Juan Araya O

Mutación del gen p53 en el cáncer de la vesícula biliar

33 formalin fixed paraffin embedded samples of gallbladdercarcinoma (30 women, age range 32-86 years) were selected. Pancreatic cancer tissue with K-ras mutations was used as control. DNA was extracted from the histological section by mean ofmicrodissection and K-ras mutations in codon 12 were detected by polymerase chain reactionand restriction fragment length polymorphism (RFLP), using previously reported technique.

Estudio bacteriológico de la bilis vesicular en un área de alto riesgo de cáncer vesicular

BACKGROUND: Gallbladder cancer is frequent in Chile and there is sparse information about the association between this type of cancer and the presence of bacteria in the gallbladder bile. AIM: To determine the presence of aerobic bacteria in gallbladder bile in patients with and without gallbladder cancer. MATERIAL AND METHODS: A microbiological analysis of bile and pathological study was performed in 608 gallbladders, obtained during to cholecystectomies performed to 513 women and 95 men aged 44 years old as a mean. RESULTS: Pathological study showed a chronic cholecystitis in 468 cases (77%), an acute cholecystitis in 140 (33%), cancer in 24 (3.9%) and dysplasia in 5 cases (0.8%). A positive culture was obtained in 22.5% of women and 28.5% of males. Twenty seven percent of women over 30 years old had positive cultures compared with 10% of younger women (p < 0.001). Thirty two percent of acute cholecystitis had positive cultures, compared with 24% of chronic cholecystitis (p = 0.03). E Coli was isolated in 51% of positive cases, Streptococci-Enterococci in 24%, Enterobacter sp in 9%, Klebsiella and Proteus in lower proportions. Salmonella sp was isolated in 4 cases, being all women with chronic cholecystitis. Thirteen of 29 cases with cancer or dysplasia had positive cultures (45%), compared with 25% of patients with inflammatory gallbladder diseases (p = 0.02). Streptococci-Enterococci were isolated in 7 cases and Enterobacter sp in three. CONCLUSIONS: The presence of Salmonella sp in gallbladder bile was not frequent in the studied patients. Its role in the pathogenesis of gallbladder cancer must be reassessed.

Expresión inmunohistoquímica del complejo E-caderina-catenina en cáncer gástrico: Relación con variables clínico-morfológicas y sobrevida de pacientes

l cancer gastrico es la segunda neoplasia masfrecuente a nivel mundial, despues del cancerpulmonar. Las mayores incidencias se registran enChina, Japon, Europa del Este y Sudamerica. Estaneoplasia ocupa el segundo lugar a nivel mundialen mortalidad, con mejor sobrevida solo en Japon,Australia y Nueva Zelanda, debido principalmenteal diagnostico precoz

Expresión de CD44 (HCAM) en el carcinoma subseroso de la vesícula biliar

BACKGROUND HCAM or CD44 is a multifunctional cell adhesion molecule, related to cell-cell, cell-extracellular matrix interactions and involved in tumor invasion. AIM To study the importance of CD44 expression in subserous gallbladder carcinoma. MATERIAL AND METHODS One hundred five samples (93 female) of subserous gallbladder carcinoma and 33 non tumoral gallbladder were studied. CD44 was stained using the streptavidine-biotin technique, using human anti CD44 antibodies. Eighty subjects with carcinoma were followed for a period up to 105 months. RESULTS Mean age of patients was 62.6 years old, all tumors were adenocarcinoma, all were silent and 13% were well differentiated. CD44 was expressed in all controls and in 91%, the expression was normal. In 57% of cancer samples, CD44 expression was abnormal, in 50% it was less expressed and in 24%, it was not expressed. No differences in CD44 expression was observed between mucosa from control samples and mucosa adjacent to the tumor or superficial or deep tumoral areas. Global five years survival was 40%. No significant differences in survival were observed in those tumors with a lower of absent CD44 expression. Six patients with a higher expression died before 18 months of follow up. CONCLUSIONS Nearly 50% of subserous gallbladder carcinomas show an abnormal CD44 expression.

