Androgen receptor expression and prognosis in Hispanic/Latino women with triple negative breast cancer.

INTRODUCTION AND OBJECTIVE: Triple-negative breast cancer (TNBC) is an aggressive subtype that has no available molecular targets. It occurs most often in premenopausal African-American and Hispanic/Latino women. In Colombia, its prevalence has been reported to be 20.6%. Androgen receptor (AR) belongs to the steroid nuclear receptor family and has been recently considered a potential biomarker for breast cancer. Considering the high prevalence of TNBC in Colombian women and the lack of knowledge of AR expression, our aim was to determine the frequency of AR expression and its association with pathological variables. MATERIALS AND METHODS: 149 women diagnosed with TNBC between 2011 and 2014 were included. Clinical and pathological data were obtained from medical and pathology reports. Information on hormone receptor status, Ki67 expression and HER2 was reevaluated by a pathologist. AR expression was considered positive when it exceeded 1% of nuclear staining in tumor cells. RESULTS: AR expression was detected in 41.6% of the samples. Although we did not find statistically significant differences in clinic-pathological variables according to AR expression, patients with AR expression over 50% were younger (53.92 years vs. 60.78 years, p=0.027) and presented higher Ki67 expression (64.06% vs. 47.32%, p=0.05), compared to patients with a low AR expression. The median overall survival in our sample of TNBC patients was 2.45 years. CONCLUSIONS: The expression of AR in our sample was similar to the expression in populations of European descent. We found statistically significant differences in age at diagnosis and Ki67 expression according to AR expression.

Androgen receptor expression and prognosis in Hispanic/Latino women with triple negative breast cancer

Introduction and objective: Triple-negative breast cancer (TNBC) is an aggressive subtype that has no available molecular targets. It occurs most often in premenopausal African-American and Hispanic/Latino women. In Colombia, its prevalence has been reported to be 20.6%. Androgen receptor (AR) belongs to the steroid nuclear receptor family and has been recently considered a potential biomarker for breast cancer. Considering the high prevalence of TNBC in Colombian women and the lack of knowledge of AR expression, our aim was to determine the frequency of AR expression and its association with pathological variables. Materials and methods: 149 women diagnosed with TNBC between 2011 and 2014 were included. Clinical and pathological data were obtained from medical and pathology reports. Information on hormone receptor status, Ki67 expression and HER2 was reevaluated by a pathologist. AR expression was considered positive when it exceeded 1% of nuclear staining in tumor cells. Results: AR expression was detected in 41.6% of the samples. Although we did not find statistically significant differences in clinic-pathological variables according to AR expression, patients with AR expression over 50% were younger (53.92 years vs. 60.78 years, p=0.027) and presented higher Ki67 expression (64.06% vs. 47.32%, p=0.05), compared to patients with a low AR expression. The median overall survival in our sample of TNBC patients was 2.45 years. Conclusions: The expression of AR in our sample was similar to the expression in populations of European descent. We found statistically significant differences in age at diagnosis and Ki67 expression according to AR expression.(AU)

Introducción y objetivo: El carcinoma de mama triple negativo (CMTN) es un subtipo de carcinoma con comportamiento agresivo y sin dianas moleculares disponibles. Se presenta en mujeres premenopáusicas afroamericanas y latinas. En Colombia, la prevalencia informada es del 20.6%. Los receptores de andrógenos (RA) pertenecen a una familia de receptores nucleares y son considerados como potencial biomarcador. Debido a la alta prevalencia de CMTN en mujeres colombianas y la ausencia de datos sobre los RA, el objetivo del trabajo fue determinar la frecuencia de RA y su asociación con otras variables histopatológicas. Materiales y métodos: El estudio incluyó a 149 mujeres diagnosticadas con CMTN entre 2011 y 2014. Las variables clínicas y patológicas fueron extraídas de la historia clínica. Los receptores hormonales, índice Ki67 y Her2 fueron reevaluados por un patólogo. Los RA fueron considerados positivos cuando más del 1% de los núcleos tumorales estaban teñidos. Resultados: La expresión de RA fue detectada en el 41,6% de las muestras. No se encontraron diferencias significativas en variables patológicas de acuerdo a la expresión de RA. Sin embargo, se observó que pacientes con RA positivos mayor del 50%, eran más jóvenes (53,92 vs. 60,78 años; p=0,027) y presentaban Ki67 más elevados (64,06 vs. 47,32%; p=0,05), comparadas con pacientes de baja expresión de RA. La sobrevida global de las pacientes fue de 2,45 años. Conclusiones: La expresión de RA en la muestra fue similar a la de poblaciones de descendencia europea. Se encontraron diferencias significativas en la edad al momento del diagnóstico y en el índice Ki67, estratificadas por expresión de RA.(AU)

Adenoma canalicular multifocal del labio superior: reporte de un caso y revisión de la literatura / Multifocal canalicular adenoma of the upper lip: a case report and literature review / Adenoma canalicular multifocal do lábio superior: reporte de um caso e revisão da literatura

RESUMEN El adenoma canalicular (AC) es una neoplasia epitelial benigna infrecuente de las glándulas salivales menores localizada principalmente en el labio superior. Se manifiesta como un nódulo menor de 3 centímetros, indoloro, no ulcerado y de crecimiento lento. El diagnóstico diferencial se debe hacer con otros tumores de las glándulas salivales como adenoma de células basales, adenoma pleomórfico y carcinoma adenoide quístico. Se presenta el caso de una paciente con antecedente de adenoma canalicular en el labio superior extirpado 13 años antes, que consultó en junio de 2015 por una lesión de 8 mm de diámetro en la misma localización. En septiembre del mismo año se resecó la lesión, incluyendo la glándula salival accesoria adyacente. El estudio histopatológico confirmó nuevamente el diagnóstico de AC y mostró multifocalidad del tumor en la glándula salival accesoria.

