В данном разделе указаны критерии оценки клинической значимости применения дорогостоящей противоопухолевой лекарственной терапии в соответствии со шкалой, разработанной экспертной группой (см. стр. 7). В тексте они обозначены, как магнитуда клинической значимости (МКЗ).

В данном разделе указаны критерии оценки клинической значимости применения дорогостоящей противоопухолевой лекарственной терапии в соответствии со шкалой, разработанной экспертной группой (см. стр. 7). В тексте они обозначены, как магнитуда клинической значимости (МКЗ).

Background. Tumors of stroma of the sex cord include a family of tumors that are diverse in structure and biological characteristics, including hormone-active ovarian tumors, such as granulosa cell tumor (GCT) of the ovary and a tumor from Sertoli–Leydig cells. For these types of tumors, of particular importance is the analysis of biochemical markers, among which the most promising is inhibin B. The objective of the study. Comparative analysis of inhibin B levels in the blood serum of patients with stromal cell tumors and other types malignancies. Materials and methods. 64 patients with primary ovarian tumors were examined: 31 – GCT of the ovary, 16 – tumors from Sertoli–Leydig cells, 17 – adenocarcinomas. Comparison group – 20 patients with malignant tumors of other localizations, control – 74 healthy women and 37 patients with benign ovarian tumors. Inhibin B was determined in blood serum using the standardized Inhibin B Gen II ELISA (Beckman Coulter, USA) immunoassay. Results. The analysis of inhibin B levels in last days of the luteal phase, show an increase of marker level in patients with GCT and tumors from Sertoli–Leydig cells, while in ovarian adenocarcinomas and malignant tumors of other locations inhibin B secretion doesn’t differ from the control. The sensitivity of inhibin B in diagnostics of GCT was 93.5 %, in tumor from Sertoli–Leydig cells – 81.3 % with specificity – 100 %. Conclusion. Inhibin B is an effective biomarker of GCT and ovarian tumors from Sertoli–Leydig cells, which results must be interpreted according the functional state of the ovaries.

Background : The utility of biochemical markers in the monitoring of treatment efficacy in patients with neuroendocrine tumors (NETs) goes beyond any doubt. However, there are still no clear criteria for the assessment of clinically significant abnormalities of the main NET biomarkers chromogranin A (CgA) and serotonin. Aim : To evaluate the value of serial measurement of serum CgA and serotonin in the monitoring of the treatment effect in NET patients. Materials and methods : Serum CgA and serotonin levels were measured in 107 patients with NETs at baseline and at 3–4 weeks after the end of treatment (chemotherapy, biotherapy), as well as in 60 healthy controls. We used enzyme immunoassay based on Chromogranin A NEOLISA (Euro Diagnostica) and Serotonin ELISA (IBL International GmbH) test systems. Results : There was an association between CgA levels and the efficacy of chemotherapy in NET patients. With progression of the disease, median CgA increased significantly from 412 to 2679 ng/mL (p = 0.012), whereas in the patients with partial response it decreased from 811 to 254 ng/mL (p = 0.023). The ROC analysis showed the 33% cut-off for significant CgA changes for progression, with sensitivity of 80.0% and specificity of 95.6%. A decrease (of more than 33% compared to baseline levels) or absence of significant CgA changes was associated with stabilization of the disease or with partial response to treatment. Significantly decreased CgA levels were found in 75.0% cases of partial response and 43.48% of stabilized patients, whereas the absence of any significant changes in 25 and 66.7%, respectively. There was no association between serotonin levels and the disease behavior under treatment. Conclusion : CgA could be used as a sensitive marker of NET progression on chemotherapy.

The objective of study is to estimate the efficiency of extracorporeal free light chains of immunoglobulin elimination in patients with monoclonal gammopathies (n = 12) during hemodialysis using selective filters. Materials and methods . A blood and dialysate free light chains concentrations change was criterion of efficiency. Results and conclusion . The selective free light chains filtration give the possibility of an adequate anti-tumor therapy, could prevent the development of irreversible renal failure and hypoalbuminemia.

Bone metastasis is one of the most frequent and dangerous complications of malignant tumors. The last years, achievements in the study of bone remodeling mechanisms promoted the search of sensitive and specific criteria reflecting the intensity of osteolysis and osteosynthesis in bone metastatic lesions. The most informative and clinically valid biochemical markers of bone formation and resorption are characterized in this review. The data on their possible implications in diagnostics, monitoring and prognosis of skeletal lesions by various malignant tumors are presented. The attention to biochemical markers of bone remodeling as noninvasive methods for oncologic patients examination is gradually increasing with adoption of modern laboratory technologies to clinical practice. The last years, publications suggest the possibility of their use both for monitoring, prognosis and early diagnostics of bone metastasis. We present the results of our own investigation of serum C-telopeptide of type I collagen (СТX) as bone resorption marker and bone-specific alkaline phosphatase (BAP) as formation marker in 238 breast cancer patients using ELISA methods. The elevation of studied biochemical parameters in breast cancer patients was significantly associated with the extent of skeletal metastases (р < 0.02–0.00001), pathological fractures (р < 0.005–0.0001) and the severity of pain (р < 0.01–0.00002). Elevated rate of bone turnover was associated with reduced overall survival of breast cancer patients. The significant difference of overall survival estimated on a base of cut-off values of CTX (0.74 ng/ml) and BAP (43.7 IU/L) was found both in the groups of breast cancer patients with and without bone metastases. Serum СТХ and BAP are of value in monitoring and predicting the status of breast cancer bone metastases.

The review considers common concepts of neuroendocrine tumors. The results of original studies of biochemical markers of this type of tumor are presented. The various clinical symptoms and syndromes related to hyper-production of biologically active compounds are described. The characteristic of the most important biochemical markers in diagnostic and monitoring of effectiveness of treatment of neuroendocrine tumors is given.

The purpose of this research the study of the prognostic value of baseline CgA in the blood of patients with common secreting highly differentiated NETs receiving biotherapy.The results of application of biotherapy in 69 patients with highly differentiated NETs common. Step method of increasing the value of chromogranin A, starting with the upper limit of normal, was allocated the lowest level at which the obtained differences in progression-free survival were of statistically significant character, he was 200 U / 1.In accordance with the data obtained, we can conclude that patients with baseline ( prior to treatment ) Blood CgA below 200 IU / 1 would be the best estimate for the TTP.

The review considers common concepts of neuroendocrine tumors. The results of original studies of biochemical markers of this type of tumor are presented. The various clinical symptoms and syndromes related to hyper-production of biologically active compounds are described. The characteristic of the most important biochemical markers in diagnostic and monitoring of effectiveness of treatment of neuroendocrine tumors is given.

The paper gives the results of evaluating the time course of changes in the level of bone resorption markers (S-CTx and dPir) in pami- dronate-treated patients with bone metastases from breast cancer. It shows the relationship of these markers to clinical and X-ray find- ings. The markers were not found to be of high clinical significance as a means for diagnosing bone metastases and estimating treat- ment trends.