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1.
Medicina (B.Aires) ; 81(4): 652-655, ago. 2021. graf
Article in Spanish | LILACS | ID: biblio-1346521

ABSTRACT

Resumen La hemofilia adquirida A es un desorden hemorrágico inusual de origen autoinmune que resulta en la formación de autoanticuerpos dirigidos contra el factor VIII de la coagulación. Estos autoanticuer pos pueden actuar neutralizando parcial o completamente la activación o función del factor, o también pueden acelerar su eliminación de la circulación. La incidencia mundial de la enfermedad es de 1.5 casos por millón de habitantes por año. En cerca del 50% de los pacientes se puede detectar una enfermedad subyacente que se presume responsable de la producción de los autoanticuerpos. Se presenta el caso de un varón con hemofilia adquirida A, en contexto de adenocarcinoma de la ampolla de Vater.


Abstract Acquired hemophilia A is an unusual bleeding disorder of autoimmune origin resulting in the formation of autoantibodies directed against coagulation factor VIII. These autoantibodies can act by partially or completely neutralizing the activation or function of the factor, or they can also accelerate its elimination from the circulation. The global incidence of the disease is 1.5 cases per million inhabitants per year. In nearly 50% of cases, an underlying disease that is presumed responsible to produce autoantibodies can be detected. We report a case with acquired hemophilia A, in a patient with Vater's ampulla adenocarcinoma.


Subject(s)
Humans , Ampulla of Vater , Adenocarcinoma/complications , Adenocarcinoma/diagnosis , Common Bile Duct Neoplasms , Hemophilia A/complications , Hemophilia A/diagnosis , Autoantibodies
2.
Revagog (Impresa) ; 3(2): ´54-59, Abr-Jun. 2021. tab
Article in Spanish | LILACS, LIGCSA | ID: biblio-1344615

ABSTRACT

Con el objetivo de realizar la caracterización epidemiológica del cáncer de mama de las pacientes que asisten a la consulta externa de ginecología oncológica en el Instituto Guatemalteco de Seguridad Social (IGSS) de enero a marzo de 2,018, se realizó un estudio descriptivo transversal en 155 pacientes que acudieron a la clínica de mama del Hospital de Gineco Obstetricia del IGSS, con una media de edad de 62 años, el adenocarcinoma ductal infiltrante es el tipo histológico más frecuente en nuestra población tanto en edad reproductiva como en menopausia. Como factor protector el 69% dio lactancia materna. La etapa clínica más comúnmente diagnosticada es IIA. El Luminal A, el más frecuentemente diagnosticado por inmunohistoquímica, seguido del Luminal B y HER2neu. Se diagnostican pacientes mayormente en etapas clínicas tempranas (I y II).


In order to carry out the epidemiological characterization of breast cancer in patients attending the outpatient gynecology oncology consultation at the Guatemalan Social Security Institute (IGSS) from January to March 2018, a descriptive cross-sectional study was carried out in 155 patients who attended the breast clinic of the IGSS Obstetrics Gynecology Hospital, with a mean age of 62 years, infiltrating ductal adenocarcinoma is the most frequent histological type in our population both in reproductive age and in menopause. As a protective factor, 69% breastfed. The most diagnosed clinical stage is IIA. Luminal A, the most frequently diagnosed by immunohistochemistry, followed by Luminal B and HER2neu. Patients are diagnosed mostly in early clinical stages (I and II).


Subject(s)
Humans , Female , Adult , Middle Aged , Breast Neoplasms/diagnosis , Breast Neoplasms/epidemiology , Adenocarcinoma/diagnosis , BRCA1 Protein/analysis , BRCA2 Protein/analysis , Breast Feeding , Breast Neoplasms/prevention & control , Epidemiologic Studies , Risk Factors , Postmenopause/physiology
3.
J. coloproctol. (Rio J., Impr.) ; 41(2): 210-214, June 2021. ilus
Article in English | LILACS | ID: biblio-1286996

ABSTRACT

Abstract Jejunal adenocarcinoma is a rare type of primary small bowelmalignancy. It is generally diagnosed at late stages and as a surgical finding, with abdominal pain or discomfort being the main associated symptom. Cases presenting with perforation are even rarer, especially without disseminated disease. The relationship between cancer and coronavirus disease 2019 (COVID-19) is still being studied, as well as the postsurgical evolution of COVID-19 patients and its possible causality of intestinal perforation. We present the case of a perforated jejunal adenocarcinoma in a COVID-19-positive patient, in whom the symptomatology secondary to the perforation led to an early diagnosis, treatment and adequate postsurgical evolution, despite the concomitant condition.


Resumo O adenocarcinoma jejunal é um tipo raro de malignidade primária do intestino delgado, o qual geralmente é diagnosticado em estágios tardios e como achado cirúrgico, sendo a dor ou o desconforto abdominal o principal sintoma associado. Casos que apresentam perfuração são ainda mais raros, principalmente sem doença disseminada. A relação entre câncer e a cornonavirus disease 2019 (covid-19) ainda está sendo estudada, assim como a evolução pós-cirúrgica de pacientes com covid-19 e sua possível causalidade de perfuração intestinal. Apresentamos o caso de um adenocarcinoma jejunal perfurado em um paciente positivo para covid-19, em que a sintomatologia secundária à perfuração levou a um diagnóstico precoce, tratamento e evolução pós-cirúrgica adequada, apesar da condição concomitante.


Subject(s)
Humans , Female , Adenocarcinoma/diagnosis , COVID-19 , Intestinal Perforation , Adenocarcinoma/surgery , Intestinal Neoplasms
4.
Medisan ; 25(2)mar.-abr. 2021. tab
Article in Spanish | LILACS, CUMED | ID: biblio-1250348

ABSTRACT

Introducción: El cáncer gástrico ocupa el quinto lugar en incidencia de todos los tipos de neoplasias malignas y la segunda causa de muerte por cáncer en el mundo, pues la mayoría de los pacientes presentan más de 60 años de edad al ser diagnosticados. Objetivo: Caracterizar a ancianos con cáncer gástrico según variables de interés. Métodos: Se realizó un estudio observacional y descriptivo, de serie de casos, de 56 pacientes mayores de 60 años con diagnóstico endoscópico e histológico de cáncer gástrico, quienes fueron ingresados en el Hospital Provincial Clínico-Quirúrgico Docente Saturnino Lora de Santiago de Cuba, en el período 2016-2019. Resultados: En la serie predominaron los ancianos de 60-69 años de edad (46,4 %), principalmente del sexo masculino (67,8 %), y los síntomas más frecuentes fueron la epigastralgia (82,1 %) y la saciedad precoz (67,8 %). Entre las características más relevantes de las lesiones tumorales figuraron la localización antropilórica (55,3 %), la forma ulcerada en la endoscopia (51,7 %) y la variedad hística adenocarcinoma moderadamente diferenciado (43,4 %); asimismo, se determinó la existencia de Helicobacter pylori en 52,5 % de los resultados anatomopatológicos de las biopsias. Conclusiones: Resulta importante considerar la presencia de un adenocarcinoma gástrico en los pacientes mayores de 60 años que refieran síntomas digestivos, sobre todos si son hombres y padecen epigastralgia, más aún si al realizarle la esofagogastroduodenoscopia se observa una lesión ulcerada de localización antropilórica.


