Background. Perioperative myocardial ischemia often complicates extracardiac surgery. The problems of its prediction, diagnostics, treatment and prevention are not solved. Frequency, structure and clinical features of cardiac ischemic complications of surgical treatment of lung cancer are not well understood.The aim of the study was to investigate the frequency of postoperative myocardial infarction and myocardial ischemia in the surgical treatment of patients with non-small cell lung cancer.Methods. The frequency (%) of myocardial infarction (MI) with and without ST segment elevation of electrocardiogram, acute myocardial ischemia in a complete sample of cancer patients (n = 2051) who underwent treatment for non-small cell lung cancer for the last 10 years was calculated. By comparing the relative indicators and calculating the Odds Ratio (OR), we studied the relationship between the cardiac ischemic events with age, type of surgery, prevalence and localization of the tumour. The clinical manifestations and pathomorphology of postoperative myocardial infarction were analysed.Results. Cardiac ischemic complications of thoracotomy for lung cancer occurred in 2.73 % (95% CI 1.98–3.48) cases. Myocardial infarction with ST segment elevation was recorded in 1.07 % (95% CI 0.58–1.57) patients, MI without ST segment elevation – in 0.54 % (95% CI 0.17–0.9), myocardial ischemia – in 1.12 % (95% CI 0.62–1.63). An increase in the frequency of ischemic events after pneumonectomy was observed compared with lobectomy (OR 6.5, 95% CI 3.5–12.2) and after right-sided pneumonectomy compared with left-sided one (OR 3.2, 95% CI 1.6–6.3), and also the age over 70. Hospital mortality from MI was 39.3 %. According to autopsies of patients who died of МI, coronary atherothrombosis was detected in 2 of 22 cases.Conclusion. In the surgical treatment of non-small cell lung cancer, cardiac ischemic events develop in 2.73 % of patients. The greatest risk is associated with right-sided pneumonectomy.
Significant interest in the problem of genetic oncological diseases is due to an increase in the frequency of their detection, existing difficulties of early recognition, disagreements in the clinical and morphological criteria for diagnosis and evaluation of prognostic factors, the absence of generally accepted standards of treatment and objective assessment of their results.The introduction of new diagnostic technologies into clinical practice (molecular genetic studies, the ability to determine a wide range of hormones and peptides, immunohistochemical determination of general and specific markers, modern methods of topical diagnostics, etc.) allowed us to identify a specific genetic substrate of various types of endocrine organ tumors, previously unknown nosological forms, improve the ability to predict the disease on the preclinical level, to assess their place and importance in the structure of general oncopathology.The issues of terminology, classification, criteria for the degree of malignancy and prognostic factors of hereditary endocrine diseases are particularly relevant. The article presents and analyzes the modern classification and terminological definitions of this group of diseases. The problem of hereditary endocrine tumor diseases and syndromes associated with neuroendocrine tumors (NETs) and multiple endocrine neoplasia syndromes (MEN-syndromes) has been described. In conclusion, the situation with the study of this problem in the Russian Federation is analyzed.
Контакт ная информация: Родион Исмагилович Расулов, д-р мед. наук, заместитель главного врача по хирургии Иркутского областного онкологического диспансера, Иркутск, Россия, e-mail: gava2010@yandex.
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