OPTIMIZATION OF DIAGNOSIS OF SECONDARY METABOLIC DISORDERS AND TREATMENT TACTICS IN PATIENTS WITH ANEMIA IN NEOPLASTIC DISEASE IN COLORECTAL CANCER

Abstract

Colorectal cancer is one of the most common oncological diseases, therefore, the study of this problem is an important issue in clinical practice. This problem becomes especially urgent in case of the formation of anemic syndrome in patients, which causes the emergence of a mutual burden syndrome and increases the risks for a patient. The progressive nature of anemia in colorectal cancer is accompanied by secondary metabolic disorders. 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 anemia in neoplastic disease 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 age of the examined patients was from 22 to 79 years. It was found that prior to the initiation of treatment in patients with anemia in neoplastic disease, regardless of the course of colorectal cancer, there was a significant increase in the plasma level of free fractions of heparin, histamine and serotonin (p < 0,001); the ratio of histamine: 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. 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 anemia in neoplastic disease in patients with colorectal cancer.