bluuebunny/crossref_metadata_2025 huggingface dataset:
New pharmacological effects of caripazim
Authors: Kukushkin German V. , Zhuravleva Marina V. , Sviridkina Lyudmila P. , Yurov Dmitry E.
Published: September 2020

The effects of a proteolytic enzyme found in papaya milk juice (caripazim) on the rate of lymphatic drainage of tissues and the pharmacokinetics of cefotaxime were studied in experiments on rabbits and mice. During the study, caripazim was administered to experimental animals, and the rate of removal of Evans blue from the mesentery of mice, as well as the concentration of cefotaxime over time in the blood plasma of rabbits and the blood plasma, intestinal tissues, and livers of mice, after 1.5 and 24 h of antibiotic administration following injection of caripazim, were determined. Thus, the lymphostimulatory properties of caripazim were revealed. Its preliminary administration increased the concentration of cefotaxime in the blood plasma of rabbits in comparison with single administration of an antibiotic at all points of the study (1.5, 3, 4.5, 6, 8, 12, and 24 h). This coincides with the data from the study of the level of antibiotic in the blood plasma of mice. Administration of cefotaxime after injection of caripazim leads to an increase in its content in the intestinal tissue, after both 1.5 and 24 h, but does not affect at the accumulation of the antibiotic in the liver. The concentration ratio liver tissue / blood in mice in the main group was significantly lower than that in the control group, both 1.5 and 24 h into the experiment, which indirectly indicates a decrease in hepatic antibiotic extraction. The data obtained indicates that caripazim has the properties of an endolymphatic conductor.
Efficacy of radiotherapy vs. The combination of radio- and immunotherapy: a systematic review and meta-analysis
Authors: Voronova Veronika M. , Lebedeva Svetlana A. , Sekacheva Marina I. , Helmlinger Gabriel , Peskov Kirill V.
Published: September 2020

Introduction and objectives. The combination of radiotherapy and immune checkpoint inhibitors has demonstrated antitumor activity in numerous preclinical studies and is currently being investigated in the clinical setting. This study aims to compare the efficacy of radiotherapy alone (RT) vs. the combination of radio- and immunotherapy (IT-RT) and identify the treatment regimen associated with maximal efficacy by using a meta-analysis.

Materials and methods. A systematic literature search was performed using the PubMed database and materials of the key oncology congresses. Studies reporting 1-year overall survival (OS) of patients with brain metastases undergoing IT-RT treatment were included in the analysis. Information about 1-year OS, individual patients characteristics, and treatment regimens for both IT-RT and control RT arms was extracted. Identification of the optimal treatment regimen was performed using a mixed meta-regression modeling approach. Analysis was performed using the R statistical environment (metafoR package).

Results. In total, 30 studies were identified, of which 13 reported outcomes for the control RT groups. The analysis revealed that IT inclusion into RT is associated with a significant increase in 1-year OS; given simultaneously, IT and RT demonstrated the highest efficacy with a 1-year OS of 68% (95% confidence interval (CI): 60%75%), followed by a sequential regimen: 1-year OS = 54% (95% CI: 47%61%) and RT alone: 1-year OS = 32% (95% CI: 2539%).

Conclusion. The current study demonstrates the superiority of combined IT-RT over RT alone; simultaneous IT and RT treatment is associated with the highest efficacy.
Assessment of persistent digestive system dysfunctions in sociomedical examination
Authors: Stolov S. V. , Ugleva E. M. , Yamshchikova T. Yu. , Makarova O. V.
Published: September 2020

Based on data in the literature, this article provides criteria for assessing persistent digestive system dysfunction. This issue must be considered when referring or conducting a sociomedical examination of patients with gastrointestinal tract pathology to establish a disability group, taking into account the aspects of the existing Order No. 585 of the Ministry of Labor of Russia, On classifications and criteria used in the implementation of sociomedical examination of citizens by federal state institutions of sociomedical examination.
Comparative efficiency of various accupucture methods in early rehabilitation of patients after ischemic stroke
Authors: Molchanova E. E. , Polunina V. V. , Plotnikov V. P. , Polyaev B. A.
Published: September 2020

Three hundred and thirty patients aged 3579 years, who underwent early rehabilitation in the primary vascular department, participated in a randomized controlled trial. In 220 patients (the main group of the study), non-drug rehabilitation (in the form of a combination of physiotherapy and exercise therapy) was optimized using various reflex therapy methods. The effectiveness of including them in rehabilitation schemes was analyzed in seven subgroups. One hundred and ten patients (the comparison group) underwent comprehensive non-drug rehabilitation without the inclusion of reflex therapy. The effectiveness of rehabilitation measures was evaluated by assessing dynamics (on the first day and after two weeks) according to the National Institutes of Health Stroke Scale, Barthel index, Beck questionnaires (level of depression), Spielberger-Hanin (level of reactive anxiety), and the Motivation for Success and Motivation for Fear of Failure (level of motivation) questionnaire tests. The best indicators on almost all scales were obtained in groups where patients underwent combined reflex therapy techniques: dynamic electroneurostimulation (DENS) in combination with classical acupuncture, su jok therapy in combination with classical, auricular acupuncture and craniopuncture, and prolonged craniopuncture in combination with corporal and auricular acupuncture. Indicators were slightly lower in the cases when separate methods were applied: DENS or su jok, and in subgroups where corporal and auricular acupuncture were combined with craniopuncture (according to the methodology of Professor Yu Zhi Shun, China), or craniopuncture according to classical methodology. The lowest indicators were in the group of patients who did not use methods of reflex therapy. This study confirmed the need to integrate acupuncture techniques in the schemes of early neurorehabilitation schemes of post-stroke patients for whom combined technologies are most effective.
Local tissue interleukine profile in breast cancer
Authors: Gantsev Shamil Kh. , Bakiyev R. R
Published: September 2020

