The article offers the latest view on possibilities of diagnostic algorithm to identify vaginal cancer (VC), rare tumor of the woman’s reproductive system. The algorithm is described as a consensus of leading expert in imaging diagnostics, as well as oncogynecologysts, investigating diagnostic challenges and vaginal cancer therapies. The article sets forth the principal trends in using imaging methods, their role and possibilities for staging VC, planning and assessing the efficacy of applied therapy, on-going surveillance over patients, who have undergone specialized anti-cancer treatment

The increase in the incidence of endometrial cancer is noted not only in postmenopausal women, but also in a socially active group of women of reproductive age, starting from 25 years. Ultrasound and magnetic resonance imaging (MRI) are the main methods of non-invasive diagnosis of endometrial cancer. Our study included 69 patients with endometrial cancer stages I–IV aged 30 to 79 years. The diagnostic informativeness of the MRI method in detecting tumor invasion into the myometrium for all groups was: sensitivity – 82.30%, specificity – 6.6%, PPV – 93.30%, NPV – 40%. The diagnostic informativeness of the ultrasound method in detecting tumor invasion into the myometrium for all groups was: sensitivity – 91.3%, specificity – 88.4%. The peculiarity of this study was to evaluate the possibilities of radiation methods (ultrasound, MRI) in the staging of endometrial cancer.

A review article presents the modern methods of screening and early diagnosis of primary ovarian cancer (OC). This issue is still relevant in view of the continuing upward trend in incidence rate ratios along with a slight decrease in mortality and 5-year survival rate, as well as the lack of clear definition of the concept of pathogenesis. The diagnostic value of tumor markers and their potential, advantages and disadvantages are discussed. In light of this the need becomes evident for combination of tumor markers with radiological method of imaging, such as transvaginal sonography as the most affordable, safe and multi-reproducible method enabling to most accurately determine the nature of the process, its nosology belonging, as well as to carry out the required dynamic monitoring within a short time. More advanced imaging techniques such as computer tomography or magnetic resonance imaging proved too expensive for widespread use in view of their limited sensitivity and specificity. Attempt to assess the performance of marker screening on the base of CA-125 in groups, divided by clinical and pathogenic way of OC development also proved to be ineffective. Currently, none of the presented algorithms can meet the criteria of economic efficiency, even in the most developed countries. In view of the above, possible options to enhance their performance by developing reliable multimarker panels, the use of ultrasound color power doppler mapping, and others are considered. In addition, the feasibility and application prospects of ultrasound elastometry, mass-spectrometry, IVDMIA tests, OVA dx-test as part of screening programs are discussed. The data of recent studies on the direct comparison of diagnostic tests is given. The importance of genetic counseling for persons at high risk of cancer development process is noted. In case of mutation detection in the BRCA1, BRCA2 genes, in some countries a wide range of preventive activities is recommended: from regular «targeted» preventive examinations to the prophylactic oophorectomy and mastectomy. Increased survival rate of patients with OC is the main aim of all scientific research.

