[HETEROGENEITY OF BRAIN TISSUE AS A DEATH PREDICTOR IN PATIENTS WITH MALIGNANT TUMORS]

Abstract

The measurement of the body tissues x-ray density for monitoring and predicting the course of the disease is used in neurology and oncology for timely treatment correction, choice of tactical or strategic therapeutic algorithms. The purpose of the article is to demonstrate the possibility of predicting a fatal outcome in patients with malignant femoral tumors with polymorbidity and malignant tumors of the paranasal sinuses based on the determination of brain tissue quantitative indicators. Patient groups: 1 - control group, 10 patients, 36-55 years with acute sinusitis; 2 - control group, 10 patients, 36-55 years with exacerbation of chronic sinusitis; 3 - 49 men, 30-65 years, after surgery for paranasal sinuses malignant tumors during the 1st remission; 4 - 12 men, 35-63 years, after surgery for paranasal sinuses malignant tumors who died during monitoring; 5 - 28 men, 44-68 years, after a femur malignant tumor radical removal and simultaneous arthroplasty during remission; 6 - 11 men, 39-62 years, after a femur malignant tumor radical removal with simultaneous arthroplasty and with polymorbid diseases (ischemic stroke, small vessel disease, arterial hypertension) who died during monitoring. X-ray density measurements (minimum - Dmin, arithmetic mean - Dam ± SD; maximum - Dmax) of the poles of the right and left temporal lobes were performed on the tomograms of the orbits and basal brain level. The tissue heterogeneity was determined by the formula: Kh = Dmax/Dmin. The observation period is 4 years. The left and right temporal lobes of the patients' groups 1 and 2 are symmetrical by Dam; differences between groups are practically unreliable (P> 0.05); in patients of groups 3 and 5, with a favorable course, the left and right temporal lobes are symmetrical by Dam; asymmetry of the Dam of the left and right temporal lobes is observed in patients of groups 4 and 6 with an unfavorable course of the disease. In this case, the Dam of the right temporal lobe is reliably (P <0.05) lower than the Dam of the left temporal lobe. The patients with malignant tumors of the femur and paranasal sinuses Kh is reliably higher (P <0.05) compared to the patients with inflammatory diseases of the paranasal sinuses. In patients with an unfavorable course of cancer, Kh of the right temporal lobe reliably (P<0.05) exceeds the corresponding indicator of the left temporal lobe. A decrease in x-ray density and an increase in tissue heterogeneity in the right temporal lobe of the brain in patients with malignant tumors of the femur and paranasal sinuses are associated with a fatal outcome within 23-265 days.