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eosina&#41;&#46; Os dados cl&#237;nicos foram recuperados do registro eletr&#244;nico de casos&#46; Todos os casos foram reconfirmados por dois dermatopatologistas&#46; Existem tr&#234;s tipos de TG com base nas propor&#231;&#245;es de c&#233;lulas gl&#244;micas&#44; estruturas vasculares e m&#250;sculo liso&#58; TG s&#243;lido&#44; glomangioma e glomangiomioma&#46;<a class="elsevierStyleCrossRef" href="#bib0150"><span class="elsevierStyleSup">5</span></a></p></span><span id="sec0020" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0060">Microensaios teciduais &#40;TMA do ingl&#234;s tissue microarray&#41;</span><p id="par0015" class="elsevierStylePara elsevierViewall">Blocos de parafina e l&#226;minas histol&#243;gicas das 60 amostras de TG foram coletados e avaliados microscopicamente&#46; Um ponto de 1&#8211;2<span class="elsevierStyleHsp" style=""></span>mm dentro de cada fragmento tecidual emblocado foi selecionado&#44; e uma broca de tecido semiautom&#225;tica foi usada para isolar um cilindro de tecido &#40;1&#8211;2<span class="elsevierStyleHsp" style=""></span>mm de di&#226;metro&#41; ou no centro do bloco doador&#44; onde as c&#233;lulas do TG estavam predominantemente localizadas&#46; Esses cilindros isolados foram&#44; ent&#227;o&#44; inseridas em um novo bloco de parafina para TMA&#46; O TMA &#40;3<span class="elsevierStyleHsp" style=""></span>&#956;m de espessura&#41; foi fatiado com um sistema autom&#225;tico de cortes em parafina&#46; A an&#225;lise imuno&#8208;histoqu&#237;mica foi realizada nesses cortes histol&#243;gicos&#46;</p></span><span id="sec0025" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0065">Imunomarca&#231;&#227;o</span><p id="par0020" class="elsevierStylePara elsevierViewall">Todas as amostras patol&#243;gicas foram seccionadas&#46; Os cortes histol&#243;gicos foram desparafinizados e reidratados em xileno e bateria de &#225;lcoois&#46; Os cortes histol&#243;gicos foram&#44; ent&#227;o&#44; bloqueados com albumina de soro bovino a 2&#37;&#44; incubadas com anticorpo IL&#8208;1&#946; policlonal de coelho &#40;China&#44; Servicebio&#44; 16806&#8208;1&#8208;AP&#41; em dilui&#231;&#227;o de 1&#58;200&#59; pAb de coelho anti&#8208;IL&#8208;6 &#40;China&#44; Servicebio&#44; Gb1117&#41; em dilui&#231;&#227;o de 1&#58;800&#59; anticorpo anti&#8208;CGRP &#40;China&#44; Servicebio&#44; 16630&#8208;1&#8208;AP&#41; em dilui&#231;&#227;o de 1&#58;200 por duas horas&#44; seguido de incuba&#231;&#227;o com anticorpos secund&#225;rios biotinilados por 90 min e depois estreptavidina ligada &#224; peroxidase de r&#225;bano&#46; Posteriormente&#44; 3&#8208;amino&#8208;9&#8208;etilcarbazol foi adicionado gota a gota durante 3&#8211;5 minutos&#44; e os cortes foram contracorados com hematoxilina&#46;</p></span><span id="sec0030" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0070">Avalia&#231;&#227;o de amostra</span><p id="par0025" class="elsevierStylePara elsevierViewall">Os resultados da avalia&#231;&#227;o imuno&#8208;histoqu&#237;mica com IL&#8208;1&#946;&#44; IL&#8208;6 e CGRP no TG foram registrados para determinar as diferen&#231;as entre os grupos&#46; As tr&#234;s imunomarca&#231;&#245;es foram digitalizadas eletronicamente e analisadas utilizando CaseViewer&#46; A imunomarc&#227;o para IL&#8208;1&#946; e IL&#8208;6 foi citoplasm&#225;tica&#46; Os resultados foram expressos combinando a intensidade e a porcentagem da imunomarca&#231;&#227;o&#44; como descrito&#46;<a class="elsevierStyleCrossRef" href="#bib0155"><span class="elsevierStyleSup">6</span></a> A intensidade da imunomarca&#231;&#227;o foi pontuada da seguinte maneira&#58; 0 &#8208; sem marca&#231;&#227;o&#59; 1 &#8208; marca&#231;&#227;o fraca&#59; 2 &#8208; marca&#231;&#227;o m&#233;dia&#59; e 3 &#8208; marca&#231;&#227;o forte&#46; A porcentagem de imunomarca&#231;&#227;o foi pontuada como se segue&#58; ponto 0&#58; 0&#37; a 5&#37; do total de c&#233;lulas foram marcadas&#59; 1 ponto&#58; marca&#231;&#227;o de 6&#37; a 25&#37;&#59; 2 pontos&#58; marca&#231;&#227;o de 26&#37; a 50&#37;&#59; 3 pontos&#58; 51&#37; a 75&#37; de marca&#231;&#227;o&#59; e 4 pontos&#58; &#62;<span class="elsevierStyleHsp" style=""></span>75&#37;&#46; Os resultados foram apresentados com base no produto da intensidade pela porcentagem da marca&#231;&#227;o&#58; 0 &#8208; negativo &#40;&#8211;&#41;&#59; 1 a 7 &#8211; fracamente positivo &#40;&#43;&#41;&#59; 8 a 10 &#8211; positividade m&#233;dia &#40;&#43;&#43;&#41;&#59; e 11 a 12 &#8211; fortemente positivo &#40;&#43;&#43;&#43;&#41;&#46;</p></span><span id="sec0035" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0075">An&#225;lise estat&#237;stica</span><p id="par0030" class="elsevierStylePara elsevierViewall">A an&#225;lise foi realizada utilizando o programa IBM SPSS 26 &#40;SPSS Inc&#46;&#44; Chicago&#44; IL&#41;&#46; Os testes estat&#237;sticos inclu&#237;ram o teste U de Mann&#8208;Whitney&#46; O valor de p<span class="elsevierStyleHsp" style=""></span>&#60;<span class="elsevierStyleHsp" style=""></span>0&#44;05 foi necess&#225;rio para que os resultados fossem considerados estatisticamente significantes&#46;</p></span></span><span id="sec0040" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0080">Resultados</span><span id="sec0045" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0085">Caracter&#237;sticas clinicopatol&#243;gicas de 60 TGs &#40;<a class="elsevierStyleCrossRef" href="#tbl0005">tabela 1</a>&#41;</span><span id="sec0050" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0090">Histopatologia do TG</span><p id="par0035" class="elsevierStylePara elsevierViewall"></p><elsevierMultimedia ident="tbl0005"></elsevierMultimedia><p id="par0040" class="elsevierStylePara elsevierViewall">Todos os tipos histopatol&#243;gicos de TG cont&#234;m c&#233;lulas gl&#244;micas&#44; l&#250;mens vasculares e c&#233;lulas musculares lisas vasculares&#44; mas a propor&#231;&#227;o &#233; diferente&#46; O TG s&#243;lido &#233; composto principalmente de c&#233;lulas gl&#244;micas&#59; o glomangioma &#233; composto de c&#233;lulas gl&#244;micas que circundam um grande n&#250;mero de vasos sangu&#237;neos&#59; e um grande n&#250;mero de c&#233;lulas musculares lisas vasculares pode ser visto no glomangiomioma&#46; No presente estudo&#44; apenas dois tipos histopatol&#243;gicos de TG s&#243;lido e glomangioma foram encontrados &#40;<a class="elsevierStyleCrossRef" href="#fig0005">fig&#46; 1</a>&#41;&#46;</p><elsevierMultimedia ident="fig0005"></elsevierMultimedia></span><span id="sec0055" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0095">Express&#227;o de IL&#8208;1&#946;&#44; IL&#8208;6 e CGRP em TG</span><p id="par0045" class="elsevierStylePara elsevierViewall">Imuno&#8208;histoquimicamente&#44; as c&#233;lulas tumorais em todos os 60 casos apresentaram imunomarca&#231;&#227;o difusa para IL&#8208;1&#946; e IL&#8208;6 &#40;<a class="elsevierStyleCrossRef" href="#fig0010">fig&#46; 2A&#8208;B</a>&#41;&#46; N&#227;o houve diferen&#231;a percept&#237;vel na intensidade da marca&#231;&#227;o entre IL&#8208;1&#946; e IL&#8208;6 &#40;Z<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span><span class="elsevierStyleMonospace">&#8208;</span>0&#44;750&#44; p<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>0&#44;492&#41;&#46; N&#227;o houve diferen&#231;a na express&#227;o de IL&#8208;1&#946; nos diferentes tipos histopatol&#243;gicos de TG &#40;Z<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>&#8211;1&#44;567&#44; p<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>0&#44;155&#41;&#44; nem de IL&#8208;6 &#40;Z<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>&#8211;0&#44;685&#44; p<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>0&#44;452&#41;&#46; CGRP n&#227;o foi expresso em TG &#40;<a class="elsevierStyleCrossRef" href="#fig0010">fig&#46; 2C</a>&#41;&#46;</p><elsevierMultimedia ident="fig0010"></elsevierMultimedia><p id="par0050" class="elsevierStylePara elsevierViewall">Dois dos 60 pacientes com TG eram assintom&#225;ticos&#44; e a express&#227;o de IL&#8208;1&#946; &#40;<a class="elsevierStyleCrossRef" href="#fig0015">fig&#46; 3</a>&#41; e IL&#8208;6 &#40;<a class="elsevierStyleCrossRef" href="#fig0020">fig&#46; 4</a>&#41; foi moderada ou fortemente positiva&#46; Quatro pacientes que se queixaram de sensibilidade ao frio apresentaram colora&#231;&#227;o difusa fortemente positiva para IL&#8208;1&#946; &#40;<a class="elsevierStyleCrossRef" href="#fig0015">fig&#46; 3</a>&#41; e IL&#8208;6 &#40;<a class="elsevierStyleCrossRef" href="#fig0020">fig&#46; 4</a>&#41;&#46; A express&#227;o de IL&#8208;1&#946; n&#227;o diferiu entre os casos que apresentavam dor&#44; sem ou com intoler&#226;ncia ao frio &#40;Z<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>&#8211;0&#44;989&#44; p<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>0&#44;580&#41;&#44; nem a da IL&#8208;6 &#40;Z<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>&#8211;0&#44;878&#44; p<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>0&#44;609&#41;&#46;</p><elsevierMultimedia ident="fig0015"></elsevierMultimedia><elsevierMultimedia ident="fig0020"></elsevierMultimedia></span></span></span><span id="sec0060" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0100">Discuss&#227;o</span><p id="par0055" class="elsevierStylePara elsevierViewall">Os estudos atuais sobre TG foram principalmente relatos de casos&#46; O presente estudo descreve as caracter&#237;sticas clinicopatol&#243;gicas por meio de um estudo retrospectivo de s&#233;rie de casos de 60 TG&#46; Havia mais pacientes do sexo feminino&#44; e a propor&#231;&#227;o entre homens e mulheres foi pr&#243;xima de 1&#58;2 &#40;21&#58;39&#41;&#44; o que foi consistente com pesquisas anteriores&#46;<a class="elsevierStyleCrossRef" href="#bib0160"><span class="elsevierStyleSup">7</span></a> O TG &#233; mais comum em pessoas jovens e de meia&#8208;idade&#44; e essas geralmente apresentam maior dura&#231;&#227;o da doen&#231;a&#46; Todos os pacientes deste estudo apresentavam uma &#250;nica les&#227;o&#46; Mais da metade dos 60 casos eram localizados nos dedos&#44; especialmente nos polegares&#46; A falange distal &#233; a localiza&#231;&#227;o dolorosa mais comum&#46;<a class="elsevierStyleCrossRef" href="#bib0165"><span class="elsevierStyleSup">8</span></a> O corpo gl&#244;mico &#233; uma estrutura neurovascular termorreguladora&#46; Assim&#44; quando a temperatura muda&#44; a press&#227;o intracapsular do tumor muda e causa dor&#46; Clinicamente&#44; o TG pode ocorrer em outros &#243;rg&#227;os&#44; como est&#244;mago&#44;<a class="elsevierStyleCrossRef" href="#bib0170"><span class="elsevierStyleSup">9</span></a> rim&#44;<a class="elsevierStyleCrossRef" href="#bib0175"><span class="elsevierStyleSup">10</span></a> br&#244;nquios segmentares<a class="elsevierStyleCrossRef" href="#bib0180"><span class="elsevierStyleSup">11</span></a> por exemplo&#46; Embora raros&#44; o n&#250;mero de relatos tem crescido nos &#250;ltimos anos&#46; A etiologia do TG &#233; desconhecida&#44; mas alguns pesquisadores indicaram que pacientes com neurofibromatose tipo 1 frequentemente apresentam TG&#44; e muta&#231;&#245;es do gene da neurofibromatose tipo 1 em ambos os alelos foram encontradas nas c&#233;lulas gl&#244;micas&#46;<a class="elsevierStyleCrossRef" href="#bib0185"><span class="elsevierStyleSup">12</span></a> N&#227;o houve casos de neurofibromatose no presente estudo e n&#227;o foram encontradas outras doen&#231;as espec&#237;ficas concomitantes&#46; O tamanho m&#233;dio do tumor &#233; de 0&#44;79<span class="elsevierStyleHsp" style=""></span>cm&#44; o comprimento m&#225;ximo do tumor &#233; de 3<span class="elsevierStyleHsp" style=""></span>cm&#46; O TG costuma ser benigno e n&#227;o cresce indefinidamente&#46; Cinquenta e oito casos apresentaram dor&#44; e apenas dois casos eram assintom&#225;ticos&#59; isso pode ser decorrente de diferen&#231;as individuais&#44; pois cada pessoa tem uma percep&#231;&#227;o e limiar de dor diferentes&#46; A maioria dos casos foi classificada histopatologicamente como TG s&#243;lido e glomangioma&#46; N&#227;o havia glomangiomioma&#44; o que foi consistente com estudo anterior&#46;<a class="elsevierStyleCrossRef" href="#bib0190"><span class="elsevierStyleSup">13</span></a> O diagn&#243;stico inicial incluiu TG&#44; tumor vascular&#44; cistos e edema&#44; e a taxa de diagn&#243;sticos corretos foi de 63&#44;3&#37;&#46;</p><p id="par0060" class="elsevierStylePara elsevierViewall">Sensibilidade localizada em algum ponto&#44; dor intensa e hipersensibilidade ao frio s&#227;o manifesta&#231;&#245;es cl&#237;nicas t&#237;picas de TG&#44; embora possam n&#227;o estar presentes ao mesmo tempo&#46; Poucas pesquisas exploraram o mecanismo da dor no TG&#46;<a class="elsevierStyleCrossRefs" href="#bib0135"><span class="elsevierStyleSup">2&#44;14</span></a> A tr&#237;ade de dor t&#237;pica do TG &#233; semelhante &#224; da dor neurop&#225;tica&#58; dor espont&#226;nea&#44; hiperalgesia e dor evocada &#40;particularmente ao toque leve e ao frio&#41;&#46;<a class="elsevierStyleCrossRef" href="#bib0200"><span class="elsevierStyleSup">15</span></a> Os autores acreditam que a dor causada pelo TG seja neurop&#225;tica&#46; O mecanismo da dor neurop&#225;tica &#233; complexo&#44; envolvendo sensibiliza&#231;&#227;o central e perif&#233;rica&#46; IL&#8208;1&#946; e IL&#8208;6 s&#227;o dois tipos de mediadores da dor&#46;</p><p id="par0065" class="elsevierStylePara elsevierViewall">Estudos anteriores mostraram que a IL&#8208;1&#946; pode induzir dor e inflama&#231;&#227;o neurop&#225;tica&#44;<a class="elsevierStyleCrossRef" href="#bib0205"><span class="elsevierStyleSup">16</span></a> e a redu&#231;&#227;o de sua express&#227;o pode reduzir a dor&#46;<a class="elsevierStyleCrossRef" href="#bib0210"><span class="elsevierStyleSup">17</span></a> No n&#250;cleo vermelho&#44; a IL&#8208;6 medeia a dor neurop&#225;tica induzindo a produ&#231;&#227;o de TNF&#8208;&#945; e IL&#8208;1&#946;&#46; A IL&#8208;6 induz a produ&#231;&#227;o de IL&#8208;1&#946; por meio das vias JAK2&#47;STAT3 e ERK&#46; A dor neuronal ou a dor ap&#243;s les&#227;o nervosa depende fortemente da transdu&#231;&#227;o de sinal de citocinas &#40;particularmente IL&#8208;1&#946;&#41;&#46; A concentra&#231;&#227;o intratecal de IL&#8208;1&#946; correlacionou&#8208;se com o grau de dor mec&#226;nica anormal&#46;<a class="elsevierStyleCrossRef" href="#bib0215"><span class="elsevierStyleSup">18</span></a> A pr&#243;pria IL&#8208;1&#946;&#44; por meio de autoestimula&#231;&#227;o em c&#233;lulas endoteliais&#44; &#233; o mecanismo de superexpress&#227;o sustentada de IL&#8208;1&#946;&#46;<a class="elsevierStyleCrossRef" href="#bib0220"><span class="elsevierStyleSup">19</span></a> O TG &#233; formado pela prolifera&#231;&#227;o patol&#243;gica do corpo gl&#244;mico&#44; que &#233; composto por c&#233;lulas endoteliais&#59; portanto&#44; a IL&#8208;1&#946; pode estar relacionada &#224; patog&#234;nese do TG&#46;</p><p id="par0070" class="elsevierStylePara elsevierViewall">A IL&#8208;6 &#233; regulada positivamente em v&#225;rios modelos pr&#233;&#8208;cl&#237;nicos de dor neurop&#225;tica&#44; incluindo les&#227;o perif&#233;rica&#44; dor oncol&#243;gica e neuropatia perif&#233;rica diab&#233;tica&#46; Os n&#237;veis de IL&#8208;6 em pacientes com herpes&#8208;z&#243;ster est&#227;o significantemente aumentados&#44; relacionados &#224; gravidade da dor&#46;<a class="elsevierStyleCrossRef" href="#bib0225"><span class="elsevierStyleSup">20</span></a> Ap&#243;s a les&#227;o nervosa&#44; os n&#237;veis de IL&#8208;6 est&#227;o associados &#224; alodinia em virtude do aumento da s&#237;ntese de neur&#244;nios ou c&#233;lulas imunol&#243;gicas&#46; A IL&#8208;6 interage com neur&#244;nios na via da dor e induz a excitabilidade excessiva dos nociceptores&#46;<a class="elsevierStyleCrossRefs" href="#bib0230"><span class="elsevierStyleSup">21&#44;22</span></a></p><p id="par0075" class="elsevierStylePara elsevierViewall">O neuropept&#237;dio CGRP &#233; o principal neurotransmissor da fibra nervosa classe C&#44; desempenhando papel essencial no in&#237;cio e na manuten&#231;&#227;o da dor neurop&#225;tica&#46;<a class="elsevierStyleCrossRef" href="#bib0240"><span class="elsevierStyleSup">23</span></a> O presente estudo descobriu que o CGRP n&#227;o foi expresso no TG&#44; sugerindo que o mesmo pode n&#227;o desempenhar papel significante na dor relacionada ao TG&#46; A libera&#231;&#227;o ou express&#227;o de CGRP &#233; um dos fatores&#8208;chave na dor&#46; As concentra&#231;&#245;es de CGRP no plasma&#44; l&#237;quido sinovial e l&#237;quido cefalorraquidiano est&#227;o elevadas durante a dor&#44;<a class="elsevierStyleCrossRef" href="#bib0245"><span class="elsevierStyleSup">24</span></a> mas a express&#227;o de CGRP nos tecidos tem sido pouco estudada e o mecanismo exato n&#227;o foi totalmente descrito&#46; N&#227;o existem estudos sobre a correla&#231;&#227;o entre CGRP e TG&#46; O papel do CGRP na dor &#233; mais evidente em doen&#231;as como a enxaqueca&#46;<a class="elsevierStyleCrossRef" href="#bib0250"><span class="elsevierStyleSup">25</span></a> O TG &#233; um pequeno tumor superficial localizado&#44; e o papel espec&#237;fico do CGRP em diferentes doen&#231;as pode ser diferente&#46;</p><p id="par0080" class="elsevierStylePara elsevierViewall">Foi demonstrado que a express&#227;o de IL&#8208;1&#946; e IL&#8208;6 era alta nas c&#233;lulas de TG&#44; sugerindo que IL&#8208;1&#946; e IL&#8208;6 tenham certo papel nociceptivo no TG&#46; Sensibilidade