RESUMO
BACKGROUND: It is suspected that infiltration of stem cell areas with high-grade glioma (HGG) generates a population that compromises treatment results and survival. In this prospective study we set to assess the prognostic value of the proximity of the contrast-enhancing lesion (CEL) on MRI to the subventricular zone (SVZ) and the expression of CXCR4 and nestin as potential factors in the stem cell migration pathway. METHOD: All patients diagnosed with high-grade glioma over a three-year period from a single institution were enrolled in this prospective study. Based on MRI preoperative findings, the patients were classified into 4 Groups (I-IV) according to the proximity of the CEL on MRI to the SVZ. Histological samples were assessed with immunohistochemistry for nestin and CXCR4. Classification into groups and the presence of nestin and CXCR4 were evaluated as predictive factors for overall (OS) and progression free survival (PFS). RESULTS: Fourty patients were included in the study. In multivariate analysis, Groups II, III and IV predicted longer OS in comparison to group I (p = 0.01; p < 0.01; p < 0.01 respectively) and group III and IV predicted longer OS in comparison to group II (p < 0.01; p = 0.04 respectively). Group III predicted longer PFS than group I and II (p = 0.01; p < 0.01 respectively). The expression rates of CXCR-4 and nestin could not predict OS or PFS. CONCLUSIONS: In our study the classification according to the proximity of the contrast enhancing part of the lesion and the SVZ proved to be prognostically significant for both OS and PFS. Presence of CXCR4 or nestin was not predictive for OS or PFS.
Assuntos
Neoplasias Encefálicas/mortalidade , Glioma/mortalidade , Nestina/metabolismo , Receptores CXCR4/metabolismo , Adulto , Idoso , Biomarcadores Tumorais/metabolismo , Neoplasias Encefálicas/patologia , Neoplasias Encefálicas/cirurgia , Intervalo Livre de Doença , Feminino , Glioma/patologia , Glioma/cirurgia , Grécia/epidemiologia , Humanos , Estimativa de Kaplan-Meier , Ventrículos Laterais/patologia , Masculino , Pessoa de Meia-Idade , Células-Tronco Neoplásicas/patologia , Procedimentos Neurocirúrgicos/mortalidade , Prognóstico , Estudos ProspectivosRESUMO
In order to prepare bioactive edible gel films with enhanced properties, the feasibility of using wheat flour as a raw material with glucose added at several concentrations was studied in this investigation. Films were prepared with glucose concentrations of 0.5, 0.7 and 1 g/g of flour and characterized for their physicochemical properties, including water content, solubility, degree of swelling, chemical structure by FT-IR (ATR) spectroscopy, morphology by SEM microscopy, thermal properties by DSC, gas and water vapor permeability and antioxidant activity. Biodegradation studies were also carried out in soil for 27 days and evaluated by weight loss measurements. It was found that the gel film with the higher glucose concentration exhibits a homogeneous and continuous structure with no cracks and no fragility, accompanied by an increased thickness and solubility and a decreased degree of swelling compared to those with lower concentrations. The chemical structure of all films was verified. Moreover, the increase in glucose content leads to better gas barrier properties with lower oxygen, CO2 and water vapor transmission rates and increased water vapor permeability. A slightly elevated melting temperature was observed in the films with higher glucose content. Higher antioxidant activity was also associated with higher percentage of glucose. Finally, the biodegradation of the films ranged from 13 to nearly 70%. Therefore, it can be concluded that the addition of glucose to wheat flour in concentration up to 1 g/g could result in edible gel films with excellent properties to be used in food packaging applications.