RESUMO
OBJECTIVE: The aim of this study is to evaluate if it is necessary to remove all the radioactive sentinel lymph nodes (SLNs) not seen on lymphoscintigraphy in order to accurately stage breast cancer patients. MATERIAL AND METHODS: From March 1999 to March 2006, SLN biopsy was performed in 461 patients. All patients were only injected with radioisotope. Lymphoscintigraphy was performed in all the patients. The mean number of SLNs removed was 2.1 (range 1-15). RESULTS: The SLN was positive in 133 patients (28.8%). Lymphoscintigraphy accurately predicted the number of SLNs identified intraoperatively in 243 patients (52.7%). In 175 patients (37.9%) there were more SLNs identified intraoperatively than were seen on lymphos cintigraphy. In 11 (6.2%) of these 175 patients, additional SLNs identified intraoperatively harboured metastasis. Type of injection, need for a second injection, tumour location and age were not identified as statistically significantly associated with additional positive SLNs identified intraoperatively and not seen on lymphoscintigraphy. CONCLUSIONS: Lymphoscintigraphy does not accurately predict the number of SLNs identified intraoperatively, this number being underestimated. Surgeons should remove all radioactive SLNs to improve the detection of positive SLNs.
Assuntos
Neoplasias da Mama/patologia , Neoplasias da Mama/cirurgia , Metástase Linfática/diagnóstico , Biópsia de Linfonodo Sentinela/métodos , Feminino , Humanos , CintilografiaRESUMO
Endometrial carcinoma is the most common gynaecological malignancy in the western world and the most frequent among infiltrating tumours of the female genital tract. Despite the characterisation of molecular events associated with the development of endometrial carcinoma, those associated with the early steps of infiltration and invasion in endometrial cancer are less known. Deep myometrial invasion correlates with more undifferentiated tumours, lymph-vascular invasion, node affectation and decreased global survival. In this review we present an overview of the molecular pathology of myometrial infiltration that defines the initial steps of invasion in endometrial cancer. Down-regulation of E-cadherin as a main player of epithelial to mesenchymal transition, as well as modifications on other molecules involved in cell-cell contacts, render cells with a migratory phenotype. In addition, altered signalling pathways and transcription factors associate with myometrial invasion, histologic grade and metastasis.
Assuntos
Neoplasias do Endométrio/etiologia , Neoplasias do Endométrio/patologia , Moléculas de Adesão Celular/fisiologia , Neoplasias do Endométrio/genética , Feminino , Expressão Gênica , Humanos , Invasividade NeoplásicaRESUMO
Minimal deviation adenocarcinoma (adenoma malignum) is a rare well-differentiated form of invasive cervical adenocarcinoma. Because of its rarity and cytologic changes are subtle there are only a few reports of this pathology, been necessary the realization of large biopsy of the cervical tissue for it histological diagnosis. We made a review in the period 1994-2000, of the clinical, cytological, histological features, treatments and follow-up of 4 patients in the Gynecologic Oncology Department of the University Hospital Vall d' Hebron, Barcelona, Spain.