Acute lymphoblastic leukemia in children and adolescents: prognostic factors and analysis of survival

To describe the clinical and laboratory features of children and adolescents with acute lymphoblastic leukemia treated at three referral centers in Ceará and evaluate prognostic factors for survival, including age, gender, presenting white blood cell count, immunophenotype, DNA index and early response to treatment.METHODS: Seventy-six under 19-year-old patients with newly diagnosed acute lymphoblastic leukemia treated with the Grupo Brasileiro de Tratamento de Leucemia da Infância - acute lymphoblastic leukemia-93 and -99 protocols between September 2007 and December 2009 were analyzed. The diagnosis was based on cytological, immunophenotypic and cytogenetic criteria. Associations between variables, prognostic factors and response to treatment were analyzed using the chi-square test and Fisher's exact test. Overall and event-free survival were estimated by Kaplan-Meier analysis and compared using the log-rank test. A Cox proportional hazards model was used to identify independent prognostic factors.RESULTS: The average age at diagnosis was 6.3 ± 0.5 years and males were predominant (65%). The most frequently observed clinical features were hepatomegaly, splenomegaly and lymphadenopathy. Central nervous system involvement and mediastinal enlargement occurred in 6.6% and 11.8%, respectively. B-acute lymphoblastic leukemia was more common (89.5%) than T-acute lymphoblastic leukemia...

Acute lymphoblastic leukemia in children and adolescents: prognostic factors and analysis of survival.

OBJECTIVE: To describe the clinical and laboratory features of children and adolescents with acute lymphoblastic leukemia treated at three referral centers in Ceará and evaluate prognostic factors for survival, including age, gender, presenting white blood cell count, immunophenotype, DNA index and early response to treatment. METHODS: Seventy-six under 19-year-old patients with newly diagnosed acute lymphoblastic leukemia treated with the Grupo Brasileiro de Tratamento de Leucemia da Infância - acute lymphoblastic leukemia-93 and -99 protocols between September 2007 and December 2009 were analyzed. The diagnosis was based on cytological, immunophenotypic and cytogenetic criteria. Associations between variables, prognostic factors and response to treatment were analyzed using the chi-square test and Fisher's exact test. Overall and event-free survival were estimated by Kaplan-Meier analysis and compared using the log-rank test. A Cox proportional hazards model was used to identify independent prognostic factors. RESULTS: The average age at diagnosis was 6.3±0.5 years and males were predominant (65%). The most frequently observed clinical features were hepatomegaly, splenomegaly and lymphadenopathy. Central nervous system involvement and mediastinal enlargement occurred in 6.6% and 11.8%, respectively. B-acute lymphoblastic leukemia was more common (89.5%) than T-acute lymphoblastic leukemia. A DNA index >1.16 was found in 19% of patients and was associated with favorable prognosis. On Day 8 of induction therapy, 95% of the patients had lymphoblast counts <1000/µL and white blood cell counts <5.0×10(9)/L. The remission induction rate was 95%, the induction mortality rate was 2.6% and overall survival was 72%. CONCLUSION: The prognostic factors identified are compatible with the literature. The 5-year overall and event-free survival rates were lower than those reported for developed countries. As shown by the multivariate analysis, age and baseline white blood cell count were independent prognostic factors.

Proteins of the mitotic checkpoint and spindle are related to chromosomal instability and unfavourable prognosis in patients with myelodysplastic syndrome.

