232 resultados para Metaplasia intestinal

em Repositório Institucional UNESP - Universidade Estadual Paulista "Julio de Mesquita Filho"


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Conselho Nacional de Desenvolvimento Científico e Tecnológico (CNPq)

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A presente revisão focaliza aspectos conceituais e os principais problemas diagnósticos referentes ao esôfago de Barrett e à displasia. O esôfago de Barrett resulta de complicação da doença do refluxo gastroesofágico de longa duração. É identificado endoscopicamente pela presença de mucosa glandular no esôfago tubular acima da junção esofagogástrica. Histologicamente, é caracterizado pela substituição do epitélio estratificado pavimentoso por epitélio colunar especializado com células caliciformes, expresso como metaplasia intestinal. A importância biológica do esôfago de Barrett é o risco de progressão para câncer. A displasia é o principal marcador biológico preditivo de evolução para adenocarcinoma. Identificar e graduar a displasia constitui importante questão na prática diagnóstica. O diagnóstico patológico do esôfago de Barrett deve conter informações sobre a investigação de displasia. O principal diagnóstico diferencial da displasia é feito em relação a reatividade e regeneração epitelial no contexto de inflamação da mucosa. Como a variabilidade de interpretação é um dos principais problemas no diagnóstico da displasia, os casos de esôfago de Barrett devem ser enviados à consulta para segunda opinião diagnóstica. O exame anatomopatológico é fundamental para definir o diagnóstico de esôfago de Barrett e para rastrear a displasia, que é o principal marcador de risco para câncer nesta entidade.

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Fundação de Amparo à Pesquisa do Estado de São Paulo (FAPESP)

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RACIONAL: O câncer de estômago é o segundo tipo mais comum de neoplasia no mundo. A carcinogênese de estômago é processo de múltiplos passos, podendo manifestar-se em várias etapas como gastrite superficial, gastrite atrófica crônica, metaplasia intestinal, displasia e, finalmente, como um carcinoma. Essas condições costumam ser seqüenciais e ocorrer num período de muitos anos como resultado da exposição a uma variedade de fatores endógenos e exógenos, que causam alterações genéticas. Os recentes avanços da genética molecular têm mostrado que o acúmulo dessas várias anormalidades, incluindo a ativação de oncogenes e a inativação de genes supressores de tumores, resultam no desenvolvimento do câncer. Alterações genéticas descritas em carcinomas gástricos incluem amplificações e mutações dos genes c-ERBB2, K-RAS, c-MET e TP53. O ganho de cromossomos também foi encontrado em várias combinações com perda de outros cromossomos e pode estar associado com a expressão elevada de oncogenes, que contribuem com a progressão tumoral. CONCLUSÃO: Essas mudanças genéticas em carcinomas evidenciam o processo de múltiplas etapas da carcinogênese gástrica, por meio do acúmulo de uma série de alterações.

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Gastric carcinogenesis is attributable to interacting environmental and genetic factors, through a sequence of events including intestinal metaplasia. Using a fluorescence in situ hybridization technique, we investigated the occurrence of ancuploidies of chromosomes 3, 7, 8, 9, and 17, TP53 gene deletion, and expression of p53 in 21 intestinal metaplasia (IM) samples from cancer-free patients and in 20 gastric adenocarcinoma samples. Aneuploidies were found in 71% (15/21) of the IM samples. Trisomy of chromosomes 7 and 9 occurred mainly in complete-type IM; in the incomplete type, trisomy of chromosomes 7 and 8 were more commonly found. The TP53 gene deletion was observed in 60% (3/5) of the IM cases, and immunohistochemistry revealed p53 overexpression in 12% (2/17) of the analyzed IM cases. All gastric adenocarcinoma cases presented higher frequencies of trisomy or tetrasomy of chromosomes 3, 7, 8, 9, and 17. The TP53 deletion was found in all three of the gastric adenocarcinoma analyzed for it, and immunohistochemistry detected overexpression of protein p53 in 80% (12/15) of the analyzed cases. Our study revealed for the first time the presence of aneuploidies of chromosomes 7, 8, 9, and 17 and of TP53 gene deletion and overexpression in IM samples from cancer-free patients. These results suggest that IM and gastric adenocarcinoma may share the same genetic alterations. (C) 2004 Elsevier B.V. All rights reserved.

