[The prognostic and diagnostic possibilities in an intraamniotic infection].
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Biomedical subjects
Publications and source records attributed to A N Rybalka.
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The frequency of diagnostic errors in examination of 3827 patients with gynecological cancer diseases accounted for 21.6 up to 35%. The conformation of serum albumin in these patients was studied by means of different biochemical assays. The determination of the amount of the transitory form of albumin by reprecipitation with trichloroacetic acid appeared the most valuable for practical uses. Structural injuries to albumin depended on the localization, pattern and stage of the disease, and features of tumor metastatic spreading. The amount of the transitory form in patients with benign tumors and tumor-like processes in the ovaries (4.5-23.5%), hydatidiform mole (25%), uterine myoma (2-12.6%) rose insignificantly (5 +/- 2% in control) and increased in patients with initial stages of malignant tumors of the ovaries and uterus (28.9-43.7%). In uterine cervix carcinoma and uterine body sarcoma (stage II and higher stages) as well as in ovarian carcinoma, stages III and IV, its amount reached 57-100%.
The level of blood albumin fucose in healthy subjects and cases of non-tumor pathology and benign tumors of the uterus and ovaries was found to be I nmol of fucose/10 nmol of human serum albumin or lower, whereas in patients with malignant tumors of different localizations it was 4-7 times as high. The highest levels were recorded in patients with primary hepatic cancer and hepatic metastases. The test may be used in differential diagnosis of tumor lesions of different localization as well as for assessment of tumor progression.
The frequency and causes of diagnostic errors are discussed on the basis of 2,099 case histories of ovarian and uterine tumors. The use of physico-chemical characteristics of serum albumin as an additional means of diagnosis of these diseases in 16 patients and 20 healthy subjects was studied. Patients revealed changes in dispersion of optical rotation of serum albumin which suggest its despiralization. Although being nonspecific, changes in the extent of despiralization vary depending on tumor advancement and gravity of patient's condition. The level of modified serum albumin is also in correlation with tumor process and the patient's state, the highest values being registered at later stages of the disease.
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Under observation were 175 patients with ovarian tumors and cysts. The distribution of ABO blood groups and Rh factor in relation to this pathology was studied as compared with the control series (2000 healthy females). There was noted an increased probability of the incidence of the majority of the ovarian tumor types among AB blood group females compared with other groups (O, A and B), and just the opposite, the probability of the tumoriform processes incidence in AB group females is considerably less than in other groups. The probability of ovarian tumors malignification proved to be the least in B group females. There is noted a considerably increased relative ovarian tumor and cyst morbidity among Rh-positive females compared with Rh-negative ones.
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Under observation were 1780 females operated upon for ovarian tumors and cysts. Special attention is given to the frequent occurrence in them of hormone-dependent hyperplastic and blastomatous processes in the uterus. These processes in the uterus were observed in 41.7% of all operated patients and in 86.2% of patients, in whom the uterus was studied morphologically.
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