Introduction: Gastric cancer occupies the fifth place in incidence among all types of malignancies and is the second cause of death in the world, as most of the patients are more than 60 years when being diagnosed. Objective: To characterize aged patients according to variables of interests. Methods: An observational, descriptive and series of cases study was carried out in 56 patients older than 60 years with endoscopic and histologic diagnosis of gastric cancer, who were admitted in Saturnino Lora Teaching Provincial Clinical-Surgical Hospital, during 2016-2019. Results: Elderly in the age group 60-69 years predominated (46.4 %), mainly of the male sex (67.8 %), and the most frequent symptoms were epigastralgia (82.1 %) and the early fullness sensation (67.8 %). Among the most relevant characteristics of the tumoral lesions there were the antropiloric location (55.3 %), the ulcerated presentation in the endoscopy (51.7 %), and the histic variety mildly differentiated adenocarcinoma (43.4 %), likewise, the existence of Helicobacter pylori was confirmed in 52,5 % of the pathological biopsy results. Conclusions: It is interesting to consider the presence of a gastric adenocarcinoma in patients older than 60 years expressing gastric symptoms, mainly if they are men or suffer from epigastralgia, even more if when carrying out the esophagogastroduodenoscopy, an ulcerated lesion of antropiloric location is observed.


Subject(s)
Stomach Neoplasms/diagnosis , Stomach Neoplasms/epidemiology , Aged , Adenocarcinoma/diagnosis , Endoscopy, Digestive System , Helicobacter pylori
5.
J. coloproctol. (Rio J., Impr.) ; 41(1): 63-69, Jan.-Mar. 2021. tab, graf
Article in English | LILACS | ID: biblio-1286971

ABSTRACT

Abstract Objective Type-I collagen (Col-I) is one of the main macromolecules of the extracellular matrix, and it is involved in the desmoplastic stromal reaction, an indicator of worse prognosis in cases of colorectal cancer (CRC). The purpose of the present study was to investigate Col-I expression in cases of CRC and adenoma and to correlate with the clinical data and the data regarding the lifestyle of the patients. Methods A retrospective study including 22 patients with adenoma and 15 with CRC treated at a coloproctology service. The clinical and lifestyle data were obtained through medical records, and Col-I expression was investigated by immunohistochemistry. Results Women represented most cases of adenoma (63.64%), whereas CRC was found mainly in men (73.33%) (p=0.0448). Immunoexpression of Col-I showed a basement membrane thickening in areas of lining of epithelium and around the glands in both lesions. The cases of CRC had a quite evident fibrosis process in the stroma. The quantitative analysis demonstrated a higher protein expression in CRCs compared to adenomas (p=0.0109), as well as in female patients (p=0.0214), patients aged ≥ 50 years (p=0.0400), and in those with a positive family history of colorectal disease (p=0.0292). These results suggested a remodeling of the microenvironment of the Worked developed at the Department of Morphology, Centro de Ciências da Saúde, Universidade Federal do Espírito Santo, ES, Brazil. Conclusion The immunohistochemical analysis encourages the performance of more comprehensive studies to ascertain if our results could be a tool for the diagnosis and monitoring of the patients.


Resumo Objetivo O colágeno tipo I (Col-I) é uma das principais macromoléculas da matriz extracelular, e está envolvido na reação desmoplástica estromal, um indicador de pior prognóstico em casos de câncer colorretal (CCR). O objetivo foi investigar a expressão do Col-I emcasos de CCR e adenoma, e correlacioná-la comdados clínicos e de estilo de vida dos pacientes. Metodologia Foi realizado umestudoretrospectivo com22pacientes comadenoma e 15 comCCR tratadosemumserviço de coloproctologia.Os dados dos pacientes foramobtidos dos prontuários médicos, e a expressão do Col-I foi investigada por imunohistoquímica. Resultados As mulheres representaram a maioria dos casos de adenomas (63,64%), enquanto o CCR (73,33%) (p=0,0448) foi mais comum entre os homens. A imunoexpressão de Col-I mostrou espessamento da membrana basal em áreas de revestimento do epitélio e em volta de glândulas em ambas as lesões. O CCR apresentou fibrose no estroma. As análises quantitativas demonstraram maior expressão proteica no CCR (p=0,0109), assim como em mulheres (p=0,0214), pacientes com idade ≥ 50 anos (p=0,0400), e em pacientes com histórico positivo de doença colorretal na família (p=0,0292). Estes resultados sugerem a remodelação do microambiente tumoral na carcinogênese do CCR. As correlações clínico-patológicas positivas mostram uma ligação plausível entre o perfil do paciente e os achados imunohistoquímcos, o que indica uma possível forma de estratificação dos pacientes. Conclusão As análises imunohistoquímicas estimulam a execução de estudos mais abrangentes para confirmar se nossos resultados poderão ser uma ferramenta para o diagnóstico e o monitoramento dos pacientes.


Subject(s)
Humans , Male , Female , Colorectal Neoplasms/metabolism , Colorectal Neoplasms/pathology , Adenocarcinoma/diagnosis , Biomarkers, Tumor/metabolism , Gene Expression Regulation, Neoplastic , Collagen Type I/genetics , Extracellular Matrix/metabolism , Tumor Microenvironment/immunology
6.
J. coloproctol. (Rio J., Impr.) ; 41(1): 1-7, Jan.-Mar. 2021. tab, graf
Article in English | LILACS | ID: biblio-1286970

ABSTRACT

Abstract Objective The present study describes the epidemiological profile of patients with colorectal cancer (CRC) from the Hospital de Clínicas de Passo Fundo, Passo Fundo, RS, Brazil, between January 1, 2007 and December 31, 2016. Method Retrospective analysis of secondary data of 1,001 patients from the Hospital Cancer Registry. Results Most subjects were Caucasianmales, with a mean age of 63.68 years old. The majority of patients had incomplete elementary education and were married. In addition, 44.5% of the patients had a family history of cancer. Most subjects with a positive past or current history of alcohol intake or smoking were male. The diagnosis was mostly based on anatomopathological findings, with a predominance of adenocarcinomas and upper rectum and distal colon localization. Most lesions were in advanced stages, and the liver was the most common site for metastasis. The predominant treatment was surgery with neoadjuvant/adjuvant therapy. After the first treatment, 49.0% of the patients reported complete remission. The survival rate was 78.8% in 10 months. Conclusion The present research analyzed the profile of CRC patients.


