988 resultados para Prognostic Factors
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A etiologia do carcinoma epidermóide do pênis (CEP) está relacionada a múltiplos fatores de risco como a presença de prepúcio, pobre higiene, dermatites crônicas e tabagismo. Entretanto, o fator de risco mais extensivamente estudado, éa infecção pelo papiloma vírus humano (HPV). Está bem estabelecido que esteexerce um importante papel etiológico em neoplasias da cérvice uterina; entretanto, sua associação com CEP tem sido foco de debates, demonstrando-se presença viral variando entre 15% a 80% dos casos, sugerindo que apenas um subgrupo desses tumores seja causado pelo HPV. O prognóstico da doença é influenciado negativamente principalmente pela presença de metástases em linfonodos inguinais. Desta forma, a abordagem cirúrgica destes, assume importância decisiva na cura da doença. Poroutro lado, os métodos disponíveis para o estadiamento desses linfonodos são imprecisos e as linfadenectomias são acompanhadas de morbidade significativa. A descrição de outros marcadores histológicos é escassa, devido a raridade desses tumores.O objetivo do presente trabalho é avaliar a prevalência, distribuição e associação do HPV com parâmetros histológicos de pior prognóstico, no sentido de determinar seu possível valor preditivo para metástases inguinais, assim como avaliar os fatores prognósticos já descritos. Espécimes tumorais em parafina de 82 pacientes portadores de carcinoma epidermóide do pênis, foram testados para prevalência e distribuição do genótipo do HPV por PCR. O estado do HPV foi correlacionado com fatores histopatológicos e ocorrência de metástases inguinais. Foi também avaliada a influência de diversascaracterísticas histológicas tumorais, na sobrevida livre de doença inguinal em 5 anos. O seguimento variou entre 1 e 71 meses (média 20 meses). O DNA do HPV foi identificado em 60,9% da amostra, tendo maior prevalência dos tipos virais 11 e 6 (64% e 32%, respectivamente). Não houve correlação independente significativa das variáveis histológicas de pior prognóstico com o estado do HPV. A probalidade de sobrevida livre de doença inguinal em 5 anos, também não foi influenciada pelo HPV (log Rank teste=0,45). Os únicos fatores patológicos independentes para metástases inguinais foram estadiamento T≥T1b-T4 (p=0,02), invasão linfovascular (p=0,04) e fronte de invasão infiltrativa (p-0,03). O estado e a distribuição do HPV não mostrou correlação com fatores histológicos de pior prognóstico, nem mostrou importância na predição de metástases linfonodais em CEP.
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Pós-graduação em Medicina Veterinária - FCAV
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Pós-graduação em Ginecologia, Obstetrícia e Mastologia - FMB
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Inflammatory cells surround breast carcinomas and may act promoting tumor development or stimulating anti-tumor immunity. N-acetylglucosaminidase (NAG) has been employed to detect macrophage accumulation/activation. Myeloperoxidase (MPO) is considered a marker for neutrophils activity/accumulation. Vascular Endothelial Growth Factor (VEGF) is as strong pro-angiogenic cytokine. The aim of this study was to measure the systemic inflammatory response by measuring serum levels of NAG, MPO and VEGF in women diagnosed with breast cancer and associate this response to the peritumoral inflammatory infiltrate and to prognostic factors. Serum samples obtained from women with no evidence of disease (n = 31) and with breast cancer (n = 68) were analyzed for the activities of NAG, MPO and VEGF by enzymatic assay. Serum levels of NAG and VEGF were higher in healthy volunteers (P < 0.0001) and serum levels of MPO were higher in patients with breast cancer (P = 0.002). Serum levels of NAG were positively correlated to serum levels of MPO and VEGF (P < 0.0001 and P = 0.0012, respectively) and MPO and VEGF serum levels had also a positive correlation (P = 0.0018). The inflammatory infiltrate was not associated to serum levels of the inflammatory markers, and higher levels of MPO were associated to lymphovascular invasion negativity (P = 0.0175). (C) 2013 Elsevier Masson SAS. All rights reserved.
