The purpose of the study was to analyze the incidence and mortality rates of gastrointestinal cancer, and to provide data on the current state of cancer care for these patients. Material and methods. The crude and age-standardized incidence and mortality rates, median age of patients and increase in absolute number of cases were calculated. Mathematical and statistical methods were used. Results. The number of patients with gastrointestinal cancer continues to grow in Russia. Morphological verification of the diagnosis was 90–95 % for stomach, colon, rectum and esophagus cancers. A low incidence rate was observed for liver cancer (58.1 %) and pancreatic cancer (55 %). From 2010 to 2015, the incidence of stomach cancer decreased by 15.1 % in men and by 12.5 % in women; the incidence of colorectal cancer increased by 2.8 in men and by 4.5 % in women. The cancer mortality rates decreased for most cancers, except for liver cancer and pancreatic cancer (in men). The mortality rates for colorectal cancer and liver cancer in women were stable (7.5 per 100,000 and 2.4 per 100,000, respectively). A comparative analysis of the incidence and mortality rates in the countries of the former USSR, as well as in various regions of Russia was carried out. 

The purpose of the study was to estimate the medical care for cancer patients in the Amur region from 1999 to 2014. Material and methods. The study was based on cancer register data collected at the Oncology Dispensary of Amur region and covered the period 1999 to 2014. Results. Breast cancer is the most common cancer in women of the Amur region, accounting for 20.8 % of all cancer cases. In 2013, the breast cancer incidence rate was 52.8 per 100,000. The incidence rate for breast cancer increased by 36.4 % from 2003 to 2013, the overall rise being 2.2 %. The mortality rate decreased from 20.3 % in 2003 to 17.3 % in 2014. Cancer care in rural areas of the Amur region is worse than in Blagoveshchensk, which is the regional administrative center. The one-year mortality rate in rural areas is 1.3 times higher than that in the city. The one-year mortality rate is 1.3 times higher in rural areas than in the city, and is 1.2 times higher in the Amur region than in the Russian Federation. Conclusion. Appropriate treatment and prevention measures are recommended for further improvement of medical care for breast cancer patients in the Amur region. 

Methods of diffusion-weighted magnetic resonance imaging (DW MRI) provides information on the microstructural state of various tissues and organs. Also, a diffusion-weighted image (DWI) obtained using DW MRI applied to the differential diagnosis of benign and malignant tumors. Purpose – to compare the values obtained ADC meningiomas with cell density and proliferative activity index Ki67 tumor. Material and methods. The study included DW MRI program with 37 patients for brain meningiomas. ADC was calculated on DWI with a maximum diameter of meningioma, in the area of interest have not been included cystic and necrotic areas of the tumor. When meningiomas morphological study assessed the degree of malignancy according to WHO classification, the index of Ki67 proliferative activity and cell density in tumor tissue. Results. In most typical cases detected (MI) and atypical (MII) meningiomas – at 37.8 % and 56.7 % of patients, respectively. Anaplastic (MIII) meningioma verified in 5.5 % of patients. The average value for meningiomas ADC MI was 1375,5 ± 197,5 mm2 /s. ADC for meningiomas MII and MIII costavili 1113.1 ± 180 mm2 /sec and 689 ± 31.1 mm2 /s, respectively. Statistically significant differences between the mean values obtained by comparing ADC meningiomas MI and MIII (p=0.008) and meningiomas MII and MIII (p=0.012). No significant differences between the cell density was not detected meningiomas (p=0,834, p=0,684 p=0,766 respectively for the MI/MII, MII/MIII and MI/MIII). Statistically significant differences between the values of Ki67 index were found when comparing the groups meningiomas MI and MIII (p=0.002) and MII and MIII (p=0.007). ADC between index values and proliferative activity of Ki67, expressed marked correlation (r=-0,699, p=0,001). Conclusion. DW MRI and ADC maps can be used as an additional non-invasive method of differential diagnosis brain meningioma gradation. 

