Nowadays, there is a new concept that says that mitochondria naturally circulate in the blood and this is characteristic of both human and animal bodies. It is believed that circulating mitochondria can easily pass through tissue barriers due to their small size (50–400 nm). The phenomenon of mitochondrial intercellular transfer, which is bidirectional, has been observed in vitro and in vivo , under both physiological and pathophysiological conditions, and among a variety of cells, including malignant tumor cells. Circulating cell-free intact mitochondria are thought to play an active biological and physiological role, as mitochondria are already known to be systemic mediators of intercellular communication, transmitting hereditary and non-hereditary biological components, including MtDN A. Mitochondrial components of cellular origin, including mitochondrial DNA, were detected in the extracellular space. There are about 50,000 times more copies of the mitochondrial genome than the nuclear genome in the blood plasma of healthy people. The researchers confirmed that mitochondrial cell-free DNA (McfDNA) is stable enough for detection and quantification, implying that there are stable structures protecting these DNA molecules. The circulating mitochondrial genome, which is released as a cell-free mitochondrial DNA, is recognized as a new biomarker of mitochondrial stress and signal transduction. McfDNA has become an attractive circulating biomarker because of its potential use in diagnostic programs for various diseases, e. g., diabetes, acute myocardial infarction, and cancer. There is no doubt that detection of circulating mitochondria and their DNA in body fluids opens up a new promising scientific direction in biology and medicine. The article analyzes modern scientific data devoted to proving the existence of extracellular mitochondria, their functions outside the cell and diagnostic value.
Purpose of the study. Preclinical study in experiment of antitumor efficacy of a new substance synthesized on the basis of pyrimidin-4-one derivative.Materials and methods. The sodium salt of 4-{2-[2-[2-(4-hydroxy-3-methoxyphenyl)-vinyl]-6-ethyl-4-oxo-5-phenyl-4H-pyrimidin-1-yl}-benzsulfamide, a new inhibitor of the internal domain of the epidermal growth factor receptor (EGFR), was used in this study. All C57BL6 mice of both sexes were subcutaneously transplanted with B16/F10 melanoma. Twenty-four hours after tumor transplantation, mice in the main group (n = 18) were injected with a new EGFR inhibitor intramuscularly at a dose of 0.375 mg per mouse (15,0 mg/kg animal masses), while mice in the control group (n = 18) were injected with saline for injection. In both groups administration was carried out before natural death of animals according to the scheme: administration daily for 5 days, followed by 2 days of break. The dynamics of animal weight, dynamics of tumor node volume were evaluated, the tumor growth inhibition index (TGII) was calculated.Results. Tumor visualization time and animal weight did not statistically significantly differ between the groups during the whole study. In the main group there was a longer lifespan by 1.5 times on average (p ≤ 0.05), and smaller average tumor volume (by 19.2 times on 14 days in males, by 4.3 times in females, by 4.3 times on 28 days in males, by 2.5 times in females, p ≤ 0.05) than in the control group. At the same time, in the main group the tumor volume was smaller in males by 2.7 and 1.8 times (p ≤ 0.05), respectively on days 25 and 28 than in females. TGII in mice of both sexes was maximal on the 14th day with subsequent decrease by 40.3 % in females and only by 18.6 % in males, and during the whole experiment TGII in males was higher.Conclusion. The results showed inhibition of melanoma growth and increased lifespan of mice of both sexes (more pronounced in males) in the group with administration of a new EGFR inhibitor. This indicates the promising potential of this compound and the need to continue its preclinical study in other tumor models.