AIMS: To study the immunoexpression of proteins related to the mitotic checkpoint (cell division cycle 20 (CDC20), mitotic arrest deficient 2 (MAD2)) and the mitotic spindle (Aurora-B) in patients with myelodysplastic syndrome (MDS). METHODS: Protein expression was analysed in bone marrow tissue samples from 40 patients with MDS using immunohistochemistry. Prognostic markers (transfusion dependency, depth of cytopenias, chromosomal abnormalities and survival) were also studied. RESULTS: Higher MAD2 expression was observed among patients with platelets <50×10(9)/L than among patients with platelets ≥50×10(9)/L (42.6±22.8% vs 22.7±19.1%, respectively). Higher CDC20 expression was identified among patients with three dysplasias compared with patients who presented with one or two dysplasias (33.9±24.1% vs 10.5±5.7% vs 12.8±7.8%, respectively), among patients who exhibited a complex versus non-complex karyotype (50.0±30.2% vs 18.4±14%, respectively) and among patients with platelets <50×10(9)/L vs platelets ≥50×10(9)/L (38.2±26.2% vs 16.1±12.4%, respectively). Higher Aurora-B expression was found in patients with an abnormal versus normal karyotype (21.2±13.2% vs 7.5±5.0%, respectively). High expression of MAD2 and CDC20 (≥50%) was associated with severe thrombocytopenia. We also found statistically significant differences in the overall survival rate when comparing different degrees of CDC20, MAD2 and Aurora-B protein expression. CONCLUSIONS: To the best of our knowledge, this is the first report to demonstrate that these proteins are associated with chromosomal abnormalities and poor prognosis in patients with MDS.

The microalga Spirulina platensis presents anti-inflammatory action as well as hypoglycemic and hypolipidemic properties in diabetic rats.

Spirulina platensis (Spi) is a microalga presenting high contents of proteins, γ-linolenic acid, vitamins and minerals, and showing many biological activities. It is a promising drug for the treatment of diseases including diabetes. The objectives of this work were to study Spi effects on alloxan-induced diabetic rats, and associate this to its anti-inflammatory activity. The treatment with Spi (25, 50 or 100 mg/kg, p.o.) started 48 h after the alloxan injection, continuing for 5 or 10 days. Biochemical parameters were measured in sera of treated and untreated animals. The anti-inflammatory activity of Spi was assessed by the formalin test and carrageenan-induced paw edema in mice. Immunostainings for TNF-alpha were carried out in the carrageenan-induced paw edema in rats, before and after the Spi treatment, and its effect on the release of myeloperoxidase from human neutrophils was also determined. Spi decreased glycemia as well as triglyceride and total cholesterol levels of diabetic rats. Levels of urea and creatinine were also reduced, while liver transaminases were unaltered. Spi also decreased dose-dependently the 1st (neurogenic) and mainly the 2nd phase (inflammatory) of the formalin test, as well as the carrageenan-induced paw edema in mice. The anti-inflammatory effect of Spi was further confirmed by decreases in TNF-alpha immunostaining in the inflamed paw and in the myeloperoxidase release from human neutrophils. The results showed that the anti-diabetic effect of S. platensis is already manifested after a 5-day treatment. Additionally, considering the relationship between diabetes and inflammation, the microalga anti-inflammatory action may also be involved.

Metastatic prostate adenocarcinoma associated with numb chin syndrome.

Metastatic tumors to the oral cavity are rare and account for approximately 1% of all malignant oral neoplasms. About 765 cases have been published in the English- and Chinese-language literature since 1950, with less than 6% of these cases corresponding to prostate cancer metastasis. Because of their uncommon incidence, the diagnosis of oral metastases, especially those originating from the prostate gland, may represent a challenge for general dentists, oral pathologists, and oral radiologists. Thus, the aim of this study was to describe an interesting case of prostate adenocarcinoma metastasizing to the posterior mandible. In addition, association with numb chin syndrome present in this case was discussed.

Tumores testiculares bilaterais por hiperplasia congênita de restos adrenais / Bilateral testicular tumors caused by congenital adrenal rest hyperplasia

OBJETIVOS: Tumores testiculares são uma rara condição associada à hiperplasia adrenal congênita (HAC) que decorrem da hiperplasia de restos adrenais intratesticulares (HRA), raramente ocorrendo associados a neoplasias malignas. Sua diferenciação histológica com tumores de células de Leydig é muito difícil, podendo levar a orquiectomias desnecessárias. O objetivo deste relato foi apresentar esse dilema diagnóstico em um paciente com HAC e tumores testiculares bilaterais. MÉTODOS: Relatou-se o caso de um paciente masculino, 16 anos, com diagnóstico de HAC desde os 3 anos de idade, que apresentava tumorações testiculares endurecidas, indolores e de crescimento lento, sendo encaminhado para orquiectomia bilateral. RESULTADOS: Foi decidido por tratamento conservador com prednisona, havendo significativa diminuição do volume testicular e normalização dos níveis de andrógenos. CONCLUSÃO: Este caso demonstra a importância de sempre se considerar a hipótese de HRA intratesticulares no diagnóstico diferencial dos tumores testiculares. A investigação e a conduta devem ser conduzidas de maneira cautelosa para se evitar orquiectomias desnecessárias.

