Urinary system cancer is a malignancy caused by environmental exposures, the prevalence of which directly depends on the impact of environmental and anthropogenic factors. The aim of the study was to assess the kidney and bladder cancer incidence in different ecological and bioclimatic zones of Primorsky Krai. Material and methods. The incidence of kidney and bladder cancers in Primorsky Krai for the period between 1994 and 2014 was analyzed. In assessing the risk of kedney and bladder cancers in bioclimatic zones (marine climate, marine to continental transition and continental climate), environmental problems of the territories of Primorsky Krai were classified using the following ranks: critical, stress-like, satisfactory, and relatively favorable. The risk assessment was conducted using the guidance on Human Health Risk Assessment for Environmental Impact Assessment. To calculate the environmental impact on risk of urinary system cancer, the information entropy analysis was used. Results. The territories with low, medium and high incidence of bladder and kidney cancers were identified. The high incidences of kidney and bladder cancers were registered in the territories with environmental problems ranked as critical and stress-like, affected by coal, mining and chemical industries, and in the territories with intensive use of chemical pesticides. The incidence of bladder cancer in men tended to rise from the continental bioclimatic zone to the coast in all ecological zones mainly due to differences in the structure of the bioclimate between the coast and continental areas of Primorsky Krai. The increased risk of urinary system cancer was shown to be associated with parameters, such as the quality of drinking water, total pollution of the environment, chemical composition of groundwater, and the sanitary condition of the soil. Conclusion. The environmental risk assessment and ranking of territories by risk allow the cancer prevention and control programs to be developed and the need for increased cancer screening in certain areas to be identified.

Introduction. The state of pelvic and retroperitoneal lymph nodes is an important prognostic factor for cervical cancer. Lymph node size is the most widely used CT and MR criteria for assessing lymph node status. Lymph nodes measuring more than 1cm in the short axis diameter are considered malignant. However this criterion (nodal size) is not foolproof because of a high percentage of diagnostic errors. The purpose of the study was to develop objective MRI criteria for assessing lymph node metastasis in patients with cervical cancer by measuring the short- and the long-axis diameters of lymph nodes, short axis/long axis ratio (configuration index) and to evaluate their diagnostic value. Materials and methods. The prospective study included 31 patients with histologically confirmed cervical cancer, who underwent radical surgery with standard lymph node dissection. Sixty removed lymph nodes were evaluated. MRI examinations were performed using a 1.5 T scanner in T2- weighted images (T2-WI), T1-WI and T2 weighted sequences with fatty tissue signal suppressing and diffusionweighted MRI. Results. Lymph nodes measuring ≥0.8 cm in the short axis diameter were considered suspicious for metastatic disease. The sensitivity and specificity with a cutoff of ≥0.8cm were 68 % (CI 48.3‑82.9) and 80 % (CI 63.8‑90.3), respectively; the positive and negative predictive values were 71 % and 78 %, respectively; and the accuracy was 75 % (CI 62.7‑84.3). The short axis/long axis ratio (configuration index) of <1.47 indicated a likelihood of pathology in the lymph node. The absence of the hypointense signal from the fatty hilum of lymph nodes was considered as a predictor of lymph node metastasis. The analysis of this criterion showed 80 % sensitivity (CI 60.4‑91.6), 85.7 % specificity (60.4‑91.6), 80 % PPV, 85.1 % NPV and 83.3 % accuracy (CI 60.4‑91.6). Conclusion. Lymph node size of ≥0.8 cm in the short axis diameter and the short axis/long axis ratio (configuration index) of <1.47 appeared to be significant MRI criteria in the assessment of lymph node metastasis. The additional use of MRI criterion such as the absence of the hypointense signal from the fatty hilum of the lymph node made it possible to improve diagnostic accuracy up to 92 % (CI 80.9–97.4).

