RU2132059C1 - Method for diagnosing malignant neoplasm generalization in oncological patients - Google Patents

Abstract

FIELD: medicine. SUBSTANCE: method involves examining patient peripheral blood to determine the number of blood platelets, erythrocyte sedimentation rate, segmented leukocytes, lymphocytes, stabbed leukocytes, eosinophils and monocytes percentage, color index, hemoglobin, general protein level, thymol test and prothrombin index. Diagnostic indices are calculated from known formulas. Two or more positive indices of blood platelets number, erythrocyte sedimentation rate, segmented leukocytes, lymphocytes being detected when compared to threshold level being detected, malignant neoplasm generalization is diagnosed. The like positive index lacking or being in excess, patient weight, mean tumor diameter and young leukocytes, basophilic leukocytes number, thymol test, absolute value of segmented leukocytes and general population of all types of blood lymphocytes are additionally measured, diagnostic indices are calculated from known formulas. One or more positive diagnostic indices when compared to threshold level, being detected, malignant neoplasm generalization is diagnosed. Lack of the like positive indices being observed, ratios of normal cell population and blood cells subpopulation to general malignant cells population in patient organism are additionally calculated from known formulas. One or more positive indices when compared to threshold level being detected, malignant neoplasm generalization is diagnosed. Lack of the like positive indices being detected, malignant neoplasm generalization diagnosis is excluded. EFFECT: enhanced accuracy of diagnosis. 6 tbl

Description

 The invention relates to medicine, in particular to oncology, and can be used to recognize the generalization of oncopathology in patients based on hematological, biochemical and anthropometric data.

 This method identifies the neglect of the tumor process on the basis of which the patient is tested according to 3 subprograms: ST1, ST2, ST3 (Table 1-6).

 A known method for the diagnosis of the generalization of oncopathology, including clinical and instrumental (radiological, morphological and radioisotope) research methods, as well as studies of the hormonal and immunological status of the patient (Big Medical Encyclopedia. / Ed. By B.V. Petrovsky. - 3rd ed. - M .: Soviet Encyclopedia, 1981, v. 17, p. 367 - 368).

 However, these methods are not highly informative.

 The proposed method allows you to more accurately identify the generalization of the tumor, without resorting to invasive and expensive visualizing methods of examination, as well as a hidden generalization of the process.

This goal is achieved by examining the patient’s peripheral blood, determining platelet count, erythrocyte sedimentation rate, percentage of segmented white blood cells, lymphocytes, stab leukocytes, eosinophils and monocytes, color indicator, hemoglobin content, total protein, thymol sample and prothrombin Diagnostic indices are calculated using the formulas:
IK15 = ESR • Tr / (Hb • CPU),
IKP2 = TR • (C + P + E) / ((L + M) • 100),
IKP8 = ESR • Tim • IK15 • IKP5 / (OB • Bel • PI),
ICP5 = Hb • Bel • OB • PI • (E + 1) / (ESR • 100000),
where ESR is the erythrocyte sedimentation rate (mm / h), Tr is the number of platelets in the blood (• 10 ⁹ / l), Hb is the hemoglobin content in the blood (g / l), CP is the color indicator of blood, C-, P-, E-, L-, M - percentage of the corresponding cells in the blood formula, Tim - thymol sample (units), OB - concentration of total bilirubin in the blood (µmol / l), Bel - total protein in the blood (g / l) , PI - prothrombin blood index (%) and in the presence of 2 or more positive indicators of diagnostic indices or values of platelet counts, segmented leukocytes the number of patients, lymphocytes and erythrocyte sedimentation rate relative to the threshold level, they diagnose the generalization of a malignant neoplasm, and in the absence or presence of 1 similar positive indicator, the patient’s weight, average tumor diameter, as well as the content of young white blood cells, basophils, thymol test, the absolute number of segmented white blood cells and the total the population of all blood lymphocytes, diagnostic indices are calculated by the formulas:
IKP4 = CPU • S • Tr • D / ((M + 1) • L • 1000),
PCM1 = (Tim + 1) • D • Tr / (PI • Hb),
IKM2 = ESR • (P + S + S) / (L + M + E + B),
IKM3 = D • Tr / Weight,
IKM4 = IK15 • IKB2 • (Tim + 1) / (Lott • Weight),
PCM5 = D • Tr / PI,
IKM6 = C • Subs • (P + 1) • (Tim + 1) / (Ltot • L • OB),
PCM7 = (ESR + C + P + S) / (PI + L),
PCM8 = (PI + Hb + L) / Tr,
PCM9 = PCM7 / (PCM8 + 1),
IKM10 = D • (ESR + Tr) / (PI + Hb + Weight),
where Weight is the weight of the examined patient (kg), D is the average diameter of the tumor, Yu is the percentage of young white blood cells in blood fomula, B is the percentage of basophils in the blood formula, Tim is the thymol test (unit), Sabs is the absolute number of segmented white blood cells in blood (• 10 ⁹ l), Л _that is the total number of lymphocytes in the blood, calculated by the formula Ltot = Labs • BCC, where for men BCC = Weight • 0.07 and for women CTC = Weight • 0.065 and if 1 and a more positive indicator of diagnostic indices relative to the threshold level is diagnosed by generalization of a malignant neoplasm, and in the absence of analogous positive indicators, the ratio of the number of populations of normal cells and subpopulations of blood cells to the total number of malignant cells in the patient’s body is additionally determined by the formulas: Weight / D, Ltot / D, Trtot / D, Ertot / D, Stot / D, Ltot / D and Mtot / D, where Ltot Trtot, Ertot, Ltot, Stot and Mtot is the total population of these cells in the blood, calculated by the formula: Ntot = Nabs • BCC and in the presence of 1 or more positive indicators relative to thresholds Level generalization diagnosed malignancy, and exclude the presence of generalization of cancer in the absence of similar positive indicators.