localizada e dor intensa geralmente coexistem&#46; Nos quatro pacientes com intoler&#226;ncia ao frio&#44; a intensidade da imunomarca&#231;&#227;o com IL&#8208;1&#946; e IL&#8208;6 tamb&#233;m foi forte&#44; sugerindo que podem n&#227;o desempenhar papel na hipersensibilidade ao frio&#46; No entanto&#44; como havia apenas quatro pacientes com intoler&#226;ncia ao frio&#44; &#233; necess&#225;rio aprofundar a pesquisa com amostra maior&#46;</p></span><span id="sec0065" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0105">Conclus&#245;es</span><p id="par0085" class="elsevierStylePara elsevierViewall">O TG &#233; raro por&#233;m &#233; mais comum em mulheres&#46; &#192;s vezes&#44; sua apar&#234;ncia &#233; dif&#237;cil de distinguir do hemangioma&#44; cisto epid&#233;rmico e outros tumores&#46; O diagn&#243;stico deve ser baseado nas manifesta&#231;&#245;es cl&#237;nicas combinadas com o exame histopatol&#243;gico&#46; A maioria dos pacientes apresenta alodinia&#44; e alguns pacientes apresentam dor induzida pelo frio&#46; IL&#8208;1&#946; e IL&#8208;6 foram expressos em todos os casos de TG&#44; sugerindo que podem participar do mecanismo da dor&#44; mas n&#227;o da causa da hipersensibilidade ao frio&#46; Ainda n&#227;o foi observado que o CGRP desempenhe qualquer papel nesse tumor&#46;</p></span><span id="sec0070" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0110">Suporte financeiro</span><p id="par0090" class="elsevierStylePara elsevierViewall">Este trabalho recebeu suporte financeiro da National Natural Science Foundation of China &#40;21874014&#41;&#46;</p></span><span id="sec0080" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0115">Contribui&#231;&#227;o dos autores</span><p id="par0100" class="elsevierStylePara elsevierViewall">Yuehua Sun&#58; Obten&#231;&#227;o&#44; an&#225;lise e interpreta&#231;&#227;o dos dados&#44; elabora&#231;&#227;o e reda&#231;&#227;o do manuscrito&#44; an&#225;lise estat&#237;stica&#46;</p><p id="par0105" class="elsevierStylePara elsevierViewall">Ruiqun Qi&#58; Participa&#231;&#227;o efetiva na orienta&#231;&#227;o da pesquisa&#44; concep&#231;&#227;o e planejamento do estudo&#46;</p><p id="par0110" class="elsevierStylePara elsevierViewall">Ze Wu&#58; Revis&#227;o cr&#237;tica da literatura&#46;</p><p id="par0115" class="elsevierStylePara elsevierViewall">Xiaodong Zhang&#58; Participa&#231;&#227;o intelectual em conduta proped&#234;utica e&#47;ou terap&#234;utica de casos estudados&#44; revis&#227;o cr&#237;tica do manuscrito&#46;</p><p id="par0120" class="elsevierStylePara elsevierViewall">Jun Niu&#58; Aprova&#231;&#227;o da vers&#227;o final do manuscrito&#46;</p></span><span id="sec0085" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0120">Conflito de interesses</span><p id="par0125" class="elsevierStylePara elsevierViewall">Nenhum&#46;</p></span></span>"
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              "titulo" => "Microensaios teciduais &#40;TMA do ingl&#234;s tissue microarray&#41;"
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              "identificador" => "sec0025"
              "titulo" => "Imunomarca&#231;&#227;o"
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              "titulo" => "Avalia&#231;&#227;o de amostra"
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              "titulo" => "Caracter&#237;sticas clinicopatol&#243;gicas de 60 TGs &#40;tabela 1&#41;"
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                  "identificador" => "sec0050"
                  "titulo" => "Histopatologia do TG"
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                  "titulo" => "Express&#227;o de IL&#8208;1&#946;&#44; IL&#8208;6 e CGRP em TG"
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          "titulo" => "Agradecimentos"
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          "titulo" => "Refer&#234;ncias"
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    "tienePdf" => true
    "fechaRecibido" => "2023-01-24"
    "fechaAceptado" => "2023-03-24"
    "PalabrasClave" => array:1 [
      "pt" => array:1 [
        0 => array:4 [
          "clase" => "keyword"
          "titulo" => "Palavras&#8208;chave"
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          "palabras" => array:5 [
            0 => "Dor"
            1 => "Interleucina&#8208;1 beta"
            2 => "Interleucina&#8208;6"
            3 => "Pept&#237;dio relacionado ao gene da calcitonina"
            4 => "Tumor gl&#244;mico"
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    "resumen" => array:1 [
      "pt" => array:3 [
        "titulo" => "Resumo"
        "resumen" => "<span id="abst0005" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0010">Fundamentos</span><p id="spar0005" class="elsevierStyleSimplePara elsevierViewall">O tumor gl&#244;mico &#40;TG&#41; &#233; neoplasia benigna que se origina de c&#233;lulas mesenquimais&#46; Apresenta&#8208;se com sensibilidade e alodinia ao frio nos dedos&#44; principalmente na regi&#227;o subungueal&#46; Existem poucos estudos que investigaram o mecanismo da dor&#46;</p></span> <span id="abst0010" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0015">Objetivos</span><p id="spar0010" class="elsevierStyleSimplePara elsevierViewall">Analisar as caracter&#237;sticas clinicopatol&#243;gicas do TG e identificar nele a express&#227;o de IL&#8208;1&#946;&#44; IL&#8208;6 e CGRP&#44; al&#233;m de explorar o poss&#237;vel mecanismo da dor&#46;</p></span> <span id="abst0015" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0020">M&#233;todos</span><p id="spar0015" class="elsevierStyleSimplePara elsevierViewall">Os dados cl&#237;nicos e patol&#243;gicos de 60 pacientes com TG foram analisados retrospectivamente&#46; Microensaios teciduais e avalia&#231;&#227;o imuno&#8208;histoqu&#237;mica foram utilizados para medir a express&#227;o de IL&#8208;1&#946;&#44; IL&#8208;6 e CGRP&#46;</p></span> <span id="abst0020" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0025">Resultados</span><p id="spar0020" class="elsevierStyleSimplePara elsevierViewall">O TG &#233; mais comum em mulheres&#44; e a propor&#231;&#227;o entre homens e mulheres foi pr&#243;xima de 1&#58;2&#44; principalmente em pessoas de meia&#8208;idade&#46; Ocorre frequentemente nas pontas dos dedos das m&#227;os&#44; especialmente nos polegares&#46; Os pacientes geralmente apresentam dor espont&#226;nea&#44; sensibilidade e hipersensibilidade ao frio&#46; Ambos os mediadores da dor IL&#8208;1&#946; e IL&#8208;6 foram altamente expressos em c&#233;lulas de TG de pacientes com e sem hipersensibilidade ao frio&#44; embora o CGRP n&#227;o tenha sido expresso em TG&#46;</p></span> <span id="abst0025" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0030">Limita&#231;&#245;es do estudo</span><p id="spar0025" class="elsevierStyleSimplePara elsevierViewall">Pequeno tamanho amostral&#59; mais pesquisas s&#227;o necess&#225;rias para explorar o mecanismo espec&#237;fico&#46;</p></span> <span id="abst0030" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0035">Conclus&#245;es</span><p id="spar0030" class="elsevierStyleSimplePara elsevierViewall">IL&#8208;1&#946; e IL&#8208;6 foram altamente expressos em c&#233;lulas de TG&#44; sugerindo que tenham certo papel nociceptivo no TG&#46; Nos quatro pacientes com intoler&#226;ncia ao frio&#44; a intensidade da express&#227;o de IL&#8208;1&#946; e IL&#8208;6 tamb&#233;m foi forte&#44; sugerindo que podem n&#227;o desempenhar papel na hipersensibilidade ao frio&#46; No entanto&#44; como haviam apenas quatro pacientes com intoler&#226;ncia ao frio&#44; &#233; necess&#225;rio realizar pesquisas mais aprofundadas utilizando amostra maior&#46; O papel espec&#237;fico do CGRP no TG ainda n&#227;o foi encontrado&#46;</p></span>"
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            "titulo" => "Resultados"
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          4 => array:2 [
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            "titulo" => "Conclus&#245;es"
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      0 => array:2 [
        "etiqueta" => "&#9734;"
        "nota" => "<p class="elsevierStyleNotepara" id="npar0005">Como citar este artigo&#58; Sun YH&#44; Qi RQ&#44; Wu Z&#44; Zhang XD&#44; Niu J&#46; The clinicopathologic and immunohistochemical features of 60 cutaneous glomus tumor&#58; a retrospective case series study&#46; An Bras Dermatol&#46; 2024&#59;99&#58;238&#8211;43&#46;</p>"
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        "etiqueta" => "&#9734;&#9734;"
        "nota" => "<p class="elsevierStyleNotepara" id="npar0010">Trabalho realizado no Key Laboratory of Immunodermatology&#44; The First Hospital of China Medical University&#44; Shenyang&#44; China</p>"
