[The efficacy of radio-iodine-therapy in patients with differentiated form cancer of thyroid gland in various after thyroidectomy]. / Effektivnost' radioiodterapii bol'nykh s differentsirovannym rakom shchitovidnoi zhelezy v raznye sroki posle vypolneniia tireoidéktomii.

Results of treatment of 376 patients, ageing 18-76 yrs, were analyzed to investigate the radioiodine therapy (RITH) efficacy for the thyroid differentiated cancer depending on the term of its conduction after the operation. In patients with the thyroid gland residual tissue (THGRT) only the first course of RITH efficacy was 82.6-96.1%, the THGRT and metastases devitalization in regional lymph nodes and lungs was achieved in 72.7-81.6% of patients. The RITH courses number had constituted 2.5-6.3 at average and median summary activity for one patient--11-33.8 GBq. It was suggested that tendency for the courses number and summary activity enhancement in patients with regional and distant metastases was caused by the tumor tissue mass increase according to elongation the period of time between thyroidectomy and RITH conduction. It is necessary to determine the RITH conduction urgency, basing on the risk factors analysis.

[Analysis of efficacy of complex treatment of patients with differentiated forms of the thyroid gland cancer using distant radiation therapy]. / Analiz éffektivnosti kompleksnogo lecheniia bol'nykh s differentsirovannymi formami raka shchitovidnoi zhelezy s ispol'zovaniem distantsionnoi luchevoi terapii.

Retrospective analysis of efficacy of complex treatment, including surgical intervention, radioiodine therapy (RITH), suppressive hormonotherapy of differentiated forms of the thyroid gland cancer (DFTHGC) was done in 281 patients with positive effect of postoperative distant radiation therapy (PDRTH) application as a component of the treatment. Positive effect of therapy was estimated basing on the dynamic scintigraphy data with 131I and determination of thyroglobulin level in blood serum. The PDRTH conduction does not improve prognosis of the disease, does not lower the tumor metastasizing frequency to regional lymph nodes and remote organs and does not replace RITH. To achieve positive result in 12.8% of patients with PDRTH more than two courses of RITH were performed, enhancing so the total radiation dosage on the organism. To provide protracted nonrecurrent survival of patients with DFTHGC the radical approach is necessary, envisaging performance of thyroidectomy, the timely conduction of RITH with subsequent suppressive therapy using L-thyroxin.

[The importance of radionuclide tests in postop monitoring of patients with differentiated thyroid cancer]. / Znachenie radionuklidnogo issledovaniia v posleoperatsionnom monitoringe bol'nykh s differentsirovannym rakom shchitovidnoi zhelezy.

The results of postoperative dynamic examination of 270 patients with differentiated cancer (DC) of thyroid gland (TG) using radionuclide method were analysed. In 74.7% of patients the residual TG tissue was revealed, in 21.8%--the cancer metastases in cervical and mediastinal lymph nodes, in 2.6%--the distant metastases. Inradicalicity of the 1st operation in 14.1% of patients had caused the necessity of the reoperation performance in 43.1% of them. The radioiodine therapy performance after the operation was indicated in 65.5% of patients with DCTG, the distance radiation therapy--in 1.1%. The necessity of performance of postoperative radionuclide monitoring in patients with DCTG was established.

[Treatment and monitoring of patients with differentiated cancer of thyroid gland]. / Lechenie i monitoring bol'nykh s differentsirovannym rakom shchitovidnoi zhelezy.

There were examined 200 patients aged from 19 to 77 years with differentiated cancer of the thyroid gland (TG). The combined treatment, which included performance of operation, radioiodine therapy and hormonotherapy, was conducted to all the patients. Total and maximum subtotal TG resection was performed in 90% patients, nonradical operation--in 10%, 23% patients were reoperated. Postoperative monitoring according to chart was done with application of dynamic scintigraphy and determination of the thyroglobuline level in the blood serum. The TG residual tissue (RT) was revealed in 61% patients and in 39%--the cancer metastases in the lymphatic nodes. RT of TG was eliminated in 86.8% patients after the first radioiodine therapy course conduction in middle remedial activity (2.79 +/- 0.11) GBq, the metastases devitalization--in 67.9% in middle remedial activity (4.07 +/- 0.12) GBq.

