Angiogenesis plays a major role in the functioning of the organism, therefore any type of disruption in its regulation results in severe consequences. Tumor in which the balance between pro-angiogenic and anti-angiogenic factors is shifted in favor of the former factors, is a proof of this fact. Vascular endothelial growth factor (VEGF) is a key protein that stimulates the formation of blood vessels. Moreover, its biological effects depend on the interaction with a corresponding receptor (VEGF-R1, -R2, -R3 ). Findings on VEGF- R1 appear to be the most contradictory: neither its tissue specifi city nor its cellular localization have been identifi ed yet. Furthermore, different isoforms of this receptor can display both pro- and anti-angiogenic properties. Full size membrane — associated mVEGF-R1 promotes proper blood vessel maturation in the process of embryogenesis, while truncated, soluble sVEGF-R1, on the contrary, inhibits angiogenesis. In addition, VEGF-R1 functions are not limited to «vascular» effects. Thus, receptor type 1 is expressed by many tumor cells and is responsible for their survival, migration, invasion and metastasis. The most recent data on co-localization of VEGF-R1 with nuclear lamina are of particular interest. Such localization of receptor type 1 allows it to bind to a ligand directly inside the cell, and it is necessary to consider this in the development of anti-angiogenic drugs. Expression of VEGF-R1 in tumor cells and its important role in their progression strongly suggest that receptor type 1 can be considered as a prospective target in cancer therapy in the future.
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The identifi cation of systemic level of gene expression regulation through the use of small non-coding molecules — microRNA should be considered one of the most outstanding discoveries in biology over the last decade. Based on the analysis of the world literature the article demonstrates biological and clinical role of microRNA in the pathogenesis of ovarian cancer. Since ovarian cancer as any type of malignant tumors is characterized by deep genetic and epigenetic disorders in the levels of microRNA expression, gynecologic oncologists take a particular interest in the study of this problem. At the present time a number of efforts have been made to reveal the key microRNA, prospective for the diagnosis, evaluation of the prognosis and for the creation of targeted therapy drugs for this pathology. All this was presented by the authors based on the review of the world literature.
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The article describes two clinical cases of patients with family history of cancer who have been diagnosed with recurrent melanoma of the vulva (MV). Using specifi c PCR and PCR product sequencing exon 11 KIT gene mutation was detected in tumor biopsy material obtained from both patients, while BRAF gene and NRAS gene mutation were absent. Positive dynamics in response to therapy with tyrosine kinase inhibitor Imatinib (Gleevec) and temporary process stabilization were observed. During further treatment a minor NRAS gene mutation was identifi ed in metastatic modifi ed inguinal lymph node of one of the patients, which indicated a molecular heterogeneity of the melanoma of the vulva being one of the cause of acquired resistance to targeted therapy.
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Objective of the study. The development of an evidence-based algorithm of carrying out hormonal therapy only in patients with atypical endometrial hyperplasia and well-differentiated adenocarcinoma of the endometrium who are under 40 years of age whose reproductive function remains unrealized.
Materials and Methods. The present study included 50 residents of the city of Krasnoyarsk and Krasnoyarsk region at the age from 18 to 40 years with morphologically verifi ed diagnosis of atypical endometrial hyperplasia and well-differentiated adenocarcinoma of the endometrium who hadn’t fulfi lled their reproductive function. They received the gonadotropine- releasing hormone analogue (GnRH) and levonorgestrel-releasing intrauterine system. Ultrasound scan with colour Doppler imaging, magnetic resonance tomography (MRT), hysteroscopy with fractional separate diagnostic curettage of uterine cavity, morphological assessment of endometrial scraping cytology and endometrial aspirates as well as their immunohistochemical evaluation using the following antibody panel: ER, PR, Ki 67, Bcl — 2, p53, E-cadherin had been performed before the treatment.
Results. Complete response to the treatment was achieved in 100% of cases. From 2008 to the present no recurrence has occurred in patients who had undergone the treatment, the 5-year survival was 100%. Spontaneous pregnancy with subsequent delivery occurred in 12 patients of 50 (24 ± 4,9%).
Conclusions. Results of the combination treatment demonstrated the high effectiveness of this type of treatment used for the patients with atypical endometrial hyperplasia and well-differentiated adenocarcinoma of the endometrium.
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Objective of the study. To compare the results of the treatment of patients with endometrial cancer who underwent surgery in the volume of radical hysterectomy and lymphadenectomy performed by laparoscopic and laparotomy access. The article also considers the possibility of the use of TachoComb® agent in patients with endometrial cancer during video-assisted surgical procedures (a clinical observation).
