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BACKGROUND: Biomarkers play a role in identifying, managing, and predicting cancer outcomes. In lung cancer, they are used at various time points. Doubts remain regarding their accuracy for differential diagnosis and histological subtyping. A diagnostic test study was conducted. It included malignant lesions and controls with benign lesions. Before lung biopsy, all patients had the following biomarkers measured in serum (Pro-GRP,NSE,CYFRA21-1,SCC-Ag,CEA). METHODS: The predictive capacity of serum biomarkers was evaluated to discriminate between lung cancer and benign pathology. The accuracy was also assessed for distinguishing between SCLC and NSCLC and explored their ability to perform histological subtyping. RESULTS: 93 patients were included, 60 with lung cancer, 33 with benign pathology. Pro-GRP and NSE were elevated in SCLC compared with NSCLC or nonmalignant disease. The most accurate for differentiating between malignant and benign pathology were CEA and CYFRA21-1. Pro-GRP had a poor predictive capacity for distinguishing NSCLC from SCLC. However, combined with CEA and CYFRA21-1, performance improved. For SCLC, the diagnostic capacity of Pro-GRP increased by combining with biomarkers, such as NSE/CYFRA21-1. CONCLUSIONS: Biomarkers lacked the sensitivity and specificity for independent differential diagnosis or histological subtyping. However, the observed patterns in biomarker levels associated with specific histological subtypes suggest potential utility in a multi-biomarker approach or in conjunction with other diagnostic tools. This insight could guide future research to improve diagnostic accuracy and personalized treatment strategies in lung cancer.
Biomarkers are crucial for identifying, managing, and predicting outcomes in lung cancer, though they lack accuracy in differentiating histological subtypes.CEA and CYFRA21-1 were the most accurate biomarkers for distinguishing between malignant and benign pathology.Pro-GRP and NSE levels were elevated in SCLC compared to NSCLC. Pro-GRP alone had poor predictive capacity for differentiating NSCLC from SCLC, but combining it with CEA and CYFRA21-1 improved diagnostic performance.Patterns in biomarker levels suggest that a multi-biomarker approach, especially when combined with other diagnostic tools, could improve diagnostic accuracy.
Assuntos
Antígenos de Neoplasias , Biomarcadores Tumorais , Carcinoma Pulmonar de Células não Pequenas , Queratina-19 , Neoplasias Pulmonares , Humanos , Carcinoma Pulmonar de Células não Pequenas/sangue , Carcinoma Pulmonar de Células não Pequenas/diagnóstico , Biomarcadores Tumorais/sangue , Neoplasias Pulmonares/sangue , Neoplasias Pulmonares/diagnóstico , Diagnóstico Diferencial , Masculino , Feminino , Pessoa de Meia-Idade , Idoso , Antígenos de Neoplasias/sangue , Queratina-19/sangue , Carcinoma de Pequenas Células do Pulmão/sangue , Carcinoma de Pequenas Células do Pulmão/diagnóstico , Antígeno Carcinoembrionário/sangue , Serpinas/sangue , Fosfopiruvato Hidratase/sangue , Sensibilidade e Especificidade , AdultoRESUMO
OBJECTIVE: The investigators aimed to identify the clinical characteristics of patients with or without delirium and preexisting depression, dementia, both, or neither by using validated tools easily administered in clinical practice. METHODS: In this cross-sectional prospective observational study conducted in Medellín, Colombia, 200 geriatric inpatients were evaluated with the Delirium Diagnostic Tool-Provisional (DDT-Pro), Informant Questionnaire on Cognitive Decline in the Elderly, Hachinski Ischemic Scale, Cornell Scale for Depression in Dementia, and Charlson Comorbidity Index-short form. Delirium motor subtype, mortality, and length of hospital stay were assessed. RESULTS: The study included 134 patients without delirium (67%), 14 with delirium only (7%), 16 with delirium and dementia (8%), 13 with delirium and depression (7%), and 23 with delirium, dementia, and depression (the three Ds) (12%). Prevalence rates of dementia (59%) and depression (55%) among 66 patients with delirium were higher than prevalence rates among patients without delirium (13% and 28%, respectively), suggesting that both conditions are risk factors. Main medical diagnoses, mortality, and dementia type did not differ among groups. Motor subtypes were similar among delirium groups. Patients in the delirium groups, except those in the delirium and depression group, were older than patients without delirium. Medical burden was highest among the patients with delirium and dementia and those with all three conditions. Delirium and dementia were more severe when comorbid with each other. Depression was most severe among patients with delirium and depression. Patients with all three conditions had a longer length of hospital stay than those without delirium. CONCLUSIONS: Using brief tools to detect dementia and depression in conjunction with the DDT-Pro to assess delirium diagnosis and severity is feasible and enables a more in-depth evaluation of elderly hospitalized patients. Because previous longitudinal research suggests that these comorbid conditions influence prognosis following a delirium episode, better identification of the three Ds offers proactive interventional opportunities. Depression is an underrecognized risk factor for delirium.
