RESUMO
OBJECTIVE: To investigate the possible role of chromatin texture parameters, nuclear morphology, DNA ploidy and clinical functional status in discriminating benign from malignant adrenocortical tumors (ACT). PATIENTS AND METHODS: Forty-eight cases of clinically benign (n=40) and clinically malignant (n=8) ACT with a minimum of 5-years' follow-up were evaluated for chromatin texture parameters (run length, standard deviation, configurable run length, valley, slope, peak and other 21 Markovian features that describe the distribution of the chromatin in the nucleus), nuclear morphology (nuclear area, nuclear perimeter, nuclear maximum and minimum diameter, nuclear shape), and DNA ploidy. Nuclear parameters were evaluated in Feulgen-stained 5 mum paraffin-sections analyzed using a CAS 200 image analyzer. RESULTS: Since ACTs present different biological features in children and adults, patients were divided into two groups: children (< or = 15 years) and adults (>15 years). In the group of children DNA ploidy presented a marginal significance (p=0.05) in discriminating ACTs. None of the parameters discriminated between malignant and benign ACT in the adult group. CONCLUSION: ACTs are uncommon and definitive predictive criteria for malignancy remain uncertain, particularly in children. Our data point to DNA content evaluated by image analysis as a new candidate tool for this challenging task. Texture image analysis did not help to differentiate malignant from benign adrenal cortical tumors in children and adults.
Assuntos
Neoplasias do Córtex Suprarrenal/genética , Neoplasias do Córtex Suprarrenal/patologia , Núcleo Celular/patologia , Cromatina/química , Cromatina/genética , Processamento de Imagem Assistida por Computador , Adolescente , Neoplasias do Córtex Suprarrenal/classificação , Adulto , Criança , Pré-Escolar , Humanos , Lactente , Antígeno Ki-67/metabolismo , Pessoa de Meia-Idade , Ploidias , Adulto JovemRESUMO
Several studies have shown that cytometry, including DNA analysis, gives valuable information on the grade and stage of bladder cancer when performed on cytological preparations obtained from urine. Although, cytometry should not be used as a screening tool, it has a role in the follow-up of patients with a previous history of superficial bladder cancer. In this group of patients, the combination of cytological examination with cytometric evaluation allows the detection of the majority of recurrent tumors. In patients treated with chemotherapy or immunotherapy, the presence or the appearance of an aneuploid cell population is a good indication of tumor recurrence or progression. A variety of wet laboratory immunoassays, on-slide immunoassays, in situ hybridization procedures and post-nucleic acid extraction molecular techniques have been designed to complement cytology and cytometry and to improve the overall sensitivity and specificity of the detection of recurrent urothelial neoplasia.