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2.
Rev. lab. clín ; 12(4): 165-170, oct.-dic. 2019. ilus, tab, graf
Artigo em Espanhol | IBECS | ID: ibc-187314

RESUMO

La infiltración leptomeníngea en el mieloma múltiple es una complicación poco frecuente y grave que se presenta generalmente tras recaídas de la enfermedad. Para establecer un correcto diagnóstico es necesario demostrar por citología la presencia de células plasmáticas clonales en el líquido cefalorraquídeo. Desde el laboratorio clínico detectamos esta complicación en una paciente diagnosticada de mieloma múltiple refractario, tras analizar una muestra de líquido cefalorraquídeo. La paciente presentaba diversos síntomas neurológicos como incontinencia fecal y disminución de la movilidad en ambas extremidades inferiores. Inicialmente observamos en el líquido pleocitosis, proteinorraquia y niveles elevados de células de alta fluorescencia, asociadas en ocasiones a células malignas. El proteinograma e inmunofijación del líquido confirmó la presencia del componente monoclonal ya detectado en sangre, y tras procesar la muestra por citometría de flujo pudimos confirmar la infiltración de células plasmáticas malignas en el sistema nervioso central. Nuestro laboratorio desempeñó un papel central y esencial en el diagnóstico de esta infrecuente complicación, mediante el uso combinado del proteinograma, la inmunofijación, la citometría de flujo y el autoanalizador hematológico, incluyendo en este último las células de alta fluorescencia, prometedor biomarcador en el cribado de la presencia de células tumorales en líquidos biológicos


Leptomeningeal involvement in multiple myeloma is a rare and serious complication that usually occurs after relapses of the disease. To establish a correct diagnosis, it is necessary to demonstrate, by cytology, the presence of clonal plasma cells in the cerebrospinal fluid. The clinical laboratory detected this complication in a patient diagnosed with refractory multiple myeloma after analysing a cerebrospinal fluid sample. The patient suffered from several neurological symptoms, such as faecal incontinence and lower limb mobility limitation. Pleocytosis and proteinorachia was initially observed, along with high levels of high-fluorescence cells, which are sometimes associated with malignant cells. The protein electrophoresis and immunofixation of the cerebrospinal fluid confirmed the presence of the monoclonal component, already detected in blood. After processing the sample by flow cytometry it was confirmed that there was infiltration of malignant plasma cells in the central nervous system. This laboratory played a central and essential role in the diagnosis of this uncommon complication, by the combined use of protein electrophoresis, immunofixation, flow cytometry, and the haematology autoanalyser. This latter included the high fluorescence cells as a promising biomarker in the screening for the presence of tumour cells in biological fluids


Assuntos
Humanos , Feminino , Pessoa de Meia-Idade , Invasividade Neoplásica/diagnóstico , Neoplasias do Sistema Nervoso Central/secundário , Mieloma Múltiplo Latente/patologia , Líquido Cefalorraquidiano , Leucocitose/diagnóstico , Citometria de Fluxo/métodos , Biomarcadores Tumorais/análise , Cadeias kappa de Imunoglobulina/análise , Cadeias lambda de Imunoglobulina/análise
3.
Cir. Esp. (Ed. impr.) ; 97(8): 432-437, oct. 2019. tab, graf
Artigo em Espanhol | IBECS | ID: ibc-187616

RESUMO

La nueva 8.ª edición del sistema de clasificación TNM para el cáncer de esófago y cardias, o de la unión esofagogástrica, aporta importantes novedades en la confección de los estadios TNM. Se presentan 2 clasificaciones actualizadas por estadios, clínicos (cTNM) y patológicos (pTNM), junto a otra clasificación patológica aplicable a los casos que reciben tratamiento neoadyuvante (ypTNM). Hay un notable aumento de la complejidad con respecto a versiones anteriores, pero aún es pronto para conocer si las actuales modificaciones redundarán, como es su objetivo principal, en una manifiesta mejora de la discriminación pronóstica de la supervivencia entre los grupos de pacientes que configuran, si bien las expectativas iniciales son favorable


The new 8th edition of the TNM classification system for esophageal and cardia or esophagogastric junction cancer provides important innovations in the TNM stages. Two classifications are presented, updated by stages, clinical (cTNM) and pathological (pTNM) methods, together with another pathological classification applicable to cases receiving neoadjuvant treatment (ypTNM). There is a notable increase in complexity compared to previous versions, but it is still early to determine whether the current modifications will result in a clear improvement in the prognostic discrimination of survival among the patient groups (which is their main objective), although the initial expectations are favorable


Assuntos
Humanos , Adenocarcinoma/patologia , Neoplasias Esofágicas/patologia , Junção Esofagogástrica/patologia , Estadiamento de Neoplasias/métodos , Reprodutibilidade dos Testes , Adenocarcinoma/classificação , Adenocarcinoma/mortalidade , Adenocarcinoma/cirurgia , Calibragem , Neoplasias Esofágicas/mortalidade , Neoplasias Esofágicas/cirurgia , Junção Esofagogástrica/cirurgia , Linfonodos/patologia , Invasividade Neoplásica , Estadiamento de Neoplasias/classificação , Estadiamento de Neoplasias/normas , Estados Unidos
4.
Cir. Esp. (Ed. impr.) ; 97(8): 451-458, oct. 2019. tab, ilus, graf
Artigo em Espanhol | IBECS | ID: ibc-187619