Purpose of the study. Is to determine the features in the content and activity of some components of the plasminogen activation system in the blood of patients of different ages with leiomyomas (LM) and uterine corpus endometrial cancer (UCEC).Patients and methods. The study was carried out in patients with LM (n = 35) and UCEC T1a-2N0M0 (n = 56) of reproductive, perimenopausal and postmenopausal ages. Using ELISA methods, the content and activity of urokinase (u-PA), tissue plasminogen activator (t-PA), their inhibitor PAI-1, as well as the content of the soluble form of the u-PA receptor (su-PAR) were determined in the blood of patients. The Student´s test was used for statistical processing.Results. Regardless of the nature of the uterus tumor, it has been noted a significant increase in the activity and blood level of PAI-1 (up to 8 times, p < 0.01), especially pronounced in patients with UCEC of reproductive age. It was combined with the absence of changes or with a decreasing in blood level of su-PAR by more than 40 % (p < 0.05). We observed a rise of u-PA blood level without changes in one´s activity in patients with LM of perimenopausal age. And in patients with LM and UCEC of postmenopausal age an increase in u-PA blood level as well as elevation of u-PA activity (up to 3.9 times, p < 0.01–0.05) were noted. There was an increase in the calculated t-PA index (activity per unit mass) by 1.4–2.8 times (p < 0.05) in the most patients. The indicators of LM patients were characterized by the minimum value of the ratio “t-PA activity/u-PA activity in the blood” among all studied subgroups of patients. Age-related features of the researched parameters were observed more often in the cases of LM than in the cases of UCEC. The most pronounced differences between LM and UCEC were observed in patients of reproductive and postmenopausal age, characterized by stable hormonal levels.Conclusion. The participation of the plasminogen activation system in the pathogenesis of tumor lesions of the uterine body has been shown. The system’s “response” to the development of tumors in the uterus has both general characteristics and features that depend on the nature of the tumors and on the age-specific hormonal regulation of the body, which are most pronounced in postmenopausal women. The results obtained can be used in research aimed at clarifying the targets of targeted therapy for LM and UCEC in accordance with the age of patients.
The issue on the differential diagnosis of formations of purulent-inflammatory etiology and the choice of treatment method taking into account the visual picture does not lose its relevance. Ultrasound (US) is not less crucial than computed tomography (CT) for the primary diagnosis of spleen abscesses. This article presents clinical observations of patients with suspected spleen abscesses admitted to the emergency room of the Novosibirsk City Clinical Hospital No. 1 with emergency indications for 2017–2022. All patients underwent ultrasound with Philips Affiniti 70G, Mindray M9, and General Electric Logiq P6 devices. While performing ultrasound in In-mode, attention was paid to the main signs: localization (in the parenchyma, subcapsular), quantity, contours (wall thickness), the nature of the abscess contents, dimensions (volume calculated according to the formula for irregularly shaped formations, A × B × C × 0.52), the presence or absence of effusion in pockets the spleen. The formations were classified by volume into small (up to 50 ml), medium (50–100 ml) and large (more than 100 ml). The main ultrasound signs in the seroscale mode have been determined. The presented clinical observations illustrate the possibilities of ultrasound for deciding on the method of treatment: for primary diagnosis (including emergency), it was possible to determine the presence of formations of purulent- inflammatory etiology, to determine the localization, the main signs in which minimally invasive treatment was effective (formed abscess of "medium" volume). Surgical abdominal treatment was preferable in the presence of multiple abscesses (without a formed capsule) of small size.
Purpose of the study was to compare of the average long-term results of classical prostate enucleation using the Millin method and enucleation performed using a holmium laser (HoLEP).Patients and methods. This study, conducted on the basis of the Endocrinology Research Center of the Ministry of Health of the Russian Federation, included 100 patients operated on for obstruction of the prostatic part of the urethra over the period 2020–2023. The main indication for surgery was benign prostatic hyperplasia. The selection criterion for patients was a prostate volume of more than 80 cm3. The patients were divided into 2 groups depending on the intervention performed: in the 1st group Millin surgery was performed (n = 50), in group 2n laser enucleation of the prostate was done (n = 50). The data obtained during the operation in the early postoperative period, as well as the results of postoperative follow-up of patients were analyzed.Results. In the mid-term period, 4–6 months after surgery, patients from both groups were observed to improve their condition and reduce complaints of dysuric phenomena. The results were obtained illustrating a shorter inpatient stay for patients who underwent HoLEP (4.3 ± 0.6 days versus 10.0 ± 2.4 during Millin surgery), which is correspondingly associated with a faster recovery after this intervention compared with the classic one. A statistically significant (p-value < 0.05) problem of patients from the HoLEP group was urethral stricture, which occurred in 6 % of the subjects from this group and did not occur in the Millin surgery group. In fact, scarring of the bladder neck was more commonly obserbed (10 % vs. 8 %) in the Millin surgery group. However, these complications were not more than 10 %. As a result of the study, there was no statistically significant effect of using HoLEP on erectile dysfunction in patients, which suggests the potential of this technique for a lower incidence of worsening erectile dysfunction compared with open intervention.Conclusions. HoLEP is a safe method of prostate enucleation, applicable for its large volume, in particular, up to 80 cm3. This procedure is an alternative to classical open surgery, and can be recommended for patients with polymorbidity to reduce the risk of perioperative complications and reduce rehabilitation time. Millin surgery is also a reliable treatment method with high sensitivity to the detection of cellular atypia and a large volume of cytoreduction. The decision on the surgical procedure used must be made individually for each patient.
