC areas (p=0.38). Comparing the two areas in each case, there was agreement in the expression of erbB-2 (ICC=0.64), PR (ICC=0.71) and ER (ICC=0.64). Restricting the analysis to tumors with the in situ component harboring necrosis (comedo), the ICC for erbB-2 was 0.4, compared to 0.6 for the whole sample. In this select group, the ICC for PR/ER did not differ substantially from those obtained with the complete dataset: as for the ER, ICC=0.7 (versus 0.7 for the entire sample) and for PR, ICC=0.7 (versus 0.6 for the entire sample). CONCLUSIONS: our findings suggest that the erbB-2 and the ER/PR expressions do not differ in the contiguous in situ and invasive components of breast ductal tumors.

Asunto(s)

Femenino , Humanos , Persona de Mediana Edad , Neoplasias de la Mama/metabolismo , Carcinoma Ductal de Mama/metabolismo , Carcinoma Intraductal no Infiltrante/metabolismo , /biosíntesis , Receptores de Estrógenos/biosíntesis , Receptores de Progesterona/biosíntesis , Neoplasias de la Mama/química , Neoplasias de la Mama/patología , Estudios Transversales , Carcinoma Ductal de Mama/química , Carcinoma Ductal de Mama/patología , Carcinoma Intraductal no Infiltrante/química , Carcinoma Intraductal no Infiltrante/patología , /análisis , Receptores de Estrógenos/análisis , Receptores de Progesterona/análisis

RESUMEN

CONTEXT AND OBJECTIVE: Over the last few years, different models for human skin equivalent reconstructed in vitro (HSERIV) have been reported for clinical usage and applications in research for the pharmaceutical industry. Before release for routine use as human skin replacements, HSERIV models need to be tested regarding their similarity with in vivo skin, using morphological (architectural) and immunohistochemical (functional) analyses. A model for HSERIV has been developed in our hospital, and our aim here was to further characterize its immunoarchitectural features by comparing them with human skin, before it can be tested for clinical use, e.g. for severe burns or wounds, whenever ancillary methods are not indicated. DESIGN AND SETTING: Experimental laboratory study, in the Skin Cell Culture Laboratory, School of Medical Sciences, Universidade Estadual de Campinas. METHODS: Histological sections were stained with hematoxylin-eosin, Masson's trichrome for collagen fibers, periodic acid-Schiff reagent for basement membrane and glycogen, Weigert-Van Gieson for elastic fibers and Fontana-Masson for melanocytes. Immunohistochemistry was used to localize cytokeratins (broad spectrum of molecular weight, AE1/AE3), high molecular weight cytokeratins (34betaE12), low molecular weight cytokeratins (35betaH11), cytokeratins 7 and 20, vimentin, S-100 protein (for melanocytic and dendritic cells), CD68 (KP1, histiocytes) and CD34 (QBend, endothelium). RESULTS: Histology revealed satisfactory similarity between HSERIV and in vivo skin. Immunohistochemical analysis on HSERIV demonstrated that the marker pattern was similar to what is generally present in human skin in vivo. CONCLUSION: HSERIV is morphologically and functionally compatible with human skin observed in vivo.

Asunto(s)

Materiales Biocompatibles , Queratinas/análisis , Piel/citología , Ingeniería de Tejidos , Antígenos CD/análisis , Antígenos CD34/análisis , Antígenos de Diferenciación Mielomonocítica/análisis , Biomarcadores/análisis , Células Cultivadas , Humanos , Inmunohistoquímica , Proteínas S100/análisis , Ingeniería de Tejidos/normas , Vimentina/análisis