Resumo Objetivo Descrever o perfil de pacientes com câncer colorretal (CCR) no Hospital de Clínicas de Passo Fundo, Passo Fundo, RS, Brasil, de 01 de janeiro de 2007 a 31 de dezembro de 2016. Método Análise retrospectiva de dados secundários de 1.001 pacientes obtidos através do Registro Hospitalar de Câncer. Resultados Evidenciou-se predomínio do sexo masculino, com média de idade de 63,68 anos, majoritariamente caucasianos. O grau escolar prevalente foi fundamental incompleto e o estado civil foi casado. Um total de 44,5% dos pacientes tinha histórico familiar de neoplasia. Em relação ao consumo de álcool/cigarro, dentre os que faziam ou já fizeram uso, a maioria era homem. O diagnóstico foi majoritariamente por meio anatomopatológico, com predomínio de adenocarcinoma e localização no reto superior e no cólon distal, ocorrendo mais comumente em estágios avançados, com a metástase hepática sendo a mais presente. O tratamento predominante foi cirurgia com adjuvância/neoadjuvância. Após o primeiro tratamento, 49,0% dos pacientes apresentaram remissão completa. A sobrevida foi de 78,8% em 10 meses. Conclusão A presente pesquisa possibilitou a análise do perfil dos pacientes com CCR.


Subject(s)
Humans , Male , Female , Adult , Middle Aged , Aged , Colorectal Neoplasms/pathology , Adenocarcinoma/diagnosis , Health Profile
7.
J. coloproctol. (Rio J., Impr.) ; 41(1): 23-29, Jan.-Mar. 2021. tab
Article in English | LILACS | ID: biblio-1286969

ABSTRACT

Abstract Background Colorectal cancer (CRC) is the third most common cancer among men, and the second among women worldwide. In Brazil, the incidence andmortality of CRC continues to increase. In colonoscopies, adenoma detection rates (ADRs) higher than 25% are associated linearly with better outcomes and lower rates of interval cancer. Objective To assess the colonoscopy quality indexes. Methods This is a cross-sectional retrospective study in which anatomopathological data and data regarding the colonoscopies were collected from the patient records of Hospital Moinhos de Vento, in Southern Brazil. The exams were performed by doctors from the Colorectal Service from June to August 2015. Results A total of 430 exams were included. Most patients were women (60.9% [262]), with a mean age of 56.96 years. The cecal intubation rate was of 96.7% (416). The quality of the bowel preparation was excellent or good in 92.95% (396) of the cases. The average time of removal of the colonoscope in normal exams was of 6.15 minutes. Polyps were detected in 201 patients (46.7%), and adenomas, in 125 patients (29.1%); 12 patients (2.8%) had advanced adenomas, and 6 (2.3%) had malignant neoplasms. The proximal serrated lesion detection rate (PSLDR) was of 6.7% (29). The prevalence ratio (PR) of adenomas among men was 1.78 times greater than in women (95% confidence interval [95%CI]: 1.16-2.75). The PR of adenomas among people aged 50 years or older was 2.41 times that of those under 50 years of age (95%CI: 1.43-4.06). Conclusion The data obtained are in line with international quality criteria in colonoscopy. More studies are needed to assess the ADR in the Brazilian population.


Resumo Introdução O câncer colorretal (CCR) é o terceiro mais comum em homens e o segundo mais comum em mulheres em todo o mundo. A incidência e mortalidade do CRC continuam a aumentar no Brasil. Taxas de detecção de adenoma superiores a 25% em colonoscopias estão associadas linearmente a melhores resultados emenores taxas de câncer de intervalo. Objetivo Avaliar a qualidade das colonoscopias analisadas. Métodos Este é um estudo transversal e retrospectivo no qual dados anatomopatológicos e relacionados às colonoscopias foram coletados de registros dos pacientes do Hospital Moinhos de Vento, no Sul do Brasil. Os exames foram realizados por médicos do Serviço de Coloproctologia de junho a agosto de 2015. Resultados Foram incluídos 430 exames. A maioria dos pacientes era do sexo feminino (60,9% [262]), com idade média de 56,96 anos. A taxa de intubação cecal foi de 96,7% (416). A qualidade do preparo intestinal foi excelente ou boaem92,95% (396) dos casos.O tempomédio de retirada do colonoscópio emexames normais foi de 6,15 minutos. Pólipos foram detectados em 201 pacientes (46,7%), e adenomas, em 125 (29.1%); 12 pacientes (2,8%) tinhamadenomas avançados, e 6 (2,3%), neoplasias malignas. A taxa de detecção de lesões serrilhadas foi de 6,7% (29). A razão prevalência (RP) de adenomas emhomens foi de 1,78 vezes emrelação amulheres (intervalo de confiança de 95% [IC95%]: 1,16-2,75). A RP de adenomas entre pacientes com 50 anos ou mais foi 2,41 vezes maior do que a daqueles com mais de 50 anos (IC95%: 1,43-4,06). Conclusão Os dados obtidos estão de acordo com os critérios internacionais de qualidade em colonoscopia. Mais estudos são necessários para avaliar as taxas de detecção de adenoma na população brasileira.


Subject(s)
Humans , Male , Female , Middle Aged , Colorectal Neoplasms/diagnosis , Adenocarcinoma/diagnosis , Colonic Polyps/diagnosis , Colonoscopy/statistics & numerical data
8.
J. coloproctol. (Rio J., Impr.) ; 41(1): 87-95, Jan.-Mar. 2021. tab, graf
Article in English | LILACS | ID: biblio-1286967

ABSTRACT

Abstract Objective This metanalysis aimed to evaluate the sensitivity and specificity of computed tomography colonography in colorectal polyp detection. Methods A literature search was performed in the PubMed and Web of Science databases. Results A total of 1,872 patients (males 57.2%, females 42.8%) aged 49 to 82 years old (mean age 59.7 ± 5.3 years) were included in this metanalysis. The estimated sensitivity of computed tomography colonography was 88.4% (46.3-95.7%, coefficient of variation [CV]=28.5%) and the estimated specificity was 73.6% (47.4-100.0%, CV=37.5%). For lesions up to 9mm, the sensitivity was 82.5% (62.0-99.9%, CV =25.1%) and the specificity was 79.2% (32.0-98.0%, CV=22.9%). For lesions>9mm, the sensitivity was 90.2% (64.0-100.0%, CV=7.4%) and the specificity was 94.7% (80.0-100.0%, CV=6.2%). No statistically significant differences in sensitivity according to the size of the lesion were found (p=0.0958); however, the specificity was higher for lesions>9mm (p<0.0001). Conclusions Most of the studies analyzed in the present work were conducted before 2010, which is about a decade after computed tomography colonography started being indicated as a screening method by European and American guidelines. Therefore, more studies aimed at analyzing the technique after further technological advancements are necessary, which could lead to the development of more modern devices.


