EPIDEMIOGICAL STUDIES
Introduction. The population-level survival analysis for cancer patients was not carried out in Russia due to the absence of population-based cancer registries, meeting the requirements of international Agency for Research on Cancer. This opportunity has appeared only with the establishment of the population-based cancer registry in St. Petersburg. Cancer survival estimation is possible only under conditions of strict adherence to the principles of the study. Analysis of survival of cancer patients is the main criterion of the objective assessment of the effectiveness of anticancer therapy. Malignant tumors of the nasal cavity, middle ear and accessory sinuses are classified by two ICD-10 diagnosis codes: С30 and С31 (С30: malignant tumors of the nasal cavity and middle ear; C31: malignant tumors of accessory sinuses). Database of the population-based cancer registry promotes the study of survival by any parameter including the fourth character of the ICD-10 code and histological type of the tumor.
Purposes and objectives. To estimate the observed and relative survival rates in patients with malignant tumors of the nasal cavity, middle ear and accessory sinuses and to compare the results obtained with the EU average (according to the EuroCare program), as well as to estimate survival of this group of patients according to sex, age, stage of disease and histological type of the tumor.
Material and methods. Between 1994 and 2009, 565 cases with malignant tumors of the nasal cavity, middle ear and accessory sinuses were selected from the population-based cancer registry. There were used the observed and relative survival rates calculated according to the international standards.
Results. We estimated the 5-year observed and relative survival rates in patients with cancers of the nasal cavity, middle ear and sinuses, using ICD-10 codes С30 and 31 and taking into account sex, age, stage of disease and histological structure of tumors. A clear trend toward increase in the 5-year observed and relative survival rates in patients with malignant tumors of the nasal cavity, middle ear and accessory sinuses was observed.
The paper analyzes the rates of cancer morbidity and mortality from 1998 to 2014 in the Amur region. During the study period, the incidence of skin cancer increased significantly with increasing the crude incidence rate by 60.7 %, and standardized incidence rate by 19.5 %. For melanoma, the corresponding rates were 87.3 % and 43.3 %, respectively. In contrast to the incidence rates, the absolute, crude and age-standardized mortality rates decreased. The analysis of age-adjusted melanoma skin cancer incidence rates indicated that the highest incidence was observed in the age group of 75 years and older. Early skin cancer (stage I–II) was registered in 95.4 % of patients, and early melanoma in 68.8 %. The mortality rates in the first year after diagnosis increased by 0.7 % in patients with skin cancer and decreased by 5 % in patients with melanoma. The number of patients who followed up for 5 year and more significantly increased. The role of primary cancer care in the region was estimated.
Lung cancer incidence in the Omsk region was studied. Advanced lung cancer was shown to be commonly detected in patients of the 30 to 49 age group. For this patient group, adenocarcinoma was the most common histological type of lung cancer. The highest incidence of lung cancer was observed in both men and women aged 45–47 years. Thus, to improve early detection of lung cancer, the optimal age for lung cancer screening should be in the age range of 40–50 years.
CLINICAL STUDIES
The aim of the study was to compare the efficacy of the optimized ultrasound technique with the use of additional methods (change in the patient’s body position, forced type of breath and abdominal scanning with high-frequency probes) for assessing the preoperative staging in 47 patients with primary epithelial ovarian cancer. It was shown that the optimized ultrasound technique, especially in cases with low-volume ascites, allowed improvement in preoperative staging of ovarian cancer, with sensitivity of 87%.
We analyzed imaging findings of 18 patients with atypical manifestations of parasitic diseases of the lung, who were admitted to the hospital with suspected lung cancer or metastatic lung cancer. The common CT, MRT and US findings of parasitic lung disease are fluid-containing lesions, septal structures (echinococcosis, alveolar echinococcosis, cisticercosis), no evidence of bronchial involvement and the absence of contrast agent accumulation in the affected area (paragonimiasis, shistosomiasis, toxoplasmosis, pneumocystis). Realtime monitoring with dynamic CT is often critical for differential diagnosis between atypical manifestations of parasitic lung disease and cancer or secondary lung tumor.
Overexpression of ABC drug transporters can cause multidrug resistance (MDR) in cancer cells, which is a major obstacle in the success of cancer chemotherapy. Our study revealed a correlation between the expression of invasive breast cancer resistance-associated proteins, such as P-glycoprotein (ABCB1), MRP2 (ABCC2), BCRP (ABCG2) in tumor cells and pathologic response to neoadjuvant chemotherapy. The response to neoadjuvant chemotherapy was shown to be associated with a lack of BCRP expression in tumor cells. The pathologic tumor response was correlated with the presence of positive MRP2 expression and the expression level of P-glycoprotein in cells of invasive breast cancer.
The results of the combined treatment of 36 patients with muscle-invasive bladder cancer treated with neoadjuvant combination chemotherapy with Gemzar + Cisplatin. The control group included 167 patients who underwent surgical treatment. In multivariate statistical analysis found that the use neoadjuvant combination chemotherapy significantly improves long-term results of treatment at a moderate degree of tumor differentiation (G2), bladder cancer II stage, in the absence of lymph node involvement (N0) and in patients younger than 65 years.
