RESUMEN
OBJECTIVE: The authors conducted a prospective analysis in order to investigate through lipid peroxidation metabolites the generation of oxygen free radicals after one-lung ventilation (OLV). METHODS: From 2001 to 2003, 212 patients were prospectively studied for lung reexpansion/reperfusion injury. They were classified in six groups. Group A, non-OLV lobectomy group; B, OLV pneumonectomy group; C-E, OLV lobectomy of 60, 90, and 120 min duration, respectively; F, normal subjects as baseline group. Preoperative, intraoperative and postoperative strict blood sampling protocol was followed. Malondialdehyde (MDA) plasma levels were measured. The recorded values were analyzed and statistically compared between groups and within each one. RESULTS: Comparison of groups C-E (OLV) to all other documented significant (P<0.001) increase of MDA levels during lung reexpansion and for the following 12h. The magnitude of oxidative stress was related to OLV duration (group E>D>C, all P<0.001). The removal of cancer-associated parenchyma led to MDA level decrease postoperatively (P<0.001) especially after pneumonectomy (A vs. B, P<0.001). CONCLUSIONS: (1) Lung reexpansion provoked severe oxidative stress. (2) The degree of the amount of generated oxygen free radicals was associated to the duration of OLV. (3) Patients with lung cancer had a higher production of oxygen free radicals than normal population. (4)Tumor resection removes a large oxidative burden from the organism. (5) Mechanical ventilation and surgical trauma are weak free radical generators. (6) Manipulated lung tissue is also a source of oxygen free radicals, not only intraoperatively but also for several hours later.
Asunto(s)
Carcinoma de Pulmón de Células no Pequeñas/cirugía , Neoplasias Pulmonares/cirugía , Estrés Oxidativo , Daño por Reperfusión/etiología , Respiración Artificial/efectos adversos , Adulto , Anciano , Biomarcadores/sangre , Carcinoma de Pulmón de Células no Pequeñas/metabolismo , Femenino , Radicales Libres/metabolismo , Humanos , Peroxidación de Lípido , Pulmón/irrigación sanguínea , Pulmón/metabolismo , Neoplasias Pulmonares/metabolismo , Masculino , Malondialdehído/sangre , Persona de Mediana Edad , Neumonectomía/efectos adversos , Periodo Posoperatorio , Estudios Prospectivos , Respiración Artificial/métodosRESUMEN
BACKGROUND: Human chorionic gonadotropin (hCG) is normally produced and secreted by trophoblastic cells during pregnancy and from gestational trophoblastic neoplasms. It is also detected in ovarian, stomach, and colon adenocarcinomas, as well as in squamous cell carcinoma of the oesophagus. Recently, interest in its role in the pathogenesis of tumours has been enlivened after the presence of beta hCG in the cell membrane of several malignant cells was shown in vitro. AIMS: To investigate the circulating concentrations of beta hCG in patients with exocrine pancreatic adenocarcinoma and to examine its potential prognostic value. PATIENTS: Thirty six patients with exocrine pancreatic adenocarcinoma, 12 patients with chronic pancreatitis, and 21 healthy volunteers were studied. METHODS: beta hCG serum concentrations were detected by the application of a radioimmunoassay technique. RESULTS: Fifteen of 36 patients with pancreatic adenocarcinoma and only one patient with chronic pancreatitis had detectable plasma concentrations of beta hCG (p < 0.01). The patients with circulating serum titres of beta hCG had a worse outcome compared with the group of beta hCG negative patients: the difference was statistically significant (p = 0.01). CONCLUSION: More than 40% of pancreatic exocrine tumours produce beta hCG and its production is correlated with an adverse effect on outcome.
Asunto(s)
Adenocarcinoma/sangre , Biomarcadores de Tumor/sangre , Gonadotropina Coriónica Humana de Subunidad beta/sangre , Neoplasias Pancreáticas/sangre , Adenocarcinoma/mortalidad , Adulto , Anciano , Anciano de 80 o más Años , Distribución de Chi-Cuadrado , Enfermedad Crónica , Femenino , Humanos , Masculino , Persona de Mediana Edad , Neoplasias Pancreáticas/mortalidad , Pancreatitis/sangre , Pronóstico , Tasa de SupervivenciaRESUMEN
The objective of this study was to evaluate the levels of several pituitary and gonadal hormones in pancreatic adenocarcinoma. We examined circulating levels of LH, FSH, Testosterone, Oestradiol, Progesterone and delta 4-Androstenedione in 36 patients with pancreatic adenocarcinoma, 12 patients with chronic pancreatitis and 87 age matched controls. According to our findings males with pancreatic cancer were found to have higher levels of FSH (p < 0.01). LH and oestradiol (p < 0.001) and lower levels of progesterone (p < 0.01) and testosterone (p < 0.05) than the controls. Female patients with pancreatic cancer were found to have higher levels of oestradiol (p < 0.001) and lower levels of LH, FSH and progesterone (p < 0.001), compared with group of healthy volunteers. Our data provide evidence of a generalised dysfunction of the hypothalamic-hypophysial-gonadal axis in pancreatic cancer patients.