Diferenciación neuroendocrina y marcadores de proliferación celular en adenocarcinoma de próstata en un grupo de casos con antígeno prostático específico normal vs elevado / Neuroendocrine differentiation and markers of cell proliferation in a group of patients with prostate adenocarcinoma and normal or high serum prostate-specific antigen levels

Objetivo. Investigar la población de células neuroendocrinas y sus características morfológicas en pacientes con cáncer de próstata y antígeno sérico normal versus antígeno sérico elevado. Material y métodos. En 13 años se identificaron 372 casos de cáncer de próstata de los cuales 19 (5.1%) con antígeno sérico normal (Grupo I). Se seleccionaron 16 grupos controles con antígeno sérico elevado y características histopatológicas similares (Grupo II). Se evaluaron porcentaje de necrosis tumoral, invasión vascular y perineural, inmunohistoquímica: sinaptofisina, enolasa neuroespecífica, antígeno prostático específico, Ki-67 y p53. Resultados. En el grupo I, se obtuvieron 61 % de casos positivos para antígeno tisular, 28.6 % sinaptofisina, 7.1 % para enolasa neuroespecífica, 50 % para p53 y 78.6 % para Ki-67. En el grupo II, los resultados fueron: sinaptofisina 13.3%, enolasa-neuroespecífica 26.6%, antígeno tisular 93%, p53 46.6% y Ki-67 66.7%. Con punto de corte de antígeno tisular expresado en < 80% de células neoplásicas, en el grupo I se encontraron 69.2% de casos, y en el grupo II 21.4% (p = 0.02). Conclusiones. El único dato histológico que mostró diferencia significativa fue la expresión tisular de antígeno prostático específico en < 80% de las células neoplásicas en el grupo I. Se asoció el incremento de las células neuroendocrinas con el menor número de células productoras de antígeno tisular; esta situación podría ser más visible al estudiar un mayor número de pacientes con características semejantes.

OBJECTIVE: Study the morphologic characteristics of neuroendocrine cells in prostate cancer with normal versus elevated prostate specific antigen (PSA). MATERIALS AND METHODS: 372 cases of prostate cancer were identified during a 13 year period, of which 19 displayed normal PSA (group I). Sixteen controls with elevated PSA and similar histopathological characteristics (group II) were included. We studied the degree of tumor necrosis, vascular and perineural invasion. Synaptophysin (SP), neuron specific enolase (NSE), PSA, Ki-67 and p53 inmunoreactivity were also analyzed. RESULTS: Group I positive findings were 61% PSA, 28.6% SP. 7.1% NSE, 50%p53, and 78.6% Ki-67. Group II positive findings were 93% PSA, 13.3% SP, 26.6% NSE 46.6% p53, and 66.7% Ki-67. When we used a <80% cut off point for PSA immunoreactivity in tumor cells, 69.2% of group I and 21.4% of group II were found. CONCLUSIONS: The sole histopathological finding that showed statistical significance was the tissular expression of the specific prostatic antigen in 80% of neoplasic cells in group I. The increase of neuroendocrine cells was associated with a smaller number of tissular antigen producing cells, a finding that could be more apparent if we were to study a larger sample size.

Effects of hyperbaric oxygen on peripheral nerves.

BACKGROUND: Injuries of peripheral nerves are common and usually are part of acute traumatic injuries to the limbs. Damage to peripheral nerves may be extensive. Microsurgery has improved the rate of recovery of these injuries, but some problems remain to be solved. The purpose of this investigation was to study the long-lasting effects of hyperbaric oxygenation on peripheral nerves after transection and repair with microsurgery in the rat sciatic nerve model. METHODS: Forty male Wistar rats were divided randomly into four groups: (1) no hyperbaric oxygen, sectioned and repaired (n = 10), euthanized at 7 weeks; (2) hyperbaric oxygen, sectioned and repaired (n = 10), euthanized at 7 weeks; (3) no hyperbaric oxygen, sectioned and repaired (n = 10), euthanized at 14 weeks; and (4) hyperbaric oxygen, sectioned and repaired (n = 10), euthanized at 14 weeks. Nerve recovery was assessed by neurophysiologic studies at 7 or 14 weeks. Foot-ankle angle response (dorsiflexion) and histopathology with automated morphometry were performed after 7 or 14 weeks. Statistical analysis was performed with the Friedman test and the Mann-Whitney U test. RESULTS: At 7 weeks, motor latency showed statistical significance in both groups, treated and not treated, whereas amplitude, axons, and blood vessel number was higher in the hyperbaric oxygen-treated group. After 14 weeks, electromyography showed no denervation and a better foot-ankle angle response in the hyperbaric oxygen groups. CONCLUSION: These results suggest that functional recovery in transected peripheral nerves may be improved and accelerated by hyperbaric oxygenation following microsurgical repair.