Purpose of the study. To study the CT semiotics of intrahepatic cholangiocarcinoma (ICC) to determine the prognostic markers of recurrence. To analyze the association between CT characteristics of ICC and mutations in IDH1/2, MET, KRAS, BRAF, ERBB2, EGFR, FGFR genes.Materials and methods. We analyzed databases and diagnostic images of Vishnevsky National Medical Research Center of Surgery and Loginov Moscow Clinical Research Center for the period from April 2016 to January 2022 using the key queries «intrahepatic cholangiocarcinoma», «liver», «hepatocellular carcinoma», «metastases», «radio genomics». 142 patients with liver neoplasms were identified, including 90 cases of ICC, 31 cases of hepatocellular carcinoma and 21 cases of metastatic liver lesions, all morphologically verified (histologic and immunohistochemical analysis of biopsy material).Results. Associations between CT features and mutations of MET and IDH1/2 genes were determined. According to the results of statistical analysis all four CT-signs, such as bile duct dilatation, capsule retraction, presence of dropout foci and tissue volume changes, are correlated with the probability of recurrence (death) in patients with ICC.Conclusion. In a retrospective study, our results emphasize the potential prognostic significance of CT signs of ICC. We identified CT signs that allow differential diagnosis of ICC with hepatocellular carcinoma and colorectal cancer metastases. We also identified associations between CT signs of ICC and mutations of IDH1/2 and MET genes, which may allow us to non-invasively obtain data on clinically significant molecular markers of tumors to apply a personalized approach to patient treatment.
The development of new local treatment methods of peritoneal carcinomatosis in ovarian cancer is an urgent task due to the fact that in most cases complete surgical cytoreduction is technically impossible, and systemic cytostatic therapy does not provide a stable therapeutic effect. The pressurized intraperitoneal aerosolized chemotherapy (PIPAC) is a local method of treating peritoneal carcinomatosis in ovarian cancer, which allows for uniform distribution of medicinal aerosol over the peritoneum and is used together with standard combined treatment in order to improve its outcomes.Purpose of the study. To analyze the effect of PIPAC, used in addition to the standard combined treatment of ovarian cancer with peritoneal carcinomatosis, on the clinical outcome of surgical treatment and long-term results.Patients and methods. Our prospective randomized open-label controlled trial included 169 patients with newly diagnosed ovarian cancer with peritoneal carcinomatosis. The main group included 84 patients and 85 in the control group. Randomization was performed intraoperatively using a digital randomizer. The distribution was homogeneous according to the stages of ovarian cancer (Barnard's criterion = 0.292) and the peritoneal carcinomatosis index (PCI) (Mann-Whitney U test = 0.625). We used a combination of surgical cytoreduction with a one-time PIPAC session and subsequent systemic chemotherapy within the framework of one hospitalization, further PIPAC sessions were performed 2 more times with an interval of 42 days in combination with systemic chemotherapy within the framework of one hospitalization. All patients were operated on at the first stage in the volume of extirpation of the uterus with appendages and removal of the large omentum, all underwent systemic cytotoxic therapy scheme: paclitaxeln 175 mg/m2 , carboplatin AUC 5–7) (6 courses with an interval of 21 days). In the main group, 3 sessions of PIPAC were added to the standard treatment. To study the surgical safety profile of PIPAC, all adverse events of a surgical profile were recorded at each hospitalization. The duration of life without relapse was estimated as the main outcome, the median relapse-free survival was the main indicator. The total duration of the study was 36 months.Results. During statistical processing, it was found that the median disease-free survival in the group with the use of PIPAC was 8 months higher. Thus, in the control group, the median disease-free survival was 13 months in the 95 % confidence interval (in the range of values from 12 to 14 months), in the main group – 21 months (95 % confidence interval, range from 18 to 22 months). Surgical adverse events were reported in 1.2 % after 252 sessions of PIPAC over the entire study period. These phenomena didn’t require additional medical interventions, didn’t increase the duration of hospitalization and didn’t lead to the exclusion of patients from the clinical trial protocol.Conclusion. The use of the PIPAC technique as an additional method of standard regional treatment has demonstrated an improvement in the results of treatment of newly diagnosed ovarian cancer with peritoneal carcinomatosis. PIPAC has a favorable surgical safety profile and is a promising method of local exposure to peritoneal carcinomatosis in both clinical and research work.
