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3.
Acta otorrinolaringol. esp ; 70(4): 200-206, jul.-ago. 2019. tab, graf
Artigo em Espanhol | IBECS | ID: ibc-185396

RESUMO

Introducción y objetivos: El tratamiento principal de los carcinomas diferenciados de tiroides es la cirugía seguida de radioyodo. El propósito de este estudio es exponer nuestra experiencia en el manejo de estos tumores. Material y método: Se presenta un estudio retrospectivo de los 55 pacientes intervenidos quirúrgicamente de un carcinoma diferenciado de tiroides en nuestro hospital entre los años 2007 y 2011. Resultados: La edad media al diagnóstico fue de 49 años, con un predominio femenino (78% de los casos). El 78% de los pacientes se encontraban en fases iniciales (estadios i y ii). El diagnóstico histopatológico definitivo fue de carcinoma papilar en el 84% y folicular en el 16% restante. A todos, salvo a 2 pacientes (4%), se les realizó una tiroidectomía total, acompañada de linfadenectomía en el 58% de los casos. Un 9% de los pacientes presentó hipoparatiroidismo permanente y aunque un 18% sufrió parálisis recurrencial unilateral transitoria, un 40% de ellos se recuperó completamente a los 6 meses. Se administró radioyodo en el postoperatorio al 89% de los pacientes. Se produjo un 40% de recidivas, la mayor parte de las cuales (29% de los pacientes) se localizaron a nivel cervical. La supervivencia a los 5 años fue del 87%, siendo del 95% en el subtipo papilar y descendiendo al 56% en el folicular (p = 0,001). Discusión/conclusiones: Los carcinomas diferenciados de tiroides son tumores con un pronóstico excelente tras un tratamiento quirúrgico adecuado previa valoración preoperatoria exhaustiva y seguimiento postoperatorio estricto debido a las tasas significativas de recidiva


Introduction and objectives: Radioiodine is the principal treatment for differentiated thyroid carcinomas. The aim of this study is to present our experience in the management of these tumours. Material and method: We present a retrospective study of 55 patients operated for differentiated thyroid carcinoma in our hospital between 2007 and 2011. Results: The mean age at time of diagnosis was 49 years, and females predominated (78% of cases). Seventy eight percent of the patients were in the initial stages (stages i and ii). The definitive histopathological diagnosis was papillary carcinoma in 84% and follicular carcinoma in the remaining 16%. All of the patients, with the exception of 2 (4%), underwent total thyroidectomy, with lymphadenectomy in 58% of cases. Nine percent of the patients had permanent hypoparathyroidism and although 18% suffered transitory unilateral paralysis, 40% of these female patients had completely recovered after 6 months. Eighty-nine percent of the patients were given radioiodine postoperatively. There was a recurrence rate of 40% most of which was at cervical level (29% of the patients). Survival at 5 years was 87%, 95% of the papillary subtype, falling to 56% of the follicular subtype (P = .001). Discussion/conclusions: The prognosis for differentiated thyroid carcinomas is excellent after appropriate surgical treatment, thorough preoperative assessment,and strict postoperative follow-up due to the significant recurrence rates


Assuntos
Humanos , Masculino , Feminino , Adulto , Adenocarcinoma Folicular/cirurgia , Carcinoma Papilar/cirurgia , Neoplasias da Glândula Tireoide/cirurgia , Adenocarcinoma Folicular/patologia , Adenocarcinoma Folicular/radioterapia , Biópsia por Agulha Fina , Carcinoma Papilar/patologia , Carcinoma Papilar/radioterapia , Seguimentos , Radioisótopos do Iodo/uso terapêutico , Estimativa de Kaplan-Meier , Metástase Neoplásica , Recidiva Local de Neoplasia/epidemiologia , Prognóstico , Radioterapia Adjuvante , Estudos Retrospectivos , Neoplasias da Glândula Tireoide/patologia , Neoplasias da Glândula Tireoide/radioterapia , Tireoidectomia
4.
Aten. prim. (Barc., Ed. impr.) ; 50(supl.2): 51-56, nov. 2018. graf
Artigo em Espanhol | IBECS | ID: ibc-179657

