Caracterización del infiltrado linfocitario (CD, CD4, CD8, CD45RO y FOXP3) e inestabilidad microsatelital en pacientes con cáncer colorrectal / Lymphocyte infiltration and microsatellite instability in colorectal cancer patients

Background: In colorectal cancer (CRC) patients, lymphocyte infiltration (LI) and microsatellite instability (MSI) have been associated with better prognosis. Aim: To analyze the association between components of LI (CD3/CD4/CD8/CD45R0/FoxP3) and MSI status with metastatic stages in CRC patients. Material and Methods: Prospective study of 109 patients diagnosed with CRC. The expression of CD3, CD4, CD8, CD45R0 and FoxP3 markers, was evaluated by immunohistochemical analysis, and tumors were classified into negative, low and intense expression. The MSI was assessed with seven markers amplified by PCR from normal and tumoral DNA. Tumors were grouped in MSS (stable)/MSI-low and MSI-high. Statistical analysis was performed with Fischer's exact test. Results: 29 percent, 28 percent, 12 percent and 86 percent of tumors exhibits intense expression of CD3+, CD4+, CD8+ and CD45RO+ lymphocytes, respectively. 84 percent of the tumors presented MSS/ MSI-low and 16 percent had MSI-high. Tumors that show a high density of T cells (CD3+, CD4+ y CD45R0+) are associated with early stage tumors (I and II) (p = 0.023; p = 0.030 and p = 0.003, respectively). Additionally, there was a significant association between the MSS/MSI-low tumors and a reduced ability to recruit CD8+ cytotoxic T lymphocytes (p = 0.037) and CD3+ (p = 0.064). Conclusion: There is an association between high densities of CD3+, CD4+ and CD45RO+ lymphocytes and non-metastatic tumors. In addition, MSS/ MSI-low tumors are associated with a lower recruitment of CD8+ and CD3+ lymphocytes.

Introducción: En el cáncer colorrectal (CCR), se sugiere que un mejor pronóstico podría asociarse a una respuesta inmune antitumoral (del huésped) y/o a la presencia de una alta inestabilidad microsatelital (MSI). Objetivo: Determinar si los niveles de expresión de los marcadores de linfocitos T (CD3/CD4/CD8/ CD45RO/FoxP3) y el estado de MSI se asocian a estadios metastásicos en pacientes con CCR. Material y Método: Estudio prospectivo de 109 pacientes con diagnóstico de CCR. El análisis de expresión de los marcadores CD3/CD4/CD8/CD45RO/FoxP3 fue realizado por inmunohistoquímica; los tumores fueron clasificados en negativo, débil e intenso. La MSI fue evaluada con siete marcadores amplificados desde ADN normal y tumoral; los tumores fueron agrupados en: MSS (estable)/MSI-baja y MSI-alta. El análisis estadístico fue realizado con el test exacto de Fischer. Resultados: Una intensa expresión de los marcadores CD3+, CD4+, CD8+ y CD45RO+, fue observada en el 29 por ciento, 28 por ciento, 12 por ciento y 86 por ciento de los tumores, respectivamente. El 16 por ciento de los tumores presentó MSI-alta. Los tumores que presentan una alta densidad de linfocitos T (CD3+, CD4+ y CD45RO+) se asocian a estadios tempranos I-II (p = 0,023; p = 0,030 y p = 0,003, respectivamente). Adicionalmente, se identificó una asociación estadística significativa entre los tumores con MSS/MSI-baja y una menor capacidad de reclutar linfocitos T citotóxicos CD8+ (p = 0,037) y totales CD3+ (p = 0,064). Conclusión: Existe una asociación entre altas densidades de linfocitos T CD3+, CD4+ y CD45RO+ y tumores con estadios no metastásicos. Además, tumores con MSS/MSI-baja se asocian a un menor reclutamiento de linfocitos T CD8+ y CD3+.