OBJECTIVES: Testicular tumors are a rare condition associated with congenital adrenal hyperplasia (CAH), originated from intratesticular adrenal rest tumors, and they are rarely associated with malignant tumors. Their histological differentiation from Leydig-cell tumors is quite difficult, which would lead to inappropriate orchiectomies. Thus the objective of this report was to present this diagnostic dilemma. METHODS: Reported the case of 16-yr-old boy with previous diagnosis of CAH with bilateral testicular enlargement who was recommended to be submitted to a bilateral orchiectomy. RESULTS: Considering this findings, it was decided to treat conventionally with prednisone with significant reduction of testicular volume, and normalization of androgens levels. CONCLUSION: This case shows the importance of intratesticular adrenal rest tumors in the differential diagnosis of testicular tumors. Cautious approach during investigation and treatment are recommended to avoid inappropriate orchiectomies.

Influência do CD 20 na refratariedade do linfoma de Hodgkin clássico ao tratamento inicial com o esquema ABVD, no Ceará, Brasil / Influence of CD 20 antigen expression in the refractoriness of classical Hodgkin lymphoma in the first line treatment with ABVD protocol in Ceará state, Brazil

INTRODUÇÃO: A significância prognóstica do marcador imunológico CD 20 no linfoma de Hodgkin clássico (LHc) ainda é incerta, particularmente no que se refere à refratariedade ao tratamento inicial. OBJETIVOS: Avaliar a influência da positividade do marcador CD 20 na refratariedade do LHc ao tratamento poliquimioterápico inicial, com o esquema doxorubicina 25 mg/m², bleomicina 10 mg/m², vinblastina 6 mg/m² e dacarbazina 375 mg/m² (ABVD), no Ceará, Brasil. MATERIAL E MÉTODOS: Estudo analítico incluindo 97 pacientes com diagnóstico de LHc firmado entre janeiro de 2000 e dezembro de 2004. A análise foi realizada avaliando variáveis demográficas, clínicas e laboratoriais. RESULTADOS: Foi evidenciada uma positividade do CD 20 em 38,1 por cento dos pacientes. Na análise bivariada, CD 20 positivo (razão de chance [RC] = 4,02; intervalo de confiança [IC] = 1,09 - 8,54; p = 0,02), a presença de sintomas B (RC = 4,02; IC = 1,18-17,51; p = 0,01) e a elevação da desidrogenase lática (mediana não-refratários 248,5 [200,5 - 389,5]; mediana refratários 356 [208,5 - 545]; p = 0,03) apresentaram relação de pior prognóstico quanto à refratariedade. Na regressão logística, o CD 20 positivo (RC ajustada = 3,6; IC = 0,99 - 13,09; p = 0,05) e a presença de sintomas B (RC ajustada = 5,41; IC = 1,16 - 25,34; p = 0,03) continuaram apresentando pior prognóstico. DISCUSSÃO: Esses dados coincidem com a literatura, em que a positividade do marcador CD 20 está relacionada com pior resposta ao tratamento com ABVD. CONCLUSÃO: Os nossos dados indicam que o tratamento com ABVD não é completamente adequado para a abordagem terapêutica inicial deste subgrupo de pacientes e novas pesquisas precisam ser realizadas no sentido de aperfeiçoar o tratamento destes pacientes.