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    ]
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          "pt" => "<p id="spar0035" class="elsevierStyleSimplePara elsevierViewall">Histopatologia do tumor gl&#244;mico&#46; &#40;A&#41; O tumor gl&#244;mico s&#243;lido &#233;ra composto por c&#233;lulas redondas monom&#243;rficas dispostas em camadas&#46; &#40;B&#41; O glomangioma apresenta grande n&#250;mero de l&#250;mens vasculares&#44; circundados por diversas camadas de c&#233;lulas gl&#244;micas &#40;Hematoxilina &#38; eosina&#44; 100&#215;&#41;&#46;</p>"
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        "descripcion" => array:1 [
          "pt" => "<p id="spar0040" class="elsevierStyleSimplePara elsevierViewall">Imagens representativas da marca&#231;&#227;o imuno&#8208;histoqu&#237;mica de amostras de tumor gl&#244;mico&#46; &#40;A&#41; IL&#8208;1&#946; foi fortemente expressa em c&#233;lulas gl&#244;micas &#40;200&#215;&#41;&#46; &#40;B&#41; IL&#8208;6 foi fortemente expressa em c&#233;lulas gl&#244;micas &#40;200&#215;&#41;&#46; &#40;C&#41; CGRP n&#227;o foi expresso em c&#233;lulas gl&#244;micas &#40;200&#215;&#41;&#46;</p>"
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        "etiqueta" => "Figura 3"
        "tipo" => "MULTIMEDIAFIGURA"
        "mostrarFloat" => true
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        "descripcion" => array:1 [
          "pt" => "<p id="spar0045" class="elsevierStyleSimplePara elsevierViewall">Express&#227;o de IL&#8208;1&#946;&#46; &#40;A&#41; Express&#227;o moderada em c&#233;lulas gl&#244;micas em caso assintom&#225;tico &#40;200&#215;&#41;&#46; &#40;B&#41; Forte express&#227;o em c&#233;lulas gl&#244;micas em caso com alodinia &#40;200&#215;&#41;&#46; &#40;C&#41; Express&#227;o moderada em c&#233;lulas gl&#244;micas em caso com sensibilidade ao frio &#40;200&#215;&#41;&#46;</p>"
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        "etiqueta" => "Figura 4"
        "tipo" => "MULTIMEDIAFIGURA"
        "mostrarFloat" => true
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          "pt" => "<p id="spar0050" class="elsevierStyleSimplePara elsevierViewall">Express&#227;o de IL&#8208;6&#46; &#40;A&#41; Forte express&#227;o em c&#233;lulas gl&#244;micas em caso assintom&#225;tico &#40;200&#215;&#41;&#46; &#40;B&#41; Forte express&#227;o em c&#233;lulas gl&#244;micas em caso com alodinia &#40;200&#215;&#41;&#46; &#40;C&#41; Forte express&#227;o em c&#233;lulas gl&#244;micas em caso com sensibilidade ao frio &#40;200&#215;&#41;&#46;</p>"
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                  \t\t\t\t" scope="col" style="border-bottom: 2px solid black">Caracter&#237;sticas&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t"><span class="elsevierStyleBold">Sexo&#44; n</span>&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t">&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
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                  \t\t\t\t  " align="left" valign="\n
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                  \t\t\t\t">21&#58;39&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
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                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
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                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span><span class="elsevierStyleItalic">M&#233;dia &#40;varia&#231;&#227;o&#41;</span>&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t">40 &#40;8&#8208;92&#41;&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t  " align="" valign="\n
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                  \t\t\t\t">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
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                  \t\t\t\t  " align="left" valign="\n
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                  \t\t\t\t">6&#44;31 &#40;10 dias&#8208;30 anos&#41;&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t\ttable-entry\n
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                  \t\t\t\t  " align="" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span><span class="elsevierStyleItalic">D&#237;gito&#58; extrad&#237;gito</span>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
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                  \t\t\t\t  " align="left" valign="\n
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                  \t\t\t\t">38&#58;22&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span><span class="elsevierStyleHsp" style=""></span>M&#227;os e artelhos&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t  " align="left" valign="\n
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                  \t\t\t\t">40&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span><span class="elsevierStyleHsp" style=""></span>Bra&#231;os e pernas&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t  " align="left" valign="\n
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                  \t\t\t\t">13&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span><span class="elsevierStyleHsp" style=""></span>Tronco&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
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                  \t\t\t\t">6&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span><span class="elsevierStyleHsp" style=""></span>Face&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
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                  \t\t\t\t">1&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span><span class="elsevierStyleItalic">M&#227;o esquerda&#58; m&#227;o direita</span>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
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                  \t\t\t\t">21&#58;17&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t">2&#58;3&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t\ttable-entry\n
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                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span><span class="elsevierStyleHsp" style=""></span>Palma da m&#227;o&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t">1&#58;1&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t">0&#44;79 &#40;0&#44;1&#8208;3&#44;3&#41;&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t">2&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t">38 &#40;63&#44;3&#37;&#41;&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t">8 &#40;13&#44;3&#37;&#41;&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t\ttable-entry\n
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                  \t\t\t\t\ttable-entry\n
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                  \t\t\t\t">2 &#40;3&#44;3&#37;&#41;&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t\ttable-entry\n
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                  \t\t\t\t">2 &#40;3&#44;3&#37;&#41;&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t\ttable-entry\n
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                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span><span class="elsevierStyleItalic">Corpo estranho</span>&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">1 &#40;1&#44;7&#37;&#41;&nbsp;\t\t\t\t\t\t\n
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                  """
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          "pt" => "<p id="spar0055" class="elsevierStyleSimplePara elsevierViewall">Resumo dos achados clinicopatol&#243;gicos em 60 pacientes com tumor gl&#244;mico</p>"
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                    0 => array:2 [
                      "titulo" => "Immunohistochemical demonstration of cyclooxygenase&#8208;2 in glomus tumors"
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                          "etal" => false
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                            0 => "T&#46; Yanai"
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                    0 => array:2 [
                      "doi" => "10.2106/JBJS.L.00341"
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                        "tituloSerie" => "J Bone Joint Surg Am&#46;"
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                        "paginaFinal" => "304"
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Artigo original
Características clinicopatológicas e imuno‐histoquímicas de 60 tumores glômicos cutâneos: estudo retrospectivo de série de casos
Yuehua Suna, Ruiqun Qib, Ze Wua, Xiaodong Zhanga, Jun Niua,
Corresponding author
niujun06@yeah.net

Autor para correspondência.
