Artigos Originais Archives - Page 5 of 81 - Revista Brasileira de Ginecologia e Obstetrícia
Summary
Revista Brasileira de Ginecologia e Obstetrícia. 2014;36(10):473-479
DOI 10.1590/S0100-720320140005046
To determine whether the antral follicle count can predict the number of retrieved oocytes in patients undergoing in vitro fertilization (IVF) and to correlate it with maternal age and pregnancy rate.
This was a retrospective observational study based on a review of medical records from 193 patients who underwent assisted reproduction techniques between September 2010 and September 2012 in a Clinic for Human Reproduction. The study included women indicated for IVF who had follicle-stimulating hormone levels below 10 mIU/mL on third day of the menstrual cycle, with oocyte recipients being excluded. The patients were divided into three groups according to the number of antral follicle (up to 10 follicles, 11–22 follicles, and 23 or more follicles). To compare these three groups with the group of patients who became pregnant, patients who had not developed oocytes and had not undergone embryo transfer were also excluded. Spearman's correlation coefficient was used to measure the level of association between the numerical variables, and χ2 test was used to compare pregnancy rates with antral follicle count. To assess the likelihood of pregnancy, we used multivariate logistic regression, with the level of significance set at 5%.
The pregnancy rate of the sample was 35.6%. There was a positive significant correlation (sc) between antral follicle count and number of retrieved oocytes (sc=0.5; p<0.05) and a negative correlation between antral follicle count and age (sc= -0.5; p<0.05). There was no significant difference (p=0.16) when groups with different numbers of follicles were compared to the positive pregnancy test group; however, a cutoff of 27 antral follicles was observed in multivariate analysis, after which the probability of successful gestation tended to remain constant.
The antral follicle count decreases over the years, is a predictor of the number of retrieved oocytes and can predict the likelihood of the success of in vitro fertilization.
Summary
Revista Brasileira de Ginecologia e Obstetrícia. 2014;36(10):473-479
DOI 10.1590/S0100-720320140005046
To determine whether the antral follicle count can predict the number of retrieved oocytes in patients undergoing in vitro fertilization (IVF) and to correlate it with maternal age and pregnancy rate.
This was a retrospective observational study based on a review of medical records from 193 patients who underwent assisted reproduction techniques between September 2010 and September 2012 in a Clinic for Human Reproduction. The study included women indicated for IVF who had follicle-stimulating hormone levels below 10 mIU/mL on third day of the menstrual cycle, with oocyte recipients being excluded. The patients were divided into three groups according to the number of antral follicle (up to 10 follicles, 11–22 follicles, and 23 or more follicles). To compare these three groups with the group of patients who became pregnant, patients who had not developed oocytes and had not undergone embryo transfer were also excluded. Spearman's correlation coefficient was used to measure the level of association between the numerical variables, and χ2 test was used to compare pregnancy rates with antral follicle count. To assess the likelihood of pregnancy, we used multivariate logistic regression, with the level of significance set at 5%.
The pregnancy rate of the sample was 35.6%. There was a positive significant correlation (sc) between antral follicle count and number of retrieved oocytes (sc=0.5; p<0.05) and a negative correlation between antral follicle count and age (sc= -0.5; p<0.05). There was no significant difference (p=0.16) when groups with different numbers of follicles were compared to the positive pregnancy test group; however, a cutoff of 27 antral follicles was observed in multivariate analysis, after which the probability of successful gestation tended to remain constant.
The antral follicle count decreases over the years, is a predictor of the number of retrieved oocytes and can predict the likelihood of the success of in vitro fertilization.
Summary
Revista Brasileira de Ginecologia e Obstetrícia. 2014;36(9):393-397
DOI 10.1590/SO100-720320140005066
To evaluate the obstetric and perinatal outcomes evolution of triplet pregnancies.