[Importance of scintigraphy in the evaluation of surgical treatment outcome in differentiated cancer of the thyroid gland]. / Znachenie stsintigrafii v otsenke iskhoda khirurgicheskogo lecheniia differentsirovannogo raka shchitovidnoi zhelezy.

Experience of radionuclide investigation in 493 patients with differentiated cancer of thyroid gland is summarized. The consequences due to incorrect conducting of patients with cancer after the operation were adduced on distinct examples. The program for conducting and observation of patients with thyroid gland cancer after the operation conduction was proposed directed on the early diagnosis of recurrencies and metastases, determination of indications for radioiodine therapy.

[The effect of environmental factors on the concentration of tumor markers in the blood serum and on the indices characterizing thyroid function]. / Vliianie nekotorykh faktorov okruzhaiushchwei sredy na kontsentratsiiu v syvorotke krovi opukholevykh markerov i pokazateli, kharakterizuiushchie sostoianie shchitovidnoi zhelezy.

Combined versus separate exposure of male organism to cesium-137 and chemical agents results in a more pronounced hyperferritinemia in the former case. In female chemists the ferritin level is dependent to a considerable extent on the menstrual cycle showing a tendency for the iron-containing protein level to decrease because of the action of a number of chemical agents. The rise of the level of cancer embryonic antigen is more readily seen in persons with high levels of cesium-137. Concentrations of carbohydrate antigen (CA-125) and mucin-like antigen are appreciably higher in female chemists incorporating cesium-137, and in those within the 30-km radius of the ChNPP. The level of thyroglobulin was raised in the chemists having a background incorporation of cesium, the liquidators of the aftermaths, and particularly in those happened to be in the 30-km zone. Each of the unfavourable factors taken separately (chemical agent or cesium-137) had lesser effect on the degree of elevation of TG content and hormone-forming function of the thyroid gland. An additional information has been obtained concerning the risk groups, which, however, serves as an indirect measure of carcinogenic effect various environmental factors exert on the organism.

[A cytogenetic examination of persons subjected to radiation exposure in certain regions of Ukraine]. / Tsitogeneticheskoe obsledovanie lits, podvergshikhsia radiatsionnomu vozdeistviiu v nekotorykh regionakh Ukrainy.

We have summarized the results of cytogenetic studies of peripheral blood lymphocytes conducted in the institutions of Kiev and Kharkov in persons irradiated after the accident of the Chernobyl NPP. The average level of chromosomal aberrations and the appearance of cytogenetic markers characteristic of their irradiation effect was higher in the examinees in comparison with the control. The increase in the number of aberrations in certain Kiev residents as well as the development of lymphogranulomatosis in some liquidators of the accident were detected. The increase in the frequency of chromosomal aberrations in liquidators of the accident was accompanied by the reduction in the level of reparative DNA synthesis of blood lymphocytes. The necessity to expand cytogenetic examination in persons that participated in the liquidation of the accident on the ChNPP and Kiev inhabitants is discussed.

[Changes in the levels of tumor markers in those working with different chemically active substances]. / Izmenenie urovnei opukholevykh markerov u rabotaiushchikh s razlichnymi khimicheski aktivnymi veshchestvami.

Groups at risk for malignant neoplasia were identified among workmen occupationally exposed to different chemical substances, using immunoradiometric and enzyme immunoassays of tumor-associated antigens. Exposure to the above occupational hazard was found to affect the workmen and cause certain chronic illness accompanied by some increase in concentration of a number of tumoral markers. Increase in tumour antigens suggests indirectly that the chemical substances may have carcinogenic activity. We have every reason to recommend these tests as an additional method for identification of groups at high risk for subsequent development of tumours in the digestive system and reproductive organs of persons occupationally exposed to chemical substances.

[Radioimmunologic analysis of trypsin and C-peptide tumor markers for evaluation of treatment efficiency in patients with pancreatic and Vater's ampulla cancer]. / Ispolzovanie radioimmunologicheskogo analiza opukholevykh markerov, tripsina i C-peptida dlia otsenki éffectivnosti lecheniia bolnykh rakom podzheludochnoi zhelezy i bolshogo sosochka dvenadtsatiperstnoi kishki.

