Purpose: To demonstrate a rare clinical case of early recurrence of verified primary genital lymphoma and the possibility of 99mTc-1-Thio-D-glucose (99mTc-TG) SPECT/CT using to brain metastasis diagnosis. Material and methods: A patient with a diagnosis of primary diffuse large B-cell genital lymphoma underwent magnetic resonance imaging (MRI) to assess the extent of the disease. Post-treatment follow-up included 18F-FDG PET/CT. To diagnose brain metastasis, 99mTc-TG SPECT/CT and MRI were performed. Results: A rare case of early recurrence of diffuse large B-cell lymphoma with a primary local lesion in the genital organs is described. The possibility of modern methods of nuclear medicine in the diagnosis of early recurrence of malignant lymphoma has been demonstrated. 99mTc-TG SPECT/CT and MRI, were useful for visualization of a high metabolic brain tumor at the outpatient stage and recommendation of high-dose therapy according to the scheme MT-R was done. Conclusion: The article presents a rare clinical case of early recurrence of diffuse large B-cell genital lymphoma. Possibilities of SPECT/CT with 99mTc-TG for visualization of lymphoma metastasis to the brain were demonstrated.

МЕТАБОЛИЧЕСКАЯ ОДНОФОТОННАЯ ЭМИССИОННАЯ КОМПЬЮТЕРНАЯ ТОМОГРАФИЯ С «99MTC-1-ТИО-D-ГЛЮКОЗОЙ» -НОВЫЕ ВОЗМОЖНОСТИ СТАДИРОВАНИЯ ЛИМФОМЫ ХОДЖКИНА

The purpose of the study was to provide up-to-date data on the efficacy of positron emission computed tomography (PET) for the diagnosis, assessment of tumor extension and monitoring of colorectal cancer.Material and Methods. The Medline and Pubmed databases were used for searching for publications devoted to clinical trials of diagnostic value of PET with 18F-Ftordesoxyglucose (PET with 18F-FDG).Results. Data on the value of PET with 18F-FDG in visualization of the primary tumor, detection of lymph node and distant metastases and assessment of the treatment response in patients with colorectal cancer were presented.Conclusion. PET with 18F-FDG was shown to be a promising imaging method for colorectal cancer. It is the most sensitive method in the detection of liver metastases. 18F-FDG PET is particularly superior to CT and MET in the ability to assess tumor response to treatment and predict early tumor response to therapy. The development of new radiopharmaceuticals for the diagnosis, staging, monitoring and prediction of colorectal cancer is of great importance.

We studied the effects of combined chemotherapy with doxorubicin/docetaxel on erythroid and granulocytic hematopoietic lineages with particular attention focused on their recovery in patients with stages III-IV breast cancer. Intensification of differentiation of erythroid and granulocytic CFU (even under conditions of their suppressed proliferation) provided the increase in the content of mature and morphologically differentiated elements in the bone marrow and peripheral blood. High proliferative activity of erythroid and granulomonocytic precursors resulted from enhanced production of hematopoiesis-stimulating activities by microenvironment elements.

The breast cancer occupies the first place in the structure of women cancer morbidity and mortality for many years. The treatment of this pathology includes two types of chemotherapy: neoadjuvant and adjuvant. Neoadjuvant chemotherapy (NACT) follows surgical treatment and makes it possible to assess the sensitivity of the tumor to the medication. The obtained data can be used to correct the subsequent adjuvant chemotherapy. However, there is a lot of evidence of the ability of NACT to increase the risk of progression of malignant tumors. The bone marrow progenitor cells are components of premetastatic niches. Objective: to assess the effect of neoadjuvant chemotherapy on the level of bone marrow progenitor cells in the blood of patients with breast cancer. In a prospective study were included 31 patients newly diagnosed with invasive breast cancer, of which 17 patients was performed neoadjuvant chemotherapy, 14 patients - without neoadjuvant chemotherapy. The method of multicolor flow cytometry was used to assess the dynamics of bone marrow progenitor cells (hematopoietic stem cells (HSC) and hematopoietic progenitor cells (HPC), endothelial progenitor cells (EPC), mesenchymal stem cells (MSC) in blood of patients with invasive carcinoma of a non-specific type during NACT. It has been shown that neoadjuvant chemotherapy leads to a statistically significant increase the number of endothelial cell precursor cells (EPC) in the blood of patients with invasive breast carcinoma (p = 0.036). The level of mesenchymal stem cells in the blood of patients with invasive breast carcinoma increases at the level of a statistical trend (p = 0.06) during neoadjuvant chemotherapy. Based on these data we can conclude that neoadjuvant chemotherapy enhances the recruitment of bone marrow cells involved in the formation of premetastatic niches.

