Assuntos
Anticorpos Anti-Idiotípicos/sangue , Cirrose Hepática/sangue , Miócitos de Músculo Liso/imunologia , Hepatopatia Gordurosa não Alcoólica/imunologia , Adulto , Anticorpos Anti-Idiotípicos/imunologia , Bilirrubina/sangue , Bilirrubina/imunologia , Feminino , Humanos , Fígado/imunologia , Fígado/metabolismo , Fígado/patologia , Cirrose Hepática/imunologia , Cirrose Hepática/patologia , Masculino , Miócitos de Músculo Liso/metabolismo , Hepatopatia Gordurosa não Alcoólica/sangue , Hepatopatia Gordurosa não Alcoólica/patologia , Tempo de Protrombina , Albumina Sérica , Triglicerídeos/sangue , Triglicerídeos/imunologiaRESUMO
BACKGROUND: The first-line treatment option for intermediate-stage hepatocellular carcinoma is trans-arterial chemoembolization (TACE). Blood indices, such as lymphocyte/monocyte ratio (LMR), lymphocyte count, neutrophil/lymphocyte ratio (NLR), platelet/lymphocyte ratio (PLR), monocyte-granulocyte/lymphocyte ratio (MGLR) and red blood cell distribution width (RDW), are prognostic biomarkers in certain diseases. The model for end-stage liver disease (MELD) and Child-Turcotte-Pugh (CTP) scores have been designed for patients with cirrhosis waiting for liver transplantation and in patients with hepatocellular carcinoma. We hypothesized possible roles for these blood indices, and the MELD and CTP scores as predictors for early recurrence of hepatocellular carcinoma after TACE. METHODS: Routine laboratory indices determined the NLR, LMR, MGLR, RDW, PLR, as well as MELD and CTP scores in 147 patients. Sensitivity and specificity of the indices for hepatocellular carcinoma recurrence 36 months after TACE were estimated by receiver operator characteristic curve. RESULTS: In multivariate regression analysis, only male sex, the lymphocyte count, CTP, the MGLR and the MELD score significantly (P < 0.01) predicted recurrence. The area under curve (AUC) for detection of recurrence for MGLR at a cut-off value 2.75 was 0.63 (95% CI 0.54-0.72) with sensitivity 70.7%, specificity 59.2% and accuracy 63%. The MELD score at cut-off value 9.5 had diagnostic performance with AUC 0.71 (0.63-0.79), sensitivity 80% and specificity 55.8% and accuracy 71.3%. CONCLUSIONS: High MGLR and MELD scores are linked to increasing frequency of hepatocellular carcinoma recurrence after TACE and could be used as novel, simple, non-invasive prognostic tests.
Assuntos
Carcinoma Hepatocelular/sangue , Neoplasias Hepáticas/sangue , Recidiva Local de Neoplasia/sangue , Prognóstico , Adulto , Idoso , Plaquetas/patologia , Carcinoma Hepatocelular/patologia , Quimioembolização Terapêutica/efeitos adversos , Feminino , Granulócitos/patologia , Humanos , Neoplasias Hepáticas/patologia , Contagem de Linfócitos , Linfócitos/patologia , Masculino , Pessoa de Meia-Idade , Monócitos/patologia , Recidiva Local de Neoplasia/patologia , Neutrófilos/patologiaRESUMO
This study was suggested to evaluate the possible role of porphyrins and DNA, and their interaction, in some photosensitive premalignant and malignant dermatoses. Twenty-five patients with photosensitive skin diseases viz. xeroderma pigmentosum and basal cell carcinoma, were randomly selected at the outpatient clinic of Dermatology in Mansoura University Hospital. Twenty-five matched normal individuals were used as a control group. In basal cell carcinoma patients, a high increase in skin DNA and decrease in skin total porphyrin, haemoglobin and haem concentrations were observed. In xeroderma pigmentosum, a significant decrease in both skin DNA and skin total porphyrin were found, at the same time, there were elevations in urinary total porphyrin, PBG and ALA concentrations, and a high decrease in haemoglobin and haem levels.
