ISSN 2415-3060 (print), ISSN 2522-4972 (online)
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JMBS 2021, 6(5): 141–150
https://doi.org/10.26693/jmbs06.05.141
Clinical Medicine

Optimization of Diagnosis of Secondary Metabolic Disorders and Treatment Tactics in Patients with Malignant Neoplasm Anemia in Colorectal Cancer

Andriiaka A. O.
Abstract

The purpose of the study was to study the content of free fraction of heparin, histamine and serotonin in plasma of peripheral venous blood of patients with malignant neoplasm anemia in colorectal cancer, depending on the severity of anemia. Materials and methods. The material for the study was the blood plasma of 445 patients (228 men and 217 women). Among them, 53 patients (31 women and 22 men) with iron deficiency anemia were examined and included in the first observation group (І) and 392 patients (206 men (52.55 %) and 186 women (47.45 %)) with colorectal cancer whose course of the underlying disease was burdened with malignant neoplasm anemia (ICD-10 code: D63.0) were included in the second observation group (II). Among the patients in the second (II) observation group, there were 222 individuals (119 men and 103 women) with malignant neoplasms of the colon (ICD-10 code: С.18), 29 individuals (16 men and 13 women) with malignant neoplasms of the rectosigmoid junction (ICD-10 code: C.19), 138 individuals (82 men and 56 women) with malignant neoplasms of the rectum (code ICD-10 C.20) and 3 patients (2 men and 1 woman) with malignant neoplasms of the anus (ICD-10 code: C.21). The mean age of the patients was 63.3 ± 1.2 years old. The plasma level of free fraction of heparin of the examined patients was determined using the photocolorimetric method on photoelectric colorimeter 56-M after its preliminary isolation by electrophoretic method according to the appropriate procedure (B. V. Mykhailychenko, S. V. Vydyborets (2000)). The plasma level of free histamine and serotonin of the examined patients was studied using the method of fluorometric analysis on the analyzer “BIAN-130”-“BIAN-100” according to the procedure of B. V. Mykhailychenko, S. V. Vydyborets (1999). Results and discussion. It was found that prior to the initiation of treatment in patients with malignant neoplasm anemia, regardless of the course of colorectal cancer, there was a significant increase in the plasma level of free fraction of heparin, histamine, serotonin (p < 0.001); the ratio of free histamine to free serotonin was also changed in comparison with the values in the control group (p < 0.05), which indicated both an increased release of heparin, histamine and serotonin from the depot, and an impaired inactivation processes of these biologically active substances. Considering all of the above and the quite obvious reasons, namely, the secondary metabolic disorders of serotonin, histamine, heparin which manifested by a significant increase in their plasma level of patients with malignant neoplasm anemia in colorectal cancer, we suggested the need to use a medicinal product in a complex of therapeutic measures which can cause antihypoxic, membrane stabilizing and anti-edema action. Conclusion. Malignant neoplasm anemia in colorectal cancer is accompanied by significant changes in the metabolism of biologically active substances – free fraction of heparin, histamine, serotonin, and the ratio of free histamine to serotonin. It was correctly concluded that in addition to the baseline therapy the administration of arginine glutamate which causes both antihypoxic and membrane-stabilizing action, reliably contributes to the normalization of secondary metabolic disorders of histamine, serotonin and heparin metabolism in malignant neoplasm anemia in patients with colorectal cancer

Keywords: colorectal cancer, anemia in neoplastic disease, free histamine, free serotonin, free heparin, blood plasma

