Background. During the COVID-19 pandemic, annual adult check-ups have been postponed, resulting in cancer screening disruption.

The aim of the study was to evaluate changes in the incidence and stage distribution of malignancies included in the screening program during the COVID-19 pandemic using the Arkhangelsk Regional Cancer Registry (ARRC).

Material and Methods. We assessed the changes of the incidence rates and stage distribution for the colon, rectum, lung, breast, cervix, uterine body, ovary, prostate and kidney cancers over the periods 2018–19 and 2020–21. Results. A total of 12354 cases with 9 cancers were selected: 6680 for the period 2018–19 and 5674 (-15.1 %) for the period 2020-21. The most significant decrease in crude and age-standardized incidence rates was registered in patients with lung (-18.0–18.1 %), rectum (-25.1–25.9 %) and cervix (-33.6–36.9 %) cancers, p<0.001. The decrease was not signifcant in patients with breast, uterine body, and kidney cancers. The proportion of patients with stage I decreased in lung cancer (-20.0 %, from 14.8 % to 11.8 %), rectum (-20.2 %, from 20.9 % to 16.7 %), and uterine cervix (-37.1 %, from 53.2 % to 33.5 %). In prostate and kidney cancers, the proportion of patients with stage I increased by 30 % (from 19.5 % to 25.4 %) and 17.6 % (from 45.9 % to 54.0 %), respectively. A signifcant reduction in the proportion of early stages during the COVID-19 pandemic was observed in lung and cervical cancer. Conclusion Postponed health checkups due to COVID-19 pandemic disruptions have led to substantial reductions in new cancers being diagnosed, mainly for cervical, lung, colon and rectal cancers. No signifcant changes were observed for other cancers. Further analysis of mortality and survival of cancer patients is required. Key words: health checkup, cancer screening, COVID-19 pandemic, cancer incidence, stage distribution>˂0.001. The decrease was not significant in patients with breast, uterine body, and kidney cancers. The proportion of patients with stage I decreased in lung cancer (-20.0 %, from 14.8 % to 11.8 %), rectum (-20.2 %, from 20.9 % to 16.7 %), and uterine cervix (-37.1 %, from 53.2 % to 33.5 %). In prostate and kidney cancers, the proportion of patients with stage I increased by 30 % (from 19.5 % to 25.4 %) and 17.6 % (from 45.9 % to 54.0 %), respectively. A significant reduction in the proportion of early stages during the COVID-19 pandemic was observed in lung and cervical cancer.

Conclusion. Postponed health checkups due to COVID-19 pandemic disruptions have led to substantial reductions in new cancers being diagnosed, mainly for cervical, lung, colon and rectal cancers. No significant changes were observed for other cancers. Further analysis of mortality and survival of cancer patients is required. 

The purpose of the study was to assess the short-term effcacy and tolerability of neoadjuvant chemotherapy (NAC) in colorectal cancer (CRC) patients with isolated liver metastasis.

Material and Methods. Since 2020, a pilot study including 23 CRC patients with liver metastasis has been conducted at the Abdominal Cancer Department of the Cancer Research Institute (Tomsk, Russia). The combined treatment modality included 3 cycles of NAC according to FOLFOXIRI + cetuximab (20 patients with wtKRAS) and FOLFOXIRI + bevacizumab (3 patients with mtKRAS) regimens followed by simultaneous laparoscopic colorectal resection and open liver resection.

Results. For liver metastases, the objective response rate reached 100 % (complete response: 8.7 %, partial response: 91.3 %). For the primary tumor, the objective response rate was 100 % (partial response). The overall NAC toxicity rate was 53.6 %. The major I–II grade toxicities included nausea/vomiting (27.5 %), polyneuropathy (10.1 %), skin reaction (10.1 %), hepatotoxicity (5.8 %), and corresponded to I–II grade. R0 resection was performed in all patients. Postoperative complications were observed in 19 (82.6 %) patients; of them 18 (78.3 %) had a febrile temperature (grade 1, according to the Clavien–Dindo classifcation) due to the use of bipolar coagulation during liver surgery, and 1 (4.4 %) patient developed a biliary fstula (3 A/B grade according to Clavien–Dindo). No postoperative death occurred. For liver metastasis, pathological complete response rate was 4.4 % (TRG1 according to Mandard); for the primary tumor, in most cases was TRG 3 – 87 %.

