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Items 1-5 of 5 |
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[Micronuclei research the esophageal mucosa and its relationship with risk factors with cancer of the esophagus]
[Article in Portuguese]
Dietz J, Diehl AS, Prolla JC, Furtado CD, Furtado AD.
Hospital Nossa Senhora Conceicao e Hospital de Clinicas de Porto Alegre, Porto Alegre, RS.
PURPOSE: To demonstrate the frequency of micronucleus in esophageal mucous cells of smokers, consumers of alcoholic beverages and "mate" drinkers. METHODS: Material collected from the midlle esophagus in 250 consecutive patients submitted to upper digestive endoscopy was stained with acridine orange and the cytologist determined the number of micronuclei vizualized per each 500 cells examined. RESULTS: The frequency of micronucleated cells did not vary significantly (p > 0.05) when the following variables were considered: sex, place of residence (rural or urban), type of care (outpatient or inpatient), ingestion of alcohol. For two variables, smoking and "mate" consumption, there were significant differences in the frequency of micronuclei in the categories exposed and formerly exposed in relation to never exposed. CONCLUSION: A higher frequency of micronucleus in the esophageal mucous in smoking and "mate" drinkers was evidenced by this study.
PMID: 11070510 [PubMed - indexed for MEDLINE]
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[High temperature "mate" infusion drinking in a population at risk for squamous cell carcinoma of the esophagus]
[Article in Portuguese]
de Barros SG, Ghisolfi ES, Luz LP, Barlem GG, Vidal RM, Wolff FH, Magno VA, Breyer HP, Dietz J, Gruber AC, Kruel CD, Prolla JC.
Grupo de Estudos e Pesquisa em Cancer de Esofago (GEPECE) do Hospital de Clinicas de Porto Alegre e da Faculdade de Medicina, Universidade Federal do Rio Grande do [email protected]
"Mate", a popular hot infusion of a herb (Ilex paraguayensis) drunk in large volumes, is a known risk factor for squamous cell carcinoma of the esophagus and there is a suspicion that high temperature of boiled water used for the infusion may contribute for carcinogenesis. METHODS: We measured the temperature of "mate" infusion drunk by a sample of the population at risk for this carcinoma in Taquara, southern Brazil. We interviewed inhabitants for drinking habits and the temperature of the infusion was measured with high precision thermometers. Temperature of the infusion was asked to consumers and their estimate compared to our measurements. We considered 60 degrees C or higher as "hot". RESULTS: In 36 residencies, 107 individuals were drinking "mate". Most individuals drank it daily (97.2%), and the medium daily volume was 1,265 ml (SD +/- 1,132 mL) ranging from 250 to 6,000 mL. The measured temperature was 60 degrees C or higher in 72% of residencies with medium of 63.4 degrees C (51-78 degrees C) and median 64.4 degrees C. CONCLUSION: In this study, "mate" was consumed in large volumes at high temperature and individuals did not estimate correctly the temperature of infusion. High temperatures of "mate" may contribute to carcinogenesis in this population.
PMID: 10962624 [PubMed - indexed for MEDLINE]
Esophageal dysplasias are detected by endoscopy with Lugol in patients at risk for squamous cell carcinoma in southern Brazil.
Freitag CP, Barros SG, Kruel CD, Putten AC, Dietz J, Gruber AC, Diehl AS, Meurer L, Breyer HP, Wolff F, Vidal R, Arruda CA, Luz LP, Fagundes RB, Prolla JC.
Gastroenterology and Pathology Services, Hospital de Clinicas de Porto Alegre, Brazil.
Diagnosis of squamous cell carcinoma of the esophagus is usually late. Staining of the mucosa with Lugol's solution during endoscopy has been suggested to identify early cancer/dysplasia and may improve prognosis. Lugol was tested during endoscopy in 96 asymptomatic subjects at risk for this tumor, who were found to have atypias after exfoliative cytology in southern Brazil. Biopsies were obtained in Lugol's 'stained' and 'unstained' areas in the esophageal mucosa and the histologic results were compared. 'Unstained' areas were present in 64 (66.7%) instances: 44 'unstained' areas over mucosa with normal appearance revealed seven dysplasias (four high and three low grade), whereas 20 'unstained' areas with visible lesions contained only one dysplasia (low grade). 'Stained' areas in 96 (100%) subjects showed two additional dysplasias (one high and one low grade). In this study, Lugol 'unstained' areas were of great value for detection of dysplasias (sensitivity = 80%; specificity = 63%; p = 0.01, Fisher's exact test; CI = 95%; odds ratio = 6.7).
