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1.
Urol Int ; 96(3): 370-2, 2016.
Artículo en Inglés | MEDLINE | ID: mdl-24481023

RESUMEN

Carcinosarcoma is a rare malignant tumor with a biphasic morphology characterized by the presence of a malignant epithelial and mesenchymal component. It has been reported in many organs, including the genitourinary tract. We describe a case of a 47-year-old woman admitted to our hospital for history of recurrent urinary tract infection, dysuria and discharge of bloody fluid from the urethra at the end of urination. A tender palpable mass under the anterior vaginal wall was found and pathological examination showed a urethral carcinosarcoma. The histopathogenetic hypothesis and clinical management were considered in this report.


Asunto(s)
Carcinosarcoma/diagnóstico , Carcinosarcoma/patología , Neoplasias Ureterales/diagnóstico , Neoplasias Ureterales/patología , Uretra/patología , Carcinosarcoma/mortalidad , Cisplatino/administración & dosificación , Resultado Fatal , Femenino , Humanos , Imagen por Resonancia Magnética , Persona de Mediana Edad , Terapia Neoadyuvante/métodos , Recurrencia Local de Neoplasia , Poliploidía , Tomografía de Emisión de Positrones , Neoplasias Ureterales/mortalidad
3.
J Chemother ; 23(6): 354-7, 2011 Dec.
Artículo en Inglés | MEDLINE | ID: mdl-22233820

RESUMEN

Many drugs can be used for adjuvant therapy of breast cancer, including anthracyclines, cyclophosphamide, 5-fluorouracil (5-fU) and, recently, taxanes (TXT) have shown promising results. 5-FU blocks thymidylate synthase (TS) which cross-links p53 mRNA, inhibiting its synthesis. TS overexpression is one of the main mechanisms involved in 5-FU drug resistance. Enough p53 mutations can confer resistance to chemotherapy using anthracyclines and 5-FU, while are associated with improved responses to TXT. The aim of this study was to examine the TS and p53 levels in tumor samples and to compare the efficacy of FEC (5-FU, epirubicin, cyclophosphamide) and TXT chemotherapy in a group of patients with differing TS and p53 status. We examined 84 breast tumor samples using immunohistochemistry. TS and p53 levels were inversely related, and TS and p53 positivity was significantly associated with the failure of FEC treatment and with a good response to TXT therapy (p <0.001). This confirms the predictive role of these two markers, which should be considered when choosing the appropriate adjuvant therapy for breast cancer.


Asunto(s)
Protocolos de Quimioterapia Combinada Antineoplásica/uso terapéutico , Neoplasias de la Mama/tratamiento farmacológico , Neoplasias de la Mama/metabolismo , Hidrocarburos Aromáticos con Puentes/uso terapéutico , Taxoides/uso terapéutico , Timidilato Sintasa/metabolismo , Proteína p53 Supresora de Tumor/metabolismo , Protocolos de Quimioterapia Combinada Antineoplásica/administración & dosificación , Biomarcadores de Tumor/genética , Biomarcadores de Tumor/metabolismo , Neoplasias de la Mama/enzimología , Neoplasias de la Mama/genética , Quimioterapia Adyuvante , Ciclofosfamida/administración & dosificación , Epirrubicina/administración & dosificación , Femenino , Fluorouracilo/administración & dosificación , Humanos , Inmunohistoquímica , Estadificación de Neoplasias , Pronóstico , Timidilato Sintasa/antagonistas & inhibidores , Timidilato Sintasa/genética , Proteína p53 Supresora de Tumor/genética
4.
Prostate Cancer Prostatic Dis ; 13(4): 316-9, 2010 Dec.
Artículo en Inglés | MEDLINE | ID: mdl-20714341