Materials and Methods. The study included patients with endometrial cancer stage I-II who have underwent the treatment in the Federal State Budgetary Institution «N.N. Blokhin Russian Cancer Research Center» of the Ministry of Healthcare of the Russian Federation since 2011 up to the present time. 584 cases of observation, when operations were performed using laparoscopic access, were analyzed. All these surgical procedures were performed using video surgical imaging platform OLYMPUS with a video system EXERA III, and in number of cases an energy system Thunderbeat was applied.
Results. Unlike laparotomy, laparoscopy has evident advantages: clinically insignifi cant intraoperative blood loss, decreased probability of the incidence of post-operative complications, reduced need for analgesic therapy, good cosmetic effect, improvement of the patients’ quality of life indicators were observed in hysterectomies in the volume of radical hysterectomy, lymphadenectomy performed by laparoscopic access. All these factors contributed to the more favourable course and outcome of postoperative period.
Conclusions. As a result the study revealed the evident advantages of the surgical treatment of patients with an early endometrial cancer performed using endoscopic techniques.
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The article summarizes the idea of sex cord stromal tumors. It refl ects the current classifi cation and clinical manifestations of different options sex cord stromal tumors, diagnostics, and treatment strategy of patients with these tumors.
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Objective of the study: To identify ultrasound imaging criteria for the different types of progression of cervical cancer and to distinguish the prognostic factors of the disease.
Materials and Methods. Ultrasound scan was performed in 96 patients aged 27 to 80 years with stages II A, B — III B of cervical cancer ( the average age was 46,8 ± 6). Based on the type of tumor growth of cervical cancer patients were divided into 4 groups: group 1 (mixed type of cervical cancer) — 47 people, group 2 (exophytic type of growth of cervical cancer) — 11 people, groups 3 and 4 included 28 and 10 patients with endophytic and infi ltrative-ulcerous types of cervical cancer respectively. Ultrasound examination was performed using «Toshiba APLIO 500» and «MedisonSono-Ace 8000» ultrasound scanners.
Results. The analysis of the results of a combined sonographic study of the patients with different types of cervical cancer revealed characteristics specifi c for each group not only in gray-scale imaging, but in Doppler blood fl ow mapping. Group 1 was characterized by high velocity of blood fl ow (the average value of intratumoral peak systolic velocity 15,15 ± 1,52 m/sec) and low-resistance fl ow (the average value of resistance index RI = 0,35 ± 0,07). The study in group 2 registered diffuse (hypervascular) type of blood fl ow in 100% of cases. Herewith, spectral Doppler indices corresponded to high velocity (the average value of intratumoral peak systolic velocity was 12,41 ± 2,93 m/sec) and low-resistance blood fl ow (the average value of resistance index RI = 0,35 ± 0,07). The evaluation of intratumoral blood fl ow in group 3 of patients revealed diffuse (hypervascular) type of blood fl ow in 7 (25,0%) patients, hypovascular — in 22 (78,6%) women. High velocity of blood fl ow (the average value of intratumoral peak systolic velocity was 13,72 ± 2,16 m/sec) and low-resistance blood fl ow (the average value of resistance index RI = 0,27 ± 0,04) were registered. The parameters of spectral Doppler sonography specifi c for the patients of group 4 of observation corresponded to high velocity of blood fl ow (the average value of intratumoral peak systolic velocity was 19,42 ± 6,6 m/sec) and low-resistance blood fl ow (the average value of resistance index RI = 0,26 ± 0,04).
Conclusions. Each type of tumor growth of cervical cancer has its own sonographic characteristics. Unfavorable types of cervical cancer with endophytic and infi ltrative-ulcerous malignant processes are characterized by sonographic features of invasive growth with spreading beyond the cervix in gray-scale imaging and predominance of low-resistance blood fl ow with the average values of resistance index RI = 0,27 ± 0,04.
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Venous thromboembolism, including deep vein thrombosis and pulmonary embolism, in the structure of morbidity and mortality in patients with cancer have a special place, which leads to the need for the prevention of thrombosis. The main role in thromboprophylaxis is given pharmacological methods. Bemiparin has shown its activity as a drug that reduces the risk of venous thromboembolism. The paper presents the possibility of the use of bemiparin in cancer patients.
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Thromboses have a signifi cant impact both on the progression of malignant tumor and on the results of the anti-tumor therapy. The modern achievements of clinical oncology demonstrate the necessity of an active prevention of thromboembolic complications at each stage of the complex and combination treatment. This determines the feasibility of the use of long-lasting regimens of prevention of thromboembolic complications and their possible recurrences in particular. Therewith cumulative toxicity of separate methods of anti-cancer therapy, that infl uence thrombus formation must be taken into consideration. The article presents the most optimal methods of active prevention of thromboembolic complications at each stage of the complex and combination treatment. In the conclusion the author states that with an adequate thrombus prevention it is possible to control the risk of the occurrence of venous thromboembolic complications successfully not only after surgical interventions but during conducting of other methods of anti-cancer treatment.
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