The development of omics technologies and sequencing has significantly expanded the understanding of the role of microorganisms that inhabit various human organs and collectively make up its microbiota in the development of cancer. The extensive literature of recent years devoted to various aspects of the participation of the microbiota in carcinogenesis substantiates the relevance of analyzing the impact of its features on the processes of carcinogenesis in various human organs.Purpose of the study. Analysis of literature data on the key issues of the relationship between the human microbiome and the risk of cancer and explore possible prospects for its use in the diagnosis, therapy and prevention of cancer.Materials and methods. A literature search was carried out in the databases NCBI MedLine (PubMed), Scopus, Web of Science, based on an extended list of keywords that included all the localizations of malignant neoplasms (MNs) considered in the review. Original studies, meta-analyses, randomized controlled trials, and reviews published in recent years were used.Results. Recent studies using omics technologies have shown significant differences in the composition of microbial communities of healthy and tumor tissues and have made it possible to characterize the potential tumor microbiota in some types of cancer. The microbiota present in the various organs of the human body forms a network through which it interacts via migration or by forming metabolic axes between organs. Dysbiosis plays an important role in carcinogenesis, and its presence in one organ can negatively affect the condition of other distant organs and contribute to the development of pathological conditions in them.Conclusion. Numerous studies conducted over the past decade have revealed a complex relationship between microorganisms, tumors, and the host, reflecting the diverse effects of the microbiota on various organ- specific types of MNs. Gastrointestinal tract tumors, as well as sites outside it with significant bacterial associations, have been identified for a better understanding of the multifaceted mechanisms by which the microbiota influences cancer. The data obtained so far complement the emerging possibilities of using the microbiota in clinical practice, which represents a new approach to the prevention and treatment of malignant neoplasms.
Purpose of the study. Analysis of the molecular and biological features of synovial sarcoma (SS), as well as its tissue microenvironment according to modern research.Materials and methods. The analysis of literature sources was carried out mainly in the databases «Istina» and «PubMed», publication date limitations were set up from 2019 to 2023. The following keywords for the search were used: «synovial sarcoma», «chromosomal aberrations», «carcinogenesis».Results. Understanding the molecular mechanisms and signaling pathways in the development of SS may lead to the development of more effective treatment strategies. The importance of further research in this area cannot be overestimated, as it can provide new data to create innovative approaches aimed at improving the prognosis and quality of patients’ lives. Chromosomal aberrations, such as translocations and deletions, can lead to the activation of oncogenes or inactivation of tumor suppressor genes, which, in turn, contributes to the malignant transformation of cells. Epigenetic changes such as DNA methylation and histone modifications also play an important role in the regulation of genes related to the growth and survival of tumor cells. Disorders in these processes can contribute to tumor progression by altering the expression of key genes involved in the cell cycle, apoptosis, and angiogenesis. Additionally, part of the review is devoted to the interaction of atypical cells against the background of chromosomal aberrations and epigenetic changes with the SS microenvironment. These factors may have a certain effect on the growth and progression of synovial sarcoma. In addition, the review discusses various aspects of the diagnosis of SS using modern molecular genetic methods. Examples of successful use of targeted therapy and immunotherapy are given, which open up new prospects in the treatment of this disease.Conclusion. The importance of molecular biological and molecular genetic analysis of SS for the possibility of an interdisciplinary approach in the study and treatment of this aggressive malignant tumor has been revealed.
Primary multiple malignancies (PMMs) are defined as two or more malignant tumors of various pathogenic origin detected simultaneously or sequentially in one patient. Despite the successes of modern medicine, the incidence of PMMs is steadily increasing. According to worldwide statistics, the incidence of PMMs in the oncological population has increased from 2.4 to 8.0 % over the course of the 20 year span. The number of patients with PMMs is also increasing in the Russian Federation. Total of 58,217 PMMs were detected for the first time in our country in 2021, which constitutes 10.0 % of all newly diagnosed malignant neoplasms. Two tumors are usually observed among patients with PMMs (in 84–100 % of patients), three tumors occur in 9.9–16.0 % of these patients, four in 1.62 %, and five or more occur in only 0.095 %.Currently, the pathogenesis of this condition has not yet been fully studied. There are hypotheses that endogenous, exogenous, hereditary, and therapeutic factors are involved in the occurrence of PMMs. Endogenous factors include immunologic status, endocrine factors, and hereditary predisposition. Exogenous factors are represented by lifestyle and environmental factors such as smoking and alcohol, low physical activity, as well as prolonged exposure to ultraviolet radiation and industrial pollution. Iatrogenic factors, including radiation therapy and chemotherapy, can also increase the risk of developing PMMs.This article represents a clinical case of a patient born in 1942, in whom, during 11 years of follow-up care, primary multiple synchronous metachronous cancers of 5 localizations and 4 histological types were verified and treated. The presented clinical case is interesting for a very rare number of neoplasms and a relatively high duration of follow-up period. The authors describe in detail each stage, the choice of diagnostic methods and the definition of treatment tactics with an assessment of the accuracy of clinical decision-making.
