gastro-jРоссийский журнал гастроэнтерологии, гепатологии, колопроктологииRussian Journal of Gastroenterology, Hepatology, Coloproctology1382-43762658-6673«Gastro» LLC10.22416/1382-4376-2023-33-6-16-25gastro-j-832Research ArticleОРИГИНАЛЬНЫЕ ИССЛЕДОВАНИЯORIGINAL ARTICLESРоль сывороточных и ультрасонометрических маркеров в ранней диагностике злокачественной трансформации перидуктального фиброза печени на фоне инвазии Opisthorchis felineusRole of Serum and Ultrasonometric Markers in the Early Diagnosis of Malignant Transformation of Periductal Liver Fibrosis in Patients with Opisthorchis Felineus Infectionhttps://orcid.org/0000-0001-6116-8323КовширинаА. Е.KovshirinaA. Е.

Ковширина Анна Евгеньевна — ассистент кафедры пропедевтики внутренних болезней с курсом терапии педиатрического факультета 

634050, г. Томск, Московский тракт, 2

Anna E. Kovshirina — Teaching Assistant at the Department of Propaedeutics of Internal Diseases with a course of therapy at the Faculty of Pediatrics

634050, Tomsk, Moskovskiy Tract, 2

annutakovshirina@gmail.comhttps://orcid.org/0000-0002-7130-9609ФедороваО. С.FedorovaO. S.

Федорова Ольга Сергеевна — доктор медицинских наук, проректор по научной работе и последипломной подготовке, заведующая кафедрой факультетской педиатрии с курсом детских болезней 

634050, г. Томск, Московский тракт, 2

Olga S. Fedorova — Dr. Sci. (Med.), Vice-rector for Scientific Work and Postgraduate Training, Head of the Department of Faculty Pediatrics with a Course in Childhood Diseases

634050, Tomsk, Moskovskiy Tract, 2

olga.sergeevna.fedorova@gmail.comhttps://orcid.org/0000-0001-6818-9792КовширинаЮ. В.KovshirinaYu. V.

Ковширина Юлия Викторовна — кандидат медицинских наук, начальник отдела высшего и дополнительного образования

127254, г. Москва, ул. Добролюбова, 11

Yulia V. Kovshirina — Cand. Sci. (Med.), Head of the Department of Higher and Further Education

127254, Moscow, Dobrolyubova str., 11

yulia.v.kovshirina@gmail.comhttps://orcid.org/0000-0002-5205-9739ПетровВ. А.PetrovV. A.

Петров Вячеслав Алексеевич — младший научный сотрудник центра биологических исследований и биоинженерии Центральной научно-исследовательской лаборатории

634050, г. Томск, Московский тракт, 2

Vyacheslav A. Petrov — Junior Researcher, Center for Biological Research and Bioengineering, Central Research Laboratory

634050, Tomsk, Moskovskiy Tract, 2

vyacheslav.a.petrov@mail.ruФГБОУ ВО «Сибирский государственный медицинский университет» Министерства здравоохранения Российской ФедерацииРоссияSiberian State Medical UniversityRussian FederationФГБУ «Центральный научно-исследовательский институт организации и информатизации здравоохранения»РоссияCentral Research Institute for Organization and Informatization of Health CareRussian Federation2023011220233361625Copyright © Ковширина А.Е., Федорова О.С., Ковширина Ю.В., Петров В.А., 20242024Ковширина А.Е., Федорова О.С., Ковширина Ю.В., Петров В.А.Kovshirina A.Е., Fedorova O.S., Kovshirina Y.V., Petrov V.A.This work is licensed under a Creative Commons Attribution 4.0 License.https://www.gastro-j.ru/jour/article/view/832Цель исследования

Цель исследования: изучить роль сывороточных и ультрасонометрических маркеров в ранней диагностике злокачественной трансформации перидуктального фиброза печени при формировании холангиокарциномы на фоне хронической инвазии Opisthorchis felineus у населения эндемичных регионов.

