Microvascular density analysis and histological parameters of oral cancer progression.

OBJECTIVES: This study aimed to investigate the role of blood and lymphatic microvascular density in the progression of oral squamous cell carcinoma (OSCC). MATERIALS AND METHODS: The sample was composed of 54 cases of OSCC. The immunoexpression to anti-alpha-smooth muscle actin (α-SMA) and to anti-endoglin (CD105) was used to determine the microvessel density (MVD); anti-podoplanin (D2-40) was used to assess the lymphatic vessel density (LVD); vascular endothelial growth factor (VEGF) was evaluated in malignant cells. The histological differentiation, the worst pattern of invasion (WPOI), tumour thickness and tumour budding (TB) intensity were assessed using haematoxylin-eosin and anti-pan-cytokeratin (AE1/AE3). Patients' age and sex, TNM classification and follow-up time were collected from the medical records. RESULTS: MVD markers presented a similar pattern of expression in blood vessels. However, only α-SMA + MVD was significantly higher among women and in tumours ≤4 cm. LVD was lower in tumours with lymph node metastasis. Regarding the histological parameters, high TB intensity was associated with histological differentiation, advanced clinical stage, greater tumour thickness and reduced disease-free survival. No difference was found in VEGF. CONCLUSIONS: The decrease in OSCC LVD could be related to pathological node involvement, whereas high TB intensity could indicate OSCC progression and worse patient outcomes.

Prevalence of HPV infection and cervical intraepithelial lesions in HIV positive and negative women in the city of Florianopolis / Prevalência da infecção pelo HPV e lesões intraepiteliais cervicais em mulheres HIV positivas e negativas na cidade de Florianópolis

Introduction: HPV infection is the most frequent sexually transmitted infection in women. The high oncogenic risk HPV, associated with others factors, there are a risk of progressing to a precancerous lesion of the cervix and even cancer. This evolution is related to the persistence of the infection and other factors, mainly those that interfere with the woman's immunity. The immunosuppression caused by HIV infection is an important factor for viral persistence and the appearance of these lesions. Objectives: To compare the prevalence of HPV infection and cervical intraepithelial lesions in HIV-positive and negative women and describe the possible associated risk factors. Methods: The sample consisted of 50 HIV positive women (study group) and 50 HIV negative women (control group) recruited from the public health system of Florianópolis during the months of January to April 2022. Cervical samples were collected for cytological analysis and for detection of high-risk oncogenic HPV DNA by polymerase chain reaction (PCR). Categorical variables were compared using the chi-square test, with a significance level set at 5% Results: HPV infection was more prevalent in the control group, however, HIV positive women had a higher frequency of intraepithelial lesions diagnosed on cytology. Factors such as greater number of sexual partners, depression and smoking were more frequent in the group of HIV positive women. The number of CD4 T cells less than 200 cels/mm3 was associated with a higher number of altered Pap smears and a positive HPV DNA test. The use of combination antiretroviral therapy and undetectable viral load were associated with a greater number of normal cytology and undetected HPV DNA. Conclusion: The prevalence of cervical intraepithelial lesions in HIV-infected women is higher than in women without infection. The presence of HIV infection was the most important risk factor associated with the development of cervical lesions. (AU)

