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1.
Ceska Gynekol ; 85(2): 84-93, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-32527101

RESUMO

OBJECTIVE: The aim of our study was to analyze a group of patients referred for endometrial biopsy. To evaluate the ultrasound finding of hyperplasia/polyp, the symptomatology of patients related to the result of definitive histology, to determine the severity of individual variables in connection with the detection of precancerosis/cancer. Due to the complexity of information identify women who are suitable for conservative approach. DESIGN: Unicentric retrospective observational study. SETTING: Department of Obstetrics and Gynecology, Masaryk University, University Hospital Brno. METHODS: All patients over 50 years who underwent surgical endometrial biopsy at our department in the period of 2017-2018 (n = 754) were included. We were interested in reasons of indication, the age of patients at the time of the procedure and at the menopause, the presence of risk factors for development precancerosis/cancer (hypertension, diabetes mellitus, using of tamoxifen), number of deliveries and pregnancies, symptomatology, the description of ultrasound scans, the result of histology examination, peroperative and postoperative complications. RESULTS: Perimenopause - the median of endometrial thickness in both benign and malignant histology was 8 mm (p = 0.448), the median of the largest polyp dimension was 18 mm. All patients with precancerosis/malignancy were symptomatic with irregular/excessive bleeding, no carcinoma was found in polyp. Postmenopause - the median of endometrial thickness in benign histology was 7 mm versus 16 mm in precancerosis/malignancy (p < 0.001), the median of the largest polyp dimension was the same in both histologies (13 mm, p = 0.274). The risk of malignancy was more than threefold in bleeding versus asymptomatic patients with both hyperplasia and polyp (OR 3.39, 3.79). In asymptomatic patients the risk of cancer was similar for selected cut-offs (5, 8 and 12 mm), statistically significant only for 12 mm (OR 3.54), while in symptomatic patients the risk was high for all cut-offs, however with wide confidence intervals, statistically significant for cut-offs of 8 mm (minimum 3.58) and 12 mm (minimum 4.94). CONCLUSION: We have shown that symptomatology is a strong risk factor for the presence of precancerosis/malignancy in patients with endometrial hyperplasia or polyp. The thickness of the endometrium or polyp size in asymptomatic patients does not play a major role. Ultrasound alone does not have sufficient accuracy for detection or even screening of endometrial cancer. We recommend a conservative procedure, monitoring changes in the ultrasound scan and symptomatology of the patient over time.


Assuntos
Hiperplasia Endometrial/patologia , Neoplasias do Endométrio/patologia , Pólipos/patologia , Biópsia , Endométrio , Feminino , Humanos , Histeroscopia , Gravidez , Estudos Retrospectivos , Ultrassonografia , Hemorragia Uterina
2.
PLoS One ; 15(4): e0231888, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-32343708

RESUMO

BACKGROUND AND AIMS: Inadequate bowel preparation (BP) is an unfavorable factor that influence the success of colonoscopy. Although standard education (SE) given to patients are proved useful to avoid inadequate BP. Studies concerning the effects of reinforced education (RE) on the quality of BP were inconsistent. The aim of this updated meta-analysis of randomized controlled trial was to compare the quality of BP between patients receiving RE in addition to SE and those receiving SE alone. METHODS: MEDLINE, EMBASE, Web of Science and the Cochrane Library were systemically searched to identify the relevant studies published through April 2019. The primary outcome was the rate of adequate BP. Subgroup analyses were conducted. Secondary outcomes included BP score, adenoma detection rate (ADR), polyp detection rate (PDR), insertion time, withdrawal time, adverse events, >80% purgative intake and diet compliance. Dichotomous variables were reported as odds ratio (OR) with 95% confidence interval (CI). Continuous data were reported as mean difference (MD) with 95%CI. Pooled estimates of OR or MD were calculated using a random-effects model. Statistical heterogeneity was accessed by calculating the I2 value. A P value less than 0.05 was considered significant. RESULTS: A total of 18 randomized controlled trails (N = 6536) were included in this meta-analysis. Patients who received RE had a better BP quality than those only receiving SE (OR 2.59, 95%CI: 2.09-3.19; P<0.001). A higher ADR (OR 1.35; 95%CI: 1.06-1.72; P = 0.020) and PDR (OR 1.24, 95%CI: 1.02-1.50; P = 0.030), shorter insertion (MD -0.76; 95%CI: -1.48-(-0.04); P = 0.040) and withdrawal time (MD -0.83; 95%CI: -1.83-(-0.28); P = 0.003), less nausea/vomiting (OR 0.78; 95%CI: 0.64-0.97; P = 0.020) and abdominal distension (OR 0.72; 95%CI: 0.68-0.92; P = 0.020) were achieved in the RE group. More patients had >80% purgative intake (OR 2.17; 95%CI, 1.09-4.32; P = 0.030) and were compliant with diet restriction (OR 2.38; 95%CI: 1.79-3.17; P<0.001) in the RE group. CONCLUSION: RE significantly improved BP quality, increased ADR and PDR, decreased insertion and withdrawal time and adverse events.


