Browsing by Author "Urbano, M"
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- Aberrant crypt foci: endoscopic assessment and cell kinetics characterizationPublication . Figueiredo, P; Donato, MM; Urbano, M; Goulão, H; Gouveia, H; Sofia, C; Leitão, M; Freitas, DBACKGROUND AND AIMS: Aberrant crypt foci (ACF) are preneoplastic lesions in animal models of colorectal cancer. The aim of the study is to investigate if ACF are involved in human colorectal carcinogenic process and if they can be helpful in predicting the presence of a colorectal neoplasia. METHODS: The study included, between 2003 and 2005, 182 patients, 62 with adenoma, 55 with colorectal carcinoma, 53 without colorectal lesions, and 12 with nonneoplastic mucosal polyps. The number of rectal ACF was determined by colonoscopy. Proliferation and apoptosis indexes were evaluated by immunohistochemistry in rectal ACF, in normal rectal mucosa, and in carcinomatous tissue. RESULTS: The mean number of rectal ACF in patients with rectal neoplasia was 12.64, significantly higher than in patients with neoplastic lesions elsewhere in the colon (p=0.01). The apoptosis index in ACF of patients with colorectal carcinoma or adenoma aged 50 years or older was significantly lower than in younger patients (1.3% vs 2.7%, p=0.01) and, in patients with carcinoma, lower than in normal mucosa (1.1% vs 2.1%, p=0.002). The proliferation index was significantly higher in ACF of patients with colorectal neoplasia aged less than 50 years than in normal mucosa (10.9% vs 7.7%, p=0.02). The apoptosis index in ACF foci of patients with carcinoma (1.1%) was significantly lower than in patients without lesions (2.2%) and than in normal mucosa (2%). The mean number of ACF is significantly higher in patients with polyps larger than 1 cm (11.28 vs 6.27, p=0.02). CONCLUSION: Aberrant crypt foci probably precede the appearance of neoplasia and may be helpful in predicting the presence of a colorectal neoplastic lesion.
- Adenoma seroso oligoquístico do pâncreas: a propósito de um caso clínicoPublication . Almeida, N; Alves, S; Borges, I; Gregório, C; Gomes, D; Portela, F; Sérgio, M; Rui, M; Urbano, M; Gouveia, H; Martinho, F; Freitas, D
- Citologia de aspirados por agulha fina ecoendoscopicamente guiada na avaliação de massas pancreáticas suspeitas de malignidadePublication . Urbano, M; Portela, F; Pontes, JM; Barroso, M; Fernandes, G; Calhau, CA; Gouveia, H; Leitão, M; Freitas, D
- Gastrenterite EosinofílicaPublication . Sequeira, C; Gregório, C; Ramalheira, A; Amaro, P; Urbano, M; Maçôas, F; Portela, F; Gouveia, H; Leitão, M; Donato, A; Freitas, D
- Metastização Cólica: Uma forma rara de apresentação do carcinoma gástricoPublication . Andrade, CS; Alves, S; Tomé, L; Sofia, C; Cipriano, MA; Urbano, M; Leitão, MO carcinoma gástrico é uma neoplasia com distribuição mundial, estando as fases avançadas da doença associadas à metastização à distância para múltiplos órgãos. Contudo, as metástases para o cólon são raras e habitualmente surgem como recidiva da doença, geralmente nos primeiros 5 anos após o diagnóstico. Os autores apresentam o caso clínico de um doente do sexo masculino, 69 anos de idade, com um quadro clínico de diarreia aquosa, de predomínio nocturno, sem sangue, muco ou pus, acompanhada de dor abdominal. Os exames complementares de diagnóstico revelaram a presença de metástases cólicas, como forma de apresentação de um adenocarcinoma gástrico, do tipo difuso, com células em anel desinete.Worldwide gastric carcinoma is a common malignancy and advanced stages of the disease result in distant metastases to multiple organs. Metastasis to the colon are rare and usually arise as recurrence of the disease, mostly in the first five years after diagnosis. The authors present a case of a 69 year old male with symptoms of watery diarrhoea, mostly nocturnal, without blood, mucus or pus, together with abdominal pain. Diagnostic workup revealed the presence of colonic metastases as the first manifestation of a diffuse type gastric adenocarcinoma, with signet ring cell.
- Team approach to ERCP-directed single-brush cytology for the diagnosis of malignancy.Publication . Urbano, M; Rosa, A; Gomes, D; Camacho, E; Calhau, CA; Leitão, MOBJECTIVE: To evaluate the clinical usefulness of single-brush cytology performed at ERCP as initial method for detecting pancreatobiliary malignancy, ensuring a very close relationship between endoscopists, cytotechnicians, and cytopathologists. STUDY DESIGN: All 125 cytodiagnoses considered in this study correspond to the first brushing for each patient, collected by one of the three members of a fixed team of endoscopists in the presence of the same cytotechnician. Smears were fixed immediately with Merckofix spray, stained with Papanicolau, and analyzed by the same cytopathologist in a laboratory exclusively devoted to gastrointestinal cytopathology located at the endoscopy unit. RESULTS: Of 125 cytological diagnoses 94 were considered benign, 4 suspicious, and 27 malignant. These findings were compared to the final diagnosis of 45 malignant and 80 benign lesions obtained either by surgical pathology or after at least one year of clinical follow-up. The comparison yielded 30 true positives, 78 true negatives, 1 false positive and 16 false negative results, which corresponds to a sensitivity, specificity, positive predictive value, negative predictive value, and accuracy of 65.2, 98.7, 96.8, 83, and 86.4%, respectively. CONCLUSION: Results seem to confirm the usefulness of an effective team approach to ERCP-directed brush cytology for the diagnosis of pancreatobiliary malignancy. However, sensitivity continues to be rather low.
- Tumores do Peritoneu: a propósito de dois casos de pseudomixoma peritonealPublication . Sofia, A; Donato, A; Espírito-Santo, V; Freitas, D; Martins, MI; Leitão, M; Romãozinho, JM; Domingos, J; Urbano, M; Gouveia-Monteiro, J