Lymph node involvement and not the histophatologic subtype is correlated with outcome after resection of adenocarcinoma of the ampulla of vater.

BACKGROUND: Intestinal and pancreaticobiliary types of Vater's ampulla adenocarcinoma have been considered as having different biologic behavior and prognosis. The aim of the present study was to determine the best immunohistochemical panel for tumor classification and to analyze the survival of patients having these histological types of adenocarcinoma. METHOD: Ninety-seven resected ampullary adenocarcinomas were histologically classified, and the prognosis factors were analyzed. The expression of MUC1, MUC2, MUC5AC, MUC6, CK7, CK17, CK20, CD10, and CDX2 was evaluated by using immunohistochemistry. RESULTS: Forty-three Vater's ampulla carcinomas were histologically classified as intestinal type, 47 as pancreaticobiliary, and seven as other types. The intestinal type had a significantly higher expression of MUC2 (74.4% vs. 23.4%), CK20 (76.7% vs. 29.8%), CDX2 (86% vs. 21.3%), and CD10 (81.4% vs. 51.1%), while MUC1 (53.5% vs. 82.9%) and CK7 (79.1% vs. 95.7%) were higher in pancreatobiliary adenocarcinomas. The most accurate markers for immunohistochemical classification were CDX2, MUC1, and MUC2. Survival was significantly affected by pancreaticobiliary type (p = 0.021), but only lymph node metastasis, lymphatic invasion, and stage were independent risk factors for survival in a multivariate analysis. CONCLUSION: The immunohistochemical expression of CDX2, MUC1, and MUC2 allows a reproducible classification of ampullary carcinomas. Although carcinomas of the intestinal type showed better survival in the univariate analysis, neither histological classification nor immunohistochemistry were independent predictors of poor prognosis.

E-cadherin/beta-catenin expression pattern, clinicopathological parameters and prognosis in gastric carcinomas

Objectives: This study aimed to evaluate the expression pattern of some markers (E-cadherin and â-catenin) related to cellular adhesion and their relationship with histological tumor type according to Laurén’s system, clinicopathological features and patient survival. Material and Methods: We did immunohistochemical analysis in a retrospective series of 446 gastric carcinomas using tissue microarray method (TMA). Clinicopathological features and overall survival data of all patients were retrospectively reviewed from hospital records. For all statistical analyses, p<0.05 was considered significant. Results: The reduced/absent expression of E-cadherin occurred more frequently in diffuse than intestinal type tumors and it was correlated with worse biological behavior and poor prognosis for patients with diffuse type gastric carcinomas. The pattern of â-catenin expression was closely related to histological type and E-cadherin expression. Although patients with nuclear/absent â-catenin immunoreactivity showed worse survival index, no statistical correlation was found with overall survival. In multivariated analysis, only pTNM staging system persisted as independent prognostic marker. Conclusion: In the present study, alterations in E-cadherin/â-catenin complex expression showed significant correlations with clinicopathological parameters, as well as its implications for tumor progression and prognosis in gastric cancer. Our results indicate that markers expression pattern may be a useful marker of differentiation and suggest further investigations of their prognostic relevance to specific histological groups.

Atrofia Muscular em pacientes oncológicos internados em unidade de terapia intensiva / Muscle atrophy in cancer patients in the intensive care unit

A imobilização e restrição ao leito de pacientes internados em Unidade de Terapia Intensiva causam, entre outras complicações, diminuição da força e atrofia muscular. Com o objetivo de avaliarmos estes efeitos em sete pacientes oncológicos internados na Unidade de Terapia Intensiva do Hospital do Câncer, mensuramos as espessuras dos músculos gastrocnêmio e quadríceps, com intervalo de cinco dias por meio...