RU2114431C1 - Method for setting differential diagnosis of malignant neoplasm and benign pathologic formations - Google Patents

Abstract

FIELD: medicine. SUBSTANCE: method involves examining presence of anorexia, weight losses, determining peripheral blood for blood platelets, segmented, stab neutrophil, eosinophil leukocytes, general bilirubin, glucose and prothrombin index level. Then eosinophil population is counted and diagnostic index calculated from a formula IKB2=Glucose * PI /(GB * 10), where Glucose is the glucose concentration in blood, PI is the prothrombin index in %, GB is the general bilirubin in mmole/l. Three or more indices are greater than normal value, malignant neoplasm is diagnosed. 2 or less more indices are greater than normal value, basophil, monocytes, lymphocytes, young leukocytes, hemoglobin, protein contents and erythrocyte sedimentation velocity, color index, circulating blood volume, height and weight are additionally investigated to calculate diagnostic indices. One of the diagnostic indices exceeding the normal value, malignant neoplasm is diagnosed. No indices exceeding the normal values, benign pathology is diagnosed. EFFECT: enhanced accuracy of malignant tumor diagnosis at early stage. 1 dwg , 4 tbl

Description

 The invention relates to medicine, in particular to oncology, and can be used for differential diagnosis of oncopathology.

 A known method for the diagnosis of cancer by determining hexokinase isoenzymes in biopsy specimens.

 However, the method does not have sufficient accuracy and time-consuming.

 Closest to the proposed technical essence is a method for diagnosing malignant neoplasms of various localization by incubating a certain number of peripheral blood leukocytes of a patient with aqueous extracts of a detected cancer, determining the leukocyte non-aggregation index and comparing it with the norm.

 The main disadvantage of this method is the possibility of its implementation in the presence of a detected tumor. In addition, the method requires expensive equipment and highly qualified medical specialists.

 The aim of the invention is a highly accurate differential and early diagnosis of malignant neoplasms among individuals with benign pathology and malignant tumors.

The goal is achieved in that the patient determines the presence of anorexia, weight loss, and in the peripheral blood the content of platelets (• 10 ^{9 / l} ), segmented white blood cells (• 10 ^{9 / l} ), stab (• 10 ^{9 / l} ), eosinophils and indicators of total bilirubin, glucose and prothrombin index, then calculate the size of the eosinophil population (This) by the formula Et = Eabs • BCC, where Eabs - leukocytes • E / 100; BCC - circulating blood volume for men (weight • 0.07), for women (weight • 0.065) and diagnostic index (ICB2) according to the formula: ICB2 = Glucose • PI / (OB • 10), where Glucose is the level of glucose in the blood mmol / l; PI - prothrombin index,%; OB - total bilirubin, µmol / l, and if there are 3 indicators or more above the norm, a malignant neoplasm is diagnosed, and with 2 or less indicators above the norm, blood levels of basophils, monocytes, lymphocytes, young white blood cells, hemoglobin, protein, and speed are additionally determined erythrocyte sedimentation, color indicator, circulating blood volume, age and weight of the patient, diagnostic indices are calculated by the formulas:
IKD1 = (IK1 + IK2 + IK15) • IKP6 / ((IK6 + 1) • IKB2 • IKP1);
ICD2 = IK1 • IK2 • IKP6 / (IKB2 • IKP1);
ICD3 = IK15 • IKP6 / ((IK6 + IKP1) • IKB2);
ICD4 = CPU • PI • (E + P + 1) /) Platelets • OB);
ICD5 = ICD1 / ICD4;
ICD6 = OB • Platelets • IK4 • IKP5 / (PI • IKB2 • 1000);
ICD7 = ICD3 • ICD6 / ICD4;
ICD8 = IK2 • Age / (IKB2 • Sabs • CPU • Weight);
ICD9 = PI • Sul • 100 / (OB • Platelets • Age);
ICD10 = Weight • Protein • (SG6 + 1) • PI / (SG15 • Age • OB • 100);
Where
IR1 = / C-L / • Sabs / (B + E + M);
IR2 = Sabs • L • ((2C + 5 (10 + P + 1)) / (3L + 7 (M + 1) + 9 (B + E + 1)));
IK15 = ESR • Platelets / (Hemoglobin • CPU);
IKP6 = ESR • Leukocytes • Labs • (L • C) • 10 / (Hemoglobin • Protein) • PI • (E + 1));
IK6 = (E + B + 1) • L • M • Labs / (C + P + 10);
IKP1 = С • Sabs • (П + Ю + 1) / (Л • М);
IR4 = C • Sabs / (L • M);
ICP5 = Hemoglobin • Protein • OB • (E + 1) • PI / (ESR • 100000);
where B is the percentage of basophils in the blood formula; M is the percentage of monocytes in the blood formula; L is the percentage of lymphocytes in the blood formula; Labs - the absolute number of lymphocytes in the blood (• 10 ^{9 / l} ) (the first two digits after the decimal point); Labs = White blood cells • L / 100; S - the percentage of young white blood cells in the blood formula; ESR - erythrocyte sedimentation rate, mm / h; Hemoglobin - hemoglobin content in the blood, g / l; CP - a color indicator of blood (the first two digits after the decimal point); BCC - circulating blood volume, l; Protein - total protein in the blood, g / l; Age - age of the patient (years); Weight is the weight of the patient, kg, and if there is one indicator of the diagnostic index above the norm, a malignant neoplasm is diagnosed, and in the absence of indicators above the norm, a benign pathology is diagnosed.