Assuntos
Delírio , Demência , Humanos , Idoso , Delírio/diagnóstico , Delírio/epidemiologia , Delírio/psicologia , Demência/diagnóstico , Demência/epidemiologia , Demência/psicologia , Pacientes Internados , Estudos Transversais , DDTRESUMO
SNAREs constitute the core machinery of intracellular membrane fusion, but vesicular SNAREs localize to specific compartments via largely unknown mechanisms. Here, we identified an interaction between VAMP7 and SNAP-47 using a proteomics approach. We found that SNAP-47 mainly localized to cytoplasm, the endoplasmic reticulum (ER), and ERGIC and could also shuttle between the cytoplasm and the nucleus. SNAP-47 preferentially interacted with the trans-Golgi network VAMP4 and post-Golgi VAMP7 and -8. SNAP-47 also interacted with ER and Golgi syntaxin 5 and with syntaxin 1 in the absence of Munc18a, when syntaxin 1 is retained in the ER. A C-terminally truncated SNAP-47 was impaired in interaction with VAMPs and affected their subcellular distribution. SNAP-47 silencing further shifted the subcellular localization of VAMP4 from the Golgi apparatus to the ER. WT and mutant SNAP-47 overexpression impaired VAMP7 exocytic activity. We conclude that SNAP-47 plays a role in the proper localization and function of a subset of VAMPs likely via regulation of their transport through the early secretory pathway.
Assuntos
Proteínas Q-SNARE/fisiologia , Proteínas R-SNARE/metabolismo , Animais , Cães , Células Madin Darby de Rim Canino , Transporte Proteico , Frações Subcelulares/metabolismoRESUMO
OBJECTIVE: Validations of brief delirium tools have not included analysis of psychiatric disorders comorbidities or control groups. We validated the Delirium Diagnostic Tool-Provisional (DDT-Pro) in 422 geriatric inpatients with high incidence of depression and/or dementia. METHODS: Cross-sectional study using two delirium reference standards, DSM-5-TR and Delirium Rating Scale-Revised-98 (DRS-R98). We assessed concurrent and construct DDT-Pro validity too. RESULTS: There were 117 (27.7%) delirium cases using DDT-Pro, 104 (24.6%) per DSM-5-TR and 93 (22.0%) per DRS-R98; 133 patients (31.5%) had depression and 105 (24.9%) dementia, some comorbid with delirium. DDT-Pro accuracy (AUC under ROC curve) ranges were 88.3-95.9% vs DSM-5-TR and 92.7-95.0% vs DRS-R98 for whole sample and four diagnostic groups, without statistical differences. DDT-Pro ≤6 had the most balanced sensitivity-specificity for delirium diagnosis against both DSM-5-TR and DRS-R98 with similar specificity but higher sensitivity for DRS-R98 than DSM-5-TR delirium, with the highest values in patients with depression and dementia (≥92% sensitivity, ≥81% specificity). Positive and negative likelihood ratios support diagnostic strength. Concurrent validity was high reflected by significant correlations (p < 0.001) of DDT-Pro total and item scores with DRS-R98 and Delirium Frontal Index scores, highest in groups with comorbid depression and/or dementia. The DDT-Pro represented a single construct for delirium demonstrated by one factor with high item loadings and high internal consistency reliability of its items. CONCLUSIONS: The DDT-Pro demonstrated strong performance metrics in general hospital elderly inpatients with preexisting depression and/or dementia, which is unique among brief delirium tools. Its optimized cutoff score was the same as in other populations.
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OBJECTIVE: To compare the pelvic lymph node involvement and risk of recurrence in patients with human papillomavirus (HPV)-associated endocervical adenocarcinoma stage IA2-IB1 undergoing hysterectomy and/or trachelectomy plus lymphadenectomy, according to Silva's classification system. METHODS: A retrospective cohort study was performed in two Colombian cancer centers. The cases were classified according to the Silva classification system. Clinical, surgical, and histopathological variables were evaluated. Recurrence risk was analyzed by patterns A, B, or C. A logistic regression model was performed for tumor recurrence. The Kaplan-Meier method was used to estimate overall survival and disease-free survival (DFS). A weighted kappa was performed to determine the degree of concordance between pathologists. RESULTS: A total of 100 patients were identified, 33% pattern A, 29% pattern B, and 38% pattern C. The median follow-up time was 42.5 months. No evidence of lymph node involvement was found in patients classified as A and B, while in the C pattern was observed in 15.8% (n = 6) of cases (P < 0.01). There were 7% of cases with recurrent disease, of which 71.5% corresponded to type C pattern. Patients with Silva pattern B and C had 1.22- and 4.46-fold increased risk of relapse, respectively, compared with pattern A. The 5-year DFS values by group were 100%, 96.1%, and 80.3% for patterns A, B, and C, respectively. CONCLUSION: For patients with early-stage HPV-associated endocervical adenocarcinoma, the type C pattern presented more lymph node involvement and risk of recurrence compared to the A and B patterns. The concordance in diagnosis of different Silva's patterns by independents pathologists were good.
Assuntos
Adenocarcinoma , Excisão de Linfonodo , Metástase Linfática , Recidiva Local de Neoplasia , Estadiamento de Neoplasias , Infecções por Papillomavirus , Neoplasias do Colo do Útero , Humanos , Feminino , Neoplasias do Colo do Útero/patologia , Neoplasias do Colo do Útero/virologia , Neoplasias do Colo do Útero/cirurgia , Estudos Retrospectivos , Colômbia/epidemiologia , Recidiva Local de Neoplasia/epidemiologia , Adenocarcinoma/patologia , Adenocarcinoma/virologia , Pessoa de Meia-Idade , Adulto , Infecções por Papillomavirus/complicações , Histerectomia , Linfonodos/patologia , Linfonodos/virologia , Idoso , Pelve , Intervalo Livre de Doença , TraquelectomiaRESUMO
Triple negative breast cancer (TNBC) is highly immunogenic and high levels of tumor infiltrating lymphocytes (TILs) have been associated with a better prognosis and higher probability to achieve pathological complete response. Here, we explore the potential role of stromal TILs level and composition as a prognostic and predictive biomarker in TNBC. 195 Tumor biospecimens from patients diagnosed with TNBC were included. Stromal TILs (sTILs), positive CD4/CD8 cells were evaluated. Differences in clinic-pathological characteristics according to immune infiltration were assessed. The predictive and prognostic value of immune infiltration was analyzed by multivariate models. Higher immune infiltration was observed in patients with favorable clinical-pathological features. Survival analysis showed that longer overall survival times were observed in patients with a higher infiltration of sTILs (p = 0.00043), CD4 + (p = 0.0074) and CD8 + (p = 0.008). In the multivariate analysis, low levels of sTILs were found to be associated with a higher mortality hazard (HR: 1.59, 95% CI 1.01-2.48). CD4 and CD8 immune infiltration were associated with higher odds for pathological complete response (OR: 1.20, 95% CI 1.00-1.46, OR: 1.28, 1.02-1.65, respectively). Our results suggest that immune infiltration could be used as a prognostic marker for overall survival in TNBC patients.