INTRODUCTION: The prognostic value of CD20 antigen expression in classical Hodgkin lymphoma (cHL) is uncertain, particularly regarding the refractoriness to first-line treatment. OBJECTIVES: To assess the influence of CD20 positiveness on the refractoriness of cHL to first-line chemotherapy with ABVD protocol in Ceará State, Brazil. MATERIAL AND METHODS: Analytical study including 97 patients diagnosed with cHL between January/2000 and December/2004. The analysis was performed evaluating demographic, clinical and laboratory variables. RESULTS: CD20 antigen expression was positive in 38.1 percent of the patients. In the bivariate analysis, CD20 antigen expression (OR = 4.02; CI = 1.09 - 8.54; p = 0.02), the presence of B-symptoms (OR = 4.02; CI = 1.18-17.51; p = 0.01) and an elevated lactate dehydrogenase level (median not refractory 248.5 [200.5 - 389.5]; median refractory 356 [208.5-545]; p = 0.03) showed worse prognosis as to refractoriness. In the logistic regression analysis, the presence of CD 20 (OR = 3.6; CI = 0.99-13.09; p = 0.05) and B-symptoms (OR = 5.41; CI = 1.16-25.34; p = 0.03) continued to show worse prognosis. DISCUSSION: These findings coincide with literature data indicating that CD 20 antigen expression is associated with low response to treatment with ABVD. CONCLUSION: Our data show that the treatment with ABVD is not totally appropriate for the initial therapeutic approach in this subgroup of patients and that further studies are required to optimize their treatment.

[Bilateral testicular tumors caused by congenital adrenal rest hyperplasia]. / Tumores testiculares bilaterais por hiperplasia congênita de restos adrenais.

OBJECTIVES: Testicular tumors are a rare condition associated with congenital adrenal hyperplasia (CAH), originated from intratesticular adrenal rest tumors, and they are rarely associated with malignant tumors. Their histological differentiation from Leydig-cell tumors is quite difficult, which would lead to inappropriate orchiectomies. Thus the objective of this report was to present this diagnostic dilemma. METHODS: Reported the case of 16-yr-old boy with previous diagnosis of CAH with bilateral testicular enlargement who was recommended to be submitted to a bilateral orchiectomy. RESULTS: Considering this findings, it was decided to treat conventionally with prednisone with significant reduction of testicular volume, and normalization of androgens levels. CONCLUSION: This case shows the importance of intratesticular adrenal rest tumors in the differential diagnosis of testicular tumors. Cautious approach during investigation and treatment are recommended to avoid inappropriate orchiectomies.

Cyclooxygenase-2 expression on ifosfamide-induced hemorrhagic cystitis in rats.

PURPOSE: Hemorrhagic cystitis (HC) is a limiting side effect of chemotherapy with ifosfamide (IFS). In this study, we investigated the participation of cyclooxygenase-2 (COX-2) upon ifosfamide-induced HC. METHODS: Male Wistar rats (150-200 g; six rats per group) were treated with saline, IFS (400 mg/kg, i.p.) and analyzed by changes in bladder wet weight, macroscopic and microscopic parameters, and COX-2 expression. In other groups etoricoxib (selective COX-2 inhibitor), indomethacin (non-selective COX inhibitor), thalidomide (selective TNF-alpha inhibitor), pentoxifyllin (non-selective TNF-alpha inhibitor) were added 1 h before IFS administration. The classical protocol using three doses of Mesna was also evaluated and compared with two extra doses of etoricoxib or indomethacin. RESULTS: COX-2 was expressed significantly 24 h after IFS administration mainly in myofibroblasts and mast cells evaluated by immunohistochemistry. Treatment 1 h before IFS injection with etoricoxib, indomethacin, thalidomide, and pentoxifylline reduced COX-2 expression and some macroscopic and microscopic parameters in IFS-induced HC. Moreover, addition of etoricoxib or indomethacin with the last two doses of Mesna was more efficient than three doses of Mesna alone when evaluated microscopically. CONCLUSIONS: COX-2 participates in the pathogenesis of IFS-induced HC and the treatment with COX and TNF-alpha inhibitors reduced COX-2 expression. The addition of COX-inhibitors to the last two doses of Mesna represents a new therapeutic strategy of preventing HC.

Localização no calcâneo de linfoma não-Hodgkin B de grandes células primário do osso: relato de caso e revisão de literatura / Calcaneous involvement by primary large B-cell non-Hodgkin's lymphoma of bone: a case report and literature review

Descreve-se, neste artigo, um caso raro de linfoma não-Hodgkin B de grandes células extranodal primário do osso em um paciente de seis anos de idade, do sexo masculino, com manifestaçãoclínica e radiológica inicial em localização não-comum (tálus).

A case of a 6-year-old male primary B-cell non-Hodgkin's lymphoma with lytic bone lesion in an unusual location was demonstrated by clinical and radiologic examination.

