Mechanisms of immunological tolerance providing the normal semi-allogeneic fetus pregnancy are also induced under conditions of cancer development and progression contributing to the growth of malignant tumor and avoiding the control by the host immune system. The presence of appropriate microenvironment, which is formed by trophoblast in the fi rst case and under the infl uence of a tumor in the second case, ensures angiogenesis and protection from destructive immune responses. Interaction of the maternal immune system with the fetus is a complex process, in which the immune system is active and functions to create the appropriate conditions for successful pregnancy. Nearly the same trend is observed in malignant processes, where immune system ensures tumor cell survival and progression. At the late stages of pregnancy up to partum the activation of Th1 type immune response and expression of acute infl ammation-associated genes is observed, that provides physiological rejection of the fetus. In contrast, all attributes of Th2 type immune response and chronic infl ammation remain in patients with progressive cancer. Identifi cation of the tolerance formation mechanisms and subsequent conditions for allograft fetus rejection at the end of pregnancy as well as the study of miscarriage molecular pathogenesis seem to be promising for the development of novel approaches to cancer treatment including immune therapy.
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The article reviews the cancer stem cells concept in general and specifi cally with regard to ovarian cancer
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Objective: the present study was planned and conducted with the aim to compare two surgical methods of treatment (laparotomic and endoscopic) in the patients with endometrial cancer.
Materials and Methods: All the patients (n=78) with stage I endometrial cancer who have been undergoing treatment at the National Center of Oncology of the Ministry of Health of Azerbaijan Republic since 2011, were divided into two groups.
Results: The study undertaken showed that the average duration of laparoscopic hysterectomy was 148,4 minutes versus 119,1 minutes for laparotomy. The average blood loss of the patients at laparoscopic hysterectomies was 158,6 ml, none of 37 patients needed blood component transfusion. The average volume of intra-operational blood loss in 41 patients operated, using laparotomic access, made up 231,4 ml and 6 patients needed repeated blood transfusions. Both the recovery period after laparoscopic hysterectomy and a number of occupied bed days (hospital stay) were considerably reduced (by two times).
Conclusions: The study demonstrated the advantage of laparoscopic hysterectomy over laparotomy with the following parameters: the volume of intra-operational blood loss, a number of occupied bed days, enhanced cosmetic effects, improving quality of life. It was noted that the result of the treatment doesn’t depend on the method of surgical intervention.
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The review article examines the features of etiopathogenesis, diagnosis and treatment of the rare form of cervical cancer – neuroendocrine carcinoma.
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The article analyses the data reported in the world literature publications and gives an account of the modern strategy of the treatment of the patients with early cervical cancer (feasibility of adjuvant radiotherapy or chemoradiotherapy in patients with stage Ia2-IIa cervical cancer (CC) after radical hysterectomy (radical extirpation of uterus and adnexa) (type Piver III) with/without unfavorable prognostic factors – positive lymph nodes, resection edges, lymphovascular invasion).
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Objective: The present research was intended to evaluate the effectiveness of liquid-based cytology method in early diagnosis of cervical cancer.
Materials and Methods: The evaluation of liquid-based cytology method was performed using comparative analysis between 1000 cervical smears, made by the Centralized Cytological Laboratory of the State Budget Healthcare Institution «Oncologic Dispensary № 3» (Novorossiysk), which is the routine control method at the Women’s Health Clinics of the healthcare institutions of the city, and the smears, obtained with the liquid-based cytology method from 396 healthy women. With liquid-based cytology method the material scraped from the vaginal portion of cervix and from cervical canal is transferred into liquid collection medium. This cell suspension is used for the preparation of monolayer specimen, what facilitates the elimination of non-optimal cervical smears.
Results: On the whole, with routine cytological examination the cervical pathology was detected in 29,1% of observations and with liquid-based cytology method — in 52,1%. Furthermore, the underlying diseases detected with liquid-based cytological method were diagnosed 1.4 times more often, and cervical cancer — 2.5 times more often, than with a common cytological examination.