RESUMEN

CONTEXT AND OBJECTIVE: Over the last few years, different models for human skin equivalent reconstructed in vitro (HSERIV) have been reported for clinical usage and applications in research for the pharmaceutical industry. Before release for routine use as human skin replacements, HSERIV models need to be tested regarding their similarity with in vivo skin, using morphological (architectural) and immunohistochemical (functional) analyses. A model for HSERIV has been developed in our hospital, and our aim here was to further characterize its immunoarchitectural features by comparing them with human skin, before it can be tested for clinical use, e.g. for severe burns or wounds, whenever ancillary methods are not indicated. DESIGN AND SETTING: Experimental laboratory study, in the Skin Cell Culture Laboratory, School of Medical Sciences, Universidade Estadual de Campinas. METHODS: Histological sections were stained with hematoxylin-eosin, Masson's trichrome for collagen fibers, periodic acid-Schiff reagent for basement membrane and glycogen, Weigert-Van Gieson for elastic fibers and Fontana-Masson for melanocytes. Immunohistochemistry was used to localize cytokeratins (broad spectrum of molecular weight, AE1/AE3), high molecular weight cytokeratins (34βE12), low molecular weight cytokeratins (35βH11), cytokeratins 7 and 20, vimentin, S-100 protein (for melanocytic and dendritic cells), CD68 (KP1, histiocytes) and CD34 (QBend, endothelium). RESULTS: Histology revealed satisfactory similarity between HSERIV and in vivo skin. Immunohistochemical analysis on HSERIV demonstrated that the marker pattern was similar to what is generally present in human skin in vivo. CONCLUSION: HSERIV is morphologically and functionally compatible with human skin observed in vivo.

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CONTEXTO E OBJETIVO: Nos últimos anos, diferentes modelos de pele humana reconstruída in vitro (PHRIV) foram descritos para uso clínico e aplicações em pesquisa na indústria farmacêutica. Antes de serem liberados para uso rotineiro como substitutos de pele humana, os modelos de PHRIV necessitam de testes (estudos) comparativos com a pele humana in vivo, por meio de análises morfológica (arquitetural) e imunoistoquímica (funcional). O objetivo deste trabalho é estudar as características imunoistoquímicas de um modelo de PHRIV desenvolvido em nosso serviço, comparando-as com a pele humana, para que esse modelo de PHRIV possa vir a ser testado clinicamente em casos de queimaduras e ulcerações de pele nos quais métodos tradicionais de tratamento não estejam indicados. TIPO DE ESTUDO E LOCAL: Estudo experimental laboratorial realizado no Laboratório de Cultura de Células da Pele da Faculdade de Ciências Médicas da Universidade Estadual de Campinas (FCM/Unicamp), Campinas, São Paulo, Brasil. MÉTODOS: Cortes histológicos foram corados com hematoxilina-eosina, tricrômio de Masson para fibras colágenas, ácido periódico-reagente de Schiff para membrana basal e glicogênio, Weigert-Van Gieson para fibras elásticas e Fontana-Masson para melanócitos. Estudo imunoistoquímico foi realizado para identificar citoqueratinas de amplo espectro de pesos moleculares (AE1/AE3), citoqueratinas de alto peso molecular (34βE12), citoqueratinas de baixo peso molecular (35βH11), citoqueratinas 7 e 20, vimentina, proteína S-100 (para melanócitos e células dendríticas), CD68 (KP1, histiócitos) e CD34 (QBend, endotélio). RESULTADOS: A histologia revelou similaridade satisfatória entre PHRIV e a pele in vivo. O estudo imunoistoquímico da PHRIV demonstrou padrão semelhante de marcadores usualmente presentes na pele humana in vivo. CONCLUSÃO: A PHRIV estudada é morfológica e funcionalmente compatível com a pele humana observada in vivo.

Asunto(s)

Humanos , Materiales Biocompatibles , Queratinas/análisis , Piel/citología , Ingeniería de Tejidos , Antígenos CD/análisis , /análisis , Antígenos de Diferenciación Mielomonocítica/análisis , Biomarcadores/análisis , Células Cultivadas , Inmunohistoquímica , /análisis , Ingeniería de Tejidos/normas , Vimentina/análisis

RESUMEN

CONTEXT AND OBJECTIVE: Breast cancer is thought to derive from progressively aberrant, non-invasive breast lesions, but it is not known exactly how invasive breast cancer develops from these lesions. The aim of this study was to verify the changes in c-erbB-2 and p53 protein expression between non-neoplastic ducts, ductal carcinoma in situ and invasive ductal carcinoma found in the same breast. DESIGN AND SETTING: This was a cross-sectional study at Centro de Atenção Integral à Saúde da Mulher, Campinas, Brazil. METHODS: Fifty-six women with invasive ductal carcinoma and ductal carcinoma in situ in the same breast were included. The expression of c-erbB-2 and p53 proteins was assessed in non-neoplastic and neoplastic cells using immunohistochemical techniques. RESULTS: The c-erbB-2 protein was absent in non-neoplastic ducts but was present in 46% and 36% of in situ and invasive carcinoma components, respectively. Only 2% of non-neoplastic ducts, and 18% and 16% of ductal carcinoma in situ and invasive carcinoma components, respectively, were positive for p53 protein. No significant difference in c-erbB-2 and p53 protein expression was observed between in situ and invasive components. The nuclear grade agreement between in situ and invasive carcinoma was very good. CONCLUSIONS: The invasiveness of ductal carcinoma in situ seems to be independent of the Her-2/neu and TP53 genes. The general features of an occurrence of breast carcinoma are formulated at the outset of carcinogenesis, and the Her-2/neu and TP53 genes are involved.

