Introduction. Thyroid cаncer is the most common endocrine malignancies accounting for approximately 2 % of all cancers in Russiа аnd 2.3 % in the world. Several studies have reported on the infuence of hormonаl status on the prognosis of thyroid cаncer, in pаrticulаr, femаle sex hormones, such as estrogens аnd progesterone, contribute to thyroid cell proliferation. In this regard, thyroid cancer occurring during pregnancy is of particular interest.The purpose of the study was to аnаlyze the literаture sources concerning thyroid cаncer occurring during pregnаncy and to evaluate the impact of pregnаncy on the progression of thyroid cancer.Mаteriаl аnd Methods. A literature seаrch wаs conducted using Cochrаne, Librаry, and Elibrаry databases. The review included studies from 1981 to 2022.Conclusion. Currently, most studies report thаt pregnаncy does not adversely affect the outcomes of thyroid cancer; however, many aspects concerning the hormonаl effect аnd receptor stаtus of thyroid cancer require more detаiled study.

Relevance. The ubiquitin-proteasome system controls the activity and stability of various cellular proteins that affect cellular homeostasis by the regulation of signalling cascades. The system activity is associated with the onset and progression of oral squamous cell carcinoma, as the system participates in the specific proteolysis of most intracellular proteins involved in cancer pathogenesis.Material and methods. The study included 61 patients (28 men and 33 women) aged 21 to 75 y.o. The study determined chymotrypsin-like (CTL) and caspase-like (CL) activities of circulating and intracellular proteasomes in blood serum and biopsy specimens taken from the oral mucosa by hydrolysis of the corresponding fluorogenic oligopeptide on a «Cytation1» multi-mode microplate reader-imager at an excitation wavelength of 360 nm and an emission of 460 nm, the specific activity of the proteasomes was expressed in units of activity.Results. The value of the specific chymotrypsin-like activity of circulating proteasomes in non-homogeneous leukoplakia and oral squamous cell carcinoma was 1.76 (p < 0.001) times and 2.27 (p < 0.001) times higher relative to the comparison group. Pairwise comparison of signs showed a statistically significant difference in chymotrypsinlike activity between the groups of non-homogeneous and homogeneous leukoplakia (p < 0.001), non-homogeneous leukoplakia and oral squamous cell carcinoma (p = 0.04). The values of specific chymotrypsin-like and caspase-like activities of intracellular proteasomes in biopsy specimens taken from the pathological focus in the groups of homogeneous, non-homogeneous leukoplakia and squamous cell carcinoma of the oral cavity were 1.6, 2.38, 3 (p = 0.002, p = 0.004, p = 0.03) and 1.5, 2.8 and 3.3 (p = 0.003, p = 0.012, p < 0.001) times higher compared to the control group.Conclusion. The proposed logit model for risk assessment of oral leukoplakia malignant transformation, based on the indicators of the ubiquitin-proteasome system, can improve the quality of diagnosis.

The purposeof the study was to assess the diagnostic value of endoscopic autofluorescence imaging (AFI) in patients with premalignant lesions and primary laryngeal/hypopharyngeal cancer.Material and Methods. The diagnostic value of AFI was assessed in 53 patients with chronic hyperplastic laryngeal/hypopharyngeal lesions and 48 patients with laryngeal/hypopharyngeal cancer.Results. The inclusion of video laryngoscopy with AFI in the algorithm for examining patients with chronic diseases of the upper respiratory tract made it possible to significantly improve the diagnostic efficacy of endoscopic examination in patients with premalignant lesions (high grade dysplasia) of the laryngeal mucosa. Video laryngoscopy with AFI was found to achieve higher sensitivity, specificity and accuracy rates than white light video laryngoscopy (87.5, 96.9 and 92.5 vs 50.0, 96.0 and 71.7 %, respectively, p<0.05). The video laryngoscopy with AFI allowed identification of not only pathological changes in the laryngeal and hypopharyngeal mucosa but also their malignant potential, as well as identification of areas for targeted biopsy. In 9 (18.8 %) laryngeal cancer patients, the standard white light video laryngoscopy demonstrated difficulties in the differential diagnosis of laryngeal cancer (n=4) and in assessing the extent of laryngeal cancer (n=5). In 3 out of 4 diagnostically difficult cases, video laryngoscopy with AFI made it possible to confirm the diagnosis of laryngeal cancer and in 5 cases to accurately determine the extent of hypopharyngeal cancer.Conclusion.The addition of standard videolaryngoscopy with a hightech technique of autofluorescence endoscopy makes it possible to accurately diagnose premalignant and malignant lesions of the larynx and hypopharynx.