Assuntos
Colonoscopia , Educação de Pacientes como Assunto , Adenoma/patologia , Humanos , Laxantes/administração & dosagem , Laxantes/efeitos adversos , Náusea/etiologia , Razão de Chances , Polietilenoglicóis/administração & dosagem , Polietilenoglicóis/efeitos adversos , Pólipos/patologia , Ensaios Clínicos Controlados Aleatórios como Assunto
3.
Yonsei Med J ; 61(4): 317-322, 2020 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-32233174

RESUMO

PURPOSE: To evaluate factors associated with endometrial pathology during tamoxifen use in premenopausal breast cancer (BC) patients. MATERIALS AND METHODS: We reviewed the medical records of premenopausal BC patients treated with tamoxifen who underwent endometrial biopsy with or without hysteroscopy. Clinical characteristics were compared between women with endometrial pathology (endometrial hyperplasia or cancer) and those with normal histology or endometrial polyps. RESULTS: Among 284 endometrial biopsies, endometrial hyperplasia was diagnosed in 7 patients (2.5%), endometrial cancer was diagnosed in 5 patients (1.8%), normal histology was noted in 146 patients (51.4%), and endometrial polyp was present in 114 patients (40.1%). When comparing women with endometrial cancer (n=5) to women with normal histology, abnormal uterine bleeding was more common (p=0.007), and endometrial thickness was greater (p=0.007) in women with endometrial cancer. Chemotherapy for BC was also more common in patients with endometrial cancer (p=0.037). When comparing women with endometrial polyps and those with endometrial hyperplasia or cancer, the presence of abnormal uterine bleeding was more common in patients with endometrial hyperplasia or cancer (p<0.001); however, tamoxifen duration and endometrial thickness did not differ significantly between the two groups. CONCLUSION: In premenopausal BC patients treated with tamoxifen, abnormal uterine bleeding, increased endometrial thickness, and chemotherapy for BC were associated with the occurrence of endometrial cancer. These findings may provide useful information for gynecologic surveillance and counseling during tamoxifen treatment in premenopausal BC patients.


Assuntos
Antineoplásicos Hormonais/efeitos adversos , Neoplasias da Mama/tratamento farmacológico , Hiperplasia Endometrial/induzido quimicamente , Neoplasias do Endométrio/induzido quimicamente , Endométrio/efeitos dos fármacos , Pólipos/induzido quimicamente , Pré-Menopausa , Tamoxifeno/efeitos adversos , Adulto , Antineoplásicos Hormonais/uso terapêutico , Biópsia , Hiperplasia Endometrial/diagnóstico por imagem , Hiperplasia Endometrial/patologia , Neoplasias do Endométrio/diagnóstico por imagem , Neoplasias do Endométrio/patologia , Endométrio/diagnóstico por imagem , Endométrio/patologia , Feminino , Humanos , Histeroscopia , Pessoa de Meia-Idade , Pólipos/diagnóstico por imagem , Pólipos/patologia , Fatores de Risco , Tamoxifeno/uso terapêutico , Fatores de Tempo , Doenças Uterinas , Neoplasias Uterinas/induzido quimicamente , Neoplasias Uterinas/patologia
4.
BJOG ; 127(8): 994-999, 2020 07.
Artigo em Inglês | MEDLINE | ID: mdl-32133762