Asunto(s)

Neoplasias de la Mama/metabolismo , Carcinoma in Situ/metabolismo , Carcinoma in Situ/patología , Carcinoma Ductal de Mama/metabolismo , Receptor ErbB-2/análisis , Proteína p53 Supresora de Tumor/análisis , Mama/metabolismo , Neoplasias de la Mama/patología , Carcinoma Ductal de Mama/patología , Estudios Transversales , Femenino , Humanos , Hiperplasia , Inmunohistoquímica , Invasividad Neoplásica , Oportunidad Relativa

RESUMEN

OBJECTIVE: Human herpesvirus 8 (HHV-8) and Epstein-Barr virus (EBV) are human pathogens associated to a number of neoplasms, including tumors of the Waldeyer's ring. Both viruses have been previously detected by in situ methods in tonsils and adenoids from children. HHV-8 was found in 6.8% of the cases and EBV in about one third of the cases. As they belong to the same gamma-herpesvirus subfamily and share some biological characteristics, it is of medical interest to further explore their possible relationship in the Waldeyer's ring, an issue not yet addressed in the specialized literature. The purpose of the present study is to compare the presence of EBV by in situ hybridization (ISH) in tonsils and adenoids from children up to 14 years of age in cases previously shown to be positive and negative for HHV-8. METHODS: Paraffin wax-embedded sections consisting of 38 tonsils and two adenoids from 40 patients were analyzed. HHV-8 was detected by ISH, using the T1-1 probe for the viral mRNA. EBV was also detected by ISH, using the EBER probe. Both probes and the detection systems were provided by Novocastra. RESULTS: HHV-8 was detected in 19 tonsils and one adenoid. The other 19 tonsils and one adenoid taken from the HHV-8-negative group were selected by pairing age and gender of patients with the HHV-8-positive group. In both groups EBV was detected in 13 cases and was negative in other 7. CONCLUSION: Although both viruses are related in many aspects, some biological and epidemiological features differ. This is reflected in the present results, as EBV is similarly detected in the groups negative and positive for HHV-8, favoring different mechanisms of spread.

Asunto(s)

Tonsila Faríngea/virología , Herpesvirus Humano 4/aislamiento & purificación , Herpesvirus Humano 8/aislamiento & purificación , Tonsila Palatina/virología , Tonsila Faríngea/química , Adolescente , Niño , Preescolar , ADN Viral/análisis , Femenino , Humanos , Hibridación in Situ , Lactante , Masculino , Tonsila Palatina/química , Adhesión en Parafina

RESUMEN

CONTEXT AND OBJECTIVE: Breast cancer is thought to derive from progressively aberrant, non-invasive breast lesions, but it is not known exactly how invasive breast cancer develops from these lesions. The aim of this study was to verify the changes in c-erbB-2 and p53 protein expression between non-neoplastic ducts, ductal carcinoma in situ and invasive ductal carcinoma found in the same breast. DESIGN AND SETTING: This was a cross-sectional study at Centro de Atenção Integral à Saúde da Mulher, Campinas, Brazil. METHODS: Fifty-six women with invasive ductal carcinoma and ductal carcinoma in situ in the same breast were included. The expression of c-erbB-2 and p53 proteins was assessed in non-neoplastic and neoplastic cells using immunohistochemical techniques. RESULTS: The c-erbB-2 protein was absent in non-neoplastic ducts but was present in 46 percent and 36 percent of in situ and invasive carcinoma components, respectively. Only 2 percent of non-neoplastic ducts, and 18 percent and 16 percent of ductal carcinoma in situ and invasive carcinoma components, respectively, were positive for p53 protein. No significant difference in c-erbB-2 and p53 protein expression was observed between in situ and invasive components. The nuclear grade agreement between in situ and invasive carcinoma was very good. CONCLUSIONS: The invasiveness of ductal carcinoma in situ seems to be independent of the Her-2/neu and TP53 genes. The general features of an occurrence of breast carcinoma are formulated at the outset of carcinogenesis, and the Her-2/neu and TP53 genes are involved.

