Background. One of the main directions in the field of ensuring radiation safety of “nuclear legacy” facilities is the assessment of radiation effects and most significant radiogenic risks in employees of nuclear enterprises and their descendants.

Objective. Analysis of the cancer incidence among employees of the Siberian Group of Chemical Enterprises (SGCE) exposed to ionizing radiation in the course of their professional activities.

Material and Methods. The actual values and standardized estimated risks of developing cancer among the SGCE workers occupationally exposed to ionizing radiation were calculated using generally accepted methods based on the information of the regional medical dosimetry registry of Seversk Biophysical Research Center of FMBA, containing updated data on all SGCE employees diagnosed with cancer (period from 01.01.1950 to 31.12.2015 inclusive). The control group consisted of workers who were not occupationally exposed to ionizing radiation.

Results. Among the male personnel of the SGCE, the highest incidence of cancer of the digestive, respiratory, and skin organs (including melanoma) was observed in patients aged 50–59 and 70–79 years. Among the female workers, the highest cancer incidence was in the age group 40–49 years; cancer of the gastrointestinal tract, genital tract and breast was the most common. The cancer incidence rate in the SGCE workers who occupationally exposed to ionizing radiation was not higher that that observed in the control group. The median age of male cancer patients occupationally exposed to ionizing radiation was significantly lower than the median age of male cancer patients of the control group. In female cancer patients, a significant difference in the median age of cancer diagnosis was found only in relation to skin cancer. Both male and female SGCE personnel occupationally exposed to ionizing radiation was at high risk of certain cancers: among male patients – cancer of the mesothelium and soft tissues, genital organs, eyes and brain, as well as multiple primary tumors; among female patients – cancer of lips, oral cavity, pharynx, digestive system, respiratory system, skin (including melanoma), mesothelium, soft tissues, breast, urinary tract, lymphatic and hematopoietic tissues, as well as multiple primary tumors.

Conclusion. The data obtained will allow determination of the main directions for assessing the health risks of personnel of radiation hazardous facilities and the formation of a set of measures aimed at improving the system of protection and improving the health of workers at radiation hazardous enterprises and the extension of their working longevity. 

Introduction. A multimodal approach to the treatment of locally advanced gastric cancer with the addition of systemic or local treatment methods, such as chemotherapy and radiation therapy, reduces the risk of cancer recurrence, thus improving survival of patients. Advances in anticancer therapy dictate the need to develop systems for assessing tumor response to new treatment modalities.

Material and Methods. The study included 162 patients with locally advanced gastric cancer who received treatment at the N.N. Petrov National Medical Research Center of Oncology from 2015 to 2018. All patients underwent subtotal gastric resection or gastrectomy with lymph node dissection and previously received neoadjuvant polychemotherapy. Patients were in the age range 30 to 80 years old. The tumor pathomorphological response to chemotherapy was assessed in all patients using a pathomorphological response rate system according to the classification of the Japanese Gastric Cancer Association (JGCA, 3rd English edition). All patients underwent computed tomography with pneumogastrography before neoadjuvant chemotherapy and immediately before surgery. For each of 162 patients, 96 qualitative and quantitative biomarkers of tumor and paragastric lymph node imaging were analyzed.

Results. The accuracy of determining the tumor response rate using computed tomography with pneumogastrography was 82.6 % for TRG-0/1, 90 % for TRG-1/2, and 88 % for TRG-2/3. Discussion. The tumor pathomorphological response to treatment is a predictor of long-term results; however, it can be assessed only after analyzing the surgical specimen, and this marker cannot be used in inoperable cases and for correction of palliative chemotherapy. The study of imaging biomarkers based on quantitative and qualitative data reflecting the histopathological features of the tumor and lymph nodes can help determine the tumor regression grade and optimize treatment.

Conclusion. The proposed algorithm for assessing the response grade of locally advanced gastric cancer to chemotherapy using imaging biomarkers is a promising prognostic marker and requires further study. 

Aim: to identify the pathways of lymph node metastases in non-small cell lung cancer (NSCLC).