RESUMO

El sobrediagnóstico del cáncer es la detección de cánceres asintomáticos que no crecen o que están creciendo con tal lentitud que nunca habrían causado problemas médicos en el paciente en el transcurso de su vida. Con frecuencia, son tumores detectados a través de los cribados poblacionales pero también en el contexto clínico por los hallazgos incidentales a partir de las pruebas de imagen con tecnología avanzada. Algunos de estos tumores detectados podrían incluso hasta desaparecer espontáneamente sin tratamiento. El paciente posiblemente morirá a consecuencia de otra enfermedad antes de que el cáncer haya causado síntomas. Por esa razón, el diagnóstico de estos tumores es una causa importante de sobretratamiento, lo que puede incluir riesgos graves y toxicidad. Aunque el sobrediagnóstico puede darse en cualquier enfermedad, es más relevante en el caso del cáncer


Overdiagnosis of cancer is the detection of asymptomatic cancers that do not grow or they are growing with such slowness, that they would never have caused medical problems in the patient during the course of their life. Often they are tumours that are detected through population screenings but also in the clinical context due to incidental findings from image tests with advanced technology. Some of these tumours could even disappear spontaneously without treatment. The patient may die as a result of another disease before the cancer has caused symptoms. For that reason, the diagnosis of these tumours is an important cause of over-treatment, which can include serious risks and toxicity. Although overdiagnosis can occur in any disease, it is more relevant in the case of cancer


Assuntos
Humanos , Feminino , Sobremedicalização , Carcinoma Papilar/diagnóstico , Neoplasias da Glândula Tireoide/diagnóstico , Carcinoma Ductal de Mama/diagnóstico , Adenocarcinoma/diagnóstico , Neoplasias da Mama/diagnóstico , Programas de Rastreamento , Fatores de Risco
6.
Clin. transl. oncol. (Print) ; 20(6): 740-744, jun. 2018. tab, graf
Artigo em Inglês | IBECS | ID: ibc-173622

RESUMO

Purpose: Anti-thyroglobulin antibodies (TgAb) can be used as a surrogate tumor marker in the follow-up of papillary thyroid carcinoma (PTC). We try to determine if the change in TgAb levels in the first post-operative year is a good predictor of persistence/recurrence risk in TgAb-positive PTC patients. Methods/patients: 105 patients with PTC who underwent thyroidectomy between 1988 and 2014 were enrolled. We calculated the percentage of change in TgAb levels with the first measurement at 1-2 months after surgery and the second one at 12-14 months. Results: TgAb negativization was observed in 29 patients (27.6%), a decrease of more than 50% was observed in 57 patients (54.3%), less than 50% in 12 patients (11.4%) and in 7 patients (6.7%) the TgAb level had increased. The percentage of persistence/recurrence was 0, 8.8, 16.7 and 71.4% in each group, respectively (p < 0.001). In the multivariate analysis, only the percentage of change in TgAb showed a significant association with the risk of persistence/recurrence, regardless of other factors such as age, size and TNM stages. Conclusions: Changes in TgAb levels in the first year after surgery can predict the risk of persistence/recurrence of TgAb-positive PTC patients. Patients who achieved negativization of TgAb presented an excellent prognosis


No disponible


Assuntos
Humanos , Masculino , Feminino , Pessoa de Meia-Idade , Neoplasias da Glândula Tireoide/patologia , Tireoidectomia/estatística & dados numéricos , Carcinoma Papilar/patologia , Tireoglobulina/antagonistas & inibidores , Neoplasias da Glândula Tireoide/cirurgia , Imunoglobulinas Glândula Tireoide-Estimulantes/análise , Carcinoma Papilar/cirurgia , Testes de Função Tireóidea/estatística & dados numéricos , Biomarcadores Tumorais/análise , Estudos Retrospectivos , Resultado do Tratamento
10.
Rev. esp. patol ; 50(4): 222-228, oct.-dic. 2017. tab, ilus
Artigo em Espanhol | IBECS | ID: ibc-166037