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Neoplasias de Mama Triplo Negativas , Humanos , Neoplasias de Mama Triplo Negativas/patologia , Linfócitos do Interstício Tumoral , Colômbia , Prognóstico , Biomarcadores , Biomarcadores Tumorais/análiseRESUMO
In Colombia, the human papillomavirus (HPV) vaccine was launched in 2012 in the context of a school-based national vaccination program targeting girls ages 9 to 14 and offering catch-up vaccination for girls ages 14 to 17. In this study, we evaluated the program's impact on type-specific HPV infection by comparing HPV cervical prevalence among vaccinated and nonvaccinated women. This is a comparative cross-sectional study conducted 5 years after the quadrivalent HPV vaccination implementation in a sentinel Colombian City. This study included young women (18-25 years old) who had been vaccinated in the catch-up group and were attending universities and technical institutions, and women who attended primary health care facilities for Pap smear screening. The HPV prevalence of 1,287 unvaccinated women was compared with the prevalence of 1,986 vaccinated women. The prevalence of HPV16/18 infections was significantly lower in vaccinated compared with unvaccinated women (6.5% vs. 15.4%; P < 0.001), whereas for HPV6/11 infections, a decrease of 63.7% in vaccinated women (1.02% vs. 2.81%) was observed. The adjusted effectiveness to HPV16/18 was 61.4%; 95% CI, 54.3%-67.6%. However, the effectiveness against HPV16/18 was significantly higher among women vaccinated before their sexual debut 91.5%; 95% CI, 86.8-94.5, compared with effectiveness for vaccination after their sexual debut, 36.2%; 95% CI, 23.6-46.7. Five years after the introduction of HPV vaccines in Colombia, high effectiveness of HPV to prevent HPV16/18 infections is observed in the catch-up cohorts including virgin and sexually active women. PREVENTION RELEVANCE: Monitoring HPV vaccines post-licensure plays an important role in assessing the progress of immunization programs, demonstrating the impact of vaccines on the population, and providing data for policy needs. In Colombia, HPV vaccines showed effectiveness when administered before start of sexual activity, and two doses are sufficient to achieve good protection.
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Infecções por Papillomavirus , Vacinas contra Papillomavirus , Mulheres , Adolescente , Adulto , Criança , Colômbia/epidemiologia , Estudos Transversais , Feminino , Papillomavirus Humano 16 , Papillomavirus Humano 18 , Humanos , Infecções por Papillomavirus/epidemiologia , Infecções por Papillomavirus/prevenção & controle , Vacinas contra Papillomavirus/uso terapêutico , Prevalência , Vacinação , Adulto JovemRESUMO
In mammals, the majority of DNA double-strand breaks are processed by the nonhomologous end-joining (NHEJ) pathway, composed of seven factors: Ku70, Ku80, DNA-PKcs, Artemis, Xrcc4 (X4), DNA-ligase IV (L4), and Cernunnos/XLF. Cernunnos is part of the ligation complex, constituted by X4 and L4. To improve our knowledge on the structure and function of Cernunnos, we performed a systematic mutagenesis study on positions selected from an analysis of the recent three-dimensional structures of this factor. Ten of 27 screened mutants were nonfunctional in several DNA repair assays. Outside amino acids critical for the expression and stability of Cernunnos, we identified three amino acids (Arg(64), Leu(65), and Leu(115)) essential for the interaction with X4 and the proper function of Cernunnos. Docking the crystal structures of the two factors further validated this probable interaction surface of Cernunnos with X4.
Assuntos
Enzimas Reparadoras do DNA/metabolismo , Proteínas de Ligação a DNA/metabolismo , Aminoácidos , Sítios de Ligação , Simulação por Computador , Cristalografia por Raios X , Reparo do DNA , Enzimas Reparadoras do DNA/química , Enzimas Reparadoras do DNA/genética , Proteínas de Ligação a DNA/química , Proteínas de Ligação a DNA/genética , Humanos , Mutagênese Sítio-Dirigida , Ligação Proteica , Estrutura Terciária de ProteínaRESUMO
Porcelain bladder is defined as calcification of the gallbladder wall. It is a rare condition and is seen in 0.06% to 0.8% of cholecystectomies. It origin is still unknown. We report two cases of patients with a porcelain gallbladder. One case is a 60 year-old male patient who was seen due to having biliary symptoms. The diagnosis was made by ultrasound and computed tomography, and he was surgically intervened by performing a partial cholecystectomy. The histopathology reported a gallbladder wall with sclerohyalinosis and dystrophic calcification foci. The other case is a 98 year-old female patient, whose form of presentation was incidental given that she suffered from symptoms of an intestinal obstruction. A cholecystectomy was performed with a good post-surgical outcome. A series published in between 1950 and 1960 show that the porcelain bladder can be frequently observed in patients with cancer of the gallbladder, although this relationship is currently being rejected. The reason why these cases are being presented is because of their low incidence and the controversy over what treatment to use, due to its association with gallbladder cancer.