Breast cancer ranks first in the structure of oncological diseases in women in Russia and in the World. In recent years there have been numerous reports that the growth and progression of breast cancer and other tumors depend not only on their malignant potential, but also on stromal factors presented in the tumor microenvironment and intercellular interactions. The aim of our study was to evaluate intercellular interactions of the tissues surrounding the tumor, by means of determination of the locally interleukine profile. We have identified interleukine profiles of the axillary fatty tissue from the lesions and subcutaneous fat of the anterior chest wall, located at a maximum distance from the tumors, in stage IIa-IIIb breast cancer patients. As a result we came to a conclusion: the method based on the measurement of IL-1, IL-2, IL-6, IL-10 and а-TNF levels in the tissues and in the blood allows to evaluate the immune processes occurring in the tissues surrounding the tumor; adipose tissue of various areas of breast cancer patients differs significantly according to the level of interleukines, which indicates that different involvement of adipose tissue in various areas of the immune response; there is a dependence of the local immune status of armpit adipose tissue on the expression of ER, PgR, Her2/neu on the surface of breast cancer cells.
Nutritional problems in patients with digestive tract cancer, possible ways for solutions
Authors: Shoykhet Ya. N , Galkina Oksana M. , Lazarev A. F
Published: September 2020

Malignant neoplasms of the digestive system occupy a leading place among all cancer patients. Approximately one third of all cancer deaths worldwide was linked to improper nutrition and diet, and took the second place as theoretically preventable causes of cancer. Modern methods of surgical treatment of cancer patients have an aggressive nature, causing pronounced stress in the body and give rise in metabolic disorders with changes in nutritional status. One of the prevention methods is the use of nutritional support, especially in patients who received radical surgery.
Salvage radiation therapy after radical prostatectomy with the use of new technologies in radiation oncology
Authors: Tkachev S. I , Matveev V. B , Bulychkin Petr V.
Published: September 2020

Introduction: prostate cancer (PCa) is the second cancer after lung one among all males. The main treatmentfor patients with localized prostate cancer is a radical prostatectomy (RP). After RP PCa occurs in patients at the T1-T2 stage - in 25 - 35% of all cases and in patients at the T3 stage - in 33.5 - 66% of all cases. Currently, one of the treatment options for patients with recurrence PCa after RP is a «salvage» radiation therapy. Materials and methods: medical records of 59 patients with PCa recurrence after radical prostatectomy (pT1-3pN0M0) were analyzed. Biochemical recurrence was observed in 25 (42,4%) and clinical recurrence in 34 (57,6%) patients. Radiotherapy have been prescribed to the regional lymphatic nodes to 44,0 Gy of 2,0 Gy each, to the prostate bed to 66,0 Gy of 2,0 Gy each and if the region of the clinical recurrence was identified - to 72 Gy of 2,0 Gy. Treatment was realized on linear electron accelerators using 3D technology radiotherapy: 3DCRT, IMRT, VMAT. Results: all 59 patients were treated by the «salvage» radiotherapy. Median follow-up was 48 months (24-91). Biochemical control w as achieved in 51 (86.4%) patients, locoregional control in 58 (98.3%) patients. No acute and late grade 3 or greater toxicities were observed.
The use of anti-EGFR monoclonal antibodies-EGFR blockers in the comprehensive treatment of metastatic colorectal cancer with or without the surgical removal of metastases
Authors: Kit O. I , Vladimirova L. Yu , Abramova Nataliya A. , Storozhakova A. E , Kalabanova E. A , Kabanov S. N , Popova I. L , Novoselova K. A , Tkhanovskaya N. M , Agieva A. A , Snezhko T. A , Samaneva N. Y
Published: September 2020