RESUMO

La presencia de un tumor metastásico a otro tumor es un evento poco frecuente denominado como «tumor to tumor metástasis». Uno de los principales tumores receptores es el carcinoma renal de células claras (CRCC), y de hecho se conoce que afecta a la glándula tiroides; sin embargo, la coexistencia de un tumor primario de glándula tiroides con metástasis de un CRCC es un hallazgo poco frecuente. Nosotros presentamos el que podría corresponder al cuarto caso reportado en la literatura de un CRCC asociado a un carcinoma papilar de tiroides. Se revisa adicionalmente los casos previamente publicados (AU)


The presence of metastatic tumour in another tumour is an infrequent event called tumor-to-tumor metastasis. One of the main recipients tumours is renal clear cell carcinoma (RCCC) which is known to affect the thyroid gland; however, RCCC metastases in a primary tumour of the thyroid are rare. We present a case of RCCC associated with a papillary thyroid carcinoma which is, to our knowledge, only the fourth reported case to date. In addition we review the previously published cases (AU)


Assuntos
Humanos , Masculino , Idoso , Carcinoma de Células Renais , Neoplasias Renais/patologia , Glândula Tireoide/patologia , Neoplasias da Glândula Tireoide/patologia , Metástase Neoplásica/patologia , Rim/patologia , Biópsia , Carcinoma Papilar/complicações , Carcinoma Papilar/patologia , Tireoidectomia/métodos , Neoplasias Renais/complicações , Imuno-Histoquímica/métodos
11.
Endocrinol. diabetes nutr. (Ed. impr.) ; 64(8): 451-455, oct. 2017. tab
Artigo em Espanhol | IBECS | ID: ibc-171809

RESUMO

Introducción: La linfadenectomía en la cirugía del carcinoma papilar de tiroides se aconseja cuando hay evidencia de metástasis ganglionar cervical (terapéutica) o en pacientes de alto riesgo (profiláctica), como en los tumores T3 y T4 de la clasificación TNM. La técnica de la biopsia selectiva del ganglio centinela puede mejorar el diagnóstico prequirúrgico de las metástasis ganglionares. Objetivo: Analizar el resultado de la biopsia selectiva del ganglio centinela en un grupo de pacientes con carcinoma papilar de tiroides T sin evidencia de afectación ganglionar antes de la cirugía. Pacientes y método: Estudio retrospectivo, unicéntrico en el que se incluyeron los pacientes intervenidos entre los años 2011-2013 que fueran clínicamente N0. La identificación del ganglio centinela se realizó mediante técnica isotópica. En todos los casos, se practicó linfadenectomía del compartimento afecto si el ganglio centinela era positivo, y del compartimento central en caso de ganglio centinela negativo. Resultados: Se incluyeron 43 pacientes, 34 mujeres, con una edad media de 52,3 (±17) años. De los 170 ganglios centinela resecados, 46 (27%) fueron positivos para metástasis, que correspondían a 24 (55,8%) pacientes. En las linfadenectomías se resecaron 612 ganglios. De ellos, 96 (15,6%) fueron positivos para metástasis. Doce de los treinta (40%) pacientes cT1N0 y cT2N0 pasaron a pN1 tras la biopsia selectiva del ganglio centinela, mientras que 12 de los 13 (92%) pacientes cT3N0 y cT4N0, acabaron siendo pN1. Conclusiones: La biopsia selectiva del ganglio centinela recalifica más del 50% de pacientes de cN0 a pN1. Se confirma la necesidad de vaciamiento ganglionar en los tumores T3 y T4, pero pone al descubierto la presencia de metástasis linfáticas en el 40% de los T1-T2 (AU)