RESUMO

La cirugía mínimamente invasiva permite el tratamiento de los tumores de la unión esofagogástrica en condiciones de seguridad, reduciendo las complicaciones respiratorias y parietales y mejorando la recuperación postoperatoria, manteniendo además los principios de la cirugía oncológica que permitan obtener unos resultados óptimos de efectividad a largo plazo. Para ello, es necesario un volumen de actividad suficiente y avanzar en la curva de aprendizaje de forma tutelada, para poder garantizar una resección R0 y una linfadenectomía adecuada. La mínima invasión no puede ser un objetivo en sí misma. En caso de gastrectomía total, el riesgo de afectación del margen proximal obliga a verificarlo mediante biopsia intraoperatoria, sin descartar la cirugía abierta de entrada. Por su parte, la esofagectomía mínimamente invasiva se ha ido imponiendo progresivamente. Su principal dificultad, la anastomosis intratorácica, puede realizarse mediante una sutura laterolateral mecánica o manualmente asistida por robot, gracias a la visión tridimensional y a la versatilidad del instrumental


Minimally invasive surgery provides for the treatment of esophagogastric junction tumors under safe conditions, reducing respiratory and abdominal wall complications. Recovery is improved, while maintaining the oncological principles of surgery to obtain an optimal long-term outcome. It is important to have a sufficient volume of activity to progress along the learning curve with close expert supervision in order to guarantee R0 resection and adequate lymphadenectomy. Minimal invasiveness ought not become an objective in itself. Should total gastrectomy be performed, the risk of a positive proximal margin makes intraoperative biopsy compulsory, without ruling out a primary open approach. Meanwhile, minimally invasive esophagectomy has been gaining ground. Its main difficulty, the intrathoracic anastomosis, can be safely carried out either with a mechanical side-to-side suture or a robot-assisted manual suture, thanks to the 3-D vision and versatility of the instruments


Assuntos
Humanos , Neoplasias Esofágicas/cirurgia , Esofagectomia/métodos , Junção Esofagogástrica/cirurgia , Gastrectomia/métodos , Procedimentos Cirúrgicos Robóticos , Neoplasias Gástricas/cirurgia , Anastomose Cirúrgica/métodos , Esôfago de Barrett/patologia , Neoplasias Esofágicas/patologia , Junção Esofagogástrica/diagnóstico por imagem , Junção Esofagogástrica/patologia , Esofagoscopia , Laparoscopia , Invasividade Neoplásica , Tomografia Computadorizada com Tomografia por Emissão de Pósitrons , Complicações Pós-Operatórias/prevenção & controle , Neoplasias Gástricas/patologia
5.
Actas dermo-sifiliogr. (Ed. impr.) ; 110(6): 426-433, jul.-ago. 2019. tab, graf, ilus
Artigo em Espanhol | IBECS | ID: ibc-185270

RESUMO

En ocasiones el carcinoma epidermoide cutáneo se caracteriza por tener un mayor riesgo de desarrollar recurrencia locorregional y ocasionalmente metástasis a distancia. Existen diversos factores clínico-patológicos de reconocido valor pronóstico, entre ellos la presencia de infiltración perineural. Esta consiste en la diseminación de células tumorales a través de los nervios, siendo en la mayoría de los casos un hallazgo incidental. Cuando aparecen síntomas y/o evidencia radiológica de la extensión de la infiltración perineural, se clasifica como infiltración perineural clínica y se asocia a un mayor riesgo de recurrencia local y de mortalidad


Cutaneous squamous cell carcinoma is sometimes characterized by an increased risk of locoregional recurrence and occasionally distant metastasis. Several clinical and pathological factors, including perineural invasion, have been shown to have prognostic value in this setting. Perineural invasion, that is, the spread of tumor cells into the space surrounding a nerve, is usually an incidental finding. In the presence of symptoms or radiographic evidence of perineural spread, the diagnosis is clinical perineural invasion, which is associated with an increased risk of local recurrence and mortality


Assuntos
Humanos , Carcinoma de Células Escamosas/epidemiologia , Prognóstico , Invasividade Neoplásica/patologia , Neoplasias Cutâneas/patologia , Carcinoma de Células Escamosas/classificação , Carcinoma de Células Escamosas/patologia , Recidiva Local de Neoplasia , Nervos Periféricos/patologia , Nervo Facial/anatomia & histologia , Nervo Trigêmeo/patologia
6.
Med. clín (Ed. impr.) ; 152(11): 425-430, jun. 2019. ilus, graf
Artigo em Inglês | IBECS | ID: ibc-183902

RESUMO

Introduction: Melanoma is the most dangerous skin cancer with high metastasis rate and mortality. Although the emergence of immunotherapy has brought hope for treatment, the mortality rate of melanoma is still increasing year by year. The underlying mechanism of melanoma tumor progression and metastasis is urgently needed to be clarified. Recently chemokines have been found to play an important role in tumor progression in addition to their immunocytochemical chemotaxis. Methods: In this study, human melanoma cell lines A375 and M14 were treated with SCH-527123, a small molecule antagonist of CXCR1 and CXCR2. The effects of treatment with SCH-527123 on melanoma cell proliferation, migration and invasion were evaluated in vitro by CCK-8, colony formation and transwell assays. Apoptosis was also detected by flow cytometry staining with annexin V and propidium iodide (PI). The molecular mechanisms of antagonist mediated were detected by western blot. Results: The results showed that SCH-527123 inhibited the proliferation, migration and invasion of melanoma cell lines and promoted apoptosis. The expression of CXCR1 and CXCR2 was downregulated after treatment with SCH-527123. PI3K/AKT pathway and downstream signaling were also inhibited at molecular level owing to treated with SCH-527123. Conclusion: In conclusion, our study demonstrated that SCH-527123, a small-molecule antagonist for CXCR1 and CXCR2 inhibited cell proliferation, migration and invasion in melanoma via PI3K/AKT pathway


