RESUMO
AIM: Preoperative chemotherapy (PCT) is used in primary breast cancer, to facilitate breast conservative surgery (BCS). Clinical and pathologic responses are important prognostic parameters. Biologic markers are needed to individualize treatment. PATIENTS AND METHODS: One hundred and thirty-five patients with breast carcinoma were treated with PCT, followed by surgery and adjuvant therapy. Clinical response and pathological complete response (pCR), biological markers and type of surgery were compared between invasive ductal (IDC) and invasive lobular carcinoma (ILC). RESULTS: Overall response (OR) for IDC was 75% compared to 50% for ILC (P=0.0151). Pathological CR was 15% for IDC and 0% for ILC (P=0.0066). Fifty-six percent of the responding patients had BCS, in contrast with 16% of the non-responders. BCS was performed in 50% of patients with IDC, in 38% of the patients with ILC. Salvage surgery was more necessary in ILC (19%) compared to IDC (4%) (P=0.0068). Patients with ILC were more frequently ER-positive and HER-2 negative than patients with IDC. CONCLUSIONS: Clinical and pathological responses are lower in ILC compared to IDC. After PCT, patients with large ILC should preferably be offered mastectomy with immediate breast reconstruction. However, PCT still remains valuable to evaluate tumor response and biologic factors in vivo.
Assuntos
Protocolos de Quimioterapia Combinada Antineoplásica/uso terapêutico , Neoplasias da Mama/tratamento farmacológico , Carcinoma Ductal de Mama/tratamento farmacológico , Carcinoma Lobular/tratamento farmacológico , Adulto , Idoso , Protocolos de Quimioterapia Combinada Antineoplásica/administração & dosagem , Biomarcadores Tumorais/análise , Neoplasias da Mama/química , Neoplasias da Mama/patologia , Neoplasias da Mama/cirurgia , Carcinoma Ductal de Mama/química , Carcinoma Ductal de Mama/patologia , Carcinoma Ductal de Mama/cirurgia , Carcinoma Lobular/química , Carcinoma Lobular/patologia , Carcinoma Lobular/cirurgia , Quimioterapia Adjuvante , Cisplatino/administração & dosagem , Ciclofosfamida/administração & dosagem , Doxorrubicina/administração & dosagem , Feminino , Fluoruracila/administração & dosagem , Humanos , Mastectomia Segmentar , Metotrexato/administração & dosagem , Pessoa de Meia-Idade , Terapia Neoadjuvante , Estadiamento de Neoplasias , Estudos Prospectivos , Análise de Sobrevida , Resultado do TratamentoRESUMO
The distribution of oestrogen and progesterone receptors in the human endometrial basal and functional layer during the normal menstrual cycle was investigated by means of an immunocytochemical technique. A cyclic pattern of receptor distribution was observed. The highest concentration of hormone receptors was observed in the basal layer, in accordance with the idea that this layer is the source of endometrial regeneration.
Assuntos
Endométrio/metabolismo , Ciclo Menstrual/metabolismo , Receptores de Estrogênio/metabolismo , Receptores de Progesterona/metabolismo , Adulto , Núcleo Celular/metabolismo , Endométrio/anatomia & histologia , Feminino , Humanos , Técnicas Imunoenzimáticas , Variações Dependentes do ObservadorRESUMO
The topographical distribution of oestrogen and progesterone receptors in the human endometrium and Fallopian tube was investigated by an immunocytochemical technique. A gradient of positively stained cells was observed: the highest oestrogen and progesterone receptor content was noted in the fundal part of the uterine cavity and the ampullar region of the Fallopian tube. The observed gradient is in keeping with biological and pathological events that occur in the human mullerian tract, e.g. fecundation, implantation and carcinogenesis.
Assuntos
Endométrio/metabolismo , Tubas Uterinas/metabolismo , Receptores de Estrogênio/metabolismo , Receptores de Progesterona/metabolismo , Adulto , Idoso , Núcleo Celular/metabolismo , Endométrio/anatomia & histologia , Tubas Uterinas/anatomia & histologia , Feminino , Humanos , Técnicas Imunoenzimáticas , Pessoa de Meia-Idade , Coloração e RotulagemAssuntos
Endométrio/química , Receptores de Estrogênio/análise , Receptores de Progesterona/análise , Hemorragia Uterina/metabolismo , Prolapso Uterino/metabolismo , Adulto , Núcleo Celular/química , Núcleo Celular/ultraestrutura , Endométrio/ultraestrutura , Feminino , Humanos , Ciclo Menstrual , Hemorragia Uterina/patologia , Prolapso Uterino/patologiaRESUMO
Diagnosis of mesenteric venous thrombosis is almost always delayed, due to the aspecificity of the complaints and the clinical findings, as well as the laboratory investigations. Earlier diagnosis is essential to improve the present grim mortality rate. We report a case of mesenteric venous thrombosis in a 25-year-old female. Early diagnosis was made by gynecological laparoscopy. After resection and anastomosis, the outcome was uneventful.
