RESUMO
BACKGROUND: Cervical cancer is a leading cancer in women worldwide. The Papanicolaou test (Pap test) remains the main screening tool; however, it produces high rates of false-negative and false-positive results. Gastrin-releasing peptide is a growth factor that has been implicated in many cancers, and its main receptor, the gastrin-releasing peptide receptor (GRPR), is nearly always expressed in cervical dysplasias and invasive carcinomas. The aim of this study was to evaluate the diagnostic potential of GRPR immunocytochemistry in detecting cervical dysplasia and invasive cancer. METHODS: Cervical smears were collected from 66 women in Brazil and subjected to GRPR immunocytochemistry and the Pap test. GRPR and p16 immunohistochemistry were performed in biopsies if abnormalities were detected. RESULTS: GRPR immunostaining sensitivity in detecting cervical lesions was 87.5% and its specificity was 76.7%. GRPR immunostaining showed 80% accuracy in identifying atypical squamous cells of undetermined significance (ASCUS), with 88% sensitivity and 71% specificity. CONCLUSION: This is the first immunocytochemical evaluation of GRPR expression in cervical epithelial cells. This biomarker was strongly associated with cervical dysplasia and invasive cancers. GRPR immunosignaling showed high accuracy in detecting dysplasias in cells classified as ASCUS by Pap tests. Based on these results, immunocytochemistry for GRPR may be regarded as a valuable method for early detection of cervical intraepithelial neoplasia.
Assuntos
Receptores da Bombesina/análise , Displasia do Colo do Útero/diagnóstico , Adulto , Biomarcadores Tumorais/análise , Inibidor p16 de Quinase Dependente de Ciclina , Feminino , Humanos , Imuno-Histoquímica , Pessoa de Meia-Idade , Proteínas de Neoplasias/análise , Teste de Papanicolaou , Displasia do Colo do Útero/química , Neoplasias do Colo do Útero/diagnóstico , Esfregaço VaginalRESUMO
BACKGROUND: Devic's neuromyelitis optica (NMO) is a severe neurological disease characterized by optic neuritis and transverse myelitis, which is commonly misdiagnosed as multiple sclerosis (MS). This rare syndrome has a poor prognosis, and there are very few cases described during pregnancy. CASE: We report the occurrence of NMO in a primigravida at 20 weeks, in which gestation had an adverse effect on the disease course, and emphasize the main parameters to distinguish NMO from MS. CONCLUSION: It is essential that a proper diagnosis is established before pregnancy is planned, since the prognosis for NMO and MS might differ. Although the association of gestation and NMO is extremely rare, the few available data demonstrate a significant risk of disease exacerbation. NMO patients require long term immunossupression and need to carefully evaluate the risk of getting pregnant.
Assuntos
Esclerose Múltipla/diagnóstico , Neuromielite Óptica/diagnóstico , Complicações na Gravidez/diagnóstico , Adulto , Diagnóstico Diferencial , Feminino , Humanos , Neuromielite Óptica/terapia , Gravidez , Complicações na Gravidez/terapiaRESUMO
OBJECTIVES: It was the aim of this study to evaluate whether cervical neoplasms and adjacent tissues express the gastrin-releasing peptide receptor (GRPR) and whether there is a significant difference in its distribution among preinvasive and invasive cancers. METHODS: Sections of paraffin-embedded cervical tumors (n = 88) and non-neoplastic control cervical tissues (n = 14) obtained from women registered in the Pathology Department, Academic Hospital, Federal University of Rio Grande do Sul, Porto Alegre, Brazil, were investigated by immunohistochemistry for GRPR. RESULTS: GRPR was detected in 99% of tumor specimens, mostly exhibiting a diffuse strong staining. The receptors were seldom detected in the endocervices, while ectocervices expressed GRPRs only when adjacent to neoplastic lesions. No correlation between GRPR expression and preinvasive and invasive neoplasms was found. CONCLUSIONS: To the best of our knowledge, this is the first demonstration of the widespread GRPR expression in human cervical cancer. The presence of receptors both in tumors and surrounding tissues may suggest that GRPR can play a role in the cervical carcinogenic process. These data provide a molecular basis for exploiting GRPR as a target for diagnostic and therapeutic purposes in cervical neoplasms.