 Examples of specific performance of the method.

 Example 1

 Patient D., 58 years old, weight. 56 kg, admitted with a diagnosis of peripheral cancer of the upper lobe of the right lung, 3 cm in diameter.

 Blood test: red blood cells - 4.0, hemoglobin - 121, CPU - 0.9, L - 7.2, E - 3, S - 0, P - 1, C - 54, L - 40, M - 2, ESR - 15, platelets - 260.

 Blood biochemistry: glucose - 4.0, prothrombin index - 100, total bilirubin - 12.6, tim. sample - 1.3, sul. sample - 1.7, total protein - 76.

 Kshivets indices: IK15 - 35.81, IKP2 - 3.59, IKP8 - 0.23, IKP4 - 31.59, IKM1 - 0.15, IKM2 - 18.33, IKM3 - 13.93, IKM4 - 0.41 IKM5 - 7.80, IKM6 - 0.17, IKM7 - 0.50, IKM8 - 1.0, IKM9 - 0.25, IKM10 - 2.98.

 Relationship factors: Weight / D = 18.67, Ltot / D = 9.41, Trtot / D = 339.73, Ertot / D = 5.23, Stot / D = 5.08, Ltot / D = 3.76 , Mtot / D = 0.19.

 When testing with the ST1 program, only 1 positive test was detected (this is not enough to diagnose generalization), with the ST2 program 1 positive test was detected (this is already quite enough), i.e. the patient has a generalization of a malignant neoplasm.

 Indeed, the patient died 58 days after a radical operation (upper lobectomy on the right, histologically squamous non-keratinized cancer without metastases in the lymph nodes, 3 cm in diameter, stage II) from generalization of oncopathology, i.e., the patient had a hidden generalization of the process, which is modern methods not diagnosed.

 Example 2

 Patient A., 58 years old, weight 69 kg, was admitted with a diagnosis of central cancer of the right lung, 4 cm in diameter.

 Blood test: erythrocytes - 4.1, hemoglobin - 132, CPU - 0.9, L - 7.3, E - 4, S - 0, P - 1, C - 53, L - 33, M - 9, ESR - 7, platelets - 180.

 Blood biochemistry: glucose - 5.5, prothrombin index - 109, total bilirubin - 10.4, tim. sample - 6.0, sul. sample - 1.7, total protein - 76.

