Correlation between the immunohistochemical expressions of MMP-1, MMP-7 and VEGF and prognostic factors in colorectal adenocarcinoma.

PURPOSE: To analyze the expression of metalloproteinase-1, metalloproteinase-7 and vascular endothelial growth factor (VEGF) in colorectal adenocarcinoma, and to correlate these with the clinical-pathological prognostic factors. METHODS: Tumor tissue from 82 patients was fixed in formalin and embedded in paraffin blocks. These samples were analyzed by means of the streptavidin-biotin immunohistochemical method, using the tissue microarray technique. Marker positivity was evaluated using categorical scores that determined cutoff percentages of stained tumor cells. Protein tissue expression was correlated with the variables of degree of cell differentiation, staging, disease-free interval, recurrence, survival and specific mortality. The Fisher exact and Kaplan-Meier tests were used to assess associations between the markers and the study variables. The log-rank and Wilcoxon tests were used to assess the significance of differences between curves of disease-free interval and survival. RESULTS: All tumors were positive for metalloproteinase-1; 50 (61%) were positive and 32 (39%) were negative for metalloproteinase-7; and 60 (74.1%) were positive and 21 (25.9%) were negative for VEGF. Correlation of marker expression, both in groups and individually, did not show statistical significance in relation to the degree of cell differentiation, staging, disease-free interval, survival or specific mortality. Recurrence showed a statistically significant correlation with positive expression of the three markers, when analyzed as a group (p = 0.038). CONCLUSION: The associated expression of metalloproteinase-1, metalloproteinase-7 and VEGF in colorectal adenocarcinoma is related to the incidence of disease recurrence.

Correlation between the immunohistochemical expressions of MMP-1, MMP-7 and VEGF and prognostic factors in colorectal adenocarcinoma / Correlação entre as expressões imunohistoquímicas da MMP-1, MMP-7 e do VEGF no adenocarcinoma colorretal com fatores prognósticos

PURPOSE: To analyze the expression of metalloproteinase-1, metalloproteinase-7 and vascular endothelial growth factor (VEGF) in colorectal adenocarcinoma, and to correlate these with the clinical-pathological prognostic factors. METHODS: Tumor tissue from 82 patients was fixed in formalin and embedded in paraffin blocks. These samples were analyzed by means of the streptavidin-biotin immunohistochemical method, using the tissue microarray technique. Marker positivity was evaluated using categorical scores that determined cutoff percentages of stained tumor cells. Protein tissue expression was correlated with the variables of degree of cell differentiation, staging, disease-free interval, recurrence, survival and specific mortality. The Fisher exact and Kaplan-Meier tests were used to assess associations between the markers and the study variables. The log-rank and Wilcoxon tests were used to assess the significance of differences between curves of disease-free interval and survival. RESULTS: All tumors were positive for metalloproteinase-1; 50 (61 percent) were positive and 32 (39 percent) were negative for metalloproteinase-7; and 60 (74.1 percent) were positive and 21 (25.9 percent) were negative for VEGF. Correlation of marker expression, both in groups and individually, did not show statistical significance in relation to the degree of cell differentiation, staging, disease-free interval, survival or specific mortality. Recurrence showed a statistically significant correlation with positive expression of the three markers, when analyzed as a group (p = 0.038). CONCLUSION: The associated expression of metalloproteinase-1, metalloproteinase-7 and VEGF in colorectal adenocarcinoma is related to the incidence of disease recurrence.

OBJETIVO: Analisar as expressões da metaloproteinase-1, metaloproteinase-7 e do fator de crescimento endotelial vascular no adenocarcinoma colorretal e correlacionar com os fatores prognósticos clínico-patológicos. MÉTODOS: Foram analisados tecidos fixados em formol e dispostos em blocos de parafina dos tumores de 82 pacientes, por imunohistoquímica, pelo método da estreptavidina-biotina, usando-se a técnica de arranjo em matriz de amostras teciduais (tissue microarray). Na avaliação da positividade dos marcadores foi utilizado um escore categórico, que predeterminou o valor de corte na percentagem de células coradas do tumor. As expressões teciduais das proteínas foram correlacionadas com as varáveis representadas pelo grau de diferenciação celular, estadiamento, tempo livre de doença, recidiva, sobrevida e mortalidade específica. Foram empregados os testes exato de Fisher e de Kaplan-Meier para verificar as associações dos marcadores com as varáveis estudadas. Para testar a significância das diferenças entre as curvas do tempo livre de doença e da sobrevida foram utilizados os testes de longrank e Wilcoxon. RESULTADOS: A metaloproteinase-1 foi positiva em todos os tumores. A metaloproteinase-7 foi positiva em 50 (61 por cento) e negativa em 32 (39 por cento) tumores. O fator de crescimento endotelial vascular foi positivo em 60 (74,1 por cento) e negativo em 21 (25,9 por cento) tumores. A correlação das expressões dos marcadores realizada separadamente e em conjunto não apresentou significância estatística com o grau de diferenciação celular, estadiamento, tempo livre de doença, sobrevida e mortalidade específica. A recidiva apresentou correlação estatística significante com a expressão positiva dos três marcadores, quando foram analisados em conjunto (p = 0,038). CONCLUSÃO: As expressões associadas da metaloproteinase-1, metaloproteinase-7 e do fator de crescimento endotelial vascular no adenocarcinoma colorretal se relacionam com ...