Introdução: O Papilomavírus Humano (HPV) é a infecção de transmissão sexual mais frequente na mulher. O HPV de alto risco oncogênico, associado a outros fatores, apresenta risco de evoluir para uma lesão pré-cancerosa do colo de útero e até mesmo para o câncer. Essa evolução está relacionada à persistência da infecção e outros fatores, principalmente os que interferem na imunidade da mulher. A imunossupressão causada pela infecção HIV é um fator importante para a persistência viral e o aparecimento destas lesões. Objetivos: Comparar a prevalência da infecção pelo HPV e das lesões intraepiteliais do colo de útero em mulheres HIV positivas e negativas, e descrever os possíveis fatores de risco associados. Métodos: A amostra foi composta por 50 mulheres HIV positivas (grupo de estudo) e 50 mulheres HIV negativas (grupo controle) recrutadas no sistema público de saúde de Florianópolis durante os meses de janeiro a abril de 2022. Foram coletadas amostras cervicais para análise citológica e para detecção do DNA HPV de alto risco oncogênico por reação em cadeia da polimerase (PCR). As variáveis categóricas foram comparadas pelo teste qui-quadrado, com nível de significância estabelecido em 5%. Resultados: A infecção pelo HPV foi mais prevalente no grupo controle, entretanto, as mulheres HIV positivas tiveram uma maior frequência de lesões intraepiteliais diagnosticadas na citologia. Os fatores como maior número de parceiros sexuais, depressão e tabagismo foram mais frequentes no grupo de mulheres HIV positivas. O número de células TCD4 inferior a 200 células/mm3 esteve associado a maior número de colpocitologias alteradas e teste DNA HPV positivo. O uso da terapia antirretroviral combinada e a carga viral indetectável estiveram associadas a um número elevado de citologias normais e DNA HPV não detectado. Conclusão: A prevalência de lesões intraepiteliais do colo do útero em mulheres infectadas pelo HIV foi maior que em mulheres soronegativas. A presença de infecção pelo HIV foi o fator de risco mais importante associado ao desenvolvimento de lesões cervicais.Palavras-chave: HPV. HIV. coinfecção. lesões intraepiteliais escamosas cervicais. prevalência.. (AU)

Aerobic Exercise Attenuates Kidney Injury, Improves Physical Performance, and Increases Antioxidant Defenses in Lungs of Adenine-Induced Chronic Kidney Disease Mice.

The association between chronic kidney disease (CKD) and pulmonary pathophysiological changes is well stablished. Nevertheless, the effects of aerobic exercise (AE) on lungs of CKD need further clarification. Thus, Swiss mice were divided in control, AE, CKD, and CKD + AE groups. CKD was induced by 0.2% adenine intake during 8 weeks (4 weeks of CKD induction and 4 weeks of AE). AE consisted in running on treadmill, at moderate intensity, 30 min/day, 5 days/week, during 4 weeks. Twenty-four hours after the last training day, functional capacity test was performed, and 48 h after the test, mice were euthanized. CKD mice showed a significant increase in urine output, serum urea, and creatinine concentrations, and decreased body weight and urine density, besides oxidative damage (p = 0.044), edema area (p < 0.001), leukocyte infiltration (p = 0.040), and collagen area in lung tissue (p = 0.004). AE resulted in an increase of distance traveled (p = 0.049) and maximum speed (p = 0.046), increased activity of catalase (p = 0.031) and glutathione peroxidase (p = 0.048) in lungs, increased levels of nitric oxide (NOx) in serum (p = 0.001) and bronchoalveolar lavage fluid (p = 0.047), and decreased kidney histological injury (p = 0.018) of CKD mice. However, AE also increased oxidative damage (p = 0.003) and did not change collagen content or perivascular edema in lungs (p > 0.05) of CKD mice. Therefore, AE attenuated kidney injury and improved antioxidants defenses in lungs. Despite no significant changes in pulmonary damage, AE significantly improved physical performance in CKD mice.

The challenging diagnosis of low-grade myofibroblastic sarcoma: A case report and literature update.

Low-Grade Myofibroblastic sarcoma (LGMS) is categorized as an extremely rare malignant neoplasia of myofibroblasts, which has only recently become more widely studied. Our patient was referred for evaluation of a nodule involving the palate. The histopathological analysis showed a mesenchymal tumor formed for stellate-shaped cells. Negativity for Laminin, Desmin, Collagen IV, CK pool, CD34, S100, and ALK1, discarded epithelial, endothelial, neural, and inflammatory origin. On the other hand, the positivity for Calponin and SMA demonstrated myofibroblastic and smooth muscle differentiation. The diagnosis of LGMS was endorsed and the patient was submitted for medical treatment. To date, only 18 cases describing patients diagnosed with intrabuccal LGMS have been reported in the scientific literature. Here, we introduce a rare report and for the first time, also provide an update of the literature and a clear review regarding the immunohistochemical panel to diagnose this entity, once the histopathological diagnosis is still challenging.

Analysis of Ki-67 expression in women with breast cancer: Comparative evaluation of two different methodologies by immunophenotyping.