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CONTEXTO E OBJETIVO: O câncer de mama se origina de lesões não-invasivas, tais como as hiperplasias atípicas e o carcinoma ductal in situ, porém não se sabe exatamente como o câncer se torna invasivo. O objetivo foi verificar alterações na expressão das proteínas c-erbB-2 e p53 entre ductos não-neoplásicos, carcinoma ductal in situ e carcinoma ductal invasivo presentes na mesma mama. TIPO DE ESTUDO E LOCAL: Estudo transversal, realizado no Centro de Atenção Integral à Saúde da Mulher, Campinas, São Paulo, Brasil. MÉTODOS: Cinqüenta e seis mulheres com o diagnóstico de carcinoma ductal invasivo e carcinoma ductal in situ na mesma mama foram selecionadas e incluídas neste estudo. A expressão das proteínas c-erbB-2 e p53 foi avaliada usando imunoistoquímica. RESULTADOS: A proteína c-erbB-2 estava ausente nos ductos não-neoplásicos, mas estava presente em 46 por cento e 36 por cento, respectivamente, dos componentes de carcinomas in situ e invasivos. Apenas 2 por cento dos ductos não-neoplásicos, 18 por cento e 16 por cento dos carcinomas in situ e carcinomas invasivos, respectivamente, foram positivos para a proteína p53. Não houve diferença significativa na expressão das proteínas c-erbB-2 e p53 entre os carcinomas ductal in situ e invasivo. A concordância do grau nuclear entre os carcinomas ductal in situ e invasivo foi muito boa. CONCLUSÕES: A capacidade de invadir do carcinoma in situ parece independente dos genes HER-2/neu e TP53. A aparência geral do carcinoma de mama é formulada na iniciação da carcinogênese e os genes Her-2/neu e TP53 estão envolvidos.

Asunto(s)

Humanos , Femenino , Neoplasias de la Mama/patología , Carcinoma in Situ/patología , Carcinoma Ductal de Mama/patología , /análisis , /análisis , Neoplasias de la Mama/metabolismo , Carcinoma in Situ/metabolismo , Carcinoma Ductal de Mama/metabolismo , Estudios Transversales , Hiperplasia , Inmunohistoquímica , Invasividad Neoplásica , Oportunidad Relativa

RESUMEN

OBJECTIVE: Human herpesvirus 8 (HHV8) has been associated with multicentric Castleman's disease, Kaposi's sarcoma and effusion non-Hodgkin's lymphoma. Epidemiological studies have shown seropositivity in variable proportions of populations. It seems to be sexually transmitted among adults and through oral contact among children. The virus has been demonstrated in desquamating oral epithelial cells, but there is no report on its presence in the Waldeyer's ring. The purpose of the present study is to detect HHV8 in tonsils and adenoids from children up to 20 years of age in which these organs had been surgically removed due to hypertrophy, using immunohistochemistry and in situ hybridization. METHODS: Paraffin wax-embedded sections consisting of 181 tonsils and 162 adenoids from 293 patients were analyzed. HHV8 was detected by immunohistochemistry (IHC) using the anti-LNA1 antibody (Novocastra) and the LSAB+ detection system (Dako). For the in situ hybridization (ISH), the T1-1 probe for the viral mRNA and the detection system used were provided by Novocastra. RESULTS: In 20 cases (6.83%), HHV8 was detected in cells morphologically characterized as lymphoid. In three of them epithelial cells were also positive. In 19 cases, the virus was detected in tonsils and in just 1 case in an adenoid. In all 20 cases detection was possible by ISH, whereas in only 2 of them there was a concomitant positivity by IHC. CONCLUSION: Our data support the oral route of contamination by HHV8 in children, in whom tonsils and adenoids may harbor the virus. It is found especially in tonsils and only rarely in adenoids. In these organs, ISH is the method of choice to detect this virus, probably due to the small amount of viral proteins.