Material and Methods. The frequency of mediastinal lymph node metastases and treatment outcomes were analyzed in 327 patients with stage I–III non-small cell lung carcinoma (NSCLC), who underwent lung resection with systematic lymph node dissection (SLND) between 2007 and 2011.

Results. In cases with tumor location in any lobe of the right lung, metastasis occurred in the superior and inferior mediastinal lymph nodes. In left-side tumors, the main pathways of lymphatic spread of tumors were superior and inferior mediastinal nodes as well as aortic lymph nodes. Left lower lobe tumors metastasized most often to inferior mediastinal lymph nodes. Skip metastases were observed at any location of the tumor. Routine examination of all ipsilateral mediastinal lymph nodes overstaged NSCLC in 19.5 % of cases. The overall 5-and 10-year survival rates in patients with stage I–III NSCLC with SND were 61.5 % and 49.2 %, respectively. The median survival time was 103 months.

Conclusion. Despite typical metastatic patterns of mediastinal lymph nodes in patients with NSCLC, non-specific metastasis was observed at any location of the tumor, which required mandatory systematic nodal dissection. 

The purpose of the study was to assess the feasibility of using the propeller flap to cover a large axillary fossa defect following lymph node dissection in breast cancer patients.

Material and Methods. One hundred breast cancer patients underwent surgery. Out of them, 64 underwent Madden modified radical mastectomy and 36 radical breast resection using a propeller muscle flap. Out of 100 patients, 61 were followed up (50 after mastectomy and 11 after radical resection using a propeller flap). Fifteen patients were randomly selected for examination of the flap using ultrasound (2 patients after radical resection, 13patients after radical mastectomy). The follow-up time was from 3 to 6 months. We studied the following: bleeding in the postoperative period, hematoma, duration of lymphorrhea, duration of hospitalization, ultrasound findings, hand function, size of the upper limb, and physical activity.

Results. No statistically significant differences in the number of complications related to the surgery extent were found. Here was no bleeding. Small hematoma was observed in one patient who underwent breast resection. Forty-three (70.49 %) patients did not have lymphorrhea after drainage removal. Lymphorrhea was observed for a month in 9 (14.75 %) patients, for 1–2 months in 4 (6.56 %) patients, and for 3 months or more in 5 (8.2 %) patients – 3 months or more. Twelve (19.67 %) patients developed lymphoedema of the arm. Hospitalization period was 7 bed-days in 90.0 % of cases. The flap viability reached 100.0 %. In 54 (88.53 %) of 61 patients, the active function of the arm recovered. Thirty-eight (62 %) patients had ECOG 1 status 3 years after surgery.

Conclusion. The flap made it possible to solve the local problems of covering the axillary neurovascular bundle during lymphadenectomy for breast cancer and eliminating a large axillary fossa defect. The results obtained demonstrated high engraftment rates with a small number of complications, regardless of the surgery extent. 

Background. Diagnosis of urothelial carcinoma in situ is of great importance because it has prognostic and therapeutic value.

We aim to determine the utility of EZH2 and ARID1A as a new tool in the diagnosis of carcinoma in situ.

Material and Methods. This retrospective cross-sectional study included Twenty-four specimens of flat urothelial lesions, twenty specimens of CIS, and 10 of normal adjacent urothelium that was taken by cystoscopic resection biopsy procedure. immunohistochemical expression of EZH2 and ARID1A. were evaluated in all studied cases.

Results. All normal urothelium specimens showed high nuclear staining for ARID1A and negative nuclear staining for EZH2. High EZH2 expression was observed in 80 % of CIS specimens compared to 20 % of flat urothelial lesions with atypia (p=0.001 ), while high ARID1A expression was observed in 70.8 % of flat urothelial lesions with atypia compared to 25 % of CIS specimens (p=0.001). EZH2 was more accurate and specific in the diagnosis of carcinoma in situ.

Conclusion. EZH2 and ARID1A are promising diagnostic markers for urothelial CIS. EZH2 is more accurate and specific than ARID1A in the diagnosis of carcinoma in situ versus other flat urothelial lesions. 