 Kshivets indices: IK15 = 10.61, IKP2 = 2.49, IKP8 = 0.42, IKP4 = 11.34, IKM1 = 0.35, IKM2 = 8.22, IKM3 = 10.43, IKM4 = 0.53 , PCM5 = 6.61, PCM6 = 0.72, PCM7 = 0.43, PCM8 = 1.52, PCM9 = 0.17, PCM10 = 2.41.

 Relationship factors: Weight / D = 17.25, Ltot / D = 8.81, Trtot / D = 217.35, Ertot / D = 4.95, Stot / D = 4.67, Ltot / D = 2.91 , Mtot / D = 0.79.

 When testing with the programs ST1, ST2 and ST3, no positive tests were detected, i.e. the patient does not have a generalization of the malignant neoplasm.

 Indeed, the patient is alive for more than 3 years after radical surgery (pneumonectomy on the right, histologically squamous non-keratinized cancer without metastases in the lymph nodes, 4 cm in diameter, stage II).

 Example 3

 Patient A., 58 years old, weight 70 kg, was admitted with a diagnosis of gastric cancer, 12 cm in diameter.

 Blood test: red blood cells - 3.6, hemoglobin - 109, CPU - 0.9, L - 8.8, E - 1, S - 0, P - 7, C - 79, L - 10, M - 3, ESR - 70, platelets - 340.

 Blood biochemistry: glucose - 3.6, prothrombin index - 107, total bilirubin - 8.0, tim. sample - 1.4, sul. sample - 2.0, total protein - 76.

 Kshivets indices: IK15 = 242.61, IKP2 = 22.75, IKP8 = 0.74, IKP4 = 775.99, IKM1 = 0.84, IKM2 = 430.0, IKM3 = 58.29, IKM4 = 9.29 , PCM5 = 38.13, PCM6 = 30.57, PCM7 = 1.33, PCM8 = 0.66, PCM9 = 0.80, PCM10 - 17.20.

 Relationship factors: Weight / D = 5.83, Ltot / D = 3.59, Trtot / D = 138.83, Ertot / D = 1.47, Stot / D = 2.84, Ltot / D = 0.36 , Mtot / D = 0.11.

 When testing according to the ST1 program, 6 positive tests were revealed, according to the ST2 program - 9 positive tests, according to the ST3 program - 3 positive tests, i.e., the patient has a generalization of the malignant neoplasm.

 Indeed, the patient died 111 days after the radical operation (gastrectomy, histologically adenocarcinoma without metastases in the lymph nodes, 12 cm in diameter, stage III) from the generalization of oncopathology.

 Example 4

 Patient F., 56 years old, weight 72 kg, was admitted with a diagnosis of gastric cancer, with a diameter of 3 cm.

 Blood test: red blood cells - 4.2, hemoglobin - 136, CPU - 0.9, L - 4.3, E - 5, S - 0, P - 3, C - 59, L - 30, M - 3, ESR - 5, platelets - 200.

 Blood biochemistry: glucose - 4.4, prothrombin index - 82, total bilirubin - 10.0, tim. sample - 1.0, sul. sample - 2.0, total protein - 72.

 Kshivets indices: IK15 = 8.17, IKP2 = 4.06, IKP8 = 0.07, IKP4 = 21.77 IKM1 = 0.11, IKM2 = 8.16, IKM3 = 8.33, IKM4 = 0.13, PCM5 = 7.32, PCM6 = 0.61, PCM7 = 0.60, PCM8 = 1.24, PCM9 = 0.27, PCM10 = 2.12.

 Relationship factors: Weight / D = 0.24, Ltot / D = 7.22, Trtot / D = 336.0, Ertot / D = 7.06, Stot / D = 4.26, Ltot / D = 2.17 , Mtot / D = 0.22.

 When testing with the programs ST1, ST2 and ST3, no positive tests were detected, i.e. the patient does not have a generalization of the malignant neoplasm.

 Indeed, the patient is alive for more than 3 years after radical surgery (subtotal resection of the stomach, histologically adenocarcinoma without metastases in the lymph nodes, 3 cm in diameter, stage III).