Carcinoma subseroso de la vesícula biliar: expresión del complejo caderina-catenina

Background: Subserous gallbladder carcinoma is difficult to diagnose and treat. There are no tissue markers with prognostic value in this type of tumor. Aim: To study the immunohistochemical expression of E-cadherin alpha and beta catenin in subserous gallbladder carcinoma. Patients and methods: One hundred seventeen subjects (103 women and 14 men aged 62 and 69 years as a mean, respectively), were studied. Thirty five gallbladder samples without evidence of cancer were used as controls. Expression of markers was studied with standard immunohistochemical techniques for formalin fixed and paraffin embedded tissue. Results: Ninety seven percent of tumors were adenocarcinoma. A lower or absent expression of E-cadherin, alpha catenin and beta catenin was observed in 26, 33 and 29% of tumors, respectively. Actuarial five years survival was 37%. No association between macroscopic features of the tumor and survival was observed. Well differentiated tumors had a 73% survival, whereas less differentiated tumors had a 30% survival. Tumors with a normal expression of the markers had a slightly better survival, although not significant (p=0.06). Conclusions: Approximately 30% of subserous gallbladder carcinoma have an abnormal expression of E-cadherin, alpha catenin and beta catenin. This abnormal expression has no relationship with prognosis and is probably secondary to the aberrant genic expression of the tumor (Rev Med Chile 2002; 130: 1349-57)

Carcinoma epidermoide oral y orofaríngeo: Estudio clínico-patológico

Oral and oropharingeal squamous cells carcinoma. Clinico-pathological study Introduction: Oral cancer is a common disease in many parts of the world, in Chile only accounts for 1.6% of all cancers. The majority is squamous cell carcinoma with important clinical, epidemiological and pathological differences between lip, oral and orofaringeal locations. Objective: To analyze clinical and pathological characteristics of oral and oropharingeal squamous cell carcinoma in Temuco, Chile. Materials and Methods: A descriptive, retrospective study of all diagnosed cases in 15 years (1994 and 2008). The patients were analyzed according to gender, age; and the tumors were classifi ed based on anatomic location, size, macroscopical fi ndings and degree of differentiation. Results: We found 93 carcinomas, with male to female ratio of 5:1, average age 67 years. Patients under 50 years accounted for only 8% of cases. The most common sites were lower lip, tongue and gingiva, with an average size of 28 mm, which increased towards orofarinx and more than half were moderately differentiated. Conclusions: In our region, this carcinoma most often affects the seventh decade of life and male population and has similar characteristics to those in other countries which is predominantly. The size at diagnosis is signifi cant. The detection of some differences in the group with mapuche surnames warrants a study with a larger number of cases.

Adenocarcinoma gástrico primario concomitante con tumor estromal gastrointestinal: Reporte de un caso y revisión de literatura

The concomitant presence of a primary gastric adenocarcinoma and a gastrointestinal stromal tumor in the stomach is uncommon. We report a 68-year-old male with an advanced gastric adenocarcinoma. During gastrectomy, a nodular intramural lesion was found. The pathological study, revealed a gastrointestinal stromal tumor, positive form CD117. After six months of follow up, there is no evidence of recurrence of either tumor).

Hallazgos morfológicos en casos fatales de síndrome cardiopulmonar por hantavirus: Estudio de 7 autopsias

Resumen Introduccion: El sindrome cardiopulmonar por hantavirus (SCPH) es una enfermedad infecciosa aguda, caracterizada por insufi ciencia cardio-respiratoria subita y alta mortalidad, causada por un virus ARN del genero Hantavirus , familia Bunyaviridae . Un 15% de los casos chilenos ha sido pesquisado en la Araucania. Objetivo:Conocer en casos fatales de SCPH, sus caracteristicas clinicas y morfologicas. Material y Metodo: Estudio descriptivo-retrospectivo de siete casos fatales con exa-men postmortem, de SCPH, atendidos entre 1997 y 2009 en el Hospital Regional de Temuco. Resultados: Los casos fueron principalmente pacientes jovenes, rurales, con un cuadro de compromiso respiratorio progresivo, con leucocitosis, trombopenia e infi ltrado pulmonar intersti-cial bilateral. Los principales hallazgos histopatologicos fueron un acentuado edema pulmonar intra-alveolar e intersticial, con escaso dano epitelial e in ltrado mono-nuclear y leve edema miocardico con in fi ltrado mononu-clear. Conclusiones:

Quiste aneurismático del maxilar superior: Reporte de un caso

Aneurysmal bone cysts are benign fibro osseous lesions, rarelypresent in maxillary region. We report the CT and morphological findings of aneurysmal bonecyst of the maxilla in a 15 years old female. The patient was subjected to a maxillectomy,preserving the orbit floor. The postoperative evolution has been uneventful. The tumor mainlyinvolved the maxillary sinus with extension to the orbit wall and osseous palate. Very few casesof aneurysmal bone cysts of the maxilla have been reported in the literature (Rev Med 2005;133: 1355-60).(