Background. To solve the problems of personalized medicine in oncology, preclinical studies based on the use of three-dimensional cellular models of tumors in vitro, including spheroids / tumoroids, are of great importance. They are an interesting tool for genetic, epigenetic, biomedical and pharmacological studies aiming to determine the most effective individual therapeutic approaches, since they allow modeling the dynamic evolution of a tumor disease from early stages to metastatic spread through interaction with the microenvironment.

The purpose of the study was to compare characteristic features of formation and spatial organization of spheroids, obtained from solid malignant tumors cells with various histogenesis: melanomas, soft tissue sarcomas and osteosarcomas, epithelial tumors.

Material and Methods. Solid tumor cell lines of patients who were treated from 2015 to 2021 were the basis for the creation of 3D-cell models. Fragments of tumor tissue were obtained intraoperatively: 15 samples of melanoma, 20 samples of soft tissue sarcomas and osteosarcomas, and 9 samples of epithelial tumors. All tumor cells were cultured for at least 10 passages. Methods of phase contrast, confocal microscopy, and histological techniques were used to study spheroids. Using ELISA methods and multiplex analysis, the supernatants of monolayer cell cultures and spheroids were studied for the presence of a wide range of biologically active substances that provide the processes of immunosuppression, invasion and metastasis.

Results. The use of low adhesion surfaces was proven to be preferable to obtain spheroids of a given seed concentration and size of interest. The average cultivation time of spheroids was 4.7 days, and the optimal seeding concentration was 10,000 cells per well, while the spheroid diameter varied from 300 to 1000 μm depending on the type of malignant cells: the largest spheroids formed melanoma cultures. In general, the efficiency of spheroid formation was 88.6 % (39 out of 44). The introduction of fibroblasts into the 3D construct led to increasing in the invasive potential of tumor cells, which was associated with the production of IL8 (rho=0.636, p=0.035), HGF (rho=0.850, p=0.004), SCF (rho=0.857, p=0.014), FST (rho=0.685, p=0.029), Prolactin (rho=0.810, p=0.015), PECAM1 (rho=0.788, p=0.004).

Conclusion. The technology of low-adhesive surfaces makes it possible to successfully create three-dimensional models of a tumor node from malignant tumors cells of various histogenesis. The colonization of a three-dimensional structure with fibroblasts enhances the biologically aggressive properties of tumor cells and demonstrates complex reciprocal interactions between the cellular elements of the tumor stroma and malignant cells, which brings the model closer to a real clinical situation. 

Introduction. Detection of somatic mutations in the BRAF gene can be used in clinical oncology to clarify the diagnosis, select therapy and assess the prognosis of the disease. Pyrosequencing technology makes it possible to identify both already known and new mutations, as well as to determine the mutant allele ratio in the sample.

The aim of the study was to develop the pyrosequencing-based method for detecting mutations in 592–601 codons of the BRAF gene.

Material and Methods. The nucleotide sequences were obtained using «PyroMark Q24» instrument. The sensitivity and specificity of the method were estimated using dilutions of plasmid DNA samples containing the intact BRAF gene fragment mixed with sequence containing one of the mutations V600E, V600R, V600K, V600M, and K601E. The clinical testing was performed on 200 samples from thyroid nodules.

Results. The developed method makes it possible to determine samples containing 2 % of the mutant allele for mutations V600K and V600R, 3 % for V600E and V600M, and 10 % for K601E. The pyrogram signal values for samples without mutations ranged from 0 to 19.5 % for different mutations. An analysis algorithm was developed to confirm the presence and differentiation of mutations in the 600 codon at a low proportion of the mutant allele based on the signals ratio on the pyrogram. The 47 clinical samples with mutations were found, 45 with V600E and 1 with V600_K601>E, for one sample, the type of mutation in the 600 codon could not be determined. The proportion of the mutant allele was 3.5–45 %. The concentration of extracted DNA less than 10 copies per mkl was obtained in 47 samples, of which 8 samples were found to have the mutations.