Conclusion. Combined treatment modality, including NAC with FOLFOXIRI regimen and targeted therapy for CRC with liver metastases, is well tolerated, has a signifcant damaging effect on the tumor, and does not affect the course of the postoperative period. Further studies are required to assess the long-term treatment outcomes. 

Background. To select the optimal treatment for non-small cell lung cancer (NSCLC), it is important to predict the risk of distant metastasis and the effectiveness of therapy. The effect of neoadjuvant chemotherapy (NAC) on distant metastasis remains poorly understood. In this study we evaluated the feasibility of predicting the risk of distant metastasis and effectiveness of various treatment options for pre- and intraoperative therapy in NSCLC patients with high and low risk of distant metastasis, divided based on the assessment of morphological changes in the epithelium of small bronchi located near the primary tumor.

Material and Methods. The study included 171 patients with NSCLC (T1-4N0-3M0). Various premalignant lesions: isolated basal cell hyperplasia (BCH+SM-D-), basal cell hyperplasia with squamous cell metaplasia (BCH+SM+D-) and squamous cell metaplasia with dysplasia (BCH-SM+D+) were identified in the bronchial epithelium of small bronchi taken at a distance of 3–5 cm from the tumor. Preliminary studies have shown that the detection of BCH+SM-D- or BCH-SM+D-in small bronchi are the markers of high risk of NSCLC distant metastasis, and the detection of BCH+SM+D- and BCH-SM-D- are the markers of low risk of NSCLC distant metastasis. 52.6 % of patients (90/171) received 2–3 courses of neoadjuvant chemotherapy (NAC), 41.1 % (37/90) of patients underwent intraoperative radiation therapy (IORT) at a single dose of 10–15 Gy and 47.4 % (81/171) of patients received platinum-based adjuvant chemotherapy (AC).

Results. Both treatment options (NAC+IORT+ and NAC+IORT–) effectively reduced the incidence of distant metastases in the high-risk group patients during the first 2 years of follow-up compared with the high-risk group patients who did not received therapy. In the low-risk group patients, distant metastases rarely occurred, regardless of the treatment option. Adjuvant chemotherapy was found to have no influence on the frequency of distant metastases. Metastasis-free and overall survival rates were better in the low-risk group patients or in patients who received the NAC+IORT+ regimen.

Conclusion. Combination of NAC and IORT resulted in the increase in metastasis-free and overall survival rates. 

Background. Cancer of unknown primary (CUP) is a metastatic lesion with diffcult identifcation of the primary tumor site using standard diagnostic approaches. Although the incidence of CUP is not high, this type of cancer often shows a high aggressiveness and therapy resistance and results in poor patient survival. The mechanisms of CUP origin are not clear, and further studies are needed.

This study aims to analyze the mutational landscape of CUP and identify specifc genetic alterations.

Material and Methods. Whole exome sequencing was used to analyze the mutational landscape of CUP. Results. CUP had single nucleotide variants (SNVs) in the EPHA8 (ephrin receptor) gene. CUP also harbored copy number variations (CNAs) in the ID2, FOXD4, ZMYND11, ZNF596, KIDINS220, LRRN1, GEMIN4, CEP72, TPPP, and MXRA5 genes. According to functional enrichment analysis, these genes are involved in the regulation of transcription, biogenesis of microRNA, cellular cytoskeleton, adhesion, extracellular matrix remodeling, proliferation, apoptosis, and epithelial-mesenchymal transition.

