Background. Lymphogenous metastasis in Ewing sarcoma is a relatively rare and poorly studied event associated with aggressive clinical course and poor prognosis. Until now, no risk factors for lymphogenous metastasis in patients with Ewing sarcoma are reported. The purpose of the study was to evaluate tumor characteristics as predictors for lymphogenous metastasis and to create a mathematical model for assessing the risk of developing lymph node metastases in patients with Ewing sarcoma. Material and Methods. Clinical characteristics of the tumor were studied in 88 patients with Ewing sarcoma: in 8 patients with lymphogenous metastasis and in 80 patients having no lymphogenous metastasis. The primary tumor in all patients with lymphogenous metastasis was found to have an extraskeletal origin. Morphological and immunohistochemical characteristics of the tumor were studied in 31 patients with Ewing sarcoma: in 8 patients with lymphogenous metastasis and in 23 patients without lymphogenous metastasis. Results. Statistical analysis and comparative evaluation of the characteristics of the immunophenotype and histological pattern of the tumor in the two studied groups showed significant differences regarding several of them: the structure of nuclear crowding (fusion of nuclei), focal hemorrhages, nuclear normochromasia, and positive expression of cytokeratins by tumor cells. The above signs (except for nuclear normochromasia) were the basis for creating a mathematical model capable of predicting the risk of lymphogenous metastases in Ewing sarcoma. Conclusion. The revealed association with lymphogenous metastasis of cytokeratin expression can be considered as indirect confirmation of the pathogenetic significance of the mesenchymal-epithelial transition in the mechanism of lymphogenous metastasis.

A rare clinical case of synchronous cervical adenocarcinoma and primary squamous cell ovarian carcinoma has been presented. Epidemiological and treatment aspects have been analyzed.

The study included 58 patients with stage Т1–3N0–3M0–1 squamous cell laryngeal carcinoma. The age range was from 31 to 77 years. Patients received no cancer treatment before surgery. The expression of metalloproteinases (ММP-1, -2, -9), their inhibitors (TIMP-1, -2) and inductor of metalloproteinase expression (CD147) were determined in tumor cells of different structures of squamous cell carcinoma using immunohistochemical method. Results were compared with the presence of lymphogenous metastases. Results. Five morphological structures of squamous cell carcinomas were studied: with keratinization (type 1), with cells of basaloid and acanthocyte types without kartinization (type 2), with cells of basaloid type (type 3), with pronounced cellular polymorphism (type 4) and single tumor cells (type 5). With regard to combination of these structures, tumors were divided into high-grade, low-grade and mixed tumor structures. In tumors without lymphogenous metastases, the increased expression of ММP-1, -2, and-9 was only revealed in discrete cells. In tumors with lymphogenic metastases, the increased MMP-9 expression was observed in more differentiated structures of 1, 2 and 3 types. Less frequent lymphogenous metastasis of vocal cord carcinomas was associated only with tumors of mixed structure, in which the expression of TIMP1 was reduced. Conclusion. To assess the histological differentiation of squamous cell carcinoma of the larynx, it should be considered a combination of high and low-grade tumor structures. The expression of metalloproteinases should be studied considering morphological heterogeneity of squamous cell carcinomas. The frequency of lymphogenous metastasis of high-or low-grade squamous cell carcinoma of the vocal cords did not differ from that of squamous cell carcinoma of the supra-glottal area. The frequency of lymphogenous metastasis was significantly lower in mixed squamous cell carcinomas of the vocal cords than in similar carcinomas of the supra-glottal area.

Background. The paper has been devoted to the study of clinical and morphological features of bilateral breast cancer (BC). Despite the increased interest in the lateral BC, pathogenesis of this type of cancer have been little studied. М aterials and methods. Clinical and morphological parameters were studied in 600 patients with unilateral and bilateral breast carcinoma. Results. Synchronous and metachronic bilateral breast cancer is characterized by more pronounced heterogeneity of the morphological structure with the frequent presence of discrete groups of tumor cells and ductal structures in the tumor node as compared to unilateral breast cancer. Synchronous bilateral breast cancer has a favorable clinical course and is mainly represented by the luminal A molecular genetic type. Metachronous bilateral breast cancer is often characterized as a triple negative and luminal B type with high proliferative activity and is associated with poor prognosis. There is a difference in prognostic parameters of lymphogenous and hematogenous metastasis between synchronous and metachronous breast cancer. For synchronous bilateral breast cancer, morphological parameters can serve as prognostic factors of hematogenous and lymphogenous metastasis. For metachronous breast cancer, prognosis of hematogenous metastasis is associated with severity of lymphogenous metastasis. Conclusion. The data obtained allow us to determine the typical clinical and morphological features of synchronous and metachronous bilateral breast cancers, as well as to identify additional prognostic parameters of tumor progression.