Clinical data on the efficacy and safety of cetuximab and panitumumab in 87 patients in the 1-4 lines of drug therapy for metastatic colorectal cancer (mCRC) with wild-type RAS with and without surgical removal of metastases were analyzed. Anti-EGFR drugs were prescribed for patients in the first line of therapy in 64.4%, in the second line - 14.9%, in the third line - 13.8% and 6.9% - in the fourth line. 14.9% of patients continued anti-EGFR therapy after progression during 2-3 lines (with the change of cytostatics). The use of anti-EGFR drugs in treatment for mCRC was shown to provide satisfactory results of overall survival rate and progression-free survival. The most important result of the analysis is the revealed significant increase in median overall survival from 13.4±1.6 to 18.7±2.3 months (p = 0.04838) in patients who had anti-EGFR therapy and chemotherapy with surgical treatment of distant resectable metastases. Manifestations specific for anti-EGFR drugs dermal toxicity were tolerable and managed with medical correction.Of the patients who has been undergone to cytoreductive surgical interventions for resectable metastases, clinically significant complications of the surgery were observed in 17.2% ofpatients.
Epidemiological aspects of the prevalence of thyroid cancer in the Azerbaijan Republic over the period of 2009-2015
Authors: Mardanli Fuad A. ogly , Aliyev A. D , Guliyev N. A , Aliyeva I. D , Aliyeva A. M
Published: September 2020

Analysis of the prevalence of thyroid gland cancer (TGC) of the population of Azerbaijan over the period 2009-2015 showed a relatively unfavorable situation, as evidenced by the steady rise in the morbidity rate of this nosology. Over 7 years, there was noted the gain in coefficients of extensivity and intensity of the given pathology among the population of the Republic. Prevalence factor for TGC has increased till 2015 by almost 2 times (11.7 0/0000 vs. 5.20/0000). The peak of the incidence corresponds to the age group of 50-59 years (0.60/0000). Five-year survival for this nosology has tended to the decrease, and varied in the range of from 36.3% to 29.0%.
Prior malignant neoplasms as a risk factor for the second cancer in a cohort of employees of enterprises of the nuclear industrial complex
Authors: Osipov Mikhail V. , Sokolnikov M. E
Published: September 2020

Purpose. Assessment of the persistence ofprevious malignancy as a risk factor for the detection of subsequent cancer in a cohort of nuclear workers. Material and methods. Retrospective cohort study with 60 years of follow-up on 22.373 workers of nuclear facility recruited from 1948 to 2008, with the use of data on individual external and internal dosimetry, and information about cancer incidence and mortality rate due to cancer neoplasma (CN). Results. In the studied cohort second and subsequent CN were diagnosed in 6,4% cases, out of them 92,4% were cases of second cancers, in other cases the number of CN was more than two. 8% of cases ofprimary multiple cancers were presented by non-melanoma skin cancers (NMSC). Mean age ofpersons with more than one diagnosis of cancer was 67 years. The relative risk of the detection of second CN (excepting NMSC) among persons with already diagnosed previous cancer was about 4 times higher in comparison in persons without diagnosis of solid cancer. Discussion. Detected solid tumors were proposed to be diagnosed in the order of their occurrence, but it cannot be excluded that in different latent periods of solid cancers of various localization this condition may fail to comply. The radiotherapy and the effect of dispanserization could play the essential role in the occurrence of second and subsequent cancers when the possibility of the detection of CN in a patient being under dispensary observation by oncologist is higher than in persons without dispensary observation. At the same time, the one possibility of carcinogenic effect of the first malignancy must not be excluded. Conclusions. Cancer risk among nuclear workers who have previous malignancy was 4 times higher in comparison with workers who had no previous diagnosis of cancer.
THE BRAF MUTATION V600E IN PAPILLARY THYROID CANCER, CLINICAL-MORPHOLOGICALPARALLELES AND PROGNOSIS
Authors: Ivanov A. A , Avdalyan A. M , Gerval’d V. J , Lushnikova E. L , Zorkina Yu. N , Kruglova N. M , Lazarev A. F
Published: September 2020

On the material of the 67 cases of papillary thyroid cancer (PTC) authors executed the study of the interrelationship between the BRAF mutation V600E and the forecast, biomolecular and morphological characteristics of the disease. There was implemented the analysis of samples for the presence of 7 KRAS gene mutations, 4 mutations of the PIK3CA gene, mutation BRAF V600E with the revealing of the interrelationship between such biomolecular markers for proliferation and apoptosis as Ki-67, p53, Bcl2. Also there was performed chromogenic hybridization (CISH method) in situ to study the status of the HER2 gene. There was determined the interrelationship between BRAF mutation V600E and clinical indices of prognosis: tumor sizes, capsule invasion, presence of metastases in regional lymph nodes. In addition, there was evaluated the interrelationship between BRAF mutation V600E and 10-years survival rate. No mutation were identified in KRAS, PI3K genes. BRAF mutation V600E was identified in 50 cases (75%). The frequency of V600E in women accounted of 75 ± 6.4%, in men - 67 ± 27.1%. In patients with the presence of V600E the size of a node was slightly less than in the absence of mutations and in 76% of cases did not reach the average value of 1.8 cm. Invasion into the capsule was identified in 35 ± 12.7% cases with a positive BRAF mutation V600E status and in 56 ± 8.4% - in cases with a negative status. Metastases in regional lymph nodes occurred in 36 ± 11.6% in patients with V600E and in 47 ± 18.9% of cases without this mutation. There was obtained the interrelationship between V600E and Ki-67: the average level of the proliferative activity in the presence of the given mutation was 4.4 ± 0.6%, in the absence - 9.4 ± 3.9%. No interrelationship was obtained between V600E and other biomolecular parameters or this interrelationship was tendentious in character. In terms of 10-years survival the groups with or without V600E statistically did not differ. Based on the data, it was possible to say about the absence of the negative impact of V600E on the prognosis in PTC patients
IMMEDIATE AND REMOTE RESULTS OF PALLIATIVE SURGERY IN PATIENTS WITH METASTATIC COLORECTAL CANCER
Authors: Kulikov E. P , Ryazantsev M. E , Verkin N. I , Golovkin E. Yu , Porvatova M. A , Vinogradov I. Yu , Mertsalov S. A , Volodina L. N
Published: September 2020

