RESUMO
Deep venous thrombosis (DVT) is a common surgical complication in cancer patients and evidence that inflammation plays a role in the occurrence of DVT is increasing. We studied a population of cancer patients with abdominal malignancies with the aim of investigating whether the levels of circulating inflammatory cytokines were associated with postoperative DVT, and to determine the levels in DVT diagnoses. The serum levels of C-reactive protein (CRP), interleukins (IL)-6 and IL-10, nuclear transcription factor-κB (NF-κB) and E-selectin (E-Sel) were determined in 120 individuals, who were divided into 3 groups: healthy controls, patients with and patients without DVT after surgery for an abdominal malignancy. Data were analyzed by ANOVA, Dunnet's T3 test, chi-square test, and univariate and multivariate logistic regression as needed. The CRP, IL-6, NF-κB, and E-Sel levels in patients with DVT were significantly higher than those in the other groups (P<0.05). The IL-10 level was higher in patients with DVT than in controls but lower than in patients without DVT. Univariate analysis revealed that CRP, IL-6, NF-κB, and E-Sel were statistically associated with the risk of DVT (OR=1.98, P=0.002; OR=1.17, P=0.000; OR=1.03, P=0.042; and OR=1.38, P=0.003; respectively), whereas IL-10 had a protective effect (OR=0.94, P=0.011). Multivariate analysis showed that E-Sel was an independent risk factor (OR=1.41, P=0.000). Thus, this study indicated that an increased serum level of E-Sel was associated with increased DVT risk in postoperative patients with abdominal malignancy, indicating that E-Sel may be a useful predictor of diagnosis of DVT.
Assuntos
Adulto , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Neoplasias Abdominais/cirurgia , Mediadores da Inflamação/metabolismo , Trombose Venosa/etiologia , Neoplasias Abdominais/sangue , Proteína C-Reativa/análise , Estudos de Casos e Controles , Citocinas/sangue , Selectina E/sangue , /sangue , /sangue , NF-kappa B/sangue , Período Pós-Operatório , Medição de Risco , Fatores de RiscoRESUMO
Deep venous thrombosis (DVT) is a common surgical complication in cancer patients and evidence that inflammation plays a role in the occurrence of DVT is increasing. We studied a population of cancer patients with abdominal malignancies with the aim of investigating whether the levels of circulating inflammatory cytokines were associated with postoperative DVT, and to determine the levels in DVT diagnoses. The serum levels of C-reactive protein (CRP), interleukins (IL)-6 and IL-10, nuclear transcription factor-κB (NF-κB) and E-selectin (E-Sel) were determined in 120 individuals, who were divided into 3 groups: healthy controls, patients with and patients without DVT after surgery for an abdominal malignancy. Data were analyzed by ANOVA, Dunnet's T3 test, chi-square test, and univariate and multivariate logistic regression as needed. The CRP, IL-6, NF-κB, and E-Sel levels in patients with DVT were significantly higher than those in the other groups (P<0.05). The IL-10 level was higher in patients with DVT than in controls but lower than in patients without DVT. Univariate analysis revealed that CRP, IL-6, NF-κB, and E-Sel were statistically associated with the risk of DVT (OR=1.98, P=0.002; OR=1.17, P=0.000; OR=1.03, P=0.042; and OR=1.38, P=0.003; respectively), whereas IL-10 had a protective effect (OR=0.94, P=0.011). Multivariate analysis showed that E-Sel was an independent risk factor (OR=1.41, P=0.000). Thus, this study indicated that an increased serum level of E-Sel was associated with increased DVT risk in postoperative patients with abdominal malignancy, indicating that E-Sel may be a useful predictor of diagnosis of DVT.
Assuntos
Neoplasias Abdominais/cirurgia , Mediadores da Inflamação/metabolismo , Trombose Venosa/etiologia , Neoplasias Abdominais/sangue , Adulto , Proteína C-Reativa/análise , Estudos de Casos e Controles , Citocinas/sangue , Selectina E/sangue , Feminino , Humanos , Interleucina-10/sangue , Interleucina-6/sangue , Masculino , Pessoa de Meia-Idade , NF-kappa B/sangue , Período Pós-Operatório , Medição de Risco , Fatores de RiscoRESUMO
The aim of this study was to evaluate plasma levels of ANF in patients with catecholamine-secreting tumors with and without hypertension and to relate ANF secretion to levels of plasma and urinary catecholamines and blood pressure. Twenty-one pheochromocytoma (15 with sustained, 6 with paroxysmal hypertension), 6 neuroblastoma (1 hypertensive) patients and 28 aged-matched controls were studied in basal conditions. Plasma and urinary norepinephrine (NE),epinephrine (E), dopamine (DA) and DOPA were determined by HPLC-ED and plasma ANF by RIA. Both neuroblastoma and pheochromocytoma patients had significantly higher plasma ANF levels than controls. Neuroblastomas showed higher ANF concentration than pheochromocytomas. No differences were found in plasma ANF between hypertensive and normotensive patients. Pheochromocytomas with ANF levels within the normal range had plasma and urinary NE and urinary DA and DOPA levels significantly higher than patients with high ANF. Plasma ANF levels were unrelated to systolic or diastolic blood pressure or heart rate. A negative correlation between plasma ANF and urinary DA was found only in the patients groups. In conclusion, plasma ANF was increased in pheochromocytoma and neuroblastoma patients. Our data suggest that the excessive catecholamine secretion is not responsible for the increased ANF secretion in these patients. The significance of the relationships among plasma ANF and urinary and plasma catecholamines requires further investigation.
Assuntos
Neoplasias das Glândulas Suprarrenais/sangue , Fator Natriurético Atrial/sangue , Catecolaminas/sangue , Neuroblastoma/sangue , Feocromocitoma/sangue , Neoplasias Abdominais/sangue , Neoplasias Abdominais/secundário , Adolescente , Neoplasias das Glândulas Suprarrenais/patologia , Adulto , Idoso , Biomarcadores Tumorais/sangue , Biomarcadores Tumorais/urina , Pressão Sanguínea , Catecolaminas/urina , Criança , Pré-Escolar , Feminino , Humanos , Hipertensão/sangue , Hipertensão/urina , Masculino , Pessoa de Meia-Idade , Neoplasia Endócrina Múltipla/sangue , Neoplasia Endócrina Múltipla/secundário , Estadiamento de Neoplasias , Neuroblastoma/patologia , Feocromocitoma/patologia , Neoplasias da Bexiga Urinária/sangue , Neoplasias da Bexiga Urinária/secundárioRESUMO
We report the laboratory findings from studies carried out on 37 pheochromocytoma patients; (20 males and 17 females whose age ranged from 11 to 55 years). Among the parameters measured, fasting hyperglycemia was one of the alterations most frequently encountered (59%), the difference with the normal values was highly significant (p less than 0.001). The levels found for the other parameters measured were also elevated in some cases and the difference between them and the normal values was statistically significant, the assays included were serum cholesterol and creatinine, haemoglobin, hematocrit and white blood cell and platelet counts. The response to the oral glucose load was normal in 9 patients, 6 showed a diabetic curve and 2 had a glucose intolerance response. Data from our observations and from the literature shows that these alterations may be a source of erroneous diagnosis, mainly in cases where symptoms are atypical or infrequent such as fever of unknown etiology, shock and others. Therefore recognizing these abnormalities as a sign of pheochromocytoma is very important both from the diagnostic and therapeutic points of view.