Resumo Objetivo Esta meta-análise teve como objetivo avaliar a sensibilidade e especificidade da colonografia por tomografia computadorizada na detecção de pólipos colorretais. Métodos Foi realizada uma pesquisa bibliográfica nas bases de dados da PubMed e da Web of Science. Resultados Um total de 1.872 pacientes, 57,2% homens e 42,8% mulheres, com idades entre 49 a 82 anos de idade (média de 59,7 ± 5,3 anos) foram incluídos nesta meta análise. A sensibilidade da colonografia por tomografia computadorizada foi estimada em 88,4% (46,3-95,7%; coeficiente de variância [CV]=28,5%) e a especificidade em 73,6% (47,4%-100,0%; CV=37,5%). Para lesões de até 9mm, a sensibilidade foi de 82,5% (62,0-99,9%; CV=25,1%) e a especificidade de 79,2% (32,0-98,0%; CV=22,9%). Para lesõesmaiores que 9mm, a sensibilidade foi de 90,2% (64,0-100,0%; CV=7,4%) e a especificidade de 94,7% (80,0-100,0%; CV=6,2%). Não houve diferença estatisticamente significante entre as sensibilidades por tamanho da lesão (p=0,0958), porém a especificidade foi maior em lesões acima de 9mm (p<0,0001). Conclusão A maioria dos estudos analisados no presente trabalho foi realizada antes de 2010, cerca de uma década depois que a colonografia por tomografia computadorizada passou a ser indicada como método de triagem pelas diretrizes europeias e americanas. Portanto, são necessários mais estudos com o objetivo de analisar a técnica apósmaiores avanços tecnológicos, o que poderia levar ao desenvolvimento de dispositivos mais modernos.


Subject(s)
Humans , Male , Female , Middle Aged , Aged , Aged, 80 and over , Colorectal Neoplasms/diagnosis , Adenocarcinoma/diagnosis , Colonography, Computed Tomographic/statistics & numerical data
9.
J. coloproctol. (Rio J., Impr.) ; 40(4): 394-397, Oct.-Dec. 2020. graf
Article in English | LILACS | ID: biblio-1143176

ABSTRACT

ABSTRACT The implantation cyst occurs from the imprisonment and subsequent proliferation of the colonic mucosa below the submucosa during mechanical stapling. The understanding and definition of the evaluation protocol of these lesions is important, since they can generate the need for a new complex surgical procedure and cause anxiety in patients and surgeons. This case reports the occurrence of a subepithelial lesion in follow-up imaging of a patient who underwent videolaparoscopic rectosigmoidectomy for adenocarcinoma of the proximal rectum, submitted to an endoscopic attempt to drain/detangle the lesion and subsequent histopathological analysis showing colic mucosa without changes. In line with Katsumata,it is suggested to asymptomatic patients without alteration of the CEA or suspicious imaging signs a follow up with periodic imaging methods. For symptomatic patients with normal CEA, or whose lesions are growing at follow-up exams, it is suggested to continue with the investigation, with biopsy and/or effluent sample for histopathological study in addition to an attempt at symptomatic resolution. Finally, in the presence of an alteration in CEA, despite symptoms, it is suggested that the lesion be managed as a suspected local tumor recurrence.


RESUMO O cisto de implantação ocorre a partir do aprisionamento e subsequente proliferação da mucosa colônica abaixo da submucosa durante o grampeamento mecânico. A compreensão e definição do protocolo de avaliação dessas lesões é importante, pois podem gerar a necessidade de um novo procedimento cirúrgico complexo e causar ansiedade em pacientes e cirurgiões. Este caso relata a ocorrência de uma lesão sub-epitelial na imagem de seguimento de um paciente submetido à retossigmoidectomia por via videolaparoscópica devido a adenocarcinoma do reto proximal, submetido a uma tentativa endoscópica de drenar/remover a lesão e subsequente análise histopatológica mostrando a mucosa cólica sem alterações. De acordo com Katsumata, sugere-se que pacientes assintomáticos sem alteração do CEA ou sinais de imagem suspeitos tenham um seguimento com métodos de imagem periódicos. Para pacientes sintomáticos com CEA normal, ou cujas lesões mostrem crescimento nos exames de seguimento, sugere-se continuar a investigação, com biópsia e / ou amostra de efluente para estudo histopatológico, além de uma tentativa de resolução sintomática. Finalmente, na presença de uma alteração no CEA, apesar dos sintomas, sugere-se que a lesão seja tratada como uma suspeita de recorrência local do tumor.


Subject(s)
Humans , Male , Middle Aged , Rectal Neoplasms/diagnosis , Adenocarcinoma/diagnosis , Colorectal Surgery/methods , Endoscopy/methods
10.
J. coloproctol. (Rio J., Impr.) ; 40(4): 315-320, Oct.-Dec. 2020. tab, graf
Article in English | LILACS | ID: biblio-1143170

ABSTRACT

ABSTRACT Background Current threshold for minimum lymph node harvest may not be adequate for appropriate staging in colon cancer and newer surgical techniques may allow more lymph nodes to be harvested. The aim of this study was to examine the prognostic role of harvesting and examining lymph nodes higher in number than the recommended threshold (≥12), in patients with colon cancer. Methods This retrospective study included 179 patients that underwent open colon resection for adenocarcinoma of the colon. A D3 resection with high vascular ligation was made so that large number of lymph nodes was removed in most patients. Differences in overall survival between below and above three cutoff points (≥18, ≥24, ≥40) were estimated. Results During median 33 months of follow-up, 45 patients died and mean overall survival was 108.7 ± 5.6 months (95% CI, 97.7-119.7). The mean number of lymph nodes harvested and examined was 44.0 ± 25.7 (median 38; range, 7-150). No significant effect was found for three different cut-off values (≥18, ≥24, or ≥40 nodes) on mean overall survival (p > 0.05 for all comparisons). The same was true for the whole study population as well as for N0 (N negative) and N1-2 (N positive) patient subgroups, when they are analyzed separately. Conclusions Our findings do not support the survival benefit of substantially higher number of lymph nodes harvested in colon cancer.