The significance of the study is associated with the high level of the morbidity rate of colorectal cancer, generous amount of patients with the 4th stage and the necessity of the research of palliative surgical treatment. A retrospective analysis of 364 cases with metastatic colorectal cancer included 58 patients with palliative colon resection and 306 patients with bypass anastomosis and unloading stoma. Evaluated parameters are the frequency of postoperative complications, postoperative mortality rate, median survival and one-year survival. In the group of palliative resections the frequency of postoperative complications and postoperative mortality rate were 32.7% and 20.6%, in the group of symptomatic operations the same results were 12.1% and 8.8%. Median survival, one-year survival in the group of palliative resections are longer than in the group of symptomatic operations - 10.0 and 5.1 months, 37.0% and 18.3%, respectively (p < 0.05). However, after stratification of studied subgroups according to the sign of the presence or absence of post-operative chemotherapy the survival were shown to be higher in patients with chemotherapy and hardly depended on fact of the removal of the primary tumor. To our opinion the high rate of postoperative complications and the postoperative mortality rate after palliative resections of the colon can be corrected by more precise determination of indications to their performance in emergency surgery. The improvement in survival indices is associated with the execution of postoperative adjuvant chemotherapy.
NUTRIENT CORRECTION OF FUNCTIONAL AND METABOLIC DISORDERS IN CHILDREN WITH CEREBRAL MEDULLOBLASTOMA
Authors: Korchagina Ya. A , Dolgikh V. T , Leonov O. V , Erschov A. V
Published: September 2020

The goal is to assess the effectiveness of the use of nutritional support in children with medulloblastoma after surgical treatment and standard radiotherapy. Material and methods. We examined and treated 80 children with cerebellar medulloblastoma, aged of from 6 to 16 years. The treatment was complete surgical removal of the tumor with subsequent chemoradiation therapy (40 children) and nutritional support in the form of isocaloric mixture Nutricomp Standard Liquid (40 children). Hematological and biochemical indices were evaluated before and after treatment for 60 days. Results. There were revealed anemia, thrombocytopenia, lymphocytopenia and monocytopenia. There was diagnosed the partial functional liver failure. As a result of liver failure and catabolic orientation of biochemical processes there was revealed the accumulation of oxidized products of carbohydrate and nitrogen metabolism. Nutrients were found to contribute to less secondary alteration and faster tissue repair, normalize the intensity of processes of free-radical oxidation, detoxification processes and haematopoiesis, synthesis and catabolism, the intensity of metabolic reactions. Conclusion. The introduction of nutrients in the complex chemotherapy of children with cerebral medulloblastoma contributes to normal metabolism of macro- and micronutrients, as well as to processes directly linked and dependent on their concentration, less secondary alteration and faster tissue repair, normalize the intensity of processes of free-radical oxidation, detoxification processes and haematopoiesis, synthesis and catabolism, the intensity of metabolic reactions
CHARACTERISTICS OF STEROID METABOLISM IN MALE RATS AT STAGES OF EXPERIMENTAL LIVER METASTASIS
Authors: Kaplieva I. V , Frantsiyants E. M , Trepitaki L. K , Cheryarina N. D , Pogorelova Yu. A
Published: September 2020

The aim of the study was to reveal characteristics of steroid metabolism in tumor, metastases, adrenal glands (AG) and blood serum (BS) in male rats in the course of liver metastasis, as well as diagnostic signs of metastases. Material and methods. The study included 44 white male rats weighing 180-250 g. S-45 sarcoma was transplanted intrasplenically. Estrone, estradiol, free testosterone, 17-OHP, cholesterol, cortisol (in tissues and BS), DHEAS (in tissues), DHEA and ACTH (in BS) were studied by the using standard test kits for ELISA and RIA. Results. We found that the pituitary gland does not participate in liver metastatic process (low ACTH in BS). AG are assumed to play a regulatory role of steroidogenesis in tissues. Characteristics of liver metastases that not re-metastasize - non-active metastases (NAM) are: decreased cortisol in the perifocal zone (PZ) and the less estrone increase in metastases. Characteristics of metastases that re-matastasize to lungs - active metastases (AM) are: increased cortisol in PZ and the greater estrone gain in metastases. Hypo-estradiolemia and hyper-testosteronemia were diagnostic criteria for the upcoming liver metastasis; hyper-estradiolemia along with the decline of free testosterone - signs of liver metastases; hyper-cortisolemia and hypercholesterolemia are for AM in experimental liver metastasis, hypo-cortisolemia and hypocholesterolemia are signs of NAM in the liver of male rats. Conclusion. Consequently, one of the detected pathogenetic mechanisms of liver metastasis is presented by deactivation of the central pituitary regulation of steroidogenesis with regulating function passed to AG which results in steroid imbalance with accumulation of estrone in metastases and multidirectional changes in cortisol levels in PZ and BS, depending on the activity of metastases.
STUDY OF THE EFFECTIVENESS OF TARGETED THERAPY IN METASTATIC RENAL CELL CARCINOMA PATIENTS
Authors: Alekseeva Galina N. , Gurina L. I , Volkov M. V , Evtuchenko E. V
Published: September 2020