Conclusion. Cancer of unknown primary harbors mutations in the genes that regulate different biological processes particularly cell motility. 

Introduction. Myeloid-derived suppressor cells (MDSCs) play an important role in restriction of the immune response and are associated with a poor prognosis in cancer. Mobilization of hematopoietic stem cells (HSCs) before high-dose chemotherapy (HCT) with autologous HSC transplantation (auto-HSCT) is accompanied by a signifcant increase in MDSC counts in peripheral blood and apheresis product of multiple myeloma (MM) patients. However, quantitative changes of these cells at the post-transplant and their role at the immune recovery remain unexplored.

The study was aimed to analyze the dynamics of circulating MDSC counts and the expression of suppressor molecule arginase-1 in patients with MM in the frst 12 months after HCT and auto-HSCT and evaluate association between MDSCs and transplantation outcomes.

Material and Methods. The study included 44 MM patients who underwent HCT and auto-HSCT. The relative number of granulocytic MDSCs (G-MDSCs), monocytic MDSCs (M-MDSCs), and early-stage MDSCs (E-MDSCs), as well as the expression of arginase-1 in each of MDSC subsets was evaluated by fow cytometry in patient peripheral blood samples.

Results. At the engraftment (day +12 – +16, leukocytes >1×10⁹ /l), M-MDSC relative count was increased (p_U=0.038), as well as the relative (p_U=0.003) and absolute (p_U˂0.0001) counts of G-MDSCs, decreasing after 6 months down to pre-transplant values (рU=0.007, рU=0.024 and рU=0.02, respectively) and remaining at the same level at the 12-month follow-up period. The absolute count of E-MDSCs by the time of the engraftment decreased transiently (p_U=0.004 vs before HCT), gradually recovering by 12-month follow-up (p_U=0.032 vs day +12 – +16). The remission within 12 months in the group with G-MDSCs˂0.17 % at the engraftment was observed in 67 ± 11 % of patients, with G-MDSCs >0.17 % – in 94 ± 6 % of patients (p=0.049). During the 12-month post-transplant, the number of M-MDSCs expressing arginase-1 has been increasing, with a tendency to lower values at the engraftment in patients with early MM relapse (p_U=0.09).

Conclusion. The association of early MM relapse after auto-HSCT with the lower count of G-MDSCs and the lower count of arginase-1⁺ M-MDSCs at the engraftment suggests that MDSCs is involved in the restriction of homeostatic proliferation as a factor for more effective immune recovery. 

The aim of the study was mammosphere assay optimization for quantifcation of IL6-induced stemness in differentiated (СD44^– ) T47D breast cancer cells.

Material and Methods. The effect of three commonly used cell-detaching methods (TrypLE, accutase, cell scrapper) at various confuence (40–50 % and 70–80 %) on cell viability, phenotypic profle and mammosphere formation was tested. The cell viability was examined using AnnexinV/propidium iodide assay. The phenotypic profle was analyzed by fow cytometry with fuorescent markers CD24 and CD44.

Results. Detachment of the cells using scrapper led to substantial increase in early apoptotic and late apoptotic cells in comparison with TrypLE and accutase. Dissociation with TrypLE reduced the percentage of detected CD44⁺ positive cells, whereas accutase saved the surface marker. The number of mammosphere and their diameter did not differ between groups. Incubation of differentiated (CD44^– CD24⁺) T47D cells with IL-6 for 24 hours resulted in an appearance of CD44⁺CD24⁺ and CD44⁺CD24^–/low subpopulation. Furthermore, the differentiated cells after 24 hours of IL6 exposure formed 3 times more mammospheres compared to the control.

Conclusion. Usage of cells with confuence of no more than 80 % and accutase for detachment of cells is recommended for mammosphere assay. Incubation of CD44^– CD24⁺ T47D cells with IL6 for 24 hours is suffcient for stimulation of stemness plasticity. 

