Uso antenatal de corticosteróide e evolução clínica de recém-nascidos pré-termo / Antenatal corticosteroid use and clinical evolution of preterm newborn infants

O objetivo é descrever a freqüência de utilização de corticosteróide antenatal e a evolução clínica dos recém-nascidos pré-termo. Estudo observacional prospectivo tipo coorte de todos os neonatos com idade gestacional entre 23 e 34 semanas nacidos na Rede Brasileira de Pesquisas Neonatais entre agosto e dezembro de 2001. Os prontuários médicos foram revistos, as mães entrevistadas e os pré-termos acompanhados. A análise dos dados foi realizada com o teste do qui-quadrado, t de Student, Mann-Whitney, ANOVA e regressão logística múltipla, com nível de significância de 5%.

Prevalence of steroid receptors and HER 2/neu in breast cancer biopsies of women living in Puerto Rico

OBJECTIVE: The purpose of this study is to determine the prevalence rate of estrogen and progesterone receptors and HER 2/neu in the breast cancer biopsies analyzed in the Laboratory of Immunohistochemistry of the University of Puerto Rico School of Medicine in the year 2000. This data may serve as a reference point for future studies of the epidemiological aspects of breast cancer among women living in Puerto Rico. BACKGROUND: Determination of estrogen receptor (ER) and progesterone receptor (PR) on biopsy specimens of breast carcinoma prior to treatment is standard practice in the management of breast carcinoma. ER and PR are used to identify patients who are likely to respond to endocrine therapy. The prevalence of ER, PR and Her2/neu among USA women is 77 per cent, 55 per cent and 10-34 per cent, respectively. One of the major clinical roles for testing HER 2/neu expression is to determine eligibility for treatment with Trastuzumab. METHODS: Retrospective analysis of 309 breast cancer biopsies was done. Paraffin embedded blocks of breast cancer tissue biopsies were received from different hospitals and Pathology Laboratories located throughout the island specifically for routine analysis of steroid receptor (ER/PR) and/or HER 2/neu expression. Immunostaining was performed in a Ventana Medical Systems automated instrument. RESULTS: Positive nuclear staining for ER and PR were seen in 65.9 per cent (203/308) and 51.8 per cent (159/307), respectively. In the HER2/neu test, 27.8 per cent (46/165) gave a strong and complete membranous staining (score 3+). CONCLUSIONS: There is a lower prevalence of estrogen receptor in the breast cancer biopsies of women living in Puerto Rico than their USA counterparts, but similar prevalence of progesterone receptorstatus and HER 2/neu protein over expression.

Steroid receptors in Brazilian patients with large bowel cancer

1. Twenty-two colorectal carcinomas were examined for the presence of estrogen (ER), progesterone (PR), androgen (AR) and glucocorticoid receptors (GR) by a charcoal dextran assay. 2. ER was detected in 4/13 (31 per cent ) and 5/9 (56 per cent ) of the rectum and colon carcinomas analyzed, and density values ranged from 10 to 14 and from 10 to 27 fm/mg protein, respectively. Normal distal or adjacent mucosa presented similar incidence and ER density values within the tumor ranges. 3. The incidence of PR-positive samples was also higher in colon than in rectal carcinomas (44 per cent vs 23 per cent ). Normal mucosa displayed significantly higher PR titers than the corresponding tumor tissue. It seems reasonable to assume that normal colorectal mucosa may be one of the target tissues of progesterone activity. Most tumor biopsies and normal mucosa were completely AR negative, whilst GR was present in a larger fraction (63 per cent ) of tumoral specimens, occurring more commonly in colon than in rectum carcinomas. GR incidence tended to be higher in neoplasms than in normal mucosa (54 per cent vs 38 per cent in rectum and 78 per cent vs 56 per cent in colon), suggesting that glucocorticoids may be involved in the control of tumor-cell proliferation. 4. Our findings which indicate low densities of ER, PR, and absence of AR in some large bowel cancers, suggest sex hormone and endocrine independence for those cancers. The role of glucocorticoid receptors in those forms of cancer remains to be elucidated