RESUMO

OBJECTIVE: The aim of this study was to evaluate the incidence of endometrial carcinoma, proven after hysterectomy, in patients diagnosed with atypical endometrial hyperplasia confined to a polyp. A secondary aim was to establish factors associated with (pre-)malignant alterations in a polyp. DESIGN: A retrospective cohort study. SETTING: Maastricht University Medical Centre (MUMC+) and Máxima Medical Centre in Eindhoven/Veldhoven (Máxima MC). POPULATION: Women who underwent a hysteroscopic polyp resection between 2008 and 2016. METHODS: Patient characteristics and histopathology results of the polyp and, in the case of a hysterectomy, uterus were collected from patients' charts. RESULTS: A total of 1445 complete hysteroscopic polyp resections were included. Of those, 1390 polyps showed benign histopathology results, 39 polyps contained atypical hyperplasia and 16 polyps contained endometrial carcinoma. A hysterectomy was performed in 35 women who were diagnosed with atypical hyperplasia confined to a polyp after hysteroscopic polyp resection. Histopathological assessment showed no additional (pre-)malignant changes of the endometrium in 12 women (30.8%), atypical hyperplasia in 11 women (28.2%) and endometrial carcinoma in 12 women (30.8%). None of the prognostic factors under consideration were significantly associated with (pre-)malignant changes in a polyp. CONCLUSION: The incidence of endometrial carcinoma in the surrounding endometrium after complete resection of a polyp with atypical hyperplasia is 30.8% in this study. This supports the current advice to perform a hysterectomy and bilateral salpingo-oophorectomy. No prognostic factor for (pre-)malignant changes in a polyp was established. TWEETABLE ABSTRACT: The incidence of endometrial carcinoma after complete resection of a polyp with atypical hyperplasia is high.


Assuntos
Hiperplasia Endometrial/patologia , Neoplasias do Endométrio/patologia , Pólipos/patologia , Lesões Pré-Cancerosas/patologia , Adulto , Hiperplasia Endometrial/cirurgia , Neoplasias do Endométrio/prevenção & controle , Endométrio/patologia , Feminino , Humanos , Histerectomia , Incidência , Pessoa de Meia-Idade , Lesões Pré-Cancerosas/complicações , Estudos Retrospectivos , Útero/patologia
5.
Anticancer Res ; 40(2): 789-794, 2020 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-32014921

RESUMO

BACKGROUND/AIM: To investigate tumor suppression as an indicator of malignization potential within endometrial polyps in asymptomatic postmenopausal women. MATERIALS AND METHODS: Immunohistochemical studies of the phosphatase and tensin homolog (PTEN) were performed. Cases included 52 benign postmenopausal polyps, 19 endometrioid carcinomas with coexisting benign polyps, and 12 polyps with foci of carcinoma. Controls included 31 atrophic endometria and 32 benign premenopausal polyps. PTEN was scored by quantitative methods according to staining intensity. RESULTS: The mean epithelial and stromal PTEN H-score in postmenopausal benign endometrial polyps (193.8 and 123.2, respectively) was significantly higher than that in the atrophic endometrium (135.5 and 90.2, p=0.008), and premenopausal benign endometrial polyps (100.7 and 198.7, p<0.001). Significant difference between postmenopausal endometrial polyps and endometrial carcinoma was noticed in the epithelial compartment (193.8 vs. 65.7, respectively, p<0.001). CONCLUSION: Asymptomatic benign postmenopausal polyps have a distinctively high tumor suppression compared with endometrial cancer, suggesting low malignization potential.


Assuntos
Neoplasias do Endométrio/tratamento farmacológico , Pólipos/tratamento farmacológico , Neoplasias do Endométrio/patologia , Feminino , Humanos , Pólipos/patologia , Pós-Menopausa , Estudos Retrospectivos
6.
J Surg Res ; 250: 226-231, 2020 06.
Artigo em Inglês | MEDLINE | ID: mdl-32106001

RESUMO

BACKGROUND: Gallbladder cancer is rare but associated with significant morbidity and mortality necessitating the early identification of premalignant and malignant lesions to improve overall prognosis. Despite limited evidence regarding the effectiveness of transabdominal ultrasound (US) in the detection of gallbladder polyps, it plays a key role in current European guidelines. The aim of this study was to investigate gallbladder polyp prevalence in a western European population and assess the diagnostic accuracy of transabdominal US. METHODS: Data from patients who underwent cholecystectomy for US detected gallbladder polypoid lesions at four hospitals in Ireland and the United Kingdom between 2010 and 2018 were retrospectively collected. Patient demographics, ultrasonographic, and histopathologic findings were analyzed. RESULTS: A total of 134 patients underwent cholecystectomy for US-detected gallbladder polyps. After histopathologic examination, pseudopolyps were found in 75 (56%) specimens with dysplastic or malignant polyps seen in only six (4.5%) specimens. Mean size for neoplastic polyps was 33 mm. The positive predictive value for US in detecting neoplastic polyps in this study was 4.5%, which is significantly lower than the 10%-15% reported previously. CONCLUSIONS: Although the prevalence of neoplastic polyps in this study is higher than in the previous literature, the distribution of pseudopolyps and true polyps is as expected. With all malignant polyps being >10 mm in diameter, these findings support the current size thresholds stated in European guidelines. The poor diagnostic accuracy of US demonstrated may have led to significant number of patients undergoing unnecessary surgical intervention, further supporting the argument for improved strategies for the investigation of gallbladder polyps.