a Departamento de Dermatologia, General Hospital of Northern Theater Command, Shenyang, China
b Key Laboratory of Immunodermatology, Ministério da Educação, NHC; National and Local Joint Engineering Research Center of Immunodermatological Theranostics; The First Hospital of China Medical University, Shenyang, China
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          "pt" => "<p id="spar0035" class="elsevierStyleSimplePara elsevierViewall">Histopatologia do tumor gl&#244;mico&#46; &#40;A&#41; O tumor gl&#244;mico s&#243;lido &#233;ra composto por c&#233;lulas redondas monom&#243;rficas dispostas em camadas&#46; &#40;B&#41; O glomangioma apresenta grande n&#250;mero de l&#250;mens vasculares&#44; circundados por diversas camadas de c&#233;lulas gl&#244;micas &#40;Hematoxilina &#38; eosina&#44; 100&#215;&#41;&#46;</p>"
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    "textoCompleto" => "<span class="elsevierStyleSections"><span id="sec0005" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0045">Introdu&#231;&#227;o</span><p id="par0005" class="elsevierStylePara elsevierViewall">O tumor gl&#244;mico &#40;TG&#41; &#233; neoplasia benigna de origem mesenquimal que surge do corpo gl&#244;mico&#46; Em geral&#46; ocorre nos dedos&#44; especialmente no leito ungueal&#46;<a class="elsevierStyleCrossRef" href="#bib0130"><span class="elsevierStyleSup">1</span></a> O TG &#233; frequentemente diagnosticado incorretamente&#44; causando dor e atraso no tratamento&#46; Alodinia&#44; sensibilidade localizada e hipersensibilidade ao frio s&#227;o a chave para diagnosticar o TG&#46; No entanto&#44; na pr&#225;tica&#44; os pacientes nem sempre apresentam esses sintomas simultaneamente&#46; Embora estudos anteriores tenham demonstrado que fibras nervosas&#44; mast&#243;citos e ciclooxigenase&#8208;2 s&#227;o abundantes no TG&#44;<a class="elsevierStyleCrossRefs" href="#bib0135"><span class="elsevierStyleSup">2&#8211;4</span></a> a compreens&#227;o dos mecanismos da dor ainda &#233; incompleta&#46; O presente estudo realizou an&#225;lise retrospectiva de s&#233;rie de casos de 60 pacientes com TG&#46; Foram avaliadas as express&#245;es de interleucina&#8208;1 beta &#40;IL&#8208;1&#946;&#41;&#44; interleucina&#8208;6 &#40;IL&#8208;6&#41; e pept&#237;dio relacionado ao gene da calcitonina &#40;CGRP&#44; do ingl&#234;s <span class="elsevierStyleItalic">calcitonin gene related peptide</span>&#41; em amostras de TG&#44; e seu poss&#237;vel papel no TG foi analisado&#46;</p></span><span id="sec0010" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0050">Materiais e m&#233;todos</span><span id="sec0015" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0055">Coleta de amostras de tumor gl&#244;mico</span><p id="par0010" class="elsevierStylePara elsevierViewall">Foram coletados os dados de 60 casos de TG&#44; todos atendidos no General Hospital of Northern Theater Command no per&#237;odo de 2002 a 2019 e diagnosticados com TG por meio de exame anatomopatol&#243;gico de rotina &#40;colora&#231;&#227;o com Hematoxilina &#38; eosina&#41;&#46; Os dados cl&#237;nicos foram recuperados do registro eletr&#244;nico de casos&#46; Todos os casos foram reconfirmados por dois dermatopatologistas&#46; Existem tr&#234;s tipos de TG com base nas propor&#231;&#245;es de c&#233;lulas gl&#244;micas&#44; estruturas vasculares e m&#250;sculo liso&#58; TG s&#243;lido&#44; glomangioma e glomangiomioma&#46;<a class="elsevierStyleCrossRef" href="#bib0150"><span class="elsevierStyleSup">5</span></a></p></span><span id="sec0020" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0060">Microensaios teciduais &#40;TMA do ingl&#234;s tissue microarray&#41;</span><p id="par0015" class="elsevierStylePara elsevierViewall">Blocos de parafina e l&#226;minas histol&#243;gicas das 60 amostras de TG foram coletados e avaliados microscopicamente&#46; Um ponto de 1&#8211;2<span class="elsevierStyleHsp" style=""></span>mm dentro de cada fragmento tecidual emblocado foi selecionado&#44; e uma broca de tecido semiautom&#225;tica foi usada para isolar um cilindro de tecido &#40;1&#8211;2<span class="elsevierStyleHsp" style=""></span>mm de di&#226;metro&#41; ou no centro do bloco doador&#44; onde as c&#233;lulas do TG estavam predominantemente localizadas&#46; Esses cilindros isolados foram&#44; ent&#227;o&#44; inseridas em um novo bloco de parafina para TMA&#46; O TMA &#40;3<span class="elsevierStyleHsp" style=""></span>&#956;m de espessura&#41; foi fatiado com um sistema autom&#225;tico de cortes em parafina&#46; A an&#225;lise imuno&#8208;histoqu&#237;mica foi realizada nesses cortes histol&#243;gicos&#46;</p></span><span id="sec0025" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0065">Imunomarca&#231;&#227;o</span><p id="par0020" class="elsevierStylePara elsevierViewall">Todas as amostras patol&#243;gicas foram seccionadas&#46; Os cortes histol&#243;gicos foram desparafinizados e reidratados em xileno e bateria de &#225;lcoois&#46; Os cortes histol&#243;gicos foram&#44; ent&#227;o&#44; bloqueados com albumina de soro bovino a 2&#37;&#44; incubadas com anticorpo IL&#8208;1&#946; policlonal de coelho &#40;China&#44; Servicebio&#44; 16806&#8208;1&#8208;AP&#41; em dilui&#231;&#227;o de 1&#58;200&#59; pAb de coelho anti&#8208;IL&#8208;6 &#40;China&#44; Servicebio&#44; Gb1117&#41; em dilui&#231;&#227;o de 1&#58;800&#59; anticorpo anti&#8208;CGRP &#40;China&#44; Servicebio&#44; 16630&#8208;1&#8208;AP&#41; em dilui&#231;&#227;o de 1&#58;200 por duas horas&#44; seguido de incuba&#231;&#227;o com anticorpos secund&#225;rios biotinilados por 90 min e depois estreptavidina ligada &#224; peroxidase de r&#225;bano&#46; Posteriormente&#44; 3&#8208;amino&#8208;9&#8208;etilcarbazol foi adicionado gota a gota durante 3&#8211;5 minutos&#44; e os cortes foram contracorados com hematoxilina&#46;</p></span><span id="sec0030" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0070">Avalia&#231;&#227;o de amostra</span><p id="par0025" class="elsevierStylePara elsevierViewall">Os resultados da avalia&#231;&#227;o imuno&#8208;histoqu&#237;mica com IL&#8208;1&#946;&#44; IL&#8208;6 e CGRP no TG foram registrados para determinar as diferen&#231;as entre os grupos&#46; As tr&#234;s imunomarca&#231;&#245;es foram digitalizadas eletronicamente e analisadas utilizando CaseViewer&#46; A imunomarc&#227;o para IL&#8208;1&#946; e IL&#8208;6 foi citoplasm&#225;tica&#46; Os resultados foram expressos combinando a intensidade e a porcentagem da imunomarca&#231;&#227;o&#44; como descrito&#46;<a class="elsevierStyleCrossRef" href="#bib0155"><span class="elsevierStyleSup">6</span></a> A intensidade da imunomarca&#231;&#227;o foi pontuada da seguinte maneira&#58; 0 &#8208; sem marca&#231;&#227;o&#59; 1 &#8208; marca&#231;&#227;o fraca&#59; 2 &#8208; marca&#231;&#227;o m&#233;dia&#59; e 3 &#8208; marca&#231;&#227;o forte&#46; A porcentagem de imunomarca&#231;&#227;o foi pontuada como se segue&#58; ponto 0&#58; 0&#37; a 5&#37; do total de c&#233;lulas foram marcadas&#59; 1 ponto&#58; marca&#231;&#227;o de 6&#37; a 25&#37;&#59; 2 pontos&#58; marca&#231;&#227;o de 26&#37; a 50&#37;&#59; 3 pontos&#58; 51&#37; a 75&#37; de marca&#231;&#227;o&#59; e 4 pontos&#58; &#62;<span class="elsevierStyleHsp" style=""></span>75&#37;&#46; Os resultados foram apresentados com base no produto da intensidade pela porcentagem da marca&#231;&#227;o&#58; 0 &#8208; negativo &#40;&#8211;&#41;&#59; 1 a 7 &#8211; fracamente positivo &#40;&#43;&#41;&#59; 8 a 10 &#8211; positividade m&#233;dia &#40;&#43;&#43;&#41;&#59; e 11 a 12 &#8211; fortemente positivo &#40;&#43;&#43;&#43;&#41;&#46;</p></span><span id="sec0035" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0075">An&#225;lise estat&#237;stica</span><p id="par0030" class="elsevierStylePara elsevierViewall">A an&#225;lise foi realizada utilizando o programa IBM SPSS 26 &#40;SPSS Inc&#46;&#44; Chicago&#44; IL&#41;&#46; Os testes estat&#237;sticos inclu&#237;ram o teste U de Mann&#8208;Whitney&#46; O valor de p<span class="elsevierStyleHsp" style=""></span>&#60;<span