RESUMO
PURPOSE: Treatment of recurrent ovarian carcinoma is a challenge, particularly for the clear cell (CCC) subtype. However, there is a preclinical rationale that these patients could achieve a benefit from antiangiogenic therapy. To assess this hypothesis, we used the growth modulation index (GMI), which represents an intrapatient comparison of two successive progression-free survival (PFS). METHODS: We conducted a retrospective real-world study performed on 34 patients with recurrent ovarian cancer, treated with bevacizumab-containing regimens from January 2009 to December 2017. The primary endpoint was GMI. An established cut-off > 1.33 was defined as a sign of drug activity. RESULTS: 73.5% of patients had high-grade serous ovarian carcinoma (HGSOC), and 17.7% had CCC; 70.6% of patients received carboplatin/gemcitabine/bevacizumab, and 29.4% received weekly paclitaxel/bevacizumab. According to histological subtype, the overall response rate and median PFS were 52% and 14 months for HGSOC and 83.3% and 20 months for CCC, respectively. The overall population median GMI was 0.99; it was 0.95 and 2.36 for HGSOC and CCC, respectively. CCC subtype was significantly correlated with GMI > 1.33 (odds ratio 41.67; 95% confidence interval 3.6-486.94; p = .03). CONCLUSION: Adding bevacizumab to chemotherapy in recurrent CCC is associated with a remarkable benefit in this cohort. The efficacy of antiangiogenic drugs in CCC warrants further prospective evaluation.
Assuntos
Adenocarcinoma de Células Claras/tratamento farmacológico , Inibidores da Angiogênese/uso terapêutico , Bevacizumab/uso terapêutico , Cistadenocarcinoma Seroso/tratamento farmacológico , Recidiva Local de Neoplasia/tratamento farmacológico , Neoplasias Ovarianas/tratamento farmacológico , Adenocarcinoma de Células Claras/mortalidade , Adenocarcinoma de Células Claras/patologia , Adulto , Idoso , Antineoplásicos Imunológicos/uso terapêutico , Protocolos de Quimioterapia Combinada Antineoplásica/uso terapêutico , Carboplatina/uso terapêutico , Intervalos de Confiança , Cistadenocarcinoma Seroso/mortalidade , Cistadenocarcinoma Seroso/patologia , Desoxicitidina/análogos & derivados , Desoxicitidina/uso terapêutico , Feminino , Humanos , Pessoa de Meia-Idade , Recidiva Local de Neoplasia/mortalidade , Recidiva Local de Neoplasia/patologia , Razão de Chances , Neoplasias Ovarianas/mortalidade , Neoplasias Ovarianas/patologia , Paclitaxel/uso terapêutico , Intervalo Livre de Progressão , Estudos Retrospectivos , GencitabinaRESUMO
Because of advances in the understanding of histological and molecular characteristics in ovarian cancer, it is now possible to recognize the existence of five subtypes, which in turn has allowed a more refined therapeutic approach and better design of clinical trials. Each of these five subtypes has specific histological features and a particular biomarker expression, as well as mutations in different genes, some of which have prognostic and predictive value. CA125 and HE4 are examples of ovarian cancer biomarkers used in the diagnosis and follow-up of these malignancies. Currently, somatic or germinal mutations on BRCA1 and BRCA2 genes are the most important biomarkers in epithelial ovarian cancer having prognostic and predictive value. This article will review the histological and molecular characteristics of the five subtypes of ovarian cancer, describing the most important biomarkers and mutations that can guide in diagnosis, screening and tailored treatment strategy.
