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Vol. 9. Issue 1.
Pages 19-32 (January - February 2003)
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Vol. 9. Issue 1.
Pages 19-32 (January - February 2003)
ARTIGO ORIGINAL/ORIGINAL ARTICLE
Open Access
A determinação quantitativa da área de microvasos intratumorais pode ser um indicador útil para tratamento coadjuvante em carcinomas de células não pequenas operados do pulmão
Morphometric intratumoral microvessel area evaluation could be a useful indicator for coadjuvant therapy in ressected NSCLC
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Luciane Cristina Dreher Irion1, João Carlos Prolla2, Antônio Atalíbio Hartmann3, Vinícius Duval da Silva4
1 Mestre em Patologia pela Fundação Faculdade Federal de Ciências Médicas de Porto Alegre (FFFCMPA). Pós-graduanda (doutoramento em Patologia) na FFFCMPA. Porto Alegre, RS, Brasil. Este trabalho tem origem na dissertação de mestrado da autora.
2 Professor titular do Departamento de Medicina Interna da Faculdade de Medicina da Universidade Federal do Rio Grande do Sul (UFRGS). Professor orientador do programa de pós-graduação em Medicina: Patologia, FFFCMPA. Porto Alegre, RS, Brasil.
3 Professor adjunto do departamento de Patologia da FFFCMPA e professor co-orientador do programa de pós-graduação em Medicina: Patologia, FFFCMPA. Porto Alegre, RS, Brasil.
4 Professor do departamento de Patologia da Faculdade de Medicina da Pontifícia Universidade Católica do Rio Grande do Sul (PUCRS).
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RESUMO

Objectivo: Realizar a medida da área vascular tumoral e a contagem individual dos microvasos, demonstrados por imuno-histoquímica, em imagens de campos microscópicos de carcinoma de células não pequenas dos pulmões, verificando a correlação dessas medidas com a sobrevida dos pacientes. Tipo do estudo: transversal e observacional. Material e métodos: O material foi proveniente de peças cirúrgicas de 107 pacientes com carcinoma de células não pequenas dos pulmões tratados no Pavilhão Pereira Filho – Santa Casa de Porto Alegre. A partir de cortes de tecido incluídos em parafina, foi realizada imuno-histoquímica com o anticorpo monoclonal anti-CD 34 (clone QB-End10; DAKO Corporation). A área vascular tumoral e a contagem de microvasos foram obtidas com o auxílio do programa de computador Image Pro Plus – 3.0. Resultados: A sobrevida média, em cinco anos, nos casos com alta área vascular (utilizando a média das áreas como ponto de corte) foi 21,7 meses±2,5, sendo significativamente menor (P < 0,0001) do que os de baixa área vascular, com 38,9 meses±3,0. O coeficiente de correlação entre a medida de área de microvasos e a contagem numérica destes foi 0,5 (P = = 0,001). A área vascular tumoral apresentou maior correlação com a sobrevida (coef. correlação – 0,48/P=0,001) do que a contagem numérica dos microvasos tumorais (coef. de correlação – 0,2 / P=0,03). Não foi encontrada correlação significativa entre a medida de área de microvasos e classificação histológica do tumor, sistema TNM, estado linfonodal e estadiamento clínico. Conclusão: A medida de área vascular tumoral, estabelecida com auxílio de computador, pode ser utilizada como um factor prognóstico para o carcinoma de células não pequenas dos pulmões.

REV PORT PNEUMOL IX (1): 19-32

Palavras-chave:
Angiogénese
CD 34
Imuno-histoquímica
Carcinoma de células não pequenas dos pulmões
Análise de imagem
ABSTRACT

Objective: To accomplish the tumor vascular area measure and the microvessel count, shown by immunohistochemistry, in non small cell lung cancer (NSCLC) microscopic images, and verify the correlation between these measurements and patients survival. Design: cross-sectional and observational. Material and methods: The material was deriving from 107 NSCLC surgical specimens in Pavilhão Pereira Filho — Santa Casa, Porto Alegre. Immunohistochemistry with anti-CD 34 monoclonal antibody (QB-End10; DAKO Corporation) was performed on paraffin-embedded tissue sections. The tumoral vascular area and the microvessel count were obtained by Image Pro Plus – 3.0 program. Results: The 5-year survival rate of high vascular area group (the cut-off was the mean of areas) was 21.7months±2.5, significantly lower (P < 0.0001) than the low vascular area cases, 38.9months±3.0. The correlation coefficient between microvessel area and microvessel count was 0.5 (P=0.001). The tumoral vascular area shown higher correlation to survival (correlation coefficient: –0.48 / P=0.001) than the tumoral microvessel count (correlation coefficient: –0.2 / P=0.03). There was not any significant correlation between the microvessel areas and the histological type, the TNM, the lymph nodes status and the clinical staging. Conclusion: The tumoral vascular area measurement, with computed assistance, can be used as a prognostic marker in NSCLC.

REV PORT PNEUMOL IX (1): 19-32

Key-words:
Angiogenesis
CD 34
Immunohistochemistry
NSCLC
Image analysis
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