class="elsevierStyleHsp" style=""></span>0&#44;05 foi necess&#225;rio para que os resultados fossem considerados estatisticamente significantes&#46;</p></span></span><span id="sec0040" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0080">Resultados</span><span id="sec0045" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0085">Caracter&#237;sticas clinicopatol&#243;gicas de 60 TGs &#40;<a class="elsevierStyleCrossRef" href="#tbl0005">tabela 1</a>&#41;</span><span id="sec0050" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0090">Histopatologia do TG</span><p id="par0035" class="elsevierStylePara elsevierViewall"></p><elsevierMultimedia ident="tbl0005"></elsevierMultimedia><p id="par0040" class="elsevierStylePara elsevierViewall">Todos os tipos histopatol&#243;gicos de TG cont&#234;m c&#233;lulas gl&#244;micas&#44; l&#250;mens vasculares e c&#233;lulas musculares lisas vasculares&#44; mas a propor&#231;&#227;o &#233; diferente&#46; O TG s&#243;lido &#233; composto principalmente de c&#233;lulas gl&#244;micas&#59; o glomangioma &#233; composto de c&#233;lulas gl&#244;micas que circundam um grande n&#250;mero de vasos sangu&#237;neos&#59; e um grande n&#250;mero de c&#233;lulas musculares lisas vasculares pode ser visto no glomangiomioma&#46; No presente estudo&#44; apenas dois tipos histopatol&#243;gicos de TG s&#243;lido e glomangioma foram encontrados &#40;<a class="elsevierStyleCrossRef" href="#fig0005">fig&#46; 1</a>&#41;&#46;</p><elsevierMultimedia ident="fig0005"></elsevierMultimedia></span><span id="sec0055" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0095">Express&#227;o de IL&#8208;1&#946;&#44; IL&#8208;6 e CGRP em TG</span><p id="par0045" class="elsevierStylePara elsevierViewall">Imuno&#8208;histoquimicamente&#44; as c&#233;lulas tumorais em todos os 60 casos apresentaram imunomarca&#231;&#227;o difusa para IL&#8208;1&#946; e IL&#8208;6 &#40;<a class="elsevierStyleCrossRef" href="#fig0010">fig&#46; 2A&#8208;B</a>&#41;&#46; N&#227;o houve diferen&#231;a percept&#237;vel na intensidade da marca&#231;&#227;o entre IL&#8208;1&#946; e IL&#8208;6 &#40;Z<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span><span class="elsevierStyleMonospace">&#8208;</span>0&#44;750&#44; p<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>0&#44;492&#41;&#46; N&#227;o houve diferen&#231;a na express&#227;o de IL&#8208;1&#946; nos diferentes tipos histopatol&#243;gicos de TG &#40;Z<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>&#8211;1&#44;567&#44; p<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>0&#44;155&#41;&#44; nem de IL&#8208;6 &#40;Z<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>&#8211;0&#44;685&#44; p<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>0&#44;452&#41;&#46; CGRP n&#227;o foi expresso em TG &#40;<a class="elsevierStyleCrossRef" href="#fig0010">fig&#46; 2C</a>&#41;&#46;</p><elsevierMultimedia ident="fig0010"></elsevierMultimedia><p id="par0050" class="elsevierStylePara elsevierViewall">Dois dos 60 pacientes com TG eram assintom&#225;ticos&#44; e a express&#227;o de IL&#8208;1&#946; &#40;<a class="elsevierStyleCrossRef" href="#fig0015">fig&#46; 3</a>&#41; e IL&#8208;6 &#40;<a class="elsevierStyleCrossRef" href="#fig0020">fig&#46; 4</a>&#41; foi moderada ou fortemente positiva&#46; Quatro pacientes que se queixaram de sensibilidade ao frio apresentaram colora&#231;&#227;o difusa fortemente positiva para IL&#8208;1&#946; &#40;<a class="elsevierStyleCrossRef" href="#fig0015">fig&#46; 3</a>&#41; e IL&#8208;6 &#40;<a class="elsevierStyleCrossRef" href="#fig0020">fig&#46; 4</a>&#41;&#46; A express&#227;o de IL&#8208;1&#946; n&#227;o diferiu entre os casos que apresentavam dor&#44; sem ou com intoler&#226;ncia ao frio &#40;Z<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>&#8211;0&#44;989&#44; p<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>0&#44;580&#41;&#44; nem a da IL&#8208;6 &#40;Z<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>&#8211;0&#44;878&#44; p<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>0&#44;609&#41;&#46;</p><elsevierMultimedia ident="fig0015"></elsevierMultimedia><elsevierMultimedia ident="fig0020"></elsevierMultimedia></span></span></span><span id="sec0060" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0100">Discuss&#227;o</span><p id="par0055" class="elsevierStylePara elsevierViewall">Os estudos atuais sobre TG foram principalmente relatos de casos&#46; O presente estudo descreve as caracter&#237;sticas clinicopatol&#243;gicas por meio de um estudo retrospectivo de s&#233;rie de casos de 60 TG&#46; Havia mais pacientes do sexo feminino&#44; e a propor&#231;&#227;o entre homens e mulheres foi pr&#243;xima de 1&#58;2 &#40;21&#58;39&#41;&#44; o que foi consistente com pesquisas anteriores&#46;<a class="elsevierStyleCrossRef" href="#bib0160"><span class="elsevierStyleSup">7</span></a> O TG &#233; mais comum em pessoas jovens e de meia&#8208;idade&#44; e essas geralmente apresentam maior dura&#231;&#227;o da doen&#231;a&#46; Todos os pacientes deste estudo apresentavam uma &#250;nica les&#227;o&#46; Mais da metade dos 60 casos eram localizados nos dedos&#44; especialmente nos polegares&#46; A falange distal &#233; a localiza&#231;&#227;o dolorosa mais comum&#46;<a class="elsevierStyleCrossRef" href="#bib0165"><span class="elsevierStyleSup">8</span></a> O corpo gl&#244;mico &#233; uma estrutura neurovascular termorreguladora&#46; Assim&#44; quando a temperatura muda&#44; a press&#227;o intracapsular do tumor muda e causa dor&#46; Clinicamente&#44; o TG pode ocorrer em outros &#243;rg&#227;os&#44; como est&#244;mago&#44;<a class="elsevierStyleCrossRef" href="#bib0170"><span class="elsevierStyleSup">9</span></a> rim&#44;<a class="elsevierStyleCrossRef" href="#bib0175"><span class="elsevierStyleSup">10</span></a> br&#244;nquios segmentares<a class="elsevierStyleCrossRef" href="#bib0180"><span class="elsevierStyleSup">11</span></a> por exemplo&#46; Embora raros&#44; o n&#250;mero de relatos tem crescido nos &#250;ltimos anos&#46; A etiologia do TG &#233; desconhecida&#44; mas alguns pesquisadores indicaram que pacientes com neurofibromatose tipo 1 frequentemente apresentam TG&#44; e muta&#231;&#245;es do gene da neurofibromatose tipo 1 em ambos os alelos foram encontradas nas c&#233;lulas gl&#244;micas&#46;<a class="elsevierStyleCrossRef" href="#bib0185"><span class="elsevierStyleSup">12</span></a> N&#227;o houve casos de neurofibromatose no presente estudo e n&#227;o foram encontradas outras doen&#231;as espec&#237;ficas concomitantes&#46; O tamanho m&#233;dio do tumor &#233; de 0&#44;79<span class="elsevierStyleHsp" style=""></span>cm&#44; o comprimento m&#225;ximo do tumor &#233; de 3<span class="elsevierStyleHsp" style=""></span>cm&#46; O TG costuma ser benigno e n&#227;o cresce indefinidamente&#46; Cinquenta e oito casos apresentaram dor&#44; e apenas dois casos eram assintom&#225;ticos&#59; isso pode ser decorrente de diferen&#231;as individuais&#44; pois cada pessoa tem uma percep&#231;&#227;o e limiar de dor diferentes&#46; A maioria dos casos foi classificada histopatologicamente como TG s&#243;lido e glomangioma&#46; N&#227;o havia glomangiomioma&#44; o que foi consistente com estudo anterior&#46;<a class="elsevierStyleCrossRef" href="#bib0190"><span class="elsevierStyleSup">13</span></a> O diagn&#243;stico inicial incluiu TG&#44; tumor vascular&#44; cistos e edema&#44; e a taxa de diagn&#243;sticos corretos foi de 63&#44;3&#37;&#46;</p><p id="par0060" class="elsevierStylePara elsevierViewall">Sensibilidade localizada em algum ponto&#44; dor intensa e hipersensibilidade ao frio s&#227;o manifesta&#231;&#245;es cl&#237;nicas t&#237;picas de TG&#44; embora possam n&#227;o estar presentes ao mesmo tempo&#46; Poucas pesquisas exploraram o mecanismo da dor no TG&#46;<a class="elsevierStyleCrossRefs" href="#bib0135"><span class="elsevierStyleSup">2&#44;14</span></a> A tr&#237;ade de dor t&#237;pica do TG &#233; semelhante &#224; da dor neurop&#225;tica&#58; dor espont&#226;nea&#44; hiperalgesia e dor evocada &#40;particularmente