Introduction: Lymphadenectomy is recommended during surgery for papillary thyroid carcinoma when there is evidence of cervical lymph node metastasis (therapeutic) or in high-risk patients (prophylactic) such as those with T3 and T4 tumors of the TNM classification. Selective sentinel lymph node biopsy may improve preoperative diagnosis of nodal metastases. Objective: To analyze the results of selective sentinel lymph node biopsy in a group of patients with papillary thyroid carcinoma and no evidence of nodal involvement before surgery. Patients and method: A retrospective, single-center study in patients with papillary thyroid carcinoma and no clinical evidence of lymph node involvement who underwent surgery between 2011 and 2013. The sentinel node was identified by scintigraphy. When the sentinel node was positive, the affected compartment was removed, and when sentinel node was negative, central lymph node dissection was performed. Results: Forty-three patients, 34 females, with a mean age of 52.3 (±17) years, were enrolled. Forty-six (27%) of the 170 SNs resected from 24 (55.8%) patients were positive for metastasis. In addition, 94 (15.6%) out of the 612 lymph nodes removed in the lymphadenectomies were positive for metastases. Twelve of the 30 (40%) low risk patients (cT1N0 and cT2N0) changed their stage to pN1, whereas 12 of 13 (92%) high risk patients (cT3N0 and cT4N0) changed to pN1 stage. Conclusions: Selective sentinel lymph node biopsy changes the stage of more than 50% of patients from cN0 to pN1. This confirms the need for lymph node resection in T3 and T4 tumors, but reveals the presence of lymph node metastases in 40% of T1-T2 tumors (AU)


Assuntos
Humanos , Feminino , Masculino , Adulto , Pessoa de Meia-Idade , Idoso , Biópsia de Linfonodo Sentinela/métodos , Carcinoma Papilar/diagnóstico , Metástase Neoplásica/diagnóstico , Metástase Neoplásica/patologia , Neoplasias da Glândula Tireoide/diagnóstico , Glândula Tireoide/patologia , Tri-Iodotironina/análise , Tiroxina/análise , Estudos Retrospectivos , Excisão de Linfonodo/métodos
12.
Clín. investig. ginecol. obstet. (Ed. impr.) ; 44(3): 134-135, jul.-sept. 2017.
Artigo em Espanhol | IBECS | ID: ibc-164934

RESUMO

Las metástasis intramusculares son un hallazgo muy infrecuente, suponen aproximadamente el 1% de las metástasis, siendo más frecuente a nivel de musculatura abdominal y miembros inferiores. Esta baja incidencia es debido a que existen diferentes mecanismos de resistencia al desarrollo de las mismas, además existe un infradiagnóstico de las mismas por su baja sintomatología


Intramuscular metastases are rarely diagnosed, it about 1% all kind of metastases, and frequently are localized in the abdominal muscles and lower extremity. Low incidence is due to different resistance mechanisms to its develop, thus an underdiagnosis because its low symptomatology


Assuntos
Humanos , Feminino , Idoso , Músculo Deltoide/patologia , Neoplasias Musculares/secundário , Neoplasias Ovarianas/patologia , Metástase Neoplásica/patologia , Carcinoma Papilar/patologia
13.
Arch. esp. urol. (Ed. impr.) ; 70(6): 612-617, jul.-ago. 2017. ilus
Artigo em Espanhol | IBECS | ID: ibc-164565

RESUMO

Objectivo: Presentamos el caso de un paciente con enfermedad renal quística adquirida en hemodiálisis por enfermedad renal terminal que desarrolló dos de las complicaciones más graves asociadas a esta entidad; un carcinoma renal y hemorragia renal espontánea. Métodos: Nuestro caso se trata de un paciente con enfermedad renal quística adquirida (ERQA), monorreno e intervenido por carcinoma renal de células claras 4 años antes, que desarrolló un síndrome de Wünderlich (SW). Resultados: En el estudio anatomopatológico de la pieza de nefrectomía se objetivó un carcinoma renal papilar en el contexto de un riñón poliquístico tras intervención de urgencia por SW. Conclusiones: La hemorragia renal es una complicación grave de la ERQA. Los pacientes sometidos a diálisis deben ser vigilados de forma activa por el riesgo de desarrollar ERQA y las complicaciones asociadas (AU)