The purpose of the study was to identify functional features of circulation monocytes in patients with nonmetastatic breast cancer.

Material and Methods. The study cohort consisted of 10 breast cancer patients treated at Tomsk Cancer Research Institute. 7 healthy female volunteers were enrolled as a control group. CD14+16-, CD14+16+ and CD14-16+ monocytes subsets were obtained from blood by sorting. Whole transcriptome profling was provided in monocytes from patients and healthy females. Macrophages were differentiated from the obtained monocytes under in vitro conditions. The ability of conditioned media obtained from macrophages to infuence apoptosis and proliferation of MDA-MB 231 cell line was evaluated.

Results. Transcriptomic profling revealed signifcant changes in monocytes of breast cancer patients. CD14+16- subset showed higher expression of transporters ABCA1 and ABCG1; chemokines CCR1, CRRL2, CXCR4; maturation and differentiation factors Mafb and Jun; endocytosis mediating factors CD163 and Siglec1; proteases and tetrasponins ADAM9, CD151, CD82, and growth factor HBEGF in patient group. Macrophages derived from monocytes of breast cancer patients produced factors that supported proliferation of the MDA-MB 231 cell line, which was not observed for monocytes from healthy volunteers.

Conclusion. Thus, breast carcinoma has a systemic effect on peripheral blood monocytes, programming them to differentiate into macrophages with tumor supporting capacity. 

Background. Prostate cancer (PCa) is the most common human cancer worldwide. In the progression of prostate cancer, the total number of macrophages in the tumor tissue is associated with poor prognosis and increased risk of metastasis. However, the heterogeneity of intratumoral macrophages at various stages of PCa development, and the role of tumor-associated macrophages (TAMs) have been insuffciently investigated.

The aim of the study was to analyze the morphological features, size and number of TAMs in PCa tissue samples, and to reveal their correlation with clinical data of patients.

Material and Methods. Immunohistochemical analysis of 36 paraffn blocks of patients with PCa (pT2a–3bN0–1M0) was performed using antibodies to the scavenger receptor CD68.

Results. Foamy CD68+ macrophages were found in the tumor tissue. The indicator “number of macrophages per total number of felds of view with macrophages” was the lowest in patients with a Gleason score of 6 (5.8) (11.0 – in patients with a Gleason score ≥ 8). Macrophages formed larger clusters in patients with severe PCa. Small but not large macrophages were signifcantly more common in patients with lymph node metastases (48 vs 24 in the N0 group; p=0.14). The number of small macrophages (smaller than 100 µm²) increased in a series of patients with Gleason scores of 6, 7 and ≥ 8 (24, 47.5, 72, respectively, p=0.052).

Conclusion. As the tumor process progressed and the risk of biochemical recurrence increased, there was a trend towards an increase in the total area of large, foamy TAMs, presumably rich in lipids, as well as wider distribution of small macrophages with a tendency to form clusters. We hypothesize that foamy macrophages are involved in the further recruitment of small TAMs, subsequently leading to metastasis and tumor progression. 

Background. Curcumin is a polyphenol that has pharmacological activity that can inhibit tumor cell growth and induce apoptosis through various mechanisms. However, the specifc mechanism of curcumin cytotoxicity remains controversial because of many anti- and pro-apoptotic signaling pathways in various cell types.

This study aims to examine the relationship among curcumin on RASSF1A, Bax protein levels, and caspase-3 activity in supporting the apoptotic mechanism in CSA03 breast cancer cells.

Material and Methods. Curcumin administration to cancer cells is based on differences in dosage with 24-hour incubation. Cytotoxicity after curcumin administration was determined using MTS. RASSF1A and Bax protein levels were tested through ELISA. Caspase-3 activity was used to determine apoptosis and was tested using fow cytometry.