Thyroid hormones (TH) influence the processes of cell proliferation and differentiation, but their role in the processes of carcinogenesis is contradictory.The purpose of the study. To study the effect of induced hyperthyroidism in mice of both sexes with intertwined Lewis carcinoma (LLC) on the activity of the hypothalamic-pituitary-thyroid axis (GGT).Materials and methods. The experimental model was mixed-sex mice of the C57BL/6 line with subcutaneously transplanted LLC on the background of induced hyperthyroidism (main group). Two control groups were used: control group I – mice with sodium liothyronine- induced hyperthyroidism and control group II – mice with subcutaneously transplanted LLC. On the 25th day after tumor transplantation, the level of thyrotropin- releasing hormone (TRH), thyroid- stimulating hormone (TSH), triiodothyronine (T3), total and free thyroxine (T4, FT4) was determined in the homogenates of GGT organs and in blood serum.Results. In female mice, hyperthyroidism caused an increase in the level of TRH in the hypothalamus and a decrease in TSH in the pituitary gland; in males, a decrease in TRH only in the hypothalamus. In control group II, euthyroid disorder syndrome developed: In mice of both sexes, serum levels of T4 and FT4 were found to decrease against the background of unchanged T3 levels and an increase in TSH content only in females. In the females of the main group, an increase in the level of TSH in the thyroid gland caused a decrease in T3 content in 73 % of animals against the background of normal T4 and elevated FT4 levels, in 27 % of females the T3 level increased. In males, in 73 % of the observations, the T3 level was increased against the background of high T4 and FT4 values and unchanged TSH levels. In the skin and LLC samples of the mice of the main group, an increase in T3 levels was noted.Conclusion. The growth of LLC against the background of hyperthyroidism is a process with multifactorial effects. High levels of T3 in blood serum and skin stimulated the proliferation of tumor cells, which led to the formation of subcutaneous tumors of a larger volume in the mice of the main group. Sex differences in the GGT response indicate different mechanisms that implement pathological processes.
Understanding the effects on tumor cells underlies possible practical use of collagen- containing composition (HCCC) for the treatment of radiation therapy related complications. Purpose of the study. Is to investigate the effects of heterogeneous HCCC on growth, viability, proliferative activity and stem cell pool of cervical cancer in vitro. Materials and methods. HeLa cells were incubated with commercially available HССC (trademark Sphero®GEL in two versions: Medium and Light) for 24–72 h. We determined the total number of tumor cells, their viability by MTT assay, the total proportion of cells in S + G2 + M phases by flow cytometry, as well as the relative and absolute number of cancer stem cells (CSCs) identified by the ability to remove the fluorescent dye Hoechst 33342 from cells (SP method) and CD133 expression, after incubation with HCCC in two dilutions and in control samples. Results. When using HCCC–Medium in a dilution of 1/5 (the lowest of the studied dilutions), decrease in the total number of tumor cells by 13 % from the control level was recorded during the entire observation period (p < 0.05). This effect was accompanied by parallel decrease in cell viability and decrease in proliferative activity in the first time after the onset of exposure compared to control (p < 0.05). The tendency towards decreases in the absolute number of CSCs, which were independently detected by SP and CD133 immunophenotyping methods after 72-hour incubation with HCCC–Medium 1/5, was observed. The number of SP and CD133+ cells decreased by 1.3 times compared to control. Similar, but short-term or less pronounced effects were shown for HCCC–Medium in a higher dilution of 1/20 and HCCC–Light in all dilutions in relation to the total number of tumor cells and the size of CSC pool. Conclusion. The obtained results prove the absence of stimulating effect of HCCC–Medium and HCCC–Light on both the total mass of HeLa tumor cells and the CSC subpopulation in vitro and show the prospects for further preclinical and clinical studies on the use of HCCC in rehabilitation programs for treatment of atrophic and/or radiation vaginitis of varying severity in cancer patients.