Conclusion. The pyrosequencing-based method was developed for the detection of somatic mutations in 592–601 codons of the BRAF gene. The technique provided sufficient sensitivity to detect frequent mutations in the 600 codon and allowed the detection of rare mutations. Extraction of DNA from clinical samples obtained by fine-needle aspiration biopsy in most cases provided a sufficient concentration of DNA, which made it possible to use the technique in combination with cytological analysis without additional sampling. This approach can be applied to determine somatic mutations in DNA fragments of same length for other oncogenes. 

The issue of factors that modify the tumor process stays relevant. The effect of unilateral sciatic nerve ligation on the growth of Guerin's transplantable carcinoma and the lifespan of white outbred rats of the same age, which differed in adaptation status and aging rates, was studied.

Material and Methods. The motor activity (open field test), the character and tension of the general nonspecific adaptional reactions of the body (AR) according to Garkavi–Kvakina–Ukolova, the dynamics of tumor sizes and the lifespan of rats after Guerin’s carcinoma transplantation were evaluated.

Results. The effect of unilateral sciatic nerve ligation differed from the unidirectional negative effects known in tumor-bearing animals after bilateral ligation of the sciatic nerve. In groups with unilateral ligation of the sciatic nerve and a false operation, more than 40 % of animals showed an increase in lifespan compared with the maximum lifespan in the control group. At the same time, in the most cases, the tumor growth rate was similar to the control indicators or exceeded them (more 25 % of cases). A temporary inhibition of tumor growth was observed only in individual animals. There was no direct relationship between tumor growth or lifespan and the degree of decrease in the motor activity of animals 4 weeks after nerve ligation. A correlation between the changes in the ARs and lifespans of animals and, to a lesser extent, the dynamics of tumor growth was observed. The distinct negative effect of increased aging rate, measured by animal weight, on tumor development and lifespan in studied rats was shown, but not in the cases of sciatic nerve ligation. Unilateral sciatic nerve ligation had a multidirectional effect on tumor growth and lifespan in rats with different rates of aging, depending, probably, on the individual pain sensitivity and the individual features of systemic regulation of tumor-bearing animals.

Conclusion. The results reflect the complex relationship between processes associated with chronic pain, oncogenesis, aging and features of neuroendocrine and immune regulation of experimental animals. The question of the reasons for the preservation of viability in animals that underwent surgery and ligation of the sciatic nerve, when the tumors reach large sizes, exceeding this indicator in the control group, needs to be clarified. 

The purpose of the study: to compare the activity of vancomycin, teicoplanin and linezolid and to determine their place in the current treatment of nosocomial infections caused by gram-positive microflora.

Material and Methods. 640 gram-positive microorganisms (S. aureus, E. faecium, E. faecalis) isolated in 2018 from various pathological materials from cancer patients treated at N.N. Blokhin National Medical Research Center of Oncology were studied. Literature data from 1982 to 2019, concerning efficacy of glycopeptides (vancomycin, teicoplanin) and linezolid against these pathogens were analyzed.

Results. Data analysis showed that percentage of methicillin-resistant Staphylococcus aureus (MRSA) was 89 % and percentage of vancomycinresistant enterococci (VRE) was 5.1 % among Enterococcus faecalis and 16.4 % among Enterococcus faecium. The susceptibility of the studied gram-positive microorganisms to teicoplanin, vancomycin and linezolid ranged from 83.3 to 98.8 % (p>0.5). In general, teicoplanin, vancomycin, and linezolid had equally high microbiological activity against nosocomial strains of S. aureus and Enterococcus spp. Also, according to the literature data, a comparative assessment of the clinical effectiveness and cost-effectiveness of glycopeptides and linezolid was assessed.

Conclusion. Vancomycin and teicoplanin are still the main drugs for the treatment of various infections caused by resistant gram-positive microflora. However, teicoplanin, with an efficacy equal to that of vancomycin, has a number of significant advantages over the latter: better tolerability, lower frequency of adverse reactions, and pharmacokinetic features that make it possible to use it once a day both intravenously and intramuscularly. Both drugs, along with linezolid, can be used to treat infections caused by gram-positive microorganisms in cancer patients. 