Results. The results indicated that curcumin had a cytotoxicity effect of 40.85 µg/mL. At concentrations of 40 µg/mL and 50 µg/mL, curcumin increases levels of protein RASSF1A (∆ = 26.53% and 47.35%, respectively), Bax (∆ = 48.79% and 386.15%), and caspase-3 (∆ = 1,678.51% and 1,871.889%) signifcantly.

Conclusions. Curcumin exhibits anti-proliferative activity and apoptotic (Caspase-3) effects through activation of RASSF1A and Bax. 

Background. Nanoparticles (NPs) of zinc and silver oxide are promising antitumor agents, the use of which can enhance modern approaches to cancer treatment. Using bicomponent ZnO-Ag nanoparticles, one can increase the efficiency due to the occurrence of a synergistic antitumor effect. Among the main physicochemical properties that affect the antitumor activity of nanoparticles, one can distinguish their size and distribution of components inside the particle or their microstructure, however, these aspects are currently poorly understood.

The aim of this study is the synthesis of ZnO-Ag nanoparticles using electrical explosive of wire technology and the in vitro study of the antitumor activity of NPs against breast ductal adenocarcinoma MCF-7 (ATCC HTB-22) and the HeLa cell line isolated from a cervical tumor.

Material and Methods. ZnO-Ag nanoparticles were obtained by simultaneous electric explosion of zinc and silver twisted wires in a gas mixing atmosphere: argon and oxygen. The content of the components was regulated by varying the wire diameters. Physicochemical properties were studied using X-ray phase analysis, thermal desorption of nitrogen, and transmission electron microscopy. Antitumor activity in vitro was studied using the MTT test against HeLa and MCF-7 cell lines.

Results. As a result of an electric explosion of twisted wires in an argon + oxygen gas mixture, ZnO-Ag NPs with different contents of components and the structure of Janus nanoparticles were obtained. The study of the physicochemical properties of nanoparticles showed that an increase in the silver content led to a decrease in the average particle size, an increase in their specific surface area, an increase in their photochemical activity and the ability to generate reactive oxygen species. The high antitumor activity of nanoparticles with a minimum silver content can be explained by a decrease in the size of silver fragments from 46 nm to 23 nm and a decrease in the average particle size from 92 nm to 54 nm. A decrease in the size of NPs and their components contributes to an increase in their solubility and, accordingly, cytotoxicity. In addition, a decrease in the size of crystallites makes it possible to increase the number and length of the ZnO-Ag interface.

Conclusion. In the present study, bicomponent ZnO–Ag NPs were synthesized using the joint electric explosion of zinc and silver wires in a mixed atmosphere of argon and oxygen. A study of the physicochemical properties of nanoparticles was carried out and it was found that they all have the structure of Janus nanoparticles, an average size of 54 to 92 nm, and photochemical activity and the ability to generate ROS. Using the MTT test, the antitumor activity of NPs was confrmed using MCF-7 and HeLa cell lines. The high effciency of ZnO-Ag NPs containing 20% wt. silver indicates the possibility of using these NPs in antitumor therapy. 

Background. Pleural metastases of thymic epithelial tumors are detected in 5–7 % of patients at initial diagnosis and in 10 % of patients during a follow-up after radical surgery for the primary tumor. Partial pleuroectomy is the cornerstone of treatment strategy in this group of patients.

The aim of the study was to assess the role of surgery in the treatment of patients with thymic epithelial tumors with pleural dissemination.

Material and Methods. From January1, 2010 to June 30, 2021, 21 patients with thymic epithelial tumors (thymoma – 13, thymic cancer – 8) and pleural implants (stage IVA – 11, isolated pleural metastases as tumor progression after radical surgery – 10) underwent partial pleuroectomy with resection of the diaphragm and lung if necessary. Four patients underwent inthraoperative photodynamic therapy and another 4 patients received intrapleural hyperthermic chemotherapy.