Gastric cancer is one of the most common malignancies and the third most common cause of cancer-related death worldwide. Recent advances in the surgical treatment of gastric cancer are related to the use of extended lymph node dissection (D2), however, tumor characteristics such as tumor size, histological type, degree of differentiation as well as the presence of lymphovascular invasion and lymph node involvement are well known factors that influence long-term treatment outcomes. The purpose of the study was to analyze the survival rates in patients, who received curative treatment for locally advanced gastric cancer, depending on the extent of lymph node dissection, and tumor characteristics. Material and methods. Using the Kaplan-Meier method and analysis of variance, long-term treatment outcomes were analyzed in 662 patients with gastric cancer, who underwent either limited/standard lymph node dissection (D1) or extended lymph node dissection (D2). Results. The overall and 5-year survival rates were found to be significantly higher in patients undergoing a D2 lymph node dissection than in patients who had a D1 dissection, with the median survival time being 32.0 months compared to 46.0 months, respectively. Tumor characteristics, such as, disease stage, regional lymph node metastasis and invasion grade (poorly differentiated tumor) had a greater impact on survival than the extended lymph node dissection. Conclusion. Extended lymph node dissection (D2) should be performed routinely in the curative surgical treatment of gastric carcinoma. The beneficial effect from D2 lymph node dissection was observed in gastric cancer patients with different histological characteristics such as the type, grade and depth of tumor invasion. The standardization of surgical procedures and detection of the tumor at an early stage lowered the operative risk in the treatment of gastric cancer.

A new technique of concurrent chemoradiotherapy and local electromagnetic hyperthermia for treatment of patients with newly diagnosed glioblastoma was developed at the Cancer Research Institute of Tomsk National Research Medical Center. A total of 20 patients with glioblastoma received concurrent chemoradiotherapy with temozolamide and local hyperthermia. Local hyperthermia was performed using the Celsius TCS device, 2 times a week (8–10 sessions). All patients tolerated the treatment well. The most common toxicity profile of concurrent thermochemoradiotherapy with temozolamide was hematological and neurological. It should be noted that no neurological toxicity was found in randomized trials of chemoradiotherapy with temodal. If the predominant hematologic toxicity might be associated with a small sample of patients in the study, the neurologic toxicity was likely to be related with greater toxic effects of chemotherapy on the brain during local hyperthermia, however, the causes of neurological toxicity during adjuvant chemotherapy courses at the moment we can not explain. Short-term results of concurrent thermochemoradiotherapy demonstrated the objective response rate of 70 %, however, adjuvant chemotherapy produced an increase in the incidence of disease progression during adjuvant chemotherapy. One-year recurrence-free survival rate was 53.3 ± 13.3 %, with a median time to progression of 10.5 months. One-year overall survival rate was 91.7 ± 8 % at a median follow-up time of 9 months. The median overall survival was not reached. A short follow-up time did not allow us to make conclusions about the impact of local hyperthermia on the treatment outcomes. However, there was a tendency towards increase in recurrence-free and overall survivals in patients with newly diagnosed glioblastoma.

Purpose. To determine the correlation between prognostic factors (age, differentiation grade assessed using the Gleason scoring system, serum prostate specific antigen, prostate volume, and serum testosterone) and the volume of skeletal metastasis expressed as bone metastasis index (BMI) in patients with disseminated prostate cancer (DPC). Material and methods. We conducted a retrospective analysis of 157 patients with initially diagnosed DPC treated at the Khabarovsk Regional Cancer Center from 2003 to 2013. Bone metastases were revealed in all patients. The volume of skeletal metastasis was measured using a novel automated computeraided diagnosis system devised by the specialists of Computer Center of the Russian Academy of Sciences. Results. The patients were divided into four groups. Group1: BMI≤1 % and Gleason score≤5; group 2: BMI ≤1 % and Gleason Score≥3; group 3: BMI>1 % and Gleason score≤5; group 4: BMI>1 % and Gleason score>5. The median survival time was 48 months in group 1 patients, 36.5 months in group 2, 33 months in group 3 and 20 months in group 4 patients. Both log-rank and Wilcoxon tests demonstrated a statistically significant difference in survival curves between the groups 1 and 3, and between the groups 2 and 4. There was also a difference in differentiation grade assessed by the Gleason score system between these two pairs of groups. Correlation of other prognostic factors, such as age, serum prostate specific antigen, prostate volume, and serum testosterone with the volume of skeletal metastasis demonstrated that BMI predominantly influenced the survival of prostate cancer patients. Conclusion. The assessment of prognostic factors allowed the patients’ groups with the worst prognosis to be identified. The bone metastasis index and differentiation grade of the tumor appeared to be independent predictors of high death risk in patients with disseminated prostate cancer.

