[The system of lipid peroxidation and antioxidant protection of saliva in lung cancer.]

The aim of the study was to study the parameters of the lipid peroxidation system and antioxidant protection in saliva in lung cancer of various histological types. In the case-control study, 740 volunteers participated in the study, which were divided into 3 groups: primary (lung cancer, n = 347), comparison group (non-malignant pulmonary pathologies, n = 178) and control (conditionally healthy, n = 215). Questioning, biochemical examination of saliva, histological verification of the diagnosis were conducted to all participants. The parameters of lipoperoxidation and antioxidant protection are determined spectrophotometrically. Intergroup differences are estimated by a nonparametric criterion. Against the background of lung cancer, the development of oxidative stress is observed, which is manifested in the increase in the level of lipid peroxidation products, as well as in the reduction of antioxidant protection in saliva. It is shown that the activity of the enzymes of the first link of antioxidant protection is significantly reduced (p<0.0001), whereas the activity of salivary peroxidases increases (p = 0.0037). The parameters of non-enzymatic protection vary in different directions: the level of uric acid in lung pathologies decreases (p = 0.0399), whereas albumin concentration increases, under these conditions, it begins to exhibit pro-oxidant properties. Differences between non-small cell and neuroendocrine lung cancer have been revealed by the nature of the dynamics of antioxidant protection indices. In general, the disturbance of the balance of the lipid peroxidation system and antioxidant protection is the result of a disruption in the coordination of immunometabolic processes and indicates a decrease in adaptive reactions of the organism.

[Activity of metabolic enzymes of saliva with neuroendocrine tumors of the lung of various degrees of malignancy.]

Up to the present time, problems of optimizing the methods of diagnosis and predicting the course of lung cancer, which occupies the leading positions in the structure of oncological diseases, remain topical. The purpose of the study was to study the characteristics of the activity of metabolic salivary enzymes in neuroendocrine tumors of the lung, depending on the degree of malignancy. In the casecontrol study, 156 people took part, divided into 2 groups: primary (neuroendocrine lung tumors, n=56) and control (conventionally healthy, n=100). All the participants went through a questionnaire survey, saliva biochemical counts, and a histological verification of their diagnosis. Between-group differences were measured with the nonparametric test. It is shown that against the background of neuroendocrine lung tumors, metabolic changes are observed characterized by a decrease in the de Ritis coefficient (p=0.0350) and lactate dehydrogenase activity (p=0.0492), as well as an increase in activity of alanine aminotransferase (p=0.0114), alkaline phosphatase (p=0.0150) and α-amylase (p=0.0328). Statistically significant differences between neuroendocrine tumors of different degrees of malignancy (G1+G2 and G3) were detected for aminotransferases (ALT - p=0.0421; AST - p=0.0472); alkaline phosphatase (p=0.0454) and α-amylase (p=0.0263). A decrease in the activity of the enzymes studied against the background of the progression of the disease, including the presence of distant and regional metastasis is shown. The most promising is the study of the activity of salivary α-amylase for the diagnosis of neuroendocrine lung tumors of high degree of malignancy.

[Study of arginase activity of mixed saliva in cancer].

The aim of the study was to investigate the activity of arginase of mixed saliva with the subsequent application of the results obtained in clinical laboratory diagnostics. Arginine metabolic parameters were studied in particular arginase activ- ity, concentration of nitric oxide, urea and uric acid. There was found a three-fold increase of arginase activity and a four- fold reduction of nitric oxide in mixed saliva of patients on the background of cancer. There was established inverse rela- tionship between arginase activity and nitric oxide as well as between the concentration of urea and nitrogen oxides. Basic possibility of differential diagnosis of benign and malignant neoplastic disease was showed .using chemometric methods. Imbalance of arginase activity and nitric oxide in the saliva of cancer patients could be an important diagnostic and prog- nostic criterion.

[Gaseous disorders and their role in the development of hepatopulmonary syndrome in liver cirrhosis associated with COPD].

OBJECTIVE: To evaluate the indicators of arterial blood gasometry and levels of nitric oxide (NO) in exhaled breath of patients with liver cirrhosis (LC) in combination with COPD, and determine frequency of occurrence of hepatopulmonary syndrome (HPS). The comparison group consisted of 20 patients with COPD, control - 15 volunteers. Gas measurement was estimated by ABL 725 radiometer (Denmark). MATERIAL AND METHODS: We examined 57 patients with liver cirrhosis. The patients were divided into 2 groups: 1st--Patients with liver cirrhosis (n = 48), 2nd group--the CPU and COPD (n = 9). Comparison group consisted of 20 patients with COPD, control - 15 volunteers. The gasometry was evaluated by ABL 725 radiometer (Denmark). NO levels in exhaled air was estimated using the NIOX MINO (Sweden). Contrast electrocardiography was performed on ATL HDI 5000 (Bothell, WA, USA). RESULTS: We found that the PaO2 was lower in the 2nd group compared with the control and with the 1st group (81.4 +/- 5.2; 95.5 +/- 5.3 and 94.5 +/- 5.1 mm Hg; p < 0.05), but the lowest PaO2 was in the group with COPD (68.4 mm Hg). AaDO2 was higher in the group with COPD (37.7 mm Hg). In the 2nd group this indicator was higher as compared with the control and with the 1st group (26.8 +/- 5.4; 8.2 +/- 4.5 and 14.9 +/- 5.2 mm Hg; p < 0.05). A strong negative correlation in the 1st and the 2nd groups between AaDO2 and PaO2 (r = -0.67 and r = -0.93; p < 0.05) was obtained. Content of NO in exhaled air was higher in the 1st and 2nd groups compared with control (18.7 +/- 4.1; 18,9 +/- 4.5 and 11.0 +/- 3.3 ppb; p < 0.05). Intrapulmonary shunts were detected in 3 patients in the 1st and 2nd groups. CONCLUSION: The relationship between measures of blood gas composition showed the leading role of hypoxemia in increasing the risk of formation of HPS in the LC, especially when combined with COPD.

[Role of biological tumor markers CEA, Cyfra-21, NSE, TU M2-PK in diagnosis and treatment of lung cancer].

The authors investigated the dependence of increasing serum oncomarkers CEA, Cyfra-21, NSE, TU M2-PK on survival in 739 patients with nonsmall cell lung cancer. The tests for the determination of the content of CEA, Cyfra-21, NSE in blood serum have low sensitivity and are of little use for the diagnosis of lung cancer. The tests because of their simplicity and low cost can be used for the detection of groups of patients with preliminarily diagnosed nonsmall cell lung cancer needing additional methods of examination for more exact staging of the disease and exclusion of remote metastases and more active using adjuvant method of treatment. The use of tumor pyruvate kinase can be perspective for clinical oncopulmonology. However, due to its low specificity, further experiences are required for using this oncomarker in the group of patients with nonsmall cell lung cancer.

[The first successful bilateral lung transplantation in Russia].

Lung transplantation is one of the most difficult fields of contemporary transplantology. The operation was performed on a 53-year-old female who had been suffering from terminal stage COPD. The period of cold ischemia for the right and left lung was 1 hour 30 minutes and 2 hours 25 minutes respectively. The total operation time was 4 hours and 40 minutes. There were no surgical complications. There were no signs of transplant rejection 6 weeks after the operation. The considerable decrease in dispnea and increase in quality of life were registered during the follow-up. FEV1 was increased by 80% and 6 minute walk test distance was increased by 200 meters.