Objective. To study the relapse-free overall survival in metastatic renal cell carcinoma (mRCC) patients after the targeted therapy and to develop optimal approach to the treatment shedule. Material and methods. The research included 88 mRCC patients of mean age of 55.5 + 9.6 years, 63 (71.6%) men and 25 (28.4%) women. 42.0% patients had a favorable prognosis, 52.3% - intermediate one and 5.7% of the cases had poor prognosis. First line targeted therapy was carried out in 88 patients, the second line - in 26 patients, and the third line - in 7 patients. Results. The one or several lines of targeted therapy allowed to achieve 20 months of a median in survival without progression of the disease. Several lines of treatment increased a median of general survival up to 42 months in comparison with the patients who were involved in the one line of treatment (a median = 30 months), p = 0.001. Side effects of targeted therapy were reversible. In the first line targeted therapy the preference was given to sunitinib, in the second line - to sorafenib. Sorafenib had an advantage in case of not light-cellular forms of renal carcinoma. In cases with favorable prognosis factors, metastases into organ parenchyma, targeted therapy with bevacizumab was carried out.
AN APPROACH OF THE INTRAOPERATIVE RESTORATION OF THE ANTERIOR WALL OF THE MAXILLARY SINUS FOR PRECANCEROUS DISEASES
Authors: Artamonova Alina V. , Samsonova O. A , Lazarev A. F , Glikenfreid G. M , Matviyenko K. N , Zorkina Yu. N , Glotov S. S
Published: September 2020

Osseous defects in the anterior wall of maxillary sinuses, which might appear as a result of maxillary sinusotomy, cause the retraction of soft tissues into the sinus with a follow-up adhesion to the posterior wall. This results in the obliteration of the sinus with scar tissue, formation of synechia, the obliteration of anastomosis and an increase in disease recurrences rate. We propose a new method of the plastic closure of the defect of the anterior wall of the maxillary sinus to restore the continuity of osseous walls of sinuses, which can be used in ORL clinics, oncological centers or dental clinics. For the first time a fragment made from polyether-polytetrafluorethylene threads was used. This implant has all necessary properties: it is durable, flexible and elastic; it is light and bioinert, it has no negative impact on the body; it is easily treated and is available for the use. We determined exact indications for the plastic closure of the defect of the anterior wall of the maxillary sinus. Using of the implant and the placing it on the muscle-periosteal graft protects it from the contact with the mucous lining of the maxillary sinus. The fixation of this implant not only to the underlying soft tissues but also to the overlying ones, creates a good frame, whereas preliminary sinus sanitation by ultrasound cavitation and layer-by-layer low-frequency ultrasonication of stitches allows slash risks of infecting the plastic material and surrounding soft tissues and, as a result, to reduce the number of recurrences of the disease in patients.
PROGNOSTIC SIGNIFICANCE OF REARRANGEMENTS OF EML4-ALK IN PATIENTS WITH STAGE TI-II ADENOCARCINOMA IN THE RELATIONSHIP WITH SOME CLINICAL AND MORPHOLOGICAL PARAMETERS
Authors: Avdalyan Ashot M. , Panasyan A. U , Ivanov A. A , Samuilenkova O. V , Bakharev S. Y , Bliznyuk A. S , Lazarev A. F.I
Published: September 2020

The purpose of the study: determination of ALK gene status (mutation) in patients with stage TI-II adenocarcinoma in the relationship with survival, stage, size, metastases in bronchopulmonary lymph nodes and the amplification of Her2/Neu. Materials. 98 stage I-II adenocarcinoma patients. Cases with a mutation in ALK account for 20 (4.8% without randomization). There was used the immunohistochemical method and in situ hybridization. Results. The survival rate of adenocarcinoma patients with metastases in the lymph nodes was lower than in cases without metastases: 8.3 ± 7.8% and 40.9 ± 13% respectively. None of patients with a mutation ALK lived up to 9 years in contrast to the cases without mutations (37.4 ± 12.6%). In the presence of amplification of the Her2 gene survival rate in adenocarcinoma patients was lower if compared to cases without amplification (p = 0.02). Correlation between ALK mutation and amplification of Her2 with increased N is not revealed. Thus, an independent criterion of the prognosis for cases with of stage I-II lung adenocarcinoma is the N index (χ2 = 9.6, p = 0.001). The rate of mutation of ALK was lower, but had the second largest impact on the prognosis (χ2 = 7.7, p = 0.005).
ASSOCIATION OF THE FOLATE METABOLISM GENES WITH THE RISK FOR LUNG, PROSTATE, BREAST AND UTERINE CANCER
Authors: Shilova A. N , Shkoda Olga S. , Lomivorotov V. V , Shilova J. N
Published: September 2020

