Alterações cromossômicas em células uroteliais esfoliadas de pacientes com história de carcinoma de células transicionais
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Data
2007-02-28
Autores
Marcondes, João Paulo De Castro [UNESP]
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Editor
Universidade Estadual Paulista (Unesp)
Resumo
O carcinoma de células transicionais (CCT) da bexiga possui como principal característica o alto índice de recorrência (70% dos carcinomas superficiais). Desta forma, é necessário acompanhar rigorosa e periodicamente os pacientes acometidos por tal neoplasia, bem como empregar técnicas sensíveis para a detecção precoce da doença, tanto em pacientes submetidos à ressecção do tumor de bexiga, quanto em pacientes considerados como grupo de risco para o desenvolvimento do CCT. O presente estudo tem por objetivo utilizar o teste do micronúcleo como ferramenta para a avaliação de danos cromossômicos em células uroteliais obtidas por lavado vesical de pacientes com história de CCT. A freqüência de células uroteliais micronucleadas foi avaliada em 77 pacientes (não tabagistas, tabagistas atuais e ex-tabagistas) sem ou com história de CCT, mas com diagnóstico atual negativo para neoplasia. Foi detectado aumento significativo (P=0,003) de células micronucleadas somente nos pacientes não fumantes e com história de CCT, quando comparados aos indivíduos do grupo controle (não fumantes e sem história de CCT). Não foram detectados efeitos do tabagismo na freqüência de células micronucleadas, e nem associação desse hábito com o grau do tumor. Concluindo, indivíduos não tabagistas com história de neoplasia urotelial apresentaram freqüência aumentada de micronúcleos em células esfoliadas da bexiga, mesmo após a ressecção do tumor. Portanto, o epitélio citologicamente normal da bexiga de indivíduos com história de CCT, pode apresentar células geneticamente instáveis, que poderiam conferir um risco aumentado para desenvolvimento neoplásico.
The main feature of transitional cell carcinoma (TCC) is the high recurrences rates of superficial carcinomas. Therefore, patients must be monitored regularly by periodic cystoscopies. The employment of sensible techniques are important for detecting bladder cancer and early disease in patients undergoing tumor resection and individuals with high risk for tumor development. To evaluate whether cytogenetic disorders can be evolved in the tumor development and recurrences, the frequency of micronucleated cells (MNC) was established in non-neoplastic exfoliated bladder cells from patients with history of TCC. Seventy-seven patients with and without history of bladder cancer, either smokers or non-smokers, with current diagnosis negative for neoplasia were included. The results showed a significant increase (P < 0.01) of MNC in patients with history of TCC and non-smokers when compared to counterpart group (without history of TCC and non-smokers). However, the same association was not observed in patients with TCC and smokers and in patients without history of TTC and smokers. Furthermore, was not observed correlation between smoking habits and tumor grade. These results suggesting that non smokers with history of urothelial tumor had an increase of MNC even after tumor resection. Thus, the macroscopically normal looking urothelium of patients of history of TCC, still could be harbored genetically instable cells that can be related to high risk for neoplastic development.
The main feature of transitional cell carcinoma (TCC) is the high recurrences rates of superficial carcinomas. Therefore, patients must be monitored regularly by periodic cystoscopies. The employment of sensible techniques are important for detecting bladder cancer and early disease in patients undergoing tumor resection and individuals with high risk for tumor development. To evaluate whether cytogenetic disorders can be evolved in the tumor development and recurrences, the frequency of micronucleated cells (MNC) was established in non-neoplastic exfoliated bladder cells from patients with history of TCC. Seventy-seven patients with and without history of bladder cancer, either smokers or non-smokers, with current diagnosis negative for neoplasia were included. The results showed a significant increase (P < 0.01) of MNC in patients with history of TCC and non-smokers when compared to counterpart group (without history of TCC and non-smokers). However, the same association was not observed in patients with TCC and smokers and in patients without history of TTC and smokers. Furthermore, was not observed correlation between smoking habits and tumor grade. These results suggesting that non smokers with history of urothelial tumor had an increase of MNC even after tumor resection. Thus, the macroscopically normal looking urothelium of patients of history of TCC, still could be harbored genetically instable cells that can be related to high risk for neoplastic development.
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Palavras-chave
Cancer, Fumo - Vicio
Como citar
MARCONDES, João Paulo De Castro. Alterações cromossômicas em células uroteliais esfoliadas de pacientes com história de carcinoma de células transicionais. 2007. 42 f. Dissertação (mestrado) - Universidade Estadual Paulista, Faculdade de Medicina de Botucatu, 2007.