Factores de crecimiento y dependencia hormonal en el cáncer de mama / Growth factor and hormone dependence in the breast cancer

Se efectuó la determinación de receptores a factor de crecimiento epidérmico (RFCE) y receptores esteroides (RE y RPg) en 33 muestras de tumores mamarios humanos. En 10 de ellos se realizó también una prueba funcional para RE: desplazamiento por Tamoxifen (Tam) y por Estradiol (E2) de la unión específica RE-3HE2. Pra RCFE se obtuvo un rango de valores de 0 a 220 fm/mg con un 52% de RFCE+. Se estableció como valor límite de separación entre RFCE+ y RFCE-, 20 fm/mg. Los valores para RE oscilaron entre 0 y 500 fm/mg con un 67% de tumores RE+. El 47% de los tumores fueron RPg+, con valores entre 0 y 760 fm/mg. La relación entre RFCE con RE y RPg evidenció una correlación negativa con RPg (p<0.01); el 76% de los tumores RFCE+ fueron RPg- (13 de 17). El 50% de los tumores RFCE+ (10 de 17) fueron RE+, lo que muestra una tendencia a la correlación negativa, que no llega a tener significancia estadística. En cuanto al Indice de Desplazamiento (ID), que es una medida de la afinidad relativa del E2 y del Tam por el RE, los tumores ensayados que fueron RFCE+, dieron resultados bajos (ID<0.1), lo que indica que son tumores RE+ poco desplazables por Tam. Ambos factores (RFCE e ID) fueron indicadores de mal pronóstico, a pesar de ser tumores RE+. Tres de ellos fueron RPg+. La evolución de estos pacientes y un mayor número de casos, permitirá establecer cuáles de estos parámetros se corresponden mejor a la enfermedad. Se destaca la importancia del dosaje de RFCE y de otros factores de crecimiento, para una mejor comprensión de la tumorogénesis mamaria. En tal sentido, el RFCE es un elemento más a considerar, tanto en el pronóstico, como el tratamiento de las neoplasias mamarias

Receptores endometriais / Endometrial receptors

Is this work we analised importance of the estrogen and progesterone receptors in the human endometrium, showing their probable intra-cellular mechanism of action, anatomic distribution intra-uterine, numeric variationduring the menstrual cycle and correlation between hormonal and receptors levels. We belive the endomentrial receptors have great clinical importance, and must be studied carefully in order to help us to understand the woman physiology better

Steroid receptors in meningiomas

Dados epidemiológicos sugerem uma associaçäo entre meningiomas e hormônios sexuais. Há preponderância da incidência da incidência destes tumores em mulheres, sendo diagnosticados mais frequentemente entre 35 e 55 anos. Progressäo tumoral pode ocorrer durante a gravidez e a associaçäo entre meningiomas e câncer de mama é estatisticamente significativa. O efeito benéfico positivo dos glicocorticóides no tratamento clínico de tumores intracranianos está bem documentado, embora este efeito seja relacionado com o edema cerebral e näo com proliferaçäo tumoral. A presença de receptores intracelulares específicos parece ser condiçäo necessaria embora näo suficiente para a expressäo dos efeitos celulares destes esteróides. O objetivo do nosso trabalho foi a determinaçäo de receptores de estrógeno (ER), progesterona (PR), andrógeno (AR) e glicocorticóide (GR) em 10 meningiomas através da metodologia do carväo-dextrana. Neste estudo verificamos que somente 20% dos meningiomas contém receptores de estrógeno e as concentraçöes determinadas säo baixas. Receptores de progesterona estäo presentes em 90% dos tumores, em alta concentraçäo (média + ou - dp = 60 + ou - 38 fMol/mg prot). Cerca de 70% dos meningiomas contém níveis intermediários de AR e GR. Testes de competiçäo demonstram que todos os receptores säo específicos. Incidência e concentraçäo de todos os receptores säo maiores em pacientes do sexo feminino. A ocorrência de receptores de progesterona, andrógeno e glicocorticóide pode indicar a possível utilidade de manipulaçäo endócrinas em meningiomas näo operáveis