[Modern approaches to the components of multimodal antinociceptive protection in patients with ovarian cancer]. / Sovremennye podkhody k komponentam mul'timodal'noi antinotsitseptivnoi zashchity u bol'nykh rakom yaichnikov.

OBJECTIVE: The aim was to analyze the effectiveness of the inclusion of a stress-limiting metabolic component into multimodal anesthesia (MMA) in patients operated for ovarian cancer. METHODS: A randomized study of the effectiveness of several variants of MMA was conducted in 65 patients with ovarian cancer 55.6±10.3 years old. Prior to the operation, a two-sided TAR block was performed. Anesthesia was maintained by sevoflurane. Analgesia was realized with lidocaine, magnesium sulfate, fentanyl, and nonsteroidal anti-inflammatory drugs. The patients were divided into 2 groups. In the 1st (n=36) group, in order to expand the stress-limiting capabilities of MMA, before surgery, intraoperatively and in the next three days, Remaxol was included. In the 2nd (n=29) group, Remaxol was not used. Biochemical parameters were studied: POL/AOS, stress and antistress reactions, the content of C-reactive protein, haptoglobin and liver enzymes. RESULTS: Before the operation, the examined patients revealed dysregulation of the antioxidant system, endogenous intoxication (EI), intensification of the systemic inflammatory response, and fermentopathy. The results obtained in the groups depended on the nature of the MMA used. In the group where Remaxol was used as a metabolic component of MMA, there was a change in the dynamics of antistress reactions, characterized by a directed intergroup vector of increased resistance, with a predominance of the development of long-term adaptation processes, allowing to prevent the formation of disorders in the POL/AOS system, to reduce the concentration of acute phase proteins, fermentopathy. CONCLUSION: The introduction of Remaxol into MMA improves the quality of antinociceptive protection, promotes regression of POL products, and prevents the progression of hepatopathy and EI, contributing to the development of stress-limiting mechanisms of long-term adaptation in patients with ovarian cancer in the intra and near perioperative period.

Prediction of early recurrencies of uterine body cancer based on monitoring of serum biological markers.

The aim of this work was to optimize the prognosis of early recurrences of uterine cancer by searching for informative laboratory biomarkers. The study included 343 patients with I-IV stages FIGO endometrial adenocarcinoma the ages of 53 and 76 years. In patients before surgery, as well as 3 and 6 months after the end of primary treatment, the concentration of oncological markers CA-125, HE4, DJ-1, DKK-1 was determined in blood serum by ELISA and electrochemiluminescence immunoassay. We analyzed the predictive informativeness of monitoring markers to assess the risk of early recurrences of cancer within two years after surgery. In patients with uterine cancer with the stage of the disease and the degree of tumor differentiation in the blood serum, the concentration of DJ-1 is changed. With myometrial invasion of more than 50%, increased serum levels of three markers - CA-125, HE4, and DJ-1. Depending on the risk of disease recurrence, the assessment of which was determined by intraoperative and histological characteristics, a difference was revealed in the content of HE4 and DJ-1 markers in the blood. It was found that the risk of early recurrence of uterine cancer increased (p<0,05) when the concentration of CA-125 exceeded the level of 29,3 U/ml, HE4 was above 79,3 pmol/l, DJ-1 was above 90,0 ng/ml and DKK-1 above 47,3 pg/ml 6 months after the end of primary treatment. The highest predictive information value was found for monitoring DJ-1 and HE4 in blood serum, which indicates that they are promising for use in continuous monitoring of the course of cancer.