Novosti
Khirurgii

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Year 2015 Vol. 23 No 3

GENERAL & SPECIAL SURGERY

B.F. SHEVCHENKO, A.M. BABIY, O.M. TATARCHUK, V.A. MACARCHUK, O.P. PETISHKO

NON-INVASIVE ASSESSMENT OF FIBROUS TRANSFORMATION AND INFLAMMATORY ACTIVITY OF THE PANCREAS AT CHRONIC PANCREATITIS

SE "Institute of Gastroenterology of the National Academy of Sciences",
Dnipropetrovsk,
Ukraine

Objectives. To work out the program of non-invasive assessment of inflammation activity and fibrous transformation degree of the pancreas at chronic pancreatitis.
Methods. The comparison analysis of biochemical, immunological and sonoelastometric results with those of morphological assessment of the pancreatic biopsies obtained during surgical interventions due to the complications of chronic pancreatitis had been carried out in 86 patients. Age of patients varied from 26 up to 76, there were 69 (80,2%) males and 17 (19,8%) females.
Results. The followings operative interventions had been performed in 86 patients: in 27 (31,3%) – symptomatic operations as the first stage of surgical treatment (external drainage of pseudocysts, gastroenteric bypass and others), in 16 (18,7%) – drainage operations (cystogastro-, cystojejuno-, cystopancreatico-, pancreatico-jejunostomy), in 43 (50,0%) – resection-drainages (Beger’s and Frey’s procedures so as hybrid modifications) and resections (distal resections of the pancreas).
According to ROC analysis of the non-invasive assessment of inflammation activity, the high sensitivity and specificity were typical for PMN-elastase (83,3% and 92,9%) and the ratio of TNF-α / IL-10 (91,7% and 84,6%), the evaluation of the fibrotic transformation degree of the pancreas – the ratio between protein-bonded hydroxyproline (HPð/b) and free hydroxyproline (HPf) – HPp/b / HPf (93,3% and 88,9%) and TNF-α/TGF-β1 (87,8% and 81,8%), the estimation of the severity of the fibrotic transformation according to the sonoelastometric images of anatomical parts of the pancreas – a head (83,3% and 88,9%) and a body (81,8% and 76,9%), the valuation of inflammation activity in the head of pancreas at the early (73,3% and 80,0%) and later (87,5% and 100,0%) degrees of pancreatic fibrosis at cronic pancreatitis.
Conclusion. Thus, indices of PMN-elastase, the ratio of TNF-α/IL-10, ÍPp/b/ÍPf, TNF-α/TGF-β1, sonoelastometry of pancreatic head and body in assessing of fibrotic transformation degree and pancreatic inflammation activity allowed establishing validity of each research methods and using them as diagnostic non-invasive markers of the morphological state of the pancreas at chronic pancreatitis.

Keywords: pancreas, chronic pancreatitis, fibrous transformation, inflammation, non-invasive markers
p. 275-285 of the original issue
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Address for correspondence:
49074, Ukraina, g.Dnepropetrovsk,
prospekt im. Gazetyi "Pravda", d. 96,
GU "Institut gastroenterologii NAMN Ukrainyi",
otdelenie khirurgii organov pischevareniya,
tel. office: 38 0562 27 05 59,
e-mail: aleksandr_babiy@ukr.net,
Babiy Aleksandr Mihaylovich
Information about the authors:
Shevchenko B.F. MD, professor, a chief researcher of the department of surgery of the digestive organs of SE "Institute of Gastroenterology of NAMS of Ukraine".
Babiy À.Ì. PhD, a senior researcher of the department of surgery of the digestive organs of SE "Institute of Gastroenterology of NAMS of Ukraine".
Tàtarchuk Î.Ì. PhD, a senior researcher of the laboratory of microbiology and immunology of SE" Institute of Gastroenterology of NAMS of Ukraine".
Macarchuk V.A. A researcher of the biochemistry laboratory of SE "Institute of Gastroenterology of NAMS of Ukraine".
Petishko O.P. A researcher of the department of the scientific-organizational, methodical work and informative technologies of SE "Institute of Gastroenterology of NAMS of Ukraine".
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