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Vivian Resendehttp://lattes.cnpq.br/1290681403759825Antônio Nocchi KalilMarcelo Moura LinharesLuciana Costa FariaEduardo Paulino JuniorVivian ResendeFrancisco Guilherme Cancela e PennaEvandro Luis de Oliveira Costahttp://lattes.cnpq.br/5133386534647747Leonardo do Prado Lima2023-02-01T13:09:29Z2023-02-01T13:09:29Z2022-10-26http://hdl.handle.net/1843/49345A expressão de marcadores biomoleculares de células tronco no carcinoma hepatocelular (CHC) tem sido associada a mau prognóstico e ao comportamento biológico agressivo. Tumores que expressam citoqueratina 19 (CK19), um biomarcador de células tronco, são tidos como agressivos levando a menor sobrevida geral e livre de doença. O objetivo dessa pesquisa foi verificar a expressão de CK19, por meio de análise imuno-histoquímica, em 87 pacientes (61 homens e 26 mulheres) submetidos à ressecção de CHC com intenção curativa. Todos os pacientes incluídos no estudo tinham função hepática preservada. A expressão imuno-histoquímica de CK19 foi positiva em 12 pacientes (15%), nos quais em 9 (75%) a EpCAM foi positiva. A média dos valores de alfafetoproteína foi de 5637,77+/-30,53(min.1,68; max.199.000,00) e a mediana de 13,97 (IQ: 4,2; IIIQ: 212). Hepatite por vírus C foi a principal etiologia da cirrose nos pacientes (40,22%) seguido pelo vírus B (22,98%). O CHC esteve presente em 19 pacientes (21,84%) com fígado não cirrótico e em 13 (14,94%) a etiologia foi etanólica. A maioria dos pacientes foi submetida a hepatectomia menor e a necessidade de hemotransfusão per-operatória ocorreu em 32% dos pacientes. A mortalidade per-operatória foi de 12,64%. O tempo médio de internação foi de 6,87 (min 3; max 33) dias. Os CHCs foram, na maioria, bem diferenciados. Invasão angiolinfática esteve presente em 44 (50,57%) dos tumores. Não houve associação entre a marcação positiva para CK19 e as variáveis analisadas. A sobrevida geral após ressecção do carcinoma hepatocelular foi de 83,4 % em 12 meses, 66,7% aos 36 meses e 44,3% aos 60 meses. A sobrevida livre de doença foi de 73,8% em 12 meses, 37,8% aos 36 meses e 27,7% aos 60 meses. Não houve associação positiva entre a expressão de CK19 com a sobrevida geral ou sobrevida livre de doença. O numero de nódulos maior que 3 teve impacto negativo na curva de sobrevida geral e livre de doença (p=0,033 e p=0,004). Em conclusão, o maior número de nódulos teve impacto negativo na sobrevida geral e livre de doença, enquanto a positividade para CK19 não apresentou associação com a sobrevida dos pacientes.The expression of biomolecular stem cell markers in hepatocellular carcinoma (HCC) has been associated with poor prognosis and aggressive biological behavior. Tumors that express cytokeratin 19 (CK19), a stem cell biomarker, are considered aggressive, leading to lower overall and disease-free survival. The objective of this research was to verify the expression of CK19, through immunohistochemical analysis, in 87 patients (61 men and 26 women) who underwent resection of HCC with curative intent. All patients included in the study had preserved liver function. The immunohistochemical expression of CK19 was positive in 12 patients (15%), in which 9 (75%) EpCAM was positive. The mean alpha-fetoprotein values were 5637.77+/-30.53 (min.1.68; max.199,000.00) and the median was 13.97 (IQ: 4.2; IIIQ: 212). Virus C hepatitis was the main etiology of cirrhosis in patients (40.22%) followed by virus B (22.98%). HCC was present in 19 patients (21.84%) with non-cirrhotic liver and in 13 (14.94%) the etiology was ethanolic. Most patients underwent minor hepatectomy and the need for perioperative blood transfusion occurred in 32% of patients. The perioperative mortality was 12.64%. The mean length of hospital stay was 6.87 (min 3; max 33) days. Most CHCs were well differentiated. Angiolymphatic invasion was present in 44 (50.57%) of the tumors. There was no association between positive CK19 expression and the variables analyzed. Overall survival after resection of hepatocellular carcinoma was 83.4% in 12 months, 66.7% at 36 months and 44.3% at 60 months. Disease-free survival was 73.8% in 12 months, 37.8% at 36 months and 27.7% at 60 months. There was no positive association between CK19 expression and overall survival or disease-free survival. The number of nodules greater than 3 had a negative impact on the overall and disease-free survival curve (p=0.033 and p=0.004). In conclusion, the greater number of nodules had a negative impact on overall and disease-free survival, while CK19 positivity was not associated with patient survival.CNPq - Conselho Nacional de Desenvolvimento Científico e TecnológicoporUniversidade Federal de Minas GeraisPrograma de Pós-Graduação em Ciências Aplicadas à Cirurgia e à OftalmologiaUFMGBrasilMED - DEPARTAMENTO DE CIRURGIAPrograma Institucional de Internacionalização – CAPES - PrIntCarcinoma HepatocelularQueratinasCélulas-Tronco NeoplásicasImuno-HistoquímicaCarcinoma hepatocelularCitoqueratina 19Células tronco cancerosasImuno-histoquímicaExpressão do biomarcador de células tronco (CK19) - análise de sobrevida geral e livre de doença em pacientes com carcinoma hepatocelular ressecadosinfo:eu-repo/semantics/publishedVersioninfo:eu-repo/semantics/doctoralThesisinfo:eu-repo/semantics/openAccessreponame:Repositório Institucional da UFMGinstname:Universidade Federal de Minas Gerais (UFMG)instacron:UFMGORIGINALEXPRESSÃO DO BIOMARCADOR DE CÉLULAS TRONCO (CK19) – ANÁLISE DE SOBREVIDA GERAL E LIVRE DE DOENÇA EM PACIENTES COM CARCINOMA HEPATOCELULAR RESSECADOS.pdfEXPRESSÃO DO BIOMARCADOR DE CÉLULAS TRONCO (CK19) – ANÁLISE DE SOBREVIDA GERAL E LIVRE DE DOENÇA EM PACIENTES COM CARCINOMA HEPATOCELULAR RESSECADOS.pdfapplication/pdf4558158https://repositorio.ufmg.br/bitstream/1843/49345/3/EXPRESSA%cc%83O%20DO%20BIOMARCADOR%20DE%20CE%cc%81LULAS%20TRONCO%20%28CK19%29%20%e2%80%93%20ANA%cc%81LISE%20DE%20SOBREVIDA%20GERAL%20E%20LIVRE%20DE%20DOENC%cc%a7A%20EM%20PACIENTES%20COM%20CARCINOMA%20HEPATOCELULAR%20RESSECADOS.pdfab6b4379902c54076d27935e02dde5c8MD53LICENSElicense.txtlicense.txttext/plain; charset=utf-82118https://repositorio.ufmg.br/bitstream/1843/49345/4/license.txtcda590c95a0b51b4d15f60c9642ca272MD541843/493452023-02-01 10:09:30.113oai:repositorio.ufmg.br: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ório InstitucionalPUBhttps://repositorio.ufmg.br/oaiopendoar:2023-02-01T13:09:30Repositório Institucional da UFMG - Universidade Federal de Minas Gerais (UFMG)false
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