Assuntos
Calcinose , Doenças da Vesícula Biliar , Idoso de 80 Anos ou mais , Calcinose/cirurgia , Feminino , Doenças da Vesícula Biliar/diagnóstico , Humanos , Masculino , Pessoa de Meia-IdadeRESUMO
BACKGROUND: The Population Cancer Registry of Cali (RPCC) has operated since 1962, disseminating high quality information to provide a framework to assess and control the burden of cancer in Cali. METHODS: The collection of new cancer cases in permanent residents of Cali is done through active search in and notification from hospitals, and public and private laboratories. The Secretary of Municipal Public Health provides individual information on general mortality and death from cancer. Tumors are coded with ICDO-3 and mortality with ICD-10. Presented rates are standardized by age and trends are assessed by estimating the percentage annual change using the regression analysis in JoinPoint. The 5-year net survival was analyzed with the Pohar-Perme estimator. RESULTS: The 88.5% of the registered cancers had morphological verification (MV). The proportion of unknown primary site represented 5% and the death certificate only cases (DCO) varied between 0 to3% depending on the cancer site. All deaths were certified by a physician, 94.2% of cancer deaths were correctly certified. The ill-defined site proportion was 5.3% and that of uterine cancer not specified (C55) was 0.5%. For survival analysis, existing data collection procedure and infrastructure ensures assessment of the patient's vital status and follow-up, with an average lost to follow-up of 13.2%. COMMENT: The information has been published in the eleven volumes of "Cancer Incidence in Five Continents" confirming high quality of the collected data. The RPCC PCRC has also participated in the Concord Study and is participating in SURVCAN-3.
ANTECEDENTES: El Registro Poblacional de Cáncer de Cali (RPCC) opera de manera continua desde 1962 divulgando información de calidad para proporcionar un marco para valorar y controlar el impacto del cáncer en Cali. MÉTODOS: La recolección de los casos nuevos de cáncer en residentes permanentes de Cali se hace mediante búsqueda activa y por notificación en los hospitales y laboratorios públicos y privados. La Secretaria de Salud Pública Municipal proporciona la información individual de mortalidad general y por cáncer. Los tumores se codifican con la CIO-3 y la mortalidad con la CIE-10. Las tasas se estandarizan por edad y la tendencia se estudia con el porcentaje de cambio anual y con la regresión de JoinPoint. La supervivencia neta a 5 años se analizó con el estimador de Pohar-Perme. RESULTADOS: El 88.5% de los canceres tuvieron verificación morfológica (VM). La proporción de los casos codificada como de sitio mal definido representó el 5% y el certificado de defunción como única evidencia del diagnóstico de cáncer (DCO) varió entre 0-3% dependiendo de la localización. Todas las defunciones fueron certificadas por un médico, el 94.2% de las muertes por cáncer fueron bien certificadas. La proporción de sitio mal definido fue 5.3% y la de cáncer de útero no especificado (C55) fue 0.5%. En todos los casos de supervivencia fue posible el seguimiento y la proporción de censuras fue 13.2. COMENTARIO: La información ha sido publicada en los once volúmenes de "Cancer Incidence in Five Continents". El RPCC participó en el Estudio Concord y está participando en SURVCAN-3.
Assuntos
Efeitos Psicossociais da Doença , Neoplasias/epidemiologia , Sistema de Registros/estatística & dados numéricos , Adolescente , Adulto , Idoso , Idoso de 80 Anos ou mais , Colômbia/epidemiologia , Feminino , Seguimentos , Humanos , Incidência , Masculino , Pessoa de Meia-Idade , Neoplasias/mortalidade , Análise de Regressão , Análise de Sobrevida , Adulto JovemRESUMO
BACKGROUND: The Cali Population Cancer Registry (RPCC) has been in continuous operation since 1962 with the objective of producing valid statistics on the incidence of cancer, its patterns, trends and survival rates. METHODS: During the period 2008-2012, 23,046 new cases were registered and during 2011-2015 there were 12,761 cancer deaths. The trend of the rates was described with the APC average annual change rate and with the Joinpoint analysis. We analyzed the individual data of 38,671 adults (15-99 years) diagnosed with cancer between 1995-2009, and we calculated the standardized net survival by age for the 14 most common cancer body sites, using the Pohar-Perme method. RESULTS: Prostate and breast cancer were the first cause of cancer morbidity. The incidence rates in these were susceptible to early detection, tumors stabilized after decades of growth, while an increase in the incidence of colon cancer and papillary thyroid carcinoma was observed. The incidence rates of cervical and stomach cancer and conditions related to infectious agents decreased, although the number of absolute cases increased, due to the growth and aging of the population. Gastric cancer was responsible for the highest number of cancer related deaths. The types of cancer related to tobacco consumption (lung, oral cavity, esophagus, pancreas, urinary bladder) showed low numbers and a tendency to decrease. During the period 2000-2004, the 5-year net survival improved for cancers of the breast, cervix, prostate, melanoma and thyroid, although in the period 2005-2009 a stagnation was observed. In stomach, liver and lung cancer, the 5-year net survival was less than 15%. The 5-year overall survival in children was 51.0% (95% CI: 47.5, 54.3) and in adolescents 44.6% (95% CI: 36.0, 52.8). COMMENT: RPCC has been an advisor to the Colombian government in the evaluation of CPRs in the country and its data has contributed significantly to different aspects of cancer control in Colombia.