 The scenario of the ST3 subprogram is similar to the ST1 and ST2 subprograms: if the patient has at least 1 positive test, then generalization of the tumor process should be excluded. If a cancer patient goes through all 3 subprograms of ST1-3, without going beyond the permissible number of positive tests, then the patient has stages I-III of the tumor process. The overall accuracy of the method in a sample of over 4 thousand cancer patients reaches 96%, and it also identifies the so-called "hidden" generalization of oncopathology, which is generally impossible to recognize by modern diagnostic methods.

Claims (1)

A method for diagnosing the generalization of malignant neoplasms in cancer patients by examining the patient’s peripheral blood, characterized in that it determines the number of platelets (TP), erythrocyte sedimentation rate (ESR), percentage of segmented white blood cells (C), lymphocytes (L), stab white blood cells ( P), eosinophils (E) and monocytes (M), color index (CP), hemoglobin (Hb), total protein (Bel), thymol test (Tim) and prothrombin index (PI), diagnostic indices (IR1, IR2 are calculated ... IRn) by the formulas:
IK15 = ESR • Tr / (Нb • CPU),
IKP2 = Tr • (C + P + E) / ((L + M) • 100),
IKP8 = ESR • TIM • IK15 • IKP5 / (OB • Bel • PI),
IKP5 = Нb • Bel • OB • PI • (E + 1) / (ESR • 100000),
where ESR is the erythrocyte sedimentation rate (mm / h);
Tr - the number of platelets in the blood (• 10 ⁹ / l);
Нb - hemoglobin content in the blood (g / l);
CP - a color indicator of blood;
C-, P-, E-, L-, M- - percentage of the corresponding cells in the blood formula,
Tim - thymol test (unit);
OB - the concentration of total bilirubin in the blood (µmol / l);
Bel - total protein in the blood (g / l);
PI - prothrombin blood index (%)
and if there are two or more positive diagnostic indexes or values of platelet counts, segmented white blood cells, lymphocytes and erythrocyte sedimentation rate relative to the threshold level, the generalization of the malignant neoplasm is diagnosed, and in the absence or presence of one similar positive indicator, the patient’s weight, average tumor diameter, are additionally determined as well as the content of young white blood cells, basophils, thymol test, the absolute number of segmented leukemia cytosis and the total population of all blood lymphocytes, calculate diagnostic indices by the formulas:
IKP4 = CPU • S • Tr • D / ((M + 1) • L • 1000),
PCM1 = (Tim + 1) D • Tr / (PI • Hb),
IKM2 = ESR • (P + S + S) / (L + M + E + B),
IKM3 = D • Tr / Weight,
IKM4 = IK15 • IKB2 • (Tim + 1) / (Lott • Weight),
PCM5 = D • Tr / PI,
IKM6 = C • Subs • (P + 1) • (Tim + 1) / (Ltot • L • OB),
PCM7 = (ESR + C + P + S) / (PI + L),
PCM8 = (PI + Hb + L) / Tr,
PCM9 = PCM7 / (PCM8 + 1),
IKM10 = D • (ESR + Tr) / (PI + Нb + Weight),
where Weight is the weight of the examined patient (kg);
D is the average diameter of the tumor;
S - the percentage of young white blood cells in the blood formula;
B - the percentage of basophils in the blood formula;
Tim - thymol test (unit);
Sabs - the absolute number of segmented white blood cells in the blood (• 10 ⁹ / l);
Lott - the total number of lymphocyte populations in the blood, calculated by the formula Lott = Labs • BCC, where for men BCC = Weight • 0.07 and for women BCC = Weight • 0.065
and in the presence of one or more positive indicators of diagnostic indices with respect to the threshold level, the generalization of a malignant neoplasm is diagnosed, and in the absence of similar positive indicators, the ratio of the number of populations of normal cells and subpopulations of blood cells to the total number of malignant cells in the patient’s body is determined by the formulas:
Weight / L, Ltot / D, Trtot / D, Ertot / D, Stot / D, Ltot / D and Mtot / D,
where Ltot, Trtot, Ertot, Ltot, Stot and Mtot is the total population of these cells in the blood, calculated by the formula
Ntot = Nabs • BCC
and in the presence of one or more positive indicators relative to the threshold level, the generalization of the malignant neoplasm is diagnosed, and in the absence of similar positive indicators, the presence of generalization of the malignant neoplasm is ruled out.

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