Cancer is primarily a disease in which late diagnosis is linked to poor prognosis, and unfortunately, detection and management are still challenging. Circulating tumor cells (CTCs) are a potential resource to address this disease. Cell fusion, an event discovered recently in CTCs expressing carcinoma and leukocyte markers, occurs when ≥2 cells become a single entity (hybrid cell) after the merging of their plasma membranes. Cell fusion is still poorly understood despite continuous evaluations in in vitro/in vivo studies. Blood samples from 14 patients with high-grade serous ovarian cancer (A.C. Camargo Cancer Center, São Paulo, Brazil) were collected with the aim to analyze the CTCs/hybrid cells and their correlation to clinical outcome. The EDTA collected blood (6 mL) from patients was used to isolate/identify CTCs/hybrid cells by ISET. We used markers with possible correlation with the phenomenon of cell fusion, such as MC1-R, EpCAM and CD45, as well as CEN8 expression by CISH analysis. Samples were collected at three timepoints: baseline, after one month (first follow-up) and after three months (second follow-up) of treatment with olaparib (total sample = 38). Fourteen patients were included and in baseline and first follow-up all patients showed at least one CTC. We found expression of MC1-R, EpCAM and CD45 in cells (hybrid) in at least one of the collection moments. Membrane staining with CD45 was found in CTCs from the other cohort, from the other center, evaluated by the CellSearch® system. The presence of circulating tumor microemboli (CTM) in the first follow-up was associated with a poor recurrence-free survival (RFS) (5.2 vs. 12.2 months; p = 0.005). The MC1-R expression in CTM in the first and second follow-ups was associated with a shorter RFS (p = 0.005). CEN8 expression in CTCs was also related to shorter RFS (p = 0.035). Our study identified a high prevalence of CTCs in ovarian cancer patients, as well as hybrid cells. Both cell subtypes demonstrate utility in prognosis and in the assessment of response to treatment. In addition, the expression of MC1-R and EpCAM in hybrid cells brings new perspectives as a possible marker for this phenomenon in ovarian cancer.
Resumo: Drogas antineoplásicas são carcinogênicas, levam a potencial exposição e efeitos sobre a saúde do trabalhador da área da saúde que lida com elas, relacionado à toxicidade da droga e o nível de exposição. Na legislação brasileira, RDC 220 e NR32 colocam como boas práticas de administração destas drogas, o uso de avental impermeável de punho elástico e luvas cirúrgicas. Esta revisão teve como objetivos identificar as evidências sobre uso de EPI em terapia antineoplásica e evidências de níveis diferentes de exposição dos profissionais aos antineoplásicos, relacionados às fases da assistência de enfermagem. Os resultados mostraram que riscos da manipulação de drogas antineoplásicas, envolvem inalação de aerossóis; contato direto com pele e mucosas e ingestão de alimentos contaminados por resíduos desses agentes. Assim, recomendam-se práticas seguras de manuseio entre os profissionais envolvidos no cuidado direto com pacientes em tratamento antineoplásico, visando diminuição dos riscos eminentes às práticas de trabalho.Descritores: Biossegurança, Risco Ocupacional, Enfermagem Oncológica. Biosafety in oncology nursing: an integrative review
Background: The creation and evolution of research nurse, connected with some specialty, brings a new path to be covered and structured inside nursering. The position of Researcher Nurse was initially created decentralized only one Department. In past the years and after the role of work was being consolidating. This paper describes the creations and evolution of Research Nurses in the scene an Oncology Research Practice at a Cancer Center.
Drogas antineoplásicas são carcinogênicas, levam a potencial exposição e efeitos sobre a saúde do trabalhador da área da saúde que lida com elas, relacionado à toxicidade da droga e o nível de exposição. Na legislação brasileira, RDC 220 e NR32 colocam como boas práticas de administração destas drogas, o uso de avental impermeável de punho elástico e luvas cirúrgicas. Esta revisão teve como objetivos identificar as evidências sobre uso de EPI em terapia antineoplásica e evidências de níveis diferentes de exposição dos profissionais aos antineoplásicos, relacionados às fases da assistência de enfermagem. Os resultados mostraram que riscos da manipulação de drogas antineoplásicas, envolvem inalação de aerossóis; contato direto com pele e mucosas e ingestão de alimentos contaminados por resíduos desses agentes. Assim, recomendam-se práticas seguras de manuseio entre os profissionais envolvidos no cuidado direto com pacientes em tratamento antineoplásico, visando diminuição dos riscos eminentes às práticas de trabalho.Descritores: Biossegurança, Risco Ocupacional, Enfermagem Oncológica. Biosafety in oncology nursing: an integrative reviewAbstract: Antineoplastic drugs are carcinogenic, lead to potential exposure and health effects of the health care worker who deals with them, related to the toxicity of the drug and the level of exposure. In Brazilian law, DRC 220 and NR32 pose as good management practices of these drugs, the use of impervious apron elastic wrist and surgical gloves. This review aimed to identify the evidence on use of PPE in antineoplastic therapy and evidence of different levels of exposure of professionals to antineoplastic, related to the phases of nursing care. The results showed that the risks of handling antineoplastic drugs involve inhalation of aerosols; direct contact with skin and mucous membranes and ingestion of food contaminated by residues of these agents. So, are recommended safe handling practices among professionals involved in direct patient care in antineoplastic treatment, to decrease the eminent risk to the working practices. Descriptors: Biosecurity, Occupational Risk, Oncology Nursing. Bioseguridad en enfermería oncológica: una revisión integradoraResumen: Fàrmacs antineoplàsics són cancerígens, conduir a exposición i salut potencials efectes del treballador de la salut que s'ocupa d'ells, relacionat amb la toxicitat de la droga i el nivell d'exposición. En la llei brasilera, República Democràtica del Congo 220 i NR32 es fan passar per bones pràctiques de maneig d'aquests medicaments, l'ús d'un davantal impermeable canell elàstica i guants quirúrgics. Aquesta revisión va tenir com a objectiu identificar l'evidència sobre l'ús de PPE en la teràpia antineoplásica i proves de diferents nivells d'exposición dels professionals a antineoplàstic, relacionats amb les fases de l'atención d'infermeria. Els resultats van mostrar que els riscos de manipulación de fàrmacs antineoplàsics impliquen la inhalació d'aerosols; el contacte directe amb la pell i les membranes mucoses i la ingestión d'aliments contaminats per residus d'aquests agents. Per tant, es recomanen les pràctiques de maneig segur dels professionals involucrats en l'atenció directa al pacient en el tractament antineoplàstic, per disminuir el risc eminent per a les pràctiques de treball. Descriptores: Bioseguretat, Riesgo Laboral, Enfermería Oncológica.
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