Objective: We report a case of acquired renal cystic disease associated with renal dialysis and end-stage renal disease. The patient suffered the two major complications related with acquired renal cystic disease; hemorrhage and renal carcinoma. Methods: Our case is a patient with acquired renal cystic disease, single kidney after surgery for renal clear cell carcinoma four years earlier, who developed a Wünderlich syndrome (WS). Results: The histological study of the nephrectomy specimen showed a renal papillary carcinoma in the context of acquired renal cystic disease after surgery for a WS. Conclusions: Renal hemorrhage is a serious complication that can lead to a fatal outcome. Patients undergoing dialysis should be monitored actively due to the risk of developing acquired renal cystic disease and associated complications (AU)


Assuntos
Humanos , Masculino , Pessoa de Meia-Idade , Doenças Renais Císticas/complicações , Carcinoma de Células Renais/patologia , Neoplasias Renais/patologia , Falência Renal Crônica/terapia , Hemorragia/etiologia , Carcinoma Papilar/patologia , Doenças Renais Policísticas/complicações , Diálise Renal , Nefrectomia
14.
Clin. transl. oncol. (Print) ; 19(8): 1028-1034, ago. 2017. tab, graf
Artigo em Inglês | IBECS | ID: ibc-164681

RESUMO

Background. Serum thyroglobulin (Tg) is the key parameter used in the follow-up of subjects with differentiated thyroid cancer (DTC). Current guidelines advise its measurement to take place when Thyrotropin (TSH) levels are >30 µU/ml (stimulated Tg) and when TSH < 0.1 µU/ml (suppressed Tg). Although stimulated Tg levels <1 ng/ml have been shown to display excellent prognosis, relapses may occur despite low Tg levels. Recently, very low cut-off levels of stimulated Tg have been proposed for determining the recurrence risk in these subjects. In this study, we aimed to assess the association between ablative stimulated Tg obtained before radioactive iodine ablation therapy (RAI) (ASTg) and late stimulated Tg obtained 6-12 months after primary therapy (LSTg) in a group of subjects with DTC. We also aimed to establish a cut-off level of Tg for recurrence. Methods. We retrospectively analyzed 393 subjects with low or intermediate risk DTC diagnosed at our institution between January 2000 and December 2010 with a mean follow-up period of 64.4 months (range 14-192 months). All stimulated Tg levels were performed following levothyroxine withdrawal in this study. Results. Histopathological analysis indicated papillary carcinoma in 362 (92.1%) subjects and follicular carcinoma in 31 (7.9%) subjects. Three hundred and twenty-four (82.4%) of our cases were females, and 69 (17.6%) were males. Recurrence occurred in 82 (20.9%) of the subjects. Relapse was significantly more frequently observed in subjects with ASTg ≥ 2 ng/ml; and LSTg ≥ 2 ng/ml. (p = 0.004 and p < 0.001, respectively). In subjects negative for thyroglobulin antibodies (Tg-ab), an ASTg value ≥5.6 ng/ml was established to increase the risk of recurrence by 2.38-fold (p = 0.002), whereas an LSTg ≥ 0.285 ng/ml increased the risk of relapse by 3.087-fold (p < 0.001). Conclusion. As a result of this study, we determined that the optimum cut-off level for both ASTg and LSTg may be lower than those previously reported. Using such a lower cut-off may improve sensitivity for detecting relapse (AU)


No disponible


Assuntos
Humanos , Adulto , Pessoa de Meia-Idade , Idoso , Neoplasias da Glândula Tireoide/terapia , Tireoglobulina/efeitos da radiação , Isótopos de Iodo/análise , Recidiva Local de Neoplasia/tratamento farmacológico , Carcinoma Papilar/terapia , Neoplasias da Glândula Tireoide/tratamento farmacológico , Tiroxina/uso terapêutico , Estudos Retrospectivos , Prognóstico , Tireoidectomia
16.
Radiología (Madr., Ed. impr.) ; 59(2): 100-114, mar.-abr. 2017. tab, ilus
Artigo em Espanhol | IBECS | ID: ibc-161430