Results. R0 resection was performed on 12 (57.2 %) patients. Postoperative complications were observed in 6 (28.6 %) patients. The mortality rate was 7.5 %. The overall 1-, 3- and 5-year survival rates were 78 % (95 % CI 61–95), 49 % (95 % CI 23–75), and 41 % (95 % CI 15–67), respectively. The median overall survival time was 29 months (95 % CI 0–60.6). Recurrence occurred in 10 (47.6 %) cases. One-year recurrence-free survival was 60 % (95 % CI 30–90). Independent negative predictors for overall survival were: thymic cancer, incomplete resection, presence of postoperative complications and local recurrence.

Conclusion. Surgery is the mainstay of treatment for patients with pleural metastases (stage IVA thymomas and recurrent thymomas). Metastasectomy of pleural implants will be suffcient to achieve a complete resection. 

The purpose of the study was to search for data on the evolution of virtual planning of reconstruction with a fibular graft.

Material and Methods. A literature search was carried out in Scopus, RSCI databases in the time interval from 1975 to 2021 using the keywords: “computer”, “surgery”, “facial”, “microsurgery”, “fibula”, “implant”, “fibular flap”, “planning”.

Results. Various planning techniques with a description of technical features and estimation of advantages and disadvantages as well as methods of minimizing errors and reducing the time spent on the modeling with an improvement in functional and aesthetic outcomes were discussed. Surgical workflows of robot-assisted osteotomies of a fibular graft were described. Complications, difficulties, and the financial aspect of fibula free flap maxillofacial reconstructions were assessed.

Conclusion. Virtual planning of microsurgical reconstructions using a fibular graft reduces operating time. The accuracy of graft fixation is increased and diastases between the osteotomy lines as well as between the native jaw and the graft are decreased. Planning allows surgeons to improve symmetry or keep it in the original form, thus affecting the aesthetic aspect and emotional state of the patient. Virtual planning requires certain financial costs, but the wide range of benefits should convince the professionals to use it as often as possible. 

Background. Colorectal cancer is among the most lethal and prevalent malignances in the world. The management of localized colorectal cancer is highly debated. Surgical resection of the rectum, such as total mesenteric excision (TME) is usually associated with significant morbidity and mortality. The integration of various chemotherapy options into the standard treatment of localized rectal cancer could potentially enhance the tumor control with a subsequent reduction in the frequency of recurrence, thus improving overall and disease-free survival. Moreover, there are categories of patients for whom surgical treatment is contraindicated and chemotherapy will be more useful for them. Although rectal cancer is predominantly a disease of older patients, current guidelines do not incorporate optimal treatment recommendations for elderly patients with comorbidities; therefore this issue remains a matter of debate.

Aim. We aimed to consider alternative approaches to the treatment of localized rectal cancer and the management of selected patients with this diagnosis.

Material and Methods. We searched for publications in the Pubmed, eLibrary databases and up-to-date information on the basis of world cancer associations.

Conclusions. Comparison of surgery with concurrent chemoradiotherapy for localized rectal cancer showed that in some cases neoadjuvant therapy can be useful and successful, acting as an ideal alternative. However, this approach may be suitable for selected patients who meet certain criteria. In addition, a follow-up care after treatment should include a specific range of diagnostic imaging tests. 

Purpose of the study to analyze current ideas about the relationship between the microbiota (microbiome) and the human body in the aspect of cancer pathogenesis, ambivalent character of these interactions, and the role of the immune system and immunoinfammatory status that promotes carcinogenesis or prevents neoplastic processes.

Material and Methods. Literature search was carried out using Medline, Cochrane Library, Elibrary and PubMed systems, including publications over the last 7 years.

