Estudo clínico-patológico, da proliferação celular e da apoptose no adenocarcinoma gástrico da cárdia
Autor(a) principal: | |
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Data de Publicação: | 2006 |
Outros Autores: | , , |
Tipo de documento: | Artigo |
Idioma: | por |
Título da fonte: | Repositório Institucional da UNIFESP |
Texto Completo: | http://dx.doi.org/10.1590/S0004-28032006000300006 http://repositorio.unifesp.br/handle/11600/3240 |
Resumo: | BACKGROUND/AIMS: In view of the increased incidence of carcinoma of the cardia over recent years, this work had the aim of studying the clinicopathological aspects, cell proliferative and tumor apoptotic indices of this neoplasm, their interrelations and possible influences on the prognosis. MATERIAL AND METHODS: Forty cases of adenocarcinoma of the cardia were studied between 1988 and 2001, with a minimum clinical follow-up of 3 years. Patients were excluded if they had previous chemotherapy or radiotherapy treatment, presented early neoplasia, or died during the operations or for other reasons unrelated to cancer. Gender; age, Laurén and Ming histological type, staging, and the presence or absence of intestinal metaplasia, epithelial dysplasia and Helicobacter pylori in the adjacent mucosa were analyzed. The apoptotic index was evaluated via hematoxylin-eosin in the primary tumor. To analyze the cell proliferation tumor, PCNA was utilized. The immunohistochemical technique utilized was streptavidin-biotin-peroxidase. For the survival analysis, cases with distant metastasis upon diagnosis were excluded. For the statistical analysis, the Student t and Mann-Whitney tests, Kaplan-Meier curves and Cox regression model were utilized. RESULTS: The mean age was 61 years (median: 63). There was predominance of the male gender (72.5%), diffuse histological type (55%) and infiltrative histological type (72.5%), and the more advanced stages (III and IV: 67.5%). There was no association with intestinal metaplasia and/or H. pylori. No epithelial dysplasia was detected in adjacent mucosa in any of the cases. The mean apoptotic index was 7.05 in 10 high power fields and 11.40 in 500 cells (2.28%). The mean positivity to PCNA was 275.05 cells in ten high power fields and 409.33 in 500 cells (81.9%). There was a positive correlation between the cell proliferative and apoptotic indices. There was a positive correlation for intestinal histological type with PCNA and apoptotic indices, in 10 high power fields. The mean survival was 28.41 months. Age over 63 and apoptotic index over 7.05 showed a negative correlation with survival, in multivariate analysis. CONCLUSIONS: Adenocarcinoma of the cardia predominated in male adults of mean age 61 years, and the predominant type was diffuse in more advanced stages. There was a correlation between apoptosis and tumoral cell proliferation. Survival in cases of adenocarcinoma of the cardia is still low. Both age and apoptosis were independent prognostic factors in cancer of the cardia. |
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Estudo clínico-patológico, da proliferação celular e da apoptose no adenocarcinoma gástrico da cárdiaAnalysis of clinicopathological, tumor cell proliferation and apoptosis parameters in adenocarcinoma of the gastric cardiaCell proliferationApoptosisCardiaStomach neoplasmsAdenocarcinomaProliferação celularApoptoseCárdiaNeoplasias gástricasAdenocarcinomaBACKGROUND/AIMS: In view of the increased incidence of carcinoma of the cardia over recent years, this work had the aim of studying the clinicopathological aspects, cell proliferative and tumor apoptotic indices of this neoplasm, their interrelations and possible