Характеристики адаптационных реакций и распространенность опухолевого процесса различной локализации

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Introduction. The systemic regulation in cancer is poorly studied. A multilevel periodic system comprises general nonspecific adaptational reactions (AR) of the body, different in their nature and tension, associated with levels and ratio of the activity of various neuroendocrine and immune system components [1-3]. The purpose of the study was to reveal an association between AR characteristics and malignant spread in the lungs and biliopancreatoduodenal organs. Material and methods. The study included 28 patients with lung cancer (LC) with various malignant spread: group (gr.) 1 - unresectable LC, chemoradiation treatment (10); gr. 2 - resectable metastatic LC, T2-3N1-2M0-1 (7); gr. 3 - resectable non-metastatic LC (11). Another cohort involved 32 patients with biliopancreatoduodenal cancer (BPDC) with different malignant spread and surgery volume: 19 patients - radical surgery (RS gr.), 13 patients - palliative surgical bypass (PS gr.). All patients were aged 30-70 years, men to women ratio - 3:2. The values of hematological parameters in patients were analyzed using an expert computer program “Antistress”, and qualitative and quantitative (score) characteristics of AR were obtained [2]. The minimal quantitative indicator (QI) - 10-20 - corresponded to the stress AR of “very low” reactivity levels (LRL, VLRL), while the maximal noted score - 2800 - had the elevated activation AR of “moderate” reactivity levels (MRL) and was associated with the most balanced neuroimmune regulation in the studied patients. Statistical processing of results was performed using the t-test, Wilcoxon test and the fractional estimates. Results and discussion. All patients showed a significant decrease in the adaptational status - the prevalence of stress ARs and tensioned anti-stressor ARs of VLRL and LRL (70-100%). LC patients in gr. 3 had AR characteristics reflecting the most favorable body status: the development of anti-stressor MRL ARs, as well as AR QI elevated by 1.8-2.7 times compared to gr. 1 and 2 (Table). In patients with similar surgeries, for example with atypical lung resection, AR QI in gr. 3 was notably higher than in gr. 2 - respectively, 1300 ± 278 and 95 ± 18 (p < 0.01). These results suggested that different AR QI in patients of gr. 2 and 3 were associated with the presence or absence of metastases and not with the surgical volume. Similar differences in the adaptational status were observed in patients with BPDC. Prior to the surgery, PS gr. showed the prevalence of the lowest QI - stress AR and training AR of VLRL, as well as stress AR of LRL (61%). Same ARs in RS gr. were almost 3 times less frequent (21% of cases, p < 0.05). Stress ARs of VLRL were not observed. Surgery caused a predictable decline in the adaptational status of most patients in all groups (p < 0.05). However, despite a greater surgical volume of radical pancreatoduodenal resection compared with bypass anastomosis, AR QI in RS gr. one day after the surgery was markedly higher than in PS gr. - 187 ± 39 and 80 ± 24, respectively (p < 0.05). Conclusion. The study demonstrated an association between the malignant spread in the lungs and BPD organs and AR characteristics reflecting the state of systemic neuroendocrine and immune mechanisms of the nonspecific antitumor resistance of the body.

Об авторах

Г В Жукова

ФГБУ «Ростовский научно-исследовательский онкологический институт» Минздрава России

А И Шихлярова

ФГБУ «Ростовский научно-исследовательский онкологический институт» Минздрава России

У М Газиев

ФГБУ «Ростовский научно-исследовательский онкологический институт» Минздрава России

М С Зинькович

ФГБУ «Ростовский научно-исследовательский онкологический институт» Минздрава России

А В Снежко

ФГБУ «Ростовский научно-исследовательский онкологический институт» Минздрава России

Ю Н Лазутин

ФГБУ «Ростовский научно-исследовательский онкологический институт» Минздрава России

А Н Шевченко

ФГБУ «Ростовский научно-исследовательский онкологический институт» Минздрава России

М И Брагина

ФГБУ «Ростовский научно-исследовательский онкологический институт» Минздрава России

А И Жадобина

ФГБУ «Ростовский научно-исследовательский онкологический институт» Минздрава России

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