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The evolution and phenotypic expression of mucosal lesions of the gastric stump were investigated in male rats submitted to gastric resection with reconstruction by the Billroth II technique (BII with biliopancreatic reflux, BPR) or by the Roux-en-Y procedure (without BPR). Animals were studied at 24, 36, 54 and 64 weeks after surgery and the phenotypic expression of lesions analysed using routine hematoxylin and eosin staining, immunohistochemical staining for pepsinogen isoenzyme 1 and histochemical procedures for mucins (paradoxical concanavalin A, galactose oxidase Schiff (GOS) and sialidase GOS reactions). BPR was found to be responsible for the formation of adenomatous hyperplasia (AH), increasing in incidence and size with time, since the Roux-en-Y procedure failed to induce the gastric stump lesions observed after BII reconstruction. AHs always occurred in the transition of the gastrojejunal junction, a site offering special conditions for BPR influence, and were classified as gastric (G), intestinal (I) and G+I types according to their phenotypic expression. No pure I type AH was diagnosed at any time point. The G and G+I types developed at approximately equal incidences (i.e., G type 7/17, G+I type 10/17 at the 64th week). It was suggested that both gastric and intestinal mucosal elements were stimulated to proliferate by BPR, with the gastric mucosa tending to demonstrate AH. Intestinal type components of AH were found adjacent to the jejunum and not at the stomach margin, indicating an origin from intestinal mucosa. No metaplasia of the gastric mucosa was observed in any animal after partial gastric resection. In 101 rats submitted to the BII procedure, 5 mucinous adenocarcinomas were eventually diagnosed, mostly located in the subserosa of the gastrojejunal junction. All carcinomas expressed the phenotype of cells of the small intestine. Evidence of malignant transformation within the gastric components of AH was not observed even at the 64th week. In conclusion, all lesions induced by BPR in the rat remnant stomach are benign, and the few true cancers that arise in association are derived from the small intestine.

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Use of antibiotics as an additive in poultry diets to improve growth has been discussed in relation to bacterial resistance and the development of new products and management practices. This study was carried out to test the efficacy of a new substance (Saccharomyces cereviside cell walls, var. Calsberg- SCCW) obtained from the brewery industry, added (at 0.1 and 0.2%) to broiler chicken diets (based on corn and soybean meal), on performance and intestinal mucosa development. In Experiment 1 (carried out in litter-floor pens) the results revealed higher body weight gain,for the total experimental period and higher villus height at 7 d of age for the birds fed 0.2%,SCCW. In a field test using 44,000 broilers that,received feed containing 0.2% SCCW,. The results also showed higher body weight gain and better feed conversion for SCCW-supplemented birds. The present findings show that SCCW improved body weight gain in broiler chickens and that this effect can be attributed to the trophic effect of this product on the intestinal mucosa, because it increases villus height, particularly during the first 7. d of a chicken's life.

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This study aimed at evaluating the effect of the use of different growth promoters on the morphometry and ultra-structure of the intestinal mucosa of 42-day-old broilers. A total number of 36 male Cobb broilers was distributed in a randomized experimental design with a 3 x 3 factorial arrangement, with 3 prebiotic and 3 probiotic sources in the feed, summing up 9 treatments, with 4 replicates each. There was a significant interaction (P<0.01) among the studied factor for villi height (VH) in all intestinal segments, and for crypt depth (CD) in the duodenum and the ileum. In the duodenum, higher villi were obtained in the control group, with the combination of B. subtilis and prebiotics, and with the single use of MOS+OA. No VH differences were observed between the control group and those fed prebiotics. In the jejunum, the highest villi were obtained with the use of the bacterial pool, followed by the control group, and by the use of B. subtilis. Higher villi were also obtained in the control group and in the groups fed MOS, when B. subtilis was used in combination with prebiotics, and when the bacterial pool was used individually or in combination with MOS. In the ileum, the highest villi were obtained with the individual use of B. subtilis, and when MOS+OA or MOS were individually used or in combination with the bacterial pool. As to duodenal CID, deeper crypts were observed in the control group and in those fed B. subtilis or MOS+OA. In the ileum, deeper crypts were also found in the control group and those fed B. subtilis. Deeper crypts were also found when the bacterial pool was individually used or in combination with MOS+OA, and with the individual use of MOS. It was concluded that the use of growth promoters was beneficial to Increase intestinal villi height when Bacillus subtilis was used in combination with prebiotics. The other growth promoters (MOS+OA, MOS, and bacterial pool), can be individually used in most situations. The tested growth promoters did not influence intestinal villi density.

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O objetivo deste estudo foi avaliar os efeitos da utilização de diferentes ingredientes fibrosos nas dietas sobre o desempenho, a composição corporal e a morfometria intestinal de juvenis de pacu. Foram avaliadas cinco dietas isoproteicas (23% de proteína digestível), isoenergéticas (3250kcal de energia digestível/kg) e isofibrosas (9% de fibra bruta), sendo a principal fonte fibrosa de cada constituída por farelo de soja, casca de soja, farelo de girassol e polpa cítrica; esta última em dois níveis de inclusão (30 e 45%). Foram utilizados 300 juvenis de pacu (25,12±0,78 gramas), alojados em 25 aquários (200 litros). Os melhores resultados de crescimento e conversão alimentar foram obtidos com as dietas contendo farelo de soja e farelo de girassol. As dietas contendo casca de soja e polpa cítrica prejudicaram o desempenho dos juvenis de pacu, e o efeito negativo foi acentuado com o aumento da inclusão de polpa cítrica. Além disto, somente nos peixes alimentados com a dieta com 45% de polpa cítrica foi observada diminuição na densidade de vilosidades por área no epitélio intestinal. A partir dos resultados obtidos, pode-se concluir que alguns ingredientes fibrosos podem afetar negativamente o desempenho e as características do epitélio intestinal de juvenis de pacu.