The Ki-67 antigen is a nuclear protein with proven prognostic value in different neoplasms and recognizes the predictive value in breast cancer (BC). No consensus exists on the ideal cutoff point. In this study, Ki-67 expression was evaluated in samples of BC by flow cytometry (FC) and compared with immunohistochemical (IHC) examination. For this, the BC tissue samples were sectioned, macerated, filtered, and marked with anti-Ki-67 FITC and anti-CD45 V500 antibodies. We selected the neoplastic cells according to CD45 expression and size and internal complexity (FSC × SSC) using the Infinicity 1.7 software. Lymphocytes were negative control. We compared the results with IHC analyses carried out in parallel and independently. The expression of Ki-67 was evaluated in both methodologies through Bland-Altman analysis. Among the 44 samples analyzed, only three showed bias higher than the established confidence interval (mean bias 2.1%, p = 0.62), with no significant difference for the perfect mean bias (0%). Therefore, one can state that FC provides results equivalent to IHC analysis and possibly analyzes more cells simultaneously. The results obtained in this study show the absence of observational bias through software analysis in a larger number of tumor cell populations. We can conclude that FC may be a promising alternative method for investigating Ki-67 in solid tumours.

Evaluation of ER, PR and HER2 markers by flow cytometry for breast cancer diagnosis and prognosis.

BACKGROUND AND AIMS: Laboratory diagnosis of breast cancer (BC) is done by morphological analysis and immunohistochemistry (IHC). However, this methodology still has some limitations. The aim of this study is to validate flow cytometry (FC) immunophenotyping to investigate diagnostic and prognostic markers of BC. METHODS: Tumor samples from surgical specimens of patients previously diagnosed with BC, were first sliced and then macerated together with PBS. Then, sample was filtered and the single cell suspension obtained was labeled with antibodies against estrogen (ERα), progesterone (PR) and HER2 receptors and CD45. The results were compared, in terms of sensitivity, specificity, positive predictive value (PPV) and negative predictive value (NPV), with reference methods. RESULTS: Results obtained comparing FC with reference methods were: ERα detection (sensitivity: 75%; specificity: 90%; PPV: 96.7%; NPV: 47.4%); PR detection (sensitivity: 72%; specificity: 70%; PPV: 79.3%; NPV: 60.8%); HER2 detection (sensitivity: 80%; specificity: 90.2%; PPV: 66.7%; NPV: 94.9%). CONCLUSION: The results obtained show the capacity of this methodology on BC markers differentiation. FC, together with morphological analysis and IHC can overcome individual limitations of each methodology and provide reliable results on a faster and efficient manner, resulting in improvements on BC diagnosis and prognosis.

Association of TNFRSF1A and IFNLR1 Gene Polymorphisms with the Risk of Developing Breast Cancer and Clinical Pathologic Features.

Several genes have been associated with breast cancer (BC) susceptibility. The tumor necrosis factor receptor superfamily, member 1A (TNFRSF1A), and interferon lambda receptor 1 (IFNLR1) genes encode receptors that mediate the action of inflammatory cytokines. Previous studies have demonstrated the association of the variants rs1800693 (TNFRSF1A) and rs4649203 (IFNLR1) with some inflammatory diseases. The present study aimed to verify a possible association of these variants with BC, its clinical pathologic features, as well as epidemiological data in a Brazilian population. A total of 243 patients and 294 individuals without history of BC were genotyped for these polymorphisms through TaqMan® SNP genotyping assays by qPCR. For the TNFRSF1A gene, no significant results were found. For IFNLR1, the AA genotype (p = 0.008) and the A allele (p = 0.02) were significantly associated with a lower risk of developing BC. When analyzing the age, it was observed that each increase of one year contributes to the development of BC (p < 0.001). Also, the smoking habit (p < 0.001) and body mass index (p = 0.018) increase the risk of disease development. Analyzing progesterone receptor factor an association was found with the AA genotype of the IFNLR1 (p = 0.02). The findings suggest that polymorphism in the immune-related IFNLR1 gene contribute to BC susceptibility in a Brazilian population. These findings can contribute to the further understanding of the role this gene and pathways in BC development.

Retrospective study of 124 cases of salivary gland tumors and literature review.

