UDC 616.211:616.216.1]-002-006.5-036.87-08
Shulga N. V.
Kharkiv
National Medical University, Kharkiv, Ukraine
LOGICO-STATISTIC
REASONING OF OXIDATION-ANTIOXIDATION BALANCE PERIOPERATIVE CORRECTION IN
COMPLEX TREATMENT OF PATIENTS WITH BREAST CANCER
Breast cancer
is one of
most frequent causes of mortality
from tumors, in all the world over
600 thousand women die due to
it [1]. The main method of effective treatment
of breast 4cancer is an adequate surgical operation,
while this is not fully
enough to get the best
results [2] and operation itself
is characterized by stress and
damage [3]. The problem
of anesthesiologic tactics is the development of a system of
metabolic disturbances correction by
ahead intensive care on different
stages of complex treatment.
Oxidation-reductive metabolism
in oncological pathology has been investigated for
prolonged time and actively enough
[4]. Its changes are interpreted as
one of pathogenic
mechanisms of formation and development
of oncological diseases, and as target for
neoadjuvant therapy at radical surgical operations.
However, the
absence of data about oxidative
proteins and nucleonic acids modification, bioenergic
metabolism, role of NO-dependent metabolites remain unclear. Because
of same, the intensive care
of patients with breast cancer, especially on
different stages of surgical treatment,
requires the further improvement basing on
pethogenetic correction of changes in
the system of antioxidant defense.
All above mentioned proves a number of unsettled
questions in this problem and highlights its
topicality.
Aim of the research was to evaluate the perioperative correction of
oxidative-reductive metabolism efficacy in complex treatment of patients with
breast cancer by using factor analysis.
Material and methods. In the prospective randomized controlled research
that included 126 patients with breast cancer the role of oxidative stress have
been studied in the complex treatment, particularly in anaesthesiological
provision of surgical treatment and intensive care has been investigated using
factor analysis.
Following aspects
have been studied: metaboliñ changes connected with
amount and duration of neoadjuvant therapy which define the peculiarities of
pre-operational and intraoperational intensive care
and are conditioned by clinico-functional state of
different components of pro- and antioxidant status of patients.
The complex
logico-statistical evaluation of data in order to find multiple interrelations
between variables in the massive of available data has been performed by the
method of factor analysis. Some quality (category) parameters has been
transformed into quantity parameters with their point values. The threshold
p-level value has been chosed as equal to 0.05.
Results and discussion. Thirty-eight variables have been included into
factor analysis, on base of which 4 factors have been chosed,
in total they explained 53.72 % of all variability of empiric data.
Taking
into account the parameters which loaded the most powerful factor 1, it
reflected clinico-general oxidative aspects of
condition.
The joint factor 1 together with second
by importance factor (factor 2) have explained almost half (46.47 %) of parameters
variability. Taking into account variables included in factor 2, it has been associated
with oxidative proteins modification.
Factors 3, 4 have lower influence
on parameters variability, while most interesting is the fact that they have
been loaded certain groups of parameters.
Thus, factor 3 reflected clinico-energetic
context, load of factor 4 included mostly
characteristics of clinico-hematological parameters.
Conclusions. Thus, as a result of
performed factor analysis four main factors have been stated, by joint action
of which 53.72 % of parameters variability may be explained in breast
cancer and surgical operation with quadrantectomy of brest with lymphodissection.
By action of first
most powerful factors which reveal clinico-general
oxidative aspects and oxidative modification of proteins is explained
46.47 % of variability of parameters.
Factor estimation
values by most powerful factor have differentiated the groups of patients with
proposed treatment and standard approach with high level of evidence.
Further perspectives
of investigations are related to prognosis of results of perioperative correction
of oxidative-reductive metabolism efficacy in complex treatment of patients
with breast cancer.
References
1.
Cost-utility analyses of
drug therapies in breast cancer:
a systematic review / V. Nerich, S. Saing, E. M. Gamper [et al.]
// Breast Cancer Res Treat. — 2016. — Vol. 159, No. 3. —
P. 407–424.
2.
Current perspectives of molecular pathways
involved in chronic inflammation-mediated breast cancer / S. Suman, P. K. Sharma, G. Rai [et al.]
// Biochem Biophys Res Commun. — 2016. — Vol. 472, No. 3. —
P. 401–409.
3.
Redox homeostasis
of breast cancer lineages contributes to differential cell death response to exogenous hydrogen
peroxide / F. Hecht, J. M. Cazarin, C. E. Lima [et al.] // Life Sci. — 2016. — No. 158. — P. 7–13.
4.
The impact of a breast
cancer diagnosis on health-related quality of life.
A prospective comparison among middle-aged to elderly women
with and without breast cancer / R. V. Karlsen, K. Frederiksen, M. B. Larsen [et al.] // Acta Oncol. — 2016. — Vol. 55, No. 6. —
P. 720–727.