Comprehensiveness and programmatic vulnerability to stds/hiv/aids in primary care / La integralidad y vulnerabilidad programática de las ets/vih/sida en la atención básica / A integralidade e a vulnerabilidade programática às DST/HIV/AIDS na Atenção Básica




This study aimed to identify programmatic vulnerability to STDs/HIV/AIDS in primary health centers (PHCs). This is a descrip - tive and quantitative study carried out in the city of São Paulo. An online survey was applied (FormSUS platform), involving administrators from 442 PHCs in the city, with responses received from 328 of them (74.2%), of which 53.6% were nurses. At - tention was raised in relation to program - matic vulnerability in the PHCs regarding certain items of infrastructure, prevention, treatment, prenatal care and integration among services on STDs/HIV/AIDS care. It was concluded that in order to reach comprehensiveness of actions for HIV/ AIDS in primary health care, it is necessary to consider programmatic vulnerability, in addition to more investment and reor - ganization of services in a dialogue with the stakeholders (users, multidisciplinary teams, and managers, among others).


.

Objetivo Fue identificar la vulnerabilidad programática de las Unidades Básicas de Salud con la atención a las ETS/VIH/SIDA. Método Es un estudio descriptivo con un abordaje cuantitativo llevado a cabo en el Municipio de San Pablo. Fue utilizado un formulario online (el FormSUS) con los gerentes de las 442 Unidades Básicas de Salud del Municipio de San Pablo. Participaran en el estudio 74.2% de los gerentes, estos 53.6% eran enfermeros. Resultados Se destaca la vulnerabilidad programática de las Unidades Básicas de Salud en relación a algunos elementos de la infraestructura, acciones de prevención, tratamiento, prenatal y la integración entre los servicios en la atención a las ETS/VIH/SIDA. Conclusión La construcción de tales marcadores constituye un instrumento, presentado en otro artículo, el cual puede ayudar a apoyar la captura de vulnerabilidades de las mujeres en relación a las ETS/VIH en el contexto de los servicios de Atención Primaria de Salud. Los marcadores constituyen importante herramienta para operacionalizar el concepto de vulnerabilidad en la Atención Primaria. Además, promueven procesos de trabajo inter e multidisciplinar e inter e multisectorial. La propuesta de un instrumento basado en dichos marcadores puede apoyar la captura de la vulnerabilidad de las mujeres en relación a las ETS/VIH. .

Objetivo Identificar a vulnerabilidade programática às DST/HIV/aids na Atenção Básica para o enfrentamento do HIV/Aids. Método Estudo descritivo, com abordagem quantitativa, realizado no Município de São Paulo (MSP). Utilizou-se formulário online (FormSUS), com gerentes das 442 Unidades Básicas de Saúde (UBS) do MSP. Participaram do estudo 74,2% gerentes, dos quais 53,6% eram enfermeiros. Resultados Destaca-se a vulnerabilidade programática nas UBS com relação a alguns itens de infraestrutura, ações de prevenção, de tratamento, no pré-natal e de integração entre os serviços na atenção às DST/HIV/aids. Conclusão Para a efetivação da integralidade no enfrentamento do HIV/aids na Atenção Básica é necessário atentar para a vulnerabilidade programática, além de mais investimentos e reorganização dos serviços, num diálogo com os atores sociais envolvidos (usuários, equipe multiprofissional, gerentes, gestores, entre outros).


 .

Baixas doses de 5-fluorouracil aumentam a atividade antitumoral de células dendríticas transfectadas com RNA de células de câncer colorretal / Low concentration of 5-fluorouracil enhances the effectiveness of RNA-transfected antitumor dendritic cells

