RESUMO
Patterns of invasion and stromal response are understudied in vulvar squamous cell carcinoma. The aim of this study was to explore whether histologic features such as an infiltrative pattern of invasion and fibromyxoid stromal response (FMX-SR) are meaningful prognostic factors. We reviewed 143 vulvar squamous cell carcinoma resections and correlated patterns of invasion and stromal response with patient age, ethnicity, depth of invasion, tumor size, perineural invasion (S100/AE1/3 stain), lymph node involvement (LNI), extranodal extension, margin status, pathologic stage, and recurrence. Univariate analyses of continuous variables were performed using t tests, whereas Pearson χ tests were used for categorical variables. Logistic regression analyses examined the relationship between histopathologic characteristics and clinical outcomes. There was a statistically significant association between infiltrative tumors and an FMX-SR in comparison with noninfiltrative tumors (P<0.001). Tumors with FMX-SR were significantly more deeply invasive (P=0.0025) and more likely to have LNI (P=0.0364), extranodal extension (P=0.0227), and perineural invasion (P=0.0011) compared with tumors without FMX-SR. For cases with negative surgical margins, the association between tumors with FMX-SR and LNI was significantly strengthened (odds ratio=4.73, P=0.0042), even after adjustments for age, race, and depth of invasion (odds ratio=4.34, P=0.0154). The presence of both FMX-SR and an infiltrative pattern of invasion in tumors with negative margins was significantly associated with LNI (P=0.0235) and recurrence (P=0.0124). These results suggest that interactions between nerve, tumor, and stromal cells play a role in tumor progression and represent additional prognostic factors that help stratify those patients at highest risk for LNI, extranodal extension, and recurrence.
Assuntos
Carcinoma de Células Escamosas/secundário , Fibroma/patologia , Nervos Periféricos/patologia , Células Estromais/patologia , Neoplasias Vulvares/patologia , Adulto , Idoso , Idoso de 80 Anos ou mais , Biomarcadores Tumorais/análise , Carcinoma de Células Escamosas/química , Carcinoma de Células Escamosas/etnologia , Carcinoma de Células Escamosas/cirurgia , Distribuição de Qui-Quadrado , Progressão da Doença , Feminino , Fibroma/química , Fibroma/etnologia , Fibroma/cirurgia , Humanos , Modelos Logísticos , Metástase Linfática , Pessoa de Meia-Idade , Invasividade Neoplásica , Recidiva Local de Neoplasia , Estadiamento de Neoplasias , Neoplasia Residual , Razão de Chances , Nervos Periféricos/química , Estudos Retrospectivos , Fatores de Risco , Células Estromais/química , Fatores de Tempo , Resultado do Tratamento , Neoplasias Vulvares/química , Neoplasias Vulvares/etnologia , Neoplasias Vulvares/cirurgia , Adulto JovemRESUMO
Notalgia paraesthetica is a neuropathic pruritus on the back. The aim of this retrospective study was to examine patient characteristics in a consecutive cohort from Brazil and Germany. A total of 65 patients (49 women, 16 men; age range 25-80 years, mean 56.2 ± 12.7 years; median 57.0 years) were investigated in order to determine the spinal or peripheral origin of notalgia paraesthetica. Protein gene product 9.5-positive intraepidermal nerve fibers were significantly reduced in the pruritic compared with the non-lesional area (p < 0.05). In 32.3% of patients, radiological examinations showed a stenosis and in 47.7% a degeneration. A correlation between the radiological findings and the exact dermatomal localization of notalgia paraesthetica was found in 15.7% of the involved areas. The significant reduction in intraepidermal nerve fiber density suggests that damage to the peripheral nerves is a more important aetiological factor than spinal changes in notalgia paraesthetica.