Objective. To compare the functional activity of natural killer cells in peripheral blood and ascites from patients with different stages of colorectal and ovarian cancers and benign ovarian tumors. Material and methods. The study included 10 patients with stage IIIC ovarian cancer (FIGO, 2009), 5 patients with benign ovarian tumors (BOTs), and 15 patients with colorectal cancer (T_2–4N_0–2M₀ ). The control group consisted of 5 healthy donors. To evaluate the number and functional activity of NK-cells in peripheral blood and ascites, the FACS Canto II Flow Cytometer was used. Results. In peripheral blood of patients with ovarian and colorectal cancers, the relative number of activated NK-cells capable of secreting granzyme B (GB) (CD56 + CD107a + GB + PF-) was significantly lower and the proportion of degranulated NK-cells (CD56 + CD107a + GB- PF-) was higher than those of healthy donors. Low total NK-cell counts in peripheral blood were a distinctive feature of ovarian cancer patients (p<0.05). The proportion of activated peripheral blood NK-cells, containing granules of cytolytic enzymes GB and perforin (PF) increased with tumor growth. However, lymph node metastasis in patients with colorectal cancer did not affect the level and activation of NK-cells. The comparative analysis of NK-populations in patients with benign and malignant ovarian tumors revealed that the level of CD56 + cells was significantly higher in tumor ascites compared to peripheral blood. In patients with BTs, the levels of CD56 + CD107a + and activated CD56 + CD107a + GB-PF-degranulated cells was higher in ascites than in blood. In patients with ovarian cancer, the level of degranulated cells was higher in peripheral blood than in malignant ascites. Conclusion. The tumor cells and tumor microenvironment were found to affect the number and the functional activity of NK-cells. The accumulation of free fluid within the peritoneal cavity in patients with both benign and malignant ovarian tumors resulted in significantly decreased levels of NK-cells in peripheral blood and increased levels in ascites. The differences in the functional activity of NK-cells in ascites and peripheral blood of patients with ovarian cancer require further investigation of the lymphocyte receptor status and possibly cytokine-producing function of NK-cells. Key words: ovarian cancer, colorectal cancer, natural killer cells, functional activity of peripheral blood, ascites.>< 0.05). The proportion of activated peripheral blood NK-cells, containing granules of cytolytic enzymes GB and perforin (PF) increased with tumor growth. However, lymph node metastasis in patients with colorectal cancer did not affect the level and activation of NK-cells. The comparative analysis of NK-populations in patients with benign and malignant ovarian tumors revealed that the level of CD56 + cells was significantly higher in tumor ascites compared to peripheral blood. In patients with BTs, the levels of CD56 + CD107a + and activated CD56 + CD107a + GB-PF-degranulated cells was higher in ascites than in blood. In patients with ovarian cancer, the level of degranulated cells was higher in peripheral blood than in malignant ascites. Conclusion. The tumor cells and tumor microenvironment were found to affect the number and the functional activity of NK-cells. The accumulation of free fluid within the peritoneal cavity in patients with both benign and malignant ovarian tumors resulted in significantly decreased levels of NK-cells in peripheral blood and increased levels in ascites. The differences in the functional activity of NK-cells in ascites and peripheral blood of patients with ovarian cancer require further investigation of the lymphocyte receptor status and possibly cytokine-producing function of NK-cells.