O câncer colorretal (CCR) um dos principais tipos de tumor em todo mundo. Em alguns casos observa-se forte influência hereditária em seu desenvolvimento nas formas familiares, enquanto que na maioria dos pacientes (85%) essa doença se apresenta na forma esporádica, cuja origem é multifatorial, com grande influência da alimentação, tabagismo e etilismo, além de processos inflamatórios crônicos. Seu tratamento convencional consiste em intervenção cirúrgica acompanhada de terapias com doses elevadas de drogas citotóxicas. Apesar dessa intervenção radical, recidivas em pacientes com CCR são muito freqüentes, apontando para a necessidade de abordagens mais efetivas e para a possibilidade de combinação de diferentes formas de tratamento. Dada a importância do CCR como problema de saúde pública e da possibilidade de modulação do sistema imunológico dos pacientes, o presente trabalho é apresentado em dois capítulos, sendo o primeiro uma revisão de literatura sobre a doença propriamente dita, abordando os tratamentos empregados, a influência da resposta inflamatória em sua gênese e o papel da resposta imunológica na doença. Essa revisão foi redigida de acordo com as normas da revista Cancer Science. O segundo capítulo, redigido seguindo as normas da revista Cancer Immunology, Immunotherapy, refere-se ao desenvolvimento do estudo experimental, no qual foi avaliada a eficiência funcional de células dendríticas (DCs) humanas transfectadas com RNA total de células tumorais pré-tratadas com concentrações não tóxicas ou efetiva mínima de 5-fluorouracil (5-FU). Os resultados obtidos indicam que a transfecção das DCs com RNA de células tumorais expostas à droga aumenta sua capacidade de apresentação de antígenos alogênicos aos linfócitos T e de indução de resposta tumor-específica (geração in vitro de linfócitos T citotóxicos e produção de INF-γ)...

Colorectal cancer (CRC) is one of the most frequent tumor types worldwide, mainly in developed countries, and can be classified as inheritedfamilial (25%) or sporadic (75%) forms, which suggest an important relationship of gene-gene and gene-environment interactions in the development of the disease. CRC is characterized by genetic and epigenetic alterations, and is histologically featured by the infiltration of inflammatory cells among malignant and stromal cells. The most common inflammatory cells in tumor tissue are neutrophils, mast cells, natural killer cells, macrophages and dendritic cells as well as lymphocytes. However, the presence of these cells in CRC can both be associated with cancer inhibition and tumor progression, since the development a chronic inflammatory response can be a predisposal condition for the development of this type of cancer. Considering these multifactorial aspects of CRC development, in this review we present data on the main genetic and epigenetic aspects, and the influence of diet and inflammation on tumor progression...

Inhibitory effect of antibodies against human chorionic gonadotropin on the growth of colorectal tumour cells.

Human chorionic gonadotropin (hCG) was initially believed to be secreted exclusively by the embryo with its primary function being “rescue” of the corpus luteum. However, recently it has been found that the hormone (or its individual subunits) is also secreted by many cancers and that in many cases secretion is associated with poor patient prognosis. In this study, we assessed the presence of hCG in colorectal cancer cells (CCL-253) and evaluated the anti-tumour effects of anti-hCG antibodies in vitro and in vivo. Anti-hCG antibodies were reactive with CCL-253, as revealed by confocal immunoflourescence microscopy; both cell surface and intracellular expression were observed. Western blot analysis showed that antibodies appeared to interact with several moieties, indicating a level of cross-reactivity. Anti-hCG antiserum specifically reduced the viability of tumor cells and the addition of complement increased in vitro anti-tumor effects. In nude mice implanted with CCL-253 cells, administration of anti-hCG antiserum caused a significant reduction in tumor volume; all treated animals survived, while mortality was observed in control animals. Results suggest that anti-hCG antibodies can mediate significant anti-tumor activity both in vitro and in vivo and lend support to the rationale of anti-hCG immunization in the therapy of gonadotropin- sensitive cancers.

Gut Microbial Influence and Probiotics on Colorectal Cancer / 대한소화기학회지

The human intestinal microbiota is a community of 10(13)-10(14) microorganisms that harbor in the intestine and normally participate in a symbiotic relationship with human. Technical and conceptual advances have enabled rapid progress in characterizing the taxonomic composition, metabolic capacity and immunomodulatory activity of the human intestinal microbiota. Their collective genome, defined as microbiome, is estimated to contain > or =150 times as many genes as 2.85 billion base pair human genome. The intestinal microbiota and its microbiome form a diverse and complex ecological community that profoundly impact intestinal homeostasis and disease states. It is becoming increasingly evident that the large and complex bacterial population of the large intestine plays an important role in colorectal carcinogenesis. Numerous studies show that gut immunity and inflammation have impact on the development of colorectal cancer. Additionally, bacteria have been linked to colorectal cancer by the production of toxic and genotoxic bacterial metabolite. In this review, we discuss the multifactorial role of intestinal microbiota in colorectal cancer and role for probiotics in the prevention of colorectal cancer.