influences on the prognosis. MATERIAL AND METHODS: Forty cases of adenocarcinoma of the cardia were studied between 1988 and 2001, with a minimum clinical follow-up of 3 years. Patients were excluded if they had previous chemotherapy or radiotherapy treatment, presented early neoplasia, or died during the operations or for other reasons unrelated to cancer. Gender; age, Laurén and Ming histological type, staging, and the presence or absence of intestinal metaplasia, epithelial dysplasia and Helicobacter pylori in the adjacent mucosa were analyzed. The apoptotic index was evaluated via hematoxylin-eosin in the primary tumor. To analyze the cell proliferation tumor, PCNA was utilized. The immunohistochemical technique utilized was streptavidin-biotin-peroxidase. For the survival analysis, cases with distant metastasis upon diagnosis were excluded. For the statistical analysis, the Student t and Mann-Whitney tests, Kaplan-Meier curves and Cox regression model were utilized. RESULTS: The mean age was 61 years (median: 63). There was predominance of the male gender (72.5%), diffuse histological type (55%) and infiltrative histological type (72.5%), and the more advanced stages (III and IV: 67.5%). There was no association with intestinal metaplasia and/or H. pylori. No epithelial dysplasia was detected in adjacent mucosa in any of the cases. The mean apoptotic index was 7.05 in 10 high power fields and 11.40 in 500 cells (2.28%). The mean positivity to PCNA was 275.05 cells in ten high power fields and 409.33 in 500 cells (81.9%). There was a positive correlation between the cell proliferative and apoptotic indices. There was a positive correlation for intestinal histological type with PCNA and apoptotic indices, in 10 high power fields. The mean survival was 28.41 months. Age over 63 and apoptotic index over 7.05 showed a negative correlation with survival, in multivariate analysis. CONCLUSIONS: Adenocarcinoma of the cardia predominated in male adults of mean age 61 years, and the predominant type was diffuse in more advanced stages. There was a correlation between apoptosis and tumoral cell proliferation. Survival in cases of adenocarcinoma of the cardia is still low. Both age and apoptosis were independent prognostic factors in cancer of the cardia.RACIONAL/OBJETIVO: Em vista do aumento na incidência do carcinoma da cárdia nos últimos anos, este trabalho visa estudar os aspectos clínico-patológicos, da proliferação celular e da apoptose tumorais, suas correlações e eventuais influências no seu prognóstico. MATERIAL E MÉTODO: Estudaram-se 40 doentes submetidos a gastrectomia total por carcinoma da cárdia, no período de 1988 a 2001, com seguimento clínico de no mínimo 3 anos. Excluíram-se aqueles com tratamento químio ou radioterápico prévio, neoplasia precoce, óbito no intra-operatório ou por outras causas não relacionadas ao câncer. Analisou-se sexo, idade, tipo histológico de Laurén, padrão de crescimento tumoral de Ming, estádio e presença ou ausência de metaplasia intestinal e/ou Helicobacter pylori na mucosa adjacente. O índice apoptótico foi avaliado por cortes histológicos corados pela hematoxilina-eosina. O índice de proliferação celular foi avaliado por meio da imunoexpressão ao PCNA, sendo a técnica imunoistoquímica utilizada a da estreptoavidina-biotina-peroxidase. Para análise da sobrevida, excluíram-se os casos com metástase à distância ao diagnóstico. Foram utilizados testes t de Student, de Mann-Whitney, curvas de Kaplan-Meier e modelo de regressão de Cox. O nível de significância adotado foi menor de 0,05. RESULTADOS: A idade média foi de 61 anos (mediana: 63); houve predomínio do sexo masculino (72,5%), tipo