INTERLEUKINE STATUS AND OTHER LABORATORY PARAMETERS IN COMBINED PANCREATIC PATHOLOGY

T.V.MISHANICH, O.M.MOSKAL, M.A.DERBAK, E.I.ARKHIY

Uzhgorod NU, Faculty of Medicine, Uzhgorod, UKRAINE

Introduction: Characteristic feature of a modern patient is polymorbidity. Comorbidity is an independent factor that leads to the emergence of a new independent process in the human body with its pathogenic mechanisms of development, clinical symptoms, diagnostic criteria and ways of treatment. Thus, in recent years the world has witnessed increase in the incidence of chronic pancreatitis, as well as diseases pathogenically associated with it.

Materials and methods: 80 patients were selected. Examination program: - complete blood count - biochemical blood examination - identification of anti - Hp IgG in blood serum, identification of interleukines 1, 6, 8. Concentration of interleukines in blood serum was determined by IEA on “Humanreader” device by using sets of reagents of “Vector – Best” company (Novosibirsk, Russia).

Results and their discussion: Based on the results there was observed a significant decrease in the indicators of Hb and red blood cells of patients with peptic ulcer disease. There was a significant increase in the average values ​​of lymphocytes in the group “Peptic ulcer disease in combination with pancreatitis”, and a significant increase in the average indicators of monocytes was found in the group “Peptic ulcer disease in combination with cholecystitis”, t ≥ 2,0. Given these changes it was reasonable to carry out a more detailed assessment of the immunological status of patients with combined pathology. The average values ​​of pro-inflammatory interleukines: IL-1, IL-6 and IL-8 in all the topical groups were high as compared to the norm. Comparing the average values ​​of IL-1 between the topical groups “Chronic pancreatitis” and “Chronic pancreatitis combined with CHD”, significant differences were found, t ≤ 2,0, but these indicators significantly differed from the average values ​​of IL-1 in the groups “Peptic ulcer disease” and “Peptic ulcer disease combined with cholecystitis”, t ≥ 2,0, where they were considerably higher. Mean values ​​of IL-8 in the group “Peptic ulcer disease combined with cholecystitis” was significantly higher the same indicators of the group “Peptic ulcer disease”, t = 2,1.

Conclusion: Evaluation of interleukine status of patients with combined pathology of the pancreas shows probable increase of pro-inflammatory interleukins as compared with the norm, which requires optimization of schemes of their treatment by means of immune correction. Significant increase of the average values ​​of lymphocytes in the group “Peptic ulcer disease in combination with pancreatitis” was established, and a significant increase in the average indicators of monocytes is characteristic for “Ulcer disease combined with cholecystitis”.

EPIDERMAL GROWTH FACTOR RECEPTOR (EGFR) GENE EXPRESSION AND ITS POLIMORPHISM IN THE PANCREATIC CANCER

G.F. MUSLIMOV

Scientific Surgical Center named after M.Topchubashov, Baku, AZERBAIJAN

Pancreatic carcinoma is characterized by very poor prognosis related to extremely aggressive growth. The annual mortality rate of this tumor illness roughly corresponds to its incidence and represents the fourth to fifth most common cancer-related cause of death in Western countries. While detailed causes of the biological aggressiveness of pancreatic carcinoma are still for the most part unknown. It is expected that a better biological understanding of the molecular alterations such as gene mutations, gene deletions and alterations and gene polymorphisms associated with pancreatic carcinoma will contribute to the improvement of current therapy modalities and will keep the rapid development of new approaches for treatment, such as gene therapy, moving forward. The majority of cases of pancreatic carcinoma overexpress growth factors which stimulate cell growth. One of these known growth factors is epidermal growth factor (EGF).The epidermal growth factor receptor (EGFR) has been implicated in tumor spread and metastasis formation. In pancreatic adenocarcinoma the role of this protein is not very well defined. The aim of this study was to evaluate the role of EGF receptors expression and its gene polymorphism in the development and clinical course of the pancreatic cancer. The tissue samples from curatively resected patients with pancreatic adenocarsinoma were examined by immunohistochemistry method. The expression of EGFR was defined in the healthy and tumor tissue specimens of the same patient employing polyclonal EGFR antibodies. These findings indicate that expression of this growth factor significantly correlated with tumor growth in pancreatic adenocarcinoma. Our randomized PCR-RFLP (Reaction-Restriction Fragment Length Polymorphism) and gele elektroforesis analyze for EGF ® ALU 1 gene polimorfizm showed that, statistically difference existed between pancreatic cancer and healthy groups for GG genotype and G allele polymorphism in 61 G®A douplet. However, these polymorphisms have no influence to stage and grade of the pancreatic cancer in patient group.

COMPARATIVE ANALYSIS OF RESULTS OF TREATMENT OF INJURIES OF BILIARY TRACTS FORMED DURING OPEN AND LAPAROSCOPIC OPERATIONS

G.F. MUSLIMOV, T. R. IBRAHIMOV, A.M. ASLANOV, G.R. ALIYEVA

Scientific Center of Surgery named after acad. M.A. Topchubashov, Baku,AZERBAIJAN

The purpose of the study - to carry out comparative analysis of the results of treatment of iatrogenic bile tracts injuries formed during open and laparoscopic operations.

Materials and methods: For the comparative analysis of the results of treatment 25 patients with lesions of the biliary tract were divided into 2 groups. The I group included 10 patients whose injuries occurred during laparoscopic cholecystectomy (LC) and in the II group - 15 patients after open cholecystectomy (OC). 20 (80%) patients of them were women, a 5 (20%) men.

In the frequency of intraoperative detection of the injury, there was a significant difference between patients exposed to OC (2/15 (13.4%)) or LC (6/10 (60.0%)). In 8 (32%) patients bile duct injury was found during surgery and the surgeon performed immediate surgical reconstruction. Among the injuries found in the immediate postoperative period, there were significantly less patients after LC than after the OC (36% vs. 64%, p <0.1). This was mainly due to the fact that among patients whose lesions were detected intraoperatively, the majority were patients after LC than after OC (66.7% vs. 16.7%, p <0.5).

All patients were divided according to the Bismuth’s classificatio: Bismuth 1 - 5 patients (20,0%), Bismuth 2 - 9 patients (36,0%), Bismuth 3 - 6 patients (24,0%), Bismuth 4 - 3 patients ( 12.0%), and Bismuth 5 - 2 patients (8.0%). In the injuries associated with LC, there were observed higher levels of injuries (Bismuth 3, Bismuth 4, Bismuth 5) with an isolated injury lobar hepatic ducts (7 patients (70.0%) versus 4 (26.7%) patients - p <0.05). Similarly, the complexity of the injury after the LC was significantly greater than after OC (55.6% vs. 27.5%, p <0.01).

In 13 (52%) patients, results of treatment were evaluated as excellent, in 8 (32%) patients - as good, and 4 (16%) – as bad. During comparative analysis of the results in 1^st group, excellent results were in 6 (60.0%), good in 3 (30.0%) and bad in 1 (10.0%) patient, whereas in the 2^nd group the results were 7 (46.7%), 5 (33.3%), 3 (20.0%), respectively. As is seen, despite the existing differences in the structure and complexity of injuries, during open and laparoscopic methods, results of treatment in these groups were not significantly different (p> 0.05).

Date: 2014-12-28; view: 985