 

Background. In addition to the transport of oxygen in tissues, erythrocytes participate in maintaining homeostasis therefore their qualitative and quantitative characterization may reflect a number of changes occurring in the body. The aim of the study was to investigate the erythrone state and reaction of red blood cells of hematopoiesis in patients with lung cancer with the assessment of ability to use such reactions as predictive signs of aggressiveness of the tumor process. Results. Clinical material indicating the presence of reaction of erythropoiesis and enzymatic antioxidant system to tumor growth in patients with lung cancer was obtained. Pathological changes in the erythrone system, including changes in the concentration of hypoxia-inducible factor 1α, quantitative and morphological characteristics of red blood cells and reticulocytes, hemoglobin concentration and the activity of superoxide dismutase correlated with tumor aggressiveness and more severe clinical status of patients. Сonclusion. A comprehensive assessment of erythropoiesis is believed can be used in selection of criteria for predicting treatment response and patients survival.

In oncology practice, despite advances in methods for early detection, surgery, radiotherapy, laser therapy, targeted therapy, etc., chemotherapy is unlikely to lose its relevance in the near future. In this context, the development of new antitumor drugs is one of the urgent problems of modern conservative oncology. Despite the importance of the search for new compounds with antitumor activity, the clinical potential of the «old» agents does not yet seem to be exhausted. The transport of antitumor agents can give them a «second life» in the clinic. When developing the targeted transport for chemotherapeutic drugs, the changes in their pharmacodynamics and pharmacokinetics are of great importance. A pharmacokinetic model of targeted transport of drug substances has been described in this paper. There have been described conditions under which it is worth to search for facility of transport for the initial active agent. Primary screening of antitumor agents have been undertaken to modify them for the targeted transport based on underlying assumptions of the model.

The purpose of the research: to develop an effective treatment regimen for patients with synchronous liver metastases from colorectal cancer. Material and methods. The study included 126 patients with colon cancer and synchronous liver metastases. The patients were divided into two groups. Group I consisted of 64 patients, who underwent resection of the colon and hepatic resection with radiofrequency ablation of metastases in the remaining portion of the liver and portal vein chemoembolization. Then, they received 4 courses of systemic chemotherapy followed by hepatic artery chemoembolization. Group II (the control group) consisted of 62 patients, who underwent resection of the colon without hepatic resection. Systemic chemotherapy was administered 3‑4 weeks after resection of the colon. Results. Postoperative complications occurred in 18 (28.1 %) patients of Group I and in 10 (16.1 %) patients of Group II. Six patients died (4 patients in Group I and 2 patients in Group II). Of the 18 postoperative complications occurred in Group I, 9 were related to hepatic resection. The median progression-free survival time was 9.0 months in Group I patients and 5.0 months in Group II patients, p=0.001. The median overall survival time was 13.8 months and 9.8 months in patients of Group I and Group II, respectively (p=0.004). Conclusion. Treatment options used for Group I patients resulted in improved survival rates.

Between 2008 and 2015, 82 patients with inoperable esophageal cancer were treated with radiation therapy. The patients were divided into 3 groups. Group I consisted of 30 patients, who received external beam radiation therapy (EBRT) in combination with brachytherapy. Group II and group III patients (30 and 22 patients, respectively) received EBRT alone. Patients of group II received EBRT at a total dose of 60–70 Gy and patients of group III received EBRT at a total dose of 40–50 Gy. Treatment outcomes were better in patients treated with combination of EBRT and brachytherapy than in patients treated with EBRT alone. There was no significant difference between groups 2 and 3 with regard to their survival rates. Two-year overall survival rates in group I, II and III were 36 %, 12 % and 12 % and the median overall survival time was 15.7; 9.7 and 6.6 months, respectively.

Background. Dysphagia is the main clinical symptom in patients with locally advanced esophageal carcinoma and proximal part of the stomach. Esophageal stenting is a highly effective and safe method to restore esophageal lumen patency. Published data indicate a high rate of stent-related complications. Material and methods. A retrospective, two-centered study included 166 patients (102 males and 64 females), who underwent endoscopically-guided esophageal stenting from 2004 to 2015. The age of the patients ranged from 36 to 92 years. Expandable metal stents were used for all patients. In most cases (81.3%), drug-eluting stents (22 mm diameter, 120 mm length) were preferable. Treatment outcomes and complications were analyzed. Results. Complications during stent placement (incorrect stent disclosure) were observed in 7 patients. All these complications were eliminated by relocating the stent to the desired position. Postoperative complications were noted in 29 patients (stent migration in 9 patients, stent fracture and migration in 2 patients, stent obstruction in 1 patient, destruction of stent coating and fragmentation in 5 patients, and dysphagia recurrence due to continuing tumor growth in 11 patients). All stent-related complications were corrected by re-endoscopy. Conclusions. The data obtained indicate the need for lifelong surveillance of patients after stenting.

