Classical osteoblastoma, atypical osteoblastoma, and osteosarcoma: a comparative study based on clinical, histological, and biological parameters

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Oliveira, Cláudia Regina Gomes Cardim Mendes de; Mendonça, Berenice Bilharino; Camargo, Olavo Pires de; Pinto, Emilia Modolo; Nascimento, Sérgio Antonio Barbosa; Latorre, Maria do Rosario D. O; Zerbini, Maria Claúdia Nogueira.

Clinics ; 62(2): 167-174, Apr. 2007. ilus, graf

Artículo en Inglés | LILACS | ID: lil-449657

OBJECTIVE:

To investigate the biological behavior of classical and atypical osteoblastomas in comparison to osteosarcomas.

Based on histological parameters, 30 osteoblastomas were subclassified as classical osteoblastomas (23/30) or atypical osteoblastoma (high cellularity, prominent blue osteoid, and epithelioid osteoblasts-7/30). Comparative immunohistochemical and clinical analysis was performed in 17 cases of patients with high-grade osteosarcoma. Formalin-fixed, paraffin-embedded archival tissue was immunostained for p53 and proliferation cell nuclear antigen. Tumors with positive p53 stain underwent molecular analyses for fragments of exon 10.

The mean proliferating cell nuclear antigen indexes for classical osteoblastoma, atypical osteoblastoma, and osteosarcoma were 33 percent, 61 percent, and 79 percent, respectively. The atypical subgroup showed similar results to those of the osteosarcoma group (P < 0.001). p53 protein was detected in 4 (13 percent) osteoblastomas (3 of these were atypical osteoblastoma), and 4 osteosarcomas (23 percent) also showed p53 positivity. DNA mutation performed in p53-positive cases was confirmed in exon 10 in 2 atypical osteoblastomas (2/3), 1 classical osteoblastoma (1/1), and 1 osteosarcoma (1/4). Disease recurrence was correlated with p53 expression (P = 0.009), atypical subtype (P = 0.031), spiculated blue bone on histology (P = 0.018), and proliferatingcell nuclear antigen labeling index > 40 (P = 0.015).

These results validate atypical osteoblastoma as an entity, with p53 and proliferation cell nuclear antigen immunoexpression closer to that of osteosarcoma than of classical osteoblastoma. Proliferating cell nuclear antigen labeling index and p53 may be useful predictors of recurrence.

Adolescente Adulto Niño Preescolar Femenino Humanos Masculino Neoplasias Óseas/patología /genética Mutación/genética Osteosarcoma Osteoblastoma/patología Antígeno Nuclear de Célula en Proliferación/análisis Neoplasias Óseas/genética Neoplasias Óseas/inmunología Análisis Mutacional de ADN Perfilación de la Expresión Génica Inmunohistoquímica Osteosarcoma Osteoblastoma/genética Osteoblastoma/inmunología Reacción en Cadena de la Polimerasa Antígeno Nuclear de Célula en Proliferación/genética Estudios Retrospectivos

Biblioteca responsable: BR1.1