Conclusions: Optimization of cervical cancer cytological screening performed with liquid-based cytology method facilitates an increase of its detection from 0.5% to 1.3%, and of cervical dysplasia — from 1.3% to 1.8% in the population-based study, and in high-risk groups these rates will be even more signifi cant.
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Chemotherapy of ovarian cancer is one of the most diffi cult problems in gynecologic oncology. The combination of platinum agents and taxanes has been the «gold» standard for 15 years. So target therapy in treatment of ovarian cancer belongs to perspective approach. By now the antiangiogenic therapy is investigated more carefully, and bevacizumab is related to the most well-known target agent. In this article it is considered the question about cost effectiveness of administration bevacizumab in the fi rst line chemotherapy of advanced ovarian cancer.
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Objective: the study of the expression of estrogen receptors α and progesterone receptors in benign breast tumors using the method of immunocytochemical analysis (ICC).
Materials and Methods: 200 immunocytochemical analyses of the expression of estrogen receptors α (alpha) and progesterone receptors were performed in the study on the cellular material of 100 patients with hormonal — dysplastic tumors of the breast: fi brocystic breast disease (FCD) was observed in 63 cases, fi broadenoma (FA) — in 32, gynecomastia — in 5 cases.
Results: The results of the studies showed that the positive reaction of both receptors or either of them in benign tumors was revealed in 51% of cases. Co-expression of ER+ and PR+ was observed in 35% of the patients: in nearly half of the studies (47%) in the patients with FA, in one third (27%) — with FCD and in 60% — in case of GM. The expression of estrogen receptors α was registered in 41 patients of 100, and progesterone — in 61.
Conclusions: the detection of the expression of estrogen receptors α and progesterone receptors with hormonal — dysplastic and benign tumors of the breast as well as the correlation of this expression with the proliferative and dysplastic changes in the lobular and ductular epithelium of the breast in series of observations, necessitates that clinicians should use the fundamentally new approaches to the treatment of this pathology.
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Patients with malignant disease often develop thromboembolic complications, and the incidence of thrombosis complicates anti-cancer therapy and affects survival rates.Low molecular weight heparins are the basis of specifi c prevention of thromboembolic complications in oncologic patients. Zibor (bemiparin) is a second – generation low molecular weight heparin which has the lowest molecular weight (3600 Da), the longest half-life, increased up to 5,3 h and the highest anti-factor Xa activity (8:1). The clinical studies demonstrated that bemiparin has high effectiveness in the prevention and treatment of thromboembolic complications.
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Objective: spectral analysis of pelvic organs in women to detect mechanisms that control tumor development.
Materials and Methods: Hardware-Software complex «In Spectrum» whose operation is based on the physical phenomenon — Raman scattering was used for the research purposes. Totally 120 test–objects of the verifi cated biopsied material were examined.
Results: Characteristic differences in the spectral analysis of healthy tissues and tumour tissues as well as of blood plasma of healthy women and patients with endometriosis, malignant neoplasms of the pelvic organs and in pregnant women with pre-eclampsia were detected in the study.
Conclusions: It has been concluded that the methodics and equipment can be used for the express diagnosis of the tumours of pelvic organs and for the dynamic monitoring of the condition of oncologic patients.
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Because of pathogenetic heterogeneity of cancer-associated anemia (CAA), it is necessary that its exact cause should be established and the appropriate etiotropic therapy should be conducted. The article presents the algorithm of the differential diagnosis and the choice of a method of treatment of cancer – associated anemia (CAA) based on the determination of the morphological type of anemia and on the performing of tests that allow to determine its cause (chronic therapeutic or hematological pathology, vitamin B12 and folate defi ciency, absolute and functional iron defi ciency as a consequence of background anemia of chronic disease). The article introduces own clinical experience in effective use of ferric carboxymaltose (FCM) in regards to normalization of hemoglobin level and restoration of storage pool of iron in 2 patients with lymphomas, as well as the examples of the effective treatment of folate (folic acid) defi ciency and B12-defi ciency anemia in the patients with solid tumors.
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