[Role of the tumor markers CA 19-9 and carcinoembryonic antigen (CEA) in diagnosis, treatment and prognosis of pancreatic cancer]. / Znachenie opukholevogo markera CA 19-9 i kartsino-émbrional'nogo antigena (KEA) v diagnostike, vybore lechebnoi taktiki i prognozirovanii raka podzheludochnoi zhelezy.

The investigation was concerned with diagnostic sensitivity, specificity and effectiveness of assay of CA 19-9 and carcinoembryonic antigen (CEA) in the choice of treatment modality and evaluation of therapy pancreatic carcinoma (PC). Either marker has been studied in 685 examinations for PC, 68--chronic pseudotumorous pancreatitis and 24--intestinal cancer at other sites since 1995. Tumor resection for PC was carried out in 31; conservative treatment--67; chemotherapy--56 and radiotherapy--in 29 cases. In CA 19-9 examinations, diagnostic sensitivity was 90.2; specificity--72.1 and effectiveness--85.3%, while in CEA determinations, 82.5; 30.9 and 68.5%, respectively. CA 19-9 and CEA levels proved to be prognostic factors of survival. An inverse correlation was observed between median survival and tumor marker concentrations: higher basal (preoperative) level of marker in blood was matched by lower median survival. A similar relationship was identified for CEA: 5-10--14.2 months; 10.1-20 ng/ml--8.0 months; 20.1-30 ng/ml--3.9 months, and more than 30 ng/ml--4.8 months. There was a direct correlation between CA 19-9 level and tumor stage. The dynamics of tumor markers, particularly, CA 19-9 correlated with treatment effectiveness during its course.

[Results of surgical treatment of patients with external abdominal hernias]. / Rezul'taty khirurgicheskogo lecheniia bol'nykh s naruzhnymi briushnymi gryzhami.

The vast material concerned with the surgical treatment of patients with external abdominal hernias collected for 10 years includes 913 planned operations and 608 emergency operations for incarcerated hernias. The overall lethality was 3.4%, lethality after planned operations being 0.1%, after emergency operations--8.4%. It was noted that the amount of elderly and senile patients among patients with incarcerated hernias had increased up to 79%. The traditional methods of autoplasty were used in 95% of the patients. In 5% of the patients the autoabdominal plasty modified by the authors was used for badly amenable to treatment inguinal hernias and postoperative ventral hernias. Better results of treatment of patients with incarcerated external hernias of the abdomen were due to early diagnosis of such hernias, timely hospitalization with special reference to the patient's age, correctly performed surgery and prophylactic measures to avoid cardiovascular and pulmonary complications at the postoperative period.

[Prognostic factors influencing results of the surgical treatment of pancreatic cancer]. / Prognosticheskie faktory, vliiaiushchie na rezul'taty khirurgicheskogo lecheniia pri rake podzheludochnoi zhelezy.

In patients with carcinoma of the pancreas 128 gastropancreatoduodenal resections (GPDR), 15 distal resections of the pancreas and 3 pancreatectomies were performed. After GPDR 5-year survival was 12%, the survival median was 24.3 months. Only one patient is living 6 years after left-sided resection and pancreatectomy. Long-term results of the operative treatment for carcinoma of the pancreas depended on the amount of regional metastases, degree of differentiation of the tumor, its size and invasion into the vessels. The long-term results were considerably worse if the tumor was localized in the uncinate process, body and tail of the pancreas. The 5-year survival was noted mainly in patients with the 0 and I stages of the disease. It shows the early diagnostics to be necessary.