Assuntos
Neoplasias da Vesícula Biliar/epidemiologia , Vesícula Biliar/diagnóstico por imagem , Pólipos/epidemiologia , Lesões Pré-Cancerosas/epidemiologia , Adolescente , Adulto , Idoso , Idoso de 80 Anos ou mais , Criança , Colecistectomia/estatística & dados numéricos , Feminino , Vesícula Biliar/patologia , Vesícula Biliar/cirurgia , Neoplasias da Vesícula Biliar/diagnóstico , Neoplasias da Vesícula Biliar/patologia , Neoplasias da Vesícula Biliar/cirurgia , Humanos , Irlanda/epidemiologia , Masculino , Pessoa de Meia-Idade , Pólipos/diagnóstico , Pólipos/patologia , Lesões Pré-Cancerosas/diagnóstico , Lesões Pré-Cancerosas/patologia , Lesões Pré-Cancerosas/cirurgia , Valor Preditivo dos Testes , Prevalência , Estudos Retrospectivos , Ultrassonografia/estatística & dados numéricos , Reino Unido/epidemiologia , Adulto Jovem
7.
Ann R Coll Surg Engl ; 102(4): e89-e90, 2020 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-31964152

RESUMO

A fibrovascular polyp is a rare benign pseudotumour of the oesophagus and hypopharynx. Although patients usually present with dysphagia, aspiration related mortality may occur. If the tumour is too large and/or located in the proximal oesophagus, it may protrude from the mouth. The general approach to treatment is complete reconstruction with cervicotomy. We present our experience of a giant oesophageal fibrovascular polyp that was protruding from the mouth and treated with endoscopic resection. A 55-year-old man was admitted to our outpatient clinic complaining of a mass protruding from his mouth when he coughed. Endoscopy and bronchoscopy both revealed a 15-18cm long polypoid mass originating from the proximal oesophagus (at the level of the hypopharynx). Complete resection was performed via endoscopy.


Assuntos
Neoplasias Esofágicas/cirurgia , Esofagoscopia/métodos , Pólipos/cirurgia , Neoplasias Esofágicas/diagnóstico , Neoplasias Esofágicas/patologia , Esôfago/patologia , Esôfago/cirurgia , Humanos , Masculino , Pessoa de Meia-Idade , Pólipos/diagnóstico , Pólipos/patologia , Resultado do Tratamento , Carga Tumoral
8.
Cancer Sci ; 111(1): 137-147, 2020 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-31724799

RESUMO

As a member of the epidermal growth factor receptor (EGFR) family, ERBB3 plays an essential role in development and disease independent of inherently inactive kinase domain. Recently, ERBB3 has been found to bind to ATP and has catalytic activity in vitro. However, the biological function of ERBB3 kinase activity remains elusive in vivo. Here we have identified the physiological function of inactivated ERBB3 kinase activity by creating Erbb3-K740M knockin mice in which ATP cannot bind to ERBB3. Unlike Erbb3 knockout mice, kinase-inactive Erbb3K740M homozygous mice were born in Mendelian ratios and showed normal development. After dextran sulfate sodium-induced colitis, the kinase-inactive Erbb3 mutant mice showed normal recovery. However, the outgrowth of ileal organoids by neuregulin-1 treatment was more attenuated in Erbb3 mutant mice than in WT mice. Moreover, in combination with the ApcMin mouse, the proportion of polyps less than 1 mm in diameter in mutant mice was higher than in control mice and an increase in the number of apoptotic cells was observed in polyps from mutant mice compared with polyps from control mice. Taken together, the ERBB3 kinase activity contributes to the outgrowth of ileal organoids and intestinal tumorigenesis, and the development of ERBB3 kinase inhibitors, including epidermal growth factor receptor family members, can be a potential way to target colorectal cancer.