RESUMO

El carcinoma papilar es el segundo renal en frecuencia. Su pronóstico es mejor que el del más frecuente carcinoma de células claras, aunque no en casos avanzados al no existir terapias específicas. Se presenta como un tumor periférico circunscrito (pequeño y homogéneamente sólido o mayor quístico-hemorrágico) o como una lesión infiltrante e invasora de venas, con peor pronóstico. Por su baja densidad vascular, el realce es menor que en otras neoplasias renales, lo que facilita su caracterización. En tomografía computarizada puede no realzar de manera concluyente, y entonces es indistinguible de un quiste hiperatenuante. La ecografía con contraste y la resonancia magnética son más sensibles para detectar vascularización. Son además característicos un patrón vascular específico, hipointensidad en T2, restricción de la difusión del agua y aumento de señal en fase opuesta. Nuestro objetivo es presentar los aspectos genéticos, histológicos, clínicos y radiológicos de estas neoplasias, en cuyo manejo tiene un papel fundamental el radiólogo (AU)


Papillary carcinoma is the second most common renal cell carcinoma. It has a better prognosis than the more frequent clear cell carcinoma, although this does not hold true for advanced cases, because no specific treatment exists. It presents as a circumscribed peripheral tumor (small and homogeneously solid or larger and cystic/hemorrhagic) or as an infiltrating lesion that invades the veins, which has a worse prognosis. Due to their low vascular density, papillary renal cell carcinomas enhance less than other renal tumors, and this facilitates their characterization. On computed tomography, they might not enhance conclusively, and in these cases they are impossible to distinguish from hyperattenuating cysts. Contrast-enhanced ultrasonography and magnetic resonance imaging are more sensitive for detecting vascularization. Other characteristics include a specific vascular pattern, hypointensity on T2-weighted images, restricted water diffusion, and increased signal intensity in opposed phase images. We discuss the genetic, histologic, clinical, and radiological aspects of these tumors in which radiologists play a fundamental role in management (AU)


Assuntos
Humanos , Masculino , Feminino , Carcinoma Papilar , Carcinoma de Células Renais , Radiologia , Achados Incidentais , Prognóstico , Tomada de Decisões/efeitos da radiação , Imuno-Histoquímica , Tomografia por Emissão de Pósitrons/instrumentação , Espectroscopia de Ressonância Magnética/instrumentação
18.
Endocrinol. diabetes nutr. (Ed. impr.) ; 64(2): 75-81, feb. 2017. ilus, tab
Artigo em Espanhol | IBECS | ID: ibc-171244

RESUMO

Introducción: La mutación V600E de BRAF (protooncogén B-Raf) asocia mayor riesgo de persistencia y recidiva en el carcinoma papilar de tiroides, y puede modificar la cirugía o el seguimiento. Las tecnologías de biología molecular empleadas en su detección son caras y técnicamente demandantes. Recientemente se ha propuesto la evaluación inmunohistoquímica (IHQ), más sencilla y asequible, que permitiría universalizar su evaluación. Objetivo: Comparar los resultados y el coste económico del estudio IHQ frente a la PCR en tiempo real (RT_PCR) para la detección de BRAF V600E en los carcinomas papilares de tiroides. Se incluyó el análisis de las diferencias clínico-patológicas según el resultado por RT_PCR. Métodos: Estudio prospectivo sobre 82 muestras consecutivas, 54 de ellas biopsias con aguja gruesa. El estudio IHQ se realizó con el anticuerpo monoclonal murino VE-1, y fue categorizado como positivo o negativo. La detección mediante RT_PCR se realizó con la prueba diagnóstica Cobas(R) 4800 (Roche) sobre ADN extraído del tejido fijado por microdisección manual. Resultados: Ambas técnicas fueron concordantes en 81 casos (98,8%), con un resultado discordante, positivo en la IHQ y negativo en la RT_PCR, atribuido a heterogeneidad histológica. Solo en gasto de material diagnóstico, la IHQ logra un ahorro superior al 50% frente a la técnica molecular. Conclusiones: La detección IHQ de la mutación BRAF V600E presenta una elevada fiabilidad, sin falsos negativos, en muestras adecuadamente procesadas. Su empleo permite abaratar costes y generalizar su empleo, especialmente en centros sin acceso rutinario a técnicas de biología molecular (AU)


