Purine dysmetabolism in esophageal cancer

Abstract

Objective: to assess the state of purine metabolism in patients with esophageal cancer, to establish the clinical and pathogenetic significance of the identified changes. Material and methods. A total of 41 patients with esophageal cancer (all men) aged from 43 to 83 years (mean age 60 years) were under observation. Adenocarcinoma was diagnosed in 39% of the patients, squamous cell carcinoma — in 61%, tumor invading into the diaphragm was found in 10% of cases, in the spleen — in 7%, lymph nodes metastasis occurred in 12% of cases, in distant organs — in 32%. The ratio of 1B, 2A, 2B, 3A and 4 stages of the disease was 1:8:4:2:7. The levels of products of purine metabolism — uric acid, oxypurinol, adenine, guanine, xanthine, hypoxanthine, xanthine oxidase, xanthine deaminase, adenosine deaminase, and 5' nucleotidase activities — were studied in blood serum. Results. Purine dysmetabolism is observed in all patients with esophageal cancer in the form of increased levels of uric acid and oxypurinol levels in the blood, xanthine oxidase, and adenosine deaminase activity, which is observed in 83–100% of the examined individuals. Changes in purine metabolism are associated with the presence of hyperuricemia (>420 µmol/l), detected in 63% of cases, with the severity of the tumor process, the germination of neoplasm in the spleen, para-aortic lymph nodes, liver, and skeletal muscle. Hyperuricemia has a negative impact on the survival of patients, and a high level of adeninemia has a predictive negative value. Conclusion. Сhanges in the purine metabolism are involved in the pathogenetic constructs of esophageal cancer, reflect the peculiarities of the tumor process, and in the future, medical technology can be developed for treating patients with esophageal cancer with purine metabolism disorders.