Níveis séricos pré-operatórios dos marcadores CEA e CA19-9 e imunoexpressão tecidual do marcador CA19-9 no carcinoma colorretal: relação com os aspectos morfológicos da neoplasia / Pre-operative sera levels of CEA and CA19-9 and tissular distribution of tumor marker CA19-9 in colorectal carcinoma: correlation with morphological features of neoplasia

OBJETIVO: Comparar os níveis séricos de CA19-9 e CEA e a expressão tecidual do CA19-9 e relacioná-los com os aspectos morfológicos do carcinoma colorretal. MÉTODOS: Quarenta e cinco pacientes com carcinoma colorretal foram operados com coleta de CEA e CA19-9 séricos pré-operatórios. Valores séricos de CEA = 5,0ng/mL e de CA19-9 = 37UI/mL foram considerados aumentados. A avaliação da imunoexpressão do CA19-9 no tecido neoplásico foi realizada por meio de estudo imunoistoquímico com anticorpo monoclonal anti-CA19-9. A intensidade de expressão do CA19-9 no tecido neoplásico foi semiquantificada em leve(+/+++), moderada(++/+++), intensa(+++/+++) e ausente. RESULTADOS: Os valores do CA19-9 sérico foram progressivamente maiores conforme o aumento da expressão do CA19-9 no tecido neoplásico, porém sem significância (p=0,06). O aumento do nível sérico do CA19-9 foi acompanhado de elevação significante (p<0,001) do nível sérico do CEA. O nível sérico do CA19-9, a imunoexpressão tecidual do CA19-9 e o nível sérico do CEA não apresentaram associação significante com características morfológicas do carcinoma colorretal. CONCLUSÃO: As expressões sérica e tissular do CA19-9 demonstraram relação diretamente proporcional entre si, enquanto que os aspectos morfológicos da neoplasia não tiveram influência no CEA e CA19-9 séricos ou na imunoexpressão do CA19-9 tissular.

OBJECTIVE: To compare sera levels of CEA and CA19-9 and tissular expression of the CA19-9 and to correlate these with morphological features of the colorectal carcinoma. METHODS: Forty five patients with colorectal carcinoma underwent surgical treatment following measurement of pre-operative levels of CA19-9 and CEA. Sera levels of CEA = 5.0ng/ml and CA19-9 = 37UI were deemed high values. Evaluation of CA19-9 immunoexpression in neoplastic tissue was carried through by means of immunohistochemical study with monoclonal antibody anti-CA19-9. The intensity of expression of CA19-9 in neoplastic areas was semi-quantified in each area of tumor differentiation into mild(+/+++), moderate(++/+++), intense(+++/+++) or absent. RESULTS: Sera CA19-9 values were progressively higher in the presence of elevated CA19-9 immunoexpression in colorectal carcinoma tissue, although not significant (p=0.06). Increased sera CA19-9 levels were found to be associated with significantly elevated (p<0.001) sera CEA levels. Levels of sera CA19-9, tissular immunoexpression of CA19-9 and sera levels of CEA presented no significant association with morphological features of the colorectal carcinoma. CONCLUSION: Sera and tissular levels of the CA19-9 marker exhibited, each other, a directly proportional relationship. The morphological features of the neoplasia had no influence on sera CEA or CA19-9 levels or tissular immunoexpression of CA19-9.