ANTECEDENTES: El Registro Poblacional de Cáncer de Cali (RPCC) está en operación continua desde 1962 con el objetivo de producir estadísticas válidas sobre la incidencia de cáncer, sus patrones, tendencias y supervivencia. MÉTODOS: Durante el periodo 2008-2012, se registraron 23,046 casos nuevos y durante 2011-2015 se registraron 12,761 defunciones por cáncer. La tendencia de las tasas se describió con el porcentaje de cambio medio anual APC y con el análisis de Joinpoint. Se analizaron los datos individuales de 38,671 adultos (15-99 años) con diagnóstico de cáncer entre 1995-2009, y se calculó la supervivencia neta estandarizada por edad para las 14 localizaciones más comunes de cáncer, con el método de Pohar-Perme. RESULTADOS: Próstata y mama fueron la primera causa de morbilidad por cáncer. Las tasas de incidencia en estos tumores susceptibles de detección temprana se estabilizaron tras décadas de crecimiento, mientras que se observó un incremento de la incidencia de cáncer de colon y carcinoma papilar de tiroides. Las tasas de incidencia de cáncer de cuello uterino y estómago, afecciones relacionados con agentes infecciosos, disminuyeron, aunque el número de los casos absolutos aumentó, debido al crecimiento y envejecimiento de la población. El cáncer gástrico fue responsable del mayor número de muertes por cáncer. Los tipos de cáncer relacionados con el consumo de tabaco (pulmón, cavidad oral, esófago, páncreas, vejiga urinaria) mostraron cifras bajas y con tendencia al descenso. Durante el periodo 2000-2004, la supervivencia neta a 5 años mejoró para los cánceres de mama, cuello uterino, próstata, melanoma y tiroides, aunque en el periodo 2005-2009 se observó un estancamiento. En cáncer de estómago, hígado y pulmón, la supervivencia neta a 5 años fue inferior al 15%. La supervivencia global a 5 años en niños fue de 51.0% (IC 95%: 47.5, 54.3) y en adolescentes de 44.6% (IC 95%: 36.0, 52.8). COMENTARIO: El RPCC ha sido asesor del gobierno colombiano en la evaluación de RPCs en el país y sus datos han contribuido significativamente a diferentes aspectos del control del cáncer en Colombia.
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Neoplasias/epidemiologia , Sistema de Registros/estatística & dados numéricos , Adolescente , Adulto , Distribuição por Idade , Idoso , Idoso de 80 Anos ou mais , Criança , Pré-Escolar , Colômbia/epidemiologia , Feminino , Humanos , Incidência , Lactente , Masculino , Pessoa de Meia-Idade , Morbidade/tendências , Mortalidade/tendências , Neoplasias/patologia , Taxa de Sobrevida , Adulto JovemRESUMO
OBJETIVO: Los tumores de ovario borderline (BOT) son un grupo de lesiones neoplásicas de origen epitelial del ovario que presentan características de tumores malignos, pero sin invasión del estroma, y se caracterizan por tener un buen pronóstico. El objetivo del estudio es determinar la concordancia diagnóstica entre biopsia contemporánea y definitiva de los BOT en nuestro centro hospitalario. MÉTODO: Se realizó un estudio analítico retrospectivo de corte transversal de las biopsias contemporáneas y definitivas de BOT en la base de datos de anatomía patológica del Hospital Padre Hurtado, entre los años 2010 y 2019. El análisis estadístico de concordancia se realizó mediante test de kappa. RESULTADOS: Se revisaron 4546 informes de biopsias entre los años 2010 y 2019. Se pesquisaron 163 tumores malignos de ovario, de los cuales 69 (42,33%) correspondieron a BOT. De estos, 39 fueron serosos (56,2%), 28 mucinosos (40,57%) y 2 (2,8%) de tipo endometrioide. El resultado de concordancia diagnóstica de BOT seroso es moderada, del 75,71% con un índice de kappa de 0,5143 (p = 0,000), y el de BOT mucinoso es débil, del 65,71% con un índice de kappa de 0,2398 (p = 0,0222). CONCLUSIONES: Los BOT corresponden a un gran porcentaje dentro de los tumores malignos del ovario, siendo el subtipo seroso el más común. La concordancia entre biopsia contemporánea y definitiva es de débil a moderada.
OBJECTIVE: Borderline ovarian tumors (BOT) are a group of neoplastic lesions of epithelial origin of the ovary that present characteristics of malignant tumors but without stromal invasion and are characterized by having a good prognosis. The objective of the study is to determine the concordance between frozen section and definitive biopsy of BOT in our hospital center. METHOD: A retrospective, cross-sectional analytical study of the frozen section and definitive BOT biopsies was performed in the pathological anatomy database of the Padre Hurtado Hospital during the years 2010 and 2019. The statistical and concordance analysis was performed using kappa tests. RESULTS: 4546 biopsy reports were reviewed during 2010 and 2018. A total of 163 malignant ovarian tumors were investigated, of which 69 (42%) corresponded to BOT. Of these, the most common subtypes were 39 (56.2%) serous, 28 (40.57%) mucinous and 2 (2.8%) endometroid. The concordance results of serous BOT is moderate, 75.71% with a kappa index of 0.5143 (p = 0.000), and mucinous BOT have fair concordance, 65.71% with a kappa index of 0.2398 (p = 0.0222). CONCLUSIONS: BOT correspond to a large percentage of malignant tumors of the ovary, with the serous subtype being the most common. The concordance between contemporary and definitive biopsy is between fair and moderate.