A prospective observational study was conducted in triplet pregnancies delivered over 16 years in a tertiary obstetric center with differentiated perinatal support. Evaluation of demographic factors, obstetric complications, gestational age at delivery, mode of delivery, birth weight and immediate newborn outcome were done over a 16 years period. A global characterization of the sample was performed considering the listed parameters. Variables were categorized in three groups according to year of occurrence: 1996-2000, 2001-2006, 2007-2011, and all parameters were compared.
Of the 33 triplets included, 72.7% resulted from induced pregnancies. All except one patient received prenatal corticosteroids and five received tocolytics. All women delivered prenatally and no significant differences were seen in the mean gestational age at delivery or birth weight towards time. There were three intrauterine fetal deaths. Neonatal immediate outcomes were not significantly different over the years.
Despite remarkable progresses in perinatal and neonatal cares, no noticeable impact in triplet gestations' outcomes was seen, sustaining that triplets should be avoided due to their great risk of prematurity and neonatal morbidities, either by limiting the numbers of embryos transferred or by fetal reduction.
Summary
Revista Brasileira de Ginecologia e Obstetrícia. 2014;36(9):393-397
DOI 10.1590/SO100-720320140005066
To evaluate the obstetric and perinatal outcomes evolution of triplet pregnancies.
A prospective observational study was conducted in triplet pregnancies delivered over 16 years in a tertiary obstetric center with differentiated perinatal support. Evaluation of demographic factors, obstetric complications, gestational age at delivery, mode of delivery, birth weight and immediate newborn outcome were done over a 16 years period. A global characterization of the sample was performed considering the listed parameters. Variables were categorized in three groups according to year of occurrence: 1996-2000, 2001-2006, 2007-2011, and all parameters were compared.
Of the 33 triplets included, 72.7% resulted from induced pregnancies. All except one patient received prenatal corticosteroids and five received tocolytics. All women delivered prenatally and no significant differences were seen in the mean gestational age at delivery or birth weight towards time. There were three intrauterine fetal deaths. Neonatal immediate outcomes were not significantly different over the years.
Despite remarkable progresses in perinatal and neonatal cares, no noticeable impact in triplet gestations' outcomes was seen, sustaining that triplets should be avoided due to their great risk of prematurity and neonatal morbidities, either by limiting the numbers of embryos transferred or by fetal reduction.
Summary
Revista Brasileira de Ginecologia e Obstetrícia. 2014;36(9):387-392
DOI 10.1590/SO100-720320140005053
To evaluate the cases of uterine rupture and dehiscence of the uterine scar at a low-risk maternity and to point out possibilities for an improved approach to these complications.
A descriptive study was conducted at a 30-bed low-risk maternity hospital that provides care to users of the public health system. The investigation was carried out by searching for cases in the delivery room registry book and later reading the medical records in order to obtain the data. The information was inserted on a form previously elaborated for this study. Cases of uterine rupure and dehiscence of the uterine scar diagnosed from 1998 to 2012 were included, with the determination of incidence, aspects related to risk factors and diagnosis, association with the use of misoprostol and oxytocin, and the outcomes observed.
A total of 39,206 deliveries were performed in this maternity during the study period, with 12 cases of uterine rupture and 16 cases of dehiscence of uterine scar being observed. The most relevant results were a high perinatal mortality associated with uterine rupture and the unsuccessful diagnosis of this complications. It was not possible to demonstrate an association with the use of misoprostol or oxytocin.
The adverse outcomes of uterine rupture could be minimized if efforts were directed at improving the diagnostic performance of the assisting teams.
Summary
Revista Brasileira de Ginecologia e Obstetrícia. 2014;36(9):387-392
DOI 10.1590/SO100-720320140005053
To evaluate the cases of uterine rupture and dehiscence of the uterine scar at a low-risk maternity and to point out possibilities for an improved approach to these complications.
