Objective of the study. The objective of the present review is to analyze morphogenesis and pathologic changes of anaccessory breast.
Materials and Methods. In writing this scientific review Russian and foreign scholarly and clinical studies, meta – analyses, as well as clinical cases, which had been described in journals, indexed in Scopus, Web of Science, PubMed data bases, were analyzed. A total of 43 sources were used to write this literature review. It is worth noting, that 38% of them were published over the past 5 years.
Results. Accessory breasts develop as a result of incomplete regression of embryonic mammary ridges (milk lines) not only in women, but in men as well. Accessory mammary glands can be localized along the entire course of mammary ridges (milk lines), but the literature describes the most common areas where accessory breast tissue occurs: in an armpit. Such breasts are most often formed without a nipple or areola, and can be susceptible to cyclical changes in the body depending on the hormonal status. The incidence of accessory breast tissue is extremely rare (found in 2-6% of women), therefore, the description of pathological changes in the aberrant breast is not a routine practice. For the most part of the world literature, the descriptions of individual clinical cases are found, while the description and morphogenesis of pathologic changes are covered only in small number of articles. The relevance of the study of pathomorphologic changes in accessory breast tissue is becoming increasingly acute, since in recent years the number of patients who underwent breast screeing has grown, and therefore, a number of cases of accessory breast identification is growing as well.
Conclusion. This article highlights the most important aspects of morphogenesis, clinical intrincacies and main mechanisms of tumorgenesis of accessory breast.
Keywords: accessory breast, ectopic breast tissue, ectopic mammary gland, aberrant breast
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Introduction. Metastases dissemination in breast cancer is a major cause of cancer – related mortality. Disseminated tumour cells (DTCs) in bone marrow (BM) can remain dormant for a long period. Detection of breast cancer micrometastases in the bone marrow can contribute to more accurate tumour staging and to the determination of adequate therapeutic strategy in this category of patients.
Objective of the study is to investigate the possibility of dissemination of tumour cells (DTCs) in bone marrow (BM) in breast cancer patients and to evaluate the relationship with clinical and morphological parameters.
Materials and Methods. Immunological and morphological studies were performed at the Laboratory of Haematopoiesis Immunology on 60 bone marrow samples obtained from breast cancer patients. Immunological examination and identification of disseminated tumour cells (DTCs) was carried out using flow cytometry technique (FRASCANTO II). Morphological evaluation of bone marrow was conducted by morphologists using light microscopy.
Results. In metastatic bone marrow lesions of breast cancer patients changes were represented by a reduced content of basophilic normoblasts, monocytes, as well as by significantly lower levels of activated mature T-cells and a slightly higher content of CD4+CD25+ cells.
Conclusions. Haematogenous spread of breast cancer is an early process and it is associated with a number of structural and functional changes in both haematopoiesis and immunopoiesis. The correlation between between bone marrow (BM) lesion and clinical and morphological data has been found. The rate of bone marrow (BM) lesion was 21,5%. The incidence of disseminated tumor cell (DTCs) lesion in bone marrow (BM) of breast cancer patients is higher in patients with invasive ductal cancer. In bone marrow metastatic lesion these changes were manifested a lower content of basophilic normoblasts, monocytes, as well in significantly reduced percentage of activated mature T-cells and a slightly higher content of CD4+CD25+ cells.
Keywords: breast cancer; disseminated tumour cells; metastasis; immune cells and immunotherapy
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Objective of the study is to assess the possibilities of transvaginal ultrasound examination in the diagnostics of the depth of tumor invasion into myometrium in patients with stage I endometrioid carcinoma and to identify a group at high risk of inaccurate diagnosis.
Materials and Methods. The data of 788 patients with morphologically verified stage I endometrioid carcinoma, who had undergone diagnostic examination which included transvaginal ultrasound imaging (TVUS) and the treatment that involved panhysterectomy with bilateral salpingo-oophorectomy or extended hysterectomy (with pelvic lymph node dissection) at Republican National and Practical Center of Oncology and Medical Radiology named after N.N. Aleksandrov in the period 2011–2015, served as material of the retrospective study. The median age was 58 years (minimal — 24 years, maximal — 80 years). Calculation of the operational characteristics of transvaginal ultrasound examination (TVUS) for the diagnostics of the depth of tumor invasion into myometrium, the binary logistic regression analysis and the Mann Whitney criterion were used as research methods. All p-values were two-sided, the differences were considered statistically significant at p < 0,05.