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Pós-graduação em Medicina Veterinária - FCAV
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Pós-graduação em Saúde Coletiva - FMB
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Pós-graduação em Ciência Animal - FMVA
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Background: Acral lentiginous melanoma is a melanoma with poor prognosis which is frequently diagnosed at an advanced stage. Since the thickness of tumour is one of the main prognostic factors, this case can exemplify how important complete histological analyses looking for focal invasiveness can be.Case report: A 77 year-old woman with a black spot with slow progressive growth on the left plantar region. She sought medical attention due to the expansion onto the dorsal surface of toes. The lesion had irregular borders and had spread to half the plantar surface. Histopathology confirmed the clinical suspicion of acral lentiginous melanoma Clark level IV and 2.6 mm Breslow thickness. The surgical specimen was entirely processed for histological evaluation, requiring 53 slides. Tumor dermal invasion was detected in only three out of 53 glass slides as the invasiveness was not identified by clinical, dermatoscopy or macroscopy exams.Conclusion: Sectioning through the entire lesion is considered very important to determinate the appropriate stage of the disease and the correct treatment and patient follow-up.
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In order to evaluate the quality of life of patients with head and neck cancer, this study analyzed data of 24 patients with squamous cell carcinoma, which indicated therapy was radiotherapy or not be combined with chemotherapy and surgery. The study was conducted in the Unit of Radiotherapy of Megavoltage located in the São José de Rio Preto-SP, in the period August 2007 to January 2008. Then, it was used the questionnaire of quality of life from University of Washington which enabled the identification of different quality of life patterns associated with the different stages of radiotherapy, indicating to be viable the prospect of recognition of prognostic factors of reduction in multiple domains of quality of life. From the data collected and analyzed, it was identified that the areas with the worst score in the begin of radiotherapy were appearance, speech and anxiety; during the treatment were taste, saliva and anxiety; and in the end were taste, saliva and swallowing. Throughout the treatment, it was observed the deterioration of patients' mood. In this regard, emphasizes the importance of dental and psychological follow-up, within the framework of a multidisciplinary care for patients with head and neck cancer during radiotherapy treatment.
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Coordenação de Aperfeiçoamento de Pessoal de Nível Superior (CAPES)
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Fundação de Amparo à Pesquisa do Estado de São Paulo (FAPESP)
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Osteosarcoma (OS) is the most common primary malignant bone tumor, usually developing in children and adolescents, and is highly invasive and metastatic, potentially developing chemoresistance. Thus, novel effective treatment regimens are urgently needed. This study was the first to investigate the anticancer effects of dehydroxymethylepoxyquinomicin (DHMEQ), a highly specific nuclear factor-kappa B (NF-kappa B) inhibitor, on the OS cell lines HOS and MG-63. We demonstrate that NF-kappa B blockade by DHMEQ inhibits proliferation, decreases the mitotic index, and triggers apoptosis of OS cells. We examined the effects of combination treatment with DHMEQ and cisplatin, doxorubicin, or methotrexate, drugs commonly used in OS treatment. Using the median effect method of Chou and Talalay, we evaluated the combination indices for simultaneous and sequential treatment schedules. In all cases, combination with a chemotherapeutic drug produced a synergistic effect, even at low single-agent cytotoxic levels. When cells were treated with DHMEQ and cisplatin, a more synergistic effect was obtained using simultaneous treatment. For the doxorubicin and methotrexate combination, a more synergistic effect was achieved with sequential treatment using DHMEQ before chemotherapy. These synergistic effects were accompanied by enhancement of chemoinduced apoptosis. Interestingly, the highest apoptotic effect was reached with sequential exposure in both cell lines, independent of the chemotherapeutic agent used. Likewise, DHMEQ decreased cell invasion and migration, crucial steps for tumor progression. Our data suggest that combining DHMEQ with chemotherapeutic drugs might be useful for planning new therapeutic strategies for OS treatment, mainly in resistant and metastatic cases. Anti-Cancer Drugs 23:638-650 (C) 2012 Wolters Kluwer Health broken vertical bar Lippincott Williams & Wilkins.
