IMMUNOHISTOCHEMICAL EXPRESSION OF CYCLIN D1 AND c-MYC PROTEINS IN INTRACRANIAL MENINGIOMA / EXPRESSÃO IMUNOISTOQUÍMICA DAS PROTEÍNAS CICLINA D1 E c-MYC EM MENINGIOMAS INTRACRANIANOS

Background: Intracranial meningioma is the most frequent tumor of the central nervous system and immunohistochemical markers are important to aid in targeted therapy and prognosis. Objective: To evaluate the expression of cyclin D1 and c-MYC markers in intracranial meningiomas and to correlate it with the aggressiveness and recurrence of these tumors. Method: Retrospective, observational, cross-sectional study using data from the medical records of patients diagnosed with intracranial meningioma who were hospitalized and underwent surgical resection. Epidemiological, clinical and radiological data were collected and recorded. Immunohistochemistry for cyclin D1 and cMYC markers was performed on all samples. The data regarding the histological grade of the tumors were crossed with the result obtained by immunostaining. Results: 51 patients were included (72.5% women and 27.5% men) with a mean age of 53.5 years. Headache was the most common symptom and tumors located at the base of the skull accounted for 53% of cases. Grade I meningiomas were detected in 58.8%, grade II in 29.4% and grade III in 9.8%. Tumor recurrence was observed in two cases (3.9%) and disease-free patients corresponded to 49%. The mean follow-up time was 798 days (13-2267). Cyclin D1 was identified in 100% of meningiomas and the intensity of its expression was weak in 52.4% of grade I lesions, moderate in 50% of grade II tumors and strong in 100% of grade III tumors (p<0.001). c-MYC was identified in 17.7% (4.7% grade I, 66.7% grade II and 100% grade III) and its expression was weak in 50% in grade II and moderate in 100% in grade III (p<0.001). The presence of markers had no statistically significant relationship with patient outcomes. Conclusion: Cyclin D1 was expressed in all samples of meningiomas and the c-MYC was expressed in 18% of cases. The higher the histological grade, the more intense was the expression of the markers. There was no evidence of a relationship between the markers and tumor recurrence.

Racional: Meningioma intracraniano é o tumor mais frequente do sistema nervoso central e marcadores imunoistoquímicos são importantes para auxiliar na terapia alvo e prognóstico. Objetivo: Avaliar a expressão dos marcadores ciclina D1 e c-MYC em meningiomas intracranianos e correlacioná-la com a agressividade e recorrência desses tumores. Método: Estudo retrospectivo, observacional, transversal utilizando dados dos prontuários de pacientes com diagnóstico de meningioma intracraniano que foram internados e submetidos à ressecção cirúrgica. Os dados epidemiológicos, clínicos e radiológicos foram coletados e anotados. Foi realizada imunoistoquímica para os marcadores ciclina D1 e c-MYC em todas as amostras. Os dados referentes ao grau histológico dos tumores foram cruzados com o resultado obtido pela imunomarcação. Resultados: Foram incluídos 51 pacientes (72,5% mulheres e 27,5% homens) com média de 53,5 anos. Cefaleia foi o sintoma mais comum e tumores localizados na base do crânio representaram 53% dos casos. Meningiomas grau I foram detectados em 58,8%, grau II em 29,4% e grau III em 9,8%. Recidiva tumoral foi observada em dois casos (3,9%) e pacientes livres de doença corresponderam a 49%. A média do tempo de seguimento foi de 798 dias (13-2267). A ciclina D1 foi identificada em 100% dos meningiomas e a intensidade de sua expressão foi fraca em 52,4% das lesões grau I, moderada em 50% 2 dos tumores grau II e forte em 100% dos tumores grau III (p<0,001). c-MYC foi identificado em 17,7% (4,7% grau I, 66,7% grau II e 100% grau III) e sua expressão foi fraca em 50% no grau II e moderada em 100% do grau III (p<0,001). A presença dos marcadores não teve relação estatisticamente significativa com o desfecho dos pacientes. Conclusão: A ciclina D1 apresentou expressão em todas as amostras de meningiomas e o marcador cMYC em 18% dos casos. Quanto maior o grau histológico mais intensa foi a expressão dos marcadores. Não se evidenciou relação dos marcadores com a recorrência tumoral.

IS THERE A CLINICAL PATHOLOGICAL CORRELATION OF COLORECTAL ADENOCARCINOMA WITH THE IMMUNOHISTOCHEMICAL EXPRESSION OF OPN AND ABCB5?

