RESUMO
Biliary tract cancers (BTCs) represent a heterogeneous group that includes intrahepatic cholangiocarcinomas (CCAs), perihilar-CCAs or Klatskin tumors, extrahepatic-CCAs, and gallbladder adenocarcinoma. These entities have distinct demographics, risk factors, clinical presentation, and molecular characteristics. In advanced BTCs, the recommendations are mainly supporting a doublet chemotherapy regimen using cisplatin/gemcitabine (CisGem) with a 5-year overall survival rate close to 5% and median overall survival (mOS) of less than a year. The lack of overall efficacy stresses the need for personalized therapies. Recently, whole-genome and transcriptome sequencing highlighted the diversity of BTCs' subtypes. Distinct genetic alterations were retrieved according to the localization, with a high rate of potentially actionable alterations. Targeted therapies and immunotherapy have since then been tested for BTCs, trying to propose a more personalized treatment. This review describes the different therapeutic options, validated and in development, for patients with advanced BTCs.
Assuntos
Protocolos de Quimioterapia Combinada Antineoplásica/uso terapêutico , Neoplasias do Sistema Biliar/terapia , Imunoterapia , Terapia de Alvo Molecular , Protocolos de Quimioterapia Combinada Antineoplásica/efeitos adversos , Neoplasias do Sistema Biliar/genética , Neoplasias do Sistema Biliar/imunologia , Neoplasias do Sistema Biliar/mortalidade , Biomarcadores Tumorais/genética , Tomada de Decisão Clínica , Humanos , Imunoterapia/efeitos adversos , Imunoterapia/mortalidade , Terapia de Alvo Molecular/efeitos adversos , Terapia de Alvo Molecular/mortalidade , Medicina de Precisão , Resultado do Tratamento , Microambiente TumoralRESUMO
Increased numbers of renal tubular epithelial cells are present in the urinary sediments of renal transplant recipients during acute rejection. Few investigators have described characteristics of renal tubular epithelial cells in cytologic preparations. This study compiles morphologic characteristics of various tubular epithelial cells and determines the type of the tubular cells present during acute allograft rejection. The results demonstrate that cuboidal forms from the small collecting ducts are the predominent tubular epithelial cells exfoliated in voided urine during acute allograft rejection.
Assuntos
Rejeição de Enxerto , Transplante de Rim , Túbulos Renais/citologia , Urina/citologia , Células Epiteliais , Epitélio/imunologia , Humanos , Córtex Renal/citologia , Medula Renal/citologia , Pelve Renal/citologiaRESUMO
Segementation of the nucleus is an important morphologic characteristic of mature neutrophils and is a useful parameter for their identification in various body fluids. From our studies, we have demonstrated that when mature neutrophils are placed in low specific gravity urine, cellular enlargement and a loss of nuclear segmentation occur, resulting in inaccurate identification. Both cytotechnologists and investigators involved in neutrophil research should be aware of the effects of tonicity on morphologic characteristics.