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.

MARKERS OF THE LUNG CANCER COMPLICATIONS.

Lung cancer (LC) occupies the first place in the structure of cancer morbidity and its prevalence is growing every year. Prognosis of LC course and its complications is a topical task of modern oncology. Further improvement of laboratory prognostic criteria for LC diagnosis and reliable markers of complications of the disease are necessary. Objective - to assess the significance of separate tumor markers in the context of diagnosis and prediction of LC complications. 1071 patients were examined (83% of men and 17% of women aged 24 to 86, average age - 59 years old). Central form of LC was found in 79% of the examined patients, peripheral - in 21% , small-cell histological variant of the disease was detected in 18% of cases and non-small-cell - in 82% (among which adenocarcinoma was detected in 47% of cases, squamous cell carcinoma - in 41%, large-cell carcinoma - in 12%). The ratio of IA, IB, IIA, IIB, III, III and IV stages of the disease was 1: 2: 4: 11: 117: 79: 120. In patients with LC there are increased values of such tumor markers as transforming growth factor ß1, vascular endothelial growth factor, C-reactive protein, osteopontin, osteocalcin, a2-macroglobulin, fibronectin, bulk viscosity of serum, its surface elasticity, tension and relaxation, which is determined by the form of the disease (central, peripheral), its histological variant (small-cell, adenocarcinoma, squamous cell and large-cell carcinoma), the degree of differentiation and the integrated severity of the tumor process, features of metastasis. With the studied immuno-biochemical and physico-chemical tumor adsorption-rheological markers, which correlate with each other, the nature of primary tumor complications (exudative pleurisy, compression syndrome, obstructive atelectasis) is closely related. Values of osteopontin and bulk viscosity have prognostic significance as to relatively unfavorable course of LC, and a high level of surface viscosity is a risk factor for possible complications of the disease.

Paraneoplastic syndrome in lung cancer.

AIM: To study the nature of different variants of paraneoplastic syndrome (PNPS) in lung cancer, taking into account the features of the tumorous process and the complications of radiochemotherapy. PATIENTS AND METHODS: We performed an analysis of the data of 1,669 patients with lung cancer aged between 24 and 87 years, among whom there were 89% of men and 11% of women. The ratio of small cell and non-small-cell histological variants of the lung cancer was 1: 4, IB, IIA, IIB, IIIA, IIIB and IV stages of cancer - 1:2:6:58:43:57. RESULTS: PNPS developed in 16% of the lung cancer patients, in these patients we have detected a marked increase in the disease incidence in women, the peripheral form of the tumor, the apical variant of Pancoast - Tobias and adenocarcinoma, but no cases of the median lower localization of the tumor. The number of the upper lobar pathology was decreased, while the severity of the cancer was significantly greater, which more often occurred with exudative pleurisy, germination of the tumor into the chest wall and compression of the upper vena cava. The 21 components of PNPS pathology were established. We distributed them conditionally into the musculoskeletal system lesions, variants of skin vasculitis and autoimmune processes, the nature of which depended on the localization and course of the tumorous process, its histological variation and severity of the course. Moreover, PNPS negatively affected the development of radiochemotherapy complications and worsened survival rate. CONCLUSIONS: The course of PNPS in lung cancer is highly diverse, being a risk factor for a severe tumorous process that worsens the survival of patients.

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.

[RHEOLOGICAL PROPERTIES OF BLOOD SERUM AT SYSTEMIC SCLEROSIS].

Systemic sclerosis (SSc) is accompanied by severe disorders of serum component of blood rheological properties (BRP), the study indicators of which performed as the monitoring of the therapeutic interventions effectiveness. BRP changes have not been established at different forms of SSc, the connection between physicochemical serum rheological properties and morphological signs of vascular skin lesions and extracardiac implications of the disease remains unknown. The purpose and objectives of the study - to evaluate the changes of BRP serum component with clinical and morphological variants of limited and diffuse form of SSc. The study included 63 patients with SSc in age from 16 to 67 years (mean 42 years), among whom there were 11% men and 89% women. In 43% of cases there was a limited form of the disease, in 57% - diffuse. The duration of the disease was 11 years. The I level activity of the pathological process is set at 41% of patients, II - at 38%, III - at 21%, anti-topoisomerase antibodies detected in serum at 78% of cases, antibodies to native deoxyribonucleic acid - at 64%, to cardiolipin - 18%. BRP is assessed by interfacial tensiometry with the determination of surface parameters. As the control parameters studied in 52 healthy people and 42 patients with limited scleroderma. Skin microincisional biopsy was performed in 37 patients. SSc is accompanied by violations of BRP, which is manifested by increasing viscoelasticity module parameters in 8% of patients, and the surface tension in 66% on the background of reducing surface elasticity level in 37%, and the latters two parameters of interfacial tensiometry differ not only from those in healthy people as well as in patients with limited scleroderma, and changes in the viscoelastic properties of the blood are prevalent in diffuse form of the disease compared to the limited form when there are dispersive correlation BRP with the severity of skin lesions and extradermal manifestations of SSc (heart, lung, kidney disease), and the elastic and relaxation serum characteristics have predictive value, respectively, in the cases of limited and diffuse forms of the disease. SSc occurs with disorders of serum level of BRP, which is more characteristic to the diffuse form of the disease and are closely related to the severity of skin and internal organs lesions, the indicators of which can be used to improve the assessment of the clinical course severity and prognosis of the individual signs of the disease.