Asunto(s)

Tonsila Faríngea/virología , Herpesvirus Humano 8/aislamiento & purificación , Inmunohistoquímica/métodos , Hibridación in Situ/métodos , Tonsila Palatina/virología , Tonsila Faríngea/cirugía , Adolescente , Adulto , Niño , Preescolar , Femenino , Infecciones por Herpesviridae/virología , Humanos , Hipertrofia/cirugía , Lactante , Masculino , Tonsila Palatina/cirugía , Sarcoma de Kaposi/virología

RESUMEN

CONTEXT: The behavior of adrenocortical tumors (ACTs) is usually difficult to establish in childhood, and the role of immunomarkers in predicting outcome has not yet been elucidated. OBJECTIVE: To investigate the relationship between clinical, pathologic, and immunohistochemical findings and prognosis in a series of children with ACTs. PATIENTS AND METHODS: Clinical data were evaluated retrospectively in 33 children with ACTs, including age at diagnosis, sex, time between first symptoms and diagnosis, clinical signs and symptoms, tumor position, and follow-up. Histologic sections were reviewed, each tumor was classified, and staging was performed according to previously published criteria. Immunohistochemical analysis of p53, Ki-67, c-Erb-B2, and Bcl-2 was performed according to previously published techniques. RESULTS: Sixty-four percent (n = 21) of the patients were female, and the age at diagnosis in the cohort ranged from 2 to 96 months. Virilization alone affected 70% (n = 23) of the patients, and 18 patients had stage 1 disease, 9 had stage 2 disease, and 3 each had stage 3 and stage 4 disease. Female sex and stage 1 and stage 2 disease were associated with good outcome. None of the histopathologic criteria evaluated correctly predicted outcome. Only tumors with a volume exceeding 200 mL were associated with malignant behavior. Because only a small number of tumors expressed the antigens, results of these immunohistochemical tests were considered inconclusive. CONCLUSION: In this sample of pediatric ACTs, the clinical and surgical parameters are the most important prognostic factors, while the immunohistochemical markers evaluated were not predictive of outcome.

Asunto(s)

Neoplasias de la Corteza Suprarrenal/patología , Adenoma Corticosuprarrenal/patología , Carcinoma Corticosuprarrenal/secundario , Neoplasias de la Corteza Suprarrenal/química , Neoplasias de la Corteza Suprarrenal/mortalidad , Adenoma Corticosuprarrenal/química , Adenoma Corticosuprarrenal/mortalidad , Carcinoma Corticosuprarrenal/química , Carcinoma Corticosuprarrenal/mortalidad , Biomarcadores de Tumor/análisis , Brasil/epidemiología , Proliferación Celular , Niño , Preescolar , Femenino , Humanos , Técnicas para Inmunoenzimas , Lactante , Masculino , Pronóstico , Estudios Retrospectivos , Tasa de Supervivencia

RESUMEN

A técnica de imuno-histoquímica é usada na rotina diagnóstica e na pesquisa em patologia humana desde 1970, porém seu uso na patologia veterinária é relativamente recente, principalmente com objetivo diagnóstico. A maior dificuldade no uso da imuno-histoquímica na patologia veterinária tem sido a falta de anticorpos específicos para os tecidos animais. Na falta de anticorpos específicos para as espécies domésticas, a patologia veterinária freqüentemente faz uso de anticorpos que apresentam reatividade cruzada entre antígenos humanos e animais. O objetivo deste trabalho foi testar a reatividade cruzada de diversos anticorpos feitos para uso humano em tecido parafinado de algumas espécies animais, utilizando-se dos novos métodos de recuperacão antigênica e amplificacão da reacão imuno-histoquímica. No presente estudo foi possível confirmar a aplicabilidade de que muitos anticorpos produzidos para diagnóstico imuno-histoquímico em patologia humana podem ser utilizados em patologia veterinária. Novos estudos são necessários a fim de se ampliar a lista de aplicabilidade desses anticorpos em diferentes espécies animais, levando sempre em consideracão as variacões de clones, diluicões, métodos de recuperacão antigênica e de revelacão.