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Humanos , Feminino , Adolescente , Adulto , Pessoa de Meia-Idade , Idoso , Adulto Jovem , Neoplasias Ovarianas/patologia , Neoplasias Ovarianas/diagnóstico , Biópsia/métodos , Estudos Transversais , Valor Preditivo dos Testes , Estudos Retrospectivos , Sensibilidade e EspecificidadeAssuntos
Citocromos b5/química , Simulação de Dinâmica Molecular , Ressonância Magnética Nuclear Biomolecular/métodos , Sequência de Aminoácidos , Animais , Bovinos , Citocromos b5/genética , Citocromos b5/metabolismo , Escherichia coli/genética , Heme/metabolismo , Humanos , Dados de Sequência Molecular , Oxirredução , Coelhos , Ratos , Proteínas Recombinantes/química , Proteínas Recombinantes/genética , Proteínas Recombinantes/metabolismo , Alinhamento de Sequência , TermodinâmicaRESUMO
Abstract Background: The Cali Population Cancer Registry (RPCC) has been in continuous operation since 1962 with the objective of producing valid statistics on the incidence of cancer, its patterns, trends and survival rates. Methods: During the period 2008-2012, 23,046 new cases were registered and during 2011-2015 there were 12,761 cancer deaths. The trend of the rates was described with the APC average annual change rate and with the Joinpoint analysis. We analyzed the individual data of 38,671 adults (15-99 years) diagnosed with cancer between 1995-2009, and we calculated the standardized net survival by age for the 14 most common cancer body sites, using the Pohar-Perme method. Results: Prostate and breast cancer were the first cause of cancer morbidity. The incidence rates in these were susceptible to early detection, tumors stabilized after decades of growth, while an increase in the incidence of colon cancer and papillary thyroid carcinoma was observed. The incidence rates of cervical and stomach cancer and conditions related to infectious agents decreased, although the number of absolute cases increased, due to the growth and aging of the population. Gastric cancer was responsible for the highest number of cancer related deaths. The types of cancer related to tobacco consumption (lung, oral cavity, esophagus, pancreas, urinary bladder) showed low numbers and a tendency to decrease. During the period 2000-2004, the 5-year net survival improved for cancers of the breast, cervix, prostate, melanoma and thyroid, although in the period 2005-2009 a stagnation was observed. In stomach, liver and lung cancer, the 5-year net survival was less than 15%. The 5-year overall survival in children was 51.0% (95% CI: 47.5, 54.3) and in adolescents 44.6% (95% CI: 36.0, 52.8). Comment: RPCC has been an advisor to the Colombian government in the evaluation of CPRs in the country and its data has contributed significantly to different aspects of cancer control in Colombia.
Resumen Antecedentes: El Registro Poblacional de Cáncer de Cali (RPCC) está en operación continua desde 1962 con el objetivo de producir estadísticas válidas sobre la incidencia de cáncer, sus patrones, tendencias y supervivencia. Métodos: Durante el periodo 2008-2012, se registraron 23,046 casos nuevos y durante 2011-2015 se registraron 12,761 defunciones por cáncer. La tendencia de las tasas se describió con el porcentaje de cambio medio anual APC y con el análisis de Joinpoint. Se analizaron los datos individuales de 38,671 adultos (15-99 años) con diagnóstico de cáncer entre 1995-2009, y se calculó la supervivencia neta estandarizada por edad para las 14 localizaciones más comunes de cáncer, con el método de Pohar-Perme. Resultados: Próstata y mama fueron la primera causa de morbilidad por cáncer. Las tasas de incidencia en estos tumores susceptibles de detección temprana se estabilizaron tras décadas de crecimiento, mientras que se observó un incremento de la incidencia de cáncer de colon y carcinoma papilar de tiroides. Las tasas de incidencia de cáncer de cuello uterino y estómago, afecciones relacionados con agentes infecciosos, disminuyeron, aunque el número de los casos absolutos aumentó, debido al crecimiento y envejecimiento de la población. El cáncer gástrico fue responsable del mayor número de muertes por cáncer. Los tipos de cáncer relacionados con el consumo de tabaco (pulmón, cavidad oral, esófago, páncreas, vejiga urinaria) mostraron cifras bajas y con tendencia al descenso. Durante el periodo 2000-2004, la supervivencia neta a 5 años mejoró para los cánceres de mama, cuello uterino, próstata, melanoma y tiroides, aunque en el periodo 2005-2009 se observó un estancamiento. En cáncer de estómago, hígado y pulmón, la supervivencia neta a 5 años fue inferior al 15%. La supervivencia global a 5 años en niños fue de 51.0% (IC 95%: 47.5, 54.3) y en adolescentes de 44.6% (IC 95%: 36.0, 52.8). Comentario: El RPCC ha sido asesor del gobierno colombiano en la evaluación de RPCs en el país y sus datos han contribuido significativamente a diferentes aspectos del control del cáncer en Colombia.
Assuntos
Adolescente , Adulto , Idoso , Idoso de 80 Anos ou mais , Criança , Pré-Escolar , Feminino , Humanos , Lactente , Masculino , Pessoa de Meia-Idade , Adulto Jovem , Sistema de Registros/estatística & dados numéricos , Neoplasias/epidemiologia , Incidência , Taxa de Sobrevida , Morbidade/tendências , Mortalidade/tendências , Colômbia/epidemiologia , Distribuição por Idade , Neoplasias/patologiaRESUMO
Abstract Background: The Population Cancer Registry of Cali (RPCC) has operated since 1962, disseminating high quality information to provide a framework to assess and control the burden of cancer in Cali. Methods: The collection of new cancer cases in permanent residents of Cali is done through active search in and notification from hospitals, and public and private laboratories. The Secretary of Municipal Public Health provides individual information on general mortality and death from cancer. Tumors are coded with ICDO-3 and mortality with ICD-10. Presented rates are standardized by age and trends are assessed by estimating the percentage annual change using the regression analysis in JoinPoint. The 5-year net survival was analyzed with the Pohar-Perme estimator. Results: The 88.5% of the registered cancers had morphological verification (MV). The proportion of unknown primary site represented 5% and the death certificate only cases (DCO) varied between 0 to3% depending on the cancer site. All deaths were certified by a physician, 94.2% of cancer deaths were correctly certified. The ill-defined site proportion was 5.3% and that of uterine cancer not specified (C55) was 0.5%. For survival analysis, existing data collection procedure and infrastructure ensures assessment of the patient's vital status and follow-up, with an average lost to follow-up of 13.2%. Comment: The information has been published in the eleven volumes of "Cancer Incidence in Five Continents" confirming high quality of the collected data. The RPCC PCRC has also participated in the Concord Study and is participating in SURVCAN-3.