Introduction.Nowadays discussed and actual issues of modern oncology are the diagnostics problems and care organization for patients with oral mucosa and lips precancerous diseases.Study purposes– to analyze the prevalence, structure, and primary diagnosis quality of oral mucosa and lips precancerous diseases and to identify the organizing medical care problems for the adult population with the oral cavity precancerous diseases in residents of Tomsk city and Tomsk Region.Materials and methods.For the period 2014–2019 1,664 patients were examined and treated for oral mucosa and lips diseases. The main complaints and medical history were clarified in all patients, according to the recommendations of the World Health Organization, assessed the state of the oral mucosa and lips according to the visual inspection data. To assess the primary diagnosis quality of an oral mucosa disease, we analyzed the data from a dental patient’s medical record, dentist’s referrals, and anamnesis data.Results.In the general oral mucosa and lips pathology structure almost a quarter (25.7 %) of patients were diagnosed with precancerous diseases – leukoplakia (12.5 %), lichen planus (10.8 %), viral papillomas (2.0 %) and Manganotti cheilitis (0.4 %). Malignant neoplasms of the oral cavity at different stages was established in 8.3 % of cases. A retrospective errors analysis revealed that in 100 % of leukoplakia, lichen planus, candidiasis and stomatitis cases the disease form was not indicated. In 22 % cases out of the total number of oral leukoplakia patients, the diagnosis was made mistakenly. In 12 cases of malignant neoplasm underdiagnoses, lichen planus and oral mucosa candidiasis prevailed. In half of the cases of the mistakenly diagnosed oral leukoplakia (10.2 %), oral cavity squamous cell carcinoma was detected. The average waiting time for the oncologist»s appointment was 44.3 ± 10 days.Conclusion.The results indicate a high prevalence of precancerous pathology in the oral mucosa structure diseases(25.7 %) and a long wait for specialized medical care.

Currently accepted standard of surgical treatment of patients with locally advanced stage III and IV laryngeal and laryngopharyngeal cancer is laryngectomy which leads to loss of vocal function. Therefore, vocal rehabilitation is one of the most important tasks of the doctor. It allows to increase quality of life of patients after treatment. Currently used techniques of vocal rehabilitation have their advantages and disadvantages. The article considers various techniques of vocal rehabilitation, primarily, subtotal laryngectomy with laryngotracheal shunt as a promising method of surgical rehabilitation of patients with locally advanced caner of the larynx and laryngopharynx.

The ubiquitin-proteasome system (UPS) controls the activity, subcellular localization, and stability of many cellular proteins that affect cellular homeostasis by regulating multiple signaling cascades. The activity of this system is associated with the emergence and progression of oral squamous cell carcinoma, since specific proteolysis of most intracellular proteins involved in the pathogenesis of cancer is implemented by this system. The review article presents data on the characteristics of proteasomes and the process of substrate protein ubiquitination. The role of the ubiquitin-proteasome system in the pathogenesis of oral squamous cell carcinoma is shown, and the prospects of its use in precancerous diseases are described. The literature search was carried out in the search engines Medline, eLIBRARY, Scopus, The Cochrane Library, and RSCI.

The review is devoted to modern methods of reconstructive surgery in patients with the tongue and the mouth floor cancers. The article describes the possible methods of surgical rehabilitation for patients after hemiglossectomy, glossectomy and resection of the mouth floor. The authors carried out an analysis of the most common reconstructive methods for various post-resection defects of the tongue, with the possibility of sensory and motor reinnervation of the reconstructive material used. Обзор посвящен современным методам реконструктивно-восстановительной хирургии у больных зло качественными новообразованиями языка и дна полости рта. В статье дан анализ возможных методов хирургической реабилитации больных после гемиглоссэктомии, глоссэктомии и резекции дна полости рта. Проведен анализ наиболее распространенных реконструктивных методов устранения различных пострезекционных дефектов языка, с возможностью чувствительной и двигательной реиннервации, используемого реконструктивного материала.

Thyroid cancer remains the most common malignancy of the endocrine system worldwide. The indicators of its morbidity and mortality rates have been increasing rapidly over the last decades. Most cases of differentiated thyroid cancer (follicular and papillary histotypes) are clinically manifested by nodular goiter frequently combined with uncertain results of cytological diagnosis (categories III and IV according to the Bethesda (Bethesda System for Reporting Thyroid Cytopathology) classification). All of that makes it difficult to choose a proper tactic for patient treatment. It is known that the development, progression, invasion, and metastasis of cancer cells are regulated by a variety of molecular mechanisms. This review describes several molecular aspects of thyroid nodules oncogenesis, as well as its most promising diagnostic tumor markers. Following molecular pathways are described in particular: gene mutations, protein tumor markers, and epigenetic effects of micro-RNA, histones, as well as DNA methylation. The study of the pathogenesis of this disease has a prognostic value and contributes to the search for effective therapeutic and diagnostic methods and their improvement. That is why we also reviewed modern test panels aimed at preoperative differential diagnosis of thyroid nodules. Summarizing the results of world research on this topic allows us not only to expand the understanding of the fundamental processes of oncogenesis, but also to outline promising areas for future experimental research projects. All of that together will contribute to developing new prognostic, diagnostic and therapeutic technologies, and as a result, will improve the quality of medical care for patients with thyroid cancer.

