Objective: is to evaluate the possibility of the use of the parameters of informative and transport characteristics of serum albumin for the prognosis of post-operative complications and the assessment of the effectiveness of the treatment of ovarian cancer.
Materials and Methods: The study involved 140 women with ovarian cancer, borderline ovarian tumors and benign ovarian tumors aged from 19 to 80 years who underwent treatment in the Department of Gynecology of Federal State Budgetary Institution «N.N.Blokhin Russian Cancer Research Center» of the Ministry of Healthcare of the Russian Federation. The control group included 50 healthy women. The functional properties of albumin were investigated in hospital admission examinations before the beginning of the treatment.
Results: Putting together the parameters of functional activity of serum albumin in the serum of patients with benign, borderline and malignant ovarian tumors and those of women from the control group, a signifi cant lowering of all indicators estimated in patients with ovarian cancer compared to other groups of patients as well as the decrease of DR, BE and DTE indicators in patients with borderline tumors versus healthy women and patients with benign tumors were identifi ed.
Conclusions: A comparative examination of the functional properties of serum albumin in patients with ovarian tumors and healthy women revealed signifi cant disruptions of conformational, transport and detoxifi cation characteristics of albumin in cancer and borderline tumors. It was found that the parameter of albumin confrontation DR can be used for an early diagnosis of actively growing ovarian tumors, and the identifi cation of an indicator of detoxifi cation effi ciency of albumin DTE can serve a prospective factor of the prognosis of post-operative complications following surgical treatment of patients with ovarian cancer.
Key words: albumin, ovarian cancer, post-operative complications, effectiveness of the treatment.
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Objective: To study the possibility of performing biopsy of a signal lymph node using fl uorescence lymphography.
Materials and Methods: 81 patients with breast cancer stage 0-III of which 1) 8 patients with breast cancer cTisN0M0; 2) 56 patients with breast cancer cT1-4N0M0; 3) 17 patients with breast cancer c T1-4N1-3M0 after effective systemic therapy with unidentifi ed regional metastases underwent surgery. Biopsy of a signal lymph node and mastectomy with primary breast reconstruction was performed in patients of group I. Additional axillary lymphadenectomy was not carried out. Biopsy of a signal lymph node was executed in patients of groups II and III on the fi rst stage of surgery, it was followed by organ preservation surgery or radical mastectomy with preservation of pectoral muscles +/– primary breast reconstruction + axillary lymphadenectomy of levels I–II or I–II–III.
Results. A signal lymph node was detected in 7 patients of group I, in all cases — without metastases. In group II a signal lymph node was identifi ed in 54 (96%) patients. 15 (28%) patients of 54 were found to have metastases in signal lymph nodes. False negative result occurred in 2 (4%) cases of 54. In group III a signal lymph node was found in 14 (28%) patients of 17. Metastases in signal lymph nodes were identifi ed in 5 (36%) cases of 14. False negative results were obtained in 2 (14%) cases of 14. No cases of allergic reactions or other adverse effects were diagnosed with standard subcutaneous use of indocyanine.
Conclusion. Fluorescence technique of the detection of signal lymph nodes has its own methodological issues: in most cases a signal lymph node is not visualized through the skin, it should be visualized in surgical wound using the course of lymphatic duct as guidance. Using this technique, the procedure starting from administration of the preparation to the identifi cation of a signal lymph node takes 15–30 minutes. A preliminary evaluation showed, that the application of this technique in patients with cancer with N0 is not inferior to radionuclide technique with regards to a signal lymph node detection rate and false negative rate.
Key words: breast cancer, biopsy of a signal lymph node, indocyanine green, fl uorescence lymphography
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Objective of the study. To conduct a systematic analysis of the data available in current literature concerning the place and role of ultrahighfrequency radiothermometry (UHF-RTM) in diagnostics, differential diagnostics of breast pathology, in neoadjuvant breast cancer therapy effect evaluation, in dreast pathology screening programs.