PMID: 10631911 [PubMed - indexed for MEDLINE]
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Esophageal dysplasia and chronic esophagitis: detection at upper gastrointestinal tract endoscopy.
Gruber AC, de Barros SG, Putten AC, Gigante L, Coelho N, Sekine S, Prolla JC.
Grupo de Estudos e Pesquisa em Cancer do Esofago (GEPECE) do Hospital de Clinicas de Porto Alegre, Universidade Federal do Rio Grande do Sul, Brazil.
Cancer of the esophagus becomes symptomatic at an advanced phase with a late diagnosis, when the tumor is already incurable. Early diagnosis has been shown to improve the survival rates. Conventional esophagoscopy is largely available but its sensitivity to detect early cancer or precancerous lesions remains controversial. In this study we tested the sensitivity of conventional esophagoscopy to identify suspicious areas and compared to histopathology of endoscopic biopsies to detect dysplasia and chronic esophagitis in a population at risk for cancer in southern Brazil. Adult males scheduled to have outpatient endoscopy were examined by two experienced endoscopists and any small (< 5 mm) plaque, nodule, erosion, hyperemia and or friable areas of the mucosa were biopsied and looked for the presence of early cancer or precancerous lesions. Normal appearing mucosa at the middle third of the esophagus was also biopsied and results compared for sensitivity, specificity, positive and negative predictive value. Of the 89 individuals with satisfactory biopsies, 3 had dysplasias, 29 moderate or severe chronic esophagitis and 57 normal findings at the histopathological study. We found no early cancer. We found two large, vegetating lesions confirmed to be advanced squamous cell carcinoma but they were excluded from analysis. To detect dysplasia or moderate/severe chronic esophagitis conventional esophagoscopy had a sensitivity of 40.6%, specificity of 78.9%, positive predictive value of 52% and negative predictive value of 70.3. CONCLUSIONS: In this study, conventional esophagoscopy had a low sensitivity to detect dysplasias and/or chronic esophagitis and techniques to improve endoscopic identification of these lesions in individuals at risk for cancer are much needed.
Publication Types:
PMID: 10347708 [PubMed - indexed for MEDLINE]
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Correlation of endoscopic cytology and histology in oesophageal cancer: results in Porto Alegre, RS--Brazil.
Frantz MA, Prolla JC.
Cytopathology Department, Hospital de Clinicas de Porto Alegre, Porto Alegre, RS--Brazil.
A retrospective study of oesophageal cytopathology at the Hospital de Clinicas de Porto Alegre (HCPA), RS, Brazil, from 1989 to 1992 was made assess the sensitivity, specificity, predictive values and accuracy of endoscopic cytology and biopsy; and study the correlation between cytopathological and histopathological diagnosis. Specimens from 94 patients were available for review. The final diagnosis was based on surgical pathology and follow up. The 81 patient with cancer of the oesophagus had the following sex distribution: 64 males and 17 females(a 3.7-1 ratio). No tumour was found in 13 patients. The following conclusions were made: (i) there is excellent correlation between cytology and histology in oesophageal lesions sampled by endoscopy; (ii) a correct positive cytologic report was obtained in 77 (95%) of the 81 proven oesophageal cancers; a false-negative or unsatisfactory result was given in four patients. A false-positive diagnosis of cancer was not made. There were 13 true-negative reports. These findings result in a sensitivity of 83% with 95% CI of 74.82-91.18%; a specificity of 100% (CI of 98.5-100%) a positive predictive value of 100% (CI of 99.25-100%); a negative predictive value of 48% (CI of 29.16-64.84%); (iv) of 81 patients with proven cancer, in 79 (98%) at least one of the methods was positive. In only two patients with cancer were both methods negative. These finding result in a combined sensitivity of 98% (CI of 94.92-100%); a specificity of 100% (CI of 98.5-100%); a positive predictive value of 100% (CI of 99.31-100%); and a negative predictive value of 87% CI of 70-100%). Our series confirms the value of the combined use of cytology and biopsy for the investigation of oesophageal lesions.
PMID: 8833873 [PubMed - indexed for MEDLINE]
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