Background. The treatment outcomes for non-small cell lung cancer (NSCLC) depend on the tumor stage and treatment strategy. The imaging techniques play a significant role in the diagnosis, staging and choice of appropriate treatment for NSCLC.

Purpose of the study: сomparison of the diagnostic capabilities of magnetic resonance imaging (MR) and positron emission computed tomography to select the optimal approaches to early detection of spinal and pelvic bone metastases.

Material and Methods. The treatment outcomes were analyzed in 71 patients with NSCLC. Spinal and pelvic bone metastases were detected in 24 patients using magnetic resonance imaging (MRI) and positron emission computed tomography (PET/CT). Multiple bone lesions were the most common. A total of 69 metastatic lesions were identified. To compare the capabilities of diagnostic techniques, all patients underwent PET/CT with ¹⁸F-FDG, and MRI of the spine and pelvic bones using diffused-weighted images (DWI). Statistical data processing included the calculation of the sensitivity, specificity and diagnostic accuracy of the above techniques.

Conclusion. The comparative analysis of the capabilities of modern high-tech diagnostic techniques (PET/CT with ¹⁸F-FDG and MRI of the spine and pelvic bones with DWI) in early detection of bone metastases in patients with NSCLC, PET/CT with ¹⁸F-FDG showed the greatest diagnostic value. However, taking into account the high sensitivity and specificity of MRI with DVI in detection of bone metastases and limited availability of PET/CT for patients, MRI with DVI is recommended to exclude bone metastases. 

Background. There is no unified approach to the management of patients with small choroid melanoma (CM) (thickness up to 3 mm, base diameter up to 10 mm). The study of the development of metastases in these patients is of great significance for choosing an appropriate treatment method.

Purpose: to assess the incidence of metastatic disease in patients with small CM, who were treated with transpupillary thermotherapy (TTT), photodynamic therapy (PDT), and brachytherapy (BT).

Material and Methods. The retrospective study included 149 patients with CM, who were treated at the National Cancer Center of Belarus from 2005 to 2018. All patients had tumors less than 10 mm in diameter, less than 3 mm in thickness, and had no signs of systemic progression before starting therapy. All tumors corresponded to stage T1N0M0 (American Joint Committee on Cancer (AJCC)). 44 patients were treated with PDT, 47 with TTT, and 58 with BT.

Results. The median follow-up time was 154 months (12 years) in patients treated with brachytherapy, 128 months (10 years) in patients treated with TTT and 72 months (6 years) in patients treated with PDT. During the follow-up period, metastases were observed in 1 (2.3 %) patient after PDT and in 5 (10.6 %) patients after TTT. In patients treated with BT, systemic progression was not recorded during the follow-up period. All cases of metastatic disease were associated with local recurrence or continued growth of CM.

Discussion. The 5-year metastasis-free survival after TTT was worse than after PDT (82 ± 8.0 % and 94 ± 6.0 %, respectively, p<0.0001). However, in some cases, preference can be given to laser treatment methods, allowing the patients to avoid post-radiation retinopathies. The lack of local control of the tumor can be considered a surrogate marker for the development of metastatic disease. Conclusion. The highest metastasis-free rates were observed after brachytherapy. Positron emission tomography is recommended for early detection of systemic progression of the disease. Key words: choroid melanoma, uveal melanoma, transpupillary thermotherapy, photodynamic therapy, brachytherapy, metastatic-free survival, organ-preserving treatment.>˂0.0001). However, in some cases, preference can be given to laser treatment methods, allowing the patients to avoid post-radiation retinopathies. The lack of local control of the tumor can be considered a surrogate marker for the development of metastatic disease.

Conclusion. The highest metastasis-free rates were observed after brachytherapy. Positron emission tomography is recommended for early detection of systemic progression of the disease. 

The purpose is to present a modern data on the possibilities of positron emission computed tomography combined with computed tomography (PET/CT) in the diagnosis, staging and monitoring of prostate cancer (PC).