Material and Methods. The review includes the data of national and foreign literature in this fi eld found in Pubmed and e-Library having been published.
Results. There are presented different aspects of UHF-RTM application in oncomammology: diagnostic value of the method, its capability in differential diagnostics of dishormonal huperplasias, benign and malignant tumors of the breast, prognostic value of UHF-RTM, possibility and value of the method in neoadjuvant chemotherapy impact evaluation in locally-advanced breast cancer.
Conclusion. Ultrahighfrequency radiothermometry (UHF-RTM) is highly informative method of early diagnostics of various pathology of the breasts and can be widely used in screening programs with the aim of risk groups creation for subsequent specifying diagnosis using traditional methods (ultrasound, mammography, MRI, morphological investigation). UHF-RTM also can be used in effectiveness evaluation of neoadjuvant therapy in primary-inoperable breast cancer with the aim of treatment correction.
Key words: breast cancer, ultrahighfrequency radiothermometry, diagnostics.
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Objective of the study is to analyze the course of luminal subtype B Her2-positive metastatic breast cancer and to evaluate the possibilities of integrated treatment based on a clinical observation.
Materials and Methods. A patient underwent integrated treatment for metastatic breast cancer combining radiation, chemo-, targeted and hormone therapy and was under observation for the period from 2011 to 2016.
Results. Regimens of treatment of luminal subtype b HER2-positive metastatic breast cancer allowed to have control over the course of the disease on a long-term basis. Subsequent anti-tumor treatment strategy was determined as the new foci of the disease were identifi ed.
Conclusion. The work is of signifi cant practical interest. It reveals the possibilities of modern integrated treatment of luminal subtype B HER2-positive metastatic breast cancer which includes chemo-, radiation, hormone and targeted therapy, all these measures permitted to achieve relatively long-term remission.
Key words: breast cancer, HER2neu, chemotherapy, radiation, targeted, hormone therapy
Abbreviations: Immunohistochemical examination — IHC; RE — estrogen receptors; RP — progesterone receptors; HT — hormone therapy; AI — aromatase inhibitors; PCT — polychemotherapy.
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Matrix metalloproteinase 7 applies (MMP-7), also known as matrilysin, is one of the main representatives of the proteolytic enzymes. Destroying the main components of basal membrane and extracellular matrix, MMP-7 plays an important role in the processes of tumor progression, including invasion and metastasis, neoangiogenesis and survival of malignant cells.
The aim of the study. To conduct a systematic analysis of the available in the modern literature data on diagnostic and prognostic value of MMP-7 in serum and tumor tissue of patients with endometrial cancer.
Material and methods. The review includes the data of domestic and foreign scientifi c articles found in the Internet that have been published over the past 15 years.
Results. The review briefl y illuminates the role of members of matrix metalloproteinase` family in the regulation of components of the extracellular matrix, and possible mechanisms for their participation in the progression of malignant tumors. The results of experimental and clinical studies on the levels of MMP-7 in serum and tumor tissue in patients with endometrial cancer are provided.
Conclusion. It is necessary to conduct further studies on the levels of MMP-7 in tumor tissue, serum, peritoneal washings in patients with uterine malignant tumors and endometrial hyperplasia. Key words: matrix metalloproteinase 7, matrilysin, endometrial cancer.
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Objective of the study: To conduct a systematic analysis of the data available in current literature on the particularities of the clinical course of hereditary (BRCA-associated) ovarian cancer, on the modern possibilities of its early diagnosis, prevention and treatment.
Materials and Methods. The review covers the data of academic articles written by foreign and Russian authors found in Pubmed on the subject which have been published over the past 10 years.
Results. The article describes known mechanisms of carcinogenesis of hereditary ovarian cancer, the ways of its early diagnosis and prevention, as well as it presents the possibilities of the use of targeted agents such as PARP inhibitors in the therapy of this pathology. This treatment is considered to be biologically justifi ed on both scientifi c and practical grounds.
