ABSTRACT
O rastreamento mamográfico tem potencial de reduzir o estádio no momento do diagnóstico e, portanto, reduzir a mortalidade por câncer de mama. Cada programa deve estar atrelado a serviços de referência no diagnóstico e no tratamento específico da doença. Os resultados podem ser avaliados conforme indicadores de qualidade, descritos previamente por especialistas, tais como nas orientações da European Breast Cancer Network (EBCN). Parte dos indicadores propostos pela EBCN puderam ser adequadamente analisados nas mulheres com câncer de mama detectado pelo programa de rastreamento mamográfico do Hospital de Câncer de Barretos. A intenção foi detectar falhas, avaliar resultados e propor melhorias ao programa. Alguns desses indicadores, incluindo os relacionados ao diagnóstico, a análise anatomopatológica e o tratamento cirúrgico, foram descritos neste artigo e estiveram alinhados aos recomendados pela EBCN. Isto caracteriza a qualidade de um serviço de mastologia terciário, dedicado no tratamento multidisciplinar do câncer de mama. Entretanto, os intervalos de tempo necessitam ser adaptados à realidade nacional, muito provavelmente, em virtude das características sociais brasileiras. Alguns aspectos principais foram citados, para que futuros programas de rastreamento possam delinear a análise do seu programa de qualidade.
Mammographic screening has the potential to reduce the stage at diagnosis, and thus reduce mortality from breast cancer. Each program should be connected to reference departments in the diagnosis and treatment of breast cancer. The results of a mammographic screening program can be evaluated by means of indicators of quality, previously described by experts such as the guidelines of the European Breast Cancer Network (EBCN). Part of the indicators proposed by EBCN could be properly analyzed in women with breast cancer detected by the mammographic screening program of Barretos Cancer Hospital. The intention was to detect problems, evaluate results, and propose improvements to the program. Some of these indicators, including those related to the diagnosis, pathologic analysis and surgical treatment, are described in this article, and are aligned to the recommended by EBCN. These results reflect the quality of a tertiary breast surgery department dedicated to the multidisciplinary approach of breast cancer. However, the time intervals need to be adapted to the national reality, most likely due to the brazilian social aspects. Some key points were mentioned, in order to assist future screening programs in developing countries to outline the analysis of their quality program.
ABSTRACT
As doencas de prionio sao caracterizadas pelo acumulo no cerebro da PrP-sc, uma proteina prionica infectante e protease resistente. A Prp-sc difere da PrP-c, de funcao desconhecida, apenas em termos conformacionais. As doencas humanas de prionio conhecidas sao Kuru, Gertsman Straussler (GSS), Insonia Familiar Fatal(IFF) e doencas de Creutzfeldt-Jakob (CJD)...
Subject(s)
Humans , Schizophrenia/genetics , Prion Diseases/genetics , Psychotic Disorders/genetics , Polymerase Chain Reaction , Dementia/genetics , Gene Amplification/genetics , Sequence Analysis, DNA/methods , DNA Mutational Analysis/methods , Prion Diseases/diagnosisABSTRACT
The theory of field cancerization in tumors of the head and neck reflects the complex oncogenesis that occurs in this region. The mechanisms that control cell proliferation at the molecular level in epidermoid carcinomas (ECs) of the upper aerodigestive tract are still unclear. Mutations in p53 are the genetic alterations most often detected in ECs of the head and neck and seem to contribute actively to the carcinogenic process triggered by p53 as a tumor-suppressor gene and to its association with tobacco. The objective of the present study was to investigate the expression of p53 protein in epidermoid head and neck carcinomas by immunohistochemistry and its immunohistochemical correlation with other prognostic factors. The study was conducted on 63 consecutive ECs cases not submitted to previous treatment. Specimens of the tumor and of the normal adjacent mucosa were collected during surgery and submitted to immunohistochemical reaction for the determination of the expression of anti-protein p53 antibody (M7001 DAKO A/S, Denmark). Anatomo-clinical and demographic data were not significantly correlated with the presence of lymph node metastases or p53 expression in the tumor or in the adjacent normal mucosa. Tumor localization in the larynx was significantly correlated with p53 expression. Histological grading as grades I,II,III and IV was correlated whith significant p53 expression (p = 0.025). Conclusions: 1) in the studied material obtained from 63 cases of head and neck ECs, we detected a 48 percent rate of immunohistochemically detectable p53 overexpression; 2) we did not detect a relationship between demographic patient data and p53 expression in the tumor or in the normal adjacent mucosa; 3) p53 overexpression was significantly more frequent in ECs material from the larynx; and 4) The presence of 12 cases with p53 overexpression in the normal adjacent mucosa and with a p53-negative tumor is in agreement with the theory of field concerization. Follow-up of this patient series for a longer period of time will permit a better analysis of these values.
Subject(s)
Humans , Male , Female , Adult , Middle Aged , Carcinoma, Squamous Cell/genetics , Gene Expression , Genes, p53/genetics , Tumor Suppressor Protein p53/genetics , Head and Neck Neoplasms/genetics , Prognosis , Carcinoma, Squamous Cell/diagnosis , Head and Neck Neoplasms/diagnosis , MutationABSTRACT
A amplificacao do oncogenese e a perda de heterozigose dos genes supressores de tumores tem relacao com o prognostico em uma variedade de tumores humanos. A deteccao de mutacoes nos genes supressores de tumores foi reconhecida para servir como determinante de fator de risco nos adenocarcinomas gastrintestinais.