RESUMEN

To evaluate prostate cancer (PCa) detection and incidence of pathologically insignificant PCa (pIPCa) tumour using percent-free PSA (%f-PSA) in patients with total PSA ≤ 10 ng ml(-1). From February 2002 to October 2009, 14,453 patients (median 60.5 years) were enrolled in a case-finding protocol for the early diagnosis of PCa. Indications to biopsy were suspicious digital rectal examination; PSA >10 ng ml(-1); PSA ≤ 2.5 ng ml(-1), included between 2.6-4 and 4.1-10 ng ml(-1) with %f-PSA <15, <20 and <25%, respectively. A median of 18 and 26 cores in case of primary and repeated biopsy were determined; 2123 men underwent prostate biopsy, of whom 1589 (74.8%) had a PSA ≤ 10 ng ml(-1). A PCa was found in 777 (36.6%) and in 35 (23.3%) patients at primary and repeated biopsy: 459 and 26 men had PSA ≤ 10 ng ml(-1) and 419 and 26 patients underwent surgery, respectively, 244 (58.3%) and 18 (69.2%) had an organ-confined PCa with a pIPCa incidence equal to 1.4 and 7.7%, respectively. Cancer detection rate of 28.8% in patients with PSA ≤ 10 ng ml(-1) associated with a low incidence of pIPCa should induce to introduce %f-PSA in screening programmes to reduce the risk of overdiagnosis.


Asunto(s)
Detección Precoz del Cáncer/métodos , Antígeno Prostático Específico/análisis , Neoplasia Intraepitelial Prostática/diagnóstico , Neoplasia Intraepitelial Prostática/epidemiología , Neoplasias de la Próstata/diagnóstico , Neoplasias de la Próstata/epidemiología , Adulto , Anciano , Biopsia , Protocolos Clínicos , Detección Precoz del Cáncer/estadística & datos numéricos , Humanos , Incidencia , Masculino , Persona de Mediana Edad , Antígeno Prostático Específico/sangre , Neoplasia Intraepitelial Prostática/sangre , Neoplasia Intraepitelial Prostática/patología , Neoplasias de la Próstata/sangre , Neoplasias de la Próstata/patología , Solubilidad
6.
Prostate Cancer Prostatic Dis ; 13(1): 83-6, 2010 Mar.
Artículo en Inglés | MEDLINE | ID: mdl-19901959

RESUMEN

To evaluate prostate cancer (PCa) detection after repeated negative saturation biopsy, 75 patients, aged 53-78 years, underwent transurethral resection of prostate (TURP) because of persistent suspicion of cancer; median PSA was 11.8 ng ml(-1) and 58 men complained lower urinary tract symptoms (LUTS). In 12 (16%) and 3 (4%) men a T1a and T1b PCa was found with median PSA and Gleason score equal to 14.2 vs 23.6 ng ml(-1) and 5.6 vs 7 ng ml(-1). In case of persistent suspicion of PCa after repeated negative saturation biopsy, TURP may be proposed, aside from the coexistence of LUTS, to rule out a PCa, in younger patients with high PSA values (> or =20 ng ml(-1)).


Asunto(s)
Antígeno Prostático Específico/análisis , Próstata/patología , Neoplasias de la Próstata/diagnóstico , Resección Transuretral de la Próstata , Anciano , Biopsia , Estudios de Casos y Controles , Humanos , Masculino , Persona de Mediana Edad , Prostatismo/diagnóstico
10.
Urology ; 72(6): 1198-202, 2008 Dec.
Artículo en Inglés | MEDLINE | ID: mdl-19041023