Assuntos
Carcinogênese/metabolismo , Carcinogênese/patologia , Intestinos/patologia , Organoides/metabolismo , Organoides/patologia , Receptor ErbB-3/metabolismo , Animais , Apoptose/efeitos dos fármacos , Apoptose/fisiologia , Carcinogênese/efeitos dos fármacos , Neoplasias Colorretais/tratamento farmacológico , Neoplasias Colorretais/metabolismo , Neoplasias Colorretais/patologia , Intestinos/efeitos dos fármacos , Camundongos , Camundongos Knockout , Organoides/efeitos dos fármacos , Fosforilação/efeitos dos fármacos , Fosforilação/fisiologia , Pólipos/tratamento farmacológico , Pólipos/patologia , Inibidores de Proteínas Quinases/farmacologia
10.
Pan Afr Med J ; 33: 211, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-31693718

RESUMO

Introduction: Different diagnostic tools are available to evaluate endometrial focal lesion such as hysteroscopy, sonohystrography and transvaginal ultrasound. The present study aimed to determine the diagnostic value of saline infusion sonohystrography (SIS) in diagnosis of intrauterine lesions in women with Abnormal Uterine Bleeding (AUB). Methods: This cross-sectional study recruited 100 married women with chief complain of AUB referred to gynecologic clinics at the Amir Al-Momenin hospital, Semnan, Iran from March 2014 to February 2016. All participants were in the reproductive age and post-menopausal period that showed abnormal endometrial thickness or endometrial focal lesions through transvaginal ultrasound. Participants underwent SIS, hysteroscopy plus focal lesion resection and endometrial biopsy in order. The gold standard was the histopathology of endometrial specimen reported by pathologist. Results: Mean±SD age of women was 41.2±11.3 years. To diagnose the overall focal lesions, sensitivity, specificity, positive predictive value (PPV) and negative predictive value (NPV) of the SIS were 79.6, 89.1, 89.6, and 78.8% respectively. These figures were 75.0, 87.5, 82.5 and 81.7%, respectively to diagnose polyps. The SIS sensitivity, specificity, PPV and NPV values to diagnose the myomas were 60.0, 97.8, 75.0, and 95.7% respectively. Conclusion: Findings show that, SIS probably is a proper method for detecting endometrial focal lesion including polyps and myomas. Future studies may help to define further advantages of this procedure.


Assuntos
Histeroscopia/métodos , Solução Salina/administração & dosagem , Doenças Uterinas/diagnóstico , Hemorragia Uterina/etiologia , Adulto , Estudos Transversais , Feminino , Humanos , Irã (Geográfico) , Leiomioma/diagnóstico , Leiomioma/patologia , Leiomioma/cirurgia , Pessoa de Meia-Idade , Pólipos/diagnóstico , Pólipos/patologia , Valor Preditivo dos Testes , Sensibilidade e Especificidade , Ultrassonografia/métodos , Doenças Uterinas/patologia , Doenças Uterinas/cirurgia , Neoplasias Uterinas/diagnóstico , Neoplasias Uterinas/patologia , Neoplasias Uterinas/cirurgia
12.
J Med Life ; 12(3): 266-270, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-31666829

RESUMO

The peculiarities of the microbiocenosis of the uterine cavity in 184 patients of reproductive age with different types of endometrial hyperproliferative processes were studied: Group 1, n=60, non-atypical endometrial hyperplasia (NAEH); Group 2, n=62, endometrial polyps (EPs); Group 3, n=62, NAEH + EPs. Correlation analysis of the degree of association between different biological media (uterus and genital tract) was carried out. Contamination of the uterine cavity by bacterial flora was diagnosed in all groups of patients examined. Anaerobic flora was about 30% while bacteria of the genus Bacteroides were the most common. Among aerobic organisms, representatives of the Enterobacteriaceae family and coccal flora are noted. The widest was the spectrum of isolated microorganisms in patients of group 2 (with endometrial polyps). A strong positive correlation was established between indices of genital tract contamination and the uterine cavity by coccal flora, Escherichia coli, and anaerobic organisms. The findings suggest dysbiotic changes and the presence of a chronic inflammatory focus in the endometrium, which pathogenetically substantiates the application of anti-inflammatory therapy in such patients.


