RESUMEN
Lymph node angio- and lymphangio-genesis have been shown to play an important role in the premetastatic niche of sentinel lymph nodes. In the current study we have investigated the association of angio- and lympangio-genesis related parameters in metastatic sentinel lymph nodes of patients with melanoma with the presence of nonsentinel and distant organ metastasis. Peritumoral and intratumoral relative blood and lymphatic vessel areas (evaluated by Chalkley method), blood and lymphatic microvessel densities, and the rates of blood and lymphatic vessel proliferation were assessed in primary tumors and sentinel lymph node metastasis of 44 patients with melanoma using CD34/Ki-67 and D240/Ki-67 immunohistochemical double staining. Primary melanoma exhibited significantly higher rate of lymphatic proliferation compared with its lymph node metastasis (P < 0.05), while lymph node metastasis showed significantly higher rate of blood vessel proliferation (P < 0.05). Using multivariate logistic regression model, the rate of peritumoral lymphatic proliferation was inversely associated with positive nonsentinel lymph node status (P < 0.05), whereas the rate of intratumoral blood vessel proliferation was associated with distant organ metastasis (P < 0.05). Using multivariate Cox regression analysis, the rate of intratumoral blood vessel proliferation was also inversely associated with overall survival of patients with melanoma (P < 0.05).
Asunto(s)
Ganglios Linfáticos/patología , Linfangiogénesis , Vasos Linfáticos/patología , Melanoma/secundario , Microvasos/patología , Neovascularización Patológica , Neoplasias Cutáneas/patología , Adulto , Anciano , Anciano de 80 o más Años , Biomarcadores de Tumor/análisis , Biopsia , Proliferación Celular , Distribución de Chi-Cuadrado , Femenino , Humanos , Receptores de Hialuranos/análisis , Inmunohistoquímica , Estimación de Kaplan-Meier , Antígeno Ki-67/análisis , Modelos Logísticos , Ganglios Linfáticos/química , Metástasis Linfática , Vasos Linfáticos/química , Masculino , Melanoma/irrigación sanguínea , Melanoma/química , Melanoma/mortalidad , Microvasos/química , Persona de Mediana Edad , Análisis Multivariante , Pronóstico , Modelos de Riesgos Proporcionales , Neoplasias Cutáneas/irrigación sanguínea , Neoplasias Cutáneas/química , Neoplasias Cutáneas/mortalidad , EspañaRESUMEN
BACKGROUND: Many observational studies investigated the prognostic significance of angiogenesis and lymphangiogenesis in patients with melanoma. However, the obtained results are rather contradictory, probably due to the lack of the consensus methodology. METHODS: To investigate the prognostic significance of angiogenesis and lymphangiogenesis-related parameters in patients with melanoma, we performed a retrospective investigation following the consensus recommendations for angiogenesis and lymphangiogenesis quantification in solid tumors and reporting recommendations for tumor marker (REMARK) criteria for reporting the results. Blood and lymphatic vessel Chalkley scores, endothelial cell proliferation fractions and microvessel densities were quantified using a double immunostaining for endothelial marker CD34 or lymphendothelial marker D240 and the proliferation marker Ki-67 in 196 patients with melanoma. These parameters were evaluated separately for peritumoral (PT) and intratumoral areas and were correlated with outcome. RESULTS: In multivariate analysis PT D240 Chalkley score was identified as a strongest predictor for sentinel lymph node metastases, non-sentinel lymph node metastases, distant metastases, disease free survival and overall survival in patients with melanoma. CONCLUSIONS: If additional studies corroborate our findings, we believe that the inclusion of PT D240 Chalkley counts to the routine pathology examination of melanoma samples would provide additional information for identifying high-risk patients.
Asunto(s)
Melanoma/irrigación sanguínea , Melanoma/patología , Neoplasias Cutáneas/irrigación sanguínea , Neoplasias Cutáneas/patología , Adulto , Anciano , Anciano de 80 o más Años , Anticuerpos Monoclonales de Origen Murino/química , Antígenos CD34/metabolismo , Biomarcadores de Tumor/metabolismo , Supervivencia sin Enfermedad , Femenino , Humanos , Antígeno Ki-67/metabolismo , Ganglios Linfáticos/patología , Linfangiogénesis , Metástasis Linfática , Masculino , Melanoma/metabolismo , Persona de Mediana Edad , Neovascularización Patológica/patología , Estudios Retrospectivos , Biopsia del Ganglio Linfático Centinela/métodos , Neoplasias Cutáneas/metabolismo , Análisis de Supervivencia , Factor C de Crecimiento Endotelial Vascular/metabolismo , Melanoma Cutáneo MalignoRESUMEN
Differences in gene expression between melanomas arising on skin intermittently and chronically sun-exposed areas were described. Additionally, several studies have shown differences in clinical characteristics and prognosis, suggesting distinct biological pathways in the development of these tumors. We performed a retrospective investigation aimed on evaluation of the differences in angiogenesis and lymphangiogenesis between melanomas arising on skin with and without signs of chronic sun-induced damage. For that purpose, we evaluated relative blood and lymphatic vessel areas, blood and lymphatic endothelial cell proliferation fractions, separately for peritumoral and intratumoral areas. We have shown that melanomas arising on sun-exposed skin exhibit lower angiogenic and lymphangiogenic potentials and better prognosis than those arising on skin without signs of chronic sun-induced damage.