The main goal of reconstructive surgery is to improve the quality of life of patients who have undergone surgery. However, recurrences and postoperative complications after such surgeries pose a serious challenge.The purpose of the study was to evaluate immediate surgical outcomes in head and neck cancer patients who underwent reconstructive surgery following tumor resection, as well as to analyze the causes of postoperative complications.Material and Methods. Immediate treatment outcomes were analyzed in 272 head and neck cancer patients, who were treated from 2008 to 2018. All patients were divided into 2 groups. Group I consisted of 172 patients, who underwent radical surgery and reconstruction. Group II comprised 100 patients, who underwent radical surgery alone. The groups were matched by stage, gender, age, previous treatment, and tumor location.Results. The incidence of recurrence was lower in Group I than in Group II (19 % versus 32 %, p>0,05). Postoperative complications occurred in 14 % of patients who underwent reconstruction of postoperative defects with rotation flaps and in 35 % of patients who underwent reconstruction with free revascularized flaps (p<0,05). The rate of complications was higher in patients undergoing maxillary and mandibular reconstructions (39,6 %) than in patients undergoing reconstructions of the other parts of the head and neck (23,7 %) (p<0,05). Patients who received chemoradiotherapy had higher rate of postoperative complications than those who had no neoadjuvant treatment (37 % versus 22 %, p>0,05).Conclusion. Knowledge of the factors that have a significant impact on the likelihood of developing postoperative complications after reconstructive surgeries makes it possible to take measures to prevent them.

Rehabilitation of patients after surgical treatment of maxillofacial cancer represents a major challenge and is the focus of attention in modem clinical oncology. The purpose of our study was to develop a personalized approach to the reconstruction of maxillofacial bone defects using bioceramic implants. We used 3D printing to customize bioceramic osteoimplants. These implants precisely fitted the anatomical shape of the maxillofacial region and had all strength characteristics. The presence of a bimodal pore structure of bioceramic implants favorably affected their integration ability. Fourteen reconstructive surgeries were performed in patients with maxillofacial tumors. In all cases, good cosmetic and functional results were achieved. Bioceramic implants meet all requirements for medical materials used in reconstructive surgery. The new technique of a personalized maxillofacial reconstruction using bioceramic implants can be safely used for cancer patients.

Хирургический метод лечения больных злокачественными новообразованиями остается основным в лечении опухолей различных локализаций. Современные требования к хирургическому этапу предполагают наряду с выполнением радикальной операции восстановление утраченных структур с достижением полноценных функциональных и эстетических результатов. Материалы, предлагаемые для реконструктивновосстановительных операций в онкологии, существенно отличаются по происхождению. К числу таких материалов относятся ауто и алломатериалы, ксеноматериалы, брефоматериалы, биологически активные молекулы белковой и небелковой природы, обладающие свойствами факторов роста, искусственные на основе трикальцийфосфата, гидроксиапатита, различные типы керамик, композиционные материалы на основе синтетических и/или биологических структур. В статье приводиться обзор используемых в настоящее методов реконструкции челюстнолицевой области. Прослежена эволюция биоматериала, используемого в качестве костного трансплантата вместо аутологичной кости при реконструкции черепнолицевой области. Surgery of malignant neoplasms of various sites remains the cornerstone method of treatment for many patients. Current requirements for surgery suggest, along with the implementation of a radical operation, the lost structures restoration with the achievement of the best functional and aesthetic results. The materials proposed for reconstructive and restorative surgery differ significantly from the origin. Such materials include auto and allomaterials, xenomaterials, brefomaterials, biologically active molecules of protein and nonprotein nature with the properties of growth factors, and artificial ones based on tricalcium phosphate, hydroxyapatite, as well as various types of ceramics, composite materials based on synthetic and / or biological structures. The article provides an overview of currently used maxillofacial reconstruction methods. The evolution of a biomaterial used as a bone graft instead of an autologous bone for the craniofacial zone reconstruction is also overviewed

A fundamentally new complex technique for preoperative planning and creation of individual implants from ceramics for the reconstruction of the maxillofacial region is clinically applicable and in demand in modern trends of reconstructive surgery were developed and approved. The developed method implies using of alumina based ceramic material, which meets the requirements for medical materials used in reconstructive surgery. It was shown that by varying the initial composition of the ceramic powder material, it is possible to achieve structural and mechanical affinity with the surrounding bone tissue. Building a 3D model of an osteoimplant on the basis of a computed tomography of the patient avoids the need for additional resection of the bone tissue and ensures complete geometric conformity of the osteoimplant to the prosthetic area. The method was approved by the reconstruction of the patient’s skull-orbital complex using a three-dimensional personalized ceramic implant. The complete absence of the inflammatory reaction after surgery was observed.

