Assuntos
Envelhecimento Saudável/fisiologia , Planejamento de Assistência ao Paciente , Saúde Pública , Idoso , Idoso de 80 Anos ou mais , Envelhecimento/genética , Envelhecimento/patologia , Pesquisa Biomédica/métodos , Pesquisa Biomédica/tendências , Senescência Celular/genética , Política de Saúde , Saúde Holística/legislação & jurisprudência , Saúde Holística/tendências , Humanos , Doenças Neurodegenerativas/genética , Planejamento de Assistência ao Paciente/legislação & jurisprudência , Planejamento de Assistência ao Paciente/tendências , Dinâmica Populacional/tendências , Saúde Pública/legislação & jurisprudência , Saúde Pública/normas , Encurtamento do Telômero/fisiologiaRESUMO
Circulating tumors cells (CTCs) can be detected in the blood of metastatic melanoma patients (MMPs) both as isolated circulating tumor cells (iCTCs) and circulating tumor microemboli (CTMs), but their clinical significance remains unknown. The aim of this work was to evaluate the prognostic impact in metastatic cutaneous melanoma of CTMs and iCTCs identified by a cytomorphological approach using the isolation by size of tumor cell (ISET) method. We characterized the phenotype of CTCs using anti-PS100, anti-SOX10, anti-CD10, and anti-TRF2 antibodies. 128 MMPs and 37 control healthy individuals with benign nevi were included in this study. Results were compared to the follow-up of patients. 109/128 (85%) MMPs showed CTCs, 44/128 (34%) with 2 to 6 CTMs and 65/128 (51%) with 4 to 9 iCTCs. PS100 expression was homogeneous in iCTCs and heterogeneous in CTMs. SOX10, CD10, and TRF2 were mainly expressed in CTMs. None of the control subjects demonstrated circulating malignant tumor cells. Overall survival was significantly decreased in patients with CTMs, independently of the therapeutic strategies. In conclusion, the presence of CTMs is an independent predictor of shorter survival from the time of diagnosis of MMPs.