RESUMO
BACKGROUND AND AIM: Hereditary non-poliposis colorectal cancers exhibit a high rate of microsatellite instability. Comparative studies involving stage and other prognostic parameters demonstrate a better prognosis in the presence of microsatellite instability versus colon cancers without microsatellite instability. METHODS: Our study included 608 cases diagnosed with colorectal adenocarcinoma by our laboratory between 2004-2010. The cases were re-evaluated with respect to criteria defined for MSI, taking into consideration age, anatomic localization, and histopathological criteria. Immunohistochemical study was performed in appropriate blocks for using MLH-1, MSH-2, MSH-6, and PMS-2. RESULTS: The specimens were re-evaluated according to the histological criteria defined for microsatellite instability. Anti-MLH-1, anti-MSH-2, anti-MSH-6, and anti-PMS-2 antibodies were applied to the paraffin blocks of 27 cases which presented morphological criteria suggestive of DNA repair mutation and had a high Mspath score. Immunohistochemical study with MLH-1, MSH-2, MSH-6, and PMS-2 for the analysis of mismatch repair was refined using the cases with higher Mspath scores. CONCLUSIONS: In this study, we reviewed the clinical and histopathological features of 608 cases with colorectal adenocarcinoma diagnosed in our laboratory between 2004-2010 and assessed pathological features in terms of microsatellite instability. The results were discussed in view of the literature.
Assuntos
Adenocarcinoma/genética , Neoplasias Colorretais/genética , Instabilidade de Microssatélites , Proteínas Adaptadoras de Transdução de Sinal/genética , Adenocarcinoma/diagnóstico , Adenocarcinoma Mucinoso/genética , Adenosina Trifosfatases/genética , Adulto , Idoso , Idoso de 80 Anos ou mais , Biomarcadores Tumorais/metabolismo , Carcinoma de Células em Anel de Sinete/genética , Neoplasias Colorretais/diagnóstico , Reparo de Erro de Pareamento de DNA , Enzimas Reparadoras do DNA/genética , Proteínas de Ligação a DNA/genética , Feminino , Regulação Neoplásica da Expressão Gênica , Humanos , Imuno-Histoquímica , Masculino , Pessoa de Meia-Idade , Endonuclease PMS2 de Reparo de Erro de Pareamento , Proteína 1 Homóloga a MutL , Proteína 2 Homóloga a MutS/genética , Proteínas Nucleares/genética , Valor Preditivo dos Testes , Prognóstico , Receptores Imunológicos/genética , Sensibilidade e EspecificidadeRESUMO
PURPOSE: The markers of prognosis are used to predict the clinical course of disease and the outcome for patients with invasive breast cancer. Our aim is to investigate the relationship of peritumoural lymphovascular invasion (LVI) with well-known prognostic markers. PATIENTS AND METHODS: Eighty-one surgically treated patients with invasive breast cancer were evaluated in this study during a mean follow-up period of 46 months (12-72). The patient's age (menopausal status), tumour size, nuclear grade, axillary lymph node involvement, and hormone receptor status were determined as markers of the prognosis. The relationship of LVI with these markers was established. RESULTS: Except for menopausal status (p = 0.25) a close relationship was found between the presence of LVI and studied prognostic factors. LVI was positive in 29% of T1, 54% of T2 (p = 0.028) and 100% of T3 tumours (p = 0.002). The rate of LVI (+) has increased gradually as 0%, 38% and 77% (p = 0.001) with grades 1, 2 and 3 respectively. Positive LVI has been determined in 85% (p < 0.0001) and 73% (p = 0.0004) of oestrogen and progesterone receptor negative tumours respectively. LVI was present in 14% and 73% (p < 0.0001) of patients with negative and positive axilla respectively. Metastatic cancer caused mortality in seven patients of whom 86% had more than four involved axillary nodes, and 100% LVI (+). CONCLUSION: The high rate of positive LVI shows a close relationship with known markers of poor prognosis. The presence of LVI can predict a worse outcome for patients with invasive breast cancer. LVI may be used as an indicator of aggressive behaviour, metastatic ability (nodal and systemic) of the primary malignancy.