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Method for prediction of cervical cancer metastases

IPC classes for russian patent Method for prediction of cervical cancer metastases (RU 2436102):
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FIELD: medicine.

SUBSTANCE: in 10-14 days following a surgical removal of a tumour in a patient, daily urine is analysed for sex hormones: oestradiol and pregnandiol. Then, they are related to each other. If the value exceeds 0.8, the onset of metastases or a recurrent disease for the following one and a half or two years is predicted. If the relation is less than 0.8, a metastases-free and recurrence-free period for more than 8-10 years is predicted.

EFFECT: use of the declared method allows determining the early onset of metastases or recurrence after combinatory treatment.

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The invention relates to medicine. More specifically to Oncology. And can be used in the prognosis of the disease cervical cancer among women of reproductive age after the combined treatment.

There is a method of individual forecasting resetstatistics survival in patients with cervical cancer (cervical cancer) on set obtained at the end of treatment indicators such as the level of hemoglobin, the absolute number of lymphocytes, the content of large granulometries lymphocytes, figure lymphocytic-macrophage transformation of monocytes, relationships, activity of superoxide dismutase and total peroxidase activity in lymphocytes and neutrophils, the relationship of vitamin E to vitamin a in neutrophils, the content of vitamin E in erythrocytes to plasma ("Conservative treatment of cervical cancer stage III with endolymphatic introduction of immunomodulatory drugs" Rozenko L.Y., author. Diss. Prof. the honey. Sciences. Rostov n/A., 1999).

But the proposed method for predicting relapse-free and resetstatistics survival of cervical cancer patients contains too many indicators that are not directly connected to each other, the result is difficult to know which ones are more informative, and which are only an addition to the main one. The combined analysis of all parameters requires not only m the CSOs of time to perform them, but a large number of performers.

Due to its complexity, bulkiness, lack of definition it cannot be used to predict the time of occurrence of metastasis of cervical cancer.

There is a method of forecasting extracranial metastases in patients with metastases to the brain by the magnitude of the content of cortisol in the blood of a patient with brain damage. With a significant reduction of hormone levels on the physiological norm note the presence of metastases in other organs (patent NG 2300110. Bull. No. 15 from 27.05.2007 "Method of detection of extracranial metastases in cancer patients with metastatic brain")

The authors suggest as a criterion for predicting metastasis to use cortisol levels. However, cortisol has no direct effect on proliferative processes in the cervix.

From the interaction of estrogens and progestins depends proanagen or antioncogene situation in the reproductive organs. During radical surgery with tumor removed and the ovaries; in the body creates a new hormonal situation and new relationships in hormone levels between the two classes of sex hormones in terms of proliferative processes: estrogens and progestins. There is a need to find new criteria for determining d is italmost resetstatistics period.

The aim of the invention is the determination criterion of the appearance of metastases.

The goal is to reach what 10-14 days after radical resection of malignant tumors of the cervix in daily urine of the patient to determine the number of sex hormones estradiol and pregnandiol. Next, calculate the ratio of the first to the second, with the value of more than 0.8 predicting the occurrence of metastasis or recurrence of the disease in the next year or two, and if the value is less than 0.8, the duration resetstatistics period of more than 8-10 years.

Analysis of the known methods of determining the timing of occurrence of metastasis or recurrence of the disease and developed allows to establish the existence of novelty and difference of the latter.

The novelty of the claimed "Method for predicting metastasis of cervical cancer" is that as a criterion, the time of occurrence of metastasis or recurrence of the disease made the ratio of sex hormones estradiol and pregnandiol. After radical surgical removal of the tumor, these sex hormones directly reflect both the state of sexual status and the condition of the whole organism and oncogenic resistance in particular.

In the available sources of information Russia, CIS and foreign countries of a similar method of determining the timing of occurrence of metastases or p is of sidebow was not found.

Developed a Method for predicting metastasis of cervical cancer is industrially applicable. It can be reproduced and repeated many times in gynecologic hospitals General medical and specialized hospitals of oncorine.

The method is as follows.

After specification of the diagnosis and the implementation of radical removal of the tumor formation at 10-14 day gather during the day the urine of the patient and determine the biochemical standard methods sex hormones: estradiol and pregnandiol. Next, calculate the ratio of estradiol to pregnandiol. If the value is more than 0.8 predicting the occurrence of metastasis or recurrence of the disease in the next year or two, and when the ratio of less than 0.8 - resistant resetstatistics or disease-free period of more than 8-10 years.