 The method is as follows: for the diagnosis using 2 programs: Diagnosis-1 and Diagnosis-2 (see drawing). Both programs are launched sequentially: first, the Diagnosis-1 program, if its results are negative (no oncopathology has been identified), then the Diagnosis-2 program starts. If her results are negative, then the examined patient has a benign pathology.

1. Diagnosis-1
This program is based on 9 indicators of a general and biochemical blood test, as well as clinical symptoms (see tab. 1-2), where IKB2 is the Kshivets diagnostic index, calculated by the formula:
IKB2 = Glucose • PI / (ABOUT • 10),
Where
Glucose - the level of glucose in the blood (mmol / l); PI - prothrombin index (%); ABOUT - the content of total bilirubin in the blood (µmol / l); This is the eosinophil population in the bloodstream:
This = Abs • BCC,
where Ebs = White blood cells • E / 100;
for men, BCC = Weight • 0.07; for women BCC = Weight • 0.065;
where White blood cells - the total number of white blood cells in the peripheral blood (• 10 ^{9 / l} ) (the first two digits after the decimal point); E - percentage of eosinophils in the blood formula; Platelets - the number of platelets in the peripheral blood (• 10 ^{9 / l} ); Pubs - the number of stab leukocytes in the blood (• 10 ^{9 / l} );
Pubs = White blood cells • P / 100,
Where
P is the percentage of stab leukocytes in the blood formula; Sabs - the number of segmented white blood cells in the blood (• 10 ^{9 / l} );
Subs = WBC • S / 100,
Where
C is the percentage of segmented white blood cells in the blood formula; Anorexia - a decrease or lack of appetite.

 With differential and early diagnosis, the number of positive tests (blood counts that exceed the threshold level) is calculated. If out of 9 tests 3 or more are positive, then with the accuracy and interval probability indicated in Table. 2, the patient has any malignant neoplasm (cancer, hemoblastosis, sarcoma). If there are 0-2 positive tests, then the patient with a probability indicated in the same table has a benign pathology.

