Avaliação de margens cirúrgicas de neoplasma de pele quimicamente induzido em ratos (Rattus norvegicus albinus wistar)
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Data
2022-03-02
Autores
Carra, Gabriel João Unger [UNESP]
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Universidade Estadual Paulista (Unesp)
Resumo
O carcinoma espinocelular (CEC) é caracterizado pela proliferação maligna de queratinócitos epidérmicos. A cirurgia é a principal conduta terapêutica em lesões passíveis de ressecção em cães e gatos, sendo preconizada a confecção de margens amplas de segurança. Devido à esse fator, muitas vezes é necessária a confecção de grandes defeitos cirúrgicos e o emprego de técnicas que aceleram a reparação tecidual é sugerida. Dentre estas técnicas, o emprego do plasma rico em plaquetas (PRP) é bastante aceito com o objetivo de acelerar a reparação tecidual. Sugere-se, entretanto, que o estímulo angiogênico em leito cirúrgico de lesões neoplásicas pode levar à recidiva local. Assim, observa-se a necessidade de avaliar outros critérios que acompanham o desenvolvimento tumoral, a fim de desenvolver uma metodologia mais fidedigna na investigação das margens de segurança. O presente estudo objetivou avaliar se a aplicação de PRP em leito cirúrgico após a exérese tumoral de neoplasma quimicamente induzido em ratos pode influenciar a recidiva neoplásica, formação de novos vasos e alteração da expressão de fibras colágenas. Concluiu-se que, aos moldes de neoplasmas de pele quimicamente induzidos, as margens cirúrgicas de 5mm são insuficientes para evitar a recidiva de lesões tumorais, bem como a avaliação histológica para visualização de células tumorais em bordos cirúrgicos é um critério insuficiente para detectar alterações teciduais pré-neoplásicas e pode acarretar no comprometimento da eficácia terapêutica. Concluiu-se ainda que a contagem de densidade microvascular (CDMV) e gradação de atipia celular são fatores correlatos e podem indicar alterações teciduais que antecedem a formação neoplásica.
Squamous cell carcinoma (SCC) is characterized by the malignant proliferation of epidermal keratinocytes. Surgery is the main therapeutic approach in lesions that can be resected in dogs and cats, and wide safety margins are recommended. Due to this factor, it is often necessary to make large surgical defects and the use of techniques that accelerate tissue repair is suggested. Among these techniques, the use of platelet-rich plasma (PRP) is widely accepted with the aim of accelerating tissue repair. It is suggested, however, that the angiogenic stimulus in the surgical bed of neoplastic lesions can lead to local recurrence. Thus, there is a need to evaluate other criteria that accompany tumor development, in order to develop a more reliable methodology in the investigation of safety margins. The present study aimed to evaluate whether the application of PRP in the surgical bed after tumor excision of chemically induced neoplasm in rats can influence neoplastic recurrence, formation of new vessels and alteration of collagen fiber expression. It was concluded that, for chemically induced skin neoplasms, surgical margins of 5mm are insufficient to prevent recurrence of tumor lesions, as well as histological evaluation for visualization of tumor cells in surgical edges is an insufficient criterion to detect pre-neoplastic tissue alterations and may compromise the therapeutic efficacy. It was also concluded that the microvascular density count (MVDC) and grading of cell atypia are correlated factors and may indicate tissue alterations that precede neoplastic formation.
Squamous cell carcinoma (SCC) is characterized by the malignant proliferation of epidermal keratinocytes. Surgery is the main therapeutic approach in lesions that can be resected in dogs and cats, and wide safety margins are recommended. Due to this factor, it is often necessary to make large surgical defects and the use of techniques that accelerate tissue repair is suggested. Among these techniques, the use of platelet-rich plasma (PRP) is widely accepted with the aim of accelerating tissue repair. It is suggested, however, that the angiogenic stimulus in the surgical bed of neoplastic lesions can lead to local recurrence. Thus, there is a need to evaluate other criteria that accompany tumor development, in order to develop a more reliable methodology in the investigation of safety margins. The present study aimed to evaluate whether the application of PRP in the surgical bed after tumor excision of chemically induced neoplasm in rats can influence neoplastic recurrence, formation of new vessels and alteration of collagen fiber expression. It was concluded that, for chemically induced skin neoplasms, surgical margins of 5mm are insufficient to prevent recurrence of tumor lesions, as well as histological evaluation for visualization of tumor cells in surgical edges is an insufficient criterion to detect pre-neoplastic tissue alterations and may compromise the therapeutic efficacy. It was also concluded that the microvascular density count (MVDC) and grading of cell atypia are correlated factors and may indicate tissue alterations that precede neoplastic formation.
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Cirurgia veterinária, Oncologia, Neoplasias, Plasma rico em plaquetas, Carcinoma de células escamosas