Cytohistologic correlation of nuclear grade in breast carcinoma.

OBJECTIVE: To compare the nuclear grade (NG) in cytologic material (CNG) obtained from breast fine needle aspiration biopsies (FNABs) with the NG observed in surgical biopsies (BNG) of the same tumors. STUDY DESIGN: The study group consisted of 135 breast carcinomas with both FNAB and biopsy. Most of them were invasive ductal carcinomas. Cytologic aspirates and tissue sections were graded simultaneously by the three authors using a multiheaded microscope. Fisher's modification of Black's nuclear grading scheme was used. RESULTS: There was agreement between CNG and BNG in 70.37% of tumors. The percentage coincidence was slightly greater for NG 3. CONCLUSION: Nuclear grade can be easily established on FNAB. The lack of correlation (29.63%) may have been due to tumor heterogeneity and observer subjectivity when assigning nuclear grade.

[Expression of p53 and bcl-2 in colorectal adenomas and carcinomas]. / Expresión de p53 y de bcl-2 en adenomas y carcinomas colorrectales.

Recent publications have associated p53 and bcl-2 genes in the process of neoplastic transformation. As the colonic adenoma-carcinoma sequence is an adequate natural model for carcinogenesis, it was considered interesting to analyze the expression of bcl-2 and p53 in these neoplasms. Seventy three adenomatous polyps (adenomas) and 60 adenocarcinomas of the colon and rectum were studied. Adenomas showed mild dysplasia in 16, moderate in 27, severe in 15 and focal carcinoma in the remaining 15. Adenocarcinomas surpassed the deep muscle layer in every case and were moderately differentiated. The studied gene expression was analized immunohistochemically using antibodies bcl-2 from Dako and p53 from Novocastra, both at a 1:100 dilution. Cytoplasmic stain for bcl-2 and nuclear stain for p53 above 10% of the cells were considered positive for each gene respectively. Results showed that there was accumulation of p53 protein in 26/58 (45%) adenomas with different grades of dysplasia. This result is similar to the reactivity found in adenomas with focal carcinoma where 8/15 (53%, p = 0.4) were positive but different from adenocarcinomas which were positive in 47/60 (78%, p = 0.0001). Regarding bcl-2, positivity was found in 53/73 (73%) of all the adenomas whereas adenocarcinoma showed expression in 14/60 (23%, p = 0.0000). When adenomas were grouped according to their degree of dysplasia and the existence of focal carcinoma, a diminishing frequency of reactivity for bcl-2 was found and when adenomas with three different grades of dysplasia were fused together, 47/58 (81%) were positive and this was compared with adenomas having focal carcinoma, 6/15 (40%) and with adenocarcinoma, 14/60 (23%), they showed significant differences (p = 0.001 and p = 0.0000 respectively). The analysis of the frequency of expression for both genes studied in the different lesions described yielded an inverse relation between them. This study allows the conclusion that the expression of bcl-2 is an early event in carcinogenesis and that it is replaced by mutation of p53 as the neoplastic change progresses.

Diagnostic value of p53 protein in the study of serous effusions.

The differential diagnosis between neoplastic and reactive mesothelial cells is one of the most frequent problems in the study of serous effusions. We assessed the utility of the immunohistochemical determination of p53 protein as a marker of malignancy in 34 embedded blocks of neoplastic fluids and 30 nonneoplastic effusions. Eleven (32.4%) of the tumor fluids were positive for this antibody, while all the nonneoplastic fluids were negative. A specificity of 100% and a sensitivity of 59% were observed. The immunohistochemical determination of p53 protein seems to be helpful in the differential diagnosis of effusions; its principal limitation is its relatively low sensitivity.

Diagnóstico de carcinomas indiferenciados con marcadores epiteliales / Diagnosis of undifferentiated carcinomas with epithelial markers

Con el objeto de determinar el valor diagnóstico de una serie de marcadores epiteliales se estudiaron 25 carcinomas indifenciados y 5 carcinomas indiferenciados de pequeñas células. Como grupo control positivo fueron marcados 16 carcinomas epidermoides o adenocarcinomas y como control negativo, 5 linfomas malignos. fueron utilizados sueros monoclonales contra queratina (AE1) y el antígeno epitelial de membrana (EMA) y policlonal para la demostración de antígeno carcinoembrionario (ACE). El método de marcación utilizado fue el de peroxidads-antiperoxidasa para ACE y el complejo acidinabiotina par AE1 y EMA. Del grupo control positivo todos los tumores fueron positivo con EMA, uno negativo con AE1, 20(80%) con EMA y 17(68%) con ACE. Tomando en cuenta los 3 marcadores, fueron positivos 24 de los 25 tumores (96%). Los carcinomas indiferenciados de pequeñas células y los linfomas malignos fueron negativos. Este trabajo confirma la utilidad de los marcadores epiteliais como ayuda diagnóstica para la tipificación de neoplasias indifernciadas. El empleo simultáneo de vários marcadores mejora los resultados

Diagnóstico de carcinomas indiferenciados con marcadores epiteliales / Diagnosis of undifferentiated carcinomas with epithelial markers

Con el objeto de determinar el valor diagnóstico de una serie de marcadores epiteliales se estudiaron 25 carcinomas indifenciados y 5 carcinomas indiferenciados de pequeñas células. Como grupo control positivo fueron marcados 16 carcinomas epidermoides o adenocarcinomas y como control negativo, 5 linfomas malignos. fueron utilizados sueros monoclonales contra queratina (AE1) y el antígeno epitelial de membrana (EMA) y policlonal para la demostración de antígeno carcinoembrionario (ACE). El método de marcación utilizado fue el de peroxidads-antiperoxidasa para ACE y el complejo acidinabiotina par AE1 y EMA. Del grupo control positivo todos los tumores fueron positivo con EMA, uno negativo con AE1, 20(80%) con EMA y 17(68%) con ACE. Tomando en cuenta los 3 marcadores, fueron positivos 24 de los 25 tumores (96%). Los carcinomas indiferenciados de pequeñas células y los linfomas malignos fueron negativos. Este trabajo confirma la utilidad de los marcadores epiteliais como ayuda diagnóstica para la tipificación de neoplasias indifernciadas. El empleo simultáneo de vários marcadores mejora los resultados (AU)