Finding possible diagnostic markers for differentiating benign and malignant thyroid tumors on example investigate of rheological properties1.

BACKGROUND: The functioning of the thyroid gland is a multi-component process that in some conditions may undergo alterations. The thyroid gland is part of the endocrine system that produces the iodine-containing hormones thyroxine and triiodothyronine. Thyroid hormones, control metabolism and energy, growth processes, maturation of tissues and organs, regulation of blood flow, and, therefore, providing vital functions of the body. The role of thyroid hormones in the regulation of blood flow is determined by the intensity of their production and the quantity in the blood. Presumably, in case of oncological and non-oncological diseases of the thyroid gland, the fluidity of the blood, which depends on the rheological properties, will be different. OBJECTIVE: Our aim was investigating rheological characteristics for studying of changes of rheology in patients with thyrotoxicosis, with benign tumor pathology of the thyroid gland, with thyroid cancer and finding possible diagnostic markers for differentiating benign and malignant thyroid tumors. METHODS: In this regard, we examined, using modern methods accepted in clinical practice, a standard list of recommended diagnostic tests in the group of patients (thyrotoxicosis: n = 25; benign tumor: n = 47), thyroid cancer: n = 35) and control group (n = 15), and with new original methods, parameters that describe the rheological properties of the blood, such as blood rheological index, volume, thickness, surface area of erythrocytes, erythrocyte aggregation index, deformation index, plasma viscosity, hematocrits. RESULTS: Against the background of relative changes in the studied values, it is necessary to pay attention to the fact that erythrocyte aggregation in patients with a benign form and control, as well as in patients with a malignant form and control, differ significantly from each other, in addition, there is a significant difference between aggregation in the group of patients with benign and control aggregation. malignant forms of the disease. It is significant that aggregability differs in patients with thyrotoxicosis and in controls. This indicates that erythrocyte aggregation is particularly informative. The blood rheological index most clearly demonstrated the difference between benign and malignant forms of the disease. Significantly changed compared to control in various forms of thyroid diseases. CONCLUSION: Additional diagnostic markers for differentiating benign and malignant thyroid tumors may be consideredeerythrocyte aggregation index and blood rheological index.

Hemorheological, microvascular and hemodynamic disorders during coronary heart disease.

Significance of the hemorheological disorders in development of acute vascular syndromes is presently well known, but their role in pathogenesis of chronic coronary heart disease has not been yet sufficiently analyzed. Aim of the present study was the investigation of the relationship between the hemorheological, vascular and hemo-dynamic factors responsible for development of the coronary heart disease. We investigated 64 patients with coronary heart disease of the functional classes I-IV with and without the heart failure. For evaluation of the hemorheological disorders we investigated its most significant symptom, the erythrocyte aggregability, with the "Georgian technique" that provided us with direct and quantitative data. We investigated also the tone of the hand's resistance arteries with an original non-invasive technique based on measurement of the flow velocity changes in the patients and in the healthy controls radial arteries by using the Doppler technique during standardized postischemic hyperemia. Echocardiographically we studied the standard characteristics of left ventricular function (systolic and diastolic volume, its mass and ejection fraction). ECG by standard leads and the blood pressure were investigated in all patients. We found that the rheological disorders are manifested in the early stages of the disease before its functional manifestation. The most pronounced hemorheological disorders were in evidence in the patients with unstable angina and heart failure. As to the arteriolar resistance index, it was increased only in 45 per cent of all the investigated patients and no significant difference between the patients with the heart failure and without it was found. There was a negative relationship between erythrocyte aggregability and the ejection fraction of the left ventricle and the positive correlation between erythrocyte aggregability and left ventricle hypertrophy (p<0.01). We concluded that the blood rheological disorders represent themselves a factor that plays a significant role in pathogenesis of the coronary heart disease. They are predictors of the disease and not only risk factors as it is generally believed. Measurement and correction of these disturbances in its early stages have a high clinical significance.

Hemorheological disorders and arteriolar resistance during ischemic heart disease.

It could be conjectured that the hemorheological disorders are involved in development of the ischemic heart disease. But this fact was so far insufficiently cleared up. The present studies were carried out in patients with various forms of chronic ischemic heart disease. We investigated the most significant factor of rheological disorders in the microcirculation, the erythrocyte aggregability, with a technique that provided us with the direct and quantitative data. Simultaneously we investigated in the same patients the tone of the resistance arteries of the hand with an original non-invasive technique. We found that the erythrocyte aggregability increased almost twice in the blood of investigated patients as compared to the healthy control group. The aggregability was positively correlated with severity of the disease. The most pronounced hemorheological disorders were found in the patients with the heart failure. As to the arteriolar resistance index, it was increased only in 45 percent of all the investigated patients and no significant difference between the patients with the heart failure and without it was found available. We concluded that the blood rheological disorders represent themselves a factor that plays a significant role in pathogenesis of development of the heart disease.