[The biochemical markers in diagnostic of neuroendocrine tumors].

The review considers common concepts of neuroendocrine tumors. The results of original studies of biochemical markers of this type of tumor are presented. The various clinical symptoms and syndromes related to hyper-production of biologically active compounds are described. The characteristic of the most important biochemical markers in diagnostic and monitoring of effectiveness of treatment of neuroendocrine tumors is given.

[Current methods of systemic amyloidosis diagnosis and monitoring of its course].

AIM: To determine clinical significance of measuring blood levels of protein precursors of AA- and AL-amyloidosis - SAA and immunoglobulin free light chains (ILC), respectively. MATERIAL AND METHODS: SAA concentrations were studied with ELISA in 43 rheumatoid arthritis (RA) patients including complicated with reactive AA-amyloidosis (n = 31). Inflammation activity and its severity were studied (indices Li, richi, HAQ, DAS4). A modern quantitative nephelometric method Freelite estimated ILC levels in 31 patients with AL-amyloidosis. RESULTS: Patients with RA complicated with AA-amyloidosis and free of it had a strong correlation between blood serum SAA concentration and activity of joint disease. Elevated SAA concentrations to 160 mg/l (normal 10 mg/l) were detected in many patients with clinical remission of the joint syndrome. Significal inhibition of AA-amyloidosis progression was seen only in SAA concentration drop under 60 mg/l. For AL-amyloidosis patients ILC fall by less than 3 normal value means a 6-time increase in chances of a favourable outcome. CONCLUSION: Monitoring of blood levels of proteins precursors of AA- and AL-amyloidosis is a key factor in prognosis of the disease and treatment efficacy.

[Pharmacodynamic characteristics of velcade efficacy in resistant and recurrent multiple myeloma: determination of free light chains of blood serum immunoglobulins].

AIM: To ascertain individual sensitivity to velkeid in patients with resistant and recurrent multiple myeloma (MM) by determination of free light chains (FLC) of serum immunoglobulins. MATERIAL AND METHODS: Fourteen patients with MM stage III (Gcappa-5, Glambda-2, Acappa-3, Alambda-1, BJcappa-3) aged 52-75 years with documented resistance to treatment or recurrence received second-line monotherapy with velkeid. The drug was injected intravenously (jet) in a dose 1.3 mg/m2 on the treatment day 1, 4, 8 and 11. Free light chains concentration was examined with antibodies to their latent determinants (Binding Site, UK) on nephelometer (Hitathi-911, Japan) on velkeid treatment day 1, 2, 3, 5, 9 and 12. RESULTS: Nine patients showed lowering of FLC concentration and responded to treatment by Durie criteria. CONCLUSION: Dynamic follow-up of FLC concentration of the tumor clone in resistant and recurrent MM evaluates pharmacodynamics of the drug. The method provides prognosis of late clinical results.

[Diagnostic significance of type IV collagen and hyaluronic acid in the serum of patients with chronic hepatitis C for staging hepatic fibrosis].

AIM: To evaluate diagnostic value of serologic fibrosis markers (hyaluronic acid--HA and type IV collagen C-IV) in patients with chronic hepatitis C (CHC) and hepatic cirrhosis (HC). MATERIAL AND METHODS: HA and C-IV were measured in 88 CHC patients with fibrosis stage 1 (n = 63) and 3 (n = 25), 13 patients with acute hepatitis C (AHC), 28 patients with hepatic cirrhosis (HC), 19 patients with pulmonary fibrosis (PF). The control group consisted of 32 healthy subjects. RESULTS: HA concentrations in the serum of CHC patients with mild to severe inflammation and fibrosis (F1 and F3) were normal (100 ng/ml). For HC diagnosis, HA test proved highly sensitive and specific (in HA 100 ng/ml sensitivity was 100%, specificity 84.6%), but this method cannot stage hepatic fibrosis. HA test was inferior to C-IV test. A mean C-IV concentration in the serum of CHC patients at the stage of marked fibrosis (F3) is significantly higher than in F1, in HC (A) patients higher than in patients with CHC F3. CONCLUSION: It is shown than concentration of C-IV above 196 ng/ml can differentiate fibrosis stage 1 from stage 3 with specificity 58.7 and sensitivity 88%.