Lesões pré-invasivas da cérvice: marcadores diagnósticos e prognósticos / Pre-invasive lesions of the cervix: diagnostic and prognostic markers

Anualmente ocorrem mais de 500.000 casos no mundo, dos quais 80 porcento em países em desenvolvimento. No Brasil, cerca de 20.000 novos casos ocorrem a cada ano. O papilomavírus humano está, virtualmente, associado a todos os casos, mas a identificação de HPV de alto risco não é a única condição associada com a lesão ou com a possibilidade de progressão. Por outro lado, os mecanismos envolvidos na biologia do vírus, principalmente os genes E6 e E7, agem como passos essenciais na indução e progressão das lesões epiteliais. Recentemente, muitos marcadores têm sido estudados para identificar as lesões de pior prognóstico e especificamente para melhorar a reprodutibilidade do diagnóstico morfológico. Os autores fazem uma revisão de importantes marcadores imuno-histoquímicos (MIB-I, p53, p16 INK4a, Cdc6) de lesões intra-epiteliais escamosas e daqueles com possibilidade de uso em futuro bem próximo.

Prognostic markers of high-grade squamous intraepithelial lesions: the role of p16INK4a and high-risk human papillomavirus.

BACKGROUND: p16INK4a seems to be an indicator of the grade of Human Papillomavirus-induced lesions and a possible predictor of the lesion evolution. There are few studies about the role of HPV test and p16INK4a in diagnosis of high-grade cervical lesions in South-American women. The aim of the present study was to evaluate the presence of p16INK4a and high-risk HPV-DNA expression in cases diagnosed as squamous intra-epithelial lesion and evaluate their role in the approach of high-grade squamous intra-epithelial lesion. METHODS: p16INK4a and high-risk Human papillomavirus were investigated in 96 samples of the cervix (13 cases of high grade squamous intraepithelial lesions, 26 cases of low grade intraepithelial lesions and 57 normal tissues). The p16INK4a was identified by immunohistochemistry using the p16INK4a kit (E6H4 clone, DakoCytomation, Carpinteria, CA) and Human papillomavirus DNA was classified by hybrid capture (Digene). Associations were evaluated by the KAPPA index. RESULTS: The p16INK4a was detected in 92.3% of the high-grade squamous intraepithelial lesions, in 15.4% of the low-grade and in none of the normal tissues. The sensitivity, specificity, positive predictive value and negative predictive value for high-grade lesion were 92.3%, 100%, 100%, and 98.3%, respectively when considering p16INK4a expression, and 100%, 70.2%, 43.3% and 100%, respectively when considering high-risk HPV. CONCLUSIONS: p16INK4a test was better associated with high-grade intraepithelial lesion (kappa = 0.95) than was the presence of high-risk HPV (kappa = 0.47). Both tests could be complementary to high-grade squamous intra-epithelial lesion screening and help to define the diagnosis of the inconclusive low-grade/high-grade squamous intraepithelial lesion cases.

Histological changes in bladders of patients submitted to ifosfamide chemotherapy even with mesna prophylaxis.

PURPOSE: Hemorrhagic cystitis (HC) is a limiting side effect of chemotherapy with ifosfamide (IFS). Mesna is the drug of choice for prevention of HC. In this study, we analyzed cystoscopic and histological changes present in bladders of patients using IFS with mesna prophylaxis. METHODS: Thirty-three patients selected for IFS plus three doses of mesna chemotherapy regime were assigned at random to two groups: Group I or reference group consisted of 18 patients yet untreated. Group II consisted of 15 patients in whom urinalysis and cystoscopy plus vesical biopsy were performed only 24 h after receiving the last dose of IFS. The cystoscopic and histological findings were used as parameters for evaluating the results. For the former the criterion adopted was macroscopic vesical changes in accordance with Gray's criteria. Histological analyses were performed by evaluation method especially adapted to this study. RESULTS: Even under treatment with three doses of mesna, 66.7% of patients presented cystoscopic alterations and 100% showed bladder mucosa microscopic alterations such as edema, exocytosis, and hemorrhage. CONCLUSIONS: The standard protocol used for prevention of IFS-induced HC with three doses of mesna does not completely prevent bladder damage. The histopathological criteria used in this study for observation of inflammatory events allowed staging the intensity of IFS-induced urothelial and mucosal injury.