RESUMO Fundamento: O limite atual para a coleta mínima de linfonodos pode não ser adequado para o estadiamento adequado no câncer de cólon e novas técnicas cirúrgicas podem permitir que um número maior de linfonodos seja coletado. O objetivo deste estudo foi examinar o papel prognóstico da coleta e exame de linfonodos em número maior do que o limite recomendado (≥ 12), em pacientes com câncer de cólon. Método: Este estudo retrospectivo incluiu 179 pacientes submetidos à ressecção aberta de cólon para adenocarcinoma de cólon. A ressecção D3 com ligadura vascular alta foi realizada para que um grande número de linfonodos fosse removido na maioria dos pacientes. As diferenças na sobrevida global entre abaixo e acima de três pontos de corte (≥ 18, ≥ 24, ≥ 40) foram estimadas. Resultados: Durante a mediana de 33 meses de seguimento, 45 pacientes morreram e a sobrevida global média foi de 108,7 ± 5,6 meses (IC 95%: 97,7-119,7). O número médio de linfonodos coletados e examinados foi de 44,0 ± 25,7 (mediana = 38; variação: 7-150). Nenhum efeito significativo foi encontrado para três valores de corte diferentes (≥ 18, ≥ 24 ou ≥ 40 linfonodos) na sobrevida global média (p >0,05 para todas as comparações). O mesmo foi verdadeiro para toda a população do estudo, bem como para os subgrupos de pacientes N0 (N negativos) e N1-2 (N positivos), quando analisados separadamente. Conclusões: Nossos achados não apoiam o benefício na sobrevida de um número substancialmente maior de linfonodos coletados no câncer de cólon.


Subject(s)
Humans , Male , Female , Adenocarcinoma/diagnosis , Colonic Neoplasms/diagnosis , Colonic Neoplasms/mortality , Lymph Node Excision/methods , Prognosis , Survival Analysis
11.
Autops. Case Rep ; 10(3): e2020145, 2020. tab, graf
Article in English | LILACS | ID: biblio-1131836

ABSTRACT

Extragonadal non-gestational choriocarcinoma (ENC) is an uncommon malignant tumor occasionally found in the gastrointestinal tract. ENC is characterized by a biphasic tumor growth with distinct areas of adenocarcinoma and choriocarcinoma differentiation. Primary choriocarcinoma of the colon is extremely rare, with only 21 cases reported in the literature. Most of the perforation of colorectal cancers occurs in the abdominal cavity, while abdominal wall abscess is rare; the psoas abscess associated with colon carcinoma is even less observed. Herein, we report the case of a 61-year-old female with poorly differentiated adenocarcinoma of the ascending colon and sigmoid, with choriocarcinomatous differentiation, masquerading a psoas abscess formation. Unfortunately, despite the aggressive therapy, the patient's disease rapidly progressed, and she died within 2 months after the diagnosis. The typical morphological pattern, immunohistochemistry, and its correlation with serum β-human chorionic gonadotropin enabled a correct diagnosis.


Subject(s)
Humans , Female , Middle Aged , Colorectal Neoplasms , Adenocarcinoma/diagnosis , Psoas Abscess/diagnosis , Colon , Choriocarcinoma, Non-gestational , Choriocarcinoma , Abdominal Wall , Abscess/diagnosis
12.
Int. j. odontostomatol. (Print) ; 14(3): 407-416, 2020. tab, graf
Article in Spanish | LILACS | ID: biblio-1114915

ABSTRACT

El adenocarcinoma NOS (no especificado de otra manera) es un tumor salival sin patrón especial poco mencionado en la literatura; su diagnóstico es un desafío porque estructuralmente no se identifica con otros carcinomas salivales más definidos. Por otro lado, Ki67 es un marcador de proliferación celular que brinda información pronóstica de las neoplasias. En cuanto a la mucina humana transmembrana MUC-1 se sobre-expresa en las neoplasias malignas perdiendo su localización exclusivamente apical. Presentamos dos casos de adenocarcinoma NOS diagnosticados con H/E y correlacionamos la expresión de Ki67 y la localización y sobreexpresión de MUC-1 con su grado histológico y pronóstico. Cortes histológicos de dos adenocarcinomas NOS de parótida en mujeres de 62 y 63 años respectivamente se colorearon con H/E e inmunomarcaron para Ki67 y MUC-1. En ambos tumores predominaban estructuras ductales, algunas quísticas, cordones celulares ramificados e islotes sólidos. Las formaciones glandulares presentaban células claras y algunas de aspecto oncocítico. Había importante atipia celular, comedonecrosis, invasión perineural, áreas hemorrágicas y compromiso de los márgenes quirúrgicos. La marcación nuclear con Ki67 fue importante; MUC-1 presentó una fuerte coloración en membranas y citoplasmas. Las dos lesiones se diagnosticaron como de alto grado de malignidad. Nuestros resultados demuestran que existe una importante proliferación marcada con Ki67 y una sobre-expresión de MUC-1 asociadas a atipia celular, infiltración perineural, necrosis y compromiso de márgenes quirúrgicos, factores asociados a un peor pronóstico. El reconocimiento de este tumor es trascendente para médicos y odontólogos ya que por la ausencia de rasgos distintivos que sí presentan otros carcinomas más específicos es fundamental el diagnóstico de exclusión.


Adenocarcinoma NOS (not otherwise specified) is a no special pattern salivary tumor briefly mentioned in the literature; its diagnosis is a challenge because structurally it is not identified with other more definite salivary carcinomas. On the other hand, Ki67 is a marker of cellular proliferation that provides prognostic information of neoplasms. As for human transmembrane mucin, MUC-1 is overexpressed in malignant neoplasms, losing their exclusively apical location. We present two cases of adenocarcinoma NOS diagnosed with H/E and correlate the expression of Ki67 and the location and over-expression of MUC-1 with its histological grade and prognosis. Histological sections of two NOS adenocarcinomas of parotid in women of 62 and 63 ages respectively were stained with H/E and immunolabelled for Ki67 and MUC-1. Both are predominated by ductal structures, some cystic, branched cell cords and solid islets. The glandular formations presented clear cells and some of oncocytic appearance. There was important cellular atypia, comedonecrosis, perineural growth, haemorrhagic areas and compromise of surgical margins. Nuclear marking with Ki67 was important; MUC-1 presented a strong staining in membranes and cytoplasms. They were diagnosed as high-grade malignancy. Our results show that there is an important proliferation marked with Ki67 and overexpression of MUC-1 associated with cellular atypia, perineural growth, necrosis and compromise of surgical margins, factorsassociated with a poor prognosis. The recognition of this tumor is transcendent for physicians and dentists since, due to the absence of distinctive features that other more specific carcinomas present, the diagnosis of exclusion is essential.