BACKGROUND: Salivary gland tumors are a rare and morphologically diverse group of lesions and their frequency is still unknown in several parts of the world. The knowledge of its population characteristics contributes to a better understanding of its etiopathogenesis. Objectives: This study investigated the frequency of salivary gland tumors in a region of southern Brazil and compared these data in a literature review. MATERIAL AND METHODS: A retrospective study was conducted of salivary gland tumors diagnosed at two pathology centers from 1995 to 2016. Patient age and gender, tumor site and frequency, histopathological diagnosis, and symptomatology were evaluated. Chi-squared tests were used to assess the associations between variables. To compare our data, we also conducted a literature review of publications in the PubMed and LILACS databases of retrospective studies of salivary gland tumors. RESULTS: A total of 124 salivary gland tumor cases was identified, 81 (65.3%) of which were classified as benign and 43 (34.6%) as malignant. Most tumors occurred in the parotid gland (57.2%). Pleomorphic adenoma was the most common tumor (59.6%), followed by adenocarcinoma not otherwise specified (8.8%). The tumors occurred more often in women (54.8%) than in men (45.2%). Malignant tumors were associated with pain in 31.4% of cases (p<0.05). The literature review included 35 articles from different countries. Women were most affected, with a mean age of 41.7 years. The most common benign tumor was pleomorphic adenoma (48.2%) and the most common malignant tumor was mucoepidermoid carcinoma (8.7%). CONCLUSIONS: The results of the present study showed that salivary gland tumors are rare. The parotid gland is the most common location and pleomorphic adenoma are the most frequent lesions. The malignant tumors presented as several histological types and the incidence was variable globally. Key words:Salivary gland neoplasms, salivary gland diseases, oral surgery, epidemiology.

Primary intraosseous carcinoma of the maxilla arising from an odontogenic keratocyst: a case report and review of the literature.

A 47-year-old man was referred for treatment of a painful lesion of 5 months' duration located on the left side of the maxilla. A small perforation in the buccal cortex was observed during the intraoral examination. Cone beam computed tomography (CBCT) showed an extensive, well-delimited radiolucent lesion extending from the alveolar ridge to the nasal cavity. An incisional biopsy was performed, and a cystic lesion consistent with an odontogenic keratocyst (OKC) was observed microscopically. The initial treatment option was decompression to be followed by enucleation. However, 3 months after decompression of the lesion, the patient returned because there was a significant increase in the size of the perforation. A destructive lytic lesion that involved the left side of the maxilla and crossed the midline was evident in the CBCT. The examination of a second incisional biopsy specimen showed epithelial neoplasia comprising islands and projections toward the surface. There was abundant keratin deposition, resulting in the formation of pearls and plugs. A diagnosis of primary intraosseous carcinoma arising from an OKC was confirmed, and the patient underwent a maxillectomy. After 1 year of follow-up, there were no signs of recurrence.

Immunohistochemical expression of matrix metalloproteinases in ameloblastomas and pericoronal follicles.

BACKGROUND: Ameloblastoma (AM) is a benign odontogenic neoplasm characterized by local invasiveness and recurrence. We compared the immunohistochemical expression of matrix metalloproteinases in different clinical types of AM as well as in normal odontogenic tissue. METHODS: Thirteen cases of solid AMs, five cases of unicystic AM and eight pericoronal follicles (PF) were selected and subjected to immunohistochemical investigation for matrix metalloproteinase-1, matrix metalloproteinase-2 and matrix metalloproteinase-9 expressions. RESULTS: The expressions of MMP-1 and MMP-2 were very high in the cytoplasm of cells throughout the entire epithelium and in fibroblasts from the adjacent connective tissue. MMP-9 expression was observed in the same location although with weaker staining. The Kruskal-Wallis test showed statistically significant differences in the epithelial expressions of MMP-1 and MMP-2; there was lower expression among solid AMs when compared with unicystic AM and PF. Compared to both types of AM, higher stromal expression of MMP-9 was found in PF. CONCLUSION: MMP-1, MMP-2 and MMP-9 seem to be associated with AM tumour behaviour as well as physiological tissue remodelling within PF.

