Cancer-associated fibroblasts (CAF) influence tumor development at primary as well as in metastatic sites, but there have been no direct comparisons of the transcriptional profiles of stromal cells from different tumor sites. In this study, we used customized cDNA microarrays to compare the gene expression profile of stromal cells from primary tumor (CAF, n = 4), lymph node metastasis (N+, n = 3) and bone marrow (BM, n = 4) obtained from breast cancer patients. Biological validation was done in another 16 samples by RT-qPCR. Differences between CAF vs N+, CAF vs BM and N+ vs BM were represented by 20, 235 and 245 genes, respectively (SAM test, FDR < 0.01). Functional analysis revealed that genes related to development and morphogenesis were overrepresented. In a biological validation set, NOTCH2 was confirmed to be more expressed in N+ (vs CAF) and ADCY2, HECTD1, HNMT, LOX, MACF1, SLC1A3 and USP16 more expressed in BM (vs CAF). Only small differences were observed in the transcriptional profiles of fibroblasts from the primary tumor and lymph node of breast cancer patients, whereas greater differences were observed between bone marrow stromal cells and the other two sites. These differences may reflect the activities of distinct differentiation programs.

RACIONAL: A ablação por radiofreqüência de tumores hepáticos primários e metastáticos é método efetivo para o tratamento paliativo de tais neoplasias. Pode ser utilizada em nódulos com até 3-4 cm de diâmetro e não mais do que três lesões a serem tratadas. É procedimento passível de execução via laparotômia, laparoscópica e percutânea. Freqüentemente vem sendo aplicado como ponte para o transplante, assim como método alternativo nos tumores recorrentes após ressecção. OBJETIVO: Apresentar a experiência alcançada em uma série de pacientes onde a ablação por radiofreqüência foi utilizada. MÉTODOS: Foram estudados 113 casos nos quais a ablação por radiofreqüência foi aplicada por via percutânea ou por meio de laparotomia no tratamento de 170 lesões. O grupo foi composto por 43 casos de carcinoma hepatocelular, 53 de metástase de tumor colorretal, seis de metástases de carcinoma neuroendócrino, quatro de metástase de tumor de mama, quatro de colangiocarcinoma; um de metástase de tumor de pâncreas; um metástase de tumor renal e um de metástase hepática de leiomiosarcoma. RESULTADOS: A média de lesões tratadas foi de 1,5 por caso com tamanho médio de 3,6 cm por lesão. Foram os seguintes segmentos acometidos: segmento I (n=7), II (n=5), III (n=6), IV (n=39), V (n=10), VI(n=11), VII (n=50) e VIII (n=42). A morbidade associada ao método foi de 26,5% e a mortalidade de 3,5%. Observou-se taxa de recorrência após o procedimento de 17,6% em média 10,6 meses após a ablação. CONCLUSÃO: A ablação por radiofreqüência é procedimento seguro que pode ser utilizado em pacientes com reserva hepática comprometida. Nas doenças metastáticas o procedimento não substitui o tratamento operatório e o uso de outros métodos de controle mas mostra benefícios na evolução dos pacientes.

BACKGROUND: Radiofrequency ablation of primary and metastatic liver tumors is an effective method for treating palliative liver tumors. This method can be used in nodules of up to 3-4 cm of diameter, having no more than three lesions to be treated. The procedure can be achieved by laparotomy, laparoscopy as well as percutaneously. This method has also frequently been applied as a bridge to liver transplantation as well as an alternative method for recurrent tumors after resection. AIM: To present the experiment achieved in a series of patients were radiofrequency ablation was utilized. METHODS: 113 cases were studied, where radiofrequency ablation was applied percutaneously or by means of laparotomy in the treatment of 170 lesions. The group was composed of 43 cases of hepatocellular carcinoma; 53 colorectal tumor metastasis; six neuroendocrine carcinomas; four breast tumor metastasis; four cholangiocarcinomas; one pancreatic tumor metastasis; one renal tumor metastasis and one leiomyosarcoma hepatic metastasis. RESULTS: The average of treated lesions was of 1,5 per case with an average size of 3,6 cm per lesion. The following segments were compromised: segment I (n=7), II (n=5), IV (n=39), V (n=10), VI (n=11), VII (n=50) and VIII (n=42). Morbidity and mortality rates associated to the method were of 26,5% and 3,5% respectively. Recurrence rates after the procedure reached 17,6% after an average of 10,6 months subsequent to ablation. CONCLUSION: Radiofrequency ablation is a safe procedure that can be used in patients with compromised hepatic function. In metastatic diseases this procedure does not substitute surgical treatment and the use of other control methods shows many benefits in the evolution of patients.