Laboratory studies in children with cancer
Oncology / / May 19, 2016
Laboratory examination of sick children with cancer confirms or excludes the data obtained in the clinical trial.First of all laboratory data allow us to evaluate the overall condition of the child, the starting positions for treatment (which is always very intense in oncology).But, along with this, in some cases, laboratory methods allow to specify the nature of the tumors, conduct a differential diagnosis, to follow the stages of development of the tumor process, to carry out dynamic monitoring of patients.
Anemia is almost always accompanied by a malignant neoplasm in children.Its degree of severity is usually associated with the passage of tumor, but also depends on the nature of the neoplasm.Anemia can be pronounced at the beginning of the disease in leukemia, neuroblastoma, but is almost invisible when nephroblastoma, soft tissue tumors.At the height of the disease it is expressed in almost all tumors.
In varying degrees, increased erythrocyte sedimentation rate (ESR).As well as anemia associate
There are no regular changes in white blood indices for tumors in children (except for acute leukemia) are not observed.It may be as mild leukopenia and mild leukocytosis.When leukemia in children one of the main indicators of the disease are changes in the white blood cells.At the same time found predominantly immature pathological forms hemocytoblasts.In the peripheral blood may be low, normal, and sharply increased the number of white blood cells (over 50-10X9 / l).
great importance is attached to the puncture of the bone marrow.Can punctured sternum, iliac bone (in young children can be punctured thigh).In acute leukemia in the bone marrow punctate are usually found high content of undifferentiated cells - reticular, hemocytoblasts, which are often deformed.When neuroblastomas in the bone marrow and are often very similar to immature lymphocyte cells.Finally, in the bone marrow cells can be detected ksantomatoznye, in some forms of histiocytosis X.
Much to recognize tumors in children gives urine.Picking incontinence in older children is carried out in the same way as in adults.It is necessary that before collecting the girls' urine to wash with warm water.Normally, urine is collected once a week (100 ml first morning urine sample).Collect urine in young children has its own characteristics.For a single collection of urine in infants boys use a small vial or tube (the lumen administered the penis), which you can attach a sticky plaster or bandage to the pubis or thigh.In girls, better to use wide-bottomed flask.This method can be used for the daily collection of urine, which often have to resort to the children's oncology.You can apply for this method is: in the male condom with one hand through the hole in its closed end carried a glass tube of sufficient size, which on the other hand wear rubber tube lowered into the jar, where the urine is collected.Sam put the condom on the genitals of the child (the boy - on the penis and scrotum, in girls - in the vulva) and strengthen conducted through two ties in front and two behind, which is fixed around the abdomen.
Of course, the most effective and reliable way to collect urine in small children - taking urine catheter.Children are different from catheters catheters used in adults, but the outer diameter.Catheterization is performed under aseptic conditions.Processed external genitalia and perineum (the warm water and soap), handled the hands of nurse, and she puts on sterile gloves.The catheter should be sterile when administered lubricated and glycerin or paraffin oil.The introduction of the catheter should be very smooth, gentle movements, slow.In some cases it is necessary to resort to the installation of an indwelling catheter (usually this procedure performed by a physician).Fixation of the catheter may be performed in various ways.
often not recommended to use a catheter to collect urine.Collect urine in children with cancer, receiving cancer treatment must be carried out on a weekly basis, and on the testimony - and more often;catheterization is the child discomfort and sometimes pain, so we recommend it in rare cases for the collection of urine and spend catheterization only in patients in the postoperative period.
Results of urine studies, in addition to general information, and give an idea about some of the specific changes.So, hematuria (blood in urine excretion with) can accompany kidney tumor;decrease in urine output (oliguria) - accompanied by leukemia, some tumors affecting the pelvis;inflammation (cystitis) can be a reaction to the medication treatment (injection, for example, cyclophosphamide).
particular importance acquired research excreted in the urine catecholamines.Their content is dramatically elevated in malignant tumors of the sympathetic nervous system.Thus, if the treatment is effective, the content of catecholamines in urine is reduced, and the complete curing comes to the norm;at relapse of the disease increases the content again.
To investigate catecholamines necessary daily amount of urine.
study of cerebrospinal fluid indicated for suspected brain tumor or during germination and metastasis of tumors in the brain.Changes of cerebrospinal fluid is usually expressed in malignant lesions increase the protein content.Increasing the amount of protein in the absence of increase in cellular elements (pleocytosis), protein-cell dissociation characteristic of brain tumors;detection in CSF diagnosis of malignant cell becomes completely clear.
for laboratory diagnostic purposes in pediatric oncology firmly established response to a-fetoprotein - AFP (reaction-Abelian Tatarinov).This reaction is based on the fact that in some tumors (tumors of the liver, teratoblastomah different bodies) present in a blood protein specific embryonic AFP.Upon successful treatment of AFP content decreases, while healing - disappears;at relapse of its content rises again, allowing you to monitor the effectiveness of treatment and course of the disease.