RESUMO
La técnica convencional (TC) que usa alcohol como agente deshidratante, es un método útil en los laboratorios de Histología y Anatomía Patológica. Recientemente, un nuevo método simplificado con acetona (TA) fué diseñado en un intento por reducir el tiempo de procesamiento de los tejidos (de 12 a 4 horas), el costo de reactivos, y como un factor importante para tener un diagnóstico veraz y rápido. En este trabajo se compararon los parámetros histológicos e inmunohistoquímicos en muestras de cáncer de mama, colon y riñón tratadas con ambos métodos. Los cortes fueron teñidos con H & E o tricrómico de Masson. También se llevó a cabo inmunohistoquímica con anticuerpos especificos para la identificación de citoqueratinas AE1/AE3, el receptor de estrógeno y receptor de progesterona. Se realizó un estudio ciego por tres especialistas en morfológía, quienes evaluaron la tinción nuclear, tinción del citoplasma y friabilidad o cambios en la estructura tisular. La especificidad y sensibilidad de la unión de los anticuerpos también fueron evaluadas. Los valores obtenidos para cada parámetro se analizaron estadísticamente con la prueba t de Student. Nuestros resultados muestran que los métodos de TC y TA no modificaron características histológicas como el patrón de tinción, ni se detectaron cambios tisulares. La positividad de la inmunohistoquímica fué similar para ambos métodos. No se observó diferencia estadística entre TC y TA. Nuestros resultados sugieren que la aplicación de la TA no modificó las propiedades histológicas e inmunohistoquímicas y que podría ser un método útil en el análisis morfológico.
The conventional technique (CT) using alcohol as a drying agent, is a useful method of histology and pathology in the laboratory. Recently, a new simplified method with acetone (TA) was designed in an attempt to reduce the processing time of the tissues (12 to 4 hours), the cost of reagents, and as an important factor to have an accurate and prompt diagnosis . This study compared the histological and immunohistochemical parameters in breast cancer, colon and kidney specimens treated with both methods. The sections were stained with H & E or Masson trichrome. Immunohistochemistry study with antibodies specific for the identification of cytokeratin AE1/AE3, the estrogen receptor and progesterone receptor was also carried out. Blind study was conducted by three specialists in morphology, who evaluated the nuclear staining, staining of the cytoplasm and friability or changes in tissue structure. The specificity and sensitivity of antibody binding were also evaluated. The values obtained for each parameter were statistically analyzed with Student t test. Our results show that the methods of CT and TA did not alter histological features as the pattern of staining, and tissue changes were detected. Immunohistochemical positivity was similar for both methods. There was no statistical difference between TC and TA. Our results suggest that implementation of the TA did not alter the histological and immunohistochemical properties and could be a useful method for morphological analysis.
Assuntos
Humanos , Acetona/química , Tecidos/patologia , Técnicas Histológicas/métodos , Biópsia , Imuno-Histoquímica , Receptores de Progesterona , Sensibilidade e Especificidade , Colo/patologia , Desidratação , Glândulas Mamárias Humanas/patologia , Queratinas , Rim/patologia , Anticorpos , NeoplasiasRESUMO
BACKGROUND: Thyroid nodules in children and adolescents may be associated to malignant neoplasms. Although thyroid cancer is a rare event in this age group, delayed diagnosis is associated to metastatic, regional or lung disease, but even in these circumstances appropriate treatment may be followed by good prognosis. We decided to review the clinical course of these patients in our hospital from 1980 to 2001. METHODS: We found fifteen patients younger than 18 years diagnosed with thyroid carcinoma, which had been followed by at least 12 months, with a mean of 95 months and a maximal of 10 years. All patients were treated by surgery and 131 iodine, and followed by scans, ultrasound and thyroglobulin analysis. RESULTS: The patients group were thirteen females and two males. At diagnosis, seven patients (46.7o%) had metastatic regional disease and eight had a thyroid nodule. Total thyroidectomy with a modified neck dissection and 131 iodine was the initial treatment for patients with regional disease and subtotal thyroidectomy and 131 iodine in the follow-up to treat the thyroid bed or metastases was the treatment for patients with localized disease. All patients had a histologic pattern of papillary carcinoma. Nine patients (60%) had local recurrence in a mean follow-up of 37 months, one patient that had been previously treated by total thyroidectomy and all patients that were treated by subtotal thyroidectomy, however, all responded to the complementary treatment. At this moment the mean follow up is 95 months and all the patients have survived. CONCLUSIONS: In our experience thyroid cancer in children and adolescents is a rare event whose delayed diagnosis is associated to regional lymph node or lung metastases. Subtotal thyroidectomy was associated to disease progression to metastases, but complementary treatment was successful and all patients have survived.