Introducción: El melanoma es el cáncer de piel más peligroso, con una alta tasa de metástasis y mortalidad. Aunque la inmunoterapia ha traído esperanza para el tratamiento, la tasa de mortalidad del melanoma sigue aumentando año tras año. Es de crucial importancia aclarar el mecanismo subyacente de la evolución y la metástasis del melanoma. Recientemente se ha descubierto que las quimiocinas juegan un importante papel en la evolución tumoral. Métodos: En el presente estudio, las líneas celulares de melanoma humano A375 y M14 se trataron con SCH-527123, un inhibidor de molécula pequeña de CXCR1 y CXCR2. Los efectos del tratamiento con SCH-527123 sobre la proliferación, migración e invasión de células de melanoma se evaluaron in vitro mediante CCK-8, formación de colonias y ensayos Transwell. También se detectó apoptosis mediante citometría de flujo con tinción con anexina V y yoduro de propidio (PI). Los mecanismos moleculares del antagonista fueron detectados por Western blot. Resultados: Los resultados mostraron que SCH-527123 inhibió la proliferación, migración e invasión de líneas celulares de melanoma y promovió la apoptosis. La expresión de CXCR1 y CXCR2 disminuyó después del tratamiento con SCH-527123. La vía de señalización de la PI3K/AKT también se inhibió a nivel molecular debido a que se trataron con SCH-527123. Conclusión: Nuestro estudio demostró que SCH-527123, un inhibidor de molécula pequeña para CXCR1 y CXCR2 inhibió la proliferación celular, la migración y la invasión del melanoma a través de la vía PI3K/AKT


Assuntos
Humanos , Receptores de Interleucina-8A/agonistas , Receptores de Interleucina-8B/agonistas , Invasividade Neoplásica , Melanoma/patologia , Apoptose/efeitos dos fármacos , Proteínas Proto-Oncogênicas c-akt/efeitos dos fármacos , Antineoplásicos/farmacologia , Proliferação de Células , Movimento Celular , Células Tumorais Cultivadas , Transdução de Sinais
7.
Rev. esp. patol ; 52(2): 125-129, abr.-jun. 2019. ilus
Artigo em Espanhol | IBECS | ID: ibc-182700

RESUMO

La enfermedad relacionada con IgG4 (ER-IgG4) es un proceso patológico que ha unificado un gran número de enfermedades consideradas como propias de distintos órganos cuya etiopatogenia se desconocía. Su diagnóstico se establece mediante criterios histológicos, radiológicos y serológicos. El tratamiento se basa en corticoides durante tiempo prolongado, reservándose el uso de rituximab para casos refractarios. Es extremadamente inusual que esta entidad asiente solo en cabeza y cuello sin afectación sistémica, por lo que hay pocos casos como el que presentamos descritos en la literatura. Exponemos el caso de una paciente con una tumoración orbitaria con afectación de senos paranasales, diagnosticada de ER-IgG4 nasosinusal. La precisión del diagnóstico propició el inicio precoz de tratamiento corticoideo. En la actualidad la paciente se encuentra asintomática


IgG4 related disease (igG4-RD) is a pathological process which integrates a large number of diseases of unknown pathogenesis, considered as being exclusive to many different organs. Diagnosis is established through histological, radiological and serological criteria. Treatment is based on long term corticosteroids; rituximab being used only in refractory cases. It is unusual for this entity to be found exclusively in the head and neck, without systemic involvement; there are only a few reported cases to date. We present a case of a nasosinusal IgG4-RD orbital tumor with paranasal sinus involvement. The accurate diagnosis made early onset corticosteroid treatment possible and the patient is currently asymptomatic


Assuntos
Humanos , Feminino , Idoso , Doença Relacionada a Imunoglobulina G4/patologia , Neoplasias dos Seios Paranasais/patologia , Neoplasias Orbitárias/patologia , Fibrose/patologia , Invasividade Neoplásica/patologia , Achados Incidentais
8.
Rev. senol. patol. mamar. (Ed. impr.) ; 32(1): 32-36, ene.-mar. 2019. ilus
Artigo em Inglês | IBECS | ID: ibc-187031

RESUMO

Secretory breast carcinoma was first described by McDivitt and Stewart in 1966, who reported seven cases of this tumoural strain in children and therefore named it "juvenile carcinoma". However, a couple of decades later, Tavassoli and Norris reported a series of 19 cases and found that most occurred in adults, and therefore they proposed changing its name to "secretory carcinoma." Since then, approximately 100 cases have been reported in the world literature. We present two cases treated with total mastectomy and sentinel node biopsy with excellent outcome. To our knowledge, only a few cases have been reported in Latin American patients


El carcinoma secretor dela mama fue inicialmente descrito por McDivitt y Stewartin en 1966, en su artículo, siete casos de este tipo de tumor se presentaron en niños, por lo tanto, se le asignó el nombre de "carcinoma Juvenil", pero un par de décadas después Tavassoli y Norris encontraron en su serie de 19 casos, que la mayoría eran adultos, y así propusieron cambiar el nombre a Carcinoma secretor. Desde ese momento aproximadamente 100 casos han sido reportados en la literatura. Nosotros presentamos dos casos tratados con mastectomía y ganglio centinela, con excelente pronóstico. Hasta donde sabemos, esta patología se ha reportado escasamente en pacientes latino americanos


Assuntos
Humanos , Feminino , Pessoa de Meia-Idade , Idoso , Neoplasias da Mama/patologia , Mastectomia/métodos , Biópsia de Linfonodo Sentinela/métodos , Invasividade Neoplásica/patologia
9.
Arch. esp. urol. (Ed. impr.) ; 72(1): 2-8, ene.-feb. 2019. tab
Artigo em Espanhol | IBECS | ID: ibc-181054