New and original values (coefficient of phosphorylation and coefficient of intracellular distribution) proposed. They are reflecting a functional state of the heat shock protein 27 kDa (Hsp27) in tumor cells of breast cancer. These coefficients are more clearly reflect the functional state of Hsp27, than classical evaluation of chaperone expression only in the cytoplasm. It has been shown that in tumors with high expression of receptor Her2/neu on the membrane in the absence of gene amplification cerb2/neu (Her2/neu (3+) FISH (-)) there are low coefficients of phosphorylation and intracellular distribution as compared with Her2/neu-positive (Her2/neu (2+/3+) FISH (+)) and Her2/neu-negative tumors (Her2/neu (0/1+) FISH (-)). The possible molecular mechanisms of the phenomenon of dissonance cerb2 / neu gene amplification and receptor Her2/neu expression on the membrane of tumor cells breast cancer are discussing.

The article is devoted to the study the characteristics of hematogenous metastasis in bilateral synchronous and metachronous breast cancer. The comparison of the obtained expression and morphological characteristics of primary tumor nodules with features of hematogenous metastasis to identify prognostically significant parameters. The study included surgical material from 566 patients with invasive carcinoma of the non-specific type of breast cancer. The study found that in patients with synchronous bilateral breast cancer tended to have a lower incidence of hematogenous metastasis in comparison with two-sided and one-sided defeat of metachronous breast cancer. On the basis of studies performed in synchronous and metachronous bilateral breast cancer for predicting hematogenous metastasis is recommended to use different prognostic parameters. The risk of hematogenous metastasis in patients synchronous bilateral cancer associated with fibrosis of the stroma of the tumor, monomorphic structure infiltrative component comprising a smaller number of different types of structures. When metachronous bilateral lesions in the case of the presence of hematogenous metastasis was detected more severe fibrosis of the stroma of the tumor was determined a lower percentage rate and the expression of receptors for estrogen, as well as more and larger percentage of the affected lymph node metastases.

A rare case of thyroid carcinosarcoma has been presented. Clinical features of progression of this rare disease have been described. The detailed assessment of the histological pattern of metastatic spread of thyroid carcinocarcoma has been given. The main causes of unfavorable outcome of this disease have been analyzed.

We studied the course of the disease in 114 patients with invasive ductal breast cancer stage T1-4N03M0, held a combined treatment at the Department of General Oncology FGBU Cancer Research Institute of Oncology, SB RAMS in the period from 2000 to 2007. Revealed additional information of importance for the prediction of hematogenous dissemination in patients with different molecular-genetic types of breast cancer. Predict this worst-case flow of tumor on the basis of information about the regional lymph nodes is possible only with triple negative breast cancer, and only in patients who are in a state of menopause.

Treatment outcomes for a patient with solitary brain metastasis after long-term relapse-free follow-up of invasive lung carcinoma were presented. Brain metastasis without other signs of disease progression was diagnosed 10 years after combined modality treatment for stage II lung cancer. Removal of intracerebral metastasis with intraoperative photodynamic therapy was performed. Histology microspecimens of the primary tumor and metastasis were similar. No signs of disease progression in the brain 9 months after surgery were found. This case demonstrates that it is important to increase cancer suspicion for patients with long-term relapse-free follow-up. The use of intraoperative photodynamic therapy with photoditazine as a sensitizer in the treatment of cerebral metastases results in a favorable anti-tumor effect, thus improving life quality of patients

Comparative analysis of the relationship between the character of dysregeneratory changes occurring in the bronchial epithelium adjacent to the tumor and the development of recurrence of squamous cell and grandular carcinomas of the lung was carried out. The study showed no any relationship between such parameters as tumor size, presence of lymphogenic metastasis, tumor stage and tumor recurrences. The incidence of recurrence in non-small cell lung cancer indirectly related to the character of dysregeneratory changes in the respiratory epithelium of the bronchial mucosa outside the tumor. High incidence rates of squamous cell carcinoma and adenocarcinoma of the lung were observed in cases with combination of basal cell hyperplasia and squamous metaplasia (BCH+SM+).

Long-term results of successful treatment of giant gastrointestinal stromal tumor (GIST) of the esophagus with unfavorable prognostic factors have been presented.