We examined 324 patients with various oncological diseases (157 patients with prostate cancer, 54 - with lung cancer, 47 - with uterine cancer, 42 - with cervical cancer and 24 patients - with breast cancer) and 391 relatively healthy donors. We investigated the frequency of key polymorphisms of folate metabolism genes (MTHFR: 677 C>T (Ala222Val); MTHFR: 1298 A>C (Glu429Ala); MTR: 2756 A>G (Asp919Glu); MTRR: 66 A>G (Ile22Met)). Analysis revealed no differences in the frequency of all examined gene polymorphisms and alleles between patients with oncological diseases and relatively healthy donors. All investigated genotypes and alleles of key folate cycle genes were not associated with the risk for the development of oncological diseases.
THE FACTOR OF IONIZING RADIATION AND THYROID CANCER IN WOMEN IN THE ALTAI KRAI
Authors: Lazarev A. F , Shoikhet Ya. N , Pisareva L. F , Petrova Valentina D. , Terekhova S. A
Published: September 2020

The purpose of the study was to study the dynamics of the incidence of thyroid cancer in the female population of the Altai Territory during the period of 1992-2016. Studies were performed with the use of data of the patient register of thyroid cancer, including information on 3026 women, with the use of methods of modern medical statistics. Intensive and standardized indices were calculated for the female population, resided near to traces of nuclear explosions executed at the Semipalatinsk test site, in the zone of the most significant radiation doses (the Main group). As a comparison, incidence rates of the remaining population of the Altai Territory (the Comparison group) and average values for the region were used. The article presents results of a descriptive epidemiological study of the incidence of thyroid cancer in the Altai Territory over 25 years (1992-2016). The results of the probabilistic association of the incidence of thyroid cancer with the ionizing radiation factor due to nuclear tests at the Semipalatinsk test site were obtained. The dynamics of the incidence of thyroid cancer by the data for five-years periods (averaged data): 1992-1996; 1997-2001; 2002-2006; 2007-2011 and 2012-2016 was studied in various territories of the Altai Territory: both on the traces of nuclear explosions - the main group, and in the rest territory (the comparison group), indices of average values for the regions. There were revealed the dynamics of the incidence of thyroid cancer in tens of years after nuclear tests in the population living in the zone with the most significant doses of radiation and its gradual decrease, due to rehabilitation measures. New approaches to the formation of high cancer risk groups for thyroid cancer in the Altai Territory are substantiated.
THE STATE OF THE MEDICAL CARE FOR LUNG CANCER PATIENTS IN THE ALTAI REGION
Authors: Cherdantseva Tatyana M. , Ageev A. G , Fedoskina A. V , Sekerinska E. L , Popov V. A , Lazarev A. F
Published: September 2020

The relevance of the study of lung cancer is associated with a high incidence and mortality rate. The article is devoted to the study of indices of the prevalence rate of the lung cancer in the Altai Territory for the period of from 2014 to 2016. An increase in the prevalence rate of lung cancer has been established to be of 61.4% (2016) per 100 00 population (both genders), the increase in the «rough index» accounted for 7.4%. With the bearing in mind the age-gender characteristics, statistical analysis showed the highest level of the prevalence rate of cancer of the trachea, bronchus and lung to be observed in males, that amounts of 19.3% among malignant tumors detected in 2016 in the Altai Territory. The greatest increase in the incidence rate of lung cancer is observed in both males and females in the age group of 60-69 years. In stage I-II lung cancer patients there is noted the gain of the specific weight and the decline in the mortality rate to 40.3 per 100 000 population of the Altai Krai.
THYROID CANCER ASSOCIATED WITH MILTINODULAR GOITER
Authors: Kulikova M. N , Popova Tatyana N. , Tolstokorov A. S , Osincev E. U , Kurochkina E. N
Published: September 2020

The incidence rate of thyroid cancer is increasing, especially among young and middle-aged people. In most cases a malignant tumor can be diagnosed at the background of multinodular goiter. Differential diagnosis of malignant and benign tumors of the thyroid presents considerable difficulties. In this situation the decision on the extent of the surgical intervention seems to be important. In the article there are described features of the diagnosis and the choice of the surgical intervention for thyroid cancer associated with multinodular goiter. The morphological examination is the decisive method of diagnosis. The decision on the extent of the operative measure should be both individualized for each particular patient and proceed from the principles of oncological radicalism and functional effect.
CLINICAL TRIAL ON CHEMOPROPHYLAXIS OF BREAST CANCER WITH AROMATASE INHIBITOR LETROZOLE IN WOMEN WITH A HIGH RISK OF DEVELOPING BREAST CANCER. PART I: SELECTION OF PATIENTS, THE FREQUENCY OF PRECANCEROUS STATES
Authors: Meshcheryakov Andrey A.
Published: September 2020