BACKGROUND: OPN ABCB5. Studies with biomarkers in TMA (tissue microarray) have been showing important results regarding its expression in colon cancer. AIM: Correlate the expression profile of the OPN and ABCB5 biomarkers with the epidemiological and clinicopathological characteristics of the patients, the impact on the progression of the disease and the death. METHOD: A total of 122 CRC patients who underwent surgical resection, immunomarking and their relationship with progression and death events were evaluated. RESULT: The average age was 61.9 (±13.4) years. The cases were distributed in 42 (35.9%) in the ascending/transverse colon, 31 (26.5%) in the sigmoid, 27 in the rectum (23.1%), 17 (14.5%) in the descending colon. Most patients had advanced disease (stages III and IV) in 74 cases (60.9%). There was a predominance of moderately differentiated tumors in 101 samples (82.8%); despite this, the poorly differentiated subtype proved to be an independent risk factor for death in 70%. Metastasis to the liver proved to be an independent risk factor for death in 75% (18/24), as well as patients with primary rectal tumors in 81.5% (22/27). CONCLUSION: The immunohistochemical expression of the OPN and ABCB5 markers was not associated with epidemiological and clinicopathological characteristics. Regarding the progression of disease and death, it was not possible to observe a correspondence relationship with the evaluated markers.

Prognosis of Patients Victim of Spontaneous Subarachnoid Hemorrhage: A Comparison between Radiologic Scales

Objective To analyze the population and the earlymortality rate (up to thirty days) of patients victim of spontaneous subarachnoid hemorrhage (SAH) according to the Hunt-Hess clinical scale and the Fisher and modified Fisher radiological scales. Materials and Methods We analyzed 46 medical records and skull computed tomography (CT) scans of patients with spontaneous SAH admitted between February 2014 and December 2017 at Hospital Universitário Evangélico Mackenzie, in the city of Curitiba, state of Paraná, Brazil. The method of the study was exploratorydescriptive, transversal and retrospective, with a quantitative approach. We analyzed epidemiological (gender, age), clinical (life habits, pathologies, Glasgow coma scale and Hunt-Hess scale) and radiological (Fisher and modified Fisher scales) variables, and the Hunt-Hess and the Fisher scales were correlated with risk of death. The data was submitted to statistical analysis considering values of p<0.05. Result There was a higher prevalence of spontaneous SAH among women (69.5%), as well as among patients aged between 51 and 60 years (34.7%). Regarding the grades on the scales, there was higher prevalence of Fisher 4, Modified Fisher 4 and Hunt-Hess 2. Evolution to death was higher among women (76.4%) and patients aged between 61 and 70 years (35,2%). Conclusion Mortality was higher among patients classified as Fisher 3, Modified Fisher 4 and Hunt-Hess > 3. The Fisher scale is better than the modified Fisher scale to assess the risk of mortality.

Is there a clinical pathological correlation of colorectal adenocarcinoma with the immunohistochemical expression of opn and abcb5? / Há correlação clínicopatológica do adenocarcinoma colorretal com a expressão imunoistoquímica do opn e abcb5?

ABSTRACT Background: Studies with biomarkers in TMA (tissue microarray) have been showing important results regarding its expression in colon cancer. Aim: Correlate the expression profile of the OPN and ABCB5 biomarkers with the epidemiological and clinicopathological characteristics of the patients, the impact on the progression of the disease and the death. Method: A total of 122 CRC patients who underwent surgical resection, immunomarking and their relationship with progression and death events were evaluated. Result: The average age was 61.9 (±13.4) years. The cases were distributed in 42 (35.9%) in the ascending/transverse colon, 31 (26.5%) in the sigmoid, 27 in the rectum (23.1%), 17 (14.5%) in the descending colon. Most patients had advanced disease (stages III and IV) in 74 cases (60.9%). There was a predominance of moderately differentiated tumors in 101 samples (82.8%); despite this, the poorly differentiated subtype proved to be an independent risk factor for death in 70%. Metastasis to the liver proved to be an independent risk factor for death in 75% (18/24), as well as patients with primary rectal tumors in 81.5% (22/27). Conclusion: The immunohistochemical expression of the OPN and ABCB5 markers was not associated with epidemiological and clinicopathological characteristics. Regarding the progression of disease and death, it was not possible to observe a correspondence relationship with the evaluated markers.

RESUMO Racional: Estudos com biomarcadores com TMA (tissue microarray) vêm demostrando resultados importantes em relação à expressão de biomarcadores em câncer de cólon. Objetivo: Correlacionar o perfil de expressão dos biomarcadores OPN e ABCB5 com as características epidemiológicas e clinicopatológicas dos pacientes, o impacto na progressão de doença e no evento óbito. Método: Foram avaliados 122 pacientes de CCR submetidos à ressecção cirúrgica e à imunomarcação e relação com os eventos progressão e óbito. Resultado: A média de idade encontrada foi de 61,9 (±13,4) anos. Os casos distribuíram-se em 42 (35,9%) no cólon ascendente/transverso, 31 (26,5%) no sigmoide, 27 no reto (23,1%), 17 (14,5%) no cólon descendente. A maioria dos pacientes apresentou doença avançada (estadio III e IV) em 74 casos (60,9%). Houve predomínio de tumor moderadamente diferenciado em 101 amostras (82,8%); apesar disso, o subtipo pouco diferenciado mostrou-se como fator de risco independente para óbito em 70% dos casos. Metástase para o fígado mostrou-se fator de risco independente para óbito em 75% dos casos (18/24), assim como pacientes com tumores primários de reto em 81,5% (22/27). Conclusão: A expressão imunoistoquímica dos marcadores OPN e ABCB5 não apresentou associação com as características epidemiológicas e clinicopatológicas. Em relação à progressão de doença e evento óbito, não se conseguiu observar relação de correspondência com os marcadores avaliados.