Purpose of the study. Is to describe the experience of creating a collection of biological images of tumor tissues and biomaterials, which are control samples, for scientific research in morphology and molecular oncology.Materials and methods. We studied the molecular markers of cell cycle regulation, apoptosis, oncogenesis and angiogenesis, the expression of proteins that regulate inflammation and tumor infiltrate cells in biocollections of verified tumors of common localizations: e. g. thyroid cancer, colorectal cancer, breast cancer, prostate adenocarcinoma, endometrioid adenocarcinoma. Also, tissue fragments with normal structure or non-tumor pathology (autoimmune thyroiditis, adenomatous and thyrotoxic goiter, benign formations of the colon, fibrocystic disease of the mammary glands, benign prostatic hyperplasia, endometrial hyperplasia) were used as control samples or comparison groups. The total number of tissue samples is n = 7000.Results. It is reasonable to gather the collection in a pathomorphological laboratory according to the profile of the medical institutions, which has a sufficient volume of incoming target material and specialized morphologists to verify tumors of a given localization. It is necessary to consider the regional and ethnic specifics of the population, which determines the sampling and mutational load. The laboratory must initiate an addition to the informed consent of patients about the possibility of conducting morphological and molecular genetic studies for scientific purposes and publishing their results in a depersonalized form for the development of new elaborations, when signing the contracts with legal entities and individuals and when serving patients within an institution. When working with biocollections, it has to consider having registers of tissue biomaterials of target disorder groups of main localizations with downloading by year from an accessible information system, consider external factors affecting the database (changes in clinical recommendations and classifications, the population of patients served, pandemics and other significant events). The standard of the preanalytical stage, data collection, development of protocols for analytical molecular genetic studies and their evaluation, the utilization of the capabilities of working with reagents for scientific tasks and modeling experiments on laboratory animals are crucial.Conclusion. The formed biocollection made it possible to carry out a number of initiative and funded domestic and international scientific projects at the request of clinicians and fundamental researchers, as well as to improve the quality standards of morphological and molecular genetic oncology diagnostics. Biobanking makes the pathological archive more accessible for review and use, significantly expanding its scientific and practical potential. Scientific and medical research do not conflict and can be used within the same laboratory.
The elongated left lobe of the liver (saddle liver, saber liver, beaver tail liver, beaver lobe) is one of the types of variant liver anatomy, characterized by the fact that the left lobe extends far beyond the midline of the body, and can come into contact with the spleen and even go above it. Due to the fact that the elongated left lobe of the liver is more often susceptible to injury and, in some cases, can imitate a subcapsular hematoma of the spleen, it seems important to increase the awareness among doctors of various specialties about the variety of morphological variations in the structure of the liver, in particular about the elongated left lobe of the liver, to unify approaches to the description and establish uniformity of wording to designate this feature of the anatomical structure of the left lobe of the liver, which will reduce the risk of diagnostic errors and errors during surgical interventions, especially in cases of blunt abdominal trauma.The article presents clinical cases with ultrasound examination of 10 patients of different ages (from 1 month to 38 years) and gender with a newly diagnosed anomaly in the structure of the left lobe of the liver, i.e an elongated left lobe. An analysis of national and foreign literature sources containing reports on various morphological variants of the liver structure and the frequency of their occurrence was carried out. Ultrasound signs were proposed to describe the elongated left lobe of the liver. The features of the ultrasound examination technique for the elongated left lobe of the liver in children older than one year are described. The variety of formulations used by different authors when describing this variant of the anatomical structure of the liver was studied.
Purpose of the study. Analytical review and analysis of available literature on texture analysis of computed tomgraphy (CT) and magnetic resonance imaging (MRI) in noninvasive diagnosis of ICC and correlation with molecular genetic features and tumor immunophenotype.Materials and methods. The scientific publications and clinical guidelines in the information- analytical systems PubMed, Scopus for 2012–2022 were carried out using the keywords: "mri", "radiomics", "texture analysis", "radiogenomics", "intrahepatic cholangiocarcinoma", "molecular". 49 articles were selected for analysis after excluding studies dealing with technical aspects of radiomics and describing individual clinical observations.Results. The presented review demonstrated the broad possibilities and prospects of application of CT and MRI texture analysis in the study of cholangiocellular cancer, including the first results in the study of molecular features (signatures) of this tumor. Correlation of texture features with the expression of immunotherapy target genes KRAS/NRAS/BRAF as well as IDH1/2 mutation was shown. Texture scores were the predominant independent predictor of microvascular invasion, which was a major independent risk factor for postoperative recurrence.Conclusion. The use of texture analysis undoubtedly demonstrates promising possibilities both in noninvasive assessment of the HCC histological differentiation grade, as well as in differential diagnosis with hepatocellular carcinoma, metastases, and requires further study for systematization and standardization of the obtained data.