[The biochemical markers of bone remodeling in cancer patients with skeletal involvement]. / Biokhimicheskie markery kostnogo remodelirovaniia u onkologicheskikh bol'nykh s porazheniem skeleta.

The report discusses a study of pyridinoline (Pyd) and deoxypyridinoline (Dpyd) as biochemical markers of bone resorption as well as total bone alkaline phosphatase level (APh) and that of its bone fraction as criteria of osteogenesis in skeletal lesions in breast, prostate and lung cancer and multiple myeloma. The investigation established a significantly enhanced Pyd and Dpyd excretion with urine and increased blood-serum APh levels in skeletal cancers (n = 271) as compared with healthy subjects (n = 173) and patients without bone metastases (n = 94). A case has been made for determination of total excretion of Pyd crosslinks of collagen to diagnose bone metastases. Most pronounced hyperenzymemia was found in prostate cancer which points to the leading role of APh as a bone metastasis marker. Pyd and Dpyd excretion and APh levels were significantly higher among patients multiple metastases with than in those with single bone metastases. The universality of pyridinoline crosslinks as skeletal damage markers has been confirmed by establishing a significant correlation between drug and therapeutic effect for Pyd and Dpyd only, in patients receiving ibandronate.

[Role of biochemical indices as metastatic markers in patients with prostatic cancer invading skeleton]. / Znachenie biokhimicheskikh pokazatelei v kachestve markerov metastazirovaniia u bol'nykh rakom predstatel'noi zhelezy s porazheniem skeleta.

Biochemical markers of resorption and formation of bone tissue (piridinoline-PD, desoxypiridinoline-DPD and alkaline phosphatase-AP, respectively) were measured in blood serum and urine of 41 prostatic cancer (PC) patients with metastases to the bones and 24 PC patients free of such metastases as well as of 40 healthy males and 11 males with benign prostatic hyperplasia (BPH). It was found that PD, DPD levels, general AP activity and activity of its bone fraction were significantly higher in PC patients with bone metastases than in the others (p < 0.001). The former had a significantly higher percent of peptide-bound and lower percent of free forms of PD and DPD (p < 0.001) vs patients without metastases and controls. Higher biochemical serum and urine indices in PC patients with bone metastases reflect enhanced intensity of both formation and resorption of bone tissue in PC with bone metastatic lesions. Therefore, it is possible to use PD, DPD and AP values in diagnosis and monitoring of metastatic skeletal destruction in PC.

[Late radiation effects in the microcirculation system of the mouse brain after chronic low-dose irradiation]. / Otdalennye radiatsionnye éffekty v sisteme mikrotsirkuliatsii golovnogo mozga myshei posle khronicheskogo oblucheniia v malykh dozakh.

The radiation reaction of the mouse brain microvascular system was investigated 15 months after chronic (dose-rate was 3 cGy/day) and acute (dose-rate 3.2 Gy/min) gamma-irradiation. Late pathological changes in the microvascular system after the acute irradiation (3 Gy) were not found. In the same time, after chronic irradiation with equivalent dose (the accumulated dose was 3 Gy) the depletion of endothelial cell population, and multiple foci of minor pathological changes of endotheliocyte ultrastructure at as many as 50% of the population were revealed. It may be more likely to lead to reduction of tolerance of brain microvascular system to an acute radiation (10 Gy) in the late period after chronic exposure. The mechanism of impairment of brain microcirculation after low chronic irradiation will have to understand.

[Antibiotic prophylaxis of postoperative infective complications in patients with rectal and colonic cancers]. / Antibiotikoprofilaktika infektsionnykh posleoperatsionnykh oslozhnenií u bol'nykh rakom priamoí i obodochnoí kishki.

The results of operative use of clindamycin and netilmycin (1st group), piperacillin (2d group), in comparison to the standard protocol (carbenicillin and its combination with gentamicin) in 103 patients operated on rectal and colonic cancer are discussed. The rate of postoperative complications was 2.3% (1st groups), 5.3% (2d groups) vs. 37.1% (control group). The authors advocate the proposed protocols of antibacterial prophylaxis of rectal and colonic cancer.

[Biochemical parameters in the diagnosis of nephrotoxicity of antineoplastic chemotherapy in children]. / Biokhimicheskie pokazateli v diagnostike nefrotoksichnosti protivoopukholevoi khimioterapii u detei.

