Objective of the study is the evaluation of the signifi cance of selective expression of cancer-testis antigens (CTA), immunogenic variant of a targeted molecule in the prognosis of the course and treatment of epithelial ovarian cancer (EOC) based on professional related research literature.
Materials and Methods. Analysis of the literature was based on the sources on the subject published in 1995–2021. The focus of the research is cancer-testis antigen (CTA), the expression of which in the tissues of ovarian cancer has pathogenetic association with major histocompatibility complex (HLA) and is linked to the progression of malignant process. The analysis includes the research papers published in different countries of the world, including Russia, which comprise a detailed description of the participation of members of X CTA (located on the X — chromosome) and non-X CTA (locate autosomes) in the progression and response to the treatment of ovarian cancer. The analysis is based on the clinical studies which provided reliable results on the research subject.
Results. Reliable data on the signifi cant correlation between the expression of cancer-testis antigen (CTA) and the following essential clinical indicators of MAGE, NY-ESO-1, JARID1B, PIWIL and CT45 families were revealed. A decrease in survival with the expression of MAGE-A1, MAGE-A3 and MAGE-A10 was observed. Correlation between the progression of the disease and hyperexpression of MAGE-A4, CA-125, MAGE-A9 was observed in serous ovarian cancer. Reduced sensitivity to chemotherapy with the hyperexpression of NY-ESO-1 and the progression of the disease for PIWIL and CT45 were detected. Resistance to chemotherapy in patients with ovarian cancer for JARID1B was confirmed.
Conclusion. The analysis of the relevant publications describing the participation of cancer-testis antigen in dissemination, drug sensitivity and survival of patients with the most aggressive ovarian cancer has identifi ed many tumor-specifi c markers. The whole collection of works that has been analyzed allows to conclude that cancer -testis antigens (CTA) and their encoding genes that have been identifi ed as a result of the analysis, have a signifi cant potential as prognostic markers in ovarian cancer.
Keywords: cancer-testis antigens, ovarian cancer, prognosis of survival and curability
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At present epithelial ovarian tumors continue to remain the most aggressive and prognostically unfavorable among all malignant neoplasms of the female reproductive system. According to current concepts, malignant epithelial ovarian tumors are morphologically heterogeneous group of the diseases, and each of their histological type has its own epidemiological, ethnic, biological, clinical, therapeutic and prognostic features. However, the existing techniques of outpatient diagnostics of these diseases, as numerous major randomized trials have shown, as a screening for ovarian cancer proved to be ineffective, therefore the development of the method of outpatient diagnostics and verifi cation both of the early and disseminated types of the disease remains an open issue. The analysis of the current approaches to the detection of ovarian cancer showed that the search for the markers of the genetic aberrations that underlie carcinogenesis of each of the subtypes of this group of tumors as well as the development of the most cost effective method of their detection, which has high sensitivity and specifi city — are the most relevant and perspective directions of the diagnosis of malignant epithelial ovarian tumors. Taking into consideration the clinical features of ovarian carcinogenesis as well as the tubal origin of the most ovarian carcinomas, the feasibility of the search of malignant cells, markers and disease predictors in the cellular content obtained from uterine cavity and cervical canal is evident. We have already attempted to assess a diagnostic signifi cance of the markers p53, p16, WT1 in the aspirate material from uterine cavity in patients with disseminated serous ovarian cancer using immunocytochemical analysis of the aspirate material that was refl ected in our previous publications. Considering that cytological and immunocytochemical profi le of endometrioid, mucinous and clear-cell ovarian cancer has its own specifi c features, this article presents the possibilities of cytologic evaluation of the aspirate material obtained from the uterine cavity in the diagnosis of non-serous ovarian carcinomas based on specifi c clinical cases.
Keywords: early diagnosis, screening, ovarian cancer, non-serous ovarian carcinomas.
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Objective of the study is to carry out an analysis of the data available in current academic literature on endometriosis and to reveal possible correlations between this disease and malignant tumors.
Materials and Methods. The literature overview comprises the data from foreign and Russian authors.
Results. The analysis of the literature conducted by us, confi rmed that endometriosis is associated with practically twofold increased risk of ovarian cancer development. Clear-cell and endometrioid histotypes of ovarian carcinomas are considered to be endometriosis-associated, that is refl ected in 3,4 and 2,3 times, respectively, higher risk of developing these types of cancer. Also, endometriosis has also been related to a very small (4%), but borderline statistically signifi cant increased risk of breast cancer development and to a 39% higher risk of thyroid cancer. Nonetheless, no statistically signifi cant relationship was identifi ed between endometriosis and endometrial cancer risk despite the apparent similarity between morphological and physiological characteristics, and an evident decrease (by 32%) of the risk of cervical cancer in patients with endometriosis compared to healthy women was observed.
Conclusion. Further study of endometriosis can contribute to more personalized approach to the management of patients with such pathology, for instance, it will allow to develop specialized screening programs for an early detection of endometriosis-associated malignant tumors.
Keywords: endometriosis, ovarian cancer, endometrial cancer, breast cancer, thyroid cancer, melanoma.
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Objective of the study is to develop the prediction model of the grade of malignancy of ovarian tumors for an early diagnosis and personifi cation of the treatment
Materials and Methods. For differential diagnostics purposes 64 patients with ovarian tumors of “unclear malignant potential” based on ultrasound imaging data underwent clinical and instrumental examination under the scheme: obtaining medical history, clinical examination, determination of CA125 and HE4 levels, albumin conformation indicator (albumin transport analysis test (ATA-test) using an analyzer AHM-09), dynamic contrast enhanced magnetic resonance imaging. Average values of apparent diffusion coeffi cient (ADC), shape type of time — intensity curve (TIC) as well as quantitative perfusion parameters Ktrans and Kep were analyzed. Multiple logistic regression analysis in IBM SPSS Statistics Subscription program for Mac OS was used for the creation of the prediction model of the grade of malignancy.
