ABSTRACT
OBJECTIVE: To determine the prevalence of p53 expression in cytologic smear collected by the RS Balloon in high-risk individuals, and test its yield in the cytologic screening of squamous cell carcinoma of the esophagus (SCCE). STUDY DESIGN: Asymptomatic individuals at risk for SCCE underwent esophageal exfoliative cytology with the RS Balloon immediately followed by upper gastrointestinal endoscopy with biopsies of unstained areas after iodine mucosal staining of the esophagus. For each patient, cytologic expression of p53 was compared with the worst endoscopic biopsy diagnosis and the histologic expression of p53. RESULTS: One hundred seventy-one individuals were submitted to the study's protocol. There were 8 lost cases (4.7%) due to inadequate cytologic samples. The final sample consisted of 163 individuals where 150 were male (92%), mean age of 52.6 +/- 12.0 years old. There were 3 cases of dysplasia/SCCE. Immunohistochemical expression of p53 protein was positive in 38 patients (23.6%), with basal layer expression in 29 (76.3%), middle layer expression in 8 (21.1%) and superficial layer in 1 (2.6%). All patients with dysplasia/SCCE had positive immunohistochemical expression of p53 protein. Immunocytochemical expression of p53 protein in cytologic smear was negative in all cytology samples. CONCLUSION: The negative results of immunocytochemical expression of p53 protein suggest that its use does not contribute to improving the performance of conventional cytology of the esophagus in the screening for SCCE and its precursor lesions.
Subject(s)
Carcinoma, Squamous Cell/diagnosis , Cytodiagnosis/methods , Esophageal Neoplasms/diagnosis , Tumor Suppressor Protein p53/analysis , Adult , Aged , Aged, 80 and over , Biopsy , Carcinoma, Squamous Cell/metabolism , Carcinoma, Squamous Cell/pathology , Esophageal Neoplasms/metabolism , Esophageal Neoplasms/pathology , Esophagoscopy , Female , Humans , Immunohistochemistry , Male , Middle Aged , Mucous Membrane/metabolism , RiskABSTRACT
A polymerase chain reaction (PCR)-based test for Pneumocystis jiroveci (formerly Pneumocystis carinii f. sp. hominis) might be an alternative to histologic diagnoses of P. jiroveci pneumonia (PCP). However, previously developed nested PCR methods tend to have low specificities (high false-positive rates). In this study, nested and quantitative real-time PCR methods for the amplification of the P. jiroveci DHPS (dihydropteroate synthase) gene were evaluated in a variety of stored clinical samples from Spain, South Africa, and Brazil. The sensitivities of both assays were high, ranging from 62.5% to 100% depending on the type of specimen. In a subset of 71 microscopically confirmed PCP cases and 70 negative cases, the sensitivities and specificities were 94% and 81% for nested PCR and 94% and 96% for real-time PCR, respectively. Real-time PCR has a statistically significantly better specificity than nested PCR (P = .015) and is likely to generate fewer false positives.
Subject(s)
Pneumocystis Infections/diagnosis , Pneumocystis carinii/isolation & purification , Polymerase Chain Reaction/methods , Bronchoalveolar Lavage Fluid/microbiology , Humans , Sensitivity and SpecificityABSTRACT
Sob o ponto de vista citopatológico, existem três grandes tipos de tumores brônquicos: carcinoma de células escamosas, adenocarcinoma e carcinoma de pequenas células, que correspondem em nossa experiência, a mais de 95 dos casos. Os demais tipos citológicos são muito raros, mas sua eventual ocorrência deve ser sempre buscada, pois seu comportamento biológico e respectivo tratamento costumam diferir e necessitam individualização. Neste trabalho, relatamos seis casos de tumores torácicos relativamente raros, com sua respectiva apresentação citopatológica: oncocitoma pulmonar, fibrossarcoma pulmonar, tumor de Askin, mieloma da parede torácica, envolvimento pleuro-pulmonar por linfoma de células T e metástase endobrônquica de carcinoma de endométrio
Subject(s)
Humans , Male , Female , Adolescent , Middle Aged , Lung Neoplasms , Thoracic Neoplasms/pathology , Adenoma, Oxyphilic , Biopsy, Needle , Fibrosarcoma , Leukemia-Lymphoma, Adult T-Cell/pathology , Sarcoma, EwingABSTRACT
Neste trabalho a literatura recente em relacao as seguintes questoes e revisada: 1) qual e a prevalencia HPV, em mulheres cujo exame citopatologico foi normal? 2) existe correlacao entre a morfologia citologica ou histologica e o tipo de HPV? 3) qual e a historia natural da infeccao pelo HPV do colo uterino? 4) quando determinar o tipo de HPV por biologia molecular? 5) que alteracoes nas estrategias de rastreamento populacional esses novos conhecimentos estao a exigir? e 6) que expectativa devemos ter em relacao as vacinas profilaticas e curativas em estudo?
Subject(s)
Humans , Female , Carcinoma/epidemiology , Papillomaviridae/isolation & purification , Uterine Cervical Neoplasms/epidemiology , Brazil , Condylomata Acuminata/epidemiology , Molecular Biology , Uterine Cervical Neoplasms/diagnosisABSTRACT
Os mecanismos de formação dos derrames serosos, transudatos e exsudatos são brevemente mencionados. A citologia dos derrames é discutida, com ênfase nas principais aplicações clínicas: diagnóstico dos derrames infecciosos piogênicos, derrames por neoplasias primárias (Mesoteliomas) e metastáticas (carcinomas e linfomas). As distinções entre células mesoteliais "reativas" e mesoteliomas e adenocarcinomas metastáticos são discutidas e ilustradas