In 2004 - 2010, in the Research Institute of Clinical Oncology of the N.N. Blokhin National Medical Research Center of Oncology there was implemented a prospective randomized clinical trial on chemoprophylaxis of breast cancer with letrozole in women with precancerous states of the breast epithelium. The hypothesis of the study supposed letrozole to be capable to eliminate or at least halt the progression of breast precancerous changes, represented by atypical hyperplasia or hyperplasia without atypia. The study included women with a potentially high risk of developing breast cancer: female patients with validated risk factors for the disease or a risk of contralateral breast cancer with a personal history of the disease. The ultimate goal of the examination was to identify patients with morphologically proven precancerous changes in the mammary gland with positive expression of estrogen receptors. To obtain a morphological material, periareolar fine-needle puncture of the mammary gland was performed. The effectiveness of the developed method of sampling happened to be high, allowing the diagnosis in 172 (96.6%) of 178 patients. Hyperplasia without atypia was detected in 69 (38.8%) women, atypical hyperplasia - in 81 (45.5%) patients, in 22 (12.3%) women no pathological changes in the epithelium were detected. The study has failed to be completed due to the slow recruitment of patients. Despite the incompleteness of the study, new data on the prevalence of breast precancerous changes in the postmenopausal women in the Russian population and significant experience in the organization and implementation of studies on chemoprophylaxis of breast cancer have been obtained.
CLINICAL CASE: NEUROENDOCRINE TUMOR OF THE SMALL INTESTINE - METASTASES IN THE LIVER, PANCREAS AND KINDEY. THE RARITY OF OBSERVATION
Authors: Patyutko Yu. I , Podluzhny D. V , Soloveva Olesya N. , Gorbunova V. A , Matveev V. B , Delektorskaya V. V , Kozlov N. A , Xiaodong Ding
Published: September 2020

Neuroendocrine neoplasms are produced by a unique group of epithelial neoplasias that exhibit common neuroendocrine characteristics and have specific terminology, classification, semiotics, and specific approaches to diagnosis and treatment. Neuroendocrine neoplasms (NEP) are most often found in the gastrointestinal tract (GIT), mainly in the small intestine. The most frequently detected metastases of GIT NEP are metastases in the liver (95%), distant metastases to other organs, such as the pancreas or kidney are extremely rare. Case report: a 45-year-old patient K., who was admitted to the department of tumors of the liver and pancreas of N.N. Blokhin National Medical Research Center of Oncology with the diagnosis of primary-multiple synchronous neoplasms: 1) neuroendocrine tumor of the small intestine G2-Ki 67 = 12% with synchronous bilobar metastases in the liver, under an operation in 2010; 2) left kidney cancer, under an operation in 2011. During the dynamic observation in 2017, lesions in the pancreas, kidney and liver were identified. After the necessary examination, a preliminary diagnosis was made as small intestine neuroendocrine tumors with liver, pancreas and kidney metastases. The patient underwent surgical treatment in the volume of resection of the hook-shaped process of the pancreas with the tumor, distal pancreas resection, splenectomy, liver resection and resection of the right kidney. According to the morphological study, changes in the pancreas, kidney, and liver corresponded with the metastases of the small intestine neuroendocrine tumor. Conclusion: Patients with pancreas and kidney metastases of small intestine neuroendocrine tumors are extremely rare to observe. Surgical therapy can be considered the only radical treatment for this case.
OPIOID-INDUCED HYPERALGESIA IN PATIENTS WITH CHRONIC PAIN SYNDROME OF ONCOLOGICAL GENESIS
Authors: Bobrova Olga P. , Shnayder N. A , Dykhno Yu. A , Petrova M. M
Published: September 2020

The role of mechanisms of the onset of opioid-induced hyperalgesia in patients with chronic pain syndrome of oncological genesis is highlighted according to the review of results of the search for Russian and English articles in the scientific bases of PubMed, Scopus, Web of Science, eLibrary. The importance of genetic factors predetermining the development of opioid-induced hyperalgesia is shown. The key role of pharmacological preparations for relief of chronic pain in the conditions of opioid-induced hyperalgesia is presented.
POSSIBILITIES FOR IMPROVEMENT OF THE EFFECTIVENESS OF SURGICAL TREATMENT OF PATIENTS WITH ADVANCED OVARIAN CANCER
Authors: Nikogosyan S. O , Sekerskaya M. N , Kuznetsov V. V
Published: September 2020