Study of relationship between p53 protein stability and pathological parameters in colorectal cancer by immunohistochemistry method

Genetic damages and dietary habits play important parts in colorectal cancer [CRC]. p53 protein, a product of p53 gene, is the most important tumor suppressor. The rate of p53 mutation and expression has been variously reported across anatomical regions. p53 protein has a short half-life which tends to increase with mutation and is likely to be traced by immunohistochemistry. This study is intended to determine the p53 protein stability by pathological parameters across different areas in CRC. This descriptive analytical research was conducted on 80 CRC cases admitted to Hospital in Isfahan, Iran from 2003 to 2007. p53 expression was detected by immunohistochemical methods in the samples after fixation, tissue processing and antigen retrieval. The obtained data were analyzed using chi-square. of the 80 specimens investigated, p53 protein stability was observed in 27 specimens [34%]. No significant relationships were observed between p53 protein stability and tumor staging, differentiation and anatomical regions [colon and rectum] but the relationship between protein stability and mutation was significant. p53 protein stability was observed in many mutated samples. Therefore, p53 protein detection in Cancer cases can be considered an important symptom of mutation signifying the prognosis and progress of cancer

Tipificación del epitelio colorrectal por lectinhistoquímica: expresión del glicotope T / Typing of colorectal epithelium by lectin histochemistry if the T glycoepitope

El presente estudio refiere a una nueva herramienta que permite detectar fechaciente y tempranamente la naturaleza maligna del epitelio colorrectal. El objetivo es determinar una característica biológica diferente entre tejido normal y neo-plásico, como es el nivel de expresión del glicoepitope T (Ag Thomsen-Friedenreich). Se lo caracterizó en una serie de 62 muestras del tejido en estudio, incluyendo 31 normales (sin lesiones anatomopatológicas) y 31 correspondientes a cánceres (en su mayoría moderada o pobremente diferenciados). La expresíon del glicoconjugado se demostró por tectínhistoquímica, usando lectina PNA. Los patrones de unión de lectina fueron determinados en células absortivas (cilídricas) y caliciformes, normales y neoplásicas, encontrándose patrones característicos y diferentes según tipo de célula y naturaleza del tejido. El análisis estadístico de la localización citoestructural del Ag T en ambas poblaciones sugiere fuertemente que existe asociación entre el patrón de expresión y el grado de diferenciación tisular. La sencillez de la metodología hace a la determinación aplicable en diagnóstico de rutina y además tiene importante valor pronóstico.

Expresión de isoantígenos glucoconjugados ABH en neoplasias gastrointestinales / Expression of glycoconjugated ABH isoantigens in gastrointestinal neoplasia

El tejido epitelial gastrointestinal normal presenta estructuras glicoesfingolipídicas que son propias de los antígenos ABH, las cuales confieren propiedades biológicas esenciales, dirigen el recambio y el tráfico transcelular y tienen gran importancia para la interacción entre células durante el desarrollo, crecimiento y diferenciación. Está descripto que la glicosilación aberrante es un atributo común del crecimiento neoplásico y uno de los principales determinantes del fenómeno relacionado con el cáncer, como es el crecimiento invasivo de la metástasis. El objetivo de este trabajo fue estudiar la expresión de los antígenos ABH en células epiteliales de neoplasias gastrointestinales. Se trabajó con catorce muestras de tumores gastrointestinales en tacos de parafina aplicando la técnica SRCA (Specific Red Cell Adherence). Se demostró que en 13 de las 14 muestras hubo pérdida total o parcial, o cambio de la expresión antigénica

The significance of CD44 variants expression in colorectal cancer and its regional lymph nodes

CD44 is a cell adhesion molecule with numerous isoforms created by mRNA alternative splicing. Expression of CD44 variants has been suggested to play a potential role in tumor progression and metastasis. We designed primers CD44V, CD44V6/7, CD44R1 and CD44V6-10 to analyze and compare the roles of each CD44 variants. Expressions of CD44 variants were investigated in normal colonic mucosa, the lymph nodes which was histopathologically free of cancer cell, and cancer tissues of 44 human colorectal cancer patients by RT-PCR method. The expression of CD44V was observed in 28 out of 39 (71.8%) tumors and 7 out of 11 (63.6%) N1 normal regional lymph nodes, and CD44V6/7 was observed in 28 out of 39 (71.8%) tumors and 9 out of 11 (81.8%) N1 normal regional lymph nodes. The expressions of CD44V and CD44V6/7 were most frequently observed compared with any other CD44 variants. In normal colonic mucosa, the expression of CD44 variants are low but in cancer tissue and its regional lymph node, the expression of CD44V and CD44V6/7 were significantly higher and more frequent than any other CD44 variants (p<0.05). These results suggest that CD44V and CD44V6/7 can be a molecular marker for colorectal cancer and its micrometastasis to the regional normal lymph node.