When examining prostate cancer, a great attention is currently paid to the study of specific molecular characteristics of the tumor. It has been found that TMPRSS2-ERG is the most common fusion gene in prostate cancer. The fusion between TMPRSS2 and ERG/ ETV1 transcription factor genes participating in the processes of growth, differentiation and transformation of cells has been described in prostate cancer. During carcinogenesis, TMPRSS2 allele loses its promoter, and one of the ERG alleles gains that promoter leading to its overexpression in these tumor cells. Prostate and breast cancer overexpressed 1 (PBOV1) promotes proliferation of tumor cells by inhibiting the cell cycle and increasing the level of cyclin D1. It has been shown that the PBOV1 gene expression is regulated by androgens through FOXA-1 and FOXA-2 transcription factors and participates in the organogenesis in the embryo, as well as it controls the division of stem cells in adults, and plays a role in the development of certain types of malignant tumors. The purpose of the study was to analyze the expression of ERG and PBOV1 genes in acinar prostatic adenocarcinoma and evaluate their relationship with morphological characteristics and lymph node metastases. Material and methods. Surgical specimens from 85 patients with stage T1–3N0–3M0 prostate cancer were morphologically studied using standard techniques. All patients underwent radical prostatectomy. Histological type of the tumor was evaluated according to the 2016 WHO classification of tumors, and the tumor grade was assessed using the Gleason scoring system. Immunohistochemical examination was performed according to the standard technique. The expression of ERG (Clone, EP 111) and PBOV1 (Polyclonal) was assessed using histological scoring system. Proliferative activity was analyzed using Ki67 nuclear staining (Clone, SP6). Data analysis was performed using Statistica 10.0. Results. The high expression level of ERG and PBOV1 proteins was associated with tumor grading (Gleason score > 6) and lymph node metastasis. Inflammatory cell infiltration of the tumor was not associated with the frequency of lymph node dissemination. However, the presence of stromal retraction in acinar tumors was found to be associated with more frequent involvement of regional lymph nodes. The level of PBOV1 expression in tumor cells correlated with proliferative activity and associated with tumor invasion into seminal vesicles. Conclusion. The study showed the relationship between ERG /PBOV1 proteins and morphological characteristics of acinar adenocarcinoma of the prostate as well as the frequency of lymph node metastasis, thus indicating prognostic significance of these markers.

The characteristics of calpain and proteasome systems in different molecular subtypes of breast cancer were studied. Tumor samples were obtained from 147 breast cancer patients, who were not previously treated with neoadjuvant therapy. Changes in the chymotrypsin-like proteasome activity and the correlation between proteasome and calpain activities were shown in different molecular subtypes of breast cancer. No changes in the calpain activity and proteasome subunits specific for various molecular subtypes of breast cancer were found. Our results show that the proteasome function undergoes changes depending on the receptor expression by tumor cells and this aspect should be further investigated.

In the literature there has been increased interest in the study of androgenetic receptors (AR) in different molecular subtypes of breast cancer (BC) but we haven’t found consensus about the role of levels of androgens and their metabolites in samples of biological fluids for the development of breast cancer. Determination of the level of androgenetic receptors in the tumor in patients with breast cancer is very relevant and promising direction in the study of the prognosis of the disease and the search for new complementary approaches to endocrine therapy of breast cancer, especially when basal-like molecular subtype.

Angiogenesis (neoangiogenesis) characterized by the formation of new blood vessels from pre-existing vessels is the main condition for the intensive growth of the primary tumor. This process is characterized by a sequence of events beginning with vasodilation, separation of pericytes from the vascular wall with subsequent proliferation of endotheliocytes and formation of vascular glomeruli surrounded by stromal cells. Evaluation of the density of microvessels, as well as «vascular kidneys» (clusters of endotheliocytes) is the most widely used method for quantifying intracellular angiogenesis. The purpose of the study was to analyze the expression characteristics of markers of neoangiogenesis (CD34 and VEGFR) in tumor tissue and to evaluate their relationship with the parameters of lymphogenous metastasis in colorectal cancer. Material and methods. Surgical specimens from 130 patients with ypT1–4N0–2M0 stage of rectal cancer, who were treated at the Thoracic and Abdominal Department of Tomsk Cancer Research Institute, were analyzed. The standard techniques for histological and immunohistochemical examinations were used. Diagnose was made according to WHO classification (2010). The study included only cases with rectal adenocarcinoma. Results. When studying the density of microvessels and «vascular budding» in a tumor tissue using an antibody to CD34, it turned out that the density of microvessels in the submucosal layer of the rectum was higher in cases with the presence of lymphogenous metastases than in cases without lymphogenous metastasis. The microvessel density determined by the antibody to VEGFR in the mucosa, submucosal and muscle layers, as well as in the serosa of the rectum did not differ between groups with the presence or absence of lymphogenous metastases. The density of «vascular kidneys» in all layers of the rectum wall was not associated with lymphogenous metastasis. Conclusion. The study showed that the expression of molecular-biological markers of neoangiogenesis in tumor tissue of patients with rectal adenocarcinoma was associated with the parameters of lymphogenous metastasis. 