RESUMO

Objetivo: Los tumores vesicales son el segundo tumor urológico con mayor incidencia en la población adulta. En los últimos años han surgido nuevas técnicas como el diagnóstico fotodinámico, con el fin de mejorar la sensibilidad para la detección del tumor vesical no musculo invasivo (TVNMI). Pretendemos actualizar el papel del diagnóstico fotodinámico en el diagnóstico del TVNMI, en los casos refractarios a BCG y como tratamiento en el tumor vesical recidivante. Material y método: Revisión bibliográfica y estudio descriptivo sobre la utilidad del diagnóstico fotodinámico en el TVNMI, en la recurrencia precoz y en la refractariedad a BCG publicados en la literatura médica universal. Resultados: La cistoscopia fotodinámica aumenta la sensibilidad de detección del TVNMI, sobre todo del carcinoma in situ (CIS) desde un 15% hasta un 30% según las distintas series publicadas. En cuanto a la recidiva del tumor vesical de alto grado, la terapia fotodinámica aumenta el tiempo libre de enfermedad en un 20% de los pacientes. En el uso de técnicas fotodinámicas para la detección del CIS tras el uso de BCG, los estudios indican un aumento de sensibilidad con un incremento de la tasa de falsos positivos. Conclusión: El diagnóstico fotodinámico podría mejorar la sensibilidad para la detección precoz de pacientes con CIS y/o T1G3. Puede ser, a su vez, una alternativa en la recurrencia del cáncer vesical, sobre todo del CIS


Objectives: Bladder tumors are the second highest incidence urological tumor in the adult population. In recent years, new techniques such as photodynamic diagnosis have arisen in order to improve the sensitivity for the detection of non muscle invasive bladder cancer (NMIBC). We intend to update the role of photodynamic diagnosis in the diagnosis of NMIBC, in cases refractory to BCG and as a treatment in the recurrent bladder cancer. Material and method: We performed a descriptive study and bibliographic review on the usefulness of pho tratatodynamic diagnosis in NMIBC, early recurrence and refractoriness to BCG published in the universal medical literature. Results: Photodynamic cystoscopy increases the detection sensitivity for NMIBC, especially carcinoma in situ (CIS) from 15% to 30% according to the different series published. Regarding high-grade bladder cancer recurrence, photodynamic therapy increases disease-free time in 20% of patients. In the use of photodynamic techniques for the detection of CIS after BCG, studies indicate an increase in sensitivity with an increase in the rate of false positives. Conclusion: Photodynamic diagnosis could improve sensitivity for the early detection of patients with CIS and/or T1G3. May be, at the same time, an alternative in the recurrence of bladder cancer, especially CIS


Assuntos
Humanos , Neoplasias da Bexiga Urinária/diagnóstico por imagem , Carcinoma/diagnóstico por imagem , Diagnóstico Precoce , Fotoquimioterapia/métodos , Vacina BCG/uso terapêutico , Bexiga Urinária/diagnóstico por imagem , Bexiga Urinária/patologia , Recidiva Local de Neoplasia/diagnóstico por imagem , Cistoscopia/métodos , Invasividade Neoplásica
10.
Clin. transl. oncol. (Print) ; 21(1): 64-74, ene. 2019. tab
Artigo em Inglês | IBECS | ID: ibc-183345

RESUMO

The goal of this article is to provide recommendations about the management of muscle-invasive (MIBC) and metastatic bladder cancer. New molecular subtypes of MIBC are associated with specific clinical-pathological characteristics. Radical cystectomy and lymph node dissection are the gold standard for treatment and neoadjuvant chemotherapy with a cisplatin-based combination should be recommended in fit patients. The role of adjuvant chemotherapy in MIBC remains controversial; its use must be considered in patients with high-risk who are able to tolerate a cisplatin-based regimen, and have not received neoadjuvant chemotherapy. Bladder-preserving approaches are reasonable alternatives to cystectomy in selected patients for whom cystectomy is not contemplated either for clinical or personal reasons. Cisplatin-based combination chemotherapy is the standard first-line protocol for metastatic disease. In the case of unfit patients, carboplatin-gemcitabine should be considered the preferred first-line chemotherapy treatment option, while pembrolizumab and atezolizumab can be contemplated for individuals with high PD-L1 expression. In cases of progression after platinum-based therapy, PD-1/PD-L1 inhibitors are standard alternatives. Vinflunine is another option when anti-PD-1/PD-L1 therapy is not possible. There are no data from randomized clinical trials regarding moving on to immuno-oncology agents


No disponible


Assuntos
Humanos , Carcinoma de Células de Transição/terapia , Neoplasias da Bexiga Urinária/terapia , Neoplasias Musculares/terapia , Antineoplásicos Imunológicos/uso terapêutico , Antineoplásicos/uso terapêutico , Invasividade Neoplásica/patologia , Neoplasias Musculares/secundário , Cistectomia/métodos , Padrões de Prática Médica
11.
Enferm. glob ; 18(53): 19-34, ene. 2019. tab
Artigo em Espanhol | IBECS | ID: ibc-183411

RESUMO

Objetivo: Analizar las asociaciones entre olores y aislamiento social en pacientes con heridas tumorales malignas.Material y método: Estudio piloto con corte transversal realizado con nueve pacientes con heridas tumorales malignas atendidas en un hospital universitario en el período de 2014 a 2016. Se recogieron datos por medio de aplicación de escala likert de cinco puntos para evaluación del aislamiento social relacionado con el olor de las heridas tumorales malignas durante las consultas de enfermería. Se analizaron los datos por estrategia estadística inferencial con cálculo de coeficiente de Spearman al nivel de significancia del 5% (α = 0,05).Resultados: Se constató correlación con significancia estadística entre el olor y las dimensiones psicosociales: constreñimiento y limitación en frecuentar locales públicos.Conclusión: El olor es el principal síntoma que genera constreñimiento y limita la convivencia social, favoreciendo el aislamiento social y la degradación de la calidad de vida de los pacientes oncológicos