Asunto(s)

Animales , Animales , Inmunohistoquímica , Biomarcadores de Tumor , Neoplasias/diagnóstico , Neoplasias/veterinaria , Patología Veterinaria

RESUMEN

OBJECTIVE: Herpes simplex virus (HSV) has been described as cause of acute tonsillitis. It has also been found in nasopharyngeal florid lymphoid infiltrate, mostly composed of CD4+, CD56+ T-cells, simulating lymphoma. In spite of its widespread prevalence in latent form, to the best of our knowledge no study is available on in situ detection of HSV in chronically hyperplastic nasopharyngeal lymphoid tissue. The purpose of the present study was to search for the presence of HSV 1 and 2 in 21 adenoids and 15 tonsils from children (2-12 years of age) in which these organs had been surgically removed due to hypertrophy. METHODS: Paraffin wax-embedded sections from the 36 cases were submitted to the in situ hybridization technique, using the biotinilated probe to Herpes simplex virus 1 and 2 (Pan Path, Amsterdam) and the Rembrandt Universal DISH & HRP Detection Kit (Pan Path, Amsterdam). Positive control consisted of a previously tested Herpes infected lung. RESULTS: In none of the 36 cases studied were positive nuclei detected in adenoid and tonsils, either in lymphoid, in stroma or in epithelial cells, as those seen in the positive control. CONCLUSION: HSV does not seem to be implied in tonsil or adenoid chronic lymphoid hyperplasia. These organs do not seem to harbor the virus latently, or the amount of virus is too low to be detected without amplification methods.

Asunto(s)

Tonsila Faríngea/inmunología , Tonsila Faríngea/virología , Antígenos CD4/inmunología , Antígeno CD56/inmunología , Herpes Simple/complicaciones , Herpes Simple/inmunología , Herpesvirus Humano 1/inmunología , Herpesvirus Humano 2/inmunología , Hibridación in Situ/métodos , Tonsilitis/inmunología , Tonsilitis/virología , Tonsila Faríngea/patología , Niño , Preescolar , Femenino , Humanos , Hiperplasia/inmunología , Hiperplasia/patología , Tejido Linfoide/inmunología , Tejido Linfoide/patología , Masculino , Nasofaringe/inmunología , Nasofaringe/patología , Tonsilitis/patología

RESUMEN

OBJETIVOS: avaliar a variação do grau nuclear e da expressão das proteínas p53 e c-erbB-2 e dos receptores de estrógeno (RE) no carcinoma ductal in situ (CDIS) e no carcinoma invasivo, presentes na mesma mama. MÉTODOS: estudo descritivo retrospectivo com 38 mulheres com CDIS associado a carcinoma invasivo da mama. Foi avaliado o grau nuclear e o realizado estudo imunohistoquímico para expressão das proteínas p53 e c-erbB-2 e para os RE. Os casos considerados positivos para a expressão das proteínas e dos RE foram aqueles com contagem de células positivas igual ou superior a 10 por cento. A concordância entre estas variáveis no componente in situ e invasivo foi avaliada pelo coeficiente kappa (k), interpretado de acordo com os critérios de Landis e Koch. O teste de MacNemar foi usado para testar diferenças entre os dois grupos. RESULTADOS: a concordância entre o grau nuclear e a expressão dos RE nos componentes in situ e invasivo foi de 0,89 para ambos, quase perfeita. A concordância para a expressão da proteína c-erbB-2 também foi considerada quase perfeita, com coeficiente de 0,84. Já a concordância entre a expressão da proteína p53 no componente in situ e no invasivo foi de 1,0, considerada perfeita. Não houve diferenças significativas entre o grau nuclear e as expressões das proteínas e dos RE nos componentes in situ e invasivo na mesma mama. CONCLUSÕES: existe concordância alta do grau nuclear e da expressão das proteínas p53 e c-erbB-2 no CDIS e no carcinoma invasivo presentes na mesma mama.

Asunto(s)

Humanos , Femenino , Adulto , Persona de Mediana Edad , Neoplasias de la Mama , Carcinoma Ductal de Mama , Oncogenes , Proteína p53 Supresora de Tumor

RESUMEN

Relatamos um raro caso de tumor de células granulares da mama, que pode simular um carcinoma tanto clinicamente quanto radiologicamente. Trata-se de uma paciente de 57 anos de idade, sem antecedentes familiares, apresentando nódulo palpável no quadrante inferior externo da mama direita, de consistência endurecida e contorno espiculado, de tamanho mamográfico de 14mm, BI-RADS V. Realizou-se biópsia excisional que diagnosticou tumor de células granulares. Microscopicamente, evidenciaram-se típicas células de citoplasma granular positivas para proteína S-100. Tal tumor é freqüentemente localizado na língua, podendo ocorrer em diversos órgãos. Na mama, aparece sobretudo em mulheres de idade mediana, pré-menopáusicas, localizando-se preferencialmente no quadrante superior interno. Geralmente apresenta bordas mal definidas com características infiltrativas