Analysis of the association between Epstein-Barr virus and classic Hodgkins lymphoma in adult patients from Ceará (Brazil) by immunohistochemistry and in situ hybridization

The prevalence of Epstein-Barr virus (EBV) in patients with classical Hodgkins lymphoma (CHL) is geographically variable. In the present study the prevalence of EBV in CHL was assessed in adult patients from Ceará, Brazil. Thirty-seven cases were immunohistochemically evaluated for EBV using latent membrane protein (LMP1) antibody and for EBV latency-associated RNA (EBER1) using in situ hybridization (ISH). Sex and age did not differ among patients as to the frequency of CHL. Nodular sclerosis was the predominant histological subtype. LMP1 was found in Reed-Sternberg cells in 67.5 percent of the cases whereas ISH detected EBER1 in 75.6 percent. Regarding histological subtypes EBV infection rates were not found statistically different in nodular sclerosis (NS) and mixed cellularity (MC) subtypes (p = 0.66).

A freqüência do vírus Epstein-Barr (EBV) em pacientes com linfoma de Hodgkin Clássico (LHC) sofre variabilidade geográfica. No presente estudo investigamos a freqüência do EBV em pacientes com LHC no estado do Ceará. Trinta e sete casos de linfoma de Hodgkin clássico foram avaliados por imuno-histoquímica para EBV usando o anticorpo monoclonal contra a proteína latente da membrana (LMP1) e pelo método de hibridização in situ para RNA associado ao EBV (EBER1). Não há diferença por sexo e idade dos pacientes no que concerne à freqüência de LHC. O subtipo histológico esclerose nodular foi predominante. LMP1 esteve presente em células Reed-Sternberg em 67,5 por cento e pela hibridização in situ, através da sonda EBER, foi evidente em 75,6 por cento dos casos. Não observamos predominância significativa da associação de EBV com os subtipos histológicos esclerose nodular (EN) e celularidade mista (CM) (p = 0,66).

[A novel model for isolation of Walker's tumoral cells using the Ficoll-Hypaque gradient]. / Um novo modelo de isolamento do tumor de Walker utilizando o gradiente de Ficoll-Hypaque.

PURPOSE: The purpose was to evaluate a novel technique for isolation of Walker's tumoral cells using a Ficoll-Hypaque gradient and its further influence on tumor development. METHODS: Twenty male Wistar rats have been divided in 2 groups: G1= without ficoll, G2= with ficoll. Tumor was excised, homogenized and suspended in lactate ringer. A sample of the cell suspension was adjusted at a concentration of 1x10(6) cells/ml (G1). A second sample was centrifuged on a Ficoll-Hypaque gradient and the cell concentration was then adjusted (G2). Tumor was implanted by subcutaneous injection of 1.0 ml in the right armpit of rats. Tumor volume (TV) and tumor weight (TW) were compared in two groups. RESULTS: There were no differences between the two groups in TV (G1=17.9+/-3.8 cm3 vs. G2=17.2+/-4.4 cm3; p=0.190) and TW (G1=7.0+/-1.8 g vs. G2=7.3+/-2.8 g; p=0.569). The histological analysis showed similar patterns of infiltration by small-undifferentiated cells and necrosis in both groups. However, a mild to moderate granulocytic exudate was more frequent in the animals whose tumors derived from Ficoll-isolated cells. Hemorrhage from slight to moderate was only observed in this group. CONCLUSION: A Ficoll-Hypaque gradient can provide more adequate isolation of Walker's tumor and the cell suspension obtained by this technique has lower contamination by other cell types.