A radioimmunological analysis of the changes in concentration of tumour markers CA 19-9, REA, beta 2-microglobulin, trypsin and C-peptide was carried out in 53 patients with pancreatic cancer and in 14 patients with cancer of the major duodenal papilla before and 7-10 days after the treatment. A control group was comprised of 116 volunteers. The levels of the tumour markers decreased after the combined use of remote radiotherapy and pancreaticoduodenal resection (PDR). After creation of cholecysto-enteroanastomosis and performance of radiotherapy they remained without changes. Exocrine pancreatic function after remote radiotherapy, especially in combination with PDR, was sharply suppressed.

[Changes in the beta 2-microglobulin levels of the blood serum in patients with benign and malignant neoplasms]. / Izmenenie urovnia beta 2-mikroglobulina v syvorotke krovi bol'nykh s dobrokachestvennymi i zlokachestvennymi novoobrazovaniiami.

Radioimmunological examination of beta 2-microglobulin in the blood serum of 525 patients revealed that increased protein levels were observed in patients with malignant tumours of the pancreas, duodenal papilla, ovaries, soft tissues, lymphomas. In benign diseases (pancreatitis, ovarian cysts) the beta 2-microglobulin concentration did not significantly exceed the discrimination value. Due to the low sensitivity and specificity this protein has dubious significance as a tumour marker. It is suggested that in some cases of malignant tumours changes of the beta 2-microglobulin level may be related to hepatorenal insufficiency, spread of the disease. These data may provide supplementary information on the prognosis and evolution of the tumour process after combined treatment.

[CA 125 in the diagnosis and evaluation of the efficacy of the treatment of cancer of the ovaries]. / CA 125 dlia diagnostiki i otsenki éffektivnosti terapii raka iachnikov.

The paper is concerned with the results of CA-125 radioimmunoassay in 163 patients (584 tests) with benign and malignant ovarian diseases and other small pelvic diseases which were diagnosed before operation as ovarian tumors. CA-125 radioimmunoassay can be used in combination with other methods for investigation of patients with suspected ovarian cancer and for differential diagnosis of malignant ovarian tumors to distinguish them from other malignant tumors of the small pelvis. The total accuracy of the method, its sensitivity and specificity were 94.6%, 96.9 and 93.2%, respectively. CA-125 levels were considerably increased in malignant ovarian tumors irrespective of their histological structure. The investigation of CA-125 indices in the course of disease was indicative of the effectiveness of antitumor therapy.

[Diagnostic value of radioimmunological analysis of CA-19-9 in the blood serum in cancer of the pancreas]. / Diagnosticheskaia znachimos't radioimmunologicheskogo opredeleniia CA 19-9 v syvorotke krovi pri rake podzheludochnoi zhelezy.

The CA 19-9 antigen content was studied in 163 patients with pancreatic diseases by radioimmunologic method with the use of commercial test-kits ("Sorin", France). Pancreatitis was diagnosed in 67 patients, pancreatic cancer--in 23, cancer of the major duodenal papilla (MDP)--in 14, malignant neoplasms of the stomach, colon and rectum, liver--in 58. All the results were verified by morphologic studies. The control group included 22 donors. In patients with pancreatic cancer, the considerable increase in the CA 19-9 level was noted when compared with antigen content in the norm and in the other patients examined. The indices of CA 19-9 in pancreatitis don't differ from the normal ones. In MDP cancer and malignant tumours of other location with tumour invasion into the pancreas, the serum CA 19-9 level was increased.

[Radioimmunologic analysis of ferritin, carcinoembryonic antigen and prolactin for evaluating the prognosis and effectiveness of treating breast cancer]. / Radioimmunologicheskii analiz ferritina, rakogo-émbrional'nogo antigena i prolaktina dlia otsenki prognoza i éffektivnosti lecheniia raka molochnoi zhelezy.

The levels of tumor markers--CEA, ferritin and prolactin (the hormone of the anterior pituitary gland) were studied in the blood serum of 178 breast cancer patients in the menopause during combined therapy using a radioimmunoassay. This combination was shown to be informative for assessment of prognosis of disease and efficacy of antitumor therapy which was confirmed by clinical and x-ray findings and observation of a tumor process in breast cancer patients over a 5-year period.