RESUMEN

OBJECTIVES: To evaluate the role of quantitative histologic findings in predicting nonorgan-confined (non-OC) prostate cancer (PCa) in patients undergoing saturation prostate biopsy (SPBx). METHODS: A total of 69 patients who had undergone SPBx underwent radical retropubic prostatectomy. Their prostate-specific antigen level was <10 ng/mL, and 49 and 20 patients had T1c and T2 PCa, respectively. The following biopsy variables from the quantitative histologic examination were evaluated as predictive of OC vs non-OC PCa: Gleason score (6), total percentage of PCa (20%), greatest percentage of PCa (50%), number of PCa-positive cores (2), presence of PCa-positive cores in both lateral margins (yes vs no), and PCa localization (unilateral vs bilateral). The results obtained from patients who had undergone SPBx were compared with those of 183 patients who had undergone 12-core prostate biopsy before radical retropubic prostatectomy. RESULTS: Overall, 32 patients had non-OC PCa. Among the men with Stage T1c PCa, the quantitative histologic findings were predictive of non-OC PCa in 12 of 17 cases. The area under the receiver operating characteristic curve was 0.935 +/- 0.29, supporting the high accuracy of quantitative histologic examination in predicting for non-OC PCa. The sensitivity in patients who underwent SPBx vs the 12-core biopsy was 78.1% and 89.4%, respectively. Also, although the specificity of each histologic parameter was significantly lower in the SPBx group, it was equivalent using quantitative histologic examination (85.6% vs 86.5%). CONCLUSIONS: In the preoperative staging of patients with clinical Stage T1c-T2 PCa and a prostate-specific antigen level <10 ng/mL who had undergone SPBx, quantitative histologic examination demonstrated good accuracy in predicting for non-OC PCa only when all pathological variables were considered.


Asunto(s)
Biopsia/métodos , Neoplasias de la Próstata/diagnóstico , Neoplasias de la Próstata/patología , Anciano , Humanos , Masculino , Oncología Médica/métodos , Persona de Mediana Edad , Antígeno Prostático Específico/sangre , Prostatectomía/métodos , Curva ROC , Reproducibilidad de los Resultados , Sensibilidad y Especificidad , Resultado del Tratamiento , Urología/métodos
11.
Pathologica ; 100(6): 482-4, 2008 Dec.
Artículo en Inglés | MEDLINE | ID: mdl-19475893

RESUMEN

Malignant tumours of the prostate other than carcinomas are rare. One such malignant tumours arising from the specialised stromal tissue of the prostate is stromal prostatic sarcoma (namely low-grade and high-grade). Herein, we report the clinico-pathological features of a high grade stromal sarcoma of the prostate occurring in a 65-year-old man who presented for urinary obstructive symptoms. The clinical picture suggested a benign prostatic hyperplasia, and surgery consisting in a transcapsular adenomectomy was performed. Following a pathological diagnosis of high grade prostatic stromal sarcoma, a radical cystoprostatectomy and bilateral pelvic node dissection was performed showing residual high grade stromal sarcoma of the prostate and incidental in situ urothelial carcinoma of the bladder. No further medical treatments were planned. One year after surgery the patient is well with no evidence of local disease or distant metastases.


Asunto(s)
Errores Diagnósticos , Neoplasias de la Próstata/patología , Sarcoma/patología , Anciano , Carcinoma in Situ/patología , Carcinoma in Situ/cirugía , Carcinoma de Células Transicionales/patología , Carcinoma de Células Transicionales/cirugía , Cistectomía , Humanos , Hallazgos Incidentales , Escisión del Ganglio Linfático , Masculino , Neoplasias Primarias Múltiples , Prostatectomía , Hiperplasia Prostática/diagnóstico , Neoplasias de la Próstata/diagnóstico , Neoplasias de la Próstata/cirugía , Sarcoma/diagnóstico , Sarcoma/cirugía , Células del Estroma/patología , Neoplasias de la Vejiga Urinaria/patología , Neoplasias de la Vejiga Urinaria/cirugía
12.
Prostate Cancer Prostatic Dis ; 11(2): 148-52, 2008.
Artículo en Inglés | MEDLINE | ID: mdl-17637759

RESUMEN

Microscopic foci of prostatitis may induce prostate-specific antigen (PSA) increase. PSA reduction after antibiotics might identify those patients in whom biopsy can be avoided. Ninety-nine patients received ciprofloxacin for 3 weeks, of whom 59 showed PSA reduction. Histology detected small foci of prostatitis in 65% of cases. Carcinoma was found in 40 and 20.3% of patients with unchanged or decreased PSA, respectively (P=0.03). No cancer was detected if PSA decreased below 4 ng/ml or more than 70%. Biopsy can be postponed, with a low risk of missing a cancer, if PSA decreases more than 70% or below 4 ng/ml.


