ABSTRACT
PURPOSE: To evaluate the relationship between microvascular density and the expression of vascular endothelial growth factor (VEGF) and KIT as possible markers of angiogenic stimulus in astrocytic tumors and correlate it with histopathological grading. METHODS: We enrolled 99 surgical specimens of supratentorial astrocytic tumors for analysis of VEGF and KIT and subsequent correlation with MVD and grading. RESULTS: KIT and VEGF expression correlated with microvascular density (p<0.005) and both VEGF and microvascular density correlated with grading (p<0.005). KIT had no significant relationship with grading (p=0.657). CONCLUSION: KIT and VEGF constitute important pathways in the angiogenesis of astrocytomas and therefore are promising prognostic tools and options for therapeutic intervention.
Subject(s)
Adult , Aged , Female , Humans , Male , Young Adult , Astrocytoma/pathology , Neovascularization, Pathologic/pathology , Proto-Oncogene Proteins c-kit/metabolism , Supratentorial Neoplasms/pathology , Biomarkers, Tumor/metabolism , Vascular Endothelial Growth Factor A/metabolism , Age Distribution , Immunohistochemistry , Microvessels/pathology , Neoplasm Grading , Retrospective Studies , Statistics, NonparametricABSTRACT
Introdução: O carcinoma epidermoide da boca e orofaringe apresenta múltiplos fatores histopatológicos e clínicos que explicam suas altas taxas de recorrência loco-regional. Objetivo: Correlacionar a infiltração perineural e o padrão de invasão muscular com a evolução dos pacientes submetidos a tratamento cirúrgico. Método: Após a escolha de 33 casos de acordo com o critério de elegibilidade entre 103 pacientes com tumor avançado, a presença de infiltração perineural e o tipo de invasão muscular foram avaliados. Resultados: Dos 33 casos, 48,5% foram positivos para infiltração perineural, enquanto 84,9% apresentaram invasão muscular. O tipo mais comum de invasão muscular foi cords, com 33,3%. Quando comparada à presença da doença, recorrência da doença e à metástase à distância, a infiltração perineural não mostrou significância estatística. A invasão muscular também não apresentou significância estatística quando comparada à situação. A significância estatística foi observada quando da comparação entre os tipos de invasão muscular e a presença de metástase à distância. Conclusão: Há um pior prognóstico para casos com invasão muscular do tipo dissociation. Pacientes com infiltração perineural e invasão muscular apresentam uma menor taxa de sobrevivência.
Introduction: Oral and oropharyngeal squamous cell carcinoma presents multiple clinical and histopathological factors, which explain its high rates of loco-regional recurrences. Objective: To correlate perineural infiltration and muscular invasion pattern in advanced mouth and oropharynx squamous cell carcinoma, with the outcome of patients who underwent surgical treatment. Method: Thirty-three cases were selected from 103 patients with advanced tumors, according to the eligibility criteria. The presence of per neural infiltration and the type of muscular invasion were evaluated. Results: From the 33 cases, 48.5% were positive for per neural infiltration, whereas 84.9% presented muscular invasion. The most common type of muscular invasion was the cords type, with 33.3%. When compared to the presence of the disease, the recurrence of the disease and distance metastasis, per neural infiltration did not show any statistical significance. The muscular invasion did not present any statistical significance when compared to the KPS as well. Statistical significance was observed when comparing the types of muscular invasion and the presence of distance metastasis. Conclusion: There is a worse prognosis for cases with muscular invasion classified as dissociation. Patients with perineural infiltration and muscular invasion present a lower survival rate.
ABSTRACT
OBJETIVOS: Caracterizar o perfil de imunoexpressão de MLH1, MSH2, MSH6 e PMS2 em adenocarcinomas gástricos, explorando seu desempenho na identificação de características clínicas e patológicas, bem como sua influência prognóstica isolada e em relação aos demais parâmetros. MÉTODOS: Cento e trinta e três casos de adenocarcinomas gástricos esporádicos localmente avançados (pT2a ou mais) operados no Hospital das Clínicas/FMUSP foram incluídos pela ausência de metástases a distância ao diagnóstico (M0) e caracterizados clínica (idade, sexo e sobrevida) e patologicamente (tamanho, local, tipo de Borrmann, tipo histológico, infiltração vascular, perineural e variáveis de estadiamento locorregional). Amostras de 1,0 mm foram dispostas em micromatrizes teciduais (TMA) para pesquisa imuno-histoquímica das enzimas MLH1, MSH2, MSH6 e PMS2, com detecção por sistema de polímeros curtos conjugados a peroxidase. Casos com resultados negativos ou incertos nas amostras de TMA tiveram repetidas as reações em secções convencionais. A associação entre o estado de expressão dos marcadores com variáveis clínicopatológicas foi avaliada através do teste do qui-quadrado ou exato de Fisher. O impacto dos parâmetros clínico-patológicos e estado de expressão das enzimas na sobrevida foi explorado em modelos uni e multivariados de Cox, com construção de curvas de Kaplan-Meyer. Todas as análises estatísticas foram consideradas significativas ao nível de p<0,05. RESULTADOS: Quarenta e cinco casos (33,6%) exibiram perda de expressão de ao menos uma enzima, sendo frequente a perda de duas (9/45: 20%), três (14/45:31,2%) ou quatro enzimas (7/45:15,5%). Anormalidade mais frequente ocorreu com o MLH1 (26,7%), seguida de MSH6 (23%), PMS2 (21%) e MSH2 (20,8%). Quando avaliadas em conjunto, houve correlação entre o estado de expressão de todos os possíveis pares, com destaque para MLH1/PMS2 (rho=0,467, p<0,001) e MSH2/MSH6 (rho=0,666, p<0,001). Perda de MLH1 associou-se a tipos I/II de Borrmann...
OBJECTIVES: To characterize immunoexpression profile of MLH1, MSH2, MSH6 e PMS2 in gastric adenocarcinomas, exploring its performance to identify distinctive clinico-pathological features, as well as their prognostic implications in univariate and multivariate analyses. METHODS: A hundred and thirty three cases of locally advanced (pT2a or higher) sporadic gastric adenocarcinomas operated on Hospital das Clínicas/FMUSP were included due to absence of distant metastases at diagnosis (M0). Clinical (age, gender and survival) and pathological features (size, local, Borrmann´s type, histological type, vascular and perineural infiltration and locorregional staging parameters) were characterized. One millimeter samples were placed on tissue microarray blocks (TMA) and immunohistochemical detection of MLH1, MSH2, MSH6 and PMS2 performed on obtained sections, with revelation developed by peroxidase conjugated short-polymer based reagents. Negative or equivocal results obtained with TMA samples were repeated on conventional sections. Association between expression status for these markers and clinico-pathological features were evaluated by chisquare or Fisher´s exact test when appropriate. Impact of clinico-pathological features and expression status on disease specific survival were explored by Cox uni and multivariate models, with Kaplan-Meyer curves being fitted to illustrate these. All statistical results were considered significant at p<0,05. RESULTS: Forty five cases (33.6%) showed loss of at least one mismatchrepair enzyme, being frequent loss of two (9/45: 20%), three (14/45:31.2%) or even the four evaluated enzymes (7/45:15.5%). The most frequent abnormality addressed MLH1 (26.7%), followed by MSH6 (23%), PMS2 (21%) and MSH2 (20.8%). When analyses were performed in conjunction, correlation was identified for the expression status of all possible pairs, mainly the functional heterodimers MLH1/PMS2 (rho=0.467, p<0.001) and MSH2/MSH6 (rho=0.666, p<0.001)...