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Translocation (8;21)(q22;q22)/RUNX1-RUNX1T1 is a molecular marker that is usually associated with a favorable outcome in both pediatric and adult patients with acute myeloid leukemia (AML). The present report describes the results of hematologic, cytogenetic, and fluorescence in situ hybridization analysis of a case of AML with maturation in a 23-year-old woman. Cytogenetic analysis revealed a balanced translocation involving chromosomal band 21q22, which disrupts the RUNX1 gene, and 10q22, with the following karyotype: 45,X,-X,t(10;21)(q24;q22)[cp16]/46,XX [4]. Interphase FISH showed, in 67% of the 300 interphase nuclei analyzed, three signals for RUNX1 and two RUNX1T1, but no signals corresponding to RUNX1-RUNX1T1 fusion gene. These results were corroborated by RT-PCR, which revealed negative results for the amplification of RUNX1-RUNX1T1 fusion gene. The patient was refractory to conventional and salvage chemotherapy regimens and early relapsed after unrelated donor bone marrow transplantation (BMT), dying of pneumonia, acute respiratory failure, and sepsis on day +80 after BMT, 1 year after diagnosis.
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Background: Prognosis of prostate cancer (PCa) is based mainly in histological aspects together with PSA serum levels that not always reflect the real aggressive potential of the neoplasia. The micro RNA (miRNA) mir-21 has been shown to regulate invasiveness in cancer through translational repression of the Metaloproteinase (MMP) inhibitor RECK. Our aim is to investigate the levels of expression of RECK and miR-21 in PCa comparing with classical prognostic factors and disease outcome and also test if RECK is a target of miR-21 in in vitro study using PCa cell line. Materials and methods: To determine if RECK is a target of miR-21 in prostate cancer we performed an in vitro assay with PCa cell line DU-145 transfected with pre-miR-21 and anti-miR-21. To determine miR-21 and RECK expression levels in PCa samples we performed quantitative real-time polymerase chain reaction (qRT-PCR). Results: The in vitro assays showed a decrease in expression levels of RECK after transfection with pre-miR-21, and an increase of MMP9 that is regulated by RECK compared to PCa cells treated with anti-miR-21. We defined three profiles to compare the prognostic factors. The first was characterized by miR-21 and RECK underexpression (N = 25) the second was characterized by miR-21 overexpression and RECK underexpression (N = 12), and the third was characterized by miR-21 underexpression and RECK overexpression (N = 16). From men who presented the second profile (miR-21 overexpression and RECK underexpression) 91.7% were staged pT3. For the other two groups 48.0%, and 46.7% of patients were staged pT3 (p = 0.025). Conclusions: Our results demonstrate RECK as a target of miR-21. We believe that miR-21 may be important in PCa progression through its regulation of RECK, a known regulator of tumor cell invasion.
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The purpose of this study is to estimate the survival probability of patients following their first admission for the treatment of AIDS to an infectious disease reference hospital in Belo Horizonte, Brazil, during 2005. Study subjects were monitored during a 12-month period to identify factors associated with survival probability. Late diagnosis was recorded among many of the 250 study subjects: almost half (44.8%) were diagnosed less than 30 days prior to or during their hospitalization. A high mortality rate was also detected: 39.6% of the subjects died during the 12 months of monitoring. The cumulative survival probability of the cohort group was estimated at 68.0% after 3 months and at 61.2% after 12 months. However, certain patient subgroups analyzed had even lower cumulative survival probabilities after 12 months of monitoring: if diagnosed during hospitalization, it was estimated at only 48.0% and those with no record of antiretroviral treatment had a 48.5% cumulative survival probability. Patients with severe anemia had the lowest survival probability, similar among the two lymphocyte count groups (<1000 mm(3) and >= 1000 mm(3)), the former with a 45.5% survival probability and the latter with a 46.7% one. The proportional death risk was 2.5-fold higher for men residing in other area than the capital city of the State of Minas Gerais and greater metropolitan region when compared with women residing there. The findings of this study highlight the importance of early diagnosis for predicting patient survival and reinforce the necessity off acilitating HIV diagnosis.