Introduction. Ovarian cancer (OC) in Russia is ranked the seventh within the structure of general cancer diseases and the third within the gynecological tumors, due to such reasons the problem of early diagnostics is still actual. New technologies, such as color Doppler ultrasonography,3D power Doppler ultrasonography contribute to increasing of opportunities of ultrasound analysis to detect any malignancy signs.Materials and methods. The paper sets out the results of comprehensive ultrasound study of 68 patients with morphologically verified OC at stages IА–В, IIА–В. The control group was made of 100 female patients with morphologically verified ovarian tumors (serosal cystadenomas, thecomas, fibromas). A complex of the following ultrasound methods was used during the study: 2D and 3D ultrasonography in B mode, in color Doppler and power mapping mode, 3D angiography, spectrum Doppler imaging.Results. Maximum size of tumor varied within a range between 37 and 300 mm (108 ± 61.2 mm). It worth noting that no direct dependence between the size of neoplasm and process phase was established. When assessing the echostructure, all ovarian tumors were divided into 3 structure types: cystic type (57.8 % of cases), cystic and solid type (33.3 % of cases), solid type (8.9 % of cases). The conducted analysis of types of small pelvis neoplasm echostructures enabled to evolve the sonographic types of ovarian tumors, more or less associated with the malignant transformation. The most relevanl Doppler ultrasonography exponents characteristic for benignant and malignant processes: resistance index in benignant tumors was 0.56, at OC – 0.32 (р < 0.001); average arterial blood velocity in benignant tumors – 7.8 cm/s, at OC – 20.1 cm/s (р < 0.001); average maximum venous flow velocity in benignant tumors – 3.2 cm/s, at OC – 9.3 cm/s (р < 0.001).Conclusion. Therefore modern ultrasonography can detect and differentiate rather efficiently the localized variants of OC, provided that the main part of diagnosis is formed in mode of color and power Doppler mapping, which shall be taken into consideration during the primary diagnostics of OC.

Int r oduction . Ovaria n cance r (OC) in Russia is ranked the seventh within the structure of general cancer diseases and the third within the gynecological tumors, due to such reasons the problem of early diagnostics is still actual. New technologies, such as color Doppler ultrasonography, 3 D power Doppler ultrasonography contribute to increasing of opportunities of ultrasound analysis to detect any malignancy signs. Material s and methods. Th e paper sets out the results of comprehensive ultrasound study of 68 patients with morphologically verified OC at stages IА–В, IIА–В. The control group was made of 100 female patients with morphologically verified ovarian tumors (serosal cystadenomas, thecomas, fibromas). A complex of the following ultrasound methods was used during the study: 2D and 3D ultrasonography in B mode, in color Doppler and power mapping mode, 3D angiography, spectrum Doppler imaging. Results . Maximu m size of tumor varied within a range between 37 and 300 mm (108 ± 61.2 mm). It worth noting that no direct dependence between the size of neoplasm and process phase was established. When assessing the echostructure, all ovarian tumors were divided into 3 structure types: cystic type (57.8 % of cases), cystic and solid type (33.3 % of cases), solid type (8.9 % of cases). The conducted analysis of types of small pelvis neoplasm echostructures enabled to evolve the sonographic types of ovarian tumors, more or less associated with the malignant transformation. The most relevanl Doppler ultrasonography exponents characteristic for benignant and malignant processes: resistance index in benignant tumors was 0.56, at OC – 0.32 (р < 0.001); average arterial blood velocity in benignant tumors – 7.8 cm/s, at OC – 20.1 cm/s (р < 0.001); average maximum venous flow velocity in benignant tumors – 3.2 cm/s, at OC – 9.3 cm/s (р < 0.001). Conclusion . Therefor e moder n ultrasonography can detect and differentiate rather efficiently the localized variants of OC, provided that the main part of diagnosis is formed in mode of color and power Doppler mapping, which shall be taken into consideration during the primary diagnostics of OC.

Background. Current complex ultrasound diagnosis using novel imaging techniques can assess, to a high accuracy, different tumor parameters during neoadjuvant chemotherapy (NCT) for locally advanced cervical cancer (CC) (Stages IIB–IIB). This assessment is very important and necessary to define further treatment policy.Materials and methods. A total of 199 patients diagnosed with Stages IIB–IIIB CC, including 60 patients with Stage IIB (T2bN0M0), 4 with Stage IIIА (T3aN0M0), and 135 with Stage IIIВ (T2bN1M0, T3aN1M0, T3bN0–1M0) (according to the International Federationof Gynecology and Obstetrics (FIGO) classification), who received NCT at Stage 1 of treatment, were examined. Complex ultrasound study was conducted before treatment initiation and after each NCT cycle. The therapeutic pathomorphism of a tumor was evaluated in surgically treated patients.Results. The criteria have been determined for evaluating the efficiency of NCT for locally advanced CC, which are based on current ultrasonographic techniques including B-mode, Doppler ultrasound (power, spectral, three-dimensional ones), as well as on the results of therapeutic pathomorphism.Conclusion. The criteria for evaluating the efficiency of NCT for CC should be based on current complex ultrasonographic techniques.

