Análise da ploidia celular em adenocarcinoma de próstata localizado tratado pela prostatectomia radical / Cellular ploidy analysis in organ confined prostate adenocarcinoma treated by radical prostatectomy

Metodologia: Tiveram a ploidia celular mensurada por citometria estática digital 61 pacientes com adenocarcinoma de próstata clinicamente localizado e tratados com prostatectomia radical entre janeiro de 1999 e dezembro de 2003. Resultados: Foram identificados 31 pacientes com histogramas diploides e 30 pacientes aneuploides. Não houve associação entre ploidia celular e fatores prognósticos como idade, margem tumoral, volume tumoral, diferenciação celular, escore de Gleason e níveis de PSA. No entanto, quando a regressão logística de Cox foi aplicada para sobrevida livre de doença, a presença de margem comprometida e a ploidia celular foram os únicos fatores prognósticos significantes (p=0,0136 e p=0,0148, respectivamente). Conclusão: Neste estudo com um pequeno número de pacientes, a ploidia celular mensurada através da citometria estática representou um fator prognóstico independente e mais forte que a diferenciação celular para sobrevida livre de doença em pacientes com adenocarcinoma de próstata localizado.

Prognostic factors in carcinoma of the penis and survival analysis based on the lymph node status

Introduction: Squamous cell carcinoma of the penis is a rare disease in the developed world but common in underdeveloped countries. We have evaluated the prognostic factors related to penile carcinoma and assessed the outcome of patients regarding the lymph node status at two institutions. Materials and methods: Between January 1990 and December 2003, 87 patients with a clinical diagnosis of penile carcinoma had been treated at Instituto de Cancer de Londrina and Universidade Estadual de Londrina and were retrospectively reviewed. Patients who were followed for more than 18 months or until death due to penile cancer were evaluated for prognostic factors. Overall survival was calculated according to lymph node status. Results: Overall survival according to lymph node status at presentation, showed a poor outcome for patients with palpable lymph nodes compared with those with clinically negative lymph node (2-year survival of 20 and 68 respectively, p < 0.0005). The same was observed in those who presented delayed lymphadenopathy compared with patients who persisted N0 during follow-up time (2-year-survival of 28 and 90 respectively, p < 0.0005). Forty eight patients were assessed for prognostic factors. Histological grade and pathological stage were all statistically significant at univariate analysis regarding disease-free survival. Conclusion: Patients with positive lymph node had a poor overall survival regardless whether or not an immediate or a delayed lymphadenectomy had been performed. Histological grade and pathological stage were the only variables statistically significant at univariate analysis with respect to disease-free survival.

Influence of sling material on inflammation and collagen deposit in an animal model.

AIM: Compare inflammation and collagen production induced by four sling materials in female rats. METHODS: Adult female rats (n=144) were submitted to a urinary incontinence model and neutering. After four weeks they were randomized in 5 groups: Sham; autologous sling; Marlex; swine intestinal submucosa (SIS), and polypropylene mesh (TVT). Animals were killed at 7, 30 and 90 days. The inflammatory infiltrated area was rated from 0 to 3 (0=area smaller than 25%, 1=between 25% and 50%, 2 between 50% and 75%, and 3 for areas greater than 75%). The presence of granuloma and necrosis was noted. Penetration in the vesical wall was evaluated employing a system of scores from 0 to 3. The amount of collagen I and III, and the total was assessed using the Picro-Sirius staining technique. RESULTS: The Sham group presented lower inflammatory parameters at 7 days. On the 30th day, the autologous fascia presented inflammatory reactions similar to the Sham group, and lower than the remaining groups. The synthetic materials demonstrated greater inflammatory reactions at 60 days. No differences between groups were observed other than those concerning collagen production, except at 60 days, when TVT and SIS differed from Fascia and Sham in the production of collagen III. CONCLUSION: Autologous fascia produced less inflammatory reaction and collagen. TVT and Marlex caused more intense and longer-lasting inflammatory reaction with greater visceral penetration. When TVT was used, this process resulted in a higher quantity of collagen III. The presence of SIS, although presenting a less intense inflammatory reaction than the synthetics, also caused greater collagen III production at 60 days.