Importance of detoxification capacity of albumin for assessing state of gastric cancer patients and effective treatment planning.

Abstract

34 Background: The aim of the study was measuring biochemical indices reflecting endotoxicosis syndrome in gastric cancer patients with adenocarcinoma of different grades and signet ring cell carcinoma. Methods: The study included 67 patients with gastric cancer divided into 4 groups depending on the tumor histotype: well- and moderately-differentiated adenocarcinoma (G1-2); poorly-differentiated adenocarcinoma (G3); signet ring cell carcinoma (SRCC); combined gastric tumors; and 12 healthy donors. The content of medium mass molecules (MMM254 and MMM280), total and effective albumin concentrations (TCA and ECA), toxicity index (IT = TCA/ECA-1) and intoxication factor (IF = MMM254/ECA⋅1000) were used to assess the level of endogenous intoxication. The Statistika 6.0 software package was used. Results: IT, reflecting the functional state of the albumin molecule, significantly exceeded the level in donors: by 2.3 times in G1-2, by 3.3 times in G3, by 3.2 times in SRCC (p < 0.01-0.001), by 2.2 times in mixed tumors (p < 0.05). The greatest increase in IT – by 4.6 times – was observed in patients with serosal invasion and tumor spread to the adjacent structures (T4 in the TNM classification). IF, which is an integral indicator of endotoxemia, in all groups of patients was significantly (p < 0.01-0.00001) higher than in donors. The increase was 55.2% in patients with G1-2, 132.7% for G3, 234.6% for T4, 66.8% for SRCC, and 59.6% for mixed tumors. The dynamic observation of patients showed that a sharp increase in the studied parameters was followed by relapses. Conclusions: The increase in IT and IF in all groups of patients indicated an enhancement of endotoxemia in gastric tumors, mainly due to the decreased detoxification capacity of albumin, as high levels of MMM were observed only in some patients. The changes were significantly more expressed in patients with G3, with the maximal changes in all the studied endotoxicosis parameters in T4. The results demonstrated the diagnostic significance of the detoxification ability of albumin for the evaluation of the state of gastric cancer patients and for the adequate treatment planning.