RESUMO
Vascular endothelial growth factor (VEGF) is an important mediator of vascular development in tumors. We aimed at clarifying the relationship between VEGF mRNA expression and invasion or metastasis of hepatocellular carcinoma (HCC). Reverse transcript-polymerase chain reaction (RT-PCR) was carried out on surgical specimens of 48 patients with HCC. The relative levels of VEGF mRNA expression were measured by determining a ratio between PCR products of VEGF and the endogenous internal standard gene beta-actin. Expression of VEGF mRNA in tumor was found in 76.5% (39/51) of patients, whereas it was 21.69% (11/51) in non tumorous liver. The levels of VEGF mRNA expression in tumors with tumorous emboli and in poor-encapsulated tumors were higher than that without tumorous emboli and in well-encapsulated tumors respectively (p < 0.05 t test). There was no significance in the expression of VEGF mRNA between large HCC (diameter > 5cm) and small HCC (diameter < or = 5cm) (p > 0.05). VEGF may play an important role in the invasion and metastasis of HCC. Angiogenesis in tumor correlates with progression of HCC.
Assuntos
Carcinoma Hepatocelular/genética , Fatores de Crescimento Endotelial/genética , Regulação Neoplásica da Expressão Gênica , Neoplasias Hepáticas/genética , Linfocinas/genética , Proteínas de Neoplasias/genética , RNA Mensageiro/biossíntese , RNA Neoplásico/biossíntese , Adulto , Idoso , Carcinoma Hepatocelular/irrigação sanguínea , Carcinoma Hepatocelular/metabolismo , Carcinoma Hepatocelular/patologia , Progressão da Doença , Fatores de Crescimento Endotelial/biossíntese , Feminino , Humanos , Neoplasias Hepáticas/irrigação sanguínea , Neoplasias Hepáticas/metabolismo , Neoplasias Hepáticas/patologia , Linfocinas/biossíntese , Masculino , Pessoa de Meia-Idade , Invasividade Neoplásica , Metástase Neoplásica , Proteínas de Neoplasias/biossíntese , Células Neoplásicas Circulantes , Neovascularização Patológica , Reação em Cadeia da Polimerase , Fator A de Crescimento do Endotélio Vascular , Fatores de Crescimento do Endotélio VascularRESUMO
BACKGROUND: A good blood bank must be able to provide compatible blood units promptly to operating room patients with minimal wastage. A "self-service" by nursing staff blood banking system that is safe, efficient, and well-accepted has been developed. STUDY DESIGN AND METHODS: Specific blood units are no longer assigned to surgical patients who have a negative pretransfusion antibody screen, irrespective of the type of surgery. A computer-generated list of the serial numbers of all group-identical blood units currently in the blood bank inventory is provided for each patient. The units themselves are not labeled with a patient's name. The group O list will be provided for group O patients, the group A list for group A patients, and so forth. Should the patient require transfusion during surgery, the operating room nurses go to the refrigerator, remove any group-identical unit, and check the serial number of the unit against the serial numbers on the patient's list. If the serial number is on that list, the blood bank will accept responsibility for compatibility. The system was implemented in 1995. RESULTS: Since implementation, a total of 2154 patients have undergone operations at this hospital. Thirty-two patients received more than 10 units of red cells each. There were no transfusion errors. The crossmatch-to-transfusion ratio was reduced from 1.67 to 1.12. Turnaround time for supplying additional or urgent units to patients in operating room was shortened from 33 to 2.5 minutes. There was no incidence of a blood unit's serial number not being on the list. Work by nurses and technical staff was reduced by nearly 50 percent. CONCLUSION: The "self-service" (by nursing staff) blood banking system described is safe and efficient. It saves staff time and can be easily set up.