The comparison analysis of the sonoelastomeric images with tissue density has revealed the basic laws – the greatest density of the tissues was defined in the loci painted in red color, and was in a range from 52.87 to 300 kPa. Sonoelastometric signs of malignant process presence in the ovaries have been determent at volume of the tumor not less than 15 cm3.

The oncological care system, established in Russia as early as the mid-twentieth century, is presently unable to provide an effective early diagnosis of malignancies, including reproductive system tumors. The past 10-15 years have become the years of missed oppor- tunities and losses to a greater extent than modernization of a primary obstetric and gynecological care system. This paper deals with this problem and a search for its solution.

The study is based on the analysis of comprehensive ultrasound examinations of 158 patients with a verified diagnosis of endometrial cancer (EC). It was conducted, by taking into account the concept of 3 types of microinvasive EC growth. Echosemiotics in each of these types is detailed. Ultrasound criteria for diagnosing the microinvasive process of EC, tumor invasion into the cervical canal are identified.

The study included patients observed and treated in Russian scientific centre of roentgenradiology Ministry of Health Russian Federation in the period from 1999 to 2010 (n = 405): including 111 postmenopausal women who are without anamnestic data on the presence of cancer at any site, and the group of patients with gynecological cancer in postmenopause in including 60 patients with endometrial cancer, 67 patients with malignant epithelial ovarian tumors, 87 observations of cervical cancer and 80 patients with vulva cancer. The average age of the patients was 58.6 ± 0.4 years. The study of bone mineral density, body mass index and the level of estrogen receptor localization in different cancers of the reproductive system. Formed by 4 different types of menopause that best reflects a combination of hormone and hormone receptor status. This separation makes it possible to plan more differentiated the hormone replacement therapy in postmenopause. Along with this, there is reasonable prospects for prevention and early diagnosis of hormone-dependent tumors of the female reproductive system.

We explored the complex of modern ultrasound technology for dynamic monitoring to assess the effectiveness of drug therapy. This paper analyzes the data of complex clinical, ultrasound and pathological study of 86 patients, was 2 groups of patients – 58 women with locally advanced cervical cancer (IIb–IIIb stages) and 28 patients with ovarian cancer (IIa−IV stages).During the morphological and ultrasonic parallels found a direct correlation between the degree of drug and the amount pathomorphism tumor focus, a reduction of vascularization and blood flow velocity.

We explored the complex of modern ultrasound technology for dynamic monitoring to assess the effectiveness of drug therapy. This paper analyzes the data of complex clinical, ultrasound and pathological study of 86 patients, was 2 groups of patients – 58 women with locally advanced cervical cancer (IIb–IIIb stages) and 28 patients with ovarian cancer (IIa − IV stages). During the morphological and ultrasonic parallels found a direct correlation between the degree of drug and the amount pathomorphism tumor focus, a reduction of vascularization and blood flow velocity.

The immediate efficacy of neoadjuvant chemotherapy was assessed for 58 patients with stage IIB-IIIB uterine cervical cancer using ultrasonography and magnetic resonance imaging. The patients were administered with the following combination of cytostatic drugs: paclitaxel or paclitaxel plus cisplatin or carboplatin. After completion of the first course of chemotherapy, tumor regression was achieved in 34.5 % of cases and stable disease was observed in 65.5 % of cases. After two courses of chemotherapy, 48.3 % of patients had achieved tumor regression and 51.7 % of patients had stable disease. Reduction in the uterine cervical mass by 40-50 % after two treatment courses indicated the tumor response to chemotherapy. Reduction in the tumor mass by less than 30 % was assessed as a low efficacy of chemotherapy (p