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References
  1. Tymchenko A, Zalessky V. Reguliatornoe vlijanie vospaleniya na kostno-mozgovoe krovotvorenie: gerontologicheskie i onkologicheskie aspekty [Regulatory Impact of Inflammation on Hematopoiesis in Bone Marrow: Aging and Cancer Aspects]. Laboratornaja diagnostika. Vostochnaya Evropa. 2019; 8(2): 237-248. [Russian]
  2. Berezhnaya NM. Semeystva interleykinov; biologiya i onkogenes [The families of interleukins: Biology and onkogenesis]. K: Naukova dumka; 2013. 576 p. [Russian]
  3. Borysenko D, Vydyborets S. Soderzhanie glukozy v erytrozytah pazientov s anemiej zlokachestvennogo novoobrazovaniya pri urotelialnom rake mochevogo puzyria [The contents of glucose in erythrocytes of patients with anemia of malignant neoplasm in urothelial cancer of the urinary bladder]. Hematologija. Transfusiologija. Vostochnaya Evropa. 2020; 6(3): 319-323. [Russian]
  4. Borysenko D, Vydyborets S. Soderzhanie molochnoj kysloty v erytrozytah pazientov s anemiej zlokachestvennogo novoobrazovaniya pri urotelialnom rake mochevogo puzyria [The contents of lactic acid in erythrocytes of patients with anemia of malignant neoplasm in urothelial cancer of the urinary bladder]. Hematologija. Transfusiologija. Vostochnaya Evropa. 2020; 6(2): 179-188. [Russian]
  5. Borysenko D, Vydyborets S. Diagnosticheskoe i prognosticheskoe znachenie soderzhaniia glukozo-6-fosfatdegidrogenazy v erytrozytah pazientov s anemiej zlokachestvennogo novoobrazovaniya pri urotelialnom rake mochevogo puzyria [Diagnostic and prognostic value of the contents of glucose-6-phosphatdegidrogenase in erythrocytes of patients with anemia of malignant neoplasm in urothelial cancer of the urinary bladder]. Hematologija. Transfusiologija. Vostochnaya Evropa. 2020; 6(1): 24-34. [Russian]
  6. Vydyborets SV, Andriiaka AO. Fiziologichna rol gepsidinu jak zentralnogo regulyatora meabolizmu zaliza (oglyad literatury) [The physiological role of hepcidin as a central regulator of iron metabolism (literature review). Simejna medyzyna. Family medicine. 2017; 1(69): 154-157. [Ukrainian]. https://doi.org/10.30841/2307-5112.1(69).2017.103346
  7. Greer JP, Arber DA, Glader B, Eds. Wintrobe’s clinical hematology. Philadelphia: Lippincott Williams & Wilkins; 2014. 2278 p.
  8. Andriiaka A. Mechanisms of anemia formation in colorectal cancer, its clinical and laboratory characteristics. SWorld journal (Bulgaria). 2021; 8(3): 59-65.
  9. Fedorenko ZP, Kolesnik OO, Gulak IO, Ryzhov AY, Sumkina OV. Kolorektalnyi rak v Ukraini: epidemiologichni ta organizatsijni aspekty problemy [Colorectal cancer in Ukraine: the epidemiological and organizational aspects of the problem]. Prakticna onkologia. Practical oncology. 2019; 2: 9-16. [Ukrainian]. https://doi.org/10.22141/2663-3272.2.2.2019.176026
  10. Linchevskii OV, Kovaliov OO, Kolesnyk OO, Beznosenko AP. Zlojakisni novoutvorennja v Ukraini (analityko-statystychnyi dovidnyk) [Malignant neoplasms in Ukraine (analytical and statistical reference book)]. Praktycna onkologia. Practical Oncology. 2019; 2: 59-118. [Ukrainian]. https://doi.org/10.22141/2663-3272.2.2.2019.176034
  11. Luniova GG, Ed. Klinichna biochimiia [Clinical Biochemistry]. Handbook. K: Atika; 2013. 1156 p. [Ukrainian]
  12. Halem E, El Banna N, Huang ME. Multifaceted roles of glutathione and glutathione-based systems in carcinogenesis and anticancer drug resistance. Antioxid Redox Signal. 2017 Nov 20; 27(15): 1217-1234. https://www.ncbi.nlm.nih.gov/pubmed/28537430. https://doi.org/10.1089/ars.2017.7134
