RESUMO
Circulating tumor cells (CTCs) have a great potential as indicators of metastatic disease that may help physicians improve cancer prognostication, treatment and patient outcomes. Heterogeneous marker expression as well as the complexity of current antibody-based isolation and analysis systems highlights the need for alternative methods. In this work, we use a microfluidic Vortex device that can selectively isolate potential tumor cells from blood independent of cell surface expression. This system was adapted to interface with three protein-marker-free analysis techniques: (i) an in-flow automated image processing system to enumerate cells released, (ii) cytological analysis using Papanicolaou (Pap) staining and (iii) fluorescence in situ hybridization (FISH) targeting the ALK rearrangement. In-flow counting enables a rapid assessment of the cancer-associated large circulating cells in a sample within minutes to determine whether standard downstream assays such as cytological and cytogenetic analyses that are more time consuming and costly are warranted. Using our platform integrated with these workflows, we analyzed 32 non-small cell lung cancer (NSCLC) and 22 breast cancer patient samples, yielding 60 to 100% of the cancer patients with a cell count over the healthy threshold, depending on the detection method used: respectively 77.8% for automated, 60-100% for cytology, and 80% for immunostaining based enumeration.
Assuntos
Neoplasias da Mama/sangue , Carcinoma Pulmonar de Células não Pequenas/sangue , Separação Celular/métodos , Neoplasias Pulmonares/sangue , Microfluídica/métodos , Células Neoplásicas Circulantes/metabolismo , Quinase do Linfoma Anaplásico , Biomarcadores Tumorais/genética , Biomarcadores Tumorais/metabolismo , Estudos de Casos e Controles , Separação Celular/instrumentação , Feminino , Humanos , Hibridização in Situ Fluorescente/métodos , Células MCF-7 , Masculino , Microfluídica/instrumentação , Células Neoplásicas Circulantes/patologia , Teste de Papanicolaou/métodos , Receptores Proteína Tirosina Quinases/genética , Receptores Proteína Tirosina Quinases/metabolismoRESUMO
El presente artículo trata del cateterismo uretral inspirado en acciones de prevención y de cuidado integral a la persona. Se propone una guía técnica para el procedimiento con aportes de otras guías basadas en evidencia, además invita a la reflexión a partir del análisis de los riesgos que implica, especialmente los que tienen que ver con la infección urinaria, importante causa de la infección intrahospitalaria. De esta manera se quiere problematizar el papel y la responsabilidad del profesional de enfermería frente a este procedimiento, subrayando la necesidad de practicarlo de manera consciente, con un conocimiento profundo de las indicaciones, riesgos, manejo y medidas alternas que facilitan la eliminación urinaria. Se hace énfasis en los principios éticos de beneficencia no maleficencia como garantes de la calidad del cuidado de enfermería, expresada en el bienestar integral del paciente y su familia.