Методы

Методы. Проведено комплексное одномоментное сравнительное исследование в дизайне «случай-контроль» с использованием оценки биохимических параметров (лактат, аланинаминотрансфераза, аспартат-аминотрансфераза, гамма-глутамилтранспептидаза, щелочная фосфатаза, глюкоза, прямой и непрямой билирубин, липопротеины высокой плотности и липопротеины низкой плотности, триглицериды, мочевина и общий белок), иммунологических параметров (трансформирующий фактор роста бета 1) и онкомаркеров (CA 19-9, СYFRA 21-1) в образцах сыворотки крови, полученных от больных инвазией О. felineus, имеющих перидуктальный фиброз и без такового, больных холангиокарциномой, развившейся на фоне инвазии Opisthorchis felineus, и больных описторхозом, а также представителей группы контроля.

Результаты

Результаты. Оценка взаимосвязи между наличием ультразвуковых признаков описторхоз-ассоциированного перидуктального фиброза 1–2-й степени и изменениями биохимических, иммунологических параметров и содержания онкомаркеров у пациентов на фоне инвазии О. felineus продемонстрировала, что уровни щелочной фосфатазы, прямого билирубина, АСТ, глюкозы и онкомаркера CA 19-9 были значимо выше в группе пациентов с холангиокарциномой на фоне описторхоза, чем у исследуемых групп с перидуктальным фиброзом на фоне инвазии и без нее, а также контролями (p < 0,01).

Выводы

Выводы. Впервые получены пилотные данные о взаимосвязи ультрасонометрических признаков перидуктального фиброза печени и увеличения биохимических показателей (щелочная фосфатаза, прямой билирубин, аспартатаминотрансфераза, глюкоза), а также повышения онкомаркера CA 19-9, которые могут быть использованы для ранней диагностики злокачественной трансформации перидуктального фиброза печени с формированием холангиокарциномы на фоне хронической инвазии О. felineus у населения эндемичных регионов.

Аim

Аim: to study the role of serum and ultrasonometric markers in the early diagnosis of malignant transformation of periductal fibrosis of the liver during the formation of cholangiocarcinoma against the background of chronic invasion of Opisthorchis felineus, in the population of endemic regions.

Methods

Methods. A comprehensive one-stage comparative study was conducted in a case-control design, using the assessment of biochemical parameters (lactate, alanine aminotransferase, aspartate aminotransferase, gamma-glutamyl transpeptidase, alkaline phosphatase, glucose, direct and indirect bilirubin, high-density lipoproteins and low-density lipoproteins, triglycerides, urea and total protein), immunological parameters (transforming growth factor beta) and tumor markers (CA 19-9, СYFRA 21-1) in blood serum samples obtained from patients with O. felineus infection, with and without periductal fibrosis, O. felineus-infected patients with cholangiocarcinoma and representatives of control groups. During the analytical stage, the relationship between the structural features of the liver ac- cording to the results of ultrasound examination (presence of opisthorchiasis-associated periductal fibrosis), clinical parameters, parasitological study data (infection intensity), and changes in biochemical, immunological parameters and tumor markers in patients against the background of O. felineus infection was assessed. Statistical analysis was performed using the R programming language (version 3.6.1).

Results

Results. Evaluation of the relationship between the presence of ultrasound signs of stage 1–2 opisthorchiasis-associated periductal fibrosis and changes in serum levels of the biochemical, immunologic parameters and oncomarkers in patients with O. felineus infection demonstrated that the levels of alkaline phosphatase, conjugated bilirubin, AST, glucose and CA 19-9 oncomarker were significantly higher in the serum of patients in the group with cholangio-carcinoma and opisthorchiasis (p < 0.01).

Conclusion

Conclusion. The first pilot data on the relationship between ultrasonometric signs of periductal liver fibrosis and the increase of CA 19-9 oncomarker as well as biochemical parameters (alkaline phosphatase, direct bilirubin, aspartate aminotransferase, glucose), which can be used for early diagnosis of malignant transformation of periductal liver fibrosis with the formation of cholangiocarcinoma in O. felineus-infected population in endemic regions, were obtained.

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The authors declare that there are no conflicts of interest present.