Results. The microbiota includes all communities of commensal, symbiotic, and pathogenic microorganisms: bacteria, fungi, archaea, and viruses that colonize the gastrointestinal tract and other organs and tissues. The microbiome is an important factor in cancer pathogenesis due to its involvement in the basic physiological functions of the host, such as digestion, development of the immune system, and modulation of endocrine functions. In the review, the influence of microbiota of different locations (gastrointestinal tract, breast, intravaginal tract) on the development and progression of breast, colorectal and cervical cancers was discussed. The role of the microbiome in cancer pathogenesis is realized by the participation in neoplastic transformation of the epithelium, regulation of tumor progression under conditions of manifested malignant process, and modifcation of the therapeutic effect of standard drugs, including the development of original probiotic-based anticancer agents. The study of the mechanisms of action of the microbiome in the host organism opens up prospects for the development of new approaches to cancer therapy. Particular attention was paid to the mechanisms of the immunomodulatory effect of the microbiota in terms of reducing the risk of malignancy, regulating tumor progression and participating in antitumor therapy. The clinical significance of determining pathogenetically significant microbial markers associated with the aggressive form of cancer, response to treatment and toxicity of therapy was discussed. Particular attention should be paid to the potential mechanisms of interaction between cancer – microbiome – probiotics, since the latter can provide modification of malignancy processes, exert an antitumor effect, and modulate the effectiveness of drug therapy. The feasibility of editing the microbiota by probiotics was considered, and antitumor properties (effects) of bacteria and strategies for modifying the microbiome for the prevention and treatment of cancer were discussed. 

Background. BRCA1 and BRCA2 were discussed as the basis of inherited adenocarcinoma and breast and ovarian malignancy. Ovarian cancer is uncommon in women below 40 years of age, and prostate cancer mainly occurs in older men cause 90 % in those above sixty-fve.

Objective. The main objective of this paper is to investigate the relationship between ovarian and prostate cancer with the BRCA1 and BRCA2 genes.

Material and Methods. The ovarian and prostate cancer mechanism is discussed in detail, and their preventive measures with screening techniques are also demonstrated. This systematic review collected the related articles from online databases using the key terms ovarian cancer, prostate cancer, BRCA genes, mutation, polymorphism, carcinoma, sarcoma, and genetic association.

Results. Based on the obtained information, it is found that the BRCA genes are highly associated with prostate cancer in men, and in women, it is significantly linked with breast cancer than ovarian cancer.

Conclusion. Therefore, early diagnosis and genetic testing for BRCA1&BRCA2 genes in both men and women are necessary. In some cases, these genes might even cause different types of cancer like pancreatic cancers. Identifying individuals with tumour-HRD through mutations in the homologous repair pathway and determining this gene expression is essential to improve treatment techniques developed during the previous decade and rapidly make their way into clinical trials practice. However, the safe introduction of these medicines into everyday practice will require a thorough understanding of treatment targets and associated adverse effects. 

Objective of the study to analyze and summarize the available data on the role of glycodelin in carcinogenesis and its expression in various cancers.

Material and Methods. A literature search was conducted in Medline, PubMed Central, NCBI databases in the time interval from January 1983 to October 2019 using the key words glycodelin and cancer. Of the 104 publications found, 21 were used to write the review.

Results. This paper presents the overview of the findings in current research focusing on the properties of glycodelin, the major lipocalin protein of the human reproductive system. Some lipocalins are known to play a key role in cancer development as well as influence signaling pathways in the regulation of cell motility, differentiation and neovascularization. Most likely they can be used as cancer markers. Glycodelin A is determined in serum and, due to its special immunoregulatory properties, can serve as a useful prognostic marker and a promising target for future anti-cancer therapies. The presence of glycodelin A in breast cancer tissue is known to be mostly linked to a better prognosis than is attributed to glycodelin-negative tissue, as glycodelin is a protein typical of differentiated tissue. On the other hand, glycodelin might play a role in neovascularisation, thereby promoting tumor growth. Glycodelin is a biomarker of aggressive malignant pleural mesothelioma and a prognostic biomarker of metastatic non-small cell lung cancer at late stages. Glycodelin hyperexpression is associated with brain metastasis in lung adenocarcinoma, and its determination can be used as an additional prognostic factor.