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).

CHARACTERISTICS OF ARTICULAR SYNDROME IN SYSTEMIC VASCULITIS.

The purpose of the study - investigation the separate joint lesion in systemic vasculitis, their X-ray sonographic characteristics, the correlation of the articular syndrome severity with extra-articular manifestations of the diseases, as well as aspects of the arthritis pathogenesis in this category of patients. The study included 525 patients in the ratio of the examined with Henoch-Schonlen purpura, microscopic polyangiitis, cryoglobulinemic vasculitis, polyarteritis nodosa, Takayasu's arteritis, Wegener's granulomatosis with polyangiitis and eosinophilic granulomatosis with polyangiitis Churg-Strauss as a 7:4:3:1:1:1:1. Joint's damage in the form of arthritis or arthralgia observed in 32-67% different groups of patients, that depending on the disease duration, the degree of the pathological process's activity, extraarticular signs severity, lung parenchyma involving and hemodynamic status in the pulmonary circulation. The frequency of the certain bone lesions, existence of tenosynovitis and enthesopathies, X-ray sonographic signs of articular syndrome in different kind of vasculitis has its own gender dimorphism. The immune system malfunction, the rheological properties of blood and endothelial function of vessels collaborate in pathogenetic constructions of arthropathy. What is more, the high value of rheumatoid factor in blood associates with severe course of joint damage. Joint syndrome at different variants of systemic vasculitis is progressing in 1/3-2/3 of cases, this syndrome has definite features of clinical course and pathogenesis.

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.

[Changes in the dynamic surface tension of urine in lupiform glomerulonephritis]. / Zminy dynamichnogo poverkhnevogo natiagu sechi pry vovchakovomu glomerulonefryti.

As many as 54 patients with systemic lupus erythematosis presenting with the kidney damage and thirteen damage-free patients were studied for the dynamic surface tension (ST) of the urine with the aid of the computerized tensiometer MPT2. The condition is characterized by a drop in ST with the surface time equal to 1 second and a slope in the curve of tensiograms. The above findings have been secured in 53.7 and 71.6 percent respectively. In lupiform glomerulonephritis there is noted further lowering of the parameters. The proposed technique will, we believe, help in carrying out the differential diagnosis of the condition, assessment of the clinical course and degree of activity of the pathological process as well as in exercising control over efficiency of the therapeutic measures adopted.

[The central mechanisms regulating the blood circulation in hyperuricemia]. / Stan tsentral'nykh mekhanizmiv rehuliatsiï krovoobihu pry hiperurykemiï.

In experiments conducted on male Wistar rats for elucidation the role of central mechanisms in development alterations of heart electric stability was studied activity of 5(1)-nucleotidase and adenosine desaminase in sensomotor cortex, hypothalamus and hippocamp. Were shown that changes of heart function were in case increased adenosine content in neurons of sensomotor cortex, hypothalamus and hippocamp. Introduction to animals with hyperuricemia DOCA, with activate 5(1)-nucleotidase and adenosine desaminase, was accompanied by changes of cAMP and cGMP content in neurons. Developing alterations of heart electric stability suggest the responsibility of injury adenosine metabolism in different brain structures of animals with hyperuricemia in alterations of central regulatory mechanisms of systemic blood flow.

[Dynamic interphasic tensiometry of the blood in chronic hepatitis and liver cirrhosis]. / Dynamichna mizhfazna tenziometriia krovi pry khronichnomu hepatyti ta tsyrozi pechinky.

Studied with the aid of the computerized tensiometer MPT2-Lauda (Germany) was dynamic surface tension (ST) of blood serum in patients with chronic hepatitis (ChH), hepatic cirrhosis (HC), and in essentially healthy people, with n = 44, 32, and 68 respectively. ChH was shown to be accompanied by a significant increase in ST indices in the region of short (t = 0.01 sec) times of the surface life as well as by a decrease in that of medium (t = 1 sec) and long (t-->infinity) times. Rise in parameters of interphase tensiograms is a prognosis-negative sign with respect to the development of HC. Correlations have been established of indices of blood ST to its content of protein, lipid, and inorganic substances and to morphological signs of affection of the liver as well.