2. Diagnosis-2
This program is launched only if the results of the Diagnosis-1 program are negative. It includes 10 diagnostic indexes of Kshivets IDK1-10 (see tab. 3-4), where the indices are calculated according to the following formulas:
IDK1 = (IK1 + IK2 + IK15) • IKP6 / ((IK6 + 1) • IKB2 • IKP1);
ICD2 = IK1 • IK2 • IKP6 / (IKB2 • IKP1);
ICD3 = IK15 • IKP6 / ((IK6 + IKP1) • IKB2);
ICD4 = CPU • PI • (E + P + 1) / (Platelets • OB);
ICD5 = ICD1 / ICD4;
ICD6 = OB • Platelets • IK4 • IKP5 / (PI • IKB2 • 1000);
ICD7 = ICD3 • ICD6 / ICD4;
ICD8 = IC2 • Age / (ICB2 • Subs • CPU • Weight);
ICD9 = PI • Sul • 100 / (OB • Platelets • Age);
ICD10 = Weight • Protein • (SG6 + 1) • PI / (SG15 • Age • ABOUT ¹⁰⁰ );
Where
IR1 = / C - L / • Sabs / (B + E + M);
IK2 = Subs • L • (((2C + 5 (10 + P + 1)) / (3L +7 (M + 1) + 9 (B + E + 1)));
IK15 = ESR • Platelets / (Hemoglobin • CPU);
IKP6 = ESR • Leukocytes • Labs • (L • C) • 10 / (Hemoglobin • Protein • PI • (E + 1));
IK6 = (E + B + 1) • L • M • Labs / (C + P + 10);
IKP1 = С • Sabs • (П + Ю + 1) / (Л • М);
IR4 = C • Sabs / (L • M);
ICP5 = Hemoglobin • Protein • OB • (E + 1) • PI / (ESR • 100000);
where B is the percentage of basophils in the blood formula; M is the percentage of monocytes in the blood formula; L is the percentage of lymphocytes in the blood formula; Labs - the absolute number of lymphocytes in the blood (• 10 ^{9 / l} ) (the first two digits after the decimal point): Labs = White blood cells • L / 100; S - the percentage of young white blood cells in the blood formula; ESR - erythrocyte sedimentation rate (mm / h); Hemoglobin - hemoglobin content in the blood (g / l); CP - a color indicator of blood (the first two digits after the decimal point); BCC - circulating blood volume (l); Protein - total protein in the blood (g / l); Age - age of the patient (years); Weight - patient weight (kg).

 Note: when M = O and C = A, 1 is set instead of zero; when calculating IK1, the numerator always has a positive number (for this, the modulus sign).

 The scenario for recognizing a malignant neoplasm according to the Diagnosis-2 program is the same as the Diagnosis-1 program. However, only 1 positive index is enough here to suspect cancer pathology in a patient. If there is not a single positive test, then the examined person has a benign pathology. Interval probabilities of oncopathology and benign pathology, as well as the accuracy of diagnosis are shown in table. 4.

 In conclusion, the following should be noted. The more positive tests are recorded, the more likely the patient has oncopathology. With comprehensive initial data, the accuracy of the diagnosis reaches 98.5% and, accordingly, the probability of missing any malignant neoplasm in the subjects is 1.5%. Such accuracy is not possessed by any of the existing diagnostic techniques.

 The entire diagnostic methodology "Superoncoprognosis-1.0" is entirely focused on the technology of expert systems and computer technology.

Examples
1. Patient K., 54 years old, weight 70 kg, hemoglobin = 121; CPU = 1.0; platelet count = 180; white blood cells = 7.1 E = 0%; P = 2%; C = 77%; L = 20%; M = 1%; ESR = 20; glucose = 4.0; prothrombin index = 78%; total bilirubin = 10.0; thymol test = 3.0; sublimate test = 1.9; total protein = 80. There is anorexia and weight loss. When testing according to the Diagnosis-1 program, 5 positive tests were revealed; the presence of anorexia (1) and weight loss (1), platelets = 180 (0), Pubs = 0.14 (0), Subs = 5.47 (1), This = 0 (1), total bilirubin = 10 (0) , prothrombin index = 78 (1), ICB2 = 3.59 (0), which is higher than the permissible level (0-2), i.e. the patient has a malignant neoplasm. Indeed, the patient revealed early gastric cancer with a diameter of 1.5 cm (highly differentiated adenocarcinoma). Operation 03.24.1981; subtotal gastrectomy. Cancer within the submucosa of the stomach wall, without metastases to the lymph nodes.