Correlação entre as classificações de TIRADS e Bethesda em punções aspirativas por agulha fina de tireóide / Correlation between TIRADS and Bethesda classification in fine needle aspiration biopsy of the thyroid

Verificar se a nova classificação TIRADS possui correlação com o sistema Bethesda. METODOLOGIA: As informações foram coletadas a partir de prontuário eletrônico do Serviço de Patologia (Centro de Patologia de Curitiba) no Hospital Nossa Senhora das Graças a partir dos laudos citopatológicos com resultados catalogados pelo Sistema Bethesda e que conste a informação da classificação do nódulo tireoidiano pelo TIRADS, compreendidos entre 22 de junho de 2013 e 22 de setembro 2013. RESULTADOS: Na classificação de TIRADS houve prevalência de TIRADS 2 (benignidade) com 82 casos (72,5%). Já no sistema Bethesda houve prevalência da categoria II (benignidade) com 89 casos (78,8%). Ao se estabelecer a correlação entre a classificação radiológica e citológica, observou-se que a grande maioria foi catalogada como benigna à ecografia, sendo que houve correspondência do ponto de vista citológico. Naqueles com diagnóstico TIRADS 4, 10 (37%) foram benignos, enquanto 17 (63%) não benignos. Já TIRADS 5, tivemos apenas um caso, e este foi classificado como não benigno pelo laudo citológico. CONCLUSÃO: Houve correlação significativa entre o sistema Bethesda e a classificação TIRADS

OBJECT: The purpose of this study is to verify that the new classification TIRADS has correlation with the Bethesda system. METHODS: Data were collected from electronic medical records of the Pathology Service (Curitiba Pathology Centre) at the Hospital Nossa Senhora das Graças from the cytopathology reports with results classified by the Bethesda System and the record information from the classification of thyroid nodules by TIRADS, ranging from June 22, 2013 and September 22, 2013. RESULTS In classification TIRADS prevalence was TIRADS 2 (benign) with 82 cases (72.5%). Bethesda already in the system was prevalent category II (benign) with 89 cases (78.8%). To establish the correlation between cytological and radiological classification, it was observed that the vast majority was cataloged as benign at ultrasound, and there was correspondence from a cytological viewpoint. Those with diagnosis TIRADS 4, 10 (37%) were benign, while 17 (63%) did not benign. Already TIRADS 5, we had only one case, and this was not classified as benign by cytological report. CONCLUSION: Significant correlation has been observed between Bethesda system and TIRADS classification

Correlação entre as classificações de TIRADS e Bethesda em punções aspirativas por agulha fina de tireóide / Correlation between TIRADS and Bethesda classification in fine needle aspiration biopsy of the thyroid

Verificar se a nova classificação TIRADS possui correlação com o sistema Bethesda. METODOLOGIA: As informações foram coletadas a partir de prontuário eletrônico do Serviço de Patologia (Centro de Patologia de Curitiba) no Hospital Nossa Senhora das Graças a partir dos laudos citopatológicos com resultados catalogados pelo Sistema Bethesda e que conste a informação da classificação do nódulo tireoidiano pelo TIRADS, compreendidos entre 22 de junho de 2013 e 22 de setembro 2013. RESULTADOS: Na classificação de TIRADS houve prevalência de TIRADS 2 (benignidade) com 82 casos (72,5%). Já no sistema Bethesda houve prevalência da categoria II (benignidade) com 89 casos (78,8%). Ao se estabelecer a correlação entre a classificação radiológica e citológica, observou-se que a grande maioria foi catalogada como benigna à ecografia, sendo que houve correspondência do ponto de vista citológico. Naqueles com diagnóstico TIRADS 4, 10 (37%) foram benignos, enquanto 17 (63%) não benignos. Já TIRADS 5, tivemos apenas um caso, e este foi classificado como não benigno pelo laudo citológico. CONCLUSÃO: Houve correlação significativa entre o sistema Bethesda e a classificação TIRADS

OBJECT: The purpose of this study is to verify that the new classification TIRADS has correlation with the Bethesda system. METHODS: Data were collected from electronic medical records of the Pathology Service (Curitiba Pathology Centre) at the Hospital Nossa Senhora das Graças from the cytopathology reports with results classified by the Bethesda System and the record information from the classification of thyroid nodules by TIRADS, ranging from June 22, 2013 and September 22, 2013. RESULTS In classification TIRADS prevalence was TIRADS 2 (benign) with 82 cases (72.5%). Bethesda already in the system was prevalent category II (benign) with 89 cases (78.8%). To establish the correlation between cytological and radiological classification, it was observed that the vast majority was cataloged as benign at ultrasound, and there was correspondence from a cytological viewpoint. Those with diagnosis TIRADS 4, 10 (37%) were benign, while 17 (63%) did not benign. Already TIRADS 5, we had only one case, and this was not classified as benign by cytological report. CONCLUSION: Significant correlation has been observed between Bethesda system and TIRADS classification