Artículo de publicación ISIContribution over time of human papillomavirus (HPV) types in human cancers has been poorly documented. Such data is fundamental to measure current HPV vaccines impact in the years to come. We estimated the HPV type-specific distribution in a large international series of invasive cervical cancer (ICC) over 70 years prior to vaccination. Paraffin embedded ICC cases diagnosed between 1940 and 2007 were retrieved from eleven countries in Central-South America, Asia and Europe. Included countries reported to have low-medium cervical cancer screening uptake. Information on age at and year of diagnosis was collected from medical records. After histological confirmation, HPV DNA detection was performed by SPF-10/DEIA/LiPA25 (version1). Logistic regression models were used for estimating the adjusted relative contributions (RC) of HPV16 and of HPV18 over time. Among 4,771 HPV DNA positive ICC cases, HPV16 and HPV18 were the two most common HPVs in all the decades with no statistically significant variations of their adjusted-RC from 1940–59 to 2000–07 (HPV16—from 61.5 to 62.1%, and HPV18—from 6.9 to 7.2%). As well, the RC of other HPV types did not varied over time. In the stratified analysis by histology, HPV16 adjusted-RC significantly increased across decades in adenocarcinomas. Regarding age, cases associated to either HPV16, 18 or 45 were younger than those with other HPV types in all the evaluated decades. The observed stability on the HPV type distribution predicts a high and stable impact of HPV vaccination in reducing the cervical cancer burden in future vaccinated generations. What’s new? Evaluation of the success or failure of human papillomavirus (HPV) vaccination programs depends in part on knowledge of the historical contribution of the different HPV types to human cancer. The present study analyzed HPV type-specific relative contributions to invasive cervical cancer (ICC) over a 70-year period prior to the implementation of HPV vaccination. The relative contributions of different HPV types, including those for which a vaccine is now available, were found to be constant across decades. The findings indicate that HPV vaccination will have a high, stable impact on cervical cancer reduction.Instituto de Salud Carlos III (Spanish Government); Grant numbers: FIS PI030240, FIS PI061246, RCESP C03/09, RTICESP C03/10, RTIC RD06/0020/0095, CIBERESP; Grant sponsor: Age`ncia de Gesti o d’Ajuts Universitaris i de Recerca; Grant numbers: AGAUR 2005SGR 00695, 2009SGR126; Grant sponsor: Marat o de TV3 Foundation; Grant number: 051530; Grant sponsor: GlaxoSmithKline Biologicals, Sanofi Pasteur MSD & Merck & Co, Inc who had no role in the data collection, analysis, or interpretation of the results
The addition of HPVs 31/33/45/52/58 to HPV types included in current vaccines could increase the ICC preventable fraction in a range of 12 to 19% across the four countries, accounting the 9-types altogether 90% of ICC cases. Assuming the same degree of efficacy of current vaccines, the implementation of the 9-valent HPV vaccine in Brazil, Mexico, India and China would substantially impact on the reduction of the world cervical cancer burden.
We had the opportunity to examine a case of fine‐needle aspiration (FNA) of a melanotic variant of medullary thyroid carcinoma (MTC) in a 20‐yr‐old man. The patient presented a single node, hardened and mobile upon deglutition, in the right lobe of the thyroid, for 9 mo, without symptoms of glandular dysfunction. Calcitonin (138 pg/ml), urinary calcium (177 mg/dl), and the carcinoembryonic antigen (341 ng/ml) were increased. The nodular aspirate, drawn by FNA, was represented by pleomorphic cells, with frequent intranuclear cytoplasmic inclusions, sometimes bi‐ or multinucleated, with abundant, finely granular cytoplasm, sometimes containing a brown pigment resembling melanin. An immunohistochemical study using monoclonal antibodies (Dako Corp., Carpinteria, CA) showed that the neoplastic cells were intensely and diffusely positive for calcitonin and chromogranin, and focally positive for HMB45. In view of these findings, the case was characterized as a melanotic variant of medullary carcinoma, a rare type of neoplasia, but having a prognosis similar to the classical variant of MTC. Diagn. Cytopathol. 2001;24:206–208. © 2001 Wiley‐Liss, Inc.