Objetivo: Identificar as associações entre odor e isolamento social em pacientes com feridas tumorais malignas. Material e método: Estudo piloto com corte transversal realizado com nove pacientes com feridas tumorais malignas atendidos em um hospital universitário no período de 2014 a 2016. Coletaram-se dados por meio de aplicação de escala likert de cinco pontos para avaliação do isolamento social relacionado ao odor de feridas tumorais malignas, durante as consultas de enfermagem. Analisaram-se os dados por estratégia estatística inferencial com cálculo de coeficiente de Spearman ao nível de significância de 5% (α = 0,05). Resultados: Constatou-se correlação com significância estatística entre o odor e as dimensões psicossociais: constrangimento e limitação em frequentar locais públicos. Conclusão: O odor é o principal sintoma que gera constrangimento e limita a convivência social, favorecendo o isolamento social e a degradação da qualidade de vida dos pacientes oncológicos


Objective: To analysis associations between odor and social isolation in patients with malignant tumor wounds.Material and method: This is a cross-sectional pilot study performed with nine patients with malignant tumor wounds treated at a university hospital from 2014 to 2016. Data were collected using a five-point Likert scale for the evaluation of social isolation related to odor of malignant tumor wounds during nursing consultations. Data were analyzed by inferential statistical strategy with Spearman's coefficient at the significance level of 5% (α = 0.05).Results: Correlation was found with statistical significance between odor and psychosocial dimensions: constraint and limitation in attending public places.Conclusion: Odor is the main symptom that causes embarrassment and limits social coexistence, favoring social isolation and degradation of the quality of life of cancer patients


Assuntos
Humanos , Masculino , Feminino , Adulto , Pessoa de Meia-Idade , Idoso , Isolamento Social/psicologia , Neoplasias/complicações , Infecção dos Ferimentos/complicações , Deiscência da Ferida Operatória/complicações , Desbridamento/enfermagem , Invasividade Neoplásica/patologia , Infecção dos Ferimentos/enfermagem , Enfermagem de Cuidados Paliativos na Terminalidade da Vida/métodos
12.
Prog. obstet. ginecol. (Ed. impr.) ; 61(6): 565-571, nov.-dic. 2018. ilus, tab, graf
Artigo em Inglês | IBECS | ID: ibc-181391

RESUMO

Background: Ovarian carcinoma is going with peritoneal dissemination in more than a half of the cases at diagnosis. Lymph node involvement is a poor prognostic factor limiting survival. Lumboaortic lymphadenectomy is a part of the therapeutic armamentarium, although there are discrepancies in the selection of patients and prognostic impact. We evaluate some nodal infiltration risk factors for this disease and lymphadenectomy prognostic influence. Material and methods: A retrospective study of 93 patients diagnosed with stage III ovarian cancer between 2006 and 2012. A total of 52 (55.9%) patients were selected to undergo a complete or optimal cytoreduction. Two groups were established according to absence or presence of retroperitoneal lymph nodes during preoperative diagnosis, to assess the objectives of this study. Results: Statistical analysis for clinical and histopathological variables determined prealbumin (p = 0'027) and Ca 125 (p = 0'048) were associated with the risk of nodal infiltration. No significant value was seen in the parameters related to the peritoneal spread of the cancer. Lumboaortic lymphadenectomy improved disease-free survival (25'7 ± 21'4 vs 35'6 ± 22 months) with statistical significance (p = 0'033) but did not appear to achieve outstanding changes in overall survival (39'7 ± 20'1 vs 41'9 ± 20'8 months). Conclusions: A poor nutritional status and high Ca 125 could be predictive factors of lymph node involvement. The performance of a systematic lumboaortic lymphadenectomy seems to increase disease-free survival in association with a properly debulking and absence of severe postoperative complications. A broader recruitment of patients will be needed to know a more accurate pattern of lymph node disease in order to carry out a selective indication for lymphadenectomy


Introducción: el cáncer de ovario se acompaña de diseminación peritoneal en más de la mitad de los casos al diagnóstico. La afectación ganglionar es un factor de mal pronóstico que limita su supervivencia. La linfadenectomía lumboaórtica forma parte del arsenal terapéutico aunque existen discrepancias en la selección de pacientes y su impacto pronóstico. Se pretende evaluar algunos factores de riesgo de infiltración nodal para esta enfermedad y la influencia pronóstica de dicha linfadenectomía. Material y métodos: estudio retrospectivo de 93 pacientes diagnosticados de cáncer ovárico en estadio III entre 2006 y 2012. Fueron seleccionadas 52 (55'9%) enfermas que se beneficiaron de una citorreducción completa u óptima, estableciéndose dos grupos ante la ausencia o presencia de adenopatías retroperitoneales durante el diagnóstico preoperatorio, para contrastar los objetivos del estudio. Resultados: el análisis estadístico de variables clínicas e histopatológicas determinó relación de la prealbúmina (p = 0'027) y Ca 125 (p = 0'048) con el riesgo de infiltración nodal. No se apreció valor significativo en los parámetros relativos a la extensión peritoneal del cáncer. La linfadenectomía lumboaórtica mejoró la supervivencia libre de enfermedad (25'7 ± 21.4 vs 35'6 ± 22 meses) con relevancia estadística (p = 0'033) pero no presentó grandes variaciones en la supervivencia global (39'7 ± 20'1 vs 41'9 ± 20'8 meses). Conclusiones: un estado nutricional deteriorado y un Ca 125 elevado podrían ser factores predictivos de afectación ganglionar. La realización de una linfadenectomía lumboaórtica sistemática parece incrementar la supervivencia libre de enfermedad ante una citorreducción adecuada y ausencia de complicaciones postquirúrgicas graves. Se necesitará un mayor reclutamiento de pacientes para conocer con más exactitud el patrón de enfermedad ganglionar a efectos de una indicación de linfadenectomía más selectiva