Conclusion. The review refects basic scientifc data and results of clinical trials, as well as identifes future prospects that allow the development of new methods for cancer detection and treatment. It should be noted that glycodelin plays an important role in tumor development, progression, angiogenesis, and the formation of distant metastases, and therefore can serve as a useful diagnostic and prognostic marker. Further studies of the functional properties of glycodelin are needed to develop promising strategies in cancer therapy. 

Background. Gastric cancer is the 5th most common cancer and the 3rd leading cause of cancer death globally. In Russia, gastric cancer is the 2-nd leading cause of death (10.7 %). Surgery in combination with perioperative/adjuvant chemotherapy is the standard treatment for locally advanced gastric cancer. Four cycles of neoadjuvant chemotherapy and 4 cycles of adjuvant chemotherapy with the FLOT regimen is the most widely used treatment modality. The basis for the widespread use of this chemotherapy regimen was the results of a large randomized FLOT4 trial, according to which the perioperative FLOT regimen showed greater efficacy compared to the ECF regimen.

The aim of the study was to demonstrate the feasibility of achieving patholopgical complete response and long-term remission after one course of neoadjuvant chemotherapy with FLOT regimen in a patient with locally advanced gastric cancer.

Case description. A 69-year-old patient presented to A. Tsyb Medical Radiological Research Centre with complaints of general weakness, moderate epigastric pain for 2 months. The examination revealed stage T3N0M0 IIA gastric cancer. The patient received one cycle of neoadjuvant chemotherapy with the FLOT regimen. Given the fact, that the patient developed massive bleeding from the tumor, it was decided to stop neoadjuvant treatment. Subtotal gastrectomy with D2 lymph node dissection was performed. Histological examination of the surgical specimen revealed pathological complete response (grade 1a according to the classification of K.Becker et al., 2003). The patient is alive with no signs of disease progression for more than 36 months after starting the treatment.

Conclusion. This clinical case demonstrated personalized approach to the treatment of patients with locally advanced gastric cancer. Pathological complete response was achieved after one cycle of neoadjuvant chemotherapy. 

The purpose of the study. Mesenchymal tumors of the esophagus comprise 2 % of all esophageal tumors. Leiomyosarcoma is the most common mesenchymal tumor in the esophagus (up to 80 %). It is located in the lower third of the esophagus. The main treatment modality of leiomyosarcoma is surgery. Due to the low frequency of occurrence, there are no unified approaches to the choice of surgical volume and access. Minimally invasive techniques have advantages over open approaches. However, final treatment approach depends on many factors: localization and location of the tumor around the circumference of the esophagus, as well as size. Endoscopic resection is feasible for small tumors with an intramural growth. In case of large leiomyomas, Lewis operation should be performed. In all other cases, tumor enucleation is the gold standard of treatment. The issue of minimally invasive surgical access is relevant. Thoracoscopic access has limitations for tumors located in the lower thoracic esophagus closer to the esophageal-gastric junction. In this regard, a laparoscopic approach with the possibility of transhiatal mobilization of the esophagus provides an adequate opportunity for tumor enucleation.

Clinical case description. We hereby report our case study in which we employ the use of laparoscopic transhiatal enucleation to remove leiomyoma of the lower thoracic part of the esophagus. A 47-year-old female presented to P.A. Herzen Moscow Oncology Research Institute with complaints of pain in the epigastrium, discomfort behind the sternum when taking solid food. R0 resection was performed. During the one year follow-up period no sign of disease recurrence was observed.

Conclusion. This approach, in our opinion, is fully justified, with careful selection of patients and compliance with guidelines of cancer surgery. Laparoscopic approach with transhiatal mobilization of the esophagus provides a good opportunity to perform the enucleation of mesenchymal tumors localized in the lower third of the thoracic region, at the level of the supraphrenic and abdominal segments.