A descriptive study was conducted at a 30-bed low-risk maternity hospital that provides care to users of the public health system. The investigation was carried out by searching for cases in the delivery room registry book and later reading the medical records in order to obtain the data. The information was inserted on a form previously elaborated for this study. Cases of uterine rupure and dehiscence of the uterine scar diagnosed from 1998 to 2012 were included, with the determination of incidence, aspects related to risk factors and diagnosis, association with the use of misoprostol and oxytocin, and the outcomes observed.
A total of 39,206 deliveries were performed in this maternity during the study period, with 12 cases of uterine rupture and 16 cases of dehiscence of uterine scar being observed. The most relevant results were a high perinatal mortality associated with uterine rupture and the unsuccessful diagnosis of this complications. It was not possible to demonstrate an association with the use of misoprostol or oxytocin.
The adverse outcomes of uterine rupture could be minimized if efforts were directed at improving the diagnostic performance of the assisting teams.
Summary
Revista Brasileira de Ginecologia e Obstetrícia. 2014;36(9):398-403
DOI 10.1590/SO100-720320140004996
To evaluate the impact of continued education provided by an external quality control laboratory on the indicators of internal quality control of cytopathology exams.
The internal quality assurance indicators for cytopathology exams from 12 laboratories monitored by the External Quality Control Laboratory were evaluated. Overall, 185,194 exams were included, 98,133 of which referred to the period preceding implementation of a continued education program, while 87,061 referred to the period following this intervention. Data were obtained from the Cervical Cancer Database of the Brazilian National Health Service.
Following implementation of the continued education program, the positivity index (PI) remained within recommended limits in four laboratories. In another four laboratories, the PI progressed from below the limits to within the recommended standards. In one laboratory, the PI remained low, in two laboratories, it remained very low, and in one, it increased from very low to low. The percentage of exams compatible with a high-grade squamous intraepithelial lesion (HSIL) remained within the recommended limits in five laboratories, while in three laboratories it progressed from below the recommended levels to >0.4% of the total number of satisfactory exams, and in four laboratories it remained below the standard limit. Both the percentage of atypical squamous cells of undetermined significance (ASC-US) in relation to abnormal exams, and the ratio between ASC-US and intraepithelial lesions remained within recommended levels in all the laboratories investigated.
An improvement was found in the indicators represented by the positivity index and the percentage of exams compatible with a high-grade squamous intraepithelial lesion, showing that the role played by the external quality control laboratory in providing continued education contributed towards improving laboratory staff skills in detecting cervical cancer precursor lesions.
Summary
Revista Brasileira de Ginecologia e Obstetrícia. 2014;36(9):398-403
DOI 10.1590/SO100-720320140004996
To evaluate the impact of continued education provided by an external quality control laboratory on the indicators of internal quality control of cytopathology exams.
The internal quality assurance indicators for cytopathology exams from 12 laboratories monitored by the External Quality Control Laboratory were evaluated. Overall, 185,194 exams were included, 98,133 of which referred to the period preceding implementation of a continued education program, while 87,061 referred to the period following this intervention. Data were obtained from the Cervical Cancer Database of the Brazilian National Health Service.
Following implementation of the continued education program, the positivity index (PI) remained within recommended limits in four laboratories. In another four laboratories, the PI progressed from below the limits to within the recommended standards. In one laboratory, the PI remained low, in two laboratories, it remained very low, and in one, it increased from very low to low. The percentage of exams compatible with a high-grade squamous intraepithelial lesion (HSIL) remained within the recommended limits in five laboratories, while in three laboratories it progressed from below the recommended levels to >0.4% of the total number of satisfactory exams, and in four laboratories it remained below the standard limit. Both the percentage of atypical squamous cells of undetermined significance (ASC-US) in relation to abnormal exams, and the ratio between ASC-US and intraepithelial lesions remained within recommended levels in all the laboratories investigated.
