185P - Evaluation of the effect of cholesorption on the concentration of TNF-α in the serum of the blood in tumours of the biliopancreatoduodenal zone

Background

It has been proven that with tumor lesions of the organs of the biliopancreatoduodenal (BPDZ), tumor cells excessively release tumor necrosis factor (TNF-α) in the blood serum and determining their level can assess the activity of the tumor process and the effectiveness of the therapy. Among the causes of mechanical jaundice, the pancreatic head tumor prevailed - 36.1% of patients, in 27.7% of patient's cholestasis was due to a liver gate tumor, in 16.6% - a tumor of the terminal segment of the choledochus, in 13.8% - cancer of the Voter papilla, 5.5% - cancer of the common hepatic duct.

Methods

The study involved 32 patients treated at the General Surgery Department in Tashkent Medical Academy with mechanical jaundice (MJ) with malignant etiology after the application of per-cutaneous-transhepatic cholangiostomy (PTCH). The age of patients ranged from 30 to 74 years, averaging 53.7 ± 3.2 years. There were 19 women and 13 men. In order to remove TNF-α from the body, cholesorption was performed.

Results

The initial concentration of TNF-α in serum averaged 467.43 ± 12.36 (in the norm of 0-5.9 pg/ml). The use of cholesorption contributed to a sharp decrease in the concentration of TNF-α in serum and enhancement of its elimination from the bile. On the 3rd day of observation in the serum, there was a decrease in the concentration of TNF-α by 55.7%. The following days, the serum TNF-α concentration tended to increase and on the 6th day, it averaged 242.05 ± 15.6pg / ml. The next day, serum levels showed a gradual decrease in the concentration of TNF-α and on the 10th day of cholesorption averaged 89.46 ± 7.4-65.49 ± 8.95pg / ml, respectively. On the 14th day of cholesorption in comparison with the initial level, the concentration of TNF-α in the serum decreased 5.5 times.

Conclusions

Thus, the use of cholesorption in patients with MJ of tumor genesis contributes to ridding the body of the pro-inflammatory cytokine TNF-α. The determination of TNF-α in the bile increases the objectivity of the method in assessing the course of the main process and the treatment carried out for BPDZ tumors.

Clinical trial identification

Editorial acknowledgement

Legal entity responsible for the study

The authors.

Funding

Has not received any funding.

Disclosure

All authors have declared no conflicts of interest.