Results. The following parameters have statistically significant relationship with the accuracy of transvaginal ultrasound (TVUS) diagnostics of the depth of tumor invasion into myometrium in patients with stage I endometrial cancer: age, presence of clinical manifestations of the disease, presence of LVSI, localization and size of the tumor. The indicators determined before choosing a diagnostic method, include: age, the presence of clinical manifestations of the disease, grade of tumor differentiation. The diagnostic sensitivity (DS) of transvaginal ultrasound (TVUS) in determining the depth of tumor invasion into myometrium for patients with stage I with G1endometrial cancer (EC) was 87,5 %, diagnostic specificity — 94,5 %, diagnostic accuracy (DA) — 94,2 %, positive predictive value (PPV) — 43,8 %, negative predictive value (NPV) — 99,4 %, in the group of low-risk of inaccurate diagnosis — 90,0, 95,2, 94,9, 52,9 and 99,4 % respectively, in the group of high-risk of inaccurate diagnosis diagnostic sensitivity (DS) — 71,0 %, diagnostic specificity — 75,0 %, diagnostic accuracy (DA) — 74,3 %, positive predictive value (PPV) — 39,3 %, negative predictive value (NPV) — 91,9 %.
Conclusion. High accuracy of diagnostics of the depth of tumor invasion into myometrium using transvaginal ultrasound (TVUS) is achieved in cases of well differentiated stage I tumors, as well as in the group of low risk of inaccurate diagnosis — in patients with moderately differentiated tumors of up to 55 years of age inclusive or with an absence of clinical manifestation of the disease. The group of high risk of inaccurate diagnosis of transvaginal ultrasound (TVUS), which includes patients with moderately differentiated tumors at the age of over 55 years with the presence of clinical manifestations of the disease, who require additional diagnostic methods, was defined.
Keywords: stage I endometrioid carcinoma, transvaginal ultrasound examination, tumor invasion into myometrium, depth of invasion
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Objective of the study is to carry out an analysis of current literature data on the classification, pathogenesis, morphology picture and molecular intrincacies of malignant epithelial ovarian neoplasms.
Materials and Methods. The review comprises the data of foreign scholarly articles found in PubMed on the subject, published over the past 10 years.
Results. The review revealed significant diversity in morphological and molecular characteristics of malignant epithelial ovarian tumors, including the role of mutations in genes KRAS, TP53, ARID1A, PIK3CA and the others. Particular attention is given to the differences in morphological and immunohistochemical patterns of various, including rare and mixed subtypes of these tumors.
Conclusion. The integration of immunohistochemistry and molecular genetic studies enhances the accuracy of identification of morphological subtypes of malignant epithelial ovarian tumors.
Keywords: malignant epithelial ovarian tumors, morphological classification, immunohistochemistry, histological sub types, ovarian cancer
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Significance. Early detection of malignant ovarian neoplasms is impeded due to the lack of non-invasive diagnostic techniques. The study of omics technologies can allow to find novel biomarkers of this disease, predictors of its progression, that will contribute to the identification of the etiology of malignant ovarian neoplasms, as well as to the development of approaches to personalized management of patients with ovarian neoplasms.
Objective of the study is to improve the results of treatment of malignant ovarian tumors by developing and introducing of a prediction program with comprehensive assessment including prognostically significant metabolomic biomarkers.
Materials and Methods. The clinical and morphological data of 44 patients with benign (n = 20), borderline (n = 3) and malignant (n = 21) ovarian neoplasms who had received treatment at Federal State Budgetary Institution V.A. Almazov National Medical Research Center for the period from 2023 to 2024, were analyzed. Metabolomic study of blood plasma was performed using chromatography-mass spectrometry techniques — gas chromatography–mass spectrometry and high performance liquid chromatography in combination with high resolution mass spectrometry.