Purpose of the study. Preventive pressurised intraperitoneal aerosol chemotherapy (PIPAC) safety assessment in the combined treatment of gastric cancer (GC).Patients and methods. The study included 48 patients with morphologically confirmed resectable GC and cardio esophageal transition, having at least one criterion that is a predictor of the development of peritoneal carcinomatosis, e. g. tumor spread to the serous layer (≥ T4a), diffuse tumor type, affected regional lymph nodes, large tumor, young age (up to 45 years), subtotally and totally affected stomach. 36 out of those patients received treatment according to the protocol. All patients received 4 cycles of neoadjuvant chemotherapy according to the FLOT scheme, radical surgical treatment in combination with a PIPAC session, 4 cycles of adjuvant chemotherapy according to the FLOT scheme. The safety assessment was carried out according to the classification of surgical complications according to Clavien-D indo and the international scale for toxicity scaling NCI–CTCAE v5.0.Results. Postoperative complications were diagnosed in 25 %, >III grade complications were revealed in 11 % of cases according to the Clavien-D indo classification. The postoperative mortality rate was 0 %.Conclusion. Preventive PIPAC of locally advanced GC and CET in combined treatment is a reproducible and safe method, which is characterized by the absence of an increase in the number of postoperative complications and mortality rate.
The purpose of the study. To estimate the number of patients with the preservation of relative dose intensity (RDI) ≥ 80 % of first-line antitumor therapy in patients with unresectable non-small cell lung cancer (NSCLC), and to compare the effectiveness of therapy in groups with optimal and lower RDI.Patients and methods. The study included 30 patients (25 men and 5 women) with locally advanced unresectable NSCLC. The median age was 57 years. The main criterion for inclusion in the study was morphologically verified NSCLC with stage IIIB-IIIC of the disease. All patients underwent simultaneous chemoradiotherapy. According to the histogenesis of the tumor process, patients with a squamous cell variant prevailed.Results. The data obtained from 22 (73.3 %) patients who retained a relative dose intensity of RDI > 80 % demonstrated that given dose intensity is sufficient to achieve a stable antitumor effect. In 8 (26.7 %) cases, however, the RDI was less than 80 %, which affected the effectiveness of the treatment. The median follow-up for overall survival (OS) was 29.2 months, progression-free survival (PFS) was 15.1 months, and local control was 21.9 months. in all patients included in the analysis. The indicators of OS in the second year had an advantage in the group of patients with RDI < 80 % and amounted to 73.3 % compared with 60.5 % in patients with RDI > 80 %. PFS was higher in the group of patients with high dose intensity, in the first year of follow-up it was 75.6 % compared with the group of patients with RDI < 80 % (62.5 %), in the second year of follow-up, PFS was 27.2 % and 20.8 %, respectively. Local control was 90.2 % in the first year in the group of patients with RDI > 80 % and 62.5 % in the group of patients with RDI < 80 %. The second year of follow-up demonstrated the advantage of the group of patients with RDI >80 % in terms of local control and amounted to 48.1 % versus 34.7 %, respectively.Conclusion. The results obtained show that maintaining relative dose intensity at a high level has a positive effect on survival rates and local control of patients with locally advanced unresectable NSCLC. However, there is a cohort of patients who did not receive the planned amount of treatment, due to the high toxicity of simultaneous chemoradiotherapy. It is necessary to develop new approaches to concomitant therapy aimed at reducing the toxicity of the combined treatment and achieving maximum antitumor effect.
Malignant tumors of the urachus are extremely rare. The frequency of urachal malignancy makes 1: 5 000 000 cases, which is 0.35–1.2 % of all the cases of bladder cancer. The small series of observations described in the literature do not allow us to formulate statistically reliable and unambiguously recommended statements about the optimal methods of diagnostics and treatment of this pathology. The diagnosis of urachus diseases is often challenging. This is associated with both the asymptomatic course and the variety of clinical flow of the disease. The treatment strategies are also largely ambiguous and ranging from the defining the indications for surgical treatment to the aggressiveness of surgical intervention. Meanwhile, 20 % of patients with urachal cancer have distant metastases at the time of detection. With everything listed above, (low frequency, little research done and aggressiveness of the flow) it makes every clinical observation of this disease valuable.This article is a clinical observation providing with the information upon the diagnosis, the choice of strategies and surgical treatment of urachal cancer in a patient suffering from multimorbidity. Volumetric formation of the bladder was detected in this patient during additional examination for macrohematuria. Cystoscopy with transurethral resection and subsequent morphological examination verified invasive mucinous adenocarcinoma of the bladder with the growth into the lamina propria and without the signs of vascular and perineural invasion. The patient underwent laparotomy, radical resection of the bladder with extended pelvic lymphadenectomy. The umbilicus, urachus and the bladder wall with the tumor, as well as the adjacent peritoneum, were excised as a single block during the surgical intervention. Morphological examination verified mucinous adenocarcinoma of urachus. The postoperative period was uneventful.There have been no signs of disease progression observed during 10-month follow-up period.
