This article presents the analysis of statistical indicators based on the form № 7 «Records of the new cases of malignant diseases», form № 35 «Records of all cases of malignant diseases»; the data sets on the distribution of cancer deaths (form № 5) and on an average annual population by sex and age released by the Federal State Statistics Service of the Russian Federation. The global standard of population age structure was used for the calculation of standardized indicators.
The article provides the data on the incidence of malignant tumors of female reproductive system, on patient populations, including those having been observed for 5 years or more, on stage distribution in patients.
The age, general and standardized indicators of incidence and mortality from ovarian cancer, endometrial and cervical cancer in Russia are developed and the tendency analysis in dynamics is performed.
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Cytoreductive surgery and chemotherapy are the main methods of treatment in the therapy of cancer, however mortality rate from metastatic cancer remains high. Immunotherapy appears to be an alternative and rational approach in the treatment of oncologic diseases. Immunotherapeutic agents are widely available and include different types of vaccines, lymphokine-activated cells, cytokines, monoclonal antibodies. Clinical studies proves this trend to be prospective. Key words: gynecologic oncology, anti-tumor immunity, immunotherapy.
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Objective: to assess the possibility of cytological method in the diagnosis of breast cancer.
Materials and Methods. 1503 cytomorphological examinations of benign and malignant diseases of the breast were conducted in the laboratory of clinical cytology of Federal State Scientifi c Institution «N.N.Blokhin Russian Cancer Research Center» , 1065 (60%) of them made up breast carcinomas. The material for cytological examination from 1036 observations was obtained in fi ne needle aspiration biopsy in 1030 cases, by scraping from tumor tissue of areola of the breast — in 4 cases and from nipple discharge — in 2 cases. Material submitted from other hospitals for consultation made up 359 observations (43,7%).
Results. Cytomorphological criteria for different histotypes of breast cancer, developed by identifi cation and analysis of tumor cells in smears and histological samples, permitted the diagnosis of breast cancer with a high level of accuracy in 96,2% of observations, and to verify the histological type of tumor in 71,4% of observations. Uninformative material was obtained in 2,1% of samples. Hypo- and hyper diagnosis occurred in 1,7% of cases. Coincidence rate of the degree of differentiation in cytological and histological examination is rather high and constituted 90,1% in cases of poorly differentiated tumors, 92,4% — of moderately differentiated tumors and 74,7% — of well differentiated tumors.
Conclusions. Cytological diagnosis of breast cancer does not pose any challenges for an experienced cytologist. High degree of accuracy of cytomorphological method in the diagnois of breast tumors allows to determine whether a neoplasm is benign or malignant, to suggest a histological type of tumor and a degree of tumor differentiation, to assess a degree of tumor dissemination and the presence of underlying changes in breast, to indicate the severity of therapeutic pathomorphosis, to measure radicalness of surgical intervention.
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The article presents the results of the authors’ own research and the most compelling literature data , certifying that the key positive regulator of neoangiogenesis — vascular endothelial growth factor (VEGF) — is a clinically signifi cant prognostic factor in different types of oncologic diseases and is a target for the modern drugs with various mechanisms of action as well. The role of VEGF as a serological marker for the diagnosis and monitoring requires further investigation.
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The article presents and analyses the results of the worldwide research studies on the role of platinum agents in the treatment of triple negative phenotype of breast cancer.
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The article describes the clinical observation of pregnancy occurred in a patient with peritoneal mesothelioma disseminated into pelvis and involving diaphragm.
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In this article the author raised the issue of such chronic systemic disease of the skeleton as osteoporosis which is characterized by the reduced bone density, damaged microarchitectonics, increased bone fragility and susceptibility to fractures. Particularities of osteoporosis progression in cancer patients are shown, the general principles of treatment of this pathology are suggested.
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The article defi nes the concept of «iron deffi ciency anemia», considers etiopathogenesis of the disease and the particularities of its course in women, the ways to improve its prevention and correction are proposed.
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There is an evidence of interaction between the hemostasis system and tumor progression factors. It is known that thrombin, besides its capacity of fi brin formation and platelet activation, is able to infl uence on the functions of a large number of cells by interacting with protease-activated receptors which are found on tumor cells as well. These receptors participate in formation of malignant phenotype of cells (adhesion, proliferation, proteolysis). Thrombin is able to infl uence on the processes of angiogenesis, stimulating the penetration of endothelial cells through basement membrane and their migration with the formation of new vascular structures. Besides that, it is able to cause the release of the main promoter of neoangiogenesis — vascular endothelial growth factor. All the mechanisms named above and many other additional mechanisms of the relationship between coagulation system and the tumor provide the possibility to make theoretical assumptions about the infl uence on the tumor by regulating the activity of coagulation system. As regards the prospects of this trend — it is a disputable question, however, a signifi cant amount of clinical and experimental evidence of the effectiveness of this approach has been accumulated. Heparins were the group of agents which were the most widely used for this purpose. The advantage of low-molecular-weight heparins over unfractionated heparins for the survival of cancer patients have been shown in several retrospective studies. Emergence of a new group of heparins — ultra low-molecular-weight heparins is of interest as regards the possibility of their use for antitumor therapy in cancer patients. Currently this particular group of drugs, used in clinical practice, includes bemiparin and semuloparin. Both drugs (bemiparin — about 3600 kDa, semuloparin — about 3000 kDa) have signifi cantly reduced molecular weight in comparison with enoxaparin (4600 kDa) which has the lowest molecular weight of all low-molecular-weight heparins used. The use of bemiparin in patients with small cell lung cancer who receive chemotherapy was associated with an increase of 2-year survival rate as compared to the control group (68,6 % against 29,4 %; р = 0,0042).
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