Summary
Revista Brasileira de Ginecologia e Obstetrícia. 2017;39(1):21-25
To evaluate the diagnostic utility of the p16ink4a protein expression as a marker for adenocarcinoma of the cervix.
In a cross-sectional study, p16ink4a expression was evaluated in 30 cervical biopsies from patients diagnosed with invasive adenocarcinoma from 2 reference clinics in Brazil, and compared with 18 biopsies of endocervical polyps (control cases). The performance of the tests for p16ink4a was evaluated using a conventional contingency table, and the Kappa (k) index was used to evaluate the agreement of the marker with the tissue diagnosis.
In total, 66% of the invasive adenocarcinoma cases were positive for p16ink4a. All of the adenomatous polyps cases used as negative controls were shown to be negative for p16ink4a. The marker showed a high sensitivity and a high negative predictive value. The Kappa index was good for p16ink4a (k 1/4 0.6).
Considering the strong association between the p16ink4a marker and the cervical adenocarcinoma, its use represents an important tool for reducing incorrect diagnoses of adenocarcinoma and thereby avoiding overtreatment.
Summary
Revista Brasileira de Ginecologia e Obstetrícia. 2007;29(11):575-579
DOI 10.1590/S0100-72032007001100005
PURPOSE: the villoglandular adenocarcinoma (VGA) of the cervix has been identified as a variant of cervical adenocarcinoma that occurs in young women, which has an excellent prognosis. Considering the scarcity of studies related to the subject, we report six cases of VGA of the cervix. METHODS: we followed the development of six cases of VGA in the period from 1995 to 2006 at Hospital São Lucas of Pontifícia Universidade Católica do Rio Grande do Sul (PUC-RS). We collected clinical and histologic information of the patients and submitted all the surgical specimens to histological review. RESULTS: mean age at diagnosis was 43.5 years (range 27-61 years). Four patients were submitted to Wertheim-Meigs radical hysterectomy and bilateral pelvic lymphadenectomy, one to conization and subsequent radiotherapy and one to pelvic lymphadenectomy followed by radiotherapy. All the patients were alive and well at the time of this writing, without evidence of recurrence. CONCLUSIONS: the implications of therapy are discussed. We propose here the inclusion of the study of the pattern of lymphovascular involvement in determining the diagnosis of VGA. Thus, in referring to this diagnosis, we will be able to opt, with caution, for conservative therapy, except for particularities of each case.
Summary
Revista Brasileira de Ginecologia e Obstetrícia. 2003;25(6):396-401
DOI 10.1590/S0100-72032003000600003
PURPOSE: to evaluate the significance of neoangiogenesis for the prognosis of endometrial carcinoma, by quantifying and comparing the vessels with the grade of histologic differentiation and tumor staging. METHODS: the 56 studied cases consisted of 11 atrophic endometria, 10 proliferative endometria, 10 GI, 13 GII and 12 GIII adenocarcinomas. Two histologic sections were obtained for each case: one was stained with hematoxylin-eosin and the other was sent for a immunohistochemical study with anti-CD34. The utilized histometric method was vessel counting at the tumoral growth interface with the adjacent stroma, and in the control group, at the endometrial gland interface with the stroma. Couting was done by a KS300, evaluating 10 fields at 100X magnification. RESULTS: the counted vessel means were 11.6 for atrophic endometria, 13.2 for proliferative endometria, 15.3 for GI adenocarcinoma, 19 for GII adenocarcinoma, and 22.7 for GIII adenocarcinoma. In the group of stage I patients, it was observed that the mean number of vessels (18.6) was similar to that observed in stages II, III and IV (20.9) computed together. CONCLUSION: less differentiated adenocarcinomas were more angiogenic than well-differentiated carcinomas and normal endometrium. Vessel counting was not influenced by the disease stage as an isolated factor.