An example is the following extract from the records.

1. Patient C, 1969, history 20330/kg, was admitted to the Department of gynecology №1 RNII in October 2007 with a diagnosis of cervical cancer St W, with complaints to contact spotting from the genital tract.

10.10.07 the operation of Wertheim. Histological analysis 972940-55 usernotification squamous cell carcinoma with invasion 6 mm

14 days after surgery in daily urine the patient has identified the hormones estradiol and pregnan the IOL. The content in daily urine estradiol 2,8, pregnandiol 2,3. Calculated the ratio of estradiol to pregnandiol, it amounted to 1.21.

With 23.10.07 on 6.12.07 held DHT on the pelvic organs in SOD 40 Gy, intracavitary Co60 therapy in SOD 18 Gr.

22.09.09 due to low back pain are assigned SRCT the study of the lumbar and sacral spine. Revealed metastatic lesion paraaortal lymph nodes, the side surface of the body of the second lumbar vertebra, the iliopsoas muscles.

One year and eleven months after the combined treatment (radical surgical removal of the tumor, the patient was identified metastases in lymph nodes and the lateral surface of the vertebral body.

In further held DHT on paraaortal lymph nodes and the 2nd lumbar vertebra in SOD 40 Gy and 3-year autohemotherapy. Heading dose - cyclophosphamide 600 mg, cisplatin 150 mg, doxorubicin 30 mg

2. A female patient, 1956, history 4536/l, was admitted to the Department of gynecology №1 RNII in April 2000 with a diagnosis of cervical cancer St IB, complaints contact spotting for 2 months.

18.04.2000, the operation of Wertheim.

Histological analysis 565268-82 usernotification squamous cell carcinoma with keratinization, the invasion more than 1 cm lymph node metastasis no.

the via 14 days after surgery, daily urine the patient has identified the hormones estradiol and pregnandiol. The content in daily urine estradiol 4,1, pregnandiol of 7.3. Calculated the ratio of estradiol to pregnandiol, he was 0,56.

In the postoperative period held DHT on the pelvic organs in SOD 40 Gy and intracavitary Co60 therapy in SOD 30 Gr.

12.02.2009 year examination in the clinic, RNII data for recurrence and metastases are not detected.

3. Patient A-C, born in 1968, history 15950/l, was admitted to the Department of gynecology №1 RNII in December 2000, a diagnosis of cervical cancer St Ia, complaints at admission was not charged.

7.12.2000, the design Bureau No. 2 performed electroconsult cervical regarding the proposed endocervicosis, postoperative histological analysis No. 41425 - 31 squamous cell carcinoma, invasion 3 mm.

26.12.2000, the operation of Wertheim, histological analysis 590241 - 48 focal dysplasia of the cervical epithelium II-III degree, granulation tissue, endocervicosis. Lymph node metastases not.

After 10 days of operation daily urine the patient has identified the hormones estradiol and pregnandiol. The content in daily urine estradiol 1,6, pregnandiol of 2.5. Calculated the ratio of estradiol to pregnandiol, he made 0.64.

In the postoperative period held DHT on the pelvic organs in SOD 40 Gr.

31.08.2009 year examination in the clinic, RNII data for recurrence and metastasis is e identified.

The proposed method of determining the timing of occurrence of metastasis or recurrence of the disease was carried out a study of the ratio of estradiol to pregnandiol in 27 patients with cervical cancer.

Women with the ratio of estradiol to pregnandiol was less than 0.8, no metastasis or recurrence of the disease for 8-10 years after radical resection of malignant tumors of the cervix.

Technical and economic efficiency of the proposed "Method for predicting metastasis of cervical cancer is possible:

- for each patient to determine the early stages of the emergence of metastasis or recurrence of the disease;

- to conduct an individualized treatment based on the status of the patient;

- to determine the ratio of hormones without significant material costs.

A method for predicting metastasis of cervical cancer, including radical surgical removal of tumor formation and biochemical studies, characterized in that 10-14 days after surgical removal of the tumor, the patient in daily urine to determine the number of sex hormones: estradiol and pregnandiol; then calculate the ratio of the first to the second, and if the value is more than 0.8 predicting the occurrence of metastasis or recurrence of the disease in the next year or two, and when the ratio IU the its forecast of 0.8 resetstatistics, relapse-free period of more than 8-10 years.

 

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