Evaluation of immunohistochemical expression of ghrelin-producing rectal cells in Wistar rats underwent to the cafeteria diet

PURPOSE:To investigate the impact of cafeteria diet on ghrelin expression in rectal tissue and identify the morphologic cell type. METHODS:Twenty-four male Wistar rats were divided into four subgroups of six animals each: RC1 (rat chow 1) and CAF1 (cafeteria diet 1) for a period of 30 days; RC2 (rat chow 2) and CAF2 (cafeteria diet 2) for a period of 60 days. The animal and rectal weight, the number and the type of immunoreactive ghrelin cells were recorded and compared between the subgroups. The statistical study was established by ANOVA and Student's t test. RESULTS:There was no difference in the total of immunoreactive cells (p=0.685) between the subgroups nor between weight and presence or absence of ghrelin expression (p=0.993). All the immunoreactive cells identified were closed-type. CONCLUSION:The cafeteria diet did not have influence on the amount of immunoreactive rectal cells of ghrelin and only one type (closed-type) of immunoreactive cells was expressed in the rectum.

Evaluation of immunohistochemical expression of ghrelin-producing rectal cells in Wistar rats receiving the cafeteria diet.

PURPOSE: To investigate the impact of cafeteria diet on ghrelin expression in rectal tissue and identify the morphologic cell type. METHODS: Twenty-four male Wistar rats were divided into four subgroups of six animals each: RC1 (rat chow 1) and CAF1 (cafeteria diet 1) for a period of 30 days; RC2 (rat chow 2) and CAF2 (cafeteria diet 2) for a period of 60 days. The animal and rectal weight, the number and the type of immunoreactive ghrelin cells were recorded and compared between the subgroups. The statistical study was established by ANOVA and Student's t test. RESULTS: There was no difference in the total of immunoreactive cells (p=0.685) between the subgroups nor between weight and presence or absence of ghrelin expression (p=0.993). All the immunoreactive cells identified were closed-type. CONCLUSION: The cafeteria diet did not have influence on the amount of immunoreactive rectal cells of ghrelin and only one type (closed-type) of immunoreactive cells was expressed in the rectum.

Estudo comparativo entre os fios de poliglecaprone-25 e de polidioxanona navesicorrafia, em ratos wistar / Comparative study between poliglecaprone-25 and polidioxanone threads onwistar mice?s urinary bladder suture

O surgimento de suturas sintéticas torna pertinentea avaliação das suas reações teciduais nos diferentessistemas. Estudar a reação inflamatória e a formaçãode litíase provocada pelos fios de poliglecaprone-25 epolidioxanona no trato urinário é de importância ímparem Urologia. Trata-se de um estudo individuado, experimental,longitudinal, prospectivo e simples-cego, noqual foram utilizados 48 ratos Wistar, distribuídos emdois grupos de 24 animais: vesicorrafia seromuscularcom poliglecaprone-25 5.0 e polidioxanona 6.0. Os gruposforam subdivididos em três subgrupos: tempo deeutanásia aos 7, 14 e 28 dias de pós-operatório. Após aeutanásia, as bexigas urinárias foram analisadas quantoà atividade inflamatória aguda e crônica. O tratamentoestatístico foi realizado pelo teste exato de Fischer(p<0,05). Encontrou-se o fio na linha de sutura em 45animais (93,75%). A litíase esteve presente em doisratos (4,2%) do subgrupo polidioxanona 28 dias (p:0,245). A inflamação aguda foi semelhante entre os grupos.Na inflamação crônica, o grupo poliglecaprone-25teve três animais (8,3%) com infiltrado acentuado demacrófagos aos sete e 28 dias (p: 0,045). Não houvediferenças entre os grupos nas demais variáveis. Nãoexistiu significância estatística entre os grupos na formaçãode litíase. O processo inflamatório foi semelhanteem todos os tempos de observação. Houve maior inflamaçãocrônica com o uso de poliglecaprone-25 aossete e 28 dias.

