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1.
Int J Gynecol Pathol ; 31(1): 8-14, 2012 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-22123718

RESUMO

Lymphatic vessels serve as major routes for regional dissemination, and therefore, lymph node status is a key indicator of prognosis. To predict lymph node metastasis, tumor lymphatic density and lymphangiogenesis-related molecules have been studied in various tumor types. To our knowledge, no previous studies have evaluated the role of intratumoral lymphatic vessel density (LVD) in the behavior of vulvar carcinomas. The aim of this study was to analyze intratumoral LVD in relation to patient survival and well-characterized prognostic factors for cancer. Thirty-five patients with vulvar squamous cell carcinoma underwent vulvectomy and dissection of regional lymph nodes. Clinical records were reviewed, in addition to histological grade, peritumoral lymphatic invasion, and depth of infiltration for each case. Tissue microarray paraffin blocks were created, and lymphatic vessels were detected using immunohistochemical staining of podoplanin (D2-40 antibody). Intratumoral LVD was quantified by counting the number of stained vessels. Higher values for intratumoral LVD were associated with low-grade and low-stage tumors, and with tumors without lymphatic invasion and reduced stromal infiltration. In a univariate analysis, high intratumoral LVD was associated with a higher rate of overall survival and a lower rate of lymph node metastasis. Our results suggest that increased intratumoral LVD is associated with favorable prognosis in vulvar squamous carcinomas.


Assuntos
Carcinoma de Células Escamosas/patologia , Linfonodos/patologia , Vasos Linfáticos/patologia , Neoplasias Vulvares/patologia , Adulto , Idoso , Idoso de 80 Anos ou mais , Biomarcadores Tumorais/análise , Carcinoma de Células Escamosas/mortalidade , Carcinoma de Células Escamosas/cirurgia , Intervalos de Confiança , Feminino , Humanos , Estimativa de Kaplan-Meier , Linfangiogênese , Metástase Linfática , Pessoa de Meia-Idade , Invasividade Neoplásica , Estadiamento de Neoplasias , Inclusão em Parafina , Prognóstico , Estudos Retrospectivos , Taxa de Sobrevida , Neoplasias Vulvares/mortalidade , Neoplasias Vulvares/cirurgia
2.
In. Coelho, Francisco Ricardo Gualda; Soares, Fernando Augusto; Foch, José; Fregnani, José Humberto Tavares Guerreiro; Zeferino, Luiz Carlos; Villa, Luisa Lina; Federico, Miriam Honda; Novaes, Paulo Eduardo Ribeiro dos Santos; Costa, Ronaldo Lúcio Rangel. Câncer do colo do útero. São Paulo, Tecmedd, 2008. p.4-17, tab.
Monografia em Português | LILACS | ID: lil-494639
3.
Aesthetic Plast Surg ; 28(5): 268-74, 2004.
Artigo em Inglês | MEDLINE | ID: mdl-15666042

RESUMO

BACKGROUND: Numerous techniques have been described for the treatment of breast hypertrophy and ptosis. Unfortunately, recurrent ptosis after mammaplasty can occur regardless of the technique used. To avoid this problem, different kinds of supporting devices have been described with variable rates of success. However, the true implications of incorporating prosthetic materials into breast surgery have never been clarified. Therefore, surgeons have traditionally been reluctant to apply any kind of prosthetic material to the breast, fearing inflammation, an unfavorable aesthetic outcome, palpable or visible deformities, and interference with the mammographic evaluation of breast cancer. This study analyzed the aesthetic, clinical, and mammographic implications of using mesh as a supportive device in periareolar breast surgery. METHODS: For this study, 18 patients (mean age, 42 years) with breast hypertrophy, ptosis, or both were managed with the double-skin periareolar mammaplasty technique, with placement of mixed (60% Polyglactine and 40% polyester) mesh. Clinical assessment was performed by three breast surgeons actively working on cancer surveillance who knew that the patients had experienced mesh application. After a mean follow-up period of 30 months, a standard mammogram was performed for each patient and analyzed by both the surgeons and an expert radiologist. The evaluated factors were hyperemia, calcifications, contour irregularities, capsular contraction, thickening or widening of the scar with extrusion of the mesh, and any palpable or hardened areas. RESULTS: According to the authors' clinical observations, there were no mesh-related abnormalities in the breast; the mesh was not palpable after the operation; and there was no recurrent ptosis. In terms of mammographic imaging, the mesh was visible as a very fine line in the periphery of the breast's parenchyma (measuring 0.2 mm on the lateral views) in three patients (17%). The mesh did not interfere with the visualization and analysis of the breast's parenchyma. In seven patients (39%), benign localized microcalcifications were detected in the breast and no further investigation was performed. In two patients (11%), grouped calcifications were detected and biopsied, with histopathologic analysis demonstrating epithelial hyperplasia with atypia. In two patients (11%), nodules smaller than 1 cm were detected and biopsied, with histopathologic analysis demonstrating a fibroadenoma in one patient and an invasive ductal carcinoma in the other. CONCLUSIONS: The use of mesh support in breast surgery can enhance the aesthetic results without inducing visible or palpable deformities or mammographic abnormalities. In terms of surveillance mammograms, the presence of the mesh did not interfere with the diagnosis and treatment of minute lesions such as calcifications and small nodules.


Assuntos
Doenças Mamárias/diagnóstico por imagem , Doenças Mamárias/cirurgia , Mamoplastia/métodos , Telas Cirúrgicas/estatística & dados numéricos , Adulto , Mama/anormalidades , Implante Mamário , Feminino , Humanos , Mamografia/métodos , Pessoa de Meia-Idade , Satisfação do Paciente , Ajuste de Prótese , Qualidade de Vida , Resultado do Tratamento
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