Introduction: The BRAF V600E mutation is the most common genetic change in papillary thyroid carcinoma and is associated with a poorer clinical course. Usual methods for its study (DNA sequencing or molecular test based on PCR) are expensive and time-consuming. Recently, immunohistochemistry (IHC) for BRAF mutation has been introduced. Objective: To compare the results of IHC and real time PCR (RT-PCR) in the detection of BRAF V600E mutation in papillary thyroid carcinoma. Analysis of clinical and pathological differences depending on RT-PCR results is included. Methods: A prospective study was performed in 82 consecutive samples, 54 of them taken through a core needle biopsy. IHC was performed on tissue fixed for 24hours with 10% neutral formalin using the anti-BRAF V600E (VE-1) mouse monoclonal primary antibody and was rated as positive or negative. DNA was extracted from formalin-fixed, paraffin-embedded tissues by manual microdissection, and BRAF mutation was detected by RT-PCR using the Cobas(R) 4800 BRAF V600 mutation test (Roche). Results: Both techniques were concordant in 81 cases, and BRAF was positive in 49. Discordance appeared in a follicular variant showing positive IHC and negative RT-PCR, attributed to histological heterogeneity. Cost of materials for IHC was less than half of the cost for RT-PCR. Conclusions: IHC appears to be a reliable, economical and easily available alternative to molecular biology techniques for routine detection of the BRAF V600E mutation in papillary thyroid carcinoma patients, provided optimal fixation conditions are used. It may be a useful technique in hospitals with no access to molecular biology techniques (AU)


Assuntos
Humanos , Masculino , Feminino , Carcinoma Papilar/diagnóstico , Neoplasias da Glândula Tireoide/diagnóstico , Imuno-Histoquímica/métodos , Reação em Cadeia da Polimerase/métodos , Mutação , Glândula Tireoide/patologia , Estudos Prospectivos
19.
Clin. transl. oncol. (Print) ; 19(2): 265-268, feb. 2017. tab
Artigo em Inglês | IBECS | ID: ibc-159460

RESUMO

Background. Up to date, there are no data about FGFR2 expression and its predictive role in papillary RCC (pRCC) patients. The aim of the present study was to test FGFR2 expression and mutations for association with survival outcome in patients with pRCC. Methods. Specimens of removed primary tumors from 214 untreated metastatic pRCC patients were evaluated by immunohistochemistry with FGFR2 antibody. FGFR2 mutations were assessed by PCR and direct sequencing, with DNA obtained from 62 paraffin-embedded pRCC samples. FGFR2 expression was tested for associations with progression-free survival (PFS), overall survival (OS) and best objective response. Results. Expression of FGFR2 was observed in 23 % (49/214) of primary pRCC, mostly in cytoplasm of tumor cells. Expression of FGFR2 was significant lower in normal tissue of kidney (1 %, P = 0.001). FGFR2 S252W mutation was found in one patient (1.6 %), and no N549K mutation was detected. FGFR2 expression was strongly associated with a number of metastatic sites, type 2 of pRCC, lower nucleolar grade (P < 0.001). FGFR2-positive patients had significantly shorter OS and PFS (P < 0.05). On multivariate analysis, FGFR2 expression, MSKCC risk group and type of pRCC were found to be independent predictors of survival. Conclusions. In this study, we described immunohistochemical expression of FGFR2 in a large series of pRCC specimens. FGFR2 expression was found to be prognostic factor for survival in patients with metastatic pRCC. FGFR2 mutations are rare across papillary types of RCC (AU)