ao toque leve e ao frio&#41;&#46;<a class="elsevierStyleCrossRef" href="#bib0200"><span class="elsevierStyleSup">15</span></a> Os autores acreditam que a dor causada pelo TG seja neurop&#225;tica&#46; O mecanismo da dor neurop&#225;tica &#233; complexo&#44; envolvendo sensibiliza&#231;&#227;o central e perif&#233;rica&#46; IL&#8208;1&#946; e IL&#8208;6 s&#227;o dois tipos de mediadores da dor&#46;</p><p id="par0065" class="elsevierStylePara elsevierViewall">Estudos anteriores mostraram que a IL&#8208;1&#946; pode induzir dor e inflama&#231;&#227;o neurop&#225;tica&#44;<a class="elsevierStyleCrossRef" href="#bib0205"><span class="elsevierStyleSup">16</span></a> e a redu&#231;&#227;o de sua express&#227;o pode reduzir a dor&#46;<a class="elsevierStyleCrossRef" href="#bib0210"><span class="elsevierStyleSup">17</span></a> No n&#250;cleo vermelho&#44; a IL&#8208;6 medeia a dor neurop&#225;tica induzindo a produ&#231;&#227;o de TNF&#8208;&#945; e IL&#8208;1&#946;&#46; A IL&#8208;6 induz a produ&#231;&#227;o de IL&#8208;1&#946; por meio das vias JAK2&#47;STAT3 e ERK&#46; A dor neuronal ou a dor ap&#243;s les&#227;o nervosa depende fortemente da transdu&#231;&#227;o de sinal de citocinas &#40;particularmente IL&#8208;1&#946;&#41;&#46; A concentra&#231;&#227;o intratecal de IL&#8208;1&#946; correlacionou&#8208;se com o grau de dor mec&#226;nica anormal&#46;<a class="elsevierStyleCrossRef" href="#bib0215"><span class="elsevierStyleSup">18</span></a> A pr&#243;pria IL&#8208;1&#946;&#44; por meio de autoestimula&#231;&#227;o em c&#233;lulas endoteliais&#44; &#233; o mecanismo de superexpress&#227;o sustentada de IL&#8208;1&#946;&#46;<a class="elsevierStyleCrossRef" href="#bib0220"><span class="elsevierStyleSup">19</span></a> O TG &#233; formado pela prolifera&#231;&#227;o patol&#243;gica do corpo gl&#244;mico&#44; que &#233; composto por c&#233;lulas endoteliais&#59; portanto&#44; a IL&#8208;1&#946; pode estar relacionada &#224; patog&#234;nese do TG&#46;</p><p id="par0070" class="elsevierStylePara elsevierViewall">A IL&#8208;6 &#233; regulada positivamente em v&#225;rios modelos pr&#233;&#8208;cl&#237;nicos de dor neurop&#225;tica&#44; incluindo les&#227;o perif&#233;rica&#44; dor oncol&#243;gica e neuropatia perif&#233;rica diab&#233;tica&#46; Os n&#237;veis de IL&#8208;6 em pacientes com herpes&#8208;z&#243;ster est&#227;o significantemente aumentados&#44; relacionados &#224; gravidade da dor&#46;<a class="elsevierStyleCrossRef" href="#bib0225"><span class="elsevierStyleSup">20</span></a> Ap&#243;s a les&#227;o nervosa&#44; os n&#237;veis de IL&#8208;6 est&#227;o associados &#224; alodinia em virtude do aumento da s&#237;ntese de neur&#244;nios ou c&#233;lulas imunol&#243;gicas&#46; A IL&#8208;6 interage com neur&#244;nios na via da dor e induz a excitabilidade excessiva dos nociceptores&#46;<a class="elsevierStyleCrossRefs" href="#bib0230"><span class="elsevierStyleSup">21&#44;22</span></a></p><p id="par0075" class="elsevierStylePara elsevierViewall">O neuropept&#237;dio CGRP &#233; o principal neurotransmissor da fibra nervosa classe C&#44; desempenhando papel essencial no in&#237;cio e na manuten&#231;&#227;o da dor neurop&#225;tica&#46;<a class="elsevierStyleCrossRef" href="#bib0240"><span class="elsevierStyleSup">23</span></a> O presente estudo descobriu que o CGRP n&#227;o foi expresso no TG&#44; sugerindo que o mesmo pode n&#227;o desempenhar papel significante na dor relacionada ao TG&#46; A libera&#231;&#227;o ou express&#227;o de CGRP &#233; um dos fatores&#8208;chave na dor&#46; As concentra&#231;&#245;es de CGRP no plasma&#44; l&#237;quido sinovial e l&#237;quido cefalorraquidiano est&#227;o elevadas durante a dor&#44;<a class="elsevierStyleCrossRef" href="#bib0245"><span class="elsevierStyleSup">24</span></a> mas a express&#227;o de CGRP nos tecidos tem sido pouco estudada e o mecanismo exato n&#227;o foi totalmente descrito&#46; N&#227;o existem estudos sobre a correla&#231;&#227;o entre CGRP e TG&#46; O papel do CGRP na dor &#233; mais evidente em doen&#231;as como a enxaqueca&#46;<a class="elsevierStyleCrossRef" href="#bib0250"><span class="elsevierStyleSup">25</span></a> O TG &#233; um pequeno tumor superficial localizado&#44; e o papel espec&#237;fico do CGRP em diferentes doen&#231;as pode ser diferente&#46;</p><p id="par0080" class="elsevierStylePara elsevierViewall">Foi demonstrado que a express&#227;o de IL&#8208;1&#946; e IL&#8208;6 era alta nas c&#233;lulas de TG&#44; sugerindo que IL&#8208;1&#946; e IL&#8208;6 tenham certo papel nociceptivo no TG&#46; Sensibilidade localizada e dor intensa geralmente coexistem&#46; Nos quatro pacientes com intoler&#226;ncia ao frio&#44; a intensidade da imunomarca&#231;&#227;o com IL&#8208;1&#946; e IL&#8208;6 tamb&#233;m foi forte&#44; sugerindo que podem n&#227;o desempenhar papel na hipersensibilidade ao frio&#46; No entanto&#44; como havia apenas quatro pacientes com intoler&#226;ncia ao frio&#44; &#233; necess&#225;rio aprofundar a pesquisa com amostra maior&#46;</p></span><span id="sec0065" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0105">Conclus&#245;es</span><p id="par0085" class="elsevierStylePara elsevierViewall">O TG &#233; raro por&#233;m &#233; mais comum em mulheres&#46; &#192;s vezes&#44; sua apar&#234;ncia &#233; dif&#237;cil de distinguir do hemangioma&#44; cisto epid&#233;rmico e outros tumores&#46; O diagn&#243;stico deve ser baseado nas manifesta&#231;&#245;es cl&#237;nicas combinadas com o exame histopatol&#243;gico&#46; A maioria dos pacientes apresenta alodinia&#44; e alguns pacientes apresentam dor induzida pelo frio&#46; IL&#8208;1&#946; e IL&#8208;6 foram expressos em todos os casos de TG&#44; sugerindo que podem participar do mecanismo da dor&#44; mas n&#227;o da causa da hipersensibilidade ao frio&#46; Ainda n&#227;o foi observado que o CGRP desempenhe qualquer papel nesse tumor&#46;</p></span><span id="sec0070" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0110">Suporte financeiro</span><p id="par0090" class="elsevierStylePara elsevierViewall">Este trabalho recebeu suporte financeiro da National Natural Science Foundation of China &#40;21874014&#41;&#46;</p></span><span id="sec0080" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0115">Contribui&#231;&#227;o dos autores</span><p id="par0100" class="elsevierStylePara elsevierViewall">Yuehua Sun&#58; Obten&#231;&#227;o&#44; an&#225;lise e interpreta&#231;&#227;o dos dados&#44; elabora&#231;&#227;o e reda&#231;&#227;o do manuscrito&#44; an&#225;lise estat&#237;stica&#46;</p><p id="par0105" class="elsevierStylePara elsevierViewall">Ruiqun Qi&#58; Participa&#231;&#227;o efetiva na orienta&#231;&#227;o da pesquisa&#44; concep&#231;&#227;o e planejamento do estudo&#46;</p><p id="par0110" class="elsevierStylePara elsevierViewall">Ze Wu&#58; Revis&#227;o cr&#237;tica da literatura&#46;</p><p id="par0115" class="elsevierStylePara elsevierViewall">Xiaodong Zhang&#58; Participa&#231;&#227;o intelectual em conduta proped&#234;utica e&#47;ou terap&#234;utica de casos estudados&#44; revis&#227;o cr&#237;tica do manuscrito&#46;</p><p id="par0120" class="elsevierStylePara elsevierViewall">Jun Niu&#58; Aprova&#231;&#227;o da vers&#227;o final do manuscrito&#46;</p></span><span id="sec0085" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0120">Conflito de interesses</span><p id="par0125" class="elsevierStylePara elsevierViewall">Nenhum&#46;</p></span></span>"