Assuntos
Biomarcadores Tumorais/análise , Neoplasias Epiteliais e Glandulares/diagnóstico , Neoplasias Ovarianas/diagnóstico , Carcinoma Epitelial do Ovário , Feminino , HumanosRESUMO
INTRODUCTION: A number of findings suggest that cyclooxygenase-2 (COX-2) is overexpressed in breast tumours. However, there is a lack of consensus in the literature regarding the pattern of expression of this protein in invasive breast ductal carcinoma and in the adjacent non-tumour ductal epithelium. This study compares the expression of COX-2 mRNA and protein in breast ductal carcinoma relative to non-tumour breast tissue. MATERIAL AND METHODS: We analysed the expression of COX-2 mRNA by quantitative PCR, and COX-2 protein by immunohistochemistry in invasive ductal carcinoma as well as in non-tumour adjacent ductal epithelium from 34 breast biopsies diagnosed as being invasive ductal carcinoma. As control, we analysed expression of COX-2 protein by immunohistochemistry in surgically-resected benign breast lesions. RESULTS: Our results show that COX-2 mRNA and protein are overexpressed in non-tumour ductal epithelium compared with invasive ductal carcinoma. However, the pattern of the protein expression is different in tumour and non-tumour tissue: COX-2 protein is expressed predominantly in the membrane of the non-tumour ductal epithelium (including in benign breast lesions) while, in invasive ductal carcinoma cells, it is localised in the cytoplasm. CONCLUSIONS: The non-tumour ductal epithelium adjacent to invasive ductal carcinoma shows a higher COX-2 expression than does the invasive ductal carcinoma. However, the different localisation of the immunohistochemically-detected protein suggests a possible post-translational regulation of the protein.
Assuntos
Neoplasias da Mama/metabolismo , Mama/metabolismo , Carcinoma Ductal de Mama/metabolismo , Adulto , Idoso , Mama/patologia , Neoplasias da Mama/patologia , Carcinoma Ductal de Mama/patologia , Epitélio/metabolismo , Epitélio/patologia , Feminino , Humanos , Imuno-Histoquímica , Pessoa de Meia-Idade , Reação em Cadeia da Polimerase , RNA Mensageiro/análiseRESUMO
Con el objeto de evaluar la eficacia de la punción aspiración con aguja fina (PAAF) en las enfermedades quirúrgicas de la glándula tiroides se realizó un estudio retrospectivo histórico. Se incluyeron 443 pacientes cuya media de edad fue de 46.5+-15.7 años (rango: 16-82 años). Del total, 65 eran hombres (14.7 por ciento). La prueba de contingencia de la Chi-cuadrado fue el utilizado para el análisis. Los resultados en función de la definición de la prueba positiva fueron los siguientes. De acuerdo con la definición amplia de la prueba, la sensibilidad de la PAAF resultó ser del 75.2 por ciento, y la especificidad del 57.4 por ciento, con una eficacia de 62.1 por ciento (Kappa=0.25032). Sin embargo, con la definición estrecha, la sensibilidad fue del 35.0 por ciento, y la especificidad del 97.2 por ciento, con una eficacia del 80.8 por ciento (Kappa=0.39540). Estos resultados muestran la utilidad de la PAAF como prueba de despistaje. Además, el diagnóstico se puede obtener en ciertos casos.
Assuntos
Humanos , Masculino , Feminino , Adolescente , Adulto , Pessoa de Meia-Idade , Biópsia por Agulha , Doenças da Glândula Tireoide/diagnóstico , Tireoidectomia , Técnicas e Procedimentos Diagnósticos , Neoplasias da Glândula Tireoide/diagnósticoRESUMO
En el paladar pueden desarrollarse una amplia variedad de tumores derivados del epitelio, del tejido correctivo y de las glándulas salivares menores. Debido a la gran cantidad de glandulas de la capa submucosa, el paladar es la localización más frecuente de los tumores de glandula salivar menor. El carcinoma adenoide quistico fue descrito por primera vez por Billroth (1856) quien lo llamo cilindroma. Su curso clinico es habitualmente prolongado y su evolución insidiosa. Los seguimientos de 5 años no son adecuados para establecer los indices de supervivencia, debido a que pueden causar la muerte hasta 10 ó 15 años tras el diagnostico. Presentamos el caso de una mujer con una neoformación de este tipo en paladar blando. Se discuten los problemas de diagnostico diferencial con los tumores epiteliales-mioepiteliales y se realiza una revision de la literatura sobre el tema