Chicken egg yolk anti-asialoGM1 immunoglobulin (IgY): an inexpensive glycohistochemical probe for localization of T-antigen in human colorectal adenocarcinomas.

A egg yolk polyclonal IgY has been prepared by immunization of white leghorn chickens with small unilamellar liposomal asialoGM1. The newly prepared anti-asialoGM1 IgY has been characterized to be specific toward the terminal carbohydrate moiety of asialoGM1, and has no cross reactivity to its sialylated counterpart (ganglioside, GM1) as evidenced by immunochromatographic studies. General glycohistochemical methods along with antigen specific lectin and immunohistochemical staining using anti-asialoGM1 IgY were used to study the expression of Thomsen-Friedenreich (T-) disaccharide antigen in human colorectal adenocarcinoma tissues. The expression of T-antigen in colon cancer tissue was detected by two T-disaccharide specific probes, chicken anti-T-yolk antibody (IgY) and Artocarpus integrifolia lectin (AIL) and was found to be more pronounced in both the secreted mucin as well as the cytoplasmic mucin deposits. These immunochemical detection methods for T-antigen showed a weaker correlation with other glycostaining methods using, alcian-blue/periodic acid-Schiff (AB-PAS) and high iron diamine (HID). However, a general enzymatic staining for galactose and galactosamine containing glycoconjugates, by galactose oxidase-Schiff method, showed a good correlation with T-antigen detection. While the T-beta specific anti-asialoGM1 could localize T-antigen in 11 of 13 (84%) human colorectal adenocarcinoma tissue sections tested, the T-alpha specific AIL could localize the T-antigen in only 6 of the tissues (46%). These observations confirm previously reported findings, of the prevalence of T-beta conformation in colon cancer, that binds significantly more with the anti-asialoGM1 IgY than with the T-alpha specific AIL. Hence, both anti-T IgY and the AIL immunohistochemical probes may have useful diagnostic value because of the ease of preparation and cost effectiveness, but the T-beta specific anti-asialoGM1 probe (IgY) would have a better prognostic value in colon adenocarcinomas.

Antígeno carcinoembrionário elevado e ausência de recorrência na monitorizaçäo do câncer colorretal / Elevated carcinoembryonic antigen and absence of recurrence in monitoring colorectal cancer

O antígeno carcinoembrionário tem sido utilizado na monitorizaçao de doentes tratados com câncer colorretal, com a finalidade de detectar recorrências; no entanto, níveis elevados nem sempre correspondem à doença em atividade. Em estudo anterior 21 por cento dos doentes operados com câncer colorretal e com antígeno carcinoembrionário elevado nao apresentavam recorrência. Nosso objetivo foi acompanhar a evoluçao destes doentes. Cinco dos 32 pacientes estudado foram excluidos, os 27 restantes sem sinais de recorrência clínica aos exames de rotina foram acompanhados. O antígeno carcinoembrionário foi detectado por ELISA. Sorine Biomédica, valor nl. até 5 ng/ml. Raio-X de tórax, tomografia computadorizada de abdome e colonoscopia foram realizadas no acompanhamento. Onze pacientes (41 por cento) apresentaram recorrência, sendo em sete, hepática. O tempo decorrido entre o primeiro antígeno carcinoembrionário elevado e o diagnóstico da recorrência foi de 6,6 meses em média. Dezesseis nao mostraram sinais de recorrência, oito apresentaram normalizaçao do antígeno carcinoembrionário e oito persistiram com níveis séricos altos. Níveis elevados de antígeno carcinoembrionário podem antecipar o diagnóstico de recorrência por outros métodos, principalmente nas matástases hepáticas. No entanto um percentual de doentes com antígeno carcinoembrionário elevado persiste sem causa aparente.