More than 430,000 new cases of bladder cancer are diagnosed every year in the world, and approximately 70–80 % of patients present with non-invasive disease. To improve the effectiveness of early detection of bladder cancer, high sensitivity diagnostic tools should be used. In our study we used flow cytometry to determine surface markers in urinary sediment cells of patients with bladder cancer. The analysis of the phenotypic features of urinary sediment cells showed an increase in the relative content of CD13+ cells in patients with non-invasive bladder cancer in comparison with the control group. In addition, there was a 4.8-fold increase in cells expressing CD15 surface antigen (p<0.001) and 4.9-fold increase in cells expressing CD45 surface antigen (p<0.001). Considering the fact, that most patients with bladder cancer develop recurrence after treatment, we studied the relationship between the expression level of surface markers of urinary sediment cells and the development of disease recurrence. The absence of differences in the level of CD15+ cells in urinary sediment of patients with recurrent bladder cancer can be explained by the absence of differences in proliferative activity of recurrent and non-recurrent tumors. The higher level of CD13+ cells in patients with recurrent bladder cancer indicates greater depth of tumor invasion. It is obvious that the deeper the tumor invasion into the submucosal layer of the bladder, the greater the likelihood of non-radical transurethral resection and the development of disease recurrence. Thus, the analysis of the level of CD13+ and CD45+ cells in the urinary sediment can provide information on tumor invasion into the bladder submucosal layer and the risk of bladder cancer recurrence.

The purpose of the study was to evaluate the value of contrast-enhanced ultrasound in detecting local spread, regional and distant metastases from cervical cancer. Materials and methods. The findings of contrast-enhanced ultrasound examination of 4 cervical cancer patients (IB1–IVB) treated at N.N. Blokhin Russian Cancer Research Center from September to October 2016 were evaluated. The HI VISION Ascendus device was used. Ultrasound patterns in different phases of contrast-enhanced accumulation and excretion were analyzed. Results. Our first experience in using contrast-enhanced ultrasound in the detection of local spread, regional and distant metastases from cervical cancer allowed us to study the structure of the tumor and its spread in greater detail. Conclusion. A small number of observations do not yet allow us to draw serious conclusions about the capabilities of this modern technology. 

In this review, we analyzed the role of inflammation in carcinogenesis, tumor development, and metastasis. In addition, the mechanisms of non-steroidal anti-inflammatory drugs (NSAIDs) and the reasons of their contradictory influence on cancers were discussed. We summarized the numerous data about effectiveness of anti-inflammatory drugs for the prevention and additional therapy of tumor diseases. In particular, divergent effects of NSAIDs may be due to the peculiarities of immune-inflammatory responses that are realized in carcinogenesis and tumor development that have yet to be studied. We also discussed the selectivity of NSAID effects on different cancers and opposite effects of anticancer drugs with similar mechanisms of action. Apparently, the unsuccessful use of NSAIDs in cancer prevention and therapy are more specific for squamous cell carcinomas. Based on the literature, we provided significant clinical findings regarding the need of NSAID use in the current therapy of certain cancers and the determination of molecular predictors of the drug effect. In fact, anti-inflammatory therapy could eliminate the factors that contribute to the appearance of invasive and metastatic tumor cells, cancer and premetastatic niches and thus prevent metastasis and recurrence. At present, some non-selective (aspirin) and selective (celecoxib) NSAIDs are highly promising in the therapy of solid tumors. 