Activating mutations of EGFR are associated with sensitivity of non-small cell lung cancer (NSCLC ) to tyrosine kinase inhibitors (TKI). Liquid biopsy using circulating cell-free tumor DNA (cfDNA) is proposed in cases when formalin fixed paraffin embedded (FFPE) tumor tissue is not available and for monitoring of EGFR status. In the study we evaluated new qPC R assay for EGFR mutations in plasma cfDNA. Sensitivity of the assay was 1 % of the mutant allele for L858R, L861Q, S768I mutations and deletions in exon 19, and 5 % of the mutant allele for G719X or T790M mutations Before surgery, mutation was detected in plasma of 4 out of 7 patients (57 %) with mutant EGFR in FFPE tumor tissue. Mutations found in cfDNA completely matched those found in tumor tissue in 2 cases. In one case with G719X and S768I mutations in FFPE tissue, only S768I was found in cfDNA. In another case, T790M was detected in plasma in addition to L858R that was present in tumor tissue. No EGFR mutations were detected in plasma DNA from 12 healthy volunteers and 13 cases of NSCLC with wt EGFR suggesting 100 % specificity of the assay. Liquid biopsy detected EGFR mutations in cfDNA in 8 of 16 cases of NSCLC with mutant EGFR being under therapy with TKI. Among them, 7 cases had mutations in liquid biopsy that matched those in tumor tissue and another case had T790M in addition to L858R. In 3 cases increased mutant allele frequency was detected 212 months before clinical progression.

We studied myelotoxicity of modern schemes of chemotherapy for breast cancer (docetaxel/doxorubicin and cyclophosphamide/doxorubicin/5-fluorouracil) towards granulocytopoiesis, the mechanisms determining the differences of hematological effects of these schemes, and the efficiency of correction of the observed changes with granulocyte CSF (filgrastim). Granulocytopoiesis stimulation with filgrastim during the treatment with docetaxel/doxorubicin combination was more pronounced than during cyclophosphamide/doxorubicin/5-fluorouracil therapy. The observed differences were found at all levels of granulocyte lineage organization (central and peripheral), which is related to different effects of the cytostatic substances used in the proposed protocols on the structures controlling hemopoiesis.

The toxic effects of combined cisplatin/docetaxel therapy cycles on erythroid and granulocytic hematopoietic lineages as well as their intercycle recovery were examined in patients with stage III-IV non-small-cell lung carcinoma. Responsiveness of the blood system to this therapy remained at a high level. Combined therapy pronouncedly activated the key elements of the erythroid and granulocytic hematopoietic lineages leading to accumulation of immature and mature myelokaryocytes in the bone marrow, enlargement of the medullary pool of mature neutrophils, and increase in the count of medullary erythroid and granulocytic precursor cells under conditions of their accelerated maturation.

Paraneoplastic neurological syndrome involves the concurrent development of cancer and neurologicaldiseases. Breast cancer is the second most common cancer associated with paraneoplastic damage to the central and peripheral nervous system. Autoimmune genesis of the disease is characterized by the presence of highly specific onconeural antibodies, which selectively affect neurons in the brain cord, spinal cord and spinal ganglia, and cause the onset of neurological symptoms within 2 years before cancer is detected. Six well-characterized onconeural antibodies detected in the blood serum of breast cancer patients can be used for the laboratory diagnosis of paraneoplastic neurological syndrome. Of them, anti-Hu, anti-CV2 and anti-amphiphysin antibodies cause polyneuropathy most often. Anti-Yo antibody is usually associated with cerebellar degeneration. Multiple neuronal autoantibodies can be simultaneously detected in a patient. Removal of the tumor may lead to stabilization and even partial regression of the neurological symptoms in 70 % of patients. Therefore, the surgical treatment of cancer should consider not only the tumor extension, but also the severity and progression of neurological deficit. We present a case of paraneoplastic cerebellar degeneration and paraneoplastic polyneuropathy in a 50-year-old woman with the neurological symptoms appeared 5 months before breast infiltrating ductal carcinoma was detected. The current approaches to the diagnosis of paraneoplastic neurological syndrome, as well as feasibility of radical removal of the tumor due to progression of neurological deficit were discussed.

The article presents the clinical cases of the targeted therapy regorafenib in metastatic colorectal cancer (mCRC) in Russia. Russian oncologists’ experience has not only confirmed the results of international clinical trials, but also clearly demonstrated the possibility of regorafenib long-term administration on the back of high efficacy and manageable safety profile.