Asunto(s)
Antibacterianos/uso terapéutico , Biopsia con Aguja , Ciprofloxacina/uso terapéutico , Antígeno Prostático Específico/sangre , Próstata/patología , Prostatitis/tratamiento farmacológico , Procedimientos Innecesarios , Anciano , Anciano de 80 o más Años , Diagnóstico Diferencial , Estudios de Seguimiento , Humanos , Masculino , Persona de Mediana Edad , Tamaño de los Órganos , Palpación , Selección de Paciente , Próstata/diagnóstico por imagen , Neoplasias de la Próstata/diagnóstico , Neoplasias de la Próstata/patología , Prostatitis/sangre , Prostatitis/diagnóstico , Riesgo , Factores de Tiempo , Ultrasonografía Intervencional
14.
Ann Oncol ; 18 Suppl 6: vi110-5, 2007 Jun.
Artículo en Inglés | MEDLINE | ID: mdl-17591802

RESUMEN

BACKGROUND: The development of oesophageal adenocarcinoma is generally closely associated with the presence of a specialised intestinal-type epithelium such as that found in Barrett's oesophagus (BO). A particular histological condition is when the distal oesophagus showing cardiac and/or fundic mucosa without intestinal metaplasia cannot be defined as 'Barrett's mucosa' [condition that we call 'columnar-lined oesophagus' (CLO)] and up till now, there has been no agreement in literature about the management of this condition. Aurora-A overexpression leads to centrosome amplification, chromosomal instability and aneuploidy in mammalian cells. PATIENTS AND METHODS: A prospective study was carried out on 28 consecutive patients who presented columnar mucosa above the gastro-oesophageal junction (GOJ) at endoscopy. As controls, two more biopsies were obtained, one on the normal-appearing squamous oesophagus above the GOJ, as far as possible from the columnar mucosa (controls A), and one taken 1 cm below the GOJ (controls B). The Aurora-A and p53 expression levels were analysed respectively by Quantitative Real Time PCR and immunohistochemistry. RESULTS: Twelve patients were affected by BO (43%) while the other 16 patients (57%) had a CLO. Nine of 28 (32%) cases were focally positive for p53 immunostaining. All the BO/CLO samples were positive for the Aurora-A transcript with regard to controls. Furthermore, 13 of 28 (46%) cases showed overexpression (above the median for the whole group). CONCLUSION: Due to the low number of cases, we are not at present able to state that statistically significant quantitative differences in Aurora-A messenger RNA expression exist between CLO and BO cases with and without dysplasia and p53-positive immunostaining. Further studies on a larger number of cases with a follow-up period are necessary in order to establish the risk of progression and the correct management of these subjects.


Asunto(s)
Esófago de Barrett/genética , Reflujo Gastroesofágico/genética , Proteínas Serina-Treonina Quinasas/biosíntesis , Proteínas Serina-Treonina Quinasas/genética , Adenocarcinoma/enzimología , Adenocarcinoma/genética , Adenocarcinoma/patología , Adulto , Aurora Quinasas , Esófago de Barrett/enzimología , Esófago de Barrett/patología , Biomarcadores/metabolismo , Neoplasias Esofágicas/enzimología , Neoplasias Esofágicas/genética , Neoplasias Esofágicas/patología , Femenino , Reflujo Gastroesofágico/enzimología , Reflujo Gastroesofágico/patología , Humanos , Masculino , Persona de Mediana Edad , Membrana Mucosa/enzimología , Membrana Mucosa/patología , Estudios Prospectivos
15.
Nucleosides Nucleotides Nucleic Acids ; 25(9-11): 1193-6, 2006.
Artículo en Inglés | MEDLINE | ID: mdl-17065089

RESUMEN

Breast cancer is a heterogeneous disease, so therapeutic predictive biological markers need to be identified. To date an accurate evaluation of predictive markers is mainly done at the primary site; however, the main goal of adjuvant therapy for breast cancer is the control of micrometastases. The aim of this study is to assess as therapeutic and/or prognostic marker, the proliferation status of primary tumors and involved nodes as measured by Ki67 and thymidylate synthase (TS) expression, in 30 breast cancer node positive patients. TS is the main target of 5-fluorouracil (5-FU) activity, and its overexpression is one of the mechanisms of 5-FU drug resistance; however, in some studies its absence is responsible for a worse response to 5-FU. Our results show that malignant cells of involved nodes were in a post mitotic phase of the cell cycle, and show a low proliferation index and TS expression, while the primary tumours and controls, were strongly positive. On these basis we can hypothesize that these cells could be less sensitive to 5-FU. Further studies are necessary to identify other mechanisms responsible for their metastasing capability and/or for their aggressiveness.