Various methods for assessment of therapeutic pathomorphosis of squamous cell laryngeal and laryngopharyngeal carcinomas were compared to predict disease outcome in 32 patients with stage II—IV (T2— 4N0—2M0) disease receiving multimodality treatment during 2006 through 2011. The proposed modification of the therapeutic pathomorphosis assessmentby tumor regions with minimal damage increases resolution capability of the corresponding classical approach. The study results suggest a relationship between the level of pathomorphosis in squamous cell laryngeal and laryngopharyngeal carcinomas and the disease clinical course. The modified assessment was found reasonable in predicting poor disease outcome, mainly recurrence.

Effect of neoadjuvant chemotherapy (NACT) on the character and immune phenotypes of disregeneratory processes and dysplasia in bronchial mucosa adjacent to the tumor was analyzed in 112 patients who underwent surgery for non-small cell lung cancer. Of these patients, 48 (42,8 %) received neoadjuvant paclitaxel and carboplatin chemotherapy. Tumor and tissue fragments of the removed lung at the distance of 4-5 cm from the lesion were the material for histological examination. In order to evaluate the effect of NACT on the character of diregeneratory processes, the levels of proliferative activity, apoptosis (Ki67, p53, bcl-2) and pavement epithelium differentiation (CD138) in cells of each version of disregeneratory changes were compared. It was found that NACT for non-small cell lung cancer influences no on the frequency of different types of disregeneratory changes occurring in bronchial mucosa adjacent to the tumor and on their expression profile.

The organ-preserving and reconstructive plastic surgeries elaborated at the Research Institute of Oncology SB RAMS (Tomsk, Russia) with the use of biocompatible implants, different types of radiation therapy and up-to-date anti-tumor agents have made possible to increase the survival rates with maintenance of the high level of cancer patients' life quality. The use of titanium-nickelide implants provides the reliable restoration of removed structures, cranial cavity hermetization, decrease in the surgery length, shortening of the wound healing period, and does not influence on immediate and long-term treatment results. Biochemical TIMP-2 marker in blood serum of patients with squamous cell cancers of oral cavity and oropharynx can be used as the marker of tumor response to chemotherapy.

Expression of the standard markers: Ki67, p53, CDX2, MUC2 and MUC5 as well as cyclophilin A and AKR1B10 proteins in different structures of parenchimatous component of a tumor in surgical specimen obtained from 107 patients with different histological types of Т1-3N0-3M0 stage gastric cancer was assessed. The diffuse-type gastric carcinoma was characterized by younger age of patients and more pronounced lymphogenic metastasis. Furthermore, p53 expression in cancer cells was registered more frequently in patients with diffuse-type than in patients with intestinal-type gastric carcinoma. However, no significant difference in expression of ki67, MUC5 and MUC2 markers between two types of gastric carcinoma was found. The level of CypA gene expression was lower in diffuse-type gastric carcinoma than in intestinal-type gastric carcinoma. In intestinal-type gastric carcinoma, the lower the levels of CDX2, MUC2, AKR1B10 and cyclophilin A, the deeper tumor invasion in the gastric wall. No such changes were found for р53, bcl2 and MUC5 markers. Thus, new findings on the relation of expression ability of tumor cells with tumor growth parameters were obtained, that requires further studies.

To carry out the cytogenetic study of chromosome aberrations in epithelial tissue of the stomach, the patients were divided into 2 groups. Group I comprised 24 patients with chronic gastritis (12 patients with metaplasia and dysplasia and 12 patients without morphological changes in the epithelium). Group II consisted of 10 patients with histologically verified intestinal-type gastric cancer. Chromosome aberrations were detected in 9 of the 12 patients (75 %) having no morphological changes in the epithelium (15q11.2-q26 deletion was found in 66 %). In patients with epithelial dysplasia, amplification of the chromosomal region 3р12-р23 was most frequently found (55,5 %). The cytogenetic analysis showed the evidence of chromosome aberrations in all studied epithelial samples, while in cells of chronic inflammation focus, aberrations were detected in 70 % of patients. Deletions in chromosomal regions 19p13.2, 19q13.1-q13 and 18q12-q21 were frequently observed in tumor-adjacent epithelial tissue (30 %), while in tumor cells, the frequent chromosomal aberrations were deletions in chromosomal regions 5q12-q23 (30 %) and 18q11.2-q21(30 %) as well as amplifications 20p11.2-p13 (20 %).