Material and Methods. A search and analysis of the largest domestic and English-language databases (Elibrary, PubMed, Elsevier, etc.) on this problem was carried out. 37 sources were found devoted to studying the results of clinical trials of the diagnostic capabilities of PET/CT with various radiopharmaceuticals.

Results. The presented data on the possibilities of PET/CT with various radiopharmaceuticals in the diagnosis of primary prostate cancer, imaging of lymphogenous and distant metastases, as well as in assessing the effectiveness of treatment.

Conclusion. This review of the literature showed that the use of PET/CT in prostate cancer largely depends on the chosen radiopharmaceutical. Moreover, it is PET/CT with PSMA-based radiopharmaceuticals that is the most promising method for examining patients with prostate cancer and can be recommended as an additional study in cases where other methods of radiation diagnostics do not give an unambiguous answer. The development of new and improving the already used radiopharmaceuticals, which will increase the sensitivity, specificity and accuracy of the diagnosis, staging, monitoring and prognosis of treatment of prostate cancer, remains relevant.

Background. In Russia, synchronous distant metastases are annually detected in approximately 6,200 patients and synchronous liver metastases in 4,000 patients. To plan treatment for rectal cancer with synchronous liver metastases, it is necessary to consider the location of the tumor, extent of the primary tumor involvement, tumor-related complications, and resectability of metastases.

The purpose of this review was to analyze the results of studies aimed at finding the best regimens for treating rectal cancer patients with synchronous liver metastases.

Material and Methods. The review includes both retrospective and prospective studies devoted to treatment of rectal cancer with synchronous liver metastases. Previous reviews and clinical recommendations were analyzed.

Results. Most oncologists are in favor of preoperative radiotherapy, especially when rectal cancer is located in the lower-and middle-ampullary regions. However, there are no randomized trials with a representative number of patients to confirm or refute this point of view. Due to the increased life expectancy of patients and introduction of modern minimally invasive surgical approaches, there is an urgent need for radical treatment of rectal cancer patients. Thus, the approaches to the treatment of primary tumors with synchronous metastatic liver damage should be the same as in stage II–III of the disease, and neoadjuvant radiation therapy is an integral part of this strategy. 

Although significant advances have been made in breast cancer treatment resulting in improved survival, cardiovascular disease has become the main cause of disability and mortality not related to cancer recurrence. In the general population, cardiovascular disease is the leading cause of death in both women and men. In patients with breast cancer, the incidence of cardiovascular diseases is even higher than in the general population. The high incidence of cardiovascular disease in breast cancer patients is likely due to the presence of common risk factors as well as the patients with breast cancer, the incidence of cardiovascular diseases is even higher than in the general population. The high incidence of cardiovascular disease in breast cancer patients is likely due to the presence of common risk factors as well as cardiotoxicity of anticancer therapy. The rise in the development of cardiovascular disease in breast cancer survivors is a major concern. This literature review will describe the incidence of cardiovascular complications with different treatment regimens for breast cancer, risk factors for their development, strategies for monitoring cardiovascular function during and after anticancer therapy, and strategies for the prevention and treatment of cardiotoxicity. 

Challenges in cancer detection, prognosis and management are currently being solved by determining circulating tumor DNA (ctDNA). The assessment of this marker has acquired particular importance in metastatic colorectal cancer (mCRC), the systemic treatment of which depends on the RAS gene status, which has prognostic and predictive value. However, the possibilities of taking samples from the primary or metastatic lesion for pathomorphological and molecular analysis in CRC are often limited. The determination of ctDNA using liquid biopsy has an advantage over standard biopsy due to its low invasiveness and high availability of the method. Analysis of mutations using ctDNA as well as changes in the level of this marker is a criterion for the effectiveness of systemic treatment, as well as a factor that determines the risk of disease progression. Currently, the potential of using ctDNA to monitor effectiveness of first-and second-line chemotherapy, as well as to predict the development of secondary resistance to EGFR inhibitors (cetuximab and panitumumab) in the first-line treatment and assessment of RAS status for returning to therapy with EGFR inhibitors in the third-line treatment of mCRC is being studied. Several pilot studies have provided evidence of the efficacy of EGFR re-treatment. The modern literature data published in leading peer-reviewed journals in Russian and international scientific citation databases, such as Medline, Elibrary, and PubMed were analyzed. Of the 138 analyzed publications, 56 were used to write this review. 