Asunto(s)
Neoplasias de la Mama/metabolismo , Regulación Enzimológica de la Expresión Génica , Regulación Neoplásica de la Expresión Génica , Antígeno Ki-67/biosíntesis , Timidilato Sintasa/biosíntesis , Antígenos de Neoplasias/biosíntesis , Antimetabolitos Antineoplásicos/farmacología , Neoplasias de la Mama/patología , Proliferación Celular , Femenino , Fluorouracilo/farmacología , Humanos , Metástasis Linfática , Metástasis de la Neoplasia , Pronóstico
16.
Anticancer Res ; 26(6B): 4357-60, 2006.
Artículo en Inglés | MEDLINE | ID: mdl-17201155

RESUMEN

UNLABELLED: The aim of the study was to verify by Ki-67 immunostaining if any difference exists in the cell proliferating fraction between primary breast tumors (PTs) and matching positive axillary lymph nodes (ALNs). PATIENTS AND METHODS: Immunohistochemistry with the monoclonal antibody against Ki-67 was performed in 160 node-positive breast carcinomas and in their respective lymph node metastases. RESULTS: An increase of Ki-67 immunoreactive cells in ALN compared with that of PTs was observed in 84% of cases (ALN: mean 17%, PTs: mean 8%; p < 0.001), whereas 16% of the cases showed Ki-67 value two to six times lower in the ALNs than in the corresponding PTs (ALN: mean 3.2%, PTs mean 12.5%; p < 0.005). The decrease of Ki-67 positive cells in the ALN was independent from the histotype and the histological grade of the tumor. CONCLUSION: A different cell proliferation fraction between PTs and matching positive ALNs was demonstrated and underlined that the existence of a group of patients with decreased number of Ki-67 immunoreactive cells in lymph node metastases compared with that of the primary tumors could be taken into account in the choice of therapeutic strategy.


Asunto(s)
Neoplasias de la Mama/inmunología , Antígeno Ki-67/inmunología , Metástasis Linfática/inmunología , Femenino , Humanos
17.
Arch. esp. urol. (Ed. impr.) ; 58(10): 1093-1094, dic. 2005. ilus
Artículo en En | IBECS | ID: ibc-044348

RESUMEN

OBJETIVOS: Presentar un caso de recurrencialocal de tumor renal 16 años después de nefrectomíaradical; analizar los datos de la literatura sobre tratamiento y pronóstico.MÉTODOS/RESULTADOS: Presentamos un caso de recurrencialocal asociado con trombosis de la vena cava que fue intervenido mediante resección en bloque del tumor y la vena cava con sustitución por una prótesis PTFE.CONCLUSIONES: La recurrencia local después de nefrectomíaradical es rara, siendo comunicada entre el 2-4% de los pacientes. Esta condición es incluso más rara después de diez años, especialmente si está asociada con trombosis de la vena cava.Se describe un caso de recurrencia local aislada de carcinoma de células renales con afectación de la cava 16 años después de nefrectomía radical. Pensamos que éste es el primer caso comunicado en la literatura. Este caso destaca la oportunidad de las revisiones periódicasde los pacientes sometidos a nefrectomía radical incluso muchos años después de cirugía