histológico difuso (55%) e infiltrativo (72,5%) e de estádios mais avançados (III e IV: 67,5%). Não houve associação com metaplasia intestinal e/ou H. pylori. O índice apoptótico médio foi de 7,05 em 10 campos consecutivos de grande aumento e de 11,40 em 500 células (2,28%). A positividade média ao PCNA foi de 275,05 células em 10 campos consecutivos de grande aumento e de 409,33 em 500 células (81,9%). Houve correlação positiva do tipo histológico intestinal com PCNA e com a apoptose em 10 campos consecutivos de grande aumento. Houve correlação positiva entre a apoptose e PCNA tumorais. A sobrevida média foi de 28,41 meses. A idade (acima de 63) e o índice apoptótico (acima de 7,05), em análise multivariada, mostraram correlação negativa com a sobrevida. CONCLUSÕES: O adenocarcinoma da cárdia ocorreu mais nos indivíduos do sexo masculino, com idade média de 61 anos, com predomínio do tipo difuso e estádios mais avançados. A sobrevivência ainda é baixa. Houve correlação positiva entre a apoptose e proliferação celular tumoral. Tanto a idade como a apoptose foram fatores prognósticos independentes no câncer da cárdia.Universidade Federal de São Paulo (UNIFESP) Escola Paulista de Medicina Departamento de PatologiaUniversidade Federal de São Paulo (UNIFESP) Escola Paulista de Medicina Disciplina de Gastroenterologia CirúrgicaUNIFESP, EPM, Depto. de PatologiaUNIFESP, EPM, Disciplina de Gastroenterologia CirúrgicaSciELOInstituto Brasileiro de Estudos e Pesquisas de Gastroenterologia - IBEPEGE Colégio Brasileiro de Cirurgia Digestiva - CBCD Sociedade Brasileira de Motilidade Digestiva - SBMD Federação Brasileira de Gastroenterologia - FBGSociedade Brasileira de Hepatologia - SBHSociedade Brasileira de Endoscopia Digestiva - SOBEDUniversidade Federal de São Paulo (UNIFESP)Mader, Ana Maria Amaral Antonio [UNIFESP]Patricio, Francy Reis da Silva [UNIFESP]Rigueiro, Moacyr Pezati [UNIFESP]Lourenço, Laércio Gomes [UNIFESP]2015-06-14T13:36:25Z2015-06-14T13:36:25Z2006-09-01info:eu-repo/semantics/articleinfo:eu-repo/semantics/publishedVersion184-190application/pdfhttp://dx.doi.org/10.1590/S0004-28032006000300006Arquivos de Gastroenterologia. Instituto Brasileiro de Estudos e Pesquisas de Gastroenterologia - IBEPEGE Colégio Brasileiro de Cirurgia Digestiva - CBCD Sociedade Brasileira de Motilidade Digestiva - SBMD Federação Brasileira de Gastroenterologia - FBGSociedade Brasileira de Hepatologia - SBHSociedade Brasileira de Endoscopia Digestiva - SOBED, v. 43, n. 3, p. 184-190, 2006.10.1590/S0004-28032006000300006S0004-28032006000300006.pdf0004-2803S0004-28032006000300006http://repositorio.unifesp.br/handle/11600/3240porArquivos de Gastroenterologiainfo:eu-repo/semantics/openAccessreponame:Repositório Institucional da UNIFESPinstname:Universidade Federal de São Paulo (UNIFESP)instacron:UNIFESP2024-07-29T11:35:35Zoai:repositorio.unifesp.br/:11600/3240Repositório InstitucionalPUBhttp://www.repositorio.unifesp.br/oai/requestbiblioteca.csp@unifesp.bropendoar:34652024-07-29T11:35:35Repositório Institucional da UNIFESP - Universidade Federal de São Paulo (UNIFESP)false |
dc.title.none.fl_str_mv |
Estudo clínico-patológico, da proliferação celular e da apoptose no adenocarcinoma gástrico da cárdia Analysis of clinicopathological, tumor cell proliferation and apoptosis parameters in adenocarcinoma of the gastric cardia |
title |
Estudo clínico-patológico, da proliferação celular e da apoptose no adenocarcinoma gástrico da cárdia |
spellingShingle |
Estudo clínico-patológico, da proliferação celular e da apoptose no adenocarcinoma gástrico da cárdia Mader, Ana Maria Amaral Antonio [UNIFESP] Cell proliferation Apoptosis Cardia Stomach neoplasms Adenocarcinoma Proliferação celular Apoptose Cárdia Neoplasias gástricas Adenocarcinoma |