Avaliação do preparo intestinal para colonoscopia comparando o uso do manitol e do polietilenoglicol: estudo prospectivo / Comparative evaluation of Bowel preparation for colonoscopy using mannitol and polyethylene glycol: a prospective study

Com o objetivo de estudar comparativamente o preparo intestinal para colonoscopia, 55 pacientes foram distribuídos aleatoriamente em grupos submetidos a preparo com polietilenoglicol (PEG) e solução de manitol. A qualidade do preparo do cólon no grupo que utilizou o PEG foi considerada excelente em 12 pacientes (44,4 por cento), bom em 15 (55,6 por cento) e ruim em nenhum caso, enquanto que naqueles indivíduos preparados com manitol a 20 por cento a qualidade foi, respectivamente, de oito (28,6 por cento), 12 (42,9 por cento) e oito (28,6 por cento) indivíduos, sendo a diferença estatisticamente significante (p=0,010). Não houve diferença estatística entre os grupos quando comparamos o grau de satisfação dos pacientes, ou a quantidade de líquido no cólon durante o exame. Conclui-se que a qualidade do preparo intestinal com PEG para colonoscopia é superior ao manitol.

With the aim of studying comparatively intestinal prepare for colonoscopy, 55 patients were randomly distributed into two groups that used polyethylene glycol (PEG) and mannitol solution. The quality of bowel prepare in the group that used PEG was considered excellent in 12 patients (44,4 percent), good in 15 (55,6 percent) and bad in no cases, while in those prepared with manitol the quality of intestine preparation was, respectively, eight (28,6 percent), 12 (42,9 percent) and eight (28,6 percent) patients. The difference was considered statistically significant (p=0,010). There wasn't any statistical difference between the groups when we compared the satisfaction degree of the patients or the amount of liquid in the colon during the colonoscopy. We can conclude that the quality of bowel preparation for colonoscopy with PEG is superior to manitol.

Metaloproteinases 1 e 7 e câncer colorretal / Metalloproteinases 1 and 7 and colorectal cancer

A metaloproteinase-1 (MMP-1) e a metaloproteinase-7 (MMP-7) são proteinases da matriz extracelular (MEC), zinco-dependentes, envolvidas no processo inicial da carcinogênese por permitirem a invasão tumoral na célula e promover o processo de metastatização. O polimorfismo dessas proteinases tem sido estudado recentemente com o objetivo de validar susa expressão e/ou atividade como marcador prognóstico. Evidências cumulativas revelam importante papel das MMP's 1 e 7 em diferentes fases da carcinogênese. A MMP-1 tem ação direta sobre a principal proteína da MEC, que é o colágeno do tecido intersticial conectivo. Sua expressão aumentada neste tecido pode indicar alto potencial de disseminação tumoral em diferentes tipos de câncer, incluindo o colorretal. A associação deste aumento da expressão também parece ser verdadeira para a MMP-7.

The metalloproteinase-1 (MMP-1) and metalloproteinase-7 (MMP-7) are proteinases of the extracellular matrix (MEC), zinc-dependent, involved in the initial process of carcinogenesis, allowing the invasion by the tumor cell and promoting the process of metastasis. The polymorphism of these proteinases has been studied recently in order to validate its expression and / or activity as a marker prognosis. Evidence shows cumulative important role of MMPs 1 and 7 in different stages of carcinogenesis. The MMP-1 is direct action on the main protein of the MEC, which is the collagen of interstitial connective tissue. Its increased expression in this tissue may indicate high potential for spread in different tumor types of cancer, including colorectal. The association of this increase of expression also appears to be true for MMP-7.

Analysis of bacteremia occurring in the presence of obstruction of the left colon in rats submitted to transoperative antegrade mechanical lavage.

With the objective of determining the association between bacteremia and transoperative antegrade mechanical lavage of the colon in an experimental model of obstruction of the left colon in rats, 40 male Wistar rats aged between 90 and 120 days were divided randomly into four groups: A, with intestinal obstruction and with mechanical lavage of the colon; B, with intestinal obstruction and without mechanical lavage of the colon; C, without intestinal obstruction and with mechanical lavage of the colon; and D, without intestinal obstruction and without mechanical lavage of the colon. Analysis of the results showed that there was no bacteremia in the animals in the sham group. On the other hand, bacterial growth in blood cultures was found in three animals (30%) in group C and in four animals (40%) in group B. Positive blood culturing was presented by eight animals (80%) of the rats in group A, and variance analysis on this finding was statistically significant (p = .0029). It can be concluded that, in this experimental model, intestinal obstruction causes a fourfold increase in the risk of bacteremia, while lavage causes an almost threefold increase in the chance of bacterial dissemination into the blood stream. This explains why there was greater incidence of bacteremia in the animals with obstruction and with lavage.