The emergence of synthetic sutures makes it relevantto assess its reactions in different human tissue andorgan systems. To evaluate the inflammatory reactionand lithogenesis induced by poliglecaprone-25 andpolidioxanone sutures in the urinary tract is of greatimportance in Urology. Classified as an experimental,longitudinal, prospective and single-blind study,in which were used 48 Wistar rats, distributed intwo groups of 24 animals each: bladder suture withpoliglecaprone-25 5.0 and polidioxanone 6.0. Thegroups were divided into three subgroups: euthanasiaat 7, 14 and 28 days postoperatively. After euthanasia,the urinary bladders were checked for acute and chronicinflammatory activity. The statistical analysis was doneby Fischer exact test (p <0.05). The suture thread wasfound on the suture line in 45 animals (93.75%).Lithiasis was present in two rats (4.2%) of 28 dayspolidioxanone subgroup (p: 0245). Acute inflammationwas similar between groups. Concerning chronicinflammation, the poliglecaprone-25 group had threeanimals (8.3%) with intense macrophages infiltration onseven and 28 days subgroups (p: 0,045). There were nodifferences between groups concerning other variables.There was no statistical significance between groups inlithogenesis. The inflammatory response was similar onall observation periods. Chronic inflammation was moreintense with the use of poliglecaprone-25 on seven and28 days subgroups.

Immunohistochemical detection of factors related to cellular proliferation and apoptosis in radicular and dentigerous cysts.

INTRODUCTION: This study proposed to investigate aspects of cell proliferation and death in the epithelium of radicular (RCs) and dentigerous (DCs) cysts. METHODS: Serial sections of 17 RCs and 9 DCs were prepared for immunohistochemical detection of caspase-3, Bcl-2, and Ki-67 antigens. RESULTS: Caspase-3 was detected mainly in the suprabasal and superficial epithelial cells of RCs and DCs, whereas Ki-67 was detected predominantly in the basal layer. Both markers had significant expression in hyperplastic epithelium related to an intense inflammation in the capsule. Immunoreactivity for Bcl-2 was restricted to the basal layer and was significantly higher in atrophic epithelium of DCs than that of RCs. CONCLUSIONS: These results suggest that epithelial proliferation is balanced by apoptosis and that the presence of inflammation inhibits the Bcl-2 expression. DCs and RCs have different formation mechanisms but have similar biological behavior in the presence of intense inflammatory infiltrate.

Cytological criteria to predict basal phenotype of breast carcinomas.

Breast carcinoma is a heterogeneous disease. It can be classified into phenotypes based on the expression of certain proteins, with distinct differences in prognosis. The basal phenotype is associated with worse prognosis and it still remains without specific treatment. However, there is currently no international consensus on the cytological criteria that could predict this phenotype. The purpose of the study was to evaluate the cytological criteria in fine-needle aspiration biopsy and to identify their association with the basal phenotype of breast carcinoma. Fine-needle aspiration biopsy specimens and tissue sections (mastectomy specimen) from 74 cases of high-grade invasive ductal breast carcinomas were consecutively retrieved from the files of three institutions. Breast carcinomas were studied using the tissue microarray technique, being classified into phenotypes: luminal A, luminal B, HER2 overexpression, and basal. The cytological criteria for all cases were reviewed blindly by two pathologists according to five cytological criteria: cellularity, cell pattern, presence of necrosis, nucleoli, and nuclear atypia. Exact Fisher test was used to test the association between cytological criteria and the phenotypes of breast carcinoma. Necrosis was present in 64.7% of basal breast carcinomas, and 31.1% of nonbasal breast carcinomas, and that result was statistically significant, showing an odds ratio (OR) of 3.80. The basal phenotype, compared with the luminal A, showed more necrosis (OR = 6.97), present/prominent nucleoli (OR = 8.18), and cellularity more frequently (OR = 18.03). Necrosis, as well as present/prominent nucleoli and abundant cellularity are criteria more frequently associated to the basal phenotype of breast carcinoma.

Possíveis discrepâncias dos achdos colposcópicos, citológicos, histológicos e moleculares: relato de um caso de pequena lesão cervical / Possible discrepancies of findings colposcopic, cytology, hisology and molecular: story of a case of small cervical injury