OBJECTIVE: To report a case of local recurrence 16 years after radical nephrectomy; to analyse literature data concerning, treatment and prognosis. METHODS/RESULTS: We report a case of local recurence associated with caval trombosis who was underwent an en–bloc resection of vena cava along with pericaval lesion and caval replacement with PTFE prosthesis. The Authors reviewed and analysed literature data. CONCLUSIONS: Local recurrence after radical nephrectomy is rare as it is reported only in 2-4% of patients. This condition is even rarer beyond 10 years especially if associated with caval trombosis. A case of isolated local recurrence of renal cell carcinoma with caval involvement 16 years after radical nephrectomy is described herein. To the best of our knowledge, this is the first case reported in literature. This case highlights the opportunity of a periodic check-up of patients submitted to radical nephrectomy, even many years after surgery


Asunto(s)
Femenino , Anciano , Humanos , Nefrectomía , Neoplasias Renales/cirugía , Recurrencia Local de Neoplasia/cirugía , Factores de Tiempo
19.
Eur J Surg Oncol ; 31(3): 309-13, 2005 Apr.
Artículo en Inglés | MEDLINE | ID: mdl-15780569

RESUMEN

AIMS: To find a predictor of extraprostatic extension in clinically localized prostate cancer (PCa), pre-operative ultrasound-guided prostate needle biopsies and clinico-pathological data were reviewed. METHODS: One hundred and eighty-three consecutive patients who underwent radical retropubic prostatectomy for clinical T1-T2 PCa and serum PSA <10 ng/ml were reviewed. Pre-operative biopsy was performed according to an extended protocol and whole-mount prostatectomy specimens were processed. The following biopsy variables were categorized to this analysis: Gleason score (< or =6, >6), TPC (< or =20%; >20%), GPC (< or =50%; >50%), cancer-positive cores (< or =2; >2), cancer-positive cores in both lateral portions (yes; no), PCa (monolateral; bilateral). RESULTS: Only 60/183 specimens showed an organ-confined PCa; the remaining ones showed pT3a in 57 cases, pT3b in 11 and pT3 with positive surgical margins in 55. A locally advanced PCa was found in 60.2 and 76.8% of T1c and T2 clinical stage, respectively. The positive predictive value and negative predictive value of biopsy findings to predict a locally advanced PCa was 89.9 and 75%, respectively. All biopsy variables associations were statistically significant; however, among these variables (non-categorized), in multivariate logistic regression analysis, only GPC was significantly associated with pathologic stage (odds ratio estimate was 1.075, 95% CI: 1.053-1.098). CONCLUSIONS: Quantitative histology, especially GPC, seems to be helpful for pre-operative staging of PCa in patients with T1c-T2 clinical stage and PSA < 10 ng/ml.


Asunto(s)
Antígeno Prostático Específico/sangre , Neoplasias de la Próstata/patología , Anciano , Biopsia , Humanos , Modelos Logísticos , Masculino , Persona de Mediana Edad , Análisis Multivariante , Estadificación de Neoplasias , Oportunidad Relativa , Valor Predictivo de las Pruebas , Neoplasias de la Próstata/inmunología , Curva ROC , Sensibilidad y Especificidad
20.
Arch Esp Urol ; 58(10): 1093-4, 2005 Dec.
Artículo en Inglés | MEDLINE | ID: mdl-16482865

RESUMEN

OBJECTIVE: To report a case of local recurrence 16 years after radical nephrectomy; to analyse literature data concerning, treatment and prognosis. METHODS/RESULTS: We report a case of local recurence associated with caval trombosis who was underwent an en-bloc resection of vena cava along with pericaval lesion and caval replacement with PTFE prosthesis. The Authors reviewed and analysed literature data. CONCLUSIONS: Local recurrence after radical nephrectomy is rare as it is reported only in 2-4% of patients. This condition is even rarer beyond 10 years especially if associated with caval trombosis. A case of isolated local recurrence of renal cell carcinoma with caval involvement 16 years after radical nephrectomy is described herein. To the best of our knowledge, this is the first case reported in literature. This case highlights the opportunity of a periodic checkup of patients submitted to radical nephrectomy, even many years after surgery.


Asunto(s)
Neoplasias Renales/cirugía , Recurrencia Local de Neoplasia/cirugía , Nefrectomía , Anciano , Femenino , Humanos , Factores de Tiempo
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