Expression of vascular endothelial growth factor and microvascular density assessment in different histotypes of basal cell carcinoma.

PURPOSE: In this study, we investigated the expression of vascular endothelial growth factor (VEGF) and tumor microvascular density (MVD) in different histotypes of basal cell skin carcinoma (BCC). METHODS: We used a total 101 histological archival specimens, including superficial, nodular, cystic, keratinocytic, adenoid infiltrative types and cases of metatypical BCC. Routine hematoxylin/eosin (H&E) and immunohistochemical ABC method with NOT AE1/AE3, anti VEGF anti CD34 antibodies were used. VEGF expression in tumor cells was studied in relation to the BCC histotype and demographic characteristics. For statistical analysis ANOVA (F test), Student's t-test, and Karl Pearson coefficient were used. RESULTS: VEGF expression was significantly lower in the superficial histotype compared to all other types of BCC. No significant difference in VEGF expression between infiltrative, metatypical, adenoid and nodular types was found, but the highest expression of VEGF was seen in the infiltrative and metatypical types. Significantly higher MVD was found in infiltrative, adenoid, metatypical and nodular types. CONCLUSION: Our results suggest that the angiogenic potential of BCC correlated with tumor histotype, and histological growth pattern BCC enable distinction of the patients with increased risk of recurrence and / or metastasis.

Arteriovenous fistulas and digital hypoperfusion ischemic syndrome in patients on hemodialysis.

AIM: To determine survival parameters as well as characteristics of patients with this syndrome. METHODS: The investigation was conducted over a period of eight years, as a prospective, non-randomized, clinical study which included 204 patients, treated by chronic hemodialysis. Most patients received hemodialysis 12 h per week. As vascular access for hemodialysis all subjects had an arteriovenous fistulae. Based on surveys the respondents were divided into groups of patients with and without digital hypoperfusion ischemic syndrome. Gender, demographic and anthropometric characteristics, together with comorbidity and certain habits, were recorded. During this period 34.8% patients died. RESULTS: Patients with digital hypoperfusion ischemic syndrome were older than those without ischemia (P = 0.01). Hemodialysis treatment lasted significantly longer in the patients with digital hypoperfusion ischemic syndrome (P = 0.02). The incidence of cardiovascular disease (P < 0.001) and diabetes mellitus (P = 0.01), as well as blood flow through the arteriovenous fistula (P = 0.036), were higher in patients with digital hypoperfusion ischemic syndrome. Statistically significant differences also existed in relation to oxygen saturation (P = 0.04). Predictive parameters of survival for patients with digital hypoperfusion ischemic syndrome were: adequacy of hemodialysis (B = -3.604, P < 0.001), hypertension (B = -0.920, P = 0.018), smoking (B = -0.901, P = 0.049), diabetes mellitus (B = 1.227, P = 0.005), erythropoietin therapy (B = 1.274, P = 0.002) and hemodiafiltration (B = -1.242, P = 0.033). Kaplan-Meier survival analysis indicated that subjects with and without digital hypoperfusion ischemic syndrome differed regarding the length of survival (P < 0.001), i.e., patients with confirmed digital hypoperfusion ischemic syndrome died earlier. CONCLUSION: Survival was significantly longer in the patients without digital hypoperfusion ischemic syndrome.