No disponible


Assuntos
Humanos , Masculino , Feminino , Neoplasias Renais/diagnóstico , Receptor Tipo 2 de Fator de Crescimento de Fibroblastos/administração & dosagem , Receptor Tipo 2 de Fator de Crescimento de Fibroblastos/análise , Metástase Neoplásica/patologia , Adenocarcinoma Papilar/complicações , Adenocarcinoma Papilar/diagnóstico , Carcinoma Papilar/complicações , Carcinoma Papilar/diagnóstico , Imuno-Histoquímica/métodos , Imuno-Histoquímica , Reação em Cadeia da Polimerase/métodos , Reação em Cadeia da Polimerase
20.
Cir. Esp. (Ed. impr.) ; 94(8): 467-472, oct. 2016. tab, ilus
Artigo em Espanhol | IBECS | ID: ibc-156226

RESUMO

INTRODUCCIÓN: Las neoplasias quísticas pancreáticas representan un grupo heterogéneo de enfermedades, donde la neoplasia mucinosa papilar intraductal está alcanzando protagonismo. El objetivo del estudio es revisar nuestra serie de neoplasias quísticas pancreáticas intervenidas y valorar la concordancia con las recomendaciones de Fukuoka. MÉTODOS: Revisamos de forma retrospectiva nuestra experiencia analizando los datos clínicos y radiológicos, la indicación quirúrgica y el estudio histológico de los 11 pacientes intervenidos en nuestro centro desde julio de 2011 a julio de 2015 por esta enfermedad, con el objetivo de valorar la concordancia con los consensos actuales. RESULTADOS: En nuestra serie la mayoría de los casos (7/11) presentaban síntomas al diagnóstico. El diagnóstico preoperatorio se alcanzó en 10 pacientes mediante radiología y/o ecoendoscopia. Las indicaciones quirúrgicas fueron presencia de síntomas, datos radiológicos de sospecha de malignidad y neoplasia de rama secundaria asintomática mayor a 30mm. Los hallazgos en estudio histológico fueron de malignidad en 6/11 (2 neoplasia invasiva, 4 displasia de alto grado), displasia moderada en 2/11, displasia de bajo grado en 2/11 y ausencia de displasia en un paciente. CONCLUSIONES: La indicación quirúrgica de las neoplasias mucinosas papilares intraductales de páncreas depende de los síntomas asociados, dimensiones, localización, riesgo y sospecha de malignidad


INTRODUCTION: Cystic pancreatic neoplasms are a heterogeneous group of pathology, and intraductal papillary mucinous neoplasia is becoming more common. The aim of this study is to review our series of cystic pancreatic neoplasms that underwent surgery and to evaluate the similarities with Fukuoka recommendations. METHODS: Retrospective review of our experience analyzing clinical and radiological data, indication for surgery and pathology study of 11 patients operated on in our centre from july 2011 to july 2015, aiming to evaluate the degree of agreement with the current consensus. RESULTS: In our series the majority of cases (7/11) had symptoms at diagnosis. Preoperative diagnosis was achieved in 10 patients using radiology and/or endoscopy. Indications for surgery were the presence of symptoms, radiological data suspicious of malignancy, and secondary branch neoplasia over 30mm. Pathological findings were malignancy in 6/11 cases (2 invasive neoplasia, 4 high grade dysplasia), moderate dysplasia in 2/11, low-grade dysplasia in 2/11 and no dysplasia in one patient. CONCLUSIONS: Surgical indication of intraductal mucinous pancreatic neoplasms depends on the associated symptoms, size, location, risk and suspicion of malignancy


Assuntos
Humanos , Masculino , Feminino , Neoplasias Pancreáticas/epidemiologia , Neoplasias Pancreáticas/prevenção & controle , Adenocarcinoma Papilar/complicações , Adenocarcinoma Papilar/epidemiologia , Carcinoma Papilar/complicações , Papiloma Intraductal/complicações , Papiloma Intraductal/epidemiologia , Papiloma Intraductal/prevenção & controle , Prognóstico , Estudos Retrospectivos , Análise Estatística
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