Every year, the world is registering more than 225 thousand new cases of ovarian cancer, more than 140 thousand women die from this disease. The surgical treatment is key in the treatment of all stages of ovarian cancer. In some cases, when the tumor is a conglomerate and all anatomical landmarks are violated, removing this conglomerate without damaging the neighboring structures is a difficult task. That is why oncogynecological studies that have to respond to all occasions. In the article, the authors analyzed modern approaches to surgery, common ovarian cancer, and also discussed ways to improve the results of surgical treatment of this group of patients.
UP-TO-DATE STRATEGY FOR SURGICAL TREATMENT OF CANCER PATIENTS WITH SEVERE CONCOMITANT CARDIOVASCULAR DISEASES
Authors: Gerasimov Sergei S. , Davydov M. I , Davydov M. M
Published: September 2020

Introduction. Surgical treatment of cancer patients with severe concomitant cardiovascular diseases (CVD) is still a debatable issue. Materials and methods. The study involved 170 cancer patients who had surgical operations. Most patients had coronary heart disease (CHD) as severe concomitant cardiovascular disease -133 cases (78.2%). Simultaneous surgeries were performed in 32 (18.8%) patients; step-by-step tactics was achieved in 138 (81.2%) patients. The study evaluated frequency of complications and mortality. Prophylactic efficiency of surgery for severe concomitant CVDs was determined, as well. The causes of deaths within long-term periods were analyzed, and 3- and 5-year survival was calculated by Kaplan-Meier method. Results. Frequency of complications and mortality in radically operated cancer patients accounted for 55.3% and 4.1%, respectively. A higher rate of complications was registered after simultaneous operations as compared with that after step-by-step tactics - 60% and 52.6% , respectively (р>0.05). Prophylactic efficiency of surgery for severe concomitant CVDs in total accounted for 92.4%. The most effective method for prophylactic myocardial revascularization was coronary bypass (CB) performed at the first step. The main cause of death of radically operated patients in the long-term period was tumor process progression - 31.7%, while CVDs caused much less deaths - 9.8% (р =0,001). 3 and 5-year survival accounted for 59% and 46%, respectively. Conclusions: Surgical treatment of severe concomitant CVDs of cancer patients is a highly effective method for prevention of severe cardiovascular complications. Step-by-step tactics is associated with less frequency of complications. Simultaneous surgery with minimal risk may be performed in a selected group of patient. In the long-term follow up period the main factors, which affected 3- and 5-year survival were the radical type of surgery and the advanced cancer process.
3D-CONFORMAL RADIATION THERAPY IN THE TREATMENT OF PATIENTS WITH HEPATOCELLULAR CANCER
Authors: Nazarenko Alexey V. , Alieva Sevil B. , Tkachev Sergey I. , Medvedev S. V , Romanov Denis S. , Breder V. V , Sagaydak I. V , Medvedeva B. M , Romanova Ksenia A. , Zaychenko O. S , Jazhgunovich I. P , Fedoseenko D. I
Published: September 2020

Despite the wide possibilities of applying various methods of local and systemic treatment and their continuous improvement, the results of treatment of patients with hepatocellular cancer in general remain unsatisfactory. Based on the latest achievements of science and technology, modern radiation therapy can be used as an effective method of local exposure to liver tumors because of its relative effectiveness and acceptable tolerability. Radiation treatment in the mode of stereotactic body radiation therapy is a promising direction in the complex treatment of patients with hepatocellular carcinoma. It makes it possible to apply ablative doses with a significant reduction of the doses on healthy organs and tissues in a short period of time and the combination of this technique with other approaches of antitumor treatment.
Primary-multiple gastrointestinal stromal tumor of the stomach
Authors: Fokeev S. D. , Kapitulin S. U. , Kazantseva E. S. , Belokrilova U. G.
Published: September 2020

The result of the radical treatment for multiple gastrointestinal stromal tumors of large size (GIST) coming from the anterior wall of the stomach has been represented.

Conducted researches at the prehospital stage are not indicated on the GIST of the stomach. The GIST presence was confirmed by the immunohistochemical study.
Some indices characterizing medical care to children with cancer in the Russian Federation
Authors: Rykov Maksim Yu. , Susuleva N. A , Polyakov V. G
Published: September 2020

Introduction. The large size of the Russian Federation, different size and density of the child population in the regions of the country require for careful planning organization of care for children with cancer and the rational use of available resources, since in spite of the significant progress made in pediatric oncology, malignant neoplasms (External testing) are the second most common cause of the death in children. Purpose of the study. Perfection of the organizational-methodological approaches to care for children with cancer in Russia in order to improve the quality and effectiveness of treatment. Material and methods. In a non-randomized non-controlled study there were included reports of regional ministries and departments of health from 83 subjects of the Russian Federation for 2013. Results. The highest incidence rate of malignant tumors (per 100,000 ofpopulation agedfrom 0 to 17 years) was registered in the Lipetsk region - 21.7, the lowest - in the Republic of Tyva - 5.5. The number of patients newly diagnosed in 2013 was the highest in the Central and Volga Federal Districts - 775 and 653, respectively. The smallest - in the Far Eastern Federal District - 138. The number of primary patients referred to the federal clinic, was the largest in the North Caucasus Federal District (North Caucasus Federal District) - 80%, the lowest - in the South - 32.5%, the largest number of doctors who do not have primary specialization