Clinicopathological features

临床病理特征
  • 文章类型: Journal Article
    In humans, the ERBB2 gene amplification and overexpression are biomarkers for invasive breast cancer and a therapeutic target. Also, TOP2α gene aberrations predict the response to anthracycline-based adjuvant chemotherapy. Although feline mammary tumors (FMTs) are good models in comparative oncology, scarce data is available regarding the ERBB2 and TOP2α status. In this study, and for the first time, the ERBB2 DNA status and RNA levels of intracellular (ICD) and extracellular (ECD) coding regions were compared with TOP2α gene status and expression profile, in samples of FMTs and disease-free tissues from the same animal. Results showed that ERBB2 and TOP2α gene status are highly correlated (r=0.87, p<0.0001, n=25), with few tumor samples presenting amplification. Also, the majority of the FMTs showed ERBB2 overexpression coupled with TOP2α overexpression (r=0.87, p<0.0001, n=27), being the ERBB2-ICD and ECD transcripts highly correlated (r=0.97, p<0.0001, n=27). Significant associations were found between TOP2α gene status or ERBB2 and TOP2α RNA levels with several clinicopathological parameters. This work highlights the need of experimental designs for a precise evaluation of ERBB2 and TOP2α gene status and its expression in FMTs, to improve their clinical management and to further validate them as a suitable model for comparative oncology studies.
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  • 文章类型: Journal Article
    子宫内膜异位症和子宫腺肌病是组织学定义。子宫内膜异位症的发生频率在一般人群中无法精确估计。当子宫内膜异位症引起疼痛和/或不育时,它被认为是一种疾病。子宫内膜异位症是一种异质性疾病,具有三种公认的亚型,通常彼此相关:浅表子宫内膜异位症(SUP),卵巢子宫内膜瘤(OMA),和深部浸润型子宫内膜异位症(DIE)。DIE通常是多灶性的,主要影响以下结构:子宫骶韧带,阴道后盲囊,膀胱,输尿管,和消化道(直肠,直肠-乙状结肠结,附录)。月经反流在子宫内膜异位症的病理生理学中的作用是主要的,并解释了病变的不对称分布,主要在骨盆后室和左侧(NP3)。所有有利于月经反流的因素都会增加子宫内膜异位症的风险(初潮早期,短周期,AUB,等。).炎症和生物类固醇激素合成是有利于病变植入和生长的主要机制。与子宫内膜异位症相关的疼痛可以通过伤害感受来解释,疼痛亢进,和中央敏感化,在单个患者中存在不同程度的关联。疼痛的类型(痛经,深度性交困难,消化或泌尿症状)与病变的位置相关。与子宫内膜异位症相关的不孕症可以通过几种非排他性机制来解释:盆腔因素(炎症),破坏自然受精;卵巢因子,与卵母细胞质量和/或数量有关;子宫因子破坏着床。骨盆因素可以通过手术切除病变来固定,从而提高自然受孕的机会(NP2)。子宫因子可以通过排卵阻断治疗来纠正,从而提高通过体外受精(NP2)怀孕的机会。计划手术时,应考虑子宫内膜异位症对卵巢储备(NP2)的影响。子宫内膜异位症是一种多因素疾病,遗传和环境因素共同作用。一级亲属发生子宫内膜异位症的风险是普通人群(NP2)的五倍。鉴定与该疾病有关的遗传变异目前对临床实践没有意义。环境因素的作用,尤其是内分泌干扰物,是合理的,但没有证明。文献综述不支持子宫内膜异位症随时间的进展,无论是在体积或数量的病变(NP3)。子宫内膜异位症患者发生急性消化道闭塞或肾功能丧失的风险似乎是例外。这些并发症在大多数情况下揭示了疾病。IVF不会增加与子宫内膜异位症(NP2)相关的疼痛强度。关于怀孕对病变的影响的数据很少,除了病变的蜕膜化的可能性,这可能使它们在成像上有可疑的一面。子宫内膜异位症对妊娠的影响存在争议。子宫内膜异位症与卵巢癌(子宫内膜样癌和透明细胞癌)(NP2)的罕见亚型之间存在流行病学关联。然而,相对危险度为中等(约1.3)(NP2),子宫内膜异位症和卵巢癌之间的因果关系至今未得到证实.考虑到子宫内膜异位症相关卵巢癌的低发病率,没有理由为患者提出筛查或降低风险的策略.
    Endometriosis and adenomyosis are histologically defined. The frequency of endometriosis cannot be precisely estimated in the general population. Endometriosis is considered a disease when it causes pain and/or infertility. Endometriosis is a heterogeneous disease with three well-recognized subtypes that are often associated with each other: superficial endometriosis (SUP), ovarian endometrioma (OMA), and deep infiltrating endometriosis (DIE). DIE is frequently multifocal and mainly affects the following structures: the uterosacral ligaments, the posterior vaginal cul-de-sac, the bladder, the ureters, and the digestive tract (rectum, recto-sigmoid junction, appendix). The role of menstrual reflux in the pathophysiology of endometriosis is major and explains the asymmetric distribution of lesions, which predominate in the posterior compartment of the pelvis and on the left (NP3). All factors favoring menstrual reflux increase the risk of endometriosis (early menarche, short cycles, AUB, etc.). Inflammation and biosteroid hormones synthesis are the main mechanisms favoring the implantation and the growth of the lesions. Pain associated with endometriosis can be explained by nociception, hyperalgia, and central sensitization, associated to varying degrees in a single patient. Typology of pain (dysmenorrhea, deep dyspareunia, digestive or urinary symptoms) is correlated with the location of the lesions. Infertility associated with endometriosis can be explained by several non-exclusive mechanisms: a pelvic factor (inflammation), disrupting natural fertilization; an ovarian factor, related to oocyte quality and/or quantity; a uterine factor disrupting implantation. The pelvic factor can be fixed by surgical excision of the lesions that improves the chance of natural conception (NP2). The uterine factor can be corrected by an ovulation-blocking treatment that improves the chances of getting pregnant by in vitro fertilization (NP2). The impact of endometrioma exeresis on the ovarian reserve (NP2) should be considered when a surgery is scheduled. Endometriosis is a multifactorial disease, resulting from combined action of genetic and environmental factors. The risk of developing endometriosis for a first-degree relative is five times higher than in the general population (NP2). Identification of genetic variants involved in the disease has no implication for clinical practice for the moment. The role of environmental factors, particularly endocrine disrupters, is plausible but not demonstrated. Literature review does not support the progression of endometriosis over time, either in terms of the volume or the number of the lesions (NP3). The risk of acute digestive occlusion or functional loss of a kidney in patients followed for endometriosis seems exceptional. These complications were revealing the disease in the majority of cases. IVF does not increase the intensity of pain associated with endometriosis (NP2). There is few data on the influence of pregnancy on the lesions, except the possibility of a decidualization of the lesions that may give them a suspicious aspect on imaging. The impact of endometriosis on pregnancy is debated. There is an epidemiological association between endometriosis and rare subtypes of ovarian cancer (endometrioid and clear cell carcinomas) (NP2). However, the relative risk is moderate (around 1.3) (NP2) and the causal relationship between endometriosis and ovarian cancer is not demonstrated so far. Considering the low incidence of endometriosis-associated ovarian cancer, there is no argument to propose a screening or a risk reducing strategy for the patients.
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