SUMMARY Canalicular adenoma is an unusual benign epithelial neoplasm of the minor salivary glands located primarily on the upper lip. It appears as a slowgrowing node, less than 3 cm in diameter, painless, and non-ulcerated. Differential diagnosis should be made with other tumors of the salivary glands such as basal cell adenoma, pleomorphic adenoma and adenoid cystic carcinoma. We report the case of a female with a history of canalicular adenoma (CA) on the upper lip, removed 13 years before, who consulted on June 2015 because of a mass, 8 mm in diameter with the same location as the previous lesion. On September 2015, the lesion and the accessory salivary gland were removed. Histopathological study found the same diagnosis as before (CA), and revealed multifocality of the neoplasm in the accessory salivary gland.

RESUMO O adenoma canalicular (AC) é uma neoplasia epitelial benigna infrequente das glândulas salivais menores localizada principalmente no lábio superior. Se manifesta como um nódulo menor de 3 centímetros, indolor, não ulcerado e de crescimento lento. O diagnóstico diferencial se deve fazer com outros tumores das glândulas salivais como são: adenoma de células basais, adenoma pleomórfico y carcinoma adenoide cístico. Se apresenta o caso de uma paciente com antecedente de adenoma canalicular no lábio superior extirpado 13 anos antes, que consultou em junho de 2015 por uma lesão de 8 mm de diâmetro na mesma localização. Em setembro do mesmo ano se ressecou a lesão, incluindo a glândula salival acessória adjacente. O estudo histopatológico confirmou novamente o diagnóstico de AC e mostrou multifocalidade do tumor na glândula salivar acessória.

Falso o verdadero: es esa la pregunta? / True or false: is that the question? / Falso ou verdadeiro, é essa a pergunta?

Objetivos: en los exámenes para estudiantes de medicina se emplean preguntas objetivas de la modalidad Falso o Verdadero (F/V), que solo tienen dos opciones de respuesta con alta probabilidad de ser contestadas correctamente por azar. El propósito de este trabajo fue demostrar que solicitar la argumentación de las respuestas disminuye el número de las correctas mejorando la capacidad de las preguntas para verificar los aprendizajes. Métodos: se revisaron 8.188 preguntas de F/V que requirieron sustentación de la respuesta, aplicadas en 28 evaluaciones de Patología de la carrera de Medicina de la Universidad de la Sabana durante cuatro semestres. Las respuestas se clasificaron en correctas e incorrectas y las sustentaciones, en correctas, parcialmente correctas o incorrectas. Se calculó el coeficiente de concordancia kappa entre las preguntas F/V y las preguntas F/V con sustentación, así como por período y por evaluación. Resultados: de un total de 8.188 preguntas, 6.112 (74,6%) fueron contestadas correctamente, 3.655 (44,6%) tuvieron sustentación correcta y 2.336 (28,5%) no fueron bien sustentadas, con un índice de concordancia global de 0,378 e índices bajos de concordancia por período. Conclusión: las preguntas de F/V pueden acompañarse de una sustentación que argumente la respuesta con el objetivo de reducir la probabilidad de responder simplemente por azar, desarrollar procesos cognitivos superiores y competencias comunicativas.

Objectives: Standard tests designed for medical students frequently include objective True/ False (T/F) questions, in which there are only two possible answers that can be successfully reached at random. The purpose of this work was to demonstrate that asking for support of the answers diminishes the number of randomly correct ones, so improving the ability of questions to verify learnings. Methods: 8.188 T/F questions whose answers had to be supported; they were applied in 28 written tests of Pathology, at the undergraduate medical program (La Sabana University, Chía, Colombia). Answers were classified as correct or incorrect, and their support, as correct, partially correct and incorrect. In order to analyze the data, the kappa agreement coefficient between T/F questions and T/F questions with support was calculated, as well as per term and per test. Results: Out of 8.188 T/F questions, 6.112 (74.6%) were correctly answered as true or false, 3.655 (44.6%) had a correct support, and 2.336 (28.5%) were not correctly supported, exhibiting a global agreement index of 0.378 and low agreement indexes per term. Conclusion: T/F questions could be accompanied by support of the answers in order to reduce the probability of randomly correct ones, to enhance the development of superior cognitive processes, and communicative essential competences.

Objetivos: nos exames para estudantes de medicina se empregam perguntas objetivas da modalidade Falso ou Verdadeiro (F/V), que só têm duas opções de resposta com alta probabilidade de ser contestadas corretamente por casualidade. O propósito deste trabalho foi demonstrar que solicitar a argumentação das respostas diminui o número das corretas melhorando a capacidade das perguntas para verificar as aprendizagens. Métodos: revisaram-se 8.188 perguntas de F/V que requereram sustentação da resposta, aplicadas em 28 avaliações de Patologia da carreira de Medicina da Universidade da Sabana durante quatro semestres. As respostas se classificaram em corretas e incorretas e as sustentações, em corretas, parcialmente corretas ou incorretas. Calculou-se o coeficiente de concordância kappa entre as perguntas F/V e as perguntas F/V com sustentação, bem como por período e por avaliação. Resultados: de um total de 8.188 perguntas, 6.112 (74,6%) foram respondidas corretamente, 3.655 (44,6%) tiveram sustentação correta e 2.336 (28,5%) não foram bem sustentadas, com um índice de concordância global de 0,378 e índices baixos de concordância por período. Conclusão: as perguntas de F/V podem acompanhar-se de uma sustentação que argumente a resposta com o objetivo de reduzir a probabilidade de responder simplesmente por casualidade, desenvolver processos cognitivos superiores e concorrências comunicativas.