title_short |
Estudo clínico-patológico, da proliferação celular e da apoptose no adenocarcinoma gástrico da cárdia |
title_full |
Estudo clínico-patológico, da proliferação celular e da apoptose no adenocarcinoma gástrico da cárdia |
title_fullStr |
Estudo clínico-patológico, da proliferação celular e da apoptose no adenocarcinoma gástrico da cárdia |
title_full_unstemmed |
Estudo clínico-patológico, da proliferação celular e da apoptose no adenocarcinoma gástrico da cárdia |
title_sort |
Estudo clínico-patológico, da proliferação celular e da apoptose no adenocarcinoma gástrico da cárdia |
author |
Mader, Ana Maria Amaral Antonio [UNIFESP] |
author_facet |
Mader, Ana Maria Amaral Antonio [UNIFESP] Patricio, Francy Reis da Silva [UNIFESP] Rigueiro, Moacyr Pezati [UNIFESP] Lourenço, Laércio Gomes [UNIFESP] |
author_role |
author |
author2 |
Patricio, Francy Reis da Silva [UNIFESP] Rigueiro, Moacyr Pezati [UNIFESP] Lourenço, Laércio Gomes [UNIFESP] |
author2_role |
author author author |
dc.contributor.none.fl_str_mv |
Universidade Federal de São Paulo (UNIFESP) |
dc.contributor.author.fl_str_mv |
Mader, Ana Maria Amaral Antonio [UNIFESP] Patricio, Francy Reis da Silva [UNIFESP] Rigueiro, Moacyr Pezati [UNIFESP] Lourenço, Laércio Gomes [UNIFESP] |
dc.subject.por.fl_str_mv |
Cell proliferation Apoptosis Cardia Stomach neoplasms Adenocarcinoma Proliferação celular Apoptose Cárdia Neoplasias gástricas Adenocarcinoma |
topic |
Cell proliferation Apoptosis Cardia Stomach neoplasms Adenocarcinoma Proliferação celular Apoptose Cárdia Neoplasias gástricas Adenocarcinoma |
description |
BACKGROUND/AIMS: In view of the increased incidence of carcinoma of the cardia over recent years, this work had the aim of studying the clinicopathological aspects, cell proliferative and tumor apoptotic indices of this neoplasm, their interrelations and possible influences on the prognosis. MATERIAL AND METHODS: Forty cases of adenocarcinoma of the cardia were studied between 1988 and 2001, with a minimum clinical follow-up of 3 years. Patients were excluded if they had previous chemotherapy or radiotherapy treatment, presented early neoplasia, or died during the operations or for other reasons unrelated to cancer. Gender; age, Laurén and Ming histological type, staging, and the presence or absence of intestinal metaplasia, epithelial dysplasia and Helicobacter pylori in the adjacent mucosa were analyzed. The apoptotic index was evaluated via hematoxylin-eosin in the primary tumor. To analyze the cell proliferation tumor, PCNA was utilized. The immunohistochemical technique utilized was streptavidin-biotin-peroxidase. For the survival analysis, cases with distant metastasis upon diagnosis were excluded. For the statistical analysis, the Student t and Mann-Whitney tests, Kaplan-Meier curves and Cox regression model were utilized. RESULTS: The mean age was 61 years (median: 63). There was predominance of the male gender (72.5%), diffuse histological type (55%) and infiltrative histological type (72.5%), and the more advanced stages (III and IV: 67.5%). There was no association with intestinal metaplasia and/or H. pylori. No epithelial dysplasia was detected in adjacent mucosa in any of the cases. The mean apoptotic index was 7.05 in 10 high power fields and 11.40 in 500 cells (2.28%). The mean positivity to PCNA was 275.05 cells in ten high power fields and 409.33 in 500 cells (81.9%). There was a positive correlation between the cell proliferative and apoptotic indices. There was a positive correlation for intestinal histological type with PCNA and apoptotic indices, in 