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        "resumen" => "<span id="abst0005" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0010">Fundamentos</span><p id="spar0005" class="elsevierStyleSimplePara elsevierViewall">O tumor gl&#244;mico &#40;TG&#41; &#233; neoplasia benigna que se origina de c&#233;lulas mesenquimais&#46; Apresenta&#8208;se com sensibilidade e alodinia ao frio nos dedos&#44; principalmente na regi&#227;o subungueal&#46; Existem poucos estudos que investigaram o mecanismo da dor&#46;</p></span> <span id="abst0010" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0015">Objetivos</span><p id="spar0010" class="elsevierStyleSimplePara elsevierViewall">Analisar as caracter&#237;sticas clinicopatol&#243;gicas do TG e identificar nele a express&#227;o de IL&#8208;1&#946;&#44; IL&#8208;6 e CGRP&#44; al&#233;m de explorar o poss&#237;vel mecanismo da dor&#46;</p></span> <span id="abst0015" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0020">M&#233;todos</span><p id="spar0015" class="elsevierStyleSimplePara elsevierViewall">Os dados cl&#237;nicos e patol&#243;gicos de 60 pacientes com TG foram analisados retrospectivamente&#46; Microensaios teciduais e avalia&#231;&#227;o imuno&#8208;histoqu&#237;mica foram utilizados para medir a express&#227;o de IL&#8208;1&#946;&#44; IL&#8208;6 e CGRP&#46;</p></span> <span id="abst0020" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0025">Resultados</span><p id="spar0020" class="elsevierStyleSimplePara elsevierViewall">O TG &#233; mais comum em mulheres&#44; e a propor&#231;&#227;o entre homens e mulheres foi pr&#243;xima de 1&#58;2&#44; principalmente em pessoas de meia&#8208;idade&#46; Ocorre frequentemente nas pontas dos dedos das m&#227;os&#44; especialmente nos polegares&#46; Os pacientes geralmente apresentam dor espont&#226;nea&#44; sensibilidade e hipersensibilidade ao frio&#46; Ambos os mediadores da dor IL&#8208;1&#946; e IL&#8208;6 foram altamente expressos em c&#233;lulas de TG de pacientes com e sem hipersensibilidade ao frio&#44; embora o CGRP n&#227;o tenha sido expresso em TG&#46;</p></span> <span id="abst0025" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0030">Limita&#231;&#245;es do estudo</span><p id="spar0025" class="elsevierStyleSimplePara elsevierViewall">Pequeno tamanho amostral&#59; mais pesquisas s&#227;o necess&#225;rias para explorar o mecanismo espec&#237;fico&#46;</p></span> <span id="abst0030" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0035">Conclus&#245;es</span><p id="spar0030" class="elsevierStyleSimplePara elsevierViewall">IL&#8208;1&#946; e IL&#8208;6 foram altamente expressos em c&#233;lulas de TG&#44; sugerindo que tenham certo papel nociceptivo no TG&#46; Nos quatro pacientes com intoler&#226;ncia ao frio&#44; a intensidade da express&#227;o de IL&#8208;1&#946; e IL&#8208;6 tamb&#233;m foi forte&#44; sugerindo que podem n&#227;o desempenhar papel na hipersensibilidade ao frio&#46; No entanto&#44; como haviam apenas quatro pacientes com intoler&#226;ncia ao frio&#44; &#233; necess&#225;rio realizar pesquisas mais aprofundadas utilizando amostra maior&#46; O papel espec&#237;fico do CGRP no TG ainda n&#227;o foi encontrado&#46;</p></span>"
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                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span><span class="elsevierStyleItalic">M&#233;dia &#40;varia&#231;&#227;o&#41;</span>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">6&#44;31 &#40;10 dias&#8208;30 anos&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleBold">Localiza&#231;&#227;o&#44; n</span>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span><span class="elsevierStyleItalic">D&#237;gito&#58; extrad&#237;gito</span>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">38&#58;22&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span><span class="elsevierStyleHsp" style=""></span>M&#227;os e artelhos&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">40&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span><span class="elsevierStyleHsp" style=""></span>Bra&#231;os e pernas&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">13&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span><span class="elsevierStyleHsp" style=""></span>Tronco&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">6&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span><span class="elsevierStyleHsp" style=""></span>Face&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">1&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span><span class="elsevierStyleItalic">M&#227;o esquerda&#58; m&#227;o direita</span>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">21&#58;17&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span><span class="elsevierStyleHsp" style=""></span>Polegar&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">8&#58;6&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span><span class="elsevierStyleHsp" style=""></span>Indicador&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">2&#58;3&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span><span class="elsevierStyleHsp" style=""></span>Dedo m&#233;dio&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">4&#58;3&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span><span class="elsevierStyleHsp" style=""></span>Indicador&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">3&#58;2&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span><span class="elsevierStyleHsp" style=""></span>Anelar&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">3&#58;2&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span><span class="elsevierStyleHsp" style=""></span>Palma da m&#227;o&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">1&#58;1&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span><span class="elsevierStyleItalic">Subungueal&#58; pele</span>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">21&#58;39&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleBold">Tamanho&#44; cm</span>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span><span class="elsevierStyleItalic">M&#233;dia &#40;varia&#231;&#227;o&#41;</span>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">0&#44;79 &#40;0&#44;1&#8208;3&#44;3&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleBold">Sintoma&#44; n</span>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span><span class="elsevierStyleItalic">Dor &#40;intoler&#226;ncia ao frio&#41;</span>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">58 &#40;4&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span><span class="elsevierStyleItalic">Indolor</span>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">2&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleBold">Patologia&#44; n</span>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span><span class="elsevierStyleItalic">Tumor gl&#244;mico s&#243;lido</span>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">33&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span><span class="elsevierStyleItalic">Glomangioma</span>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">27&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span><span class="elsevierStyleItalic">Glomangiomioma</span>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">0&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleBold">Diagn&#243;stico inicial&#44; n&#160;&#40;&#37;&#41;</span>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span><span class="elsevierStyleItalic">Tumor gl&#244;mico</span>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">38 &#40;63&#44;3&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span><span class="elsevierStyleItalic">Tumor vascular</span>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">8 &#40;13&#44;3&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span><span class="elsevierStyleItalic">Cisto</span>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">6 &#40;10&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span><span class="elsevierStyleItalic">Edema</span>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">3 &#40;5&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span><span class="elsevierStyleItalic">Granuloma piog&#234;nico</span>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">2 &#40;3&#44;3&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span><span class="elsevierStyleItalic">Fibroma</span>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
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Article information
ISSN: 26662752
Original language: Portuguese
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