Assuntos
Endométrio/patologia , Útero/microbiologia , Útero/patologia , Adulto , Feminino , Humanos , Pessoa de Meia-Idade , Pólipos/patologia , Neoplasias Uterinas/patologia
13.
Bull Exp Biol Med ; 167(6): 795-800, 2019 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-31656005

RESUMO

We performed an electron microscopic study of samples of urethral polyps obtained from 90 women (mean age 52.5±4.9 years). According to PCR and culture studies, the most common infectious agent in patients with urethral polyps is U. urealyticum (100% cases). In 70% cases, this infectious agent was present as monoinfection, of these, clinically significant concentration (>106 CFU/ml) were found in 53.3% cases. In 30% cases, associations with C. trachomatis, T. vaginalis, and M. genitalium were found. We observed significant ultrastructural heterogeneity of the epithelial cells in urethral polyps, which manifested in a combination of hyperplastic and metaplastic changes and signs of cytodestruction. Detection of mycoplasma-like bodies in connective tissue mononuclear cells and viral particles in epithelial cells during ultrastructural study, including cases with negative PCR results, indicates the pathogenetic role of latent infection in the formation of urethral polyps.


Assuntos
Pólipos/complicações , Pólipos/patologia , Neoplasias Uretrais/complicações , Neoplasias Uretrais/patologia , Infecções Urinárias/complicações , Urotélio/ultraestrutura , Infecções por Chlamydia/epidemiologia , Infecções por Chlamydia/patologia , Chlamydia trachomatis/genética , Chlamydia trachomatis/isolamento & purificação , Feminino , Humanos , Pessoa de Meia-Idade , Infecções por Mycoplasma/epidemiologia , Infecções por Mycoplasma/patologia , Mycoplasma genitalium/genética , Mycoplasma genitalium/isolamento & purificação , Reação em Cadeia da Polimerase , Pólipos/epidemiologia , Pólipos/ultraestrutura , Tricomoníase/epidemiologia , Tricomoníase/patologia , Trichomonas vaginalis/genética , Trichomonas vaginalis/isolamento & purificação , Infecções por Ureaplasma/epidemiologia , Infecções por Ureaplasma/patologia , Ureaplasma urealyticum/genética , Ureaplasma urealyticum/isolamento & purificação , Doenças Uretrais/complicações , Doenças Uretrais/epidemiologia , Doenças Uretrais/microbiologia , Doenças Uretrais/patologia , Neoplasias Uretrais/epidemiologia , Neoplasias Uretrais/ultraestrutura , Infecções Urinárias/epidemiologia , Infecções Urinárias/microbiologia , Urotélio/microbiologia , Urotélio/patologia
14.
Oncol Rep ; 42(6): 2303-2308, 2019 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-31638232

RESUMO

Endometrial polyps are common, yet the molecular mechanisms underlying their formation and progression remain unclear. We examined gene mutations possibly related to the pathogenesis of endometrial polyps, as well as to their clinical features. Four premenopausal patients with endometrial polyps, who were not under drug treatment, were recruited. Whole exomes of endometrial polyps and peripheral blood lymphocytes were analyzed by next­generation sequencing, and somatic mutations were derived by subtraction. Then, 35 samples of endometrial polyps and 12 samples of atypical polypoid adenomyoma were newly recruited to validate the identified mutations by polymerase chain reaction­reverse sequence specific oligonucleotide method. The mutations were also analyzed in separate stromal and glandular components of the polyps after laser­capture microdissection. Whole exome sequencing revealed that KRAS mutations were the only type of mutation detectable in multiple cases (2/4). Targeted mutation analysis revealed that 16 of 35 samples (45.7%) of endometrial polyps harbored RAS mutations. Mutation­positive cases exhibited a significantly higher number of endometrial polyps (3.25±2.70 vs. 1.74±0.87, P=0.045). Laser­capture microdissection in NRAS­mutated endometrial polyps revealed that both stromal and glandular components harbored RAS mutations. There was no RAS mutation in 12 samples of atypical polypoid adenomyoma. This is the first report demonstrating that pathogenic RAS mutations are frequent in non­treated endometrial polyps. RAS mutations may have an important role in tumorigenesis and in the formation of multiple endometrial polyps.