Macrophage and T lymphocyte apoptosis during experimental pulmonary tuberculosis: their relationship to mycobacterial virulence.

The kinetics of macrophage and T lymphocyte apoptosis were determined in a well-characterized mouse model of pulmonary tuberculosis, comparing strains of intermediate (H37Rv) and high virulence (Beijing strain, code 9501000). Both strains induced a high percentage of apoptotic activated macrophages at days 1 and 3 post infection, although this was twofold lower in Beijing-infected mice. Progressive pneumonia started at day 14 (Beijing) or 21 (H37Rv) post infection. Pneumonic areas contained numerous macrophages with vacuolated cytoplasm (VM). In H37Rv infection few VM were apoptotic (8.7% at day 60), and the percentage was even lower in Beijing infection (1.4% at day 28). A high percentage of VM expressed the anti-apoptotic molecule Bcl-2 (H37Rv, 83%; Beijing, 95%). Both strains induced a progressive increase of apoptotic Th1 lymphocytes, peaking at day 60 in H37Rv infection, or 28 in Beijing infection. The peak was twofold higher in the latter. VM had strong FasL immunostaining, and confocal microscopy showed numerous apoptotic Th1 cells closely associated with them, suggesting that VM might induce apoptosis of Th1 cells. These results support the hypothesis that apoptosis of macrophages is associated with protection, while apoptosis of Th1 cells favors disease progression, and is related to the virulence of the mycobacterial strain.

[Neuroendocrine differentiation and markers of cell proliferation in a group of patients with prostate adenocarcinoma and normal or high serum prostate-specific antigen levels]. / Diferenciación neuroendocrina y marcadores de proliferación celular en adenocarcinoma de próstata en un grupo de casos con antígeno prostático específico normal vs elevado.

OBJECTIVE: Study the morphologic characteristics of neuroendocrine cells in prostate cancer with normal versus elevated prostate specific antigen (PSA). MATERIALS AND METHODS: 372 cases of prostate cancer were identified during a 13 year period, of which 19 displayed normal PSA (group I). Sixteen controls with elevated PSA and similar histopathological characteristics (group II) were included. We studied the degree of tumor necrosis, vascular and perineural invasion. Synaptophysin (SP), neuron specific enolase (NSE), PSA, Ki-67 and p53 inmunoreactivity were also analyzed. RESULTS: Group I positive findings were 61% PSA, 28.6% SP. 7.1% NSE, 50%p53, and 78.6% Ki-67. Group II positive findings were 93% PSA, 13.3% SP, 26.6% NSE 46.6% p53, and 66.7% Ki-67. When we used a <80% cut off point for PSA immunoreactivity in tumor cells, 69.2% of group I and 21.4% of group II were found. CONCLUSIONS: The sole histopathological finding that showed statistical significance was the tissular expression of the specific prostatic antigen in 80% of neoplasic cells in group I. The increase of neuroendocrine cells was associated with a smaller number of tissular antigen producing cells, a finding that could be more apparent if we were to study a larger sample size.

Nivel de antígeno prostático específico en 100 sujetos con biopsia prostática / Serum level of prostatic specific antigen in 100 patients with prostatic biopsy

Objetivo. Caracterizar mejor los niveles de APE (antígeno prostático específico) en pacientes con biopsias prostáticas benignas y malignas. Métodos. Se estudiaron 100 pacientes con sospecha clínica de carcinoma prostático por elevación de APE y/o tacto rectal anormal, a los cuales se les realizó biopsia prostática. Resultados. Hubo 66 biopsias benignas y 34 carcinomas. Las medianas de APE fueron 11.2 y 45.6 ng/mL en benignos y malignos, respectivamente. En los pacientes con elevación ligera de APE (4-9.9 ng/mL. Sólo en aquéllos con 30+ hubo mayoría de carcinomas (81 por ciento). Conclusiones. Hubo una sobreposición significativa de los niveles de APE en pacientes con biopsias benignas y malignas. Solamente los valores de 30+ ng/mL fueron fuertemente sugestivos de carcinoma. Nuestros valores de APE están muy por arriba de los informados en la literatura y podrían deberse, cuando menos en parte, a las marcas de los reactivos empleados en nuestra institución (Cedex de Francia y Diagnostic Products Corp de EEUU)