Results. The average age of patients with ovarian cancer and borderline tumors was 51 years, with benign neoplasms — 53 years. Morphologically, ovarian cancer in the majority of cases was represented by serous tumors (57,1%), mucinous cancer accounted for 19,04% of cases, endometrioid cancer — for 9,52% of cases, clear cell cancer — 9,52%, in one case there was mixed tumor. Distribution of patients by stages was: stage III patients made up 52,4% of cases, stage I — 28,5%, stage II — 14,3%, stage IV — 4,8%. Mathematical filtering of data using hierarchical heat maps and unsupervised classification methods (K- means and Random Forest) that identify the most likely “outliers” of samples to build a more reliable model, was carried out based on the analysis of the primary experimental and normalized array. According to the results of t-test of the obtained data array 116 significant variables were found at q < 0,01. At q < 0,05 — 199 (fold change is 2 and false discovery rate is 0,01).
Conclusions. As a result of high-performance liquid chromatography–mass spectrometry analysis performed in the inverse chromatography mode, metabolites, that are characterized by short retention times, close to the dead time, were additionally identified. Identification of these metabolites, presumably related to polar lipids, can complement a metabolomic profile of ovarian neoplasms. It is necessary to carry out further metabolomic studies of ovarian cancer on a larger cohort and with the involvement of lipidomics techniques in addition to metabolomics.
Keywords: ovarian cancer, ovarian tumors, metabolome, omics technologies
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Objective of the study. Short non-coding RNAs are a large group of regulatory molecules that perform various biological functions. Alteration of the composition of these molecules in cervical epithelial cells is associated with irreversible changes in its morphology and the development of severe dysplasia. A comprehensive study of such changes is required for the search of novel diagnostic markers of malignant transformation.
Materials and Methods. Specimens of normal cervical epithelium (NILM, n = 12) and specimens of epithelium with the signs of severe dysplasia (HSIL, n = 12), obtained after histological examination, were analyzed. The examination was performed using deep sequencing technology (DNBseq technology), miRMaster platform was used for data analysis.
Results. The changes in the expression profile of short RNAs of different functional classes (tRNA, snRNA, snRNA, miRNA, piwiRNA), associated with the development of severe epithelial dysplasia are described, the diagnostic potential of marker representatives of different classes of short RNAs with increased and decreased expression levels in HSIL samples is assessed.
Conclusion. Short non-coding RNAs of different functional classes have a high diagnostic potential and can serve as molecular markers of morphological changes, preceding malignant transformation of cervical epithelium and the development of cervical cancer.
Keywords: sequencing, short non-coding RNAs, microRNA, dysplasia, cervical cancer
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Objective of the study is to evaluate the effectiveness, safety and long-term outcomes (one-year mortality, overall survival rate, number of recurrence cases, their localization and the time of occurrence) after minimally invasive and open radical hysterectomy in early-stage cervical cancer (CC) based on multiple factor analysis.
Materials and Methods. Retrospective multi-center study was conducted in the setting of State Budgetary Healthcare Institution of Novosibirsk Region “Novosibirsk Regional Clinical Oncologic Dispensary”, Federal State Budgetary Institution “National Medical Research Center named after Academician E.N. Meshalkin” , Limited Liability Company (LLC) “Avismed” for the period from 2010 to 2023. Criteria of inclusion were:
(1) histologically verified cervical cancer, including all histological types;
(2) stages IA1 – IIA2 (FIGO 2018);
(3) extended hysterectomy (type III) with pelvic and/or para-aortic lymphadenectomy as primary surgical treatment.
Patients with insufficient data were excluded. Based on the surgical approach, the patients were divided into 2 groups - those who had undergone minimally invasive surgery and those who had undergone open surgery, respectively.
Results of the study. The analysis was carried out on the basis of the following parameters: age, stage (FIGO 2018), TNM substage, tumour histotype, tumour size, obstetric and gynecologic history, concomitant disorders, primary treatment strategy, surgical approach, duration of surgical intervention, volume of blood loss, necessity of subsequent adjuvant therapy, intra- and postoperative complications. Long-term outcomes – overall and relapse-free survival , one-year mortality were assessed in each group as well.
Conclusion. The results obtained in these two groups were consistent, including those on overall and relapse-free survival which indicates the safety and effectiveness of minimally invasive surgery compared to open surgery. In the surgical treatment of cervical cancer it is possible to use minimally invasive treatment techniques for tumors less than 2 cm in size.
Keywords: cervical cancer, laparascopic surgery, recurrences, overall survival, open hysterectomy
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