O objetivo deste trabalho foi avaliar as discrepâncias observadas nos exames colposcópicos, citológicos e histológicos em um caso de micro-lesão cervical. Este é um estudo de acompanhamento de uma paciente com lesão cervical uterina. Os autores revisaram o prontuário médico da paciente quanto aos dados clínicos e exames colposcópicos de colo uterino, exame citológico de raspado cervical uterino, exame histológico cervical uterino e biologia molecular HPV de raspado cervical. Durante o acompanhamento da paciente estudo encontramos discrepâncias na tríade colposcopia-citologia-histologia em várias etapas da evolução do quadro. O diagnóstico final da paciente depois de oito avaliações durante 1 ano e meio foi de Lesão intra-epitelial escamosa de alto grau e neoplasia intra-epitelial cervical, nos exames citológicos e histológicos respectivamente, e foi encaminhada para conização. É um caso de micro-lesão cervical, onde a coleta mesmo orientada pela colposcopia, não foi satisfatória em algumas etapas do diagnóstico, dificultando o exame histológico. A utilização da tríplice diagnóstica colposcopia-citologia-histologia bem como teste de biologia molecular durante todo acompanhamento da paciente forneceu abordagem segura aos procedimentos terapêuticos, evitando desta forma a progressão para o câncer cervical uterino invasivo.

Carcinoma de mama: novos conceitos na classificação: [revisão] / Breast cancer: new concepts in classification: [review]

O carcinoma de mama é a neoplasia maligna mais comum em mulheres. Estudos moleculares do carcinoma de mama, baseados na identificação do perfil de expressão gênica por meio do cDNA microarray, permitiram definir pelo menos cinco sub-grupos distintos: luminal A, luminal B, superexpressão do HER2, basal e normal breast-like. A técnica de tissue microarray (TMA), descrita pela primeira vez em 1998, permitiu estudar, em várias amostras de carcinoma, os perfis de expressão protéica de diferentes neoplasias. No carcinoma de mama, os TMAs têm sido utilizados para validar os achados dos estudos preliminares, identificando, desta forma, os novos subtipos fenotípicos do carcinoma de mama. Dentre os subtipos classicamente descritos, o grupo basal constitui um dos mais intrigantes subtipos tumorais e é freqüentemente associado com pior prognóstico e ausência de alvos terapêuticos definidos. A classificação histopatológica do carcinoma de mama tem pobre valor preditivo. Portanto, a associação entre o diagnóstico histológico com técnicas moleculares nos laboratórios de anatomia patológica, por meio do estudo imunoistoquímico, pode determinar o perfil molecular do carcinoma de mama, buscando melhorar a resposta terapêutica. Este estudo visou resumir os mais recentes conhecimentos em que se baseiam os novos conceitos da classificação do carcinoma de mama.

Breast cancer is the principal cause of death from cancer in women. Molecular studies of breast cancer, based in the identification of the molecular profiling techniques through cDNA microarray, had allowed defining at least five distinct sub-group: luminal A, luminal B, HER-2-overexpression, basal and " normal" type breast-like. The technique of tissue microarrays (TMA), described for the first time in 1998, allows to study, in some samples of breast cancer, distinguished by differences in their gene expression patterns, which provide a distinctive molecular portrait for each tumor and the basis for and improved breast cancer molecular taxonomy. Another important implication is that genetic profiling may lead to the identification of new target for therapy and better predictive markers are needed to guide difficult treatment decisions. Additionally, the current pathology classification system is suboptimal, since patients with identical tumor types and stage of disease present different responses to therapy and different overall outcomes. Basal breast tumor represents one of the most intriguing subtypes and is frequently associated with poor prognosis and absence of putative therapeutic targets. Then, the purpose of this review was to resume the most recent knowledge about the breast carcinoma classification and characterization.

[Breast cancer: new concepts in classification]. / Carcinoma de mama: novos conceitos na classificação.

Breast cancer is the principal cause of death from cancer in women. Molecular studies of breast cancer, based in the identification of the molecular profiling techniques through cDNA microarray, had allowed defining at least five distinct sub-group: luminal A, luminal B, HER-2-overexpression, basal and 'normal' type breast-like. The technique of tissue microarrays (TMA), described for the first time in 1998, allows to study, in some samples of breast cancer, distinguished by differences in their gene expression patterns, which provide a distinctive molecular portrait for each tumor and the basis for and improved breast cancer molecular taxonomy. Another important implication is that genetic profiling may lead to the identification of new target for therapy and better predictive markers are needed to guide difficult treatment decisions. Additionally, the current pathology classification system is suboptimal, since patients with identical tumor types and stage of disease present different responses to therapy and different overall outcomes. Basal breast tumor represents one of the most intriguing subtypes and is frequently associated with poor prognosis and absence of putative therapeutic targets. Then, the purpose of this review was to resume the most recent knowledge about the breast carcinoma classification and characterization.