ABSTRACT
Objetivo: El presente trabajo tuvo como propósito describir las características físicas, citológicas y bioquímicas, así como clasificar los líquidos pleurales de pacientes con COVID-19 como exudados o trasudados. Material y Métodos: Se realizó un estudio observacional, transversal descriptivo. Se recopiló datos del examen citoquímico de muestras de líquido pleural procesadas entre los meses de abril a setiembre del 2020, en el laboratorio del Centro de Emergencias de Lima Metropolitana (CELIM). Resultados: Durante el periodo de estudio un total de 81 muestras de líquido pleural de pacientes con COVID-19 fueron evaluadas, de estos, 26 cumplieron con nuestros criterios de elegibilidad. Catorce líquidos (54%), tuvieron un color rojo y 18 (69%) tuvieron un aspecto turbio. Los líquidos pleurales exudativos fueron la mayoría (n = 17), las proteínas totales presentaron una media de 3.3 gr/dl (DE: 1.5), LDH una mediana de 544 U/L (RIC: 262-2016), el recuento leucocitario tuvo una mediana de 610 leucocitos/ul (RIC: 180-968) y el recuento diferencial de polimorfonucleares una mediana 29% (RIC: 15-60). En cuanto a las características clínicas, del total de exudados el 41% correspondían a neoplasias y el 23% a neumonías. Mientras que, del total de trasudados (n=9), 45% provenían de pacientes con neoplasias. Conclusiones: En nuestro estudio observamos que la mayoría de las muestras de líquido pleural de pacientes con COVID-19 fueron clasificadas como exudados. Estas presentaron un bajo porcentaje diferencial leucocitario de polimorfonucleares. Los valores de los parámetros bioquímicos tales como proteínas totales y LDH se relacionaron adecuadamente con la clasificación de exudados.
Objetive:The purpose of this work was to describe the physical, cytological and biochemical characteristics, as well as to classify the pleural fluids of patients with COVID-19 as exudates or transudates. Materials and Methods: An observational, descriptive cross-sectional study was carried out. Data was collected from the cytochemical examination of pleural fluid samples processed between the months of April to September 2020, in the laboratory of the Emergency Center of Metropolitan Lima (CELIM). Results: During the study period, a total of 81 samples of pleural fluid from patients with COVID-19 were evaluated, of these, 26 met our eligibility criteria. Fourteen liquids (54%) had a red color and 18 (69%) had a cloudy appearance. Exudative pleural fluids were the majority (n = 17), total proteins presented a mean of 3.3 g / dl (SD: 1.5), LDH a median of 544 U / L(IQR: 262-2016), the leukocyte count had a median of 610 leukocytes / ul (IQR: 180-968) and the differential polymorphonuclear count a median 29% (IQR: 15-60). Regarding the clinical characteristics, of the total exudates, 41% corresponded to neoplasms and 23% to pneumonia. While, of the total transudates (n = 9), 45% came from patients with neoplasms. Conclusions: In our study we observed that most of the pleural fluid samples from patients with COVID-19 were classified as exudates. These presented a low differential leukocyte percentage of polymorphonuclear cells. The values of the biochemical parameters such as total proteins and LDH were adequately related to the classification of exudates.
ABSTRACT
ABSTRACT BACKGROUND: Colorectal cancer is the third most common neoplasm in the world. Methylation of tumor related genes in CpG islands can cause gene silencing and been involved in the development of cancer. The potential role of DKK2 as a biomarker for early diagnosis of colorectal cancer remains unclear. OBJECTIVE: The aim of the study was to evaluate the profile of methylation and RNAm expression of DKK2 as potential predictors of colorectal cancer diagnosis and prognosis. METHODS: Expression of mRNAs encoding DKK2 in 35 colorectal cancer tissues was quantified using real-time polymerase chain reaction analysis. The DNA methylation was studied by high resolution melting analysis. The general characteristics of the patients were collected. DKK2 methylation and expression were compared to clinical, pathological aspects and overall survival. RESULTS: Among the 35 patients studied, 18 were male, 10 were on right colon and 25 on left colon. Among the 20 patients with high hypermethylation, 15 of them had mRNA low expression of DKK2. There was no significant association between DKK2 promoter methylation and mRNA DKK2 expression and clinical or pathological features. DKK2 promoter methylation (P=0.154) and DKK2 RNA expression (P=0.345) did not show significant correlation with overall survival. CONCLUSION: DKK2 promoter methylation and DKK2 RNA status appear to be biomarkers of cancer diagnosis but not predictors of prognosis.