Assuntos
Humanos , Feminino , Excisão de Linfonodo/estatística & dados numéricos , Neoplasias Ovarianas/cirurgia , Gânglios Simpáticos/cirurgia , Neoplasias Peritoneais/cirurgia , Invasividade Neoplásica/patologia , Metástase Linfática/patologia , Neoplasias Ovarianas/patologia , Gânglios Simpáticos/patologia , Neoplasias Peritoneais/patologia , Prognóstico
13.
Sanid. mil ; 74(4): 248-254, oct.-dic. 2018. ilus, tab
Artigo em Espanhol | IBECS | ID: ibc-182307

RESUMO

INTRODUCCIÓN: los meningiomas suponen el 15-20% de las neoformaciones primarias del SNC en adultos. La mayoría son benignos, encontrando únicamente un 5% de tumores malignos. La RM los caracteriza pero el diagnóstico definitivo se confirma mediante histopatología. OBJETIVOS: determinar si la agresividad de los meningiomas intracraneales utilizando la RM es congruente con la agresividad que se demuestra en el estudio histopatológico. MATERIAL Y MÉTODO: se estudian 14 casos de meningiomas intracraneales con imagen de RM y estudio histopatológico comprendidos entre los años 2004 y 2016. Se analizan sus características radiológicas determinando su agresividad mediante RM e histopatología. RESULTADOS: 7 (50%) de los 14 meningiomas fueron agresivos en el estudio mediante RM, mientras que 4 (28,6%) lo hicieron mediante el estudio histopatológico. La sensibilidad de la RM fue del 100% y la especificidad 70%. Las únicas variables que consiguieron una p < 0,05 en el estudio de agresividad mediante RM fueron los márgenes irregulares y el realce heterogéneo. CONCLUSIONES: La RM es apta para su utilización como técnica de cribado inicial en el diagnóstico de agresividad de meningiomas intracraneales, siendo limitada para su diagnóstico confirmatorio. No se han encontrado evidencias significativas para determinar qué características radiológicas definen la agresividad tumoral


AIM: meningiomas account for 15-20% Central Nervous System primary neoplasms in adults. Many are benign, but the 5% of them are malignant. MRI characterizes them, describing a series of radiological findings suggestive of aggressiveness, although the diagnosis is confirmed by histopathology. OBJECTIVES: Determine if the aggressiveness of intracranial meningiomas using MRI is consistent with histopathology. Material and METHODOLOGY: 14 cases of meningiomas with MR imaging and histopathology ranging 2004 to 2016 were reported. Its radiological characteristics were analyzed by determining their aggressiveness by MRI and Histopathology, carried out a study of diagnostic tests. RESULTS: 7 (50%) of the 14 meningiomas were aggressive in the study by MRI, while 4 (28.6%) did so by histopathology. The sensibility of MRI was 100% and specificity 70%. The only variables that achieved p < 0.05 by studying aggression MRI were irregular borders and heterogeneous enhancement. CONCLUSIONS: MRI is suitable for use as initial screening in the diagnosis of intracranial meningiomas aggressiveness, being restricted for confirmatory diagnosis. We found no significant evidence to determine what radiological characteristics define tumor aggressiveness


Assuntos
Humanos , Masculino , Feminino , Adulto , Pessoa de Meia-Idade , Idoso , Idoso de 80 Anos ou mais , Meningioma/diagnóstico por imagem , Invasividade Neoplásica/diagnóstico por imagem , Encéfalo/patologia , Neoplasias Encefálicas/diagnóstico por imagem , Dura-Máter/patologia , Encéfalo/anatomia & histologia , Encéfalo/diagnóstico por imagem , Estudos Transversais , Espectroscopia de Ressonância Magnética
14.
Rev. esp. enferm. dig ; 110(12): 768-774, dic. 2018. ilus, tab, graf
Artigo em Inglês | IBECS | ID: ibc-177926

RESUMO

Objective: the objective of this study was to analyze the anatomical and clinical features and long-term oncologic outcomes of 25 patients that underwent surgery due to intraductal papillary mucinous neoplasm of the pancreas. Material and methods: patients undergoing surgery for intraductal papillary mucinous neoplasm of the pancreas were identified from a prospective database of pancreatic resections. Demographic data, symptoms, type of surgery and type of lesion (branch type, main duct or mixed) were recorded. The lesions were classified into invasive (high grade dysplasia and carcinoma) and noninvasive (low- or intermediate-grade dysplasia). Postoperative complications were analyzed as well as the pattern of recurrence and disease-free survival at five and ten years. Results: the most common symptoms in the 25 patients (14 males and eleven females) were abdominal pain and weight loss. Eight (32%) cases were diagnosed incidentally. Twelve (48%) of the lesions were of the branch type, three affected the main duct and ten (40%) were mixed. Twelve cephalic duodenopancreatectomies and seven total pancreatectomies were performed; three were central; two, distal; and one, enucleation. Seven cases (32%) had an invasive phenotype. Three patients had locoregional and distant recurrence at six, 16 and 46 months after surgery with a median follow-up of 7.7 years. Disease-free survival at five and ten years for the noninvasive type was 94% and 57% for invasive phenotypes (p < 0.05). Conclusions: intraductal papillary mucinous neoplasm is a heterogeneous entity with well differentiated phenotypes, which requires a tailored strategy and treatment, as established in the current consensus guidelines due to its malignant potential