Purpose of the study: to present up-to-date data on molecular genetic studies aimed to identify the risks of developing prostate cancer in representatives of various ethnic groups. Material and Methods. Literary sources were searched in databases such as PubMed, Medline, Google Scholar. We had analyzed 60 sources on the risks of developing prostate cancer. The epidemiological data on the prostate cancer incidence and risk factors depending on age characteristics, hormonal status and hereditary predisposition were shown. Results. The pathogenetic features of prostate cancer depending on ethnicity were described. The paper presents data from both European and Asian ethnic groups. In a number of studies, significant genetic differences in single nucleotide polymorphisms associated with the development of prostate cancer were identified. Conclusion. Research in the field of determining the risks of developing prostate cancer becomes more and more relevant due to the emergence of new molecular genetic markers, as well as the influence of various ethnic characteristics. Nevertheless, many questions of modern diagnosis of prostate cancer are still open, therefore, research in this area remains promising. 

Introduction. Overexpression of Her2/neu is detected in 15–20 % of patients with breast cancer and associated with an aggressive form of disease and low overall and disease-free survival rates. Currently, immunohistochemical studies (IHC) and methods of in situ hybridization are used to assess Her2/neu status. One of significant drawbacks of this detection is the impossibility of simultaneous assessment of the receptor status of the primary tumor and metastatic sites. The increasing popularity of radionuclide methods using recombinant proteins as a targeting module have already demonstrated their effectiveness in solving this question at the initial stages of clinical research.

The purpose of this study is to demonstrate a clinical case of assessing the extent of breast cancer in a patient with overexpression of Her2/neu using a radiopharmaceutical based on targeted protein molecules labeled with technetium-99m.

Description of the clinical case. A patient diagnosed with stage IIIA right breast cancer (T2N2M0), multicentric growth and metastases in right axillary and subclavian lymph nodes at the diagnostic stage was injected intravenously with 99mTc-ADAPT6 radiopharmaceutical. The drug was prepared in the Department of Nuclear Medicine of Research Cancer Institute (Tomsk) immediately before its administration. Planar scintigraphy and singlephoton emission tomography of the chest organs were performed 2 hours after injection of 99mTc-ADAPT6 radiopharmaceutical. In addition to the previously described tumors, 3 foci of hyperfixation of the tracer in the projection of the 5th rib on the right along the middle-clavicular line, as well as in the projection of the 8 and 9 thoracic vertebrae (Th VIII, IX) were found. Computed tomography of the chest organs and bone scintigraphy with 99mTc-pyrophosphate showed no metastases in the 5th rib on the right and Th VIII, IX. Magnetic resonance imaging of the thoracic spine revealed 2 metastatic foci in Th VIII, IX. Planar scintigraphy with 99mTc-pyrophosphate and CT performed 6 months after injection of 99mTc-ADAPT6 revealed previously described foci in the projection of the thoracic spine (Th VIII, IX) and 5 ribs on the right along the mid-clavicular line. Conclusion. The results demonstrated during the study suggest that 99mTc-ADAPT6 is a promising tracer for molecular imaging of tumor foci with overexpression of the Her2/neu receptor in breast cancer patients. 

Currently, the development and implementation of organ-preserving methods for patients of reproductive age are the treatment priorities in modern oncology. We report a case of two successful pregnancy outcomes in a 29-year-old patient with stage IB invasive cervical cancer, who underwent laparoscopic radical trachelectomy using high-tech diagnostic and treatment techniques. Alotech, an innovative radiopharmaceutical, and Rad Pointer laparoscopic gamma scanner were used for intraoperative detection of sentinel lymph nodes. In addition, a uterine obturator was formed during surgery using a titanium nickelide shape memory implant. This case showed the feasibility of preserving the uterus after delivery by caesarean section, with no evidence of tumor recurrence according to the findings of intraoperative morphological examination.