OBJECTIVE: To evaluate the prevalence of micrometastases in lymph node tissue of patients with stage Ib1-IIA cervical cancer, the correlation of micrometastases with tumor recurrence and survival, and the expression of D2-40 in the primary tumor of patients with recurrence and/or micrometastases and its correlation with histopathologic findings. METHODS: In a retrospective study, the medical records of all patients with cervical cancer treated at a hospital in São Paulo, Brazil, between 2001 and 2007 were reviewed. Patients with no lymph node metastases and treated with radical hysterectomy without adjuvant treatment were included. Tumor sections were reviewed and lymph nodes were analyzed with AE1/AE3. Patients with and without recurrence were compared. The presence of lymph node micrometastasis or isolated tumor cells was also evaluated. RESULTS: Of the 83 patients evaluated, 15 (18%) had recurrence. Significant differences between patients with and without recurrence were observed with regard to tumor greatest axis, clinical stage, number of micrometastases, and negative lymph nodes (P≤0.04). Lymph node micrometastases and isolated tumor cells were significantly different for a stromal invasion depth greater than 2/3 (P=0.046). CONCLUSION: The presence of lymph node micrometastases is an important risk factor for tumor recurrence. These patients should be considered eligible for adjuvant radiochemotherapy treatment.
Hysterectomy , Neoplasm Micrometastasis/pathology , Neoplasm Recurrence, Local/epidemiology , Uterine Cervical Neoplasms/pathology , Adult , Aged , Brazil , Female , Follow-Up Studies , Humans , Lymphatic Metastasis , Middle Aged , Neoplasm Invasiveness , Neoplasm Staging , Prevalence , Retrospective Studies , Risk Factors , Uterine Cervical Neoplasms/surgery , Young Adult
AIMS: Histological grade is one of the most important prognostic factors in breast carcinomas, but poorly differentiated neoplasms still have quite heterogeneous biological behaviour, since they can be genetically classified as basal-like, HER2+ or even luminal. The aim was to analyse the frequency of oestrogen receptor (ER), progesterone receptor (PR) and HER2 expression profiles among breast carcinomas with <10% tubular formation, and their correlation with classic prognostic factors. METHODS AND RESULTS: One hundred and thirty-four samples of paraffin-embedded tumours were studied retrospectively. The tumours were classified in to four groups by their ER/PR/HER2 profile: (i) ER+ and/or PR+ but HER2-; (ii) ER+ and/or PR+ and HER2+; (iii) ER- and/or PR- but HER2+; and (iv) ER-, PR- and HER2- (triple-negative). The histological features of triple-negative and HER2+ carcinomas overlap. The only difference was the expression of basal cytokeratins (basal CK), which was more frequent among triple-negative carcinomas. Basal-CK expression defined a more aggressive group of tumours, according to the pathological features, regardless of the immunohistochemical profile. CONCLUSIONS: Group 1 and 2 tumours (ER+ and/or PR+ tumours with or without HER2 expression) were not statistically different, suggesting that poorly differentiated carcinomas with hormone receptors correspond to the luminal B type of tumour. Among poorly differentiated breast carcinomas, the classic profile associated with basal-CK identifies distinct subtypes equivalent to those seen by genetic classification.
Biomarkers, Tumor/metabolism , Breast Neoplasms/pathology , Carcinoma, Ductal, Breast/pathology , Receptor, ErbB-2/metabolism , Receptors, Estrogen/metabolism , Receptors, Progesterone/metabolism , Adenocarcinoma, Mucinous/metabolism , Adenocarcinoma, Mucinous/pathology , Adult , Aged , Aged, 80 and over , Breast Neoplasms/metabolism , Carcinoma, Ductal, Breast/metabolism , Carcinoma, Lobular/metabolism , Carcinoma, Lobular/pathology , Cell Proliferation , Female , Fluorescent Antibody Technique, Direct , Humans , Immunoenzyme Techniques , Keratins/metabolism , Middle Aged , Necrosis , Prognosis , Retrospective Studies , Tissue Array Analysis , Young Adult
Objetivo: Descrever seis casos de imunodeficiência combinada grave, alertando para o diagnóstico e terapêutica precoces. Metodologia: Säo descritos seis pacientes com imunodeficiência combinada grave (IDCG) admitidos na Unidade de Alergia e Imunologia do Instituto da Criança do Departamento de Pediatria da FMUSP, cujos principais dados que levaram a esta hipótese diagnóstica foram história familiar, manifestaçöes clínicas, hemograma e dosagem de imunoglobulinas. Todos os pacientes foram submetidos a um protocolo clínico e laboratorial de avaliaçäo para imunodeficiência. Resultados: A idade de ínicio do quadro clínico variou do nascimento a oito meses e a idade do diagnóstico de um a onze meses. Quatro pacientes eram do sexo masculino e dois do sexo feminino. História familiar de óbito de irmäos, por quadro infeccioso, no primeiro ano de vida esteve presente em três casos. As manifestaçöes clínicas mais comuns foram: septicemia, pneumonia grave, diarréia crônica e desnutriçäo protéico-calórica. Os principais achados laboratoriais foram linfopenia e diminuiçäo das imunoglobulinas. Todos os pacientes receberam reposiçäo de gamaglobulina endovenosa, antibioticoterapia de amplo espectro e cuidados nutricionais. O óbito ocorreu em cinco casos, sendo quatro antes da realiazaçäo do transplante de medula óssea (TMO). Conclusäo: A imunodeficiência combinada grave é uma emergência pediátrica, sendo que o diagnóstico precoce e a instituiçäo de medidas específicas, incluindo a realizaçäo do TMO, permitem melhor evoluçäo desta doença.
Male , Female , Infant, Newborn , Infant , Child , Severe Combined Immunodeficiency/diagnosis