Tratamento coadjuvante do câncer do reto: III: Imunoterapia / Adjuvant treatment in rectal cancer: III: Immunoterapy

Apesar dos resultados ainda pouco convincentes, a imunoterapia tem sido incluída em muitos ensaios clínicos como nova e promissora modalidade adjuvante de terapêutica do câncer colorreta, näo só para eliminar micro focos implantados de células neoplásicas como também para destruir as células cancerosas, circulantes. Embora haja muito para ser elucidado a respeito a inter-relaçäo do sistema imunológico com o câncer, os conhecimentos atuais sobre a resposta imune, seus modificadores biológicos e a possibilidade de produçäo laboratorial dessas substâncias naturais, por meio da engenharia genética e de técnicas de hibridoma, criam amplas perspectivas de se poder agir no sistema imunológico e na antienicidade tumoral criando, assim, uma nova, potente e específica arma auxiliar na terapêutica do câncer humano, mormente do câncer colorretal. Nesse campo, a imunoterapia cai em três principais categorias: 1) modificadores de resposta imune, 2) anticorpos monoclonais e 3) vacinas. Os modificadores da resposta imune säo substâncias intrínsecas (modificadores biológicos) tais como as interleucinas, os interferons e o fator de necrose tumoral, que exercem influências em diferentes estágios da resposta imune; ou extrínsecos, como o BCG, C. parvum, endotoxinas, outros produtos bacterianos e o levamisol, que, também, agem estimulando, de maneira específica, a resposta imune. Os anticorpos monoclonais säo anticorpos puros que podem, produzidos em grande quantidade, ser dirigidos, de forma específica, contra antígenos tumorais. Ligados à isótopos radioativos, säo usados para localizar grupos de células cancerosas em qualquer parte do organismo e, portanto, cumprem papel no diagnóstico; assim como, quando ligados às drogas anticancerosas ou às toxinas naturais, eles podem servir como carregador dessas substâncias até aos focos neoplásicos , no desempenho de auxílio à terapêutic. As vacinas, em fase inicial de aquisiçäo de conhecimentos, estäo sendo desenvolvidas e testadas para prevenir a recidiva de câncer em pacientes previamente tratados, ou para estimular a resposta imune do paciente a um tipo específico de câncer

Expresión inmunohistoquímica de la oncoproteína p53 en adenomas y adenocarcinomas del intestino grueso / Immunohistochemical expression of p53 oncoprotein in large bowel adenomas ans carcinomas

Material and methods: A random sample of 28 large bowel adenomas and 44 carcinomas was studied. Determination of p53 protein was made with an immunohistochemical method using monoclonal antibodies. Patients were followed for a mean of 36 months (range 1 to 100 months). Results: p53 immunostaining was obtained in one adenoma (3.5 percent) and in 18 carcinomas (41 percent, p = 0.01). There were no differences in survival during follow up, between cancer patients that expressed or did not express p53 protein. Conclusions: About half of colorectal tumors have immunohistochemical expression of p53 protein, as published abroad. We did not find a prognostic value for this protein in our sample

Value of tissue carcinoembryonic antigen in patients with colorectal carcinoma.

The tumours of 55 patients with colorectal carcinoma were evaluated for tissue carcinoembryonic antigen (CEA) by immunoperoxidase staining. It was shown that 33/35 patients with increased preoperative serum CEA levels above 5 ng/ml had positive tissue CEA. The other 17/20 patients who had serum CEA levels less than 5 ng/ml could be demonstrated CEA in tissue. The results of tissues CEA were compared with their preoperative serum CEA levels in the pathologic grading, histologic type and staging of cancer. It was found that tissue CEA was more sensitive than serum CEA and was correlated with serum CEA in all respects. The finding in this study suggests that tissue CEA should be performed along with preoperative serum CEA in all patients suspected of having colorectal carcinoma. The postoperative serum CEA should be determined serially in the patients who have more than 5 ng/ml serum CEA and/or tissue CEA positive although their preoperative serum CEA is less than 5 ng/ml.