Subject(s)
Choledochal Cyst/diagnosis , Pancreatic Neoplasms/diagnosis , Aged, 80 and over , Cholangiopancreatography, Endoscopic Retrograde , Choledochal Cyst/complications , Choledochal Cyst/therapy , Gallbladder/diagnostic imaging , Humans , Jaundice/complications , Male , Pancreatic Neoplasms/complications , Pancreatic Neoplasms/therapy , Stents , UltrasonographySubject(s)
Humans , Male , Aged, 80 and over , Pancreatic Neoplasms/complications , Pancreatic Neoplasms/diagnosis , Pancreatic Neoplasms/surgery , Adenocarcinoma/diagnosis , Adenocarcinoma/surgery , Common Bile Duct Diseases/complications , Cholangiography/methods , Catheterization/methods , Pancreas/pathology , Pancreas , Pancreatic Neoplasms/physiopathology , Pancreatic Neoplasms , Leukocytosis/complications , /methods , Common Bile Duct Diseases/physiopathology , Common Bile Duct Diseases/surgeryABSTRACT
BACKGROUND: 30% of patients with colorectal cancer (CRC) in Dukes stages A and B (T1-T4, N0, M0) present tumor recurrence and die after 5 years follow up. This unexpectedly poor evolution might be attributable to the presence of lymph node micrometastasis undetected in routine examination with haematoxilin-eosine (H&E). OBJECTIVE: To assess the presence of undetected micrometastasis. PATIENTS AND METHODS: we conducted a retrospective study of the locoregional lymph nodes in 85 patients operated for CRC in Dukes stages A and B (T1-T4, N0, M0), using immunohistochemistry with anticytokeratin antibodies AE1/AE3. In this descriptive, inferential bivariant and survival study, we analyzed different risk factors, including local infiltration T1/T4, Dukes A/B, number of dissected lymph nodes, vascular invasion, micrometastasis, tumor recurrence and death in the context of the presence or absence of micrometastases. RESULTS: Dukes stage and neoplastic angioinvasion are influential in patient prognosis; however, lymph node micrometastases were not associated with a poorer outcome of CRC. CONCLUSIONS: Locorregional lymph node micrometastases detected with anticytokeratine antibodies AE1/AE3 in Dukes A and B CRC patients are not associated with reduced survival.
Subject(s)
Colorectal Neoplasms/mortality , Colorectal Neoplasms/pathology , Lymph Nodes/pathology , Adult , Aged , Aged, 80 and over , Female , Humans , Immunohistochemistry , Kaplan-Meier Estimate , Lymphatic Metastasis , Male , Middle Aged , Neoplasm Staging , Prognosis , Retrospective StudiesABSTRACT
Introducción: un 30% de los pacientes con cáncer colorrectal(CCR) en estadios A y B de Dukes (T1-T4, N0, M0) presentan recidivatumoral y/o fallecen a los 5 años. Esta inesperada malaevolución, en casos presumiblemente curados podría deberse, entreotras causas, a la presencia de micrometástasis linfoganglionaresno detectadas en el estudio de rutina: hematoxilina-eosina(H&E).Objetivo: determinar si la presencia de micrometástasis linfoganglionaresdetectadas mediante inmunohistoquímica con anticuerposanticitoqueratina AE1/AE3, influyen en la evolución delCCR.Pacientes y métodos: se han estudiado los ganglios linfáticoslocorregionales de 85 pacientes con CCR en estadios A y Bde Dukes (T1-T4, N0, M0), mediante técnicas de inmunohistoquímicacon anticuerpos anticitoqueratinas AE1/AE3, para poner demanifiesto la presencia de micrometástasis. Se ha realizado un estudiodescriptivo, inferencial bivariante y de supervivencia, segúndistintos factores de riesgo, centrado en la presencia o no de micrometástasis.Resultados: hemos observado que el estadio de Dukes y laangioinvasión neoplásica son factores que influyen en el pronósticode estos pacientes. Sin embargo, no se ha demostrado que lapresencia de micrometástasis linfoganglionares se asocie a unapeor evolución en el CCR.Conclusiones: las micrometástasis linfoganglionares locorregionalesdetectadas mediante anticuerpos anticitoqueratinaAE1/AE3, en pacientes con CCR en estadios A y B de Dukes, nose asocian a una menor supervivencia(au9
Background: 30% of patients with colorectal cancer (CRC) inDukes stages A and B (T1-T4, N0, M0) present tumor recurrenceand die after 5 years follow up. This unexpectedly poor evolutionmight be attributable to the presence of lymph node micrometastasisundetected in routine examination with haematoxilin-eosine(H&E).Objective: to assess the presence of undetected micrometastasis.Patients and methods: we conducted a retrospective studyof the locoregional lymph nodes in 85 patients operated for CRCin Dukes stages A and B (T1-T4, N0, M0), using immunohistochemistrywith anticytokeratin antibodies AE1/AE3. In this descriptive,inferential bivariant and survival study, we analyzed differentrisk factors, including local infiltration T1/T4, Dukes A/B,number of dissected lymph nodes, vascular invasion, micrometastasis,tumor recurrence and death in the context of the presenceor absence of micrometastases.Results: Dukes stage and neoplastic angioinvasion are influentialin patient prognosis; however, lymph node micrometastaseswere not associated with a poorer outcome of CRC.Conclusions: locorregional lymph node micrometastases detectedwith anticytokeratine antibodies AE1/AE3 in Dukes A andB CRC patients are not associated with reduced survival(AU)
Subject(s)
Humans , Colorectal Neoplasms/pathology , Lymphatic Metastasis/pathology , Neoplasm Staging , Adenocarcinoma/pathology , Risk FactorsABSTRACT
Coeliac disease is the most frequent malabsortive syndrome in daily practice. However, its true prevalence is not exactly known. The symptoms vary from patient to patient, ranging from the classic presentation with diarrhea, weight loss and fatigue to oligosymptomatic forms, being the latter more common in adults. We report two patients in which urinary and skin spontaneous hemorrhage were the only symptoms, and led to the diagnosis. We insist on the importance of considering the diagnosis of coeliac disease in patients with this kind of clinical manifestations. The early diagnosis will allow us to reduce both the morbidity and mortality in coeliac patients.