Resumen Antecedentes: El Registro Poblacional de Cáncer de Cali (RPCC) opera de manera continua desde 1962 divulgando información de calidad para proporcionar un marco para valorar y controlar el impacto del cáncer en Cali. Métodos: La recolección de los casos nuevos de cáncer en residentes permanentes de Cali se hace mediante búsqueda activa y por notificación en los hospitales y laboratorios públicos y privados. La Secretaria de Salud Pública Municipal proporciona la información individual de mortalidad general y por cáncer. Los tumores se codifican con la CIO-3 y la mortalidad con la CIE-10. Las tasas se estandarizan por edad y la tendencia se estudia con el porcentaje de cambio anual y con la regresión de JoinPoint. La supervivencia neta a 5 años se analizó con el estimador de Pohar-Perme. Resultados: El 88.5% de los canceres tuvieron verificación morfológica (VM). La proporción de los casos codificada como de sitio mal definido representó el 5% y el certificado de defunción como única evidencia del diagnóstico de cáncer (DCO) varió entre 0-3% dependiendo de la localización. Todas las defunciones fueron certificadas por un médico, el 94.2% de las muertes por cáncer fueron bien certificadas. La proporción de sitio mal definido fue 5.3% y la de cáncer de útero no especificado (C55) fue 0.5%. En todos los casos de supervivencia fue posible el seguimiento y la proporción de censuras fue 13.2% Comentario: La información ha sido publicada en los once volúmenes de "Cancer Incidence in Five Continents". El RPCC participó en el Estudio Concord y está participando en SURVCAN-3.
RESUMO
Mlh1 is an essential factor of mismatch repair (MMR) and meiotic recombination. It interacts through its C-terminal region with MutL homologs and proteins involved in DNA repair and replication. In this study, we identified the site of yeast Mlh1 critical for the interaction with Exo1, Ntg2, and Sgs1 proteins, designated as site S2 by reference to the Mlh1/Pms1 heterodimerization site S1. We show that site S2 is also involved in the interaction between human MLH1 and EXO1 or BLM. Binding at this site involves a common motif on Mlh1 partners that we called the MIP-box for the Mlh1 interacting protein box. Direct and specific interactions between yeast Mlh1 and peptides derived from Exo1, Ntg2, and Sgs1 and between human MLH1 and peptide derived from EXO1 and BLM were measured with K(d) values ranging from 8.1 to 17.4 microM. In Saccharomyces cerevisiae, a mutant of Mlh1 targeted at site S2 (Mlh1-E682A) behaves as a hypomorphic form of Exo1. The site S2 in Mlh1 mediates Exo1 recruitment in order to optimize MMR-dependent mutation avoidance. Given the conservation of Mlh1 and Exo1 interaction, it may readily impact Mlh1-dependent functions such as cancer prevention in higher eukaryotes.
Assuntos
Proteínas Adaptadoras de Transdução de Sinal/química , Proteínas Adaptadoras de Transdução de Sinal/metabolismo , Sequência Conservada , Reparo de Erro de Pareamento de DNA , Exodesoxirribonucleases/metabolismo , Proteínas Nucleares/química , Proteínas Nucleares/metabolismo , Proteínas de Saccharomyces cerevisiae/química , Proteínas de Saccharomyces cerevisiae/metabolismo , Motivos de Aminoácidos , Sequência de Aminoácidos , Aminoácidos/metabolismo , Sítios de Ligação , Calorimetria , Dimerização , Humanos , Modelos Moleculares , Dados de Sequência Molecular , Proteína 1 Homóloga a MutL , Mutagênese Sítio-Dirigida , Mutação/genética , Peptídeos/metabolismo , Ligação Proteica , Saccharomyces cerevisiae/enzimologia , Deleção de Sequência , Especificidade da Espécie , Relação Estrutura-Atividade , Técnicas do Sistema de Duplo-HíbridoRESUMO
El uso diario de las imágenes médicas en los traumatismos de miembro inferior y su prevalencia en el segmento tobillo-pié, fue lo que estimuló la realización de este trabajo. Debido a ello decidimos correlacionar cortes cadavéricos de tipo coronal, axial y sagital con sus radiografías, para brindar una guia al enfoque diagnóstico del tobillo-pié. Como resultado obtuvimos la disposición particular que adquieren en el espacio, las estructuras anatómicas según la proyección del corte, con sus interrelaciones profundas y de superficie; ajustándonos al nuevo paradigma: la anatomía espacial en imágenes diagnósticas de tomografía axial computada y resonancia magnética. La observación metódica y sistemática de elementos del tobillo-pié en cortes, es una contribución pedagógica, aplicable a la interpretación topográfica de imágenes normales, que serviria de ayuda al estudiante y médico general. (AU)
Assuntos
Tornozelo , Pé , Espectroscopia de Ressonância Magnética , Tomografia , Extremidade Inferior , Tendão do Calcâneo , Traumatismos do PéRESUMO
El uso diario de las imágenes médicas en los traumatismos de miembro inferior y su prevalencia en el segmento tobillo-pié, fue lo que estimuló la realización de este trabajo. Debido a ello decidimos correlacionar cortes cadavéricos de tipo coronal, axial y sagital con sus radiografías, para brindar una guia al enfoque diagnóstico del tobillo-pié. Como resultado obtuvimos la disposición particular que adquieren en el espacio, las estructuras anatómicas según la proyección del corte, con sus interrelaciones profundas y de superficie; ajustándonos al nuevo paradigma: la anatomía espacial en imágenes diagnósticas de tomografía axial computada y resonancia magnética. La observación metódica y sistemática de elementos del tobillo-pié en cortes, es una contribución pedagógica, aplicable a la interpretación topográfica de imágenes normales, que serviria de ayuda al estudiante y médico general.