Asunto(s)

Humanos , Femenino , Persona de Mediana Edad , Biopsia , Neoplasias de la Mama , Inmunohistoquímica , Tumor de Células Granulares/diagnóstico

RESUMEN

Contexto: o tumor de Wilms em adulto é uma doença rara. Apresenta prognóstico pior que o tumor de Wilms na infância. Os autores relatam um caso de tumor de Wilms em paciente adulto que foi tratada com quimioterapia e nefrectomia parcial. Relato de Caso: a paciente apresentava-se com estado geral comprometido e ascite volumosa há um mês da admissão. A tomografia computadorizada de abdome revelou a presença de lesão sólida situada entre o rim e o fígado e a biópsia percutânea foi compatível com neoplasia de pequenas células. A paciente recebeu seis ciclos de taxol e cisplatina. O estudo imunoistoquímico sugeriu tratar-se de tumor de Wilms metastático. A paciente evoluiu com desaparecimento completo da ascite e persistência da massa residual retroperitoneal, que foi ressecada após o termino da quimioterapia. A paciente apresentou recidiva retroperitoneal e pulmonar dez meses após o termino do tratamento. Atualmente, encontra-se em vigência de quimioterapia. Conclusão: o tumor de Wilms em adulto apresenta uma evolução geralmente desfavorável.

Asunto(s)

Humanos , Femenino , Adulto , Neoplasias Renales , Tumor de Wilms/cirugía , Tumor de Wilms/diagnóstico , Tumor de Wilms/patología , Tumor de Wilms/tratamiento farmacológico , Recurrencia , Pronóstico

RESUMEN

CONTEXT: Surface HLA-DR antigen is usually only expressed by antigen-presenting cells (APC). In autoimmune thyroid disease, follicle cells function as APC, thus expressing HLA-DR. However, non-autoimmune thyroid diseases may also express surface class II antigens. OBJECTIVE: To evaluate the presence and pattern of HLA class II expression in autoimmune and non-autoimmune thyroid disorders. DESIGN: Retrospective: histopathological and immunohistochemical analysis. LOCATION: Referral center, university hospital. SAMPLE: Ten histologically normal thyroids, 11 GravesÆ disease, 7 HashimotoÆs thyroiditis, 10 atoxic multinodular goiter and 3 toxic adenomas were analyzed by immunohistochemistry, using a monoclonal antibody anti-HLA-DR. MAIN MEASUREMENTS: The presence of these antigens in thyroid follicular cells and their relation to inflammatory infiltrate was evaluated. The pattern of HLA-DR expression in thyroid follicular cells was analyzed: membrane, cytoplasmic or both. RESULTS: Although HLA-DR antigens were sparsely present in one of the 8 normal thyroids, in 6 of the 9 atoxic multinodular goiter and in 2 of the 3 toxic adenomas a net positivity could be seen in large areas. In all 5 HashimotoÆs thyroiditis and in 7 of the 10 GravesÆ disease cases. This expression occurred in follicle cells either in contact with inflammatory cells or not. In non-autoimmune thyroid disease, HLA-DR positivity was essentially cytoplasmic, whereas in GravesÆ disease and Hashimoto thyroiditis it was mainly in cell membranes. CONCLUSIONS: It is suggested that the HLA class II expression on the surface of follicle cells could be related to auto-antigen presentation to the immune system by these cells, leading to inflammation

Asunto(s)

Humanos , Enfermedades de la Tiroides/inmunología , Tiroiditis Autoinmune/inmunología , Antígenos HLA-DR/análisis , Genes MHC Clase II/inmunología , Enfermedades de la Tiroides/patología , Tiroiditis Autoinmune/patología , Inmunohistoquímica , Enfermedad de Graves/fisiopatología , Enfermedad de Graves/inmunología , Estudios Retrospectivos , Técnicas para Inmunoenzimas , Anticuerpos Monoclonales/análisis