Assuntos
Exoma/genética , GTP Fosfo-Hidrolases/genética , Proteínas de Membrana/genética , Mutação , Pólipos/genética , Proteínas Proto-Oncogênicas p21(ras)/genética , Doenças Uterinas/genética , Adulto , Feminino , Humanos , Pólipos/patologia , Doenças Uterinas/patologia
15.
Curr Med Sci ; 39(5): 816-819, 2019 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-31612401

RESUMO

Sometimes endometrial polyps, submucosal myomas, and endometrial cancer show similar findings under ultrasonography. The aim of this study was to assess the antidiastole value of blood flow parameters using three-dimensional (3D) power Doppler ultrasonography angiography (PDA) between endometrial cancer and uterine parenchyma lumps. The data of the blood flow indices in 3D-PDA including the vascularization index (VI), flow index (FI), and vascularization flow index (VFI) in 40 patients with endometrial cancer and 41 patients with uterine parenchyma lumps (endometrial polyps and submucosal myomas) were retrospectively analysed and compared utilizing Virtual Organ Computer-aided AnaLysis (VOCAL) software. The results showed that all the blood flow parameters (VI, FI, VFI) were significantly higher in women with endometrial cancer than in those with uterine parenchyma lumps (P<0.001). The area under the curve of ROC of VI, FI, and VFI was 0.98, 0.84, and 0.97, respectively. Thus, the best predictor of endometrial carcinoma was VI with a sensitivity of 97.0% and a specificity of 91.0%. The optimal cutoff value of VI was 4.06%. Our data demonstrated that all of the blood flow signal parameters (including VI, FI, and VFI) in 3D power Doppler ultrasonography had significant antidiastole values between endometrial cancer and uterine parenchyma lumps to assist clinicians in properly diagnosing patients.


Assuntos
Carcinoma/diagnóstico por imagem , Neoplasias do Endométrio/diagnóstico por imagem , Interpretação de Imagem Assistida por Computador/estatística & dados numéricos , Mioma/diagnóstico por imagem , Pólipos/diagnóstico por imagem , Adulto , Angiografia/estatística & dados numéricos , Área Sob a Curva , Velocidade do Fluxo Sanguíneo , Carcinoma/irrigação sanguínea , Carcinoma/patologia , Diagnóstico Diferencial , Neoplasias do Endométrio/irrigação sanguínea , Neoplasias do Endométrio/patologia , Endométrio/irrigação sanguínea , Endométrio/diagnóstico por imagem , Endométrio/patologia , Feminino , Humanos , Imageamento Tridimensional , Pessoa de Meia-Idade , Mioma/irrigação sanguínea , Mioma/patologia , Pólipos/patologia , Curva ROC , Estudos Retrospectivos , Sensibilidade e Especificidade , Software , Ultrassonografia Doppler/estatística & dados numéricos
17.
Eur Arch Otorhinolaryngol ; 276(11): 3165-3171, 2019 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-31473780

RESUMO

OBJECTIVE: To investigate the presence of sulcus vocalis in patients who underwent phonomicrosurgery due to benign vocal cord lesions. METHODS: Between January 2013 and June 2018, the records of 133 patients who underwent operations for benign vocal fold pathology were retrospectively reviewed. Intraoperative findings of the patients were noted. Patients were divided into two groups: patients with only benign vocal fold lesions (BVFL) and patients with benign vocal fold lesions and accompanying sulcus vocalis (SV + BVFL). RESULTS: In total, 67 patients (50.4%; 38 females, 29 males) had BVFL and 66 (49.6%; 37 females, 29 males) had SV + BVFL. The patients in the SV + BVFL group were significantly younger than those in the BVFL group (p = 0.039). The sulcus was unilateral in 60.6% of the patients. The presence of sulcus vocalis was 49% and 47.6% in patients with a diagnosis of polyps (n = 51) and cysts (n = 42), respectively. A total of 12 of 13 patients with multiple benign vocal fold lesions had accompanying sulcus vocalis. CONCLUSION: Approximately half of the patients who underwent operations for benign vocal fold lesions had accompanying sulcus vocalis. More than half of the sulcus associated with benign lesions was unilateral.


Assuntos
Cistos , Pólipos , Prega Vocal , Adulto , Correlação de Dados , Cistos/patologia , Cistos/cirurgia , Feminino , Humanos , Doenças da Laringe/patologia , Doenças da Laringe/cirurgia , Músculos Laríngeos/patologia , Masculino , Pessoa de Meia-Idade , Pólipos/patologia , Pólipos/cirurgia , Estudos Retrospectivos , Prega Vocal/patologia , Prega Vocal/cirurgia
18.
BMJ Case Rep ; 12(9)2019 Sep 18.
Artigo em Inglês | MEDLINE | ID: mdl-31537591