Um novo modelo de isolamento do tumor de Walker utilizando o gradiente de Ficoll-Hypaque / A novel model for isolation of Walker's tumoral cells using the Ficoll-Hypaque gradient

OBJETIVO: Analisar uma nova técnica de isolamento das células do tumor de Walker, utilizando o gradiente de ficoll-hypaque. MÉTODOS: Vinte ratos Wistar machos foram divididos em 2 grupos (G1, G2). O tumor do animal doador foi dissecado, triturado em solução de ringer lactato e filtrado. A suspensão celular obtida foi dividida em duas alíquotas (A1 e A2) e a alíquota A2 foi centrifugada em gradiente de ficoll-hypaque. As duas alíquotas foram ajustadas para uma concentração de 1X10(6) células/ml. Um ml da suspensão A1 ou A2 foi injetado por via subcutânea na axila direita dos ratos dos seus respectivos grupos. Os diâmetros tumorais, peso tumoral e análise histológica foram avaliados. RESULTADOS: Não houve diferença no volume tumoral (G1=17,9±3,8cm³; G2=17,2±4,4cm³; p=0,190) e no peso tumoral (G1=7,0±1,8g; G2=7,3±2,8g; p=0,569). A análise histológica evidenciou padrões semelhantes de infiltração de células pequenas indiferenciadas e de necrose nos dois grupos. Entretanto, exsudato granulocítico leve a moderado foi mais acentuado no G2 do que no grupo G1 e hemorragia leve a moderada foi observada somente no grupo com ficoll. CONCLUSÃO: O gradiente de ficoll-hypaque é uma técnica adequada de isolamento das células do tumor de Walker e fornece uma suspensão celular menos contaminada com outros tipos celulares.

Células de Langerhans no epitélio da prega vocal humana: estudo imunoistoquímico / Langerhans cells in human vocal folds mucosa: immunohistochemical study

Células de Langerhans (CL) são um tipo de células dendríticas que têm funções que envolvem apresentação de antígeno e a estimulação de resposta T dependente. Elas representam aproximadamente 4 por cento das células do epitélio laríngeo. OBJETIVO: Identificar a presença de CL no epitélio das pregas vocais, comparar suas subpopulações, bem com comparar a capacidade de quatro marcadores imunoistoquímicos. FORMA DE ESTUDO: Experimental. CASUíSTICA E MÉTODO: Seis cadáveres, 3 homens e 3 mulheres foram estudados. Foram analisadas amostras de pele e das pregas vocais coradas e imunomarcadas para vimentina, proteína S-100, CD-68 e fascina. Após análise histológica, foi realizado o teste t de Student e análise de variância no estudo estatístico. RESULTADOS E CONCLUSÕES: Foi possível identificar a presença de CL no epitélio das pregas vocais de humanos não fumantes de ambos os sexos. A fascina, a vimentina o CD-68 mostraram-se bons marcadores das CL, enquanto a proteína S-100 teve estatisticamente menor poder de marcação tanto na prega vocal (p=0,01) como na pele (p=0,02). Foi possível identificar três diferentes subpopulações de CL presentes tanto na prega vocal como na pele destes indivíduos, contudo apenas na pele observarmos maior quantidade estatisticamente significante na camada basal do epitélio.

Modelo experimental de tumor na cavidade oral de ratos com carcinossarcoma de Walker 256 / Experimental model of Walker 256 carcinosarcoma developed in the oral cavity of rats

OBJETIVO: Estabelecer um modelo experimental de desenvolvimento tumoral na cavidade oral de ratos, permitindo, assim, o estudo da osteólise induzida pelo tumor nos ossos do complexo maxilomandibular como também nas estruturas dentais, através da caracterização histomorfológica da reabsorção óssea e dentária. MÉTODOS: Uma suspensão de células tumorais (0,1mL) do Carcinossarcoma de Walker 256, na concentração de 10(6) células/mL foi implantado na cavidade alveolar de ratos previamente aberta por exodontia. Os animais foram observados durante 12 (doze) dias consecutivos para determinação da curva de peso corpóreo, sendo posteriormente sacrificados e as mandíbulas removidas para exames radiográfico e histológico. RESULTADOS: No exame radiográfico foi verificada área lítica, sem evidência de reparo, na região dos alvéolos. No exame microscópico foi identificada infiltração óssea, periférica e central, de pequenas células hipercromáticas e pleomórficas, com leve infiltrado inflamatório mononuclear associado e áreas de necrose. O índice de pega foi de 100 por cento. CONCLUSAO: O modelo animal de invasão óssea, do tumor de Walker na cavidade oral, possibilita a avaliação in vivo de drogas antitumorais e esquemas terapêuticos no tratamento do câncer bucal.