DYNAMICS OF THE VENOUS BLOOD ACID-BASE BALANCE AND RELATIONSHIP BLOOD PH VS TUMOR IN LARYNGEAL CANCER PATIENTS

Abstract

The characteristic for most solid tumors cells is the intracellular alkalinization and acidification of the extracellular milieu and this pH gradient inversion (pHe < pHi) is associated with tumor proliferation, invasion, metastasis, aggressiveness, and treatment resistance. However is there tumor pH (pHi and/or pHe) changes affect on venous blood plasma pH? Purpose of the study. The venous blood acid-base balance before and after the combined treatment, correlation of the venous blood pH indicators (pHb), relationship neoplasm and blood pH in patients with laryngeal cancer was study. Material and methods. Studies were performed in patients with laryngeal cancer categories T2–3 N0 M0 before and after the combined treatment. The patients were divided into four groups: Group 1 – 25 patients before the start of treatment; Group 2 – 21 patients (from Group 1) after completion of the combined treatment; Group 3 – 14 patients from Group 2 with positive results of treatment and Group 4 – 7 patients from Group 2 with a negative result of treatment (recurrence and/or metastasis of the neoplasm). The control group consisted of 15 practically healthy people (Group C). Examination of venous blood acid-base balance of patients, tumor pH and tumor cells pHi and pHe was carried. Results and discussion. The increase in pCO2 and HCO – concentration will result in decrease in the pH, but if these indicators have a clear correlation in the control group, then in patients groups there was a correlation for pHb & pCO2 and pO2 only. Besides, we marked increase in pCO2, HCO –, K+, while pO decreased in pHb after the combined treatment. It is necessary to point out the differences between some benchmarks and indicators of acid-base balance in the plasma of venous blood in primary patients and patients with recurrent laryngeal cancer. So, if pHb, pO2, and Cl– patients have statistically significant differences from control data, then differences with control pCO2 values are characteristic only for patients of Groups 1 and 3. On the pHb, pO , HCO – і mOsm. contrary, differences in the HCO – indices are characteristic only for patients of Group 4. There are statistically significant differences from the control indicators K+, Na+, Ca2+, Glu, Lac, mOsm in patients of the first group and Cl– and Lac of patients in the third group. Among the indicators in the third and fourth groups of patients, statistically significant differences were noted in the values of pHb, HCO – and Glu. In patients of groups 1 and 4, the determination of pHt and the calculation of pHi, pHe revealed decrease in pHt and pHe with increasing pHi in patients with recurrence of the neoplasm. The final stage of the study was to determine the relationship (and not correlation) of blood pH and laryngeal tumors and the relationship was noted in the «pHb-tumor» system in primary patients, but in patients in 3 and 4 Groups, that «pHb-tumor» connection is rather contradictory. Conclusion. Acid-base balance indicators obviously cannot be considered as unconditional markers of carcinogenesis, but their monitoring and, in particular, venous blood pH, of patients after special treatment, can help determine the risk group of patients who may develop of a malignant neoplasm recurrence.

Keywords

• acid-base balance
• laryngeal cancer
• relapse
• prognosis