To investigate the influence of the pineal gland through melatonin secretion on the physiological and morphological parameters of pancreatic islets, we studied the plasma biochemistry and morphological and morphometric characteristics of the endocrine pancreas of male Wistar rats. The animals were distributed into five groups of ten rats each: NC -normal control group; NS -sham-operated group; Px (25) -pinealectomised group, studied 15-25 days after surgery; Px (70) -pinealectomised group, studied 60-70 days after surgery; ALX -alloxan monohydrate-treated group. Data are analyzed statistically by ANOVA and by the Kruskal-Wallis test. Although there was no significant difference in plasma glucose or insulin levels between the Px (25), Px (70) and NC groups, Px (25) animals showed a tendency to increased glucose and reduced insulin levels. The ALX group showed a clear elevation of plasma glucose and a reduction of plasma insulin compared to the other groups. Morphometric analysis showed a larger pancreatic islet area and a lower pancreatic islet density in the pancreas of Px (70) animals and an increase in degenerative pathological processes in the pancreatic islets of the Px (25) and ALX groups. The present results suggest that melatonin, in addition to acting on tissue sensitivity to insulin (as reported in other studies), affects the secretory action of beta cells, as demonstrated by the morphological and morphometric changes observed in pinealectomised animals.Key words: pinealectomy, melatonin, pancreatic islet, rat, morphology. RESUMOA influência da glândula pineal na fisiologia, morfometria e morfologia das ilhotas pancreáticas em ratosCom o objetivo de verificar a influência da glândula pineal, por meio da secreção de melatonina (MLT) sobre a morfologia, morfometria e fisiologia das ilhotas de Langerhans (IP), especialmente sobre a secreção e ação da insulina, foram avaliados o metabolismo, a bioquímica plasmática, a morfologia e a morfometria de segmentos de pâncreas de 50 ratos Wistar. Os animais foram distribuídos em cinco grupos de dez animais cada, sendo dois grupos controles: N (controle normal); CF (submetidos à cirurgia fictícia) e três grupos experimentais: P 1 (pinealectomizados e avaliados entre 15 e 25 dias pós-cirurgia); P 2 (pinealectomizados e avaliados entre 60 e 70 dias pós-cirurgia) e Alx (tratados com Aloxana). Os resultados obtidos dos grupos experimentais foram analisados estatisticamente por ANOVA e teste de Kruskal-Wallis e comparados com os obtidos do grupo N. Embora não houvesse diferença significativa nos níveis plasmáticos de glicose ou insulina entre os grupos P 1 , P 2 e N, os animais do grupo P 1 mostraram tendência de aumento da glicose e níveis reduzidos de insulina. O grupo Alx mostrou elevação da glicemia e redução da insulinemia em relação aos demais grupos. A análise morfométrica revelou maior área e menor densidade das IP nos segmentos dos pâncreas do grupo P 2 . Em relação à análise morfológica, observou-se maior intensidade dos processos patológicos degenerati...
Histopathological and functional changes in the pancreas were studied in 94 hamsters infected and reinfected with Trypanosoma cruzi VIC strain and in 73 non-infected normal controls. Infection in each animal was verified by microhematocrit, hemoculture, specific peroxidase anti-peroxidase, polymerase chain reaction and seroagglutination. Blood glucose and insulin were determined. The number of islets per section and the number of islet cells marked with antibodies were counted. Insulitis, neuritis, fibrosis, atrophy and inflammatory infiltrates were evaluated. Experimental chagasic infection caused pancreatitis similar to human Chagas' disease, involving acini, islets and nerves, with atrophy and fibrosis, although without correlation to the number of reinfections. Erratic blood glucose levels and a tendency to hypoinsulinemia were observed in infected animals. During the acute phase, the number of somatostatin and pancreatic polipeptide producer islet cells was lower in infected hamsters, which was eventually related to changes in blood sugar levels and hypoinsulinemia. Our findings favor the hypothesis of the existence of an endocrine form of chronic chagasic infection.
Primary renal Angiosarcoma is a rare neoplasm and only 24 cases have been reported in specialized literature. We describe a case of primary renal angiosarcoma in a patient presenting with hematuria, palpable abdominal mass, left flank pain and anemia. A computerized tomography of the abdomen with contrast medium showed a tumor with 15 cm diameter, in the upper pole of the left kidney, with a low-density central area, suggesting necrosis or hemorrhage. Diagnosis was given in a morphologic base and proven by an immunohistochemical study. Primary renal angiosarcoma should be included among differential diagnosis of retroperitoneal hematoma and hemorrhagic renal tumors.
The objective of the present study was to investigate CD26 (dipeptidyl aminopeptidase IV) expression in normal and diseased thyroids and its relation to differentiation and cell proliferation. CD 26 was also evaluated as a possible marker of malignancy in thyroid neoplasias. A total of 38 normal thyroids and 117 diseased thyroids (neoplastic and non-neoplastic) were evaluated. CD26 and thyroglobulin (Tg) expression was determined by analyzing at least 200 cells/specimen. A minimum of 500 cells/specimen were counted to calculate the MIB-1-positive cell rate expressed as a percentage of total nucleated epithelial cells. CD26 expression was absent in all thyroids from fetuses and children. Among the adults, 7.1 % had CD26 expression only in oncocytic metaplastic areas. In 3 of the 7 elderly subjects, CD26 expression was present in 0.2-90% of epithelial cells. CD26 expression was observed in all diseased thyroids. Since this enzyme is also expressed in benign conditions, it is not useful as a marker of malignancy. There was no relationship between CD26 and Tg expression. The MIB-1-positive cell rate was found to be low for all kinds of thyroid tissues, and when the cell proliferation rate was analyzed according to CD26 expression, a greater cell proliferation rate was found in CD26-positive differentiated (follicular and papillary) carcinomas than in CD26-negative carcinomas. These results demonstrate that expression of this enzyme is related to the proliferative activity of follicular cells.
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