No disponible


Assuntos
Humanos , Masculino , Feminino , Pessoa de Meia-Idade , Idoso , Cistadenoma Mucinoso/patologia , Neoplasias Pancreáticas/patologia , Pancreatectomia , Neoplasias Pancreáticas/cirurgia , Diagnóstico Diferencial , Invasividade Neoplásica/patologia , Dor Abdominal/etiologia
15.
Rev. esp. patol ; 51(4): 244-247, oct.-dic. 2018. ilus
Artigo em Espanhol | IBECS | ID: ibc-179170

RESUMO

Los melanomas de vejiga urinaria son poco frecuentes. Presentamos el caso de una paciente femenina de 58 años, quien consultó por disuria y hematuria de 4 meses de evolución. Se le realizó cistoscopia y biopsia, la cual fue interpretada como melanoma invasivo. Posteriormente se realizó cistectomía parcial, en la cual se diagnosticó melanoma, confirmado por positividad de las células neoplásicas para Melan-A y HMB-45 en estudio de inmunohistoquímica. Se demostró invasión neoplásica de todo el espesor de la capa muscular y de bordes quirúrgicos. Cuatro meses después se recibió vejiga urinaria de 13×7×5cm, en la cual se encontró, además del melanoma, melanosis y nevo melanocítico en vejiga urinaria. El nevo melanocítico se demostró mediante positividad a anticuerpos melanocíticos, de células no atípicas en capa basal de urotelio vecino y distante al tumor. La paciente sobrevivió 9 meses


Primary melanoma of the urinary bladder is rare. We report a case of a 58-year-old woman, who presented with a 4 month history of dysuria and hematuria. A biopsy indicated a diagnosis of invasive melanoma and a partial cystectomy was performed. The neoplasm had invaded the entire thickness of the bladder wall and the neoplastic cells were positive for Melan A and HMB-45. Four months later a urinary bladder measuring 13×7×5cm was sent for histopathology. Melanoma, melanosis and a melanocytic nevus were seen; the latter was confirmed by the positivity to melanocytic markers of non-atypical cells in both the urothelial basal layer and areas distant from the tumour. The patient died nine months later


Assuntos
Humanos , Feminino , Pessoa de Meia-Idade , Melanoma/patologia , Neoplasias da Bexiga Urinária/patologia , Cistoscopia/métodos , Biópsia/métodos , Disuria/etiologia , Hematúria/etiologia , Invasividade Neoplásica/patologia
16.
Arch. esp. urol. (Ed. impr.) ; 71(9): 799-804, nov. 2018. ilus, tab
Artigo em Espanhol | IBECS | ID: ibc-178759

RESUMO

Objetivo: El carcinoma vesical es una neoplasia de frecuente diagnóstico en Europa, siendo en un 30% de los casos musculo-infiltrante al diagnóstico. En estos pacientes la enfermedad metastásica puede presentarse al diagnóstico o con la progresión de la enfermedad. La presencia de metástasis puede manifestarse de diversas formas, incluso como alteraciones analíticas. En este trabajo realizamos un repaso de las causas de hiponatremia en los pacientes con carcinoma vesical y su relación con la enfermedad diseminada. Método: Presentamos 2 casos clínicos de pacientes con un carcinoma vesical infiltrante y con una alteración analítica en común, la hiponatremia. Resultado: A raíz del estudio de la hiponatremia, se evidencia la presencia de metástasis. Conclusiones: Las alteraciones electrolíticas en el paciente oncológico pueden ser de causas diversas: tipo de derivación urinaria, quimioterápicos, dolor, o incluso la propia neoplasia ó sus metástasis. Se debe seguir un estudio exhaustivo para descartar las causas más importantes y poder realizar un correcto tratamiento de estos pacientes


Objective: Bladder cancer is a commonly diagnosed malignancy in Europe, being 30% muscle-invasive at diagnosis. In these patients, metastases can develop both at diagnosis and after progression. Metastatic disease can manifest in a number of different ways, even as hydroelectrolytic alterations. In this work, we go through the causes of hyponatremia in patients suffering from bladder cancer and its relationship with disseminated disease. Method: We present two cases of patients with muscleinvasive bladder cancer with a common electrolytic misbalance, hyponatremia. Results: As a result of the study, bone and cerebral metastases were revealed. Conclusions:The electrolytic alterations in the oncologic patient can have several causes: chemotherapy, urinary diversion, pain, or even to the tumor itself or its metastases. It is necessary to conduct an exhaustive study in order to discard the most important causes of hyponatremia and be able to decide an appropriate treatment


Assuntos
Humanos , Masculino , Pessoa de Meia-Idade , Idoso , Neoplasias Ósseas/complicações , Carcinoma/complicações , Hiponatremia/etiologia , Neoplasias da Bexiga Urinária/complicações , Neoplasias Ósseas/secundário , Neoplasias Encefálicas/complicações , Neoplasias Encefálicas/secundário , Carcinoma/secundário , Neoplasias da Bexiga Urinária/patologia , Invasividade Neoplásica
17.
Clin. transl. oncol. (Print) ; 20(10): 1302-1313, oct. 2018. tab, graf
Artigo em Inglês | IBECS | ID: ibc-173718

