Perfil do câncer gástrico no Hospital das Clínicas da Universidade Federal de Pernambuco / Profile of gastric cancer at the University Hospital of the Federal University of Pernambuco

A partir de um estudo retrospectivo realizado no Serviço de Endoscopia do Hospital das Clínicas-UFPE, em 10.230 exames de endoscopia digestiva alta efetuados nos anos de 91, 92 e 93 foram diagnosticados 60 casos de adenocarcinoma gástrico, resultando em incidência de 0,58 por cento da amostra. Os 60 casos estudados mostram dados rigorosamente semelhantes aos publicados na literatura mundial quanto aos aspectos epidemiológicos (idade e sexo), clínicos (dor em abdome superior, perda de peso, etc.) e localizaçao da lesao (antro e corpo). Por outro lado, encontramos baixíssimo índice de diagnóstico de câncer precoce (1,6 por cento) e elevada incidência do tipo histológico difuso (46 por cento), indiferenciado. Noventa por cento das lesoes eram Bormann III e IV. Esses três fatos podem estar relacionados com baixa suspeiçao em relaçao às lesoes precoces e/ou precursoras ou ainda a comportamento biológico mais agressivo do adenocarcinoma em nossa regiao, incluindo aí fatores ambientais diferenciados quando comparados com outras áreas de elevada incidência.

Histological diagnosis of cytomegalovirus hepatitis in liver allografts.

AIMS--To determine the incidence of histologically documented cytomegalovirus (CMV) hepatitis following orthotopic liver transplantation (OLT) and to assess the effectiveness of immunohistochemistry and in situ hybridisation (ISH) in detecting CMV. To describe the histological pattern most frequently associated with CMV hepatitis in order to select the biopsy group in which these modern techniques are most effective. METHODS--A prospective histological study was carried out on 853 biopsy specimens, obtained from 191 liver allografts (160 patients). Specimens were stained with haematoxylin and eosin and immunohistochemically (avidin-biotin complex) using monoclonal antibodies directed against early and late CMV antigens. A retrospective selection was made of 23 specimens with viral inclusion bodies in cytomegalic cells (group A) to characterise the most frequently associated histological pattern, and of 34 other specimens without viral inclusion bodies (group B) but with the same microscopic features as group A. Re-cuts from both specimen groups were studied using immunohistochemistry and ISH with a CMV specific complementary DNA probe. RESULTS--CMV infection was confirmed in 35 specimens (29 by immunohistochemistry, 23 by presence of inclusion bodies in haematoxylin and eosin stained sections, 16 by ISH) from 27 patients (incidence 16.9%). CMV hepatitis was diagnosed within 46 +/- 19 (range 21-114) days posttransplant. Twenty on (91.3%) of the 23 biopsy specimens with inclusion bodies (group A) displayed heterogeneous inflammatory foci disseminated throughout the hepatic lobule. Nineteen specimens (82.6%) were positive by immunohistochemistry and 14 (60.9%) by ISH. In eight (23.5%) of the 34 group B specimens CMV infection was confirmed by immunohistochemistry (n = 6) or ISH (n = 2). Another 12 (35.3%) of the group B specimens negative on staining with haematoxylin and eosin, immunohistochemistry and ISH came from allografts in which previous or subsequent biopsy specimens were CMV positive. CONCLUSIONS--Demonstration of cytomegalic inclusion bodies in haematoxylin and eosin sections is sufficient for a diagnosis of CMV hepatitis. The routine use of immunohistochemistry in all allograft biopsy specimens in more sensitive than demonstration of inclusion bodies by staining with haematoxylin and eosin but may yield false negative results because of the focal distribution of positive cells. ISH was less sensitive than staining with haematoxylin and eosin and/or immunohistochemistry. A histological picture of "disseminated focal hepatitis" without viral inclusion bodies selects a group of allograft biopsy specimens in which immunohistochemistry and/or ISH may improve detection of CMV.

Infeccao do parceiro sexual pelo papilomavirus humano / Partner infection by human papillomavirus

Foram examinados 60 parceiros sexuais, de mulheres diagnosticadas como portadoras de infeccao genital pelo papilomavirus, sob protocolo de investigacao. O objetivo era identificar colposcopicamente, lesoes acetobrancas na genitalia externa masculina, biopsia-las e estuda-las histopatologicamente. Predominava como sinal patognomonico, a coilocitose celular. A biopsia foi positiva em 77,1 por cento e negativa em 22,9 por cento. Os resultados da pesquisa fecham a hipotese de que o parceiro sexual masculino e, de fato, um elemento de risco, agindo como transmissor de infeccao genital pelo papilomavirus humano.

[Occurrence of Campylobacter pylori in patients with gastritis and peptic ulcer]. / Ocorrência do Campylobacter pylori em pacientes com gastrite e úlcera péptica.

Endoscopic biopsies from the gastric antrum and margin of peptic ulcers (gastric and duodenal) were obtained from 56 patients for histologic and microbiologic studies in order to establish the occurrence of Campylobacter pylori. Thirty nine of them had antral gastritis and in 37 (94.8%) the bacteria was detected. In 17 cases with normal mucosa the culture was positive in only 2 of them (p less than 0.01). Patients with duodenal and gastric ulcer had a 100% and 88.8%, respectively, of positivity to C. pylori at samples from the margin of the lesions. Bacteriologic findings were similar to those described in the literature. At the electronic microscopy bacilli were found near or adhering to the cellular surface without signs of intraepithelial penetration. This study confirms the association between C. pylori and gastritis and peptic gastroduodenal ulcer.