Plasma levels of procalcitonin and eight additional inflammatory molecules in febrile neutropenic patients

OBJECTIVE: This study aimed to examine the association between different inflammatory markers and specific clinical endpoints in patients with febrile neutropenia. METHOD: We prospectively evaluated the expression of procalcitonin (PCT), interleukin 8 (IL-8), induced protein-10, tumor necrosis factor alpha (TNF-a), two soluble TNF-a receptors (sTNF-R I and sTNF-R II), monocyte chemotactic protein-1 (MCP-1), macrophage inflammatory protein-1 alpha, and eotaxin in 37 episodes of febrile neutropenia occurring in 31 hospitalized adult onco-hematologic patients. Peripheral blood samples were collected in the morning at inclusion (day of fever onset) and on days 1, 3, and 7 after the onset of fever. Approximately 2-3 ml of plasma was obtained from each blood sample and stored at -80°C. RESULTS: The sTNF-R II level at inclusion (day 1), the PCT level on the day of fever onset, and the change (day 3 - day 1) in the IL-8 and eotaxin levels were significantly higher in patients who died during the 28-day follow-up. A requirement for early adjustment of antimicrobial treatment was associated with higher day 3 levels of IL-8, sTNF-R II, PCT, and MCP-1. CONCLUSION: Procalcitonin, sTNF-R II, IL-8, MCP-1, and eotaxin could potentially be used to assess the risk of death and the requirement for early adjustment of antimicrobial treatment in febrile, neutropenic onco-hematologic patients. The levels of the other markers showed no association with any of the evaluated endpoints.

Carcinoma gástrico: avaliação comparativa das classificações de Laurén e Carneiro / Gastric carcinoma: comparative evaluation of Lauren and Carneiro classifications

A classificação do carcinoma gástrico (CG) segundo Laurén não tem valor prognóstico. Recentemente, Carneiro propôs uma modificação da classificação de Laurén, que distingue o CG misto com pior prognóstico. Nosso objetivo foi avaliar comparativamente as classificações de Lauren e Carneiro. Cento e cinqüenta CO foram revistos e analisados segundo as duas classificações, avaliando-se ainda estadiamento e lesões da mucosa gástrica. Cinqüenta e três pacientes foram seguidos por periodo máximo de 103 meses. Observamos correspondência entre CG intestinal e glandular, CO difuso e de células isoladas, CO não-classificável e misto. O CG sólido não diferiu significativamente do intestinal. Quanto à sobrevida, não houve diferença estatisticamente significativa entre os diferentes subtipos das duas classificações. Os dados não justificam a utilização da classificação de Carneiro, muito semelhante à de Laurén, embora deva ser realizada análise da sobrevida com maior amostra de pacientes.

Gastric carcinoma (GC) classification according to Laurén does not have prognostic significance. Recently, Carneiro proposed a modification of Lauren's classification, in which mixed tumors have worse prognosis. A comparative evaluation of both classifications. One hundred and fifty cases of GC are revised and analyzed according to both classifications is made, together with pTNM evaluation and gastric mucosal lesions. Fifty three patients were followed up for period from 3 to 103 months. A correspondence between intestinal and glandular types, diffuse and isolated cell types, and unclassified and mixed types was observed. Solid type was not significantly, different from intestinal type. There was no different in survival among the different groups on both classifcations.