RESUMO

Background: Androgen deprivation therapy (ADT) remains a standard treatment for advanced prostate cancers. However, recent studies revealed that while inhibiting the growth of certain types of prostate cancer cells, ADT promotes invasion. In the current study, we explored the effects of Nur77, an orphan nuclear receptor, on prostate cancer cell invasion following ADT. Methods: Androgen receptor (AR) and Nur77 protein expression in patient tissues and cell lines were quantified via ELISA and western blot. The effects of AR-signaling on Nur77 expression were examined. The effects of Nur77 over-expression and knockdown on ADT-induced prostate cancer cell invasion were characterized. Results: The results showed that AR and Nur77 are both highly expressed in prostate cancers of patients. Nur77 is positively regulated by AR-signaling at transcriptional level in NCI-H660, a widely used prostate cancer cell line. AR antagonists, Casodex and MDV3100 treatment resulted in significant inhibition of prostate cancer cell growth but enhanced cancer cell invasion. Nur77 over-expression blocked invasion-promoting effect of ADT, which is consistent with the down-regulation of MMP9 and Snail protein expression. Further mechanistic investigations showed that Nur77 inhibited transcription of TGF-beta target genes (Snail and MMP9), and thereby inhibits TGF-beta-mediated prostate cancer cell invasion following androgen antagonism. In addition, our data suggested the nature of this inhibitory effect of Nur77 on TGF-beta-signaling is selective, for Smad3-signaling, the classical effector of TGF-beta-signaling, was not interrupted by Nur77 over-expression. Conclusion: Considering the limited success of management of prostate cancer metastasis following ADT, our data strongly suggest that Nur77 regulation could be a promising direction for search of complementary therapeutic strategy on top of classic ADT therapy


No disponible


Assuntos
Humanos , Masculino , Neoplasias da Próstata/tratamento farmacológico , Antagonistas de Androgênios/uso terapêutico , Fator de Crescimento Neural/antagonistas & inibidores , Receptores de Fatores de Crescimento Transformadores beta/metabolismo , Neoplasias da Próstata/patologia , Receptores Androgênicos , Invasividade Neoplásica/patologia
19.
Rev. esp. patol ; 51(3): 183-187, jul.-sept. 2018. ilus
Artigo em Espanhol | IBECS | ID: ibc-179074

RESUMO

La leiomiomatosis intravascular es una rara condición caracterizada por el crecimiento histológicamente benigno de células musculares lisas dentro de las venas uterinas, la vena cava inferior y, excepcionalmente, dentro de las cavidades derechas del corazón. Presentamos el caso de una mujer de 39 años de edad con antecedente de histerectomía por leiomiomas uterinos que ingresa a nuestra institución por edema de miembros inferiores y disnea progresiva de 5meses de evolución. La ecocardiografía transtorácica y la tomografía computarizada con contraste mostraron una extensa masa que se extendía desde la vena cava inferior hasta las cavidades derechas del corazón. Bajo la sospecha de un trombo intravenoso, la paciente fue tratada con una resección quirúrgica. La evaluación histopatológica de la masa resecada permitió establecer el diagnóstico de una leiomiomatosis intravascular con extensión intracardiaca


Intravascular leiomyomatosis is a rare condition characterized by histologically benign smooth muscle cell growth within the uterine veins and inferior vena cava and, rarely, into the right chambers of the heart. A 39-year-old female with a history of hysterectomy for uterine leiomyoma was admitted for lower limb oedema and progressive dyspnea of 5 months' duration. Transthoracic echocardiography and contrast-enhanced computed tomography showed a large mass extending through the inferior vena cava into the right chambers of the heart. As there was a suspicion of an intravenous thrombus, the patient underwent surgical resection. The histopathology of the resected mass led to a diagnosis of Intravascular leiomyomatosis with intracardiac extension


Assuntos
Humanos , Feminino , Adulto , Leiomiomatose/patologia , Angiomioma/patologia , Leiomioma/patologia , Veia Cava Inferior/patologia , Átrios do Coração/patologia , Neoplasias Cardíacas/patologia , Ecocardiografia/métodos , Invasividade Neoplásica/patologia , Células Neoplásicas Circulantes/patologia
20.
Clin. transl. oncol. (Print) ; 20(8): 1035-1045, ago. 2018. ilus, tab, graf
Artigo em Inglês | IBECS | ID: ibc-173687

RESUMO

Background: To investigate the effect of CXCL12 gene silencing on proliferation,invasion, angiogenesis and the relationship of MAPK/PI3K/AP-1 signaling pathway in colon cancer cells. Methods: RT-PCR and Western-blot were used to detect the expression of CXCL12 mRNA and protein in four colon cancer cell lines. Human colon cancer cells were transfected with CXCL12 siRNA carrying by Lipofectamine 2000. The expression of CXCL12 protein was confirmed by immunoblotting. WST-1, invasion and angiogenesis assay were used to examine the effect on proliferation, invasion and angiogenesis in colon cancer cells after CXCL12 siRNA silence, respectively. The phosphorylation of MAPK/PI3K/AP-1 protein levels was detected by Western blotting in CXCL12 siRNA suppression DLD-1 cell. Results: CXCL12 mRNA and proteins were only expressed in DLD-1 colon cancer cell lines. CXCL12 siRNA were transfected into DLD-1 cells, the expression CXCL12 proteins was significantly inhibited (P < 0.01), and the proliferation, invasion and angiogenesis of DLD-1 cells were inhibited significantly (P < 0.01). CXCL12 gene silencing resulted in blockage of MAPK, PI3K and AP-1 phosphorylation by CXCL12-induced in DLD-1 colon cancer cell. Conclusion: The silencing CXCL12 gene significantly inhibits the proliferation, invasion and angiogenesis ability of some types colon carcinoma cells through down-regulation of MAPK/PI3K/AP-1 signaling pathway


No disponible


Assuntos
Humanos , Quimiocina CXCL12/genética , Quinases de Proteína Quinase Ativadas por Mitógeno/genética , Fosfatidilinositol 3-Quinase/genética , Neoplasias do Colo/genética , Fator de Transcrição AP-1/genética , Metástase Neoplásica/genética , Transdução de Sinais/genética , Invasividade Neoplásica/genética , Marcadores Genéticos/genética
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