Assuntos
Nervos Periféricos/patologia , Doenças do Sistema Nervoso Periférico/patologia , Prurido/patologia , Pele/inervação , Adulto , Idoso , Idoso de 80 Anos ou mais , Dorso , Biomarcadores/análise , Biópsia , Brasil/epidemiologia , Feminino , Alemanha/epidemiologia , Humanos , Imuno-Histoquímica , Imageamento por Ressonância Magnética , Masculino , Pessoa de Meia-Idade , Nervos Periféricos/química , Doenças do Sistema Nervoso Periférico/epidemiologia , Prurido/diagnóstico por imagem , Prurido/epidemiologia , Estudos Retrospectivos , Pele/patologia , Compressão da Medula Espinal/diagnóstico por imagem , Compressão da Medula Espinal/epidemiologia , Compressão da Medula Espinal/patologia , Nervos Espinhais/química , Nervos Espinhais/patologia , Tomografia Computadorizada por Raios X , Ubiquitina Tiolesterase/análiseRESUMO
Peripheral nerves consist of 3 layers with differing characteristics: the endoneurium, perineurium, and epineurium. The perineurium represents a continuum with the pia-arachnoid from the central nervous system and extends distally with the sheath of capsular cells of peripheral sensorial organs and propioceptive receptors. It is made of layers of flattened cells surrounded by a basement membrane and collagen fibers, forming concentrically laminated structures around single nerve fascicles. Functionally, the perineurium modulates external stretching forces (that could be potentially harmful for nerve fibers), and along with endoneurial vessels, forms the blood-nerve barrier. Multiple pathologic conditions associated with the perineurium have been described. Perineurial invasion is considered an important prognostic factor in several malignant neoplasms. Perineuriomas are true benign infrequent perineurial cell neoplasms that have been divided in 2 categories: those with intraneural localization and a more common extraneural (soft tissue) group, including sclerosing and reticular variants. Sporadic cases of malignant perineuromas have been reported. Interestingly, neurofibromas and malignant peripheral nerve sheath tumors may also display perineurial cell differentiation. The histologic appearance of perineuriomas may overlap with other soft tissue spindle cell neoplasms. Immunohistochemistry is imperative for the diagnosis, although in certain cases ultrastructural studies may be needed. Typical perineuriomas are positive for epithelial membrane antigen, glucose transporter-1-1, and claudin-1, and negative for S-100 protein and neurofilaments. Perineuriomas have mostly simple karyotypes, with one or few chromosomal rearrangements or numerical changes and it seems that specific cytogenetic aberrations may correlate with perineurioma subtype.
Assuntos
Neoplasias de Bainha Neural/patologia , Nervos Periféricos/anatomia & histologia , Nervos Periféricos/patologia , Neoplasias de Tecidos Moles/patologia , Biomarcadores Tumorais/análise , Barreira Hematoneural/anatomia & histologia , Barreira Hematoneural/química , Barreira Hematoneural/patologia , Aberrações Cromossômicas , DNA de Neoplasias/análise , Humanos , Imuno-Histoquímica , Cariotipagem , Neoplasias de Bainha Neural/química , Neoplasias de Bainha Neural/genética , Neurônios/química , Neurônios/citologia , Neurônios/patologia , Nervos Periféricos/química , Neoplasias de Tecidos Moles/química , Neoplasias de Tecidos Moles/genéticaRESUMO
Backfills of the cerebral-buccal connective (CBC) of Aplysia californica revealed a cluster of five to seven pedal-buccal projection neurons in the anterolateral quadrant of the ventral surface of each pedal ganglion. Intra- and extracellular recordings showed that the pedal-buccal projection neurons shared common electrophysiological properties and synaptic inputs. However, they exhibited considerable heterogeneity with respect to their projection patterns. All pedal-buccal projection neurons that were tested received a slow excitatory postsynaptic potential from the ipsi- and contralateral cerebral-pedal regulator (C-PR) neuron, a cell that is thought to play a key role in the generation of a food-induced arousal state. Tests were conducted to identify potential synaptic follower neurons of the pedal-buccal projection neurons in the cerebral and buccal ganglia, but none were detected. Finally, nerve recordings revealed projections from the pedal-buccal projection neurons in the nerves associated with the buccal ganglion. In tests designed to determine the functional properties of these peripheral projections, no evidence was obtained supporting a mechanosensory or proprioceptive role and no movements were observed when they were fired. It is proposed that peripheral elements utilized in consummatory phases of Aplysia feeding may be directly influenced by a neuronal pathway that is activated during the food-induced arousal state.
Assuntos
Aplysia/fisiologia , Apetite/fisiologia , Biotina/análogos & derivados , Bochecha/inervação , Extremidades/inervação , Comportamento Alimentar/fisiologia , Neurônios/fisiologia , Animais , Eletrofisiologia , Gânglios dos Invertebrados/citologia , Gânglios dos Invertebrados/efeitos dos fármacos , Gânglios dos Invertebrados/fisiologia , Interneurônios/fisiologia , Vias Neurais/fisiologia , Técnicas de Patch-Clamp , Nervos Periféricos/química , Nervos Periféricos/fisiologia , Sinapses/fisiologiaRESUMO
The development and maturation of noradrenaline-containing nerves of the rat uterine artery was investigated, histochemically and biochemically, at seven different postnatal age-stages and following acute and chronic treatment with oestradiol. Morphological changes in the vessel were quantitatively evaluated on Toluidine Blue-stained semithin sections and low magnification electronmicrographs. In summary, the uterine artery is innervated at birth; the adult pattern of innervation is established at two weeks of age; the innervation density increases progressively between the infantile and prepubertal periods, accompanying proliferation and growth of smooth muscle cells in the tunica media; changes in the innervation are followed by an increase in the tissue concentration of noradrenaline and neither the endocrine changes characterizing puberty nor acute or chronic treatment with oestradiol have an effect on the pattern of development of the uterine artery and associated noradrenaline-containing nerves. Results are interpreted considering the differential susceptibility of urinogenital organs to sex hormones.