Asunto(s)
Vasos Linfáticos/patología , Melanoma/patología , Neovascularización Patológica/patología , Neoplasias Cutáneas/patología , Adulto , Anciano , Anciano de 80 o más Años , Humanos , Inmunohistoquímica , Linfangiogénesis , Persona de Mediana Edad , Estudios Retrospectivos , Luz Solar/efectos adversos , Adulto JovenRESUMEN
Aims. To evaluate the vascularization in basal cell carcinomas (BCCs) and squamous cell carcinomas (SCCs) of the skin. Methods. We performed CD31 (i.e., panendothelial marker) and CD105 (i.e., proliferating endothelium marker) immunostaining on samples of 70 SCCs and 70 BCCs of the skin. We evaluated the relative blood vessel area using the Chalkley counting method in each histologic subtype of these tumours. We calculated the degree of proliferation of blood vessel endothelium dividing CD105-Chalkley score by CD31-Chalkley score. Results. We found significantly higher peritumoral and intratumoral blood vessel area in SCC when compared to BCC (both with CD31 and CD105). Chalkley counts differed significantly between groups with different BCC histologic subtypes and SCC with different grade of differentiation. Surprisingly, the degree of proliferation of blood vessel endothelium was higher in BCC when compared to SCC. Conclusions. While SCC exhibited significantly higher intratumoral and peritumoral blood vessel areas compared to BCC, the relatively low rate of proliferating endothelium in this tumour type suggests the existence of endothelial-sprouting-independent mechanisms of vascularization in SCC.
Asunto(s)
Tuberculoma/diagnóstico , Tuberculosis Cutánea/diagnóstico , Anciano de 80 o más Años , Cicatriz/etiología , Diagnóstico Tardío , Femenino , Células Gigantes/ultraestructura , Histiocitos/ultraestructura , Humanos , Linfocitos/ultraestructura , Muslo , Negativa del Paciente al Tratamiento , Tuberculoma/microbiología , Tuberculoma/patología , Tuberculosis Cutánea/microbiología , Tuberculosis Cutánea/patologíaRESUMEN
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Asunto(s)
Humanos , Femenino , Anciano de 80 o más Años , Tuberculoma/diagnóstico , Tuberculosis Cutánea/diagnóstico , Cicatriz/etiología , Diagnóstico Tardío , Células Gigantes/ultraestructura , Histiocitos/ultraestructura , Tuberculoma/microbiología , Tuberculoma/patología , Tuberculosis Cutánea/microbiología , Tuberculosis Cutánea/patología , Negativa del Paciente al TratamientoAsunto(s)
Errores Diagnósticos , Imagen por Resonancia Magnética , Neurilemoma/diagnóstico , Neoplasias Hipofisarias/diagnóstico , Biomarcadores de Tumor/análisis , Femenino , Hemianopsia/etiología , Humanos , Hipofisectomía , Hallazgos Incidentales , Persona de Mediana Edad , Síndromes de Compresión Nerviosa/etiología , Neurilemoma/química , Neurilemoma/complicaciones , Neurilemoma/patología , Neurilemoma/cirugía , Enfermedades del Nervio Óptico/etiología , Hormonas Hipofisarias/sangre , Hormonas Hipofisarias/metabolismo , Neoplasias Hipofisarias/química , Neoplasias Hipofisarias/complicaciones , Neoplasias Hipofisarias/patología , Neoplasias Hipofisarias/cirugía , Proteínas S100/análisis , Silla Turca , Vimentina/análisisRESUMEN
Los tumores müllerianos mixtos malignos o carcinosarcomas son neoplasias poco frecuentes y altamente agresivas que suelen presentarse en pacientes mayores de 60 años, generalmente en forma de metrorragia posmenopáusica y/o presencia de masas uterinas. Entre los factores de riesgo reconocidos está descrita la historia de irradiación previa del área pélvica. Presentamos 3 casos clínicos de pacientes diagnosticadas y tratadas de tumores müllerianos mixtos uterinos malignos, existiendo en todos ellos el antecedente de neoplasias que habían precisado radioterapia pélvica como parte de su tratamiento.
The malignant Mullerian mixed tumors are rare and highly aggressive, these tumors usually occur in women over 60 years and the most common clinical appearance is that of postmenopausal vaginal bleeding or the presence of uterine mass. As a risk factor is described the history of prior irradiation of the pelvic area. We reported the case of three patients with mullerian mixed tumors, in all these cases the patients have a history of cancer who required pelvic radiation as part of their treatment.