Assuntos
Tendão do Calcâneo , Tornozelo , Pé , Traumatismos do Pé , Extremidade Inferior , Espectroscopia de Ressonância Magnética , TomografiaRESUMO
Vesícula en porcelana se define como la calcificación de la pared de la vesícula biliar. Es una rara entidad que se observa en el 0,06 a 0,8% de las colecistectomías. Su etiología sigue siendo desconocida. Reportamos dos casos de pacientes con vesícula en porcelana. Un caso es un paciente masculino de 60 años que consulta por sintomatología biliar, se realiza el diagnóstico mediante ecografía y tomografía computada y es intervenido quirúrgicamente realizándose colecistectomía parcial con anatomía patológica que informa: pared vesicular con esclerohialinosis y focos de calcificación distrófica. El otro caso es una paciente femenina de 98 años, cuya forma de presentación fue incidental dado que cursaba con cuadro de oclusión intestinal, se realizó colecistectomía con buena evolución postoperatoria. Series publicadas entre los años 1950 y 1960 avalan que la vesícula en porcelana puede observarse con frecuencia en pacientes con cáncer de vesícula, aunque recientemente se ha desestimando este tipo de relación. El motivo por el cual se presentan estos casos es su baja frecuencia y su controversia en lo que al tratamiento se refiere por su relación con el cáncer de vesícula (AU)
Porcelain bladder is defined as calcification of the gallbladder wall. It is a rare condition and is seen in 0.06% to 0.8% of cholecystectomies. It origin is still unknown. We report two cases of patients with a porcelain gallbladder. One case is a 60 year-old male patient who was seen due to having biliary symptoms. The diagnosis was made by ultrasound and computed tomography, and he was surgically intervened by performing apartial cholecystectomy. The histopathology reported a gallbladder wall with sclerohyalinosis and dystrophic calcification foci. The other case is a 98 year-old female patient, whose form of presentation was incidental given that she suffered from symptoms of an intestinal obstruction. A cholecystectomy was performed with a good post-surgical outcome. A series published in between 1950 and 1960 show that the porcelain bladder can be frequently observed in patients with cancer of the gallbladder, although this relationship is currently being rejected. The reason why these cases are being presented is because of their (AU)
Assuntos
Humanos , Masculino , Feminino , Pessoa de Meia-Idade , Idoso de 80 Anos ou mais , Calcinose/cirurgia , Doenças da Vesícula Biliar/diagnósticoRESUMO
Este estudio se propuso explorar el consumo de drogas en los adolescentes y diseñar recomendaciones preventivas dirigidas a reemplazar aquellas representaciones sociales sobre las drogas y su uso que pueden constituirse en factores de riesgo. Se aplicó una encuesta a 1492 estudiantes de ambos sexos, con edades comprendidas entre los 13 y los 22 años de la ciudad de Bogotá; se empleó también una metodología cualitativa, desarrollando 8 grupos focales, de 7 a 9 jóvenes cada uno. Las opiniones favorables y las satisfacciones que están ligadas al consumo de drogas, se relacionan con la diversión, la disminución de sensaciones y situaciones displacenteras y la emoción de romper con las normas establecidas. Se encontraron diferencias importantes en las representaciones sociales que tienen los jóvenes consumidores y no consumidores: los primeros mostraron una percepción de baja peligrosidad de las sustancias que consumen, actitud de tolerancia marcada, creencia de razones de consumo asociadas a la evasión de la realidad y sensaciones placenteras. Los no consumidores mostraron una actitud más cautelosa: más preocupados por los peligros asociados al uso de las drogas y menos interesados en usarlas para divertirse, aumentar su productividad, o alejarse de la realidad. Mantener las diferencias claras será importante al momento de planear las estrategias de prevención
The purpose of this study was to explore drug abuse among adolescents and to design preventive recommendations aimed at replacing those social representations on drugs and their use that could constitute risk factors. A survey was made of 1492 students of both sexes, aged between 13 and 22 years, in Bogotá; a qualitative methodology was also employed in eight focus groups, each composed of seven to nine youngsters. The positive opinions and satisfactions linked to drug use are related to having fun, a decrease in unpleasant sensations and situations, and to the excitement of breaking established norms. Some important differences were found in the social representations of drug users and non-users: users had a low perception of the danger of their preferred drugs, high levels of tolerance, and a belief that their drug use was mainly related to evading reality and obtaining pleasurable sensations. Nonusers were more cautious: they were more preoccupied with the dangers associated with drug use, showed less interest in using them for amusement, or for increasing their productivity or escaping from reality. Consideration of such obvious differences will be important for the planning of prevention strategies