10 high power fields. The mean survival was 28.41 months. Age over 63 and apoptotic index over 7.05 showed a negative correlation with survival, in multivariate analysis. CONCLUSIONS: Adenocarcinoma of the cardia predominated in male adults of mean age 61 years, and the predominant type was diffuse in more advanced stages. There was a correlation between apoptosis and tumoral cell proliferation. Survival in cases of adenocarcinoma of the cardia is still low. Both age and apoptosis were independent prognostic factors in cancer of the cardia. |
publishDate |
2006 |
dc.date.none.fl_str_mv |
2006-09-01 2015-06-14T13:36:25Z 2015-06-14T13:36:25Z |
dc.type.driver.fl_str_mv |
info:eu-repo/semantics/article |
dc.type.status.fl_str_mv |
info:eu-repo/semantics/publishedVersion |
format |
article |
status_str |
publishedVersion |
dc.identifier.uri.fl_str_mv |
http://dx.doi.org/10.1590/S0004-28032006000300006 Arquivos de Gastroenterologia. Instituto Brasileiro de Estudos e Pesquisas de Gastroenterologia - IBEPEGE Colégio Brasileiro de Cirurgia Digestiva - CBCD Sociedade Brasileira de Motilidade Digestiva - SBMD Federação Brasileira de Gastroenterologia - FBGSociedade Brasileira de Hepatologia - SBHSociedade Brasileira de Endoscopia Digestiva - SOBED, v. 43, n. 3, p. 184-190, 2006. 10.1590/S0004-28032006000300006 S0004-28032006000300006.pdf 0004-2803 S0004-28032006000300006 http://repositorio.unifesp.br/handle/11600/3240 |
url |
http://dx.doi.org/10.1590/S0004-28032006000300006 http://repositorio.unifesp.br/handle/11600/3240 |
identifier_str_mv |
Arquivos de Gastroenterologia. Instituto Brasileiro de Estudos e Pesquisas de Gastroenterologia - IBEPEGE Colégio Brasileiro de Cirurgia Digestiva - CBCD Sociedade Brasileira de Motilidade Digestiva - SBMD Federação Brasileira de Gastroenterologia - FBGSociedade Brasileira de Hepatologia - SBHSociedade Brasileira de Endoscopia Digestiva - SOBED, v. 43, n. 3, p. 184-190, 2006. 10.1590/S0004-28032006000300006 S0004-28032006000300006.pdf 0004-2803 S0004-28032006000300006 |
dc.language.iso.fl_str_mv |
por |
language |
por |
dc.relation.none.fl_str_mv |
Arquivos de Gastroenterologia |
dc.rights.driver.fl_str_mv |
info:eu-repo/semantics/openAccess |
eu_rights_str_mv |
openAccess |
dc.format.none.fl_str_mv |
184-190 application/pdf |
dc.publisher.none.fl_str_mv |
Instituto Brasileiro de Estudos e Pesquisas de Gastroenterologia - IBEPEGE Colégio Brasileiro de Cirurgia Digestiva - CBCD Sociedade Brasileira de Motilidade Digestiva - SBMD Federação Brasileira de Gastroenterologia - FBGSociedade Brasileira de Hepatologia - SBHSociedade Brasileira de Endoscopia Digestiva - SOBED |
publisher.none.fl_str_mv |
Instituto Brasileiro de Estudos e Pesquisas de Gastroenterologia - IBEPEGE Colégio Brasileiro de Cirurgia Digestiva - CBCD Sociedade Brasileira de Motilidade Digestiva - SBMD Federação Brasileira de Gastroenterologia - FBGSociedade Brasileira de Hepatologia - SBHSociedade Brasileira de Endoscopia Digestiva - SOBED |
dc.source.none.fl_str_mv |
reponame:Repositório Institucional da UNIFESP instname:Universidade Federal de São Paulo (UNIFESP) instacron:UNIFESP |
instname_str |
Universidade Federal de São Paulo (UNIFESP) |
instacron_str |
UNIFESP |
institution |
UNIFESP |
reponame_str |
Repositório Institucional da UNIFESP |
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Repositório Institucional da UNIFESP |
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Repositório Institucional da UNIFESP - Universidade Federal de São Paulo (UNIFESP) |
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biblioteca.csp@unifesp.br |
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1814268305522819072 |