Against the background of modest successes in the development of new diagnostic and therapeutic tools to improve the survival of patients with glial brain tumors, early diagnosis of this pathology remains relevant. Endogenous noncoding miRNAs that regulate the expression of target mRNAs have become attractive targets for the development of circulating biomarker-based assays, because sample acquisition does not require invasive sampling such as biopsy. Purpose of the study . To determine the levels of circulating microRNAs in the blood plasma of patients with glial tumors, meningiomas and apparently healthy donors, using high-output sequencing. Material and methods. 26 blood plasma samples were selected from the biobank data base of the National Medical Research Center for Oncology, and the total RNA was studied using the NGS sequencing method. The sample included: 2 cases of oligodendroglioma (grades 2–3), 6 – astrocytomas of 2–4 degrees of malignancy, 7 – glioblastomas of 4 degrees of malignancy, 7 – benign neoplasms (meningiomas), 4 – control (conditionally healthy donors). Results. During the primary analysis, a pool of 71 differentially expressed microRNAs was identified, the expression of which was tumor-specific: 20 microRNAs for glioblastoma, 4 microRNAs for astrocytoma, 23 microRNAs for oligodendroglioma, 24 microRNAs for meningioma. At the same time, 47 microRNAs showed increased levels in the blood plasma compared to the control group, 15 showed a corresponding decrease in levels. A comparative analysis identified microRNAs that specifically differentiate each tumor type. Conclusion . The results obtained seem promising and set the vector for further research, which will include expanding the sample and validating the identified biomarkers to determine their diagnostic value.
Оne of the most commonly used fluorine‑18 labeled prostate-specific membrane antigen (PSMA) ligands in positron emission tomography combined with computed tomography (PET/CT) is [18F]PSMA‑1007. In comparison to other clinically available PSMA radioligands characterized by renal clearance, [18F]PSMA‑1007 exhibits predominantly hepatobiliary excretion. It allows a better assessment of the pelvic area in patients with prostate cancer (PCa). Nevertheless, in our clinical practice, we routinely observed a notably high [ 18F]PSMA‑1007 uptake in the urinary bladder. The underlying reasons for this phenomenon remain inadequately explored.Purpose of the study. The purpose of this study was to assess the impact of preliminary hydration of patients on [18F]PSMA‑1007 uptake in the urinary bladder.Materials and methods. Prospective, multicenter, randomized controlled study included 180 patients with PCa who underwent [18F]PSMA‑1007 PET/CT. Scans were performed using three different PET/CT-systems: GE Discovery IQ Gen 2 (USA), Siemens Biograph 64 mCT and Biograph 64 TruePoint (Germany). All patients were divided into two groups: the group with hydration (n = 95, 53 %), which included the subgroups of patients with oral (n = 76, 80 %) and intravenous (n = 19, 20 %) routes of hydration, and the control group with no hydration (n = 85, 47 %). [18F]PSMA‑1007 uptake in the urinary bladder was quantified using SUVmean (Mean Standardized Uptake value), measured within a spherical VOI with a fixed volume of 2.5 cm3 delineating the bladder boundaries. Additionally, the TBRmean (Mean Target-to-Background Ratio), reflecting the ratio between urinary bladder and right gluteal muscles SUVmean.Results. SUVmean and TBRmean in urinary bladder were significantly lower (p < 0,001) in the group with hydration compared to the control group, with the following values: 1.3 [0.8; 2.0] versus 4.5 [2.7; 8.5] for SUVmean and 4.0 [2.3; 6.3] versus 13.0 [7.7; 24.0] for TBRmean. There was no significant differences in SUVmean and TBRmean between the subgroups with oral and intravenous routes of hydration (p = 0.95 for SUVmean, p = 0.49 for TBRmean). Additionally, comparatively lower interquartile range (IQR) values for both SUVmean and TBRmean in the group with hydration were noted: 1.2 versus 5.8 for SUVmean, 4.0 versus 16.3 for TBRmean.Conclusion. Preliminary hydration of patients in uptake period significantly reduces both the level and variability of [18F]PSMA‑1007 uptake in the urinary bladder.