  13. Corso CR, Asso A. Glutathione system in animal model of solid tumors: from regulation to therapeutic target. Crit Rev Oncol Hematol. 2018 Aug; 128: 43-57. https://www.ncbi.nlm.nih.gov/pubmed/29958630. https://doi.org/10.1016/j.critrevonc.2018.05.014
  14. Mykhailychenko B, Vydyborets S. Metod kil’kisnogo vyznatshennia geparynu v biosubstratah [Method of quantative determination of heparin in biological speciments]. Laboratorna diagnostika. 2000; 4: 53-56. [Ukrainian]
  15. Mikhailichenko BV, Vydyborets SV. Metod odnochasnogo fluorymetrychnogo vyznachennja biogennych aminiv v analizovanij probi biosubstratu [The metod of simultaneousfluorimetric assay of biogenic amines in biological speciments]. Laboratorna diagnostika. 1999; 2: 58-61. [Ukrainian]
  16. Rybina O, Gubkin A, Sakhin V, Rukavitsyn O. Anemicheskij syndrome v gastroenterologicheskoj practike [Anemic syndrome in gastroenterological diseases: problems and solutions]. Hematologija. Transfusiologija. Vostochnaya Evropa. 2020; 6(3): 357-371. [Russian]
  17. Sakhin VT, Kryukov EV, Rukavitsyn OA. Anemiya hronicheskih zabolevanij – osobennosti patogeneza i popytka klasifikacii [Anemia of chronic diseases – features of pathogenesis and an attempt of classification]. Pacific Medical Journal. 2019; 1: 33-37. [Russian]
  18. Weiss G, Ganz T, Goodnungh LT. Iron metabolism and its disorders. Anemia of inflammation. Blood. 2019; 133(1): 40-50. https://www.ncbi.nlm.nih.gov/pubmed/30401705. https://www.ncbi.nlm.nih.gov/pmc/articles/6536698. https://doi.org/10.1182/blood-201806-856500
  19. Zhang J. Efficacy and safety of iron therapy in patients with chronic heart failure and iron deficiency: A systematic review and meta-analysis based on 15 randomized controlled trails. Postgraduate Medical Journal. 2020; 96(1142): 1664-1672. https://www.ncbi.nlm.nih.gov/pubmed/32843482. https://doi.org/10.1136/postgradmedj-2019-137342
  20. Borysenko D, Vydyborets S. The main parameters of iron metabolism in patients with urotlial bladder cancer at different development stages of malignant neoplasm anemia. Scientific journal of Polonia university. 2020; 43(6): 247-255. https://doi.org/10.23856/4332
  21. Gordienko AV, Sakhin VT, Kryukov EV, Sotnikov AV, Rukavitsyn O. Znachenie obmena zheleza, gepcidina i rastvorimogo receptora transferrina v patogeneze anemii u pacientov, stradayushchih zlokachestvennymi novoobrazovaniyami [Significance of the exchange of iron, hepcidin, and soluble transferring receptor in the pathogenesis of anemia in patients with malignant neoplasms]. Bulletin of the Russian Military Medical Academy. 2018; 63(3): 91-94. [Russian]. https://doi.org/10.17816/brmma12258
  22. Popovych M. Zhelezo defizitnaja anemija: ozenka statusa zheleza v organizme po urovnju syvorotochnogo ferritina s uchetom rekomendazij VOZ (2020) [Iron deficiency anemia: Assesment of iron status in the human body by serum ferritin level, taking into account WHO Recommendations (2020)]. Hematology. Transfusiology. Vostochnaja Evropa. 2020; 6(4): 479-488. [Russian]
  23. Gonzalez-Costello G. Use intravenous iron in patients with iron deficiency and chronic heart failure: Real world evidence. Eur J Int Med. 2020; 80: 91-98. https://www.ncbi.nlm.nih.gov/pubmed/32439287. https://doi.org/10.1016/j.ejim.2020.04.031
  24. Martin-Malo A. (Differences between of iron in patients with iron deficiency in chronic heart failure patients. ESC Heart Failure. 2019; 6(2): 241-253. https://www.ncbi.nlm.nih.gov/pubmed/30694615. https://www.ncbi.nlm.nih.gov/pmc/articles/6437426. https://doi.org/10.1002/ehf2.12400