Introduction. Many researchers are currently searching for new, safe, and effective methods of maxillofacial reconstruction in cancer patients.In this case, special attention should be paid to ceramic implants.Objective: to develop a personalized approach to the maxillofacial reconstruction using bioactive ceramic implants.Materials and methods. We performed virtual planning of the implants for the reconstruction of the maxillofacial region basing on the preoperative spiral computed tomography scans of the facial skeleton.Results. We have developed a new method of preoperative planning and creation of individualized implants made of bioactive ceramics for reconstructing the maxillofacial region. This method is demanded in reconstructive surgery and can be applied in routine clinical practice.Conclusion. Reconstructive surgeries with the implants made of bioactive ceramics allow achieving good functional and aesthetic results in patients with large postoperative defects in the maxillofacial region, thus, improving their quality of life.

Thin TiNi fibers which having superelasticity with diameter from 90 to 30 mm obtained from medical application alloy TN-10 by traction across dies with interval annealings are researched. Fine TiNi alloy fibers diameter of 90 to 30 microns having superelastic properties, obtained from TN-10 alloy for medical purposes by traction through dies with intermediate annealing. Availability superelastic properties allow thin fibers to function long in the body as the implant material. The optimum temperature superelastic properties of thin fibers with a diameter 90-30 mm was determined. It has been shown that with decreasing fibers diameter from 90 to 30 mm maximum temperature manifestations superelastic properties without residual deformation is shifted to higher temperatures, reaching values of 93 -95 °Cfor 30 mm diameter fibers.

Structural features of porous TiNi-based materials obtained by SHS at temperatures of synthesis beginning of400 Cand600 Chave been investigated. It is found that finely porous material with a porosity P=75 % was obtained at the temperature of400 C. A surface of pore walls contains a dendritic relief, oxycarbidenitride layer and a multitude of secondary phase particles. Phase and chemical composition of the material is non-uniform. SHS material obtained at the synthesis beginning temperature of600 °Cis characterized as a coarse-porosity one P=65 %. Nano- and micropores are practically absent. The oxycarbidenitride surface layer with a variable thickness is substantially free of secondary inclusions due to the more complete processes of alloy formation. This layer has an own substructure based on carbonitride and oxynitride layers.

Recently, there has been a trend towards the search for new, safe and effective methods of reconstruction of maxillofacial defects after tumor excision. Among various materials used for bone defect reconstruction, ceramics has attached a great deal of attention. The purpose of our study was to develop a technique for personified approach to the reconstruction of maxillofacial bone defects with bioactive ceramic implants. In our study we used the technique of virtual implant planning for maxillofacial reconstruction using preoperative CT data of the patient's facial skeleton. Bioactive ceramic implant materials meet all the requirements for medical materials used in reconstructive surgery. The technique described in this paper to customize prefabricated bioactive ceramic implants enables surgeons to perform reconstruction of large postoperative defects in the maxillofacial region, thereby making custom implants suitable for any patient. The use of this technique decreases surgical time, reduces time needed for postoperative recovery, lowers overall patient morbidity and optimizes aesthetic and functional results.

The ever increasing incidence of thyroid cancer throughout the world poses the problem of differential diagnosis of thyroid nodules at various stages of their formation. Objective: to determine the most important clinical, laboratory and instrumental parameters of thyroid nodules for the assessment of their malignancy potential and to identify "defects" of clinical and instrumental examination of patients with nodular goiter in clinical practice. Materials and methods: we analyzed the data of general clinical research, hormonal profile, and thyroid ultrasound studies performed on the basis of various clinics in the city of Tomsk (41%), Endocrinology Department of the OGAUZ TOKB consultative and diagnostic polyclinic (28 %), and Cancer Research Institute (31%) for the period from 2012 to 2014. The patients were selected for surgery. Pre-operative data were compared with histological features of the nodules. Results: we analyzed «defects» of patient examination, statistical data on clinical and laboratory-instrumental parameters of thyroid nodules. Conclusion: «defects» of description of ultrasound data significantly reduce sensitivity of the method for predicting malignancy of thyroid nodules. The description of the material obtained by US-FNA alone, in the absence of the conclusion of medical cytologists, has no informative value. Low specificity of a cytological study (48.4%) and its high sensitivity (95.8%) suggests overdiagnosis of thyroid cancer.