RESUMO

Meckel's diverticulum is the most common congenital abnormality affecting the gastrointestinal tract, affecting 4% of the general population. It is classically located on the antimesenteric border of the ileum within 100 cm of the ileocaecal valve. Complications may include haemorrhage, bowel obstruction, diverticulitis, perforation and malignancy. This report explores the case of intussusception in an adult, in association with a mesenteric Meckel's diverticulum and adjacent benign polyp. A 40-year-old man presented with acute abdominal pain, affecting the central abdomen and both flanks. CT imaging revealed small bowel intussusception, with either a Meckel's diverticulum or polyp acting as a lead point. Intraoperatively, the intussusception had already resolved; however, an inflamed outpouching was identified on the mesenteric border of the ileum, with a firm mass palpable within the bowel lumen. A 70 mm small bowel resection and primary anastomosis were performed. Histopathological analysis confirmed an inflamed Meckel's diverticulum as well as an adjacent diverticulum comprising a benign polyp.


Assuntos
Intussuscepção/etiologia , Divertículo Ileal/complicações , Divertículo Ileal/cirurgia , Mesentério/patologia , Adulto , Anastomose Cirúrgica/métodos , Diagnóstico Diferencial , Trato Gastrointestinal/patologia , Humanos , Valva Ileocecal/patologia , Íleo/patologia , Íleus/diagnóstico , Íleus/etiologia , Obstrução Intestinal/etiologia , Período Intraoperatório , Intussuscepção/diagnóstico por imagem , Masculino , Divertículo Ileal/patologia , Pólipos/patologia , Complicações Pós-Operatórias , Tomografia Computadorizada por Raios X/métodos , Resultado do Tratamento
19.
Clin Nucl Med ; 44(11): 920-922, 2019 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-31524677

RESUMO

Computed tomography (CT) of a 68-year-old man showed multiple small nodules in the bilateral lungs (maximum 14 mm in the left upper lobe). CT-guided biopsy of left upper lobe lesion showed no tumor or granuloma. Fluorodeoxyglucose (FDG) PET/CT showed multiple nodules with background-to-mild FDG-avid activity, and an incidental left scrotal skin lesion with intensely increased accumulation of F-FDG (SUVmax, 11.7), suspected malignant. After urologist consultation, local dermatological findings suggested a huge wart. Excision was done, and pathology concluded nodular papillary fibroepithelial polyp with acute and chronic inflammation.


Assuntos
Fluordesoxiglucose F18 , Pólipos/diagnóstico por imagem , Tomografia Computadorizada com Tomografia por Emissão de Pósitrons , Escroto/diagnóstico por imagem , Escroto/patologia , Doença Aguda , Idoso , Doença Crônica , Diagnóstico Diferencial , Humanos , Inflamação/diagnóstico por imagem , Masculino , Pólipos/patologia
20.
Gastric Cancer ; 22(6): 1294-1300, 2019 11.
Artigo em Inglês | MEDLINE | ID: mdl-31529234

RESUMO

A 37-year-old male with tarry stool presented to our hospital. Esophagogastroduodenoscopy revealed advanced gastric cancer, fundic gland polyposis (FGPsis), and negativity for Helicobacter pylori (HP) infection. Computed tomography exhibited multiple liver tumors. Total colonoscopy (TCS) demonstrated 139 tubular adenomas. He was diagnosed as having unresectable gastric cancer and received systemic chemotherapy. His sister and mother had colorectal adenomatous polyposis as revealed by TCS. His sister had FGPsis and was negative for HP infection, whereas his mother had early gastric cancer with HP infection but not FGPsis. Genetic analysis revealed a novel mutation in exon 15 of the APC gene (NM_000038.5: c.7647_7648_delTG) for the patient, his mother, and his sister, whereas no mutation was found for his father who had no gastrointestinal polyps. Therefore, the pedigree was diagnosed as an FAP family with a novel APC germline mutation which had different gastric phenotypes depending on the status of HP infection.


Assuntos
Polipose Adenomatosa do Colo/diagnóstico , Infecções por Helicobacter/diagnóstico , Pólipos/diagnóstico , Neoplasias Gástricas/diagnóstico , Polipose Adenomatosa do Colo/genética , Polipose Adenomatosa do Colo/patologia , Proteína da Polipose Adenomatosa do Colo/genética , Adulto , Colonoscopia , Endoscopia do Sistema Digestório , Mutação em Linhagem Germinativa , Helicobacter pylori/isolamento & purificação , Humanos , Masculino , Fenótipo , Pólipos/genética , Pólipos/patologia , Neoplasias Gástricas/genética , Neoplasias Gástricas/patologia , Tomografia Computadorizada por Raios X
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