 2. Patient E., 49 years old, weight 50 kg, hemoglobin = 110; CPU = 0.8; platelet count = 160; white blood cells = 5.8; E = 4%; P = 3%; C = 42%; L = 49%; M = 2%; ESR = 6; glucose = 6.5; prothrombin index = 110%; total bilirubin = 6.8; thymol test = 7.0; sublimate test = 2.0; total protein = 70. Of the complaints, only pain in the epigastric region. When tested using the Diagnosis-1 programs [there is no anorexia (0) and weight loss (0), platelets = 160 (0), Pubs = 0.17 (0), Sub = 2.44 (0), This = 0.81 ( 0), total bilirubin = 6.8 (0), prothrombin index = 110 (0), ICB2 = 10.51 (0)] and Diagnosis-2 [ICD1 = 0.15 (0), ICD2 = 0.21 ( 0), ICD3 = 0.11 (0), ICD4 = 0.65 (0), ICD5 = 0.24 (0), ICD6 = 0.05 (0), ICD7 = 0.01 (0), ICD8 = 0.33 (0), ICD9 = 0.41 (0), ICD10 = 33.84 (0)] not a single positive test (0), ie the patient has a benign pathology. Indeed, the patient has an ulcerative stomach ulcer. Operation 03/03/1982; subtotal gastrectomy. Histologically gallstone gastric ulcer with a diameter of 2.0 cm.

 3. Patient P., 50 years old, weight 52 kg, hemoglobin = 128; CPU = 0.9; platelet count = 230; white blood cells = 8.4; E = 2%; P = 7%; C = 62%; L = 24%; M = 5%; ESR = 28; glucose = 4.0; prothrombin index = 100%; total bilirubin = 8.6 thymol sample = 0.8; sublimate test = 1.6; total protein = 60. No complaints. When testing according to the Diagnosis-1 program, only 2 positive tests were revealed; there are no anorexia (0) and weight loss (0), platelets = 230 (1), Pubs = 0.59 (0), Sabs = 5.21 (1), This = 0.61 (0), total bilirubin = 8, 6 (0), prothrombin index = 100 (0), ICB2 = 4.65 (0), which is below the threshold level (3 or more), i.e. the patient should be tested according to the Diagnosis-2 program. According to the Diagnosis-2 program, 2 positive tests were detected: ICD1 = 0.36 (0), ICD2 = 44.00 (0), ICD3 = 1.15 (0), ICD4 = 0.46 (0), ICD5 = 0, 79 (0), ICD6 = 0.08 (0), ICD7 = 0.20 (0), ICD8 = 2.24 (1), ICD9 = 0.16 (0), ICD10 = 1.49 (1), which is higher than the threshold level (1 positive test is enough), i.e. the patient has a malignant neoplasm. Indeed, the patient revealed a central cancer of the right lung with a diameter of 2.5 cm (squamous keratinizing cancer). Operation 07/07/1988; pneumonectomy on the right. Histologically: squamous keratinizing lung cancer without metastases to the lymph nodes, stage II.

 4. Patient I., 56 years old, weight 56 kg, hemoglobin = 156; CPU = 1.0; platelet count = 180; white blood cells = 4.1; E = 2%; P = 3%; C = 73%; L = 18%; M = 4%; ESR = 3; glucose = 3.3; prothrombin index = 105%; total bilirubin = 9.2; thymol test = 3.8; sublimate test = 1.5; total protein = 76. Of the complaints, only pain in the epigastric region. When tested using the Diagnosis-1 programs [there is no anorexia (0) and weight loss (0), platelets = 180 (0), Pubs = 0.12 (0), Sub = 2.99 (0), This = 0.32 ( 0), total bilirubin = 9.2 (0), prothrombin index = 105 (0), ICB2 = 3.77 (0)] and Diagnosis-2 [ICD1 = 0.03 (0), ICD2 = 0.34 ( 0), ICD3 = 0.01 (0), ICD4 = 0.38 (0), ICD5 = 0.09 (0), ICD6 = 1.46 (0), ICD7 = 0.01 (0), ICD8 = 1.56 (0), ICD9 = 0.17 (0), ICD10 = 7.76 (0)] not a single positive test (0), ie the patient has a benign pathology. Indeed, the patient has an ulcerative stomach ulcer. Operation 12/12/1988; subtotal gastrectomy. Histologically kalezny gastric ulcer with a diameter of 2.0 cm with penetration into the pancreas.