LABORATORY AND EXPERIMENTAL STUDIES
Introduction. Despite the available data on tumor cell functioning under the conditions of free radical-mediated oxidation, the mechanisms of redox regulation, cell proliferation management and apoptosis avoidance remain understudied.
The objective of the study was to identify the role of the thioredoxin system in regulating MCF-7 breast cancer cell proliferation under redox status modulation with 1.4-dithioerythritol.
Material and methods. The studies were conducted on the MCF-7 breast cancer cell line, grown in adherent cell culture. Cell redox status was modulated with5 mM N-ethylmaleimide – an SH group and peptide inhibitor and5 mM 1.4-dithioerythritol – a thiol group protector. The cell cycle was evaluated by flow cytometry, the same technique was used to measure the reactive oxygen species concentration. The levels of reduced and oxidized glutathione and the activity of thioredoxin reductase were identified by spectrophotometry. The intracellular concentrations of thioredoxin, cyclin E and cyclin-dependent kinase 2 were determined by Western blot analysis.
Results and discussion. The essential role of the thioredoxin system in regulating MCF-7 breast cancer cell proliferation was exhibited. S-phase arrest under the effect of N-ethylmaleimide and G0/G1-phase arrest under the effect of 1.4-dithioerythritol are associated with the changes in the activity of redox-sensitive protein complexes (cyclins and cyclin-dependent kinases) that regulate cell proliferation.
Conclusion. Redoxdependent modulation of proliferation regulating intracellular protein activity occurs due to the thioredoxin system. This is a promising research area for seeking molecular targets of breast cell malignization.
The paper is devoted to the study of the expression of markers associated with invasive breast carcinoma. The study included a surgical material from 107 patients with invasive carcinoma of the non-specific type of breast cancer who had not previously received neoadjuvant therapy. The study revealed a number of markers related to invasive tumor growth, characterized by a pronounced heterogeneous expression pattern in all cases. Study of the expression of markers associated with invasive breast carcinoma showed that not all cells are able to promote invasive growth in different periods of time, but the fact of detecting the positive expression of the markers in tissue tumors indicates a more aggressive cancer phenotype with a high potential for invasion.
ONCOLOGY PRACTICE
Introduction. Performance the radical surgical treatment in patients with widespread cranio-maxillary tumors is followed by appearance of extensive defects.
Objective. To explore the possibility of the applying the basic methods of eliminating defects cranio-maxillary localization after surgical treatment of tumors and their impact on quality of life and survival.
Material and methods. The results of surgical treatment of 94 patients with the widespread cranio-maxillary tumors, depending on the performed type of the surgery and method of eliminating postoperative defects were analyzed.
Results. Efficiency of different methods of reconstruction of defects of the midface and anterior skull base and their impact on quality of life and survival after the surgery were estimated. The use of general oncological methods in combination with the methods of the primary effectively correction of formed defects allows to achieve better results in the treatment of patients with widespread cranio-maxillary tumors.
The arm of the research. To develop a way to perform the laparoscopic total gastrectomy with jejunal interposition (Longmire’s procedure).
Material and methods. The study presents the technology of laparoscopic total gastrectomy with a lymph node dissection D1α and jejunal interposition. After removal of the gaster with the tumor through a mini-laparotomy (2 inch), the jejunum was cut approximately45 cm distally to the ligament of Treitz. A circular stapler was used to perform an esophago-jejunostomy with Roux-en-Y reconstruction using a standard technology. The second stage is forming a segment of the small intestine for jejunal interposition. The third stage is entering the head of the circular stapling apparatus into the stump of the duodenum on a probe retrogradely through the afferent loop of the small intestine. The fourth stage is stapled anastomosis between a free segment of the jejunum and the duodenum with the circular stapler. The procedure is finalized with hand-sewn anastomosis between the afferent and efferent loops of the small intestine.
Results. The presented technology was used to perform surgery on one patient. The increase in operative time did not lead to increased intraoperative blood loss and longer post-operative bed-days. After 1 year the patient shows no evidence of a tumor progression, manifestations of reflux esophagitis, and dumping syndrome.
Conclusion. The proposed technology allows laparoscopic total gastrectomy with jejunal interposition via a mini-invasive technology.
The article analyzed the immediate and long-term results of treatment of patients with prostate cancer receiving treatment method – robotic radiosurgery. The data of the immediate results of treatment are evaluated on the following criteria: level of total PSA, prostate volume, residual urine, changes on the international scale IPSS. The dynamics of the above indicators shows the regression of the primary focus, and the absence of pronounced radiation reactions affect the quality of life of patients. Three-year disease-free survival in patients receiving radiation therapy is 88.8 %. Overall survival, cancer-specific survival as well as 100 %.
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CASE REPORTS
ISSN 2312-3168 (Online)