RESUMO
BACKGROUND: The aim of this study was to assess detection of circulating tumor cells (CTC) using anti-CEA pre and post surgery in Chilean patients with colo-rectal cancer. MATERIALS AND METHODS: The presence of CTCs was evaluated in 80 colorectal cancer patients pre and post surgery using standard immunocytochemistry and the results were compared with findings for standard clinico-pathological parameters. RESULTS: In patients pre- surgery CEA (+) CTCs were frequently found, with no relation to tumor size or nodal status. After surgery, the presence of CTCs was associated with such clinico-pathological parameters. The frequency of CTC detection in node positive patients did not change after surgery. In patients with metastasis there was also no change in the frequency of CTC detection, and clusters of 3 or more CTCs were evident. CONCLUSIONS: Secondary CTCs are associated with clinico-pathological parameters only after surgical removal of the primary tumor, and might be important in identifying patients at high risk of relapse. Primary CTCs detected before surgical removal are frequently found, are not associated with the clinico-pathological parameters and might have a role in cancer screening. These findings suggest the need for studies with a larger population of patients.
Assuntos
Biomarcadores Tumorais/análise , Neoplasias Colorretais/patologia , Células Neoplásicas Circulantes/patologia , Estudos de Casos e Controles , Chile , Detecção Precoce de Câncer , Feminino , Seguimentos , Humanos , Masculino , Pessoa de Meia-Idade , Metástase Neoplásica , Estadiamento de Neoplasias , Prognóstico , Estudos ProspectivosRESUMO
Se presenta el caso de un paciente de 55 años de edad de la raza negra, fumador inveterado con antecedentes de salud el cual comenzó a presentar pérdida progresiva de la memoria, trastornos de conducta, irritabilidad y depresión. Se le realizan los estudios clínicos, imaginológicos y biopsia, se concluye como síndrome paraneoplásico neurológico de tipo encefalitis límbica asociado a cáncer de pulmón(AU)
The case of a 55-year-old is presented black, heavy smoker with a history of health presenting progressive memory loss, behavioral disorders, irritability and depression. He was performed clinical, imaging and biopsy studies, it is concluded as paraneoplastic neurological syndrome associated limbic encephalitis lung cancer(AU)
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Humanos , Síndromes Paraneoplásicas/diagnóstico , Síndromes Paraneoplásicas/etiologia , Encefalite Límbica/diagnóstico , Metástase Neoplásica/diagnóstico , Neoplasias PulmonaresRESUMO
Se presenta el caso de una niña de 9 años, de raza negra con condilomas acuminados de vulva, cuyas lesiones se extendían desde el clítoris a los labios y región perineal. Se han registrado pocos casos de esta enfermedad en niños en la literatura mundial. Como antecedentes patológicos de importancia fue diagnosticada infección por VIH sin tratamiento antirretroviral. El examen físico reveló múltiples condilomas y pápulas en ambos labios y clítoris. El examen ginecológico no mostró evidencia de abuso sexual. Las lesiones fueron extirpadas por tratamiento quirúrgico seguido de curas con solución antiséptica de betadine (yodo) con resultados satisfactorios. La familia recibió apoyo psicológico según fue necesario. Se concluye que los condilomas en niños son un fuerte índice de abuso sexual, pero no exclusivo(AU)
For a 9 year old girl, black with vulvar condyloma, whose lesions extended from the clitoris and perineum lip are presented. There have been few cases of this disease in children in other literatures. As significant medical history, she was diagnosed with HIV without antiretroviral treatment. Physical examination revealed multiple condylomas and bumps on both lips and clitoris. The gynecological examination showed no evidence of sexual abuse. The lesions were excised by surgery followed by healing with antiseptic Betadine (iodine) with satisfactory results. The family received counseling as necessary. As a conclusion, the condyloma in children is a strong rate of sexual abuse, but not exclusive
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Humanos , Feminino , Criança , Condiloma Acuminado/diagnóstico , Condiloma Acuminado/psicologia , Condiloma Acuminado/cirurgia , CriançaRESUMO
Hypernephroma can present as a variety of paraneoplastic, nonmetastatic conditions, including vasculitis, and rarely a lupus-type anticoagulant. Nephrectomy leads to the resolution of the systemic complaints. Malignancy, in this case hypernephroma, can present as an immune-mediated paraneoplastic syndrome which resolves after removal of the underlying tumor.