Claims (1)

A method for differential diagnosis of malignant neoplasms and benign pathology by examining a patient’s peripheral blood, characterized in that the patient determines the presence of anorexia and weight loss, and in the peripheral blood the platelet count (• 10 ^{9 / l} ), segmented white blood cells (• 10 ^{9 / l} ), stab (• 10 ^{9 / l} ), eosinophils and indicators of total bilirubin, glucose and prothrombin index, then calculate the size of the eosinophil population (This) by the formula
This = Abs • BCC,
where Eabs - leukocytes • E / 100;
BCC - the volume of circulating blood for men (weight • 0.07), for women (weight • 0.065),
and diagnostic index (IKB2) according to the formula
IKB2 = Glucose • PI / (ABOUT • 10),
where Glucose is the level of glucose in the blood, mmol / l;
PI - prothrombin index,%;
OB - total bilirubin, µmol / l,
and if there are three indicators and above the norm, a malignant neoplasm is diagnosed, and if two or less indicators above the norm, the blood levels of basophils, monocytes, lymphocytes, young leukocytes, hemoglobin, protein, as well as the erythrocyte sedimentation rate, color indicator, circulating volume are additionally determined blood, age and weight of the patient, calculate diagnostic indices according to the formulas
IKD1 = (IK1 + IK2 + IK15) • IKP6 / (IK6 + 1) • IKB2 • IKP1;
ICD2 = IK1 • IK2 • IKP6 / (INB2 • IKP1);
ICD3 = IK15 • IKP6 / ((IK6 + IKP1) • IKB2);
ICD4 = CPU • PI • (E + P + 1) / (Platelets • OB);
ICD5 = ICD1 / ICD4;
ICD6 = OB • Platelets • IK4 • IKP5 / (PI • IKB2 • 1000);
ICD7 = ICD3 • ICD6 / ICD4;
ICD8 = IC2 • Age / (ICB2 • Subs • CPU • Weight);
ICD9 = PI • Sul • 100 / (OB • Platelets • Age);
ICD10 = Weight • Protein • (SG6 + 1) • PI / (SG15 • Age • OB • 100);
where IR1 = (C - L) • Sabs / (B + E + M);
IR2 = Sabs • L • (((2C + 5 (10 + P + 1) / (3L + 7) (M + 1) + 9 (B + E + 1)));
IK15 = ESR • Platelets / (Hemoglobin • CPU);
IKP6 = ESR • Leukocytes • Labs • (L • C) • 10 / (Hemoglobin • Protein • PI • (E + 1);
IK6 = (E + B + 1) • L • M • Labs / (C + P + 10);
IPK1 = С • Sabs • (П + Ю + 1) / (Л • М);
IR4 = C • Sabs / (L • M);
IPC5 = Hemoglobin • Protein • OB (E + 1) • PI / (ESR • 100000);
CP - a color indicator of blood (the first two digits after the decimal point);
Age - age of the patient (years);
Subs - Leukocytes • C / 100;
Weight - patient weight (kg);
Protein - total protein in the blood (g / l);
B - the percentage of basophils in the blood formula;
M is the percentage of monocytes in the blood formula;
L is the percentage of lymphocytes in the blood formula;
ESR - erythrocyte sedimentation rate, mm / h;
Labs - the absolute number of lymphocytes in the blood (• 10 ^{9 / l} );
Hemoglobin - hemoglobin content in the blood, g / l,
and if there is at least one indicator of the diagnostic index above the norm, a malignant neoplasm is diagnosed, and in the absence of indicators above the norm, a benign pathology is diagnosed.

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