The purpose of the study was to systematize the data available in the modern literature on the diagnosis and treatment of metastatic melanoma without clinically evident primary tumor. Materials and methods. The results of laboratory-instrumental diagnostics, surgical and drug treatment presented in randomized clinical trials, published over the past 10 years in Medline, Embase and the Cochrane Library were analyzed. Results. Despite continuous improvement in imaging techniques, melanoma accounts for up to 12.6 % of all cases of metastatic cancer with an unknown primary site. Metastatic melanoma without clinical evidence of primary tumor accounts for approximately 1% to 8% of all melanoma cases. Conclusion. Metastatic melanoma without clinically evident primary tumor has not been extensively studied. Until now, only a few reports on metastatic melanoma without clinically evident primary tumor have been available. Therefore, further prospective studies of clinical course and optimization of diagnosis and treatment of patients with metastatic melanoma without clinically evident primary tumor are needed. 

Complications related to the impairment of the urinary flow along the urinary tract in cancer patients are the important aspect in determining the treatment strategies for these patients. The level of ureteral obstruction is an especially important factor in diagnosis of this pathology. The excretory urography and computed tomography are effective tools in determining the level of ureteral obstruction, but their capabilities in identifying the causes of urodynamic disturbances in cancer patients are limited by the evaluation of the presence/absence of concrements. The magnetic resonance imaging (MRI) is considered as the safe alternative method. It is characterized by high tissue specificity and is able to detect not only the level of ureteral obstruction, but also the cause of its occurrence. It is especially important to note that even using contrast enhancement, MRI is a safe diagnostic tool, emitting no ionizing radiation. The MRI-based accurate diagnostic algorithm for this cohort of patients decreases the number of diagnostic procedures, especially the invasive ones. It provides opportunity to start etiological treatment earlier, thus safeguarding a kidney function. 

Currently, along with the development of gravity blood surgery and transplantation, nephron-sparing surgery has become an established surgical treatment, particularly in situations in which preservation of renal parenchyma is critical. Nephron-sparing surgery includes kidney removal, different kinds of ablation, in vivo and ex vivo surgeries on the renal parenchyma and renal vascular peduncle. This review demonstrates historical experience in surgical treatment of unconventional clinical cases in urgent and plan urology, vascular surgery, and oncology, as well as evolution from traditional nephrectomy to extracorporeal renal surgery. The technique of ex vivo renal surgery is described. Our own experience of performing surgeries for non organ retroperitoneal tumors has been also shown. 

To date, the algorithm for the treatment of recurrent ovarian cancer and the criteria for selecting patients for performing secondary cytoreductive surgeries have not been fully developed. Although the role of secondary surgery in recurrent ovarian cancer remains controversial, most retrospective studies showed better survival in patients for whom maximal cytoreduction was achieved. Several studies have developed prognostic models for the feasibility of performing complete secondary cytoreduction. We report a rare case of repeated cytoreductive surgeries in combination with chemotherapy for recurrent ovarian cancer. This clinical case indicates the feasibility of performing repeated cytoreductive surgeries in patients with localized recurrent ovarian cancer undergoing previous optimal cytoreductions and having no ascites. 

Squamous cell head and neck carcinoma is frequently associated with dysphagia. An adequate enteral nutrition is the key to successful treatment and rehabilitation of these patients. Percutaneous endoscopic gastrostomy is the preferred route of feeding and nutritional support in head and neck cancer patients with dysphagia. We report a rare case of implantation metastasis of laryngeal cancer following percutaneous endoscopic gastrostomy. Our experience in treating this complication has been described. Percutaneous endoscopic gastrostomy is a less-invasive procedure than open gastrostomy. Percutaneous endoscopic gastrostomy can be accompanied by severe complications such as implantation metastasis at gastrostomy site. Careful monitoring can provide early detection of this complication and early treatment. 

75-th anniversary of Prof. G.Ts. Dambaev.

70-th anniversary of Prof. L.P. Nazarenko.