The investigation was concerned with the role of enzymouria in the assessment of nephrotoxic effects identified in 19 children with malignant solid tumors who received cisplatin polychemotherapy in a dose of 100 mg/sq.m or iphosphamide in a dose 9 g/sq.m. Chemotherapy application was followed by a persistent hyperenzymouria involving significantly higher levels of N-acetyl-beta-D-hexosaminidase, beta-glutamyl transferase and alanine aminopeptidase in the urine, as compared with basal indices. Iphosphamide treatment showed significantly higher levels of enzymouria than those in cisplatin-treated patients. Higher than normal creatinine and urea concentrations were recorded only in 2 out of 9 patients receiving iphosphamide. Enzymouria evaluation was shown to be an effective method of nephrotoxic diagnosis.

[High-dose ifosfamide in the treatment of patients with soft tissue sarcoma]. / Primenenie vysokikh doz ifosfamida u bol'nykh sarkomami miagkikh tkanei.

The increasing doses of 2.4-3.5 g/m2 ifosfamide, i/v, dropwise, were administered for 40 min, on days 1-5 each week, for 3 weeks, in 4 courses. Simultaneously, MESNA was given in a dose two-thirds of that of ifosfamide. The maximum single tolerable dose of ifosfamide was 3.2 g/m2. The dose of 3.5 g/m2 proved neurotoxic causing encephalopathy. The other toxic effects were stage III-IV neutropenia (47%), nausea and vomiting (91%) and weakness (33%). No clinical evidence of renal failure was attributed to the high dosage of the drug in the course of assays of biochemical components of the blood, blood- and urine-beta-2-microglobulins, N-acetyl-D-hexoaminidase (NAG) level in urine, creatinine clearance and complex renoscintigraphy data. On days 3-5, ifosfamide treatment was followed by increase in NAG and beta-2-microglobulin levels in urine which pointed to the toxic effect exerted on the epithelium of renal tubules. The antitumor effect was apparent in 5 (29%) patients for 6 months, which testifies to the high effectiveness of ifosfamide treatment for soft-tissue sarcoma.

[The significance of changes in lactate dehydrogenase activity for the diagnosis and effective treatment of nephroblastoma in children]. / Znachenie izmeneniia aktivnosti laktatdegidrogenazy v diagnostike i èffektivnosti lecheniia nefroblastomy u detei.

Total serum lactate dehydrogenase (LDH) activity was studied in 65 children with nephroblastoma at stage II-IV. Total LDH activity was elevated in 87% of cases. A correlation between incidence and level of LDH activity, on the one hand, and stage size of tumor, on the other, was established. The increase in total LDH activity at stages II and III in 75 and 85.7%, respectively, was found to match those in LDH concentration 1.2-4-fold and 1.3-7.3-fold, enhanced 1.4-8.4 times. Successful radiation therapy and/or surgery was followed by LDH level coming back to normal. However, failed treatment and further progression of tumor involved persistent rise in the enzyme activity.

[Biochemical parameters in the comprehensive diagnosis of lung cancer]. / Biokhimicheskie pokazateli v kompleksnoi diagnostike raka lëgkogo.

Biochemical characteristics of blood serum were studied in 310 patients with lung cancer (stage I-IV), 188 cases of non-malignant pathology od the lung and 35 healthy subjects. Mean levels of total sialic acids, lipid-bound sialic acids, neuron-specific enolase and lactate depydrogenase in blood serum of cancer patients were significantly higher than those in control groups. Mean neuron-specific enolase concentrations in small cell carcinoma of the lung were significantly higher than those in squamous cell and glandular carcinoma and carcinoid. Significant differences were observed for blood serum levels in cases of lung cancer disseminated to the liver and bones, as compared with those without distant metastases. Gamma-glutamyl transferase proced the most sensitive and specific when used for diagnosis of hepatic metastases, while alkaline phospohase--for bone metastases.

[Changes of radiosensitivity in animals after exposure to radiation within the territory of accident at the Chernobyl nuclear plant]. / Izmenenie radiochuvstvitelnosti zhivotnykh posle ékspozitsii v zone avarii na ChAES.

Mice exposed inside of 10-km zone around Chernobyl Atomic Station with follow-up acute irradiation were studied to find the changes in their life-span. It was found that the results essentially depend on the interval between exposition in zone and acute irradiation and space of time after irradiation.