RESUMO CONTEXTO: O câncer colorretal é a terceira neoplasia mais comum no mundo. A metilação de alguns genes nas ilhas CpG podem causar silenciamento gênico e estar envolvida no desenvolvimento de câncer. O potencial papel de DKK2 como um biomarcador no diagnóstico precoce de CCR permanece incerto. OBJETIVO: O objetivo do estudo foi avaliar o perfil de metilação e expressão de RNAm do gene DKK2 para identificar preditores potenciais de diagnóstico e prognóstico de CCR. MÉTODOS: A expressão de mRNAs que codificam DKK2 em 35 tecidos de câncer colorretal foi quantificada por reação em cadeia da polimerase em tempo real e a metilação do DNA foi verificada por análise de alta resolução. As características gerais dos pacientes foram coletadas. A metilação e expressão de DKK2 foram comparadas aos aspectos clínicos, patológicos e à sobrevida global. RESULTADOS: Entre os 35 pacientes estudados, 18 eram do sexo masculino, 10 tumores eram do cólon ascendente ou transverso e 25 do descendente ou reto. Entre os 20 pacientes com hipermetilação, 12 deles apresentaram baixa expressão de RNAm do gene DKK2. Não houve associação significativa entre a metilação do promotor de DKK2 e a expressão de RNAm de DKK2 e características clínicas ou patológicas. A metilação do promotor de DKK2 e a expressão do RNA de DKK2 não mostraram correlação com sobrevida global dos pacientes com CCR. CONCLUSÃO: A metilação do gene promotor e a expressão do RNAm do gene DKK2 parecem ser biomarcadores de diagnóstico de câncer, mas não se mostraram úteis na avaliação prognóstica.
Subject(s)
Humans , Male , Female , Colorectal Neoplasms/genetics , DNA Methylation , Prognosis , Biomarkers, Tumor/genetics , Biomarkers, Tumor/metabolism , Promoter Regions, Genetic , CpG Islands , Intercellular Signaling Peptides and Proteins/geneticsABSTRACT
El diagnóstico anatomo-patológico de las enfermedades neoplásicas se realiza a través del estudio morfológico, ya sea por métodos citológicos o histopatológicos, complementados en casos necesarios, por otros procedimientos o técnicas adicionales. La diferenciación citológica entre células benignas y malignas en fluidos serosos y en biopsias por aspiración con aguja fina, es frecuentemente difícil en la práctica diaria. La técnica del bloque celular es importante para poder revelar células tumorales en muestras que han sido reportadas como negativas para malignidad por los métodos cito-lógicos convencionales, pues es una metodología que permite la utilización de la inmunohistoquímica. OBjETIVO: Análisis del valor diagnóstico de la técnica de bloque celular en fluidos corporales patológicos y de biopsias por aspiración con aguja fina, en el De-partamento de Patología del Instituto del Cáncer SOL-CA-Cuenca. Período junio 2007- marzo 2008. MÉTODOS: Estudio de tipo descriptivo correlacional entre citología convencional y bloque celular. Se incluye-ron 56 casos provenientes de líquidos de lavado perito-neal; líquido ascítico, pleural, intratumoral, biliar; BAAF de glándula mamaria, tiroides, ganglio, conducto vagi-nal; tumor pancreático; y de muestras fisiológicas como la orina; a los que se les realizó cito-centrifugación en el equipo de Cytospin y técnica de bloque celular. RESULTADOS: Con la técnica de Cytospin hubo casos no concluyentes para diagnóstico, mientras que con la técnica de bloque celular (BC) no se presentaron. Con la técnica de bloque celular se encontró en un 28.5% de casos neoplásicos malignos y con la citología con-vencional, en un 10.7%. Al 30.5% se le solicitó técnicas de inmunohistoquímica para definir el origen neoplási-co, siendo la mayoría procedentes del tracto gastroin-testinal y pulmonar. CONCLUSIONES: La técnica de bloque celular debe ser un procedimiento de rutina en la sección de citología. La utilidad de los bloques celulares se debe en parte a su sencillez, y por otro lado aporta especificidad, ya que permite valorar aspectos como la arquitectura de la muestra, y realizar técnicas de citoquímica e inmuno-histoquímica y presentan una calidad óptima para su interpretación.
Anatomy-pathological diagnosis of neoplastic diseases is performed through the morphological study, either by cytological or histopathological methods, which were supplemented in necessary cases by other procedures or additional techniques. The cytological differentiation between benign and malignant cells in serous fluids and in fine needle aspiration biopsies is often difficult in daily practice. The technique of the cell block is important to be able to reveal tumor cells in samples that have been reported as negative for malignancy by conventional cytological methods, since it is a methodology that allows the use of immunohistochemistry. OBjECTIVE: Analyze the diagnostic value of the cell block technique in pathological body fluids and fine needle aspiration biopsies in the Department of Pa-thology of the SOLCA-Cuenca Cancer Institute. Period June 2007 - March 2008.METhODS: It is a descriptive correlational study between conventional cytology and cell block. A total of 56 ca-ses from peritoneal lavage fluids were included; ascites fluid, pleural, intratumoral, biliary, BAAF of mammary gland, thyroid, ganglion, vaginal duct, pancreatic tu-mor and physiological samples such as urine; who were cyto-centrifuged in the Cytospin team and cell block technique. RESULTS: With the Cytospin technique there were in-conclusive cases for diagnosis, while with the cell block technique (CB) they were not present. The cell block technique was found in 28.5% of malignant neoplas-tic cases and with 10.7% in conventional cytology. The 30.5% were asked for immunohistochemical techniques to define the neoplastic origin, being the majority from the gastrointestinal and pulmonary tract.CONCLUSIONS: The cell block technique should be a routine procedure in the cytology section. The useful-ness of the cell blocks is due to its simplicity, and on the other hand it contributes specificity, since it allows eva-luating aspects such as the architecture of the sample, and performs techniques of cytochemistry and immu-nohistochemistry presenting an optimal quality for its in-terpretation.