Contribuição ao estudo morfométrico da reação fibrótico-desmoplástica do adenocarcinoma gástrico

Abstract

XIII Abstract The aim of this study was to draw a profile of the gastric adenocarcinoma in our local medical community, mainly analysing the morphometric fybrosis (desmoplastic reaction) with the aid of Masson's trichrome stain, stablishing its histological correlation. The research material was selected from an initial 132 case sample in the period of 1992-94, on the basis of strict exclusion criteria. The epidemiological evaluation covered 70 cases only, whereas the histopathological evaluation was based on 32 cases. All cases were recorded in the files of the Department of Pathology of ^NO major hospitals in the city of Fortaleza (Walter Cantidio University Hospital and the Dr. José Frota Institute). Controls were selected form the records of the local Forensic Medicine Institute, to include deaths occurred within a six-hour period. In the epidemological evaluation the subjects consited of 53 males (75,7%) and 17 females (24,3%). As for age distribution, 37 (52,9%) were over 60 and 7 (10,0%) between 20 and 40. In the histopathologic evaluation the breakdown by tumor site was as follows: 15 had tumors placed in the antrum (46,9%), including pyloric region, 4 in the body (12,5%), 2 in the cárdia and fundus (6,3%), 6 in the antrum/body (18,8%), 1 in the body/cardia (3,1%), and 2 in the antrum/body/cardia (6,3%). Nineteen cases (59,4%) were intestinat-type and 13 (40,6), diffuse-type. In the antrum, (p=0,000, tog-rank test) and body (p=0,001, log-rank test) the mean of average fybrosis ocurrence was higher than the control group. In the cárdia ( p=0,179, tog-rank test), however, no significant difference was found.The fybrotic reaction in both antrum (p=0,000, log-rank test) and body (p=0,027% log-rank test) was greater more noticeable for the difuse-type outnumbered the intestinal-type. There was no significance in the cárdia (p=0,215, log-rank test). The cut-off point found by morphometric AHERNE's method for the antrum was 3,6 for average fybrosis, 5,8 for the body and 5,4 for the cárdia. The interval for the intestinal-type in the antmm varied between 3,6 and 11,12 points and the diffuse-type in the antrum stayed above 11,12. In the body, the intestinal-type went from 5,8 to 8,16 points and the diffuse-type, above 8,16 points. Due a small number of cases in the cárdia, it was not possible to stablish a cut-off point for intestinal and difuse type tumors. The use of cut-off points in the study proved to be another important variable in diagnosing tumors according to LAUREN's classification