Comparative evaluation of purine dysmetabolism in gastric and pulmonary adenocarcinomas.

AIM: To study the state of purine metabolism in gastric (GAC) and pulmonary (PAC) adenocarcinomas and to assess its clinical and pathogenetic significance. PATIENTS AND METHODS: One hundred and six male patients were examined, among whom were 63 subjects aged 34 to 79 suffering from GAC, and 43 subjects aged 24 to 76 suffering from PAC. In GAC, the ratio of the pyloric, corporeal and antral localization of the tumor and variant of overall gastric lesion accounted to 24:5:1:1; and that of the central and peripheral PAC was 2:1. Serum levels of purine metabolism products (uric acid, oxypurinol, adenine, guanine, xanthine, hypoxanthine) were measured and activities of xanthine oxidase, xanthine deaminase, adenosine deaminase and 5-nucleotidase were analyzed. RESULTS: Purine metabolism disorders are observed in all GAC and 91% of PAC patients; among other things, hyperuricemia is observed in ¾ and ½ of cases, respectively; moreover, the nature of changes is more pronounced in gastric cancer and, in both groups of patients, these indices reflect the disease course severity, are associated with the neoplastic process localization, have a predictive value, trigger the development of metastases. CONCLUSION: Сhanges in purine metabolism are involved in the pathogenetic patterns of GAC and PAC, reflect the course of the tumor process, are associated with tumor localization and have prognostic significance.

The Kі-67 marker for assessing the effectiveness of systemic or regional neoadjuvant polychemotherapy in patients with locally advanced breast cancer.

Over the past decades, breast cancer (BC) is the most common cancer and one of the key causes of mortality and disability among women in developed countries. AIM: Determination of the role of Ki-67 index in assessing the quality of neoadjuvant polychemotherapy treatment using regional or systemic delivery routes of pharmacological agents in patients with locally advanced breast cancer (LABC). MATERIALS AND METHODS: The retrospective analysis of 30 clinical trials of LABC treatment based on selective intra-arterial therapy in patients with BC (T4A-DN0-3M0) was used. RESULTS: The decrease in Ki-67 level in LABC after selective intra-arterial polychemotherapy was more pronounced than after systemic polychemotherapy. No correlation of the tumor metastatic potential with a Ki-67 level was detected. CONCLUSION: Assessment of Ki-67 expression allows to evaluate effectively the biological properties of the tumor, predict the course of the disease and choose the optimal tactics of neoadjuvant polychemotherapy (regional or systemic variant) as part of integrated antitumor treatment.

The state of bone metabolism in lung cancer patients.

In recent years, we have discussed the correlation of malignant tumor process with the development of osteoporosis, which can be exacerbated by ongoing chemotherapy and radiation therapy. The aim of the work was to assess the status of bone metabolism in 32 untreated patients with lung cancer without metastasis. MATERIALS AND METHODS: Patients underwent dual-energy X-ray osteodensitometry of proximal part of femoral bone. Osteopontin (OP), osteocalcin (OC) and alkaline phosphatase (AP) parameters were studied in blood, as well as osteo-associated chemical elements. RESULTS: Lung cancer proceeds with severe disorders of bone metabolism, which is accompanied by an increase in blood levels of OP, OС, AP, phosphorus, lithium, lead, strontium and cobalt against a decrease of calcium, magnesium and manganese, which were observed in 75; 78; 31; 100; 66; 47; 44; 3; 100; 100, and 6% of patients, respectively; such disorder was associated with a morphological variant of the tumor (cobalt) and stage of disease (calcium, magnesium, manganese, strontium), development of osteodeficit (OP, OC, AR, strontium, zinc). Osteodeficit in the form of osteopenia and osteoporosis is observed more common in women, in every second patient, and osteodensimetric T-score depends on the age of patients, directly correlates with the values of the OP and OC, and inversely - with a zincemia rate. CONCLUSIONS: The disorders of bone metabolism in patients with lung cancer indicate the need for the development of antiosteoporosis treatment for cancer patients.

Adsorption-rheological properties of blood serum in lung cancer patients.

