In the early stages of the disease, melanoma of the vulva, usually successfully treated surgically. However, on the later stages, in the presence of metastases, melanoma is diffi cult to treat because the traditional method of treatment, such as chemotherapy, and in some cases, radiation therapy as a component of combination therapy are not enough. That is why the treatment of disseminated melanoma is conducted with the use of new promising methods referred to in this article. Target drugs as independently and in combination with traditional methods of treatment of melanoma implies new opportunities.
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Clinical lecture is devoted to the questions of etiology, pathogenesis, clinical course and diagnosis of gestational trophoblastic neoplasia.
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Objective: This study was planned and conducted with the aim of comparing two surgical methods of treatment (laparotomic and endoscopic) of the patients with endometrial cancer.
Materials and Methods: The present paper analyzed the experience in rehabilitation of 219 patients with cervical cancer and endometrial cancer with pelvic lymph node metastases after extended-volume radiation therapy including adjuvant radiation of para-aortic lymph node region. 100 patients (45,7%) with cervical cancer and 40 patients (18,3%) with endometrial cancer of these 219 were operated, but 73 patients (33,3%) with cervical cancer and 6 (2,7%) with endometrial cancer didn’t undergo surgery. 159 patients (72,6%) underwent extended-volume radiation treatment combined with maintenance chemotherapy in neoadjuvant regimen (in 86 (54 %) observations), alternating (in 43 (27%) observations) or adjuvant (in 30 (18,8%) observations) regimens. Obligatory maintenance therapy aimed at the prevention of gastrointestinal complications and improved tolerability of treatment at the start of the fi rst session of radiotherapy included gastroprotectors (H2 blockers), drugs with central antiemetic action (serotonin 5-HT3 — and Nki-receptors antagonists), liquid antacids (almagel, phosphalugel, Maalox). For the correction of hepatotoxicity ademetionine (Heptral®) as an agent of etiotropic hepatoprotective therapy was used in the maintenance therapy.
Results: All patients included in the comparative analysis at the start of hepatotropic therapy had signs and symptoms of hepatotoxicity. According to the results of comparative analysis in general subgroup of patients who received Heptral® showed signifi cantly better results of the correction of hepatotoxicity. Normalized liver function parameters in the above mentioned category of patients after the course of Heptral® therapy was observed 2,2 times more frequently than in patients who received hepatotropic therapy in the control group; and hepatotoxicity grade 1 — was observed 1,7 times more frequently. There were no cases of upgrading of hepatotoxicity severity, of development of liver failure in a group of patients who received the course of Heptral® therapy, whereas there was a case of increased hepatotoxicity severity up to grade 3 with the development of liver failure, despite the therapy received, in the control group. There were no Heptral®-induced side effects or allergic reactions reported.
Conclusions: The developed method of rehabilitation was effective in 143 (94%) patients with cervical cancer and endometrial cancer who received multi-component treatment with extended-volume radiation therapy. Its use allowed to minimize the long-term complication rate, to decrease the expected long-term local complication rate by 22-28%, to reduce the period for repair of local damages three-fold, to improve patients’ quality of life and to shorten the mean length of rest periods in adjuvant treatment by 10,4+7,8 days (р<0,05).
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Increasing in the incidence of endometriosis is associated with a change in popular lifestyle and refers to the so called «diseases of civilization». Endometriosis is associated with malignant ovarian tumors and has similar biological traits. The formation of oxidative stress with subsequent molecular-biological consequences can be a part of complex pathogenesis of these diseases. In both cases, the level of CA-125 increases, so fallopian tubes can trigger pathological processes. General factors which affect increase in the incidence are chronic adnexitis, early menarche, late menopause, primary infertility, lack of delivery. Removal of fallopian tubes or its ligation, contraceptive pills and non-steroidal anti-infl ammatory drugs can be named as general factors which reduce the risk of prevalence.
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Objective. To determine the advantages and disadvantages of the use of liquid-based cytology system Cytospin-3 (Thermo Scientifi c Shandon, UK) and BD Prep Stain Slide Processor system in cytological diagnosis of biological fl uids in gynecologic malignancies, to evaluate the morphological features compared to the classical method and in immunocytochemical examination procedures.
Materials and Methods. Two systems were used for performing of liquid-based cytology examination: Cytospin-3 and BD Prep Stain Slide Processor device. LSAB+ Detection System («DAKO») was used for visualization of immunocytochemical reactions, peroxidase activity was revealed using 3,3-diaminobenzidine, cytological preparations were counterstained with Mayer’s hematoxylin. Monoclonal rabbit and mouse antibodies were used in the study («DAKO» Company, Denmark). Cytological preparations of pleural and peritoneal cavity effusions and peritoneal washes, processed by the classical method and on the devices Prep Stain BD and Cytospin, were examined in 30 clinical specimens. Two staining techniques were used — Papanicolaou stain and Leishman stain.
Results. The following results were obtained in cytological analysis of classical and liquid-based preparations of peritoneal washing fl uids: signifi cant amount of admixture of blood was found in 7 of 10 (70%) traditional and Cytospin preparations (70%) and it was completely absent in BD-smears; since physiological solutions are used for washing, most cells are lysed, and this disadvantage is observed almost in all types of smears in 60–80%; regardless of the method of preparation processing scarcity of cells was detected in the half of examinations, whereas thick smears were observed in 20% of traditional and Cytospin preparations; monolayer, homogeneous cell distribution in a smear were revealed in all BD-preparations, in 7 of 10 of Cytospin system and in 5 of 10 traditional smears.
Conclusions. Liquid-based Cytospin and PrepStain BD technologies allow to standardize preparations and to perform immunocytochemical, cytogenetic, morphometric examinations of cells of biological fl uids. However, it is necessary to state out that immunocytochemical reactions in Cytospin preparations are brighter than in PrepStain BD smears, but due to the presence of erythrocytes they have higher background staining.
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The article concerns the benefi ts and harms of mammography screening in women aged 40–49. Icreased mammography-detected breast cancer over time related to lower — stage disease detection, reduced treatment and lower rates of recurrence. Lower stage and results of survival supports mammography screening for detecting disease in high risk women 40–49 years.
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The burden of non-communicable diseases (NCDs) worldwide continues to grow, leading to billion losses in national income and pushing millions of people into poverty. The rapid spread of cancer in the world impose serious challenges to the world community, especially in terms of ensuring safe and effective drugs for the treatment of cancer. This situation calls for reform of international legal mechanisms governing the circulation of medicines.
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