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 (TGFβ1), fibronectin and osteopontin. Conclusion: Indices of vascular endothelial dysfunction in LC can be of diagnostic and prognostic value. Key Words: lung cancer, blood vessels, endothelium, endothelial dysfunction

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. Key Words: lung cancer, paraneoplastic syndrome

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. Key Words: lung cancer, paraneoplastic syndrome

МАРКЕРИ ЧИННИКІВ РИЗИКУ ПЕРЕБІГУ РАКУ ЛЕГЕНІВ

Objective – to evaluate significance of individual markers in the context of diagnosis and prediction of lung cancer course (LC), determination of their role in pathogenetic constructs of the disease. Materials and methods. 115 LC patients aged from 24 to 80 (average age – 58 years old) including 78 % of men and 22 % of women have been examined. None of the patients had been operated for LC previously or had undergone adiochemotherapy before the examination. Small-cell histological variant of the disease was found in 17 % of the patients, non-small cell (adenocarcinoma, squamous cell and large cell-carcinoma) – in 83 %. Levels of transforming b1 and vascular endothelial growth factors, homocysteine, endothelin-1, E and P-selectin, cyclic guanosine monophosphate, fibronectin, C-reactive protein, and a2-macroglobulin were studied in serum. Results. In addition to E-selectin, a significant increase in the concentrations of all values was detected, which was found in 34-100 % of LC cases, and their contents were associated with the form of the disease (central, peripheral), histological variant, integral severity of the tumor process, nature of primary tumor complications (exudative pleurisy, compression syndrome, obstructive atelectasis) and with the peculiarity of metastasis, herewith the values of transforming growth factor b1, vascular endothelial growth factor and fibronectin directly correlate with each other and have a certain unfavorable prognostic significance.  Conclusion. The data obtained dictate necessity of studying the concentrations of these markers in the blood of LC patients. It will be useful for assessing the severity of the course of the disease, predicting the complications of its course and selecting the optimal treatment methodology, and also for monitoring the effectiveness of radiochemotherapy.Цель работы – оценка значимости отдельнх маркеров в контексте диагностики и прогнозирования течения рака легких (РЛ), определения их роли в патогенетических построениях заболевания. Материал и методы. Обследовано 115 больнх РЛ в возрасте от 24 до 80 лет (в среднем 58 лет), среди которх бло 78 % мужчин и 22 % женщин. Ни один больной по поводу РЛ раньше не бл прооперирован и до обследования не получал радиохимиотерапию. Мелкоклеточнй гистологический вариант заболевания установлен в 1 7% от числа больнх, немелкоклеточнй (аденокарцинома, плоско- и крупноклеточная карцинома) – в 83 %. В своротке крови изучали уровни трансформирующего b1 и сосудистого ндотелиального факторов роста, гомоцистеина, ендотелина-1, Е- и Рселектина, циклического гуанозинмонофосфата, фибронектина, С-реактивного протеина и a2-макроглобулина. Результаты. Кроме Е-селектина, вявлено достоверное увеличение концентраций всех показателей, что установлено в 34-100 % случаев РЛ, а их содержимое бло связано с формой заболевания (центральная, периферическая), гистологическим вариантом, интегральной тяжестью опухолевого процесса, характером осложнений первичной опухоли (кссудативнй плеврит, компрессионнй синдром, обтурационнй ателектаз) и с особенностью метастазирования, при том параметр трансформирующего фактора роста b1, сосудистого ндотелиального фактора роста и фибронектина прямо коррелируют между собой и имеют определенную неблагоприятную прогностическую значимость. Вывод. Полученне данне диктуют необходимость изучения в крови больнх РЛ концентраций перечисленнх маркеров, что будет полезнм для оценки тяжести течения заболевания, прогнозирования осложнений его течения и вбора оптимальной методологии лечения, а также для контроля за ффективностью радиохимиотерапии.Мета роботи – оцінка значущості окремих маркерів у контексті діагностики та прогнозування перебігу раку легенів (РЛ), визна- чення їх ролі в патогенетичних побудовах захворювання. Матеріал і методи. Обстежено 115 хворих на РЛ віком від 24 до 80 років (у середньому 58 років), серед яких було 78 % чоловіків і 22 % жінок. Жодний з приводу РЛ раніше не був прооперований і до обстеження не отримував радіохіміотерапії. Дрібноклітинний гістологічний варіант захворювання встановлено у 17 % від числа хворих, недрібноклітинний (аденокарциному, плоскоклітинну та великоклітинну карциному) – у 83 %. У сироватці крові вивчали рівні трансформуючого b1 та судинного ендотеліального факто- рів зростання, гомоцистеїну, ендотеліну-1, Е- й Р-селектину, цик- лічного гуанозинмонофосфату, фібронектину, С-реактивного про- теїну і a2-макроглобуліну. Результати. Окрім Е-селектину, виявлено достовірне збільшення концентрацій всіх показників, що встановлено в 34-100 % випадків РЛ, а їх вміст був пов'язаний із формою захворювання (центральна, периферійна), гістологічним варіантом, інтеграль- ною тяжкістю пухлинного процесу, характером ускладнень пер- винної пухлини (ексудативний плеврит, компресійний синдром, об- тураційний ателектаз) і з особливістю метастазування, при цьо- му параметри трансформуючого фактора зростання b1, судинно- го ендотеліального чинника зростання й фібронектину прямо ко- релюють між собою і мають певну негативну прогностичну зна- чущість. Висновок. Отримані дані диктують необхідність вивчення в крові хворих на РЛ концентрацій перерахованих маркерів, що буде кори- сним для оцінки тяжкості перебігу захворювання, прогнозування ускладнень його перебігу та вибору оптимальної методології ліку- вання, а також контролю за ефективністю радіохіміотерапії

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 (TGFβ1), fibronectin and osteopontin. Conclusion: Indices of vascular endothelial dysfunction in LC can be of diagnostic and prognostic value. Key Words: lung cancer, blood vessels, endothelium, endothelial dysfunction

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. Key Words: lung cancer, paraneoplastic syndrome

Kidney Aspects of the Lung Cancer

Metastases in the kidney, perirenal retroperitoneal lymph nodes and adrenal glands occur in 2, 2, and 3 % of patients with lung cancer, respectively, and acute tubulointerstitial nephritis develops in 6 % of cases of radiochemotherapy complications, which impairs the survival of patients, depends on the shape and location of the primary tumor process, the degree of its differentiation, integrated severity and the use of anticancer drugs (taxanes) in combined treatment