THE EXPERIENCE OF CORRECTION OF VASCULAR ENDOTHELIAL FUNCTION AND HEMOSTASIS IN PATIENTS WITH RECTAL CANCER
A valuable trend in modern oncology it is improving the conservative treatment of rectal cancer, as one of the most common and dangerous form of malignancies
The purpose of the research – identifying of opportunities for correction of endothelial dysfunction in patients with rectal cancer and assessment of its impact on the state of the hemostatic system and the risk of thrombotic complications.
Materials and methods. The study included 86 patients with rectal cancer, including 45 men (52.3%), 41 women (47.7%) aged 45 to 70 years (mean age 62,3±1,8 years). The indices of vascular-platelet hemostasis systems: platelet aggregation; content of von Willebrand factor; for endothelial function: the content of circulating endothelial cells, NO metabolites in the blood; endothelium-dependent vasodilation.
Results of the research. Investigated indicators of vascular endothelium revealed a statistically significant excess of circulating endothelial cells, NO metabolites in the blood. There was also a significant decline in endothelium-dependent vasodilation. The degree of disorders depended on the clinical stage. Endothelial dysfunction was accompanied by disorders of the vascular-platelet hemostasis. Recent expressed in increased platelet aggregation, disaggregation and decrease excess content of von Willebrand factor in the blood. Hemostatic and endothelial disorders influenced on the risk of thrombotic complications. Using, as part of the treatment, the drug from the statin group contributed to the correction of endothelial disorders and hemostasis. In general, in all patients the frequency of thrombosis was 36.0%. There were statistically significant differences between the groups allocated depending on the use of statins. They amounted for 45.2%, p = 0.035. Development of thrombotic complications, during the correction, proved later.
Conclusions. There is a pronounced dysfunction of the vascular endothelium in patients with rectal cancer. The using of the drug from the statin group provides dynamics to its correction, which helps to reduce the frequency and increase in terms of the development of thrombotic complications.
Laura A. Pak, http://orcid.org/0000-0002-5249-3359
Semey State Medical University,
Department of Oncology and Visual Diagnostics, Semey, Kazakhstan
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4. Blum A. HMG-CoA reductase inhibitors (statins), inflammation, and endothelial progenitor cells-New mechanistic insights of atherosclerosis. Biofactors. 2014, May-Jun;40(3):295-302.
5. Brenner H, Kloor M, Pox CP. Colorectal cancer. Lancet. 2014 Apr 26;383(9927):1490-502.
6. Celermajer D.S. Testing endothelial function using ultrasound. J Cardiovasc Pharmacol. 1998, 32, Suppl 3, P.29-32.
7. Corcos L., Le Jossic-Corcos C. Statins: perspectives in cancer therapeutics. Dig Liver Dis. 2013, Oct;45(10):795-802.
8. Favoriti P, Carbone G, Greco M, Pirozzi F, Pirozzi RE, Corcione F. Worldwide burden of colorectal cancer: a review. Updates Surg. 2016, Apr 11.
9. Franchini M., Bonfanti C., Lippi G. Cancer-associated thrombosis: investigating the role of new oral anticoagulants. Thromb Res. 2015, May;135(5):777-81.
10. Glynne-Jones R., Lim F. Anal cancer: an examination of radiotherapy strategies. Int J Radiat Oncol Biol Phys. 2011, Apr 1;79(5):1290-301.
11. Hladovec J. Circulating endothelial cells as a sign of vessel wall lesions. Physiol Bohemoslov. 1978, 27(2):140-4.
12. King T.F., McDermott J.H.. Endothelial progenitor cells and cardiovascular disease. J Stem Cells. 2014, 9(2):93-106.
13. Levi M. Diagnosis and treatment of disseminated intravascular coagulation. Int J Lab Hematol. 2014, Jun;36(3):228-36.
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16. Owens A.P. 3rd, Mackman N. The antithrombotic effects of statins. Annu Rev Med. 2014, 65, P. 433-45.
17. Palefsky J.M. Screening to prevent anal cancer: Current thinking and future directions. Cancer Cytopathol. 2015, Sep;123(9):509-10.
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20. Stryjkowska-Góra A., Karczmarek-Borowska B., Góra T., Krawczak K. Statins and cancers. Contemp Oncol (Pozn). 2015, 19(3):167-75.
21. Su J.B. Vascular endothelial dysfunction and pharmacological treatment. World J Cardiol. 2015, Nov 26;7(11):719-741.
22. Undas A., Brummel-Ziedins K.E., Mann K.G. Anticoagulant effects of statins and their clinical implications. Thromb Haemost. 2014, Mar 3;111(3):392-400.
23. Violi F., Calvieri C., Ferro D., Pignatelli P. Statins as antithrombotic drugs. Circulation. 2013, Jan 15;127(2):251-7.
24. Wada H., Matsumoto T., Yamashita Y.. Diagnosis of thrombosis by hemostatic markers. Nihon Rinsho. 2014, Jul;72(7):1232-6.
Bibliography link
Пак Л.А. Опыт коррекции нарушений функции сосудистого эндотелия и системы гемостаза у больных раком прямой кишки / / Наука и Здравоохранение. 2016. №2. С. 118-128.
Pak L.A. The experience of correction of vascular endothelial function and hemostasis in patients with rectal cancer. Nauka i Zdravookhranenie [Science & Healthcare]. 2016, 2, pp. 118-128.
Пак Л.А. Тік ішектің қатерлі ісігі бар науқастарда тамыр эндотелиі қызметі мен гемостаз жүйесінің бұзылыстарын коррекциялау тәжірибесі / / Ғылым және Денсаулық сақтау. 2016. №2. Б. 118-128.