Purpose: to review the available data on molecular-genetic diagnostic and prognostic markers in prostate cancer. Material and methods. The following electronic databases were used for our systematic review: Medline, Cochrane Library and Elibrary. Of 540 studies, 61 were used for our systematic review. Results. There are currently a variety of both prognostic and diagnostic markers used for diagnosis and treatment of prostate cancer. The review presents the classification of markers depending on the method and medium in which they were identified. The molecular mechanisms of participation of the different genes and proteins in the pathogenesis and progression of prostate carcinoma were analyzed and the potential importance of their use in clinical practice was provided. Conclusion. Many of the existing markers can be used for screening and early detection of tumors, and they have been proved to have a prognostic value. However, contradictory findings with regard to certain proteins and genes require further study, their validation with the subsequent implementation into clinical practice.

The problem of prevention and treatment of hospital-acquired (nosocomial) infections excites progressive minds of humanity for centuries. The risk and incidence of nosocomial infections are constantly increasing. It becomes harder and harder to fight with them. Special attention is paid to nosocomial infections caused by resistant gram-negative organisms. This is a problem for clinics in all countries. National programs for the prevention of the development and spread of resistant strains have been developed in the majority of countries. Infectious complications develop more frequently and more severe in cancer patients than in non-cancer patients. Infectious complications in these patients are mainly associated with hospital-acquired infections. Complications caused by resistant gram-negative microorganisms, such as P. aeruginosa, A. baumannii and K. rneumoniae are especially dangerous complications. The clinical management of these patients is difficult and requires teamwork of microbiologists and clinicians.

Case report. We present the case of a 50-year-old female patient with inherited type 1 neurofibromatosis, who was found to have a tumor in the major duodenal papilla. She underwent endoscopic ultrasound-guided resection of the major duodenal papilla with subsequent histological and immunohistochemical examination. Discussion. Somatostatinomas are rare neuroendocrine tumors of the gastrointestinal tract with an annual incidence of 1 case per 40 million people. The combination of type 1neurofibromatosis and somatostatinoma of the ampulla of the major duodenal papilla occurs extremely rarely. Endoscopic ultrasound provides visualization of tumor spread in all layers of the intestinal wall and in the major duodenal papilla, thus giving opportunity to perform radical surgery by minimally invasive method. Conclusions. Minimally invasive endoscopic surgery in patients with a combination of type 1 neurofibromatosis and somatostatinoma is a good alternative to pancreatic resection in this rare category of patients. Further follow-up studies are needed.

The ability to metastasize is considered to be one of the key features of malignant tumors. However, the literature describes the possibility of dissemination of histologically verified benign tumors – uterine leiomyoma. Diagnosis of metastatic leiomyoma is a challenging task for the doctor, due to the extreme rarity of this disease, at the same time revealing the purity of the process is determining the further tactics of treatment, significantly different from the treatment of malignancies. Case report. We presented a rare case of dissemination of benign tumors – leiomyomas. The female patient of 72 years old had signs of typical malignant tumors of the ovaries, such as nodules of the abdominal cavity, ascites and metastases in the body of the lumbar vertebra, increased level of CA-125. PET-CT revealed increased FDG uptake in soft-tissue neoplasm that destruct the body of the lumbar vertebrae and the nodules in the abdominal cavity with increased metabolic activity, typical for malignant tumors. However, histological examination with immunohistochemical verification confirmed the presence of dissemination of benign tumors. Conclusion. The presence of signs, typical for the malignant tumor, such as the presence of distant metastases of various localizations, a high level of CA-125 tumor marker, increased metabolic activity on PET scan in rare cases, may occur with benign tumors. Therefore, diagnosis of tumors should always be integrated, with the obligatory account all available clinical, laboratory and instrumental data.