Abstract
Aim: to identify and assess novel potentialities of routine lab tests to improve the accuracy of preoperative staging (spread) of high-grade squamous intraepithelial lesions (HSIL) and cervical cancer (CC). Patients and Methods: 410 women aged 18–82 (median age 42 [34; 51] years) with verified HSIL or CC were enrolled. Women were selected through medical records. Test results were monitored during in-person examinations since the formulation of clinical diagnosis and after surgical staging. If no surgical staging was performed, histopathology and disease stage as established by protocol examinations using instrumental and lab tests were considered. Women were subdivided into groups based on disease stage and method of treatment. Several parameters (complete blood count, hemostasis, biochemical markers of iron metabolism) were measured. In HSIL, minimal mandatory instrumental tests included pelvic and regional lymph node ultrasound. In CC stage 1–4, pelvic and abdominal ultrasound, pelvic MRI, abdominal CT with contrast, and (sometimes) PET CT. Results: several routine parameters of peripheral blood (hemoglobin, RBCs, ESR, fibrinogen, soluble fibrin monomer complexes/SFMC, D-dimer, ADP-induced platelet activation) were identified. Changes in the levels of these parameters within/above/below reference ranges illustrate the systemic effect of malignancy on the body and are a significant marker of regional metastasis of CC undiagnosed during a clinical examination. Conclusion: complex assessment of these parameters in CC allows for suspecting metastasis and requires more careful and reasonable examinations to improve the accuracy of prehospital diagnosis and determine management strategy. KEYWORDS: HSIL, cervical cancer, diagnosis, metastases, hematological markers, hemostasis, peripheral blood parameters, disease stage. FOR CITATION: Stuklov N.I., Sushinskaya T.V., Epifanova S.V. et al. Routine laboratory tests for staging of cervical cancer. Novel potentialities. Russian Journal of Woman and Child Health. 2021;4(3):229–237 (in Russ.). DOI: 10.32364/2618-8430-2021-4-3-229-237.
Highlights
Results: several routine parameters of peripheral blood were identified
Changes in the levels of these parameters within/above/below reference ranges illustrate the systemic effect of malignancy on the body and are a significant marker of regional metastasis of CC undiagnosed during a clinical examination
Conclusion: complex assessment of these parameters in CC allows for suspecting metastasis and requires more careful and reasonable examinations to improve the accuracy of prehospital diagnosis and determine management strategy
Summary
Рутинные лабораторные показатели в стадировании рака шейки матки. Новые возможности. РЕЗЮМЕ Цель исследования: поиск и оценка новых возможностей рутинных методов лабораторной диагностики для повышения точности дооперационного стадирования (степени распространенности) у больных с внутриэпителиальным поражением плоского эпителия тяжелой степени (HSIL) и раком шейки матки (РШМ). Результаты исследования: определено несколько рутинных показателей периферической крови (гемоглобин, эритроциты, СOЭ, фибриноген, РФМК, D-димер, агрегация тромбоцитов с АДФ), изменение уровня которых в пределах или выше/ниже референсных значений отражает системное влияние злокачественной опухоли на организм и является значимым маркером наличия метастазов в регионарные лимфатические узлы, не диагностированных при клиническом обследовании у больных РШМ. Заключение: комплексная оценка этих показателей у первичных больных РШМ позволит заподозрить наличие метастатического процесса, потребует более тщательного и обоснованного обследования в целях повышения точности догоспитальной диагностики и определения правильной тактики лечения. ДЛЯ ЦИТИРОВАНИЯ: Стуклов Н.И., Сушинская Т.В., Епифанова С.В.
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