Subject(s)
Humans , Female , Middle Aged , Parotid Neoplasms/diagnosis , Parotid Neoplasms/metabolism , Parotid Neoplasms/pathology , Adenocarcinoma/metabolism , Adenocarcinoma/pathology , Prognosis , Salivary Gland Neoplasms , Immunohistochemistry , Adenocarcinoma/diagnosis , Biomarkers, Tumor , Mucin-1/metabolism , Ki-67 Antigen/metabolism , Cell Proliferation
13.
Rev. bras. cancerol ; 66(3): 1-4, 2020.
Article in Portuguese | LILACS | ID: biblio-1121019

ABSTRACT

Introdução: As metástases cutâneas são as neoplasias que acometem a derme ou o tecido celular subcutâneo e podem ser um indicador de neoplasia desconhecida de mau prognóstico. Metástases cutâneas em adenocarcinoma de reto são consideradas raras. Relato do caso: Mulher de 80 anos de idade, hipertensa e diabética, apresentou dor abdominal e hematoquezia, relatando histórico familiar de câncer. Realizou colonoscopia com resultado de biópsia para adenocarcinoma. Um ano depois, recebeu terapia neoadjuvante e radioterapia concomitante por quatro meses, com boa resposta ao tratamento. Porém, relatou lesão mandibular de crescimento rápido, com o trato gastrointestinal como sítio primário de acordo com a biópsia. Em tomografias de reavaliação, foram diagnosticados também vários nódulos diminutos em tecido subcutâneo de abdome inferior, mama e pulmão. Foi realizada nova biópsia dos nódulos de mama e imuno--histoquímica, procedimentos que sugeriram o reto como sítio primário das lesões. Sendo assim, foi iniciada quimioterapia paliativa e a paciente apresentou resposta satisfatória das lesões cutâneas logo no segundo ciclo do tratamento antineoplásico. O projeto foi aprovado pelo Comitê de Ética em Pesquisa do Hospital Pompeia sob número de parecer 311.052. Conclusão: Este caso enfatiza que lesões na pele de crescimento progressivo ou sem resposta após terapia convencional podem ser a primeira manifestação de câncer visceral avançado e devem ser apropriadamente investigadas. Dessa forma, fica claro que, por meio de um diagnóstico precoce, é possível mudar o prognóstico da doença e o seu tratamento.


Introduction: Skin metastases are neoplasms that affect the dermis or subcutaneous cell tissue and may be an indicator of an unknown neoplasm with a poor prognosis. Skin metastases in rectal adenocarcinoma are considered rare. Case report: An 80-year-old woman, hypertensive and diabetic, had abdominal pain and hematochezia, reporting a family history of cancer. Colonoscopy was performed with biopsy results for adenocarcinoma. One year later, she received neoadjuvant therapy and concomitant radiation therapy for four months, with good response to treatment. However, she reported a fast-growing mandibular lesion, with the gastrointestinal tract as the primary site according to the biopsy. In reassessment CT scans, several small nodules in subcutaneous tissue of the lower abdomen, breast and lung were also diagnosed. A new biopsy of the breast nodules and immunohistochemistry were performed, procedures that suggested the rectum as the primary site of the lesions. Therefore, palliative chemotherapy was started and the patient presented a satisfactory response to skin lesions in the second cycle of antineoplastic treatment. The project was approved by the Institutional Review Board of Hospital Pompeia through report the opinion nº 311.052. Conclusion: This case emphasizes that progressive or unresponsive skin lesions after conventional therapy can be the first manifestation of advanced visceral cancer and should be properly investigated. Thus, it is clear that, through an early diagnosis, it is possible to change the prognosis of the disease and its treatment.


Introducción: Las metástasis cutáneas son neoplasias que afectan la dermis o el tejido subcutáneo y pueden ser un indicador de neoplasia desconocida con mal pronóstico. Las metástasis cutáneas en el adenocarcinoma rectal se consideran raras. Relato del caso: Una mujer de 80 años, hipertensa y diabética, presentaba dolor abdominal y hematoquecia, e informaba antecedentes familiares de cáncer. La colonoscopia se realizó con resultados de biopsia para adenocarcinoma. Un año después, recibió terapia neoadyuvante y radioterapia concomitante durante cuatro meses, con buena respuesta al tratamiento. Sin embargo, informó una lesión mandibular de rápido crecimiento, con el tracto gastrointestinal como el sitio primario según la biopsia. En las tomografías de reevaluación, también se diagnosticaron varios nódulos pequeños en el tejido subcutáneo de la parte inferior del abdomen, mama y pulmón. Se realizó una nueva biopsia de los nódulos mamarios y la inmunohistoquímica, procedimientos que sugirieron el recto como el sitio primario de las lesiones. Por lo tanto, se inició la quimioterapia paliativa y el paciente presentó una respuesta satisfactoria a las lesiones cutáneas en el segundo ciclo de tratamiento antineoplásico. El proyecto fue aprobado por el Comité de Ética e Investigación del Hospital Pompéia a través del dictamen número 311.052. Conclusión: Este caso enfatiza que las lesiones cutáneas progresivas o que no responden después de la terapia convencional pueden ser la primera manifestación de cáncer visceral avanzado y deben investigarse adecuadamente. Por lo tanto, está claro que, a través de un diagnóstico temprano, es posible cambiar el pronóstico de la enfermedad y su tratamiento.


Subject(s)
Humans , Female , Aged, 80 and over , Rectal Neoplasms/diagnosis , Skin Neoplasms/diagnosis , Adenocarcinoma/diagnosis , Neoplasm Metastasis
14.
Rev Assoc Med Bras (1992) ; 66(5): 590-595, 2020. graf
Article in English | SES-SP, LILACS, SES-SP | ID: biblio-1136259

ABSTRACT

SUMMARY OBJECTIVE Thrombopoietin (THPO) is well-known as a megakaryocyte growth and development factor (MGDF) involved in megakaryocyte proliferation and maturation. To explore the biological effects of THPO in gastric adenocarcinoma, we conducted this study. Methods: By accessing the TCGA database, the expression level of THPO was determined in tumor tissues. The association between THPO expression and clinical features, or prognostic significance was described by Cox regression analysis and Kaplan-Meier. The SiRNA method was used to decline the THPO expression; then cell viability, invasion, and migration were detected to verify the effects of the knockdown of THPO. qPCR and western blotting were implemented to examine the expression level of THPO. Results: The expression of THPO was increased in tumor tissue and cells, its high-regulation was associated with a poor prognosis in patients with gastric adenocarcinoma. Cell viability, invasion, and migration were suppressed in AGS with the down-regulation of THPO. Furthermore, on the basis of si-THPO transfection, E-cadherin was promoted while N-cadherin and Vimentin were attenuated. CONCLUSION Our results revealed that THPO may be a potent marker of gastric adenocarcinoma, providing a novel potential screening method for gastric adenocarcinoma.