An improvement was found in the indicators represented by the positivity index and the percentage of exams compatible with a high-grade squamous intraepithelial lesion, showing that the role played by the external quality control laboratory in providing continued education contributed towards improving laboratory staff skills in detecting cervical cancer precursor lesions.
Summary
Revista Brasileira de Ginecologia e Obstetrícia. 2014;36(9):404-409
DOI 10.1590/SO100-720320140005073
To evaluate the effect of 8 weeks of functional training on body composition in postmenopausal women.
The study was conducted on 38 postmenopausal women, divided into two groups: Training Group (TG) and Control Group (CG). TG women (n=21) performed a program of physical exercise for a period of 8 weeks, 3 times a week on nonconsecutive days, with 90 minutes per session. For the same period, CG women (n=17) did not perform any systematic physical activity. All participants were assessed at baseline and after 8 weeks. The evaluations were performed by the same trained raters. Analysis of body composition was performed using dual-energy X-ray absorptiometry (DEXA), which allows estimation of body composition in the whole body and by segment. TG participants performed a functional exercise program 3 days a week (non-consecutive), with 11 stations consisting of exercises developed in circuit format sessions. The objectives of the exercises were the development of strength, agility, coordination and proprioception, followed by aerobic exercise (walking). After normality of the data was determined by the Shapiro-Wilk test (p<0.05), we applied the Student t-test for independent samples to check for possible differences in anthropometric variables and body composition between groups at both times of intervention (pre and post-test). All analyses were performed using the SPSS software v. 17.0 (SPSS Inc., Chicago, IL, USA) with the level of significance set at 5%.
At baseline, no significant difference was observed between groups regarding anthropometric body variables or age composition, indicating homogeneity of the groups. After 8 weeks of training, significant differences were observed between TG and CG regarding fat - CG=0.2±0.7 and TG=-0.4±0.5, total body fat (kg) - CG=0.2±1.3 and TG=-0.7±0.8, and total weight - CG=0.4±1.4 and TG=-0.6±1.1. Percent body fat was reduced in terms of absolute values, although without significance: CG=0.1±1.5 and TG=-0.8±1.5.
Functional training in circuit format can be used as a strategy to alter body composition in postmenopausal women, particularly in terms of reduction of adipose tissue. This is a model that promotes high adhesion on the part of the participants, suggesting that it is an attractive proposal for the investigated age group.
Summary
Revista Brasileira de Ginecologia e Obstetrícia. 2014;36(9):404-409
DOI 10.1590/SO100-720320140005073
To evaluate the effect of 8 weeks of functional training on body composition in postmenopausal women.
The study was conducted on 38 postmenopausal women, divided into two groups: Training Group (TG) and Control Group (CG). TG women (n=21) performed a program of physical exercise for a period of 8 weeks, 3 times a week on nonconsecutive days, with 90 minutes per session. For the same period, CG women (n=17) did not perform any systematic physical activity. All participants were assessed at baseline and after 8 weeks. The evaluations were performed by the same trained raters. Analysis of body composition was performed using dual-energy X-ray absorptiometry (DEXA), which allows estimation of body composition in the whole body and by segment. TG participants performed a functional exercise program 3 days a week (non-consecutive), with 11 stations consisting of exercises developed in circuit format sessions. The objectives of the exercises were the development of strength, agility, coordination and proprioception, followed by aerobic exercise (walking). After normality of the data was determined by the Shapiro-Wilk test (p<0.05), we applied the Student t-test for independent samples to check for possible differences in anthropometric variables and body composition between groups at both times of intervention (pre and post-test). All analyses were performed using the SPSS software v. 17.0 (SPSS Inc., Chicago, IL, USA) with the level of significance set at 5%.
At baseline, no significant difference was observed between groups regarding anthropometric body variables or age composition, indicating homogeneity of the groups. After 8 weeks of training, significant differences were observed between TG and CG regarding fat - CG=0.2±0.7 and TG=-0.4±0.5, total body fat (kg) - CG=0.2±1.3 and TG=-0.7±0.8, and total weight - CG=0.4±1.4 and TG=-0.6±1.1. Percent body fat was reduced in terms of absolute values, although without significance: CG=0.1±1.5 and TG=-0.8±1.5.
Functional training in circuit format can be used as a strategy to alter body composition in postmenopausal women, particularly in terms of reduction of adipose tissue. This is a model that promotes high adhesion on the part of the participants, suggesting that it is an attractive proposal for the investigated age group.
Summary
Revista Brasileira de Ginecologia e Obstetrícia. 2014;36(9):410-415
DOI 10.1590/SO100-720320140005078
To establish the prevalence of acanthosis nigricans (AN) within the context of polycystic ovary syndrome (PCOS) and its associations with obesity, insulin resistance, insulinemia, and metabolic syndrome (MS).
A cross-sectional prospective study was conducted on 100 patients with PCOS diagnosed according to the Rotterdam Consensus (2003). The skin test included, in addition to the detection of the presence of AN, the presence of hirsutism (score ≥8) and acne. In addition to clinical and biochemical data, we investigated cardiovascular risk factors present in MS such as abdominal circumference, obesity, hypertension and HDL and triglyceride levels. Insulin resistance was determined by the HOMA-IR test.
The prevalence of AN (53%) was significantly correlated with hirsutism (p=0.02), body mass index (p<0.01), basal insulinemia (p<0.01), (HOMA-IR) (p<0.01), and MS (p<0.01). The prevalence of MS reached 36% and was significantly associated only with AN (p<0.01). Although diabetes mellitus was absent, there was a significant association of altered HOMA-IR (p<0.01) with MS (p<5%) and AN (p<0.01).
AN is part of the severe phenotypic profile of PCOS as an additional predictable sign of the risks of cardiovascular disease.
Summary
Revista Brasileira de Ginecologia e Obstetrícia. 2014;36(9):410-415
DOI 10.1590/SO100-720320140005078
To establish the prevalence of acanthosis nigricans (AN) within the context of polycystic ovary syndrome (PCOS) and its associations with obesity, insulin resistance, insulinemia, and metabolic syndrome (MS).
A cross-sectional prospective study was conducted on 100 patients with PCOS diagnosed according to the Rotterdam Consensus (2003). The skin test included, in addition to the detection of the presence of AN, the presence of hirsutism (score ≥8) and acne. In addition to clinical and biochemical data, we investigated cardiovascular risk factors present in MS such as abdominal circumference, obesity, hypertension and HDL and triglyceride levels. Insulin resistance was determined by the HOMA-IR test.
The prevalence of AN (53%) was significantly correlated with hirsutism (p=0.02), body mass index (p<0.01), basal insulinemia (p<0.01), (HOMA-IR) (p<0.01), and MS (p<0.01). The prevalence of MS reached 36% and was significantly associated only with AN (p<0.01). Although diabetes mellitus was absent, there was a significant association of altered HOMA-IR (p<0.01) with MS (p<5%) and AN (p<0.01).
AN is part of the severe phenotypic profile of PCOS as an additional predictable sign of the risks of cardiovascular disease.
Summary
Revista Brasileira de Ginecologia e Obstetrícia. 2014;36(9):416-422
DOI 10.1590/SO100-720320140004995
The aim of this study was to evaluate the human papillomavirus genotypes and the frequency of multiple human papillomavirus infections, as well as to assess the association between human papillomavirus genotype, cyto-histopathological abnormalities and age range.
A retrospective cross-sectional study was carried out between June 2010 and October 2013 in Salvador, Bahia, Brazil. We analyzed 351 results of positive human papillomavirus genotyping performed using the PapilloCheck(r) test, designed to detect 24 human papillomavirus types. The cyto-histopathological abnormalities were classified as negative (negative cytology and histopathology), low-grade lesions (cytologic low-grade squamous intraepithelial lesion diagnosis or histopathologic cervical intraepithelial neoplasia 1 or vaginal intraepithelial neoplasia 1 diagnosis) and high-grade lesions (cytologic high-grade squamous intraepithelial lesion diagnosis or histopathologic cervical intraepithelial neoplasia 2+ or vaginal intraepithelial neoplasia 2+ diagnosis).
The most frequently detected high risk human papillomavirus genotype was HPBV 16, with 18.5%, 95% confidence interval (95%CI) 14.6-23.0, followed by HPV 56 (14%; 95%CI 10.5-18.0) and HPV 39 (13.4%; 95%CI 9.5-16.8). HPV 18 (5.4%; 95%CI 3.3-8.3) was among the least frequent types. Among the low risk types, HPV 42 (15.7%; 95%CI 12.0-20.0), HPV 6 (11.4%; 95%CI 8.3-15.2) and HPV 44/55 (11.1%; 95%CI 8.0-14.9) were the most frequent, while HPV 11 (2.8%; 95%CI 1.4-5.2) was the least common. The proportion of HPV 16-positive women increased with severity of cyto-histopathological abnormalities: 13.8% (12/87) in low-grade lesion and 42.4% (14/33) in high-grade lesion. There was association between low- or high-grade cyto-histopathological lesion and the high risk genotypes, HPV16, HPV 52, HPV 73 and HPV 82, and the low risk type, HPV 43. Women under 30 years showed a significantly higher frequency of HPV 16 (22.2 versus 12.9%, p =0.01), HPV 42 (19.7 versus 10.9%, p=0.01) and HPV 45 (6.6 versus 1.4%, p=0.01), and multiple human papillomavirus infections (58.1 versus 47.4%, p=0.04).
We observed variability of human papillomavirus genotype distribution in women from the state of Bahia. HPV 16 was the most frequently detected high risk human papillomavirus, as also reported for other geographic areas of Brazil and for the world in general. HPV 56 and HPV 39 were the second and the third most common genotypes, whereas HPV 18 was among the least frequent types. HPV 42, 6 and 44/55 were the most frequently detected low risk human papillomavirus, and HPV 11 was the least common.
Summary
Revista Brasileira de Ginecologia e Obstetrícia. 2014;36(9):416-422
DOI 10.1590/SO100-720320140004995
The aim of this study was to evaluate the human papillomavirus genotypes and the frequency of multiple human papillomavirus infections, as well as to assess the association between human papillomavirus genotype, cyto-histopathological abnormalities and age range.
A retrospective cross-sectional study was carried out between June 2010 and October 2013 in Salvador, Bahia, Brazil. We analyzed 351 results of positive human papillomavirus genotyping performed using the PapilloCheck(r) test, designed to detect 24 human papillomavirus types. The cyto-histopathological abnormalities were classified as negative (negative cytology and histopathology), low-grade lesions (cytologic low-grade squamous intraepithelial lesion diagnosis or histopathologic cervical intraepithelial neoplasia 1 or vaginal intraepithelial neoplasia 1 diagnosis) and high-grade lesions (cytologic high-grade squamous intraepithelial lesion diagnosis or histopathologic cervical intraepithelial neoplasia 2+ or vaginal intraepithelial neoplasia 2+ diagnosis).
The most frequently detected high risk human papillomavirus genotype was HPBV 16, with 18.5%, 95% confidence interval (95%CI) 14.6-23.0, followed by HPV 56 (14%; 95%CI 10.5-18.0) and HPV 39 (13.4%; 95%CI 9.5-16.8). HPV 18 (5.4%; 95%CI 3.3-8.3) was among the least frequent types. Among the low risk types, HPV 42 (15.7%; 95%CI 12.0-20.0), HPV 6 (11.4%; 95%CI 8.3-15.2) and HPV 44/55 (11.1%; 95%CI 8.0-14.9) were the most frequent, while HPV 11 (2.8%; 95%CI 1.4-5.2) was the least common. The proportion of HPV 16-positive women increased with severity of cyto-histopathological abnormalities: 13.8% (12/87) in low-grade lesion and 42.4% (14/33) in high-grade lesion. There was association between low- or high-grade cyto-histopathological lesion and the high risk genotypes, HPV16, HPV 52, HPV 73 and HPV 82, and the low risk type, HPV 43. Women under 30 years showed a significantly higher frequency of HPV 16 (22.2 versus 12.9%, p =0.01), HPV 42 (19.7 versus 10.9%, p=0.01) and HPV 45 (6.6 versus 1.4%, p=0.01), and multiple human papillomavirus infections (58.1 versus 47.4%, p=0.04).
We observed variability of human papillomavirus genotype distribution in women from the state of Bahia. HPV 16 was the most frequently detected high risk human papillomavirus, as also reported for other geographic areas of Brazil and for the world in general. HPV 56 and HPV 39 were the second and the third most common genotypes, whereas HPV 18 was among the least frequent types. HPV 42, 6 and 44/55 were the most frequently detected low risk human papillomavirus, and HPV 11 was the least common.
Summary
Revista Brasileira de Ginecologia e Obstetrícia. 2014;36(8):340-346
DOI 10.1509/SO100-720320140005034
To examine the expression of AKT and PTEN in a series of HER2-positive primary invasive breast tumors using immunohistochemistry, and to associate these expression profiles with classic pathologic features such as tumor grade, hormone receptor expression, lymphatic vascular invasion, and proliferation.
A total of 104 HER2-positive breast carcinoma specimens were prepared in tissue microarrays blocks for immunohistochemical detection of PTEN and phosphorylated AKT (pAKT). Original histologic sections were reviewed to assess pathological features, including HER2 status and Ki-67 index values. The associations between categorical and numeric variables were identified using Pearson's chi-square test and the Mann-Whitney, respectively.
Co-expression of pAKT and PTEN was presented in 59 (56.7%) cases. Reduced levels of PTEN expression were detected in 20 (19.2%) cases, and these 20 tumors had a lower Ki-67 index value. In contrast, tumors positive for pAKT expression [71 (68.3%)] were associated with a higher Ki-67 index value.
A role for AKT in the proliferation of HER2-positive breast cancers was confirmed. However, immunohistochemical detection of PTEN expression did not correlate with an inhibition of cellular proliferation or control of AKT phosphorylation, suggesting other pathways in these mechanisms of control.
Summary
Revista Brasileira de Ginecologia e Obstetrícia. 2014;36(8):340-346
DOI 10.1509/SO100-720320140005034
To examine the expression of AKT and PTEN in a series of HER2-positive primary invasive breast tumors using immunohistochemistry, and to associate these expression profiles with classic pathologic features such as tumor grade, hormone receptor expression, lymphatic vascular invasion, and proliferation.
A total of 104 HER2-positive breast carcinoma specimens were prepared in tissue microarrays blocks for immunohistochemical detection of PTEN and phosphorylated AKT (pAKT). Original histologic sections were reviewed to assess pathological features, including HER2 status and Ki-67 index values. The associations between categorical and numeric variables were identified using Pearson's chi-square test and the Mann-Whitney, respectively.
Co-expression of pAKT and PTEN was presented in 59 (56.7%) cases. Reduced levels of PTEN expression were detected in 20 (19.2%) cases, and these 20 tumors had a lower Ki-67 index value. In contrast, tumors positive for pAKT expression [71 (68.3%)] were associated with a higher Ki-67 index value.
A role for AKT in the proliferation of HER2-positive breast cancers was confirmed. However, immunohistochemical detection of PTEN expression did not correlate with an inhibition of cellular proliferation or control of AKT phosphorylation, suggesting other pathways in these mechanisms of control.
