In prostate cancer needle biopsies, detections of PTEN loss by fluorescence in situ hybridization (FISH) and by immunohistochemistry (IHC) are concordant and show consistent association with upgrading.

The prognostic value of phosphatase and tensin homolog (PTEN) loss in prostate cancer has primarily been evaluated by either fluorescence in situ hybridization (FISH) or immunohistochemistry (IHC). Previously, we found that PTEN loss by IHC was associated with increased risk of upgrading from biopsy (Gleason 3 + 3) to prostatectomy (Gleason 7+). Now, using an evaluable subset of 111 patients with adjacent biopsy sections, we analyzed the association between PTEN deletion in cancer and the odds of upgrading by a highly sensitive and specific four-color FISH assay. We also compared the concordance of PTEN loss by IHC and PTEN deletion by FISH. PTEN deletion was found in 27 % (12/45) of upgraded cases compared with 11 % (7/66) of controls (P = 0.03). Cancers with PTEN deletions were more likely to be upgraded than those without deletions (adjusting for age odds ratio = 3.40, 95 % confidence interval 1.14-10.11). With respect to concordance, of 93 biopsies with PTEN protein detected by IHC, 89 (96 %) had no PTEN deletion by FISH, and of 18 biopsies without PTEN protein by IHC, 15 had homozygous or hemizygous PTEN deletion by FISH. Only 4 biopsies of the 93 (4 %) with PTEN protein intact had PTEN deletion by FISH. When the regions of uncertainty in these biopsies were systematically studied by FISH, intra-tumoral variation of PTEN deletion was found, which could account for variation in immunoreactivity. Thus, FISH provides a different approach to determining PTEN loss when IHC is uncertain. Both FISH and IHC are concordant, showing consistent positive associations between PTEN loss and upgrading.

Análise Clínico-Epidemiológica de 24 pacientes com síndrome de Fournier Tratados no Hospital de Base da Faculdade de Medicina de Säo José do Rio Preto / Fournier Syndrome-Retrospective study of 24 cases treated in the Urology Department of Hospital de Base School of Medicine, Säo José do Rio Preto - Brazil

A Síndrome de Fournier é uma infecçäo fulminante extensa dos genitais, períneo ou parede abdominal. Tem início súbito, evoluçäo rápida e ausência de uma causa determinante comprovada. É mais frequente na sexta década de vida. Algumas condições favorecem sua progressäo, como Diabetes, Senilidade e Alcoolismo. Clinicamente inclui debridamento cirúrgico, antibioticoterapia, curativos, derivações (ostomias) e oxigenioterapia em câmara hiperbárica. Apresenta mortalidade elevada. este trabalho compara os resultados obtidos em nosso serviço com os dados da literatura, sendo feito estudo retrospectivo de 24 pacientes num período de 5 anos e 6 meses. Através da revisäo de prontuários foram avaliados: idade, raça, profissäo, procedência, tempo de internaçäo, debridamento, derivações, esquemas terapêuticos e intercorrências. De todos os pacientes analisados, 41 por cento eram aposentados, 87 por cento da raça branca, 62 por cento procedentes de cidades da regiäo. Destes pacientes, 58 por cento com média etária de 54 anos, ficaram internados de 6 a 15 dias, e 54 por cento realizaram 1 debridamento com tempo de internaçäo de 6 a 20 dias. Observou-se que 71 por cento näo se submeteram a derivações e 83 por cento responderam bem a um ou dois esquemas terapêuticos. Obtivemos ainda 21 por cento dos pacientes com intercorrências como choque, fístulas, orquiectomia, penectomia e 3 óbitos