RESUMO OBJETIVO Trombopoetina (THPO) é um conhecido fator de desenvolvimento e crescimento megacariócito (MGDF) envolvido na proliferação e maturação de megacariócitos. Realizamos este estudo para explorar os efeitos biológicos do THPO no adenocarcinoma gástrico. Metodologia: O nível de expressão do THPO em tecidos tumorais foi determinado acessando a banco de dados TCGA. A associação entre a expressão de THPO e características clínicas ou relevância no prognóstico foi descrita através da análise de Kaplan-Meier e regressão de Cox. O método SiRNA foi utilizado para reduzir a expressão da THPO e, em seguida, a viabilidade, invasão, e migração celular foram detectadas para verificar os efeitos da redução do THPO. qPCR e western blotting foram utilizados para examinar o nível de expressão do THPO. Resultados: A expressão do THPO estava aumentada em tecido e células tumorais, esse aumento estava associado com um prognóstico negativo para pacientes com adenocarcinoma gástrico. A invasão e migração celular foram suprimidos em AGS com a redução do THPO. Além disso, com base na transfecção de si-THPO, a E-caderina foi promovida, enquanto a N-caderina e Vimentina foram atenuadas. Conclusão nossos resultados demonstram que o thpo pode ser um potente marcador de adenocarcinoma gástrico, com potencial para ser um novo tipo de triagem para adenocarcinoma gástrico.


Subject(s)
Humans , Stomach Neoplasms/diagnosis , Thrombopoietin/metabolism , Adenocarcinoma/diagnosis , Prognosis , Stomach Neoplasms/metabolism , Adenocarcinoma/mortality , Gene Expression Regulation, Neoplastic , Cell Proliferation , Neoplasm Invasiveness
16.
Rev. Círc. Argent. Odontol ; 78(228): 18-20, ago. 2019. ilus
Article in Spanish | LILACS | ID: biblio-1123348

ABSTRACT

El adenocarcinoma de células basales, también conocido como carcinoma salival basaloide, adenoma maligno de células basales, es una neoplasia epitelial de bajo grado, infiltrante, localmente destructivo y con tendencia a ser recidivante. Su aparición es entre la 5ª y 6ª década de vida, sin predilección por sexo. Clínicamente se manifiesta con un edema o un aumento repentino de tamaño en la zona, de consistencia firme, crecimiento lento e indoloro. El diagnóstico de certeza es a través de la histopatología; su tratamiento quirúrgico, y tiene buen pronóstico en sus estadios iniciales (AU)


Basal cells adenocarcinoma also known as salivary basaloide carcinoma basal cells malignant adenoma is a low degree, infiltrating, locally destructive and prone to be relapsing, epithelial neoplasia. It occurs between the 5th and 6th decade of life, with no predilection for sex. Clinically it manifests with an edema or sudden increased size in the area, of firm consistency, slow growth and pain-less. Its treatment is surgical and the diagnosis of certainty is histopathological with a good prognosis. The purpose of this presentation is to show the case of a 57- years-old male patient with clinical and anatomopathological diagnosis of adenocarcinoma of basal cells located in the yugal mucosa (AU)


Subject(s)
Humans , Male , Middle Aged , Mouth Neoplasms/classification , Adenocarcinoma/surgery , Adenocarcinoma/diagnosis , Neoplasms, Basal Cell , Prognosis , Biopsy/methods , Oral Surgical Procedures/methods , Diagnosis, Differential , Age and Sex Distribution , Mouth Mucosa/injuries , Neoplasm Recurrence, Local/prevention & control
17.
Rev. medica electron ; 41(4): 979-992, jul.-ago. 2019. tab
Article in Spanish | LILACS, CUMED | ID: biblio-1094102

ABSTRACT

RESUMEN La infección por helicobacter pylori afecta aproximadamente al 50% de la población mundial, es causante de gastritis crónica, úlcera péptica, cáncer gástrico y linfoma del tejido linfoide asociado a la mucosa. Desde su descubrimiento, la erradicación ha sido uno de los más importantes retos en Gastroenterología. En muchos países se desconoce la prevalencia de resistencia primaria del microorganismo a los diferentes antibióticos que empíricamente se utilizan, y por no realizar pruebas de rutina que verifican su erradicación en la práctica diaria, se ignora la efectividad de los esquemas prescritos. El incremento progresivo de la resistencia a la claritromicina y metronidazol, unido a una ausencia de antibioticoterapia alternativa, desafía la capacidad para eliminar de manera efectiva a ésta bacteria. El subcitrato de bismuto ha resurgido y su adición en la terapia ha permitido aumentar las tasas de curación por encima del 90%. Actualmente se invoca que para mejorar la eficacia en el tratamiento se debe combinar una supresión potente del ácido gástrico en tratamientos combinados cuádruples con una duración de 14 días, para la mayoría de los casos. La adherencia al tratamiento es crucial para obtener buenos resultados terapéuticos.


ABSTRACT The infection for helicobacter pylori affects approximately to the world population's 50%, it is causing of chronic gastritis, peptic ulcer, gastric cancer and linfoma associated to the mucous one. From their discovery, the eradication has been one of the most important challenges in Gastroenterología. In many countries the prevalencia of primary resistance is ignored from the microorganism to the different antibiotics that empirically they are used, and for not carrying out routine tests that verify its eradication in the daily practice, the effectiveness of the prescribed outlines it is ignored. The progressive increment of the resistance to the claritromicina and metronidazol, together to an absence of alternative antibioticotherapy, challenges the capacity to eliminate from an effective way to this bacteria. The bismuth subcitrato has resurged and its addition in the therapy has allowed to increase the cure rates above 90%. At the moment it is invoked that to improve the effectiveness in the treatment, that is should combine a potent suppression of the gastric acid in combined quadruple treatments with a duration of 14 days, for most of the cases. The adherence to the treatment is crucial to obtain therapeutic good results.


Subject(s)
Humans , Drug Resistance, Microbial , Risk Factors , Helicobacter Infections/etiology , Helicobacter Infections/drug therapy , Helicobacter Infections/epidemiology , Treatment Outcome , Drug Therapy, Combination , Disease Eradication , Peptic Ulcer/diagnosis , Stomach Neoplasms/diagnosis , Tetracycline/therapeutic use , Bismuth/therapeutic use , Adenocarcinoma/diagnosis , Clarithromycin , Lymphoma, B-Cell, Marginal Zone/diagnosis , Acidity Regulator , Proton Pump Inhibitors/therapeutic use , Treatment Adherence and Compliance , Gastritis/diagnosis , Gastroenterology , Metronidazole , Metronidazole/therapeutic use
18.
Medicina (B.Aires) ; 79(3): 208-211, June 2019. ilus
Article in Spanish | LILACS | ID: biblio-1020062

ABSTRACT

Los linfomas derivados del tejido linfoide asociado a las mucosas (MALT) son entidades poco frecuentes, de bajo grado de malignidad con escaso o nulo compromiso ganglionar y representan cerca del 80% de los linfomas primarios pulmonares. La aparición sincrónica con adenocarcinoma de pulmón es un hallazgo extremadamente infrecuente. Presentamos el caso de un hombre de 68 años, ex-tabaquista, en quien durante el seguimiento de un nódulo pulmonar se identificó un segundo nódulo y la biopsia quirúrgica confirmó el diagnóstico de ambas neoplasias.