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PURPOSE: Letrozole is superior to tamoxifen in terms of response and breast preservation rates as primary systemic therapy (PST) in postmenopausal women with ER-positive early breast cancer. However, the optimum duration of endocrine PST remains uncertain. METHODS: A phase 2 multicentre, open-label trial was conducted to evaluate the efficacy of letrozole over a preoperative period of 4 months to 1 year. Seventy postmenopausal patients (over 65 years) were recruited in four centers. The primary endpoint was to establish the optimal duration of treatment defined as the time required to attain the maximum response by clinical palpation. RESULTS: The median age of the group was 79 years (66-91) and the median tumour size 35 mm (range 25-100 mm). No severe adverse events were reported. Fifty-six patients were evaluable for the primary objective. A total of 43 patients (76.8%) achieved an objective response; 29 (51.8%) being partial and 14 (25.0%) complete. The median time to objective response was 3.9 months (95% CI, 3.3-4.5) and the median time to maximum response was 4.2 months (95% CI, 4.0-4.5), although 20 (37.1%) patients achieved the maximal response within 6-12 months. CONCLUSIONS: Letrozole shows a high activity and excellent tolerability as neoadjuvant therapy in elderly patients with endocrine-dependent breast cancer. Four to six months of letrozole as PST is an optimum duration with modest benefits thereafter.
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Inibidores da Aromatase/uso terapêutico , Neoplasias da Mama/tratamento farmacológico , Terapia Neoadjuvante , Nitrilas/uso terapêutico , Pós-Menopausa , Receptores de Estrogênio/metabolismo , Receptores de Progesterona/metabolismo , Triazóis/uso terapêutico , Idoso , Idoso de 80 Anos ou mais , Neoplasias da Mama/metabolismo , Neoplasias da Mama/mortalidade , Feminino , Seguimentos , Humanos , Letrozol , Estadiamento de Neoplasias , Taxa de Sobrevida , Fatores de Tempo , Resultado do TratamentoRESUMO
BACKGROUND: Age at diagnosis is an important risk factor in neuroblastoma (NB) with worse prognosis in children older than 18 months. A more indolent course with long-term relapses and fatal outcome has been described in small series of adolescents. Our objective was to describe biological factors that contribute to this particular behaviour and could be helpful in their treatment. PROCEDURE: NB cases older than 10 years of age at diagnosis registered in the files of the Neuroblastoma Group of SEOP from 1992 to 2007 were included. Disease extension was classified according to the International Neuroblastoma Staging System (INSS). Tumour samples were studied according to the International Neuroblastoma Pathology Classification (INPC). Biological studies included MNA, 1p, 11q and 17q status and ploidy. RESULTS: Twenty-two patients, from 10.1 to 24.6 years old, were included. Advanced stages predominated. 14/17 patients presented unfavourable histology. None had NMA or 1p del. However, 11q del was found in 8/13 cases and 17q gain in 7/11. Overall survival (OS) and event-free survival (EFS) for the entire series at 5 years were 0.45 and 0.32, respectively. Moreover, 5-year OS and EFS for stage 4 patients were 0.33 and 0.15. CONCLUSIONS: NB in adolescents is a special subgroup characterised by high-risk prognostic features which differ from those seen in younger patients, especially in relation to genetic abnormalities. The outcome in stage 4 was worse than in younger metastatic children, outlining the need for new therapeutic approaches in this subgroup of patients. The exact cut-off to separate older patients has not yet been established and will probably be based on biology.
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Neoplasias Abdominais/diagnóstico , Neuroblastoma/diagnóstico , Neoplasias Abdominais/epidemiologia , Neoplasias Abdominais/genética , Neoplasias Abdominais/patologia , Adolescente , Adulto , Idade de Início , Criança , Aberrações Cromossômicas/estatística & dados numéricos , Cromossomos Humanos Par 1 , Cromossomos Humanos Par 11 , Feminino , Humanos , Hibridização in Situ Fluorescente , Masculino , Proteína Proto-Oncogênica N-Myc , Metástase Neoplásica , Neuroblastoma/epidemiologia , Neuroblastoma/genética , Neuroblastoma/patologia , Proteínas Nucleares/genética , Proteínas Oncogênicas/genética , Prognóstico , Recidiva , Estudos Retrospectivos , Adulto JovemRESUMO
BACKGROUND: Our objective was to study the proliferation and apoptotic process in 111 cases of neuroblastoma (NB) and to seek their relationship with other prognostic factors and survival. METHODS: Immunohistochemistry following ABC peroxidase was carried out for PCNA, Ki-67, bcl-2, and p53 proteins. Apoptosis analysis was performed with in situ detection of chromosomal breakdown. Molecular detection of DNA ladders by electrophoresis and amplification of MYCN was studied with PCR and Southern blot. Statistical study was performed with Pearson chi(2) and Kruskal-Wallis tests and Cox regression. RESULTS: Our results indicate that proliferative factors PCNA and Ki-67 were correlated to each other as well as to advanced stage and MYCN amplification. Regarding apoptosis, we found expression of bcl-2 protein in cases of NB without differentiation and advanced stages. p53 protein showed an inverse relation with bcl-2 and cell death measured by assay protein. In situ determination of apoptosis was found mainly in differentiated and stage 4s cases. Multivariate analysis revealed protein as the most independent risk factor of our study. CONCLUSIONS: The study of cellular proliferation and apoptosis contributes with information of prognostic value that could be applied to the design of different protocols for treatment of neuroblastoma.