The aim and objectives of the study were to investigate the state of adsorption-rheological properties of blood (ARPB) in patients with different clinical course of lung cancer (LC), the detection of violations of surface-active, viscoelastic and relaxation properties of blood serum, their association with tumor markers, the evaluation of the prognostic value of initial indexes in the development of complications from radiochemotherapy. PATIENTS AND METHODS: The study included 115 patients with LC at the age from 24 to 80 years (average age 58 years), among whom there were 78% men and 22% women. The parameters of surface (interfacial) viscosity, elasticity, viscoelasticity module, tension and relaxation of blood serum were studied by the oscillating drop method using a computer tensiometer "PAT2-Sinterface", and its volumetric viscosity was investigated using a Low-Shear-30 rotational viscometer. ARPB parameters were also studied in a control group composed from 50 healthy donors. RESULTS: Increased levels of volumetrical viscosity, surface tension, surface elasticity and the relaxation time of the blood are typical for patients with LC and depended on the localization of the tumor, its histological variant, differentiation grade, severity of the course of the disease, the number of metastases in the lymph nodes, distant organs and skeleton, involvement of the pleura and ribs, the development of compression pulmonary syndrome, metastasis into the spine, adrenals, brain, and pancreas. The surface-active, viscoelastic and relaxation properties of the blood correlated with the levels of tumor markers (TGFß1, VEGF, C-reactive protein, α2-macroglobulin). CONCLUSIONS: Integral changes of ARPB observed in every fifth patient with LC are involved in the pathogenesis of the disease, have predictive value in relation to the clinical course of disease (volumetric viscosity) and the development of complications from radiochemotherapy (surface viscosity).

Endothelial dysfunction of vessels at lung cancer.

AIM: To evaluate changes in indicators of endothelial function and their relationship with morphological forms of disease, stage of pathological process and tumor markers, by analysis the peripheral blood of lung cancer (LC) patients. MATERIALS AND METHODS: 38 LC patients without metastases (mean age - 57 years) prior chemo- and radiotherapy were included in the study. The duration of the disease manifestation was 18 months. 21% of patients had small cell LC, and the rest - non-small cell LC. The ratio of patients with stages IA, IB, IIA, IIB, IIIA and IIIB LC was 1 : 3 : 3 : 4 : 4 : 4. The enzyme immunoassay, spectrophotometry, and statistical data analysis were used. RESULTS: Endothelial dysfunction of vessels was characterized by increased blood levels of vascular endothelial growth factor (VEGF), endothelin-1 (ET1), homocysteine (HCys), cyclic guanosine monophosphate (cGMP), P-selectin (PSel) and nitrites (NO2) and simultaneously by decreased values of prostacyclin (PgI2). Those were observed in 100; 90; 76; 71; 50; 53 and 79% of LC cases, respectively. Disturbances of vascular endothelial function were associated with patient's age, disease duration, and morphological form and LC stage. Such changes were observed in women with higher prevalence. The studied indices correlated with tumor markers, namely transforming growth factor beta (TGFß1), fibronectin and osteopontin. CONCLUSION: Indices of vascular endothelial dysfunction in LC can be of diagnostic and prognostic value.

Markers of epithelial-mesenchymal transition in renal cell carcinoma.

AIM: To study the influence of markers of epithelial-mesenchymal transition (EMT) on a renal cell carcinoma (RCC) prognosis. METHODS: The surgical material of 47 RCC patients who underwent nephrectomy was studied. RCC patients were distributed in two groups: a short-term survival group (3-6 months) and a long-term survival group (17-24 months). EMT markers expression was assessed by immunohistochemical methods. RESULTS: It was determined that the rate of spindle-cell EMT was 96.4% in a short-term survival group and 42.1% in a long-term survival group. High rate Furhman's nuclear atypia, i.e. degree 3-4 occurred in 100% of cases in a short-term survival group versus 68.4% in a long-term survival group. CONCLUSION: The rate of spindle-cell EMT in RCC may serve a more sensible prognostic factor than the degree of Furhman's nuclear atypia.