The lymphomas of mucosa-associated lymphoid tissue (MALT), are uncommon entities, of low grade of malignancy with very infrequent or no lymph node involvement. They represent about 80% of the primary pulmonary lymphomas. The synchronous appearance with lung adenocarcinoma is an extremely rare finding. We present the case of an ex-smoker 68-year-old man, in whom, in the follow-up of a pulmonary nodule, a second pulmonary nodule was found. The surgical biopsy confirmed the diagnosis of both neoplasms.


Subject(s)
Humans , Male , Aged , Adenocarcinoma/diagnosis , Lymphoma, B-Cell, Marginal Zone/diagnosis , Adenocarcinoma of Lung/diagnosis , Lung Neoplasms/diagnosis , Neoplasms, Multiple Primary/diagnosis , Adenocarcinoma/surgery , Adenocarcinoma/pathology , Adenocarcinoma/diagnostic imaging , Tomography, X-Ray Computed , Adenocarcinoma of Lung/surgery , Adenocarcinoma of Lung/pathology , Adenocarcinoma of Lung/diagnostic imaging , Lung Neoplasms/surgery , Lung Neoplasms/pathology , Lung Neoplasms/diagnostic imaging
19.
Säo Paulo med. j ; 137(1): 100-103, Jan.-Feb. 2019. tab, graf
Article in English | LILACS | ID: biblio-1004736

ABSTRACT

ABSTRACT CONTEXT: Non-islet-cell-tumor-induced hypoglycemia (NICTH) is caused on rare occasions by secretion of insulin from tumor cells that are reported to have a single tissue origin. CASE REPORT: A 67-year-old male patient had cardia adenocarcinoma and concomitant lung adenocarcinoma with extensive metastases and repeated episodes of intractable hypoglycemia. Immunohistochemical staining for insulin showed that lung adenocarcinoma stained positive and gastric cardia adenocarcinoma stained weakly positive. These results indicate that tumor cells of different tissue origins co-secreted insulin. CONCLUSIONS: This is the first report on intractable hypoglycemia due to co-secretion of insulin from two kinds of primary tumor cells in a single patient.


Subject(s)
Humans , Male , Aged , Stomach Neoplasms/complications , Cardia , Adenocarcinoma/complications , Hypoglycemia/etiology , Lung Neoplasms/complications , Stomach Neoplasms/diagnosis , Immunohistochemistry , Adenocarcinoma/diagnosis , Fatal Outcome , Positron Emission Tomography Computed Tomography , Lung Neoplasms/diagnosis
20.
Rev. Col. Bras. Cir ; 46(6): e20192366, 2019. tab, graf
Article in Portuguese | LILACS | ID: biblio-1057190

ABSTRACT

RESUMO Objetivo: analisar, comparativamente, a incidência de câncer incidental de vesícula biliar em colecistectomias de urgência versus colecistectomias eletivas realizadas em hospitais públicos de Teresina-PI. Métodos: estudo observacional descritivo, quantitativo, com delineamento transversal, cujo cenário foram dois hospitais públicos de Teresina-PI. Foram analisados 6.329 prontuários de pacientes submetidos à colecistectomia, entre janeiro de 2011 e dezembro de 2017. Os dados coletados foram divididos em dois grupos e confrontados estatisticamente através do teste Z para diferença entre proporções. Resultados: detectou-se câncer incidental da vesícula biliar em 6,53% das colecistectomias de urgência e em 0,38% das eletivas. Quanto ao sexo, observou-se que, na cirurgia de urgência, 69% eram mulheres e 31%, homens, enquanto no procedimento eletivo, 78% eram mulheres e 22%, homens. Quanto à idade, a maioria dos pacientes possuía mais de 60 anos e, entre estes, 69,3% submetidos à colecistectomias de urgência e 82,6%, à eletivas. O tipo histopatológico "adenocarcinoma" foi encontrado em 84,6% das cirurgias de urgência e 100% das eletivas. Conclusão: câncer incidental de vesícula biliar foi mais frequente em colecistectomias de urgência em comparação às eletivas. O perfil dos pacientes com essa doença maligna nos dois tipos de procedimento foi do sexo feminino, maiores de 60 anos de idade e com diagnóstico histopatológico de adenocarcinoma.


ABSTRACT Objective: to comparatively analyse the incidence of incidental gallbladder cancer in emergency cholecystectomies versus in elective cholecystectomies performed in public hospitals in Teresina city, Piaui state (PI). Methods: descriptive, quantitative, observational, cross-sectional study, whose scenarios were two public hospitals in Teresina-PI. We analysed 6,329 medical records of patients undergoing cholecystectomy between January 2011 and December 2017. The collected data were divided into two groups and statistically compared using Z-test for difference between proportions. Results: incidental gallbladder cancer was detected in 6.53% of emergency cholecystectomies and in 0.38% of elective ones. Regarding gender, it was observed that in emergency surgeries 69% of patients were women and 31% men, while in elective procedures 78% were women and 22% men. Regarding age, most patients were over 60 years old, and, among these, 69.3% underwent emergency cholecystectomies and 82.6% underwent elective cholecystectomies. The histopathological type "adenocarcinoma" was found in 84.6% of patients who underwent emergency surgeries and in 100% of patients who underwent elective surgeries. Conclusion: incidental gallbladder cancer was more frequent in urgent cholecystectomies compared to elective cholecystectomies. The profile of patients with this malignant disease in both types of procedure was female, older than 60 years, and with histopathological diagnosis of adenocarcinoma.


Subject(s)
Humans , Male , Female , Infant, Newborn , Infant , Child, Preschool , Child , Adolescent , Adult , Aged , Aged, 80 and over , Young Adult , Adenocarcinoma/surgery , Adenocarcinoma/diagnosis , Cholecystitis/surgery , Incidental Findings , Gallbladder Neoplasms/surgery , Gallbladder Neoplasms/diagnosis , Cholecystectomy/methods , Adenocarcinoma/complications , Adenocarcinoma/pathology , Cholecystitis/complications , Incidence , Cross-Sectional Studies , Risk Factors , Elective Surgical Procedures , Gallbladder Neoplasms/complications , Gallbladder Neoplasms/pathology , Middle Aged
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