Conclusion. It is necessary to conduct further research focused on the identifi cation of new opportunities of the treatment of ovarian cancer including its hereditary type (carriers of BRCA 1/2 mutations).
Key words: hereditary ovarian cancer, gene BRCA 1/2 mutations, PARP inhibitors.
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Objective of the present study was to analyze the possibilities of performing organ preservation treatment for young patients with cervical cancer and to assess its results.
Materials and Methods: The analysis of the results of organ preservation treatment of 28 patients with cervical cancer of stages Ia1–IIA2 based on FIGO classifi cation was conducted in our study. Surgery of type II was performed on 5 patients (17,9%), of type III — on 23 patients (82,1%). The size of tumor in 14 patients before the treatment was 2 cm or less, in 14 patients — exceeded 2 cm.
Results. The average duration of surgical intervention was 264 minutes. The average amount of blood loss was 702 ml. The mean number of lymph nodes removed — 32,4. Intraoperative complications were observed in 3 patients (10,7%). Early postoperative complications occurred in 17 patients (60,7%). The majority of complications were of grade 1-2 and had no effect on health condition of the patients. Late postoperative complications developed in 4 patients (14,3%).
In total 28 patients have been monitored for the period from 3 to 110 months. 27 are alive and have no symptoms of disease progression. Progression occurred in 1 patient (3,6%).
3 patients tried to get pregnant (10,7%). Pregnancy occurred in 2 cases ( in 1 case - unaided, in 1 case – with the help of assisted reproductive technologies). One pregnancy ended in spontaneous abortion in second trimester. The second – ended in a live birth via a caesarean section on the 36th week of pregnancy.
Conclusion. Our own experience and literature data indicate that radical abdominal trachelectomy is an adequate method of organ preservation treatment of patients with early stage cervical cancer which provides possibility to preserve hormonal, menstrual and reproductive functions in young women and concurrently contributes to the high results of cancer treatment.
Key words: cervical cancer, organ preservation treatment, trachelectomy.
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Objective of the study is to conduct a systematic analysis of the data available in current literature on the modern possibilities of rehabilitation of cancer patients with post-castration syndrome who had undergone treatment for underlying disease.
Materials and Methods. The review includes the data from foreign and Russian articles found in PubMed on the subject, published over the past 10 years.
Results. The article provides a description of the ways of rehabilitation of cancer patients who underwent treatment for the underlying disease. In particular, it considers the present opportunities of the treatment of osteoporosis as one of the manifestation of postcastration syndrome.
Conclusion. It is necessary to pursue further research to determine the effect of vitamin D on ovarian response to gonadotropin stimulation and the outcomes of extracorporeal insemination, occurrence of clinical pregnancy and giving birth to a healthy baby in the framework of the programmes of assisted reproductive technologies.
Key words: tumors of reproductive system, osteoporosis, bisphosphonates, alendronic acid, Alendrokern
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Objective of the study is to conduct a systematic analysis of the data available in current literature as well as based on own observations on exudative onycholysis as a possible complication of antitumor treatment using paclitaxel.
Materials and Methods. The review comprises the data provided in foreign and Russian scholarly articles found in Pubmed on the subject, which have been published over the past 10 years. It also presents two cases of clinical observation of onycholysis with the development of infection in the nail bed associated with weekly administration of paclitaxel.
Results. Based on the clinical observation performed the article describes possible mechanisms of the occurrence of exudative onycholysis as a possible complication of antitumor treatment using paclitaxel. Furthermore, tactics of the management of such patients is suggested.
Conclusion. Onycholysis is a frequent complication following the treatment with paclitaxel in the regimen of its weekly administration. Occurrence of onycholysis in this case is not an independent disease of nails and should not be considered either the reason to withdraw the effective antitumor treatment or for the prescription of antibacterial preparations.
Key words: chemotherapy complications, paclitaxel, onycholysis, secondary nail infection.
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