The present study shows significance of onco-neural antibodies as markers of paraneoplastic polyneuropathy in early cancer detection. Symptoms of polyneuropathy occurred at least 6 months before tumor detection in 2/3 patients, neuronal antibodies were detected in blood serum of more than 50 % of patients.

The effect of recombinant human granulocyte colony-stimulating factor (filgrastim) on hematopoietic recovery was studied. The study included 77 patients with stage III–IV breast cancer who received chemotherapy with oxorubicin/docetaxel. Filgastrim was administered to 30 patients in the intervals between chemotherapy courses. The drug was injected subcutaneously at a dose of 300 mg, twice, on days 8 and 12 days from the last administration of docetaxel. Blood parameters were assessed within 3 cycles of chemotherapy. Filgastrin was shown to stimulate bone marrow granulocytopoiesis depressed by cytostatic drugs. The effect was realized on the level of committed precursors, morphologically differentiated bone marrow and peripheral blood cell elements, being the result of stimulation of the proliferative activity of hematopoietic progenitor cells of granulocytopoiesis under the influence of humoral factors released by cells of the microenvironment, as well as, to a large extent, the acceleration of the maturation of these cells.

Toxic effects of combined cisplatin and docetaxel treatment on the granulocytic hemopoiesis were studied in 45 patients with stage II–IV non-small cell lung carcinoma. The patients received intravenous injections of docetaxel at a dose of 75 mg/m2 followed by cisplatin 75 mg/m2. Blood parameters were assessed during 3 courses of chemotherapy. To estimate the state of granulocytic hemopoiesis, the hematological, cultural and functional methods were used. The study showed that the reactivity of granulocytopoiesis was maintained at a high level, namely, there was a significant activation of the central signals of granulocytic hematopoiesis, resulting in the accumulation of immature and mature myelokaryocytes in the bone marrow and increase in the bone marrow pool of mature neutrophils, as well as in increase in the number of bone marrow progenitor cells granulocytopoiesis in terms of acceleration of their maturing.

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.

A low level of functional properties of E. coli isolated from the mouth cavity of lung cancer patients indicated the disturbed symbiotic relationship between Escherichia and macro-organism. This evidence is followed by intensification of biological properties of E.coli, causing the parasitism and bacterial pathogenicity.

Purpose: To compare the possibility of using multiple-gated acquisition scan (MUGA) and 99mTc-MIBI GATE SPECT for evaluation and forecast of anthracycline–induced cardiotoxicity in breast cancer patients. material and methods. The study included 67 women (mean age – 44 ± 4.9 years) with breast cancer without significant pathology of the cardiovascular system. For the treatment of these patients used doxorubicin in dose of 50 mg/m2 per course in combination with various drugs. All patients were studied by MUGA (n=33) or GATE SPECT (n=34) before starting chemotherapy, at 1 hour after the first administration of doxorubicin and after the 4th course. results. After administration of doxorubicin at a dose of 50 mg/m2 was found that 11 patients according MUGA and 14 patients according GATE SPECT had a significant (10 % or more) reduction in left ventricular ejection fraction (LVEF). Significant inhibition of systolic function in this patient group remained after the 4th course treatment. In the individual analysis of the MUGA and GATE SPECT results, registered after the administration of doxorubicin at a dose of 200 mg/m2, was revealed that the criterion of LVEF reduction (10 % or more) in response to the first dose of doxorubicin can predict the development of chronic cardiotoxicity. Conclusion. The MUGA and GATE SPECT can be applied with equal effectiveness for evaluation of acute and chronic anthracycline–induced cardiotoxicity in breast cancer patients. The decrease in LVEF (10 % or more) in response to the first dose of doxorubicin can predict the development of chronic cardiotoxicity.

молочной железы (РМЖ) занимает лидирующие позиции, при этом опухоли, экспрессирующие рецептор Her2/neu, встречаются в 25–30 % случаев. Стимуляция данного рецептора в опухолевых клетках является одним из основных внутриклеточных сигналов, которые запускают различные клеточные процессы, такие как пролиферация, дифференцировка, ангиогенез, метастазирование и др. Гиперэкспрессия Her2/neu является прогностиУДК: 618.146-006.6-08:615.28

A low level of functional properties of E. coli isolated from the mouth cavity of lung cancer patients indicated the disturbed symbiotic relationship between Escherichia and macro-organism. This evidence is followed by intensification of biological properties of E.coli, causing the parasitism and bacterial pathogenicity.