Results. For the prediction of a grade of malignancy a logistic regression model was developed, it is expressed by the following equation:
p = exp(z)/1 + exp(z), with Z = 0,3811 + (–0,0066) x [age] + (0,000086) x [CA125] + ... + 4,393 x [Ktrans] + 1,596 x [Kep], where z is a dependent variable, 0,3811 is a constant, b1, b2, ... bn — regression coeffi cients for the respective variable, X1 — age, X2 — CA125 level, etc. The model of pre-operative differential diagnosis of epithelial ovarian tumors demonstrates sensitivity — of 95,3%, specifi city — 90%, diagnostic accuracy — 94% (area under the ROC curve AUC = 0,972) (95% confi dence interval: 0,937–1,0, p < 0,001), which signifi es a high performance model.
Conclusion. Introduction of the model using clinical and laboratory and imaging markers contributes to an individualized planning of treatment strategy, to an effi cient patient routing and to reducing the frequency of unnecessary/non-radical surgical interventions: if a patient has an ovarian tumor with unclear potential of malignancy based on ultrasound imaging fi ndings or tumors of stage IV–V, based on O-RADS MRI data , tumors of high malignancy risk, based on the result of the use of the diagnostic model (Z > 0,62), the treatment should be provided in oncology/gynecologic oncology hospitals in compliance with the basic cancer treatment principles.
Keywords: ovarian tumors with unclear potential of malignancy, prognosis.
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Choriocarcinoma (CC) is a rare malignant tumor. It is subdivided into gestational choriocarcinoma (GCC) which develops from germ cells and non-gestational choriocarcinoma (NGCC) which is not associated with pregnancy. Non-gestational choriocarcinoma (NGCC) occurs very rarely and its clinical features are not suffi ciently studied. The present article introduces a clinical observation of non-gestational choriocarcinoma (NGCC) in a woman in post-menopause an our experience of the treatment of this disease.
Keywords: non-gestational choriocarcinoma, diagnosis, treatment.
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The article presents a clinical case of a 23-year-old patient diagnosed with stage IIIB clear cell carcinoma of the vagina who had a complete duplication of the reproductive tract. The patient underwent a combined treatment in the clinic of Federal State Budgetary Institution «N.N. Petrov National Medical Research Center of Oncology» (chemo-radiation therapy, chemotherapy, surgical treatment).
Keywords: vaginal cancer, clear-cell carcinoma, mesonephroid vaginal carcinoma.
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Objective of the study is the analysis of concordance of breast cancer surrogate subtyping identified in immunophenotyping of core biopsy samples and surgical specimens, and its correlation with the prognosis of the disease.
Materials and Methods. The present retrospective study included 170 patients aged from 33 to 87 (the average age is 55 years) who had undergone treatment in the period from 2010 to 2021. Evaluation of the expression of estrogen receptors (ER), progesterone receptor, oncoprotein Her2/neu, proliferative index (index Ki-67) and the distribution of surrogate subtypes was performed in accordance with ASCO/CAP standardized protocols (2018–2020) and St. Gallen conference recommendations (2015–2019).
Results. Immunophenotyping of breast cancer in paired samples «core biopsy — subsequent excisional specimens» in a group of patients who hadn’t undergone neoadjuvant therapy, revealed a clinically signifi cant change of breast cancer surrogate subtype in 20 (11,9%) patients, in a group of patients after neoadjuvant therapy — in 3 (5,8%) cases. The accuracy of the estimation of prognosis of breast cancer depending on the surrogate subtype was reliably higher in phenotyping of tumor using surgical specimens, that was primarily due to a far greater volume of tumor excision specimens analyzed compared to core biopsy samples.
Keywords: breast cancer, tumor receptor status ER-estrogen receptors, progesterone receptors (PR), Ki-67, Her2/neu, surrogate subtypes
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Objective of the study is to evaluate the peculiarities of diagnosis and treatment of oncologic diseases in pregnancy, to assess the course of pregnancy, delivery and the condition of newborns.
Materials and Methods. Data of 41 patients with malignant neoplasms detected during pregnancy who had undergone treatment at the Perinatal Center of Federal State Budgetary Institution “V.A. Almazov National Medical Research Center” for the period 2015-2020 were analyzed.
Results. The majority of patients (n = 26, 63,4%) received specialized treatment during pregnancy: chemotherapy — 19 (46,3%) patients (in two cases in combination with surgical treatment), surgical treatment — 7 (17,1%) patients. In most cases the delivery were at term (n=28, 68,3%). All babies born at term (n = 28, 68,3%) corresponded to gestational age and were full term regardless of whether their mothers had undergone specialized treatment during pregnancy or not.
Conclusion. If malignant diseases are detected during pregnancy immediate further examination is required to assess the extent of the tumor , using ultrasound imaging , magnetic resonance imaging, multispiral computed tomography techniques where necessary, the assessment of the status of the fetus is also required. If a woman wants to preserve pregnancy and if treatment is required during pregnancy, the treatment is carried out without any delay with an exclusion of systemic drug therapy in the fi rst trimester of pregnancy, radiation therapy on the pelvic area at any term of pregnancy.
Keywords: malignant neoplasms, pregnancy, cancer, solid tumors, hematologic malignancies.
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