RESUMO
PURPOSE: This study aimed to validate the classification of breast cancer (BC) patients in progression risk groups based on total tumor load (TTL) value to predict lymph node (LN) affectation after neo-adjuvant systemic therapy (NAST) obtained in the NEOVATTL study. METHODS/PATIENTS: This was an observational, retrospective, international, multicenter study including patients with infiltrating BC who received NAST followed by sentinel lymph node biopsy (SLNB) analyzed with one-step nucleic acid amplification (OSNA) from nine Spanish and two Italian hospitals. Patients were classified into three groups according to the progression risk, measured as disease-free survival (DFS), based on TTL values (> 250, 250-25,000, and > 25,000 copies/µL). The previous (NEOVATTL study) Cox regression model for prognosis was validated using prognostic index (PI) and Log ratio test (LRT) analyses; the value of TTL for axillary non-SLN affectation was assessed using receiver operating characteristic (ROC) curves. RESULTS: We included 263 patients with a mean age of 51.4 (± SD 10.5) years. Patients with TTL > 25,000 copies/µL had a shorter DFS (HR 3.561 [95% CI 1.693-7.489], p = 0.0008 vs. TTL ≤ 25,000). PI and LRT analyses showed no differences between the two cohorts (p = 0.2553 and p = 0.226, respectively). ROC analysis showed concordance between TTL and non-SLN involvement (area under the curve 0.828), with 95.7% sensitivity and 92.9% specificity at a TTL cut-off of > 15,000 copies/µL. CONCLUSIONS: In BC patients who had received NAST and underwent SLNB analysis using OSNA, a TTL value of > 25,000 copies/µL was associated with a higher progression risk and > 15,000 copies/µL was predictive of non-SLN involvement.
Assuntos
Neoplasias dos Ductos Biliares , Ductos Biliares Intra-Hepáticos , Colangiocarcinoma , Radiografia Abdominal , Tomografia Computadorizada por Raios X , Adulto , Neoplasias dos Ductos Biliares/diagnóstico , Neoplasias dos Ductos Biliares/diagnóstico por imagem , Neoplasias dos Ductos Biliares/patologia , Ductos Biliares Intra-Hepáticos/diagnóstico por imagem , Ductos Biliares Intra-Hepáticos/patologia , Biópsia por Agulha Fina , Colangiocarcinoma/diagnóstico , Colangiocarcinoma/diagnóstico por imagem , Colangiocarcinoma/patologia , Humanos , Imuno-Histoquímica , MasculinoRESUMO
Las lesiones linfoproliferativas cutáneas, neoplásicas o reactivas, presentan con frecuencia problemas diagnósticos y de clasificación. En este artículo se repasan brevemente los aspectos más relevantes de los trastornos linfoproliferativos de células T, los más habituales en la piel, prestando particular atención a los aspectos anatomopatológicos. Además de la micosis fungoide, el linfoma más frecuente en la piel, se describen los trastornos linfoproliferativos CD30+ y, más resumidamente, otros linfomas cutáneos más raros, así como la hiperplasia linfoide de células T y las potenciales lesiones precursoras de la micosis fungoide (AU)
Assuntos
Humanos , Linfoma Cutâneo de Células T/patologia , Transtornos Linfoproliferativos/classificação , Micose Fungoide/patologia , Pseudolinfoma/patologia , Cútis Laxa/patologia , Linfoma Anaplásico de Células Grandes/patologiaRESUMO
Presentamos el caso de una mujer de 35 años con un nódulo umbilical violáceo y doloroso adherido al saco de una hernia umbilical. Histológicamente se observan glándulas endometriales proliferativas en la dermis sin alcanzar el panículo adiposo. La particularidad del caso reside en la localización únicamente cutánea de la endometriosis y su asociación a una hernia umbilical (AU)