Variación en parámetros bioquímicos en un grupo de pacientes con tumor cerebral primario: revisión de cuatro estudios

Resumen

Introduction: It has been well established and evidence-based fact that serum levels of proteins, cholesterol, trace elements, and
pseudouridines may suffer changes during a neoplastic disease process. This report encompassed four prospective studies, original in Iraq to our knowledge, had explored the serum total proteins (TP), pseudouridines levels, total serum cholesterol (TSC), and serum trace elements (TE), in groups of patients harboring primary brain tumours (PBT) compared to healthy persons. Patients and Methods:Study number 1: A group of 107 patients, from both sexes, aged 2-75 years, harboring PBT were admitted to and operated upon via formal craniotomy by staff neurosurgeons at The Teaching Hospital at Kadhimiyah (TTHK) and Neurosurgical Hospital (NH); their sera were tested for serum total proteins (TP); the latter biochemical parameters were compared with those of 40 healthy persons. Study number II: the same patients and healthy controls were tested for pseudouridine measurement. Study number III: Another group of 30 patients with PBT were studied for TSC levels and were compared with 30 healthy volunteers. Study number IV: A third group of 26 patients with PBT, from both sexes, their sera were tested and measured for TE; the measurements were compared to 1630 volunteers from both sexes and of different age groups. The sera and brain tumor tissue samples were analysed and examined by appropriate methods at relevant laboratories of the TTHK, NH, The Medical Research Centre (MRC) of The College of Medicine, Al-Nahrain University and the Iraqi Atomic Energy Committee (IAEC). Results and Discussion: The serum TP and PBT study: Results are shown in table 1. The serum pseudouridines and PBT study: Mean levels of pseudouridine in serum of PBT patients, were significantly higher (p < 0.01) than its levels in the (normal) controls, table 2. The TSC and PBT study: 1. Hesalthy persons from both sexes: age range, in years, 15 – 75, mean 40.5, SD ± 19.8; TSC range 142 – 230 mg / dl, mean 185.6 mg / dl, SD ± 24.9, (3.7 – 5.9 mmol / l, mean 4.8 mmol / l, SD
± 0.6), table 3. 2. Thirty persons from both sexes having peripheral tumors, with no clinical evidence of brain tumors: age range, in years, 15 – 75, mean 54.3 ± 12.8; TSC range 90 – 220 mg / dl, 143 ± 36.3 (2.3 – 5.7 mmol / l, mean 3.7 ± 0.9), table 4. 3. Thirty patients from both sexes with primary and secondary brain tumors, age range, in years, 15 - 75, mean 41.3 ± 20.9; TSC range 140 – 284 mg / dl, 217.6 ± 41.2 (3.6 – 7.3 mmol / l, 5.6 ±
1.1), table 4. Study number IV: Serum mean values (and S.D.) of all measured TEs were as follow: Se 0.045 +/- 0.011, Zn 0.320 +/- 0.095, Cu 0.607 +/- 0.154, Fe 0.880 +/- 0.456, Mg 13.625 +/- 3.994, Co 0.020 +/- 0.036, Ni 0.016 +/- 0.030, Mn 0.016 +/- 0.009, Cd 0.050 (one sample), and Cr 0.015 +/- 0.005 micrograms per milliliter (mcg / ml). All mean concentrations were consistently lower in the patients than healthy volunteers; both the Student’s (t) and probability (p value) tests were performed; for Se, Zn, Cu, Mg, Co, Ni, Mn, and Cr the p value was <0.01 showing statistically significant results; however, for Fe, though the mean concentration was also lower in the brain tumor group, there was no statistical significance, p > 0.05. Due to technical difficulties and very low concentration of Cd, it was not measured in healthy volunteers; however, it was measured in only one patient’s serum sample; this has been discarded from the study, table 5. Conclusions: Levels of serum TP, TC, and pseudouridine are higher in patients with PBT than in healthy people; however, those of serum TE are lower in the PBT group than healthy persons; the results of this report are in keeping with those of other researchers. The biochemical parameters can be an additional laboratory monitor in the investigation of PBT patients; however, both the specificity and sensitivity need to be ascertained. To our knowledge, this was the first study to be performed in Iraq in the setting of PBT