Human breast carcinomas represent a heterogeneous group of tumors diverse in behavior, outcome, and response to therapy. However, the current system of pathological classification does not take into account biologic determinants of prognosis. The purpose of this study was to classify and characterize breast carcinomas based on variations in protein expression patterns derived from immunohistochemical analyses on tissue microarrays (TMAs). Therefore, 11 TMAs representing 168 invasive breast carcinomas were constructed. Breast tumors were classified into four different subtypes depending on estrogen receptor (ER) and HER2 expression. Basal-type tumors expressed neither of these proteins and represented 7.6% of our series; basal-like HER2-overexpressing tumors did not express ER and represented 17.7%; luminal-type tumors expressed ER and represented 72.8% of this series (luminal A 56.3%, luminal B 16.5%). Moreover, we characterized each subtype based on P-cadherin (P-CD), p63, cytokeratin (CK)5, BCL2, and Ki67 expression. Basal-type tumors were mostly grade III, more frequently P-CD-, p63-, and CK5-positive, and had a high proliferation rate. Conversely, luminal-type tumors rarely expressed basal markers and had a low grade and proliferation rate. Basal-like HER2-overexpressing tumors showed a basal-type profile similar with a high grade and up-regulation of P-CD and CK5. With this study, we show that P-CD, p63, and CK5 are important molecular markers that can be used to distinguish a basal phenotype. In addition, we also demonstrate the usefulness of TMAs in breast carcinoma immunoprofiling.
BackgroundThe Cervical Cancer Database of the Brazilian National Health Service (SISCOLO) contains information regarding all cervical cytological tests and, if properly explored, can be used as a tool for monitoring and managing the cervical cancer screening program. The aim of this study was to perform a historical analysis of the cervical cancer screening program in Brazil from 2006 to 2013.Material and MethodsThe data necessary to calculate quality indicators were obtained from the SISCOLO, a Brazilian health system tool. Joinpoint analysis was used to calculate the annual percentage change.ResultsWe observed important trends showing decreased rates of low-grade squamous intraepithelial lesions (LSIL) and high-grade squamous intraepithelial lesions (HSIL) and an increased rate of rejected exams from 2009 to 2013. The index of positivity was maintained at levels below those indicated by international standards; very low frequencies of unsatisfactory cases were observed over the study period, which partially contradicts the low rate of positive cases. The number of positive cytological diagnoses was below that expected, considering that developed countries with low frequencies of cervical cancer detect more lesions annually.ConclusionsThe evolution of indicators from 2006 to 2013 suggests that actions must be taken to improve the effectiveness of cervical cancer control in Brazil.
A mortalidade por câncer do colo uterino não está reduzindo. A terrritorialização e o cadastramento das famílias pela Estratégia Saúde da Família (ESF) favorece que se identifique as mulheres que nunca fizeram o exame citológico ou que estão há mais de três anos sem fazê-lo. Este estudo analisou se o rastreamento do câncer do colo uterino em Amparo, Estado de São Paulo, Brasil, avançou no sentido de seguir as recomendações vigentes ao longo de sete anos da ESF. A periodicidade anual manteve-se alta, com discreta tendência ao espaçamento dos controles. A distribuição de exames tendeu a aumentar no grupo etário 40-59 anos e a diminuir no grupo etário com mais de 60 anos, e a cobertura anual tendeu a diminuir. Os percentuais de exames em excesso variaram de 61,2% a 65,5%. Concluindo, a qualificação do rastreamento do câncer do colo do útero foi discreta e não modificou o padrão oportunístico dos controles. Considerando que os agentes comunitários de saúde podem atuar no sentido de aumentar a cobertura dessas ações, é fundamental capacitá-los para tal.
This study estimated the prevalence and distribution of human papillomavirus (HPV) types among women with cervical intraepithelial neoplasia (CIN) grade III and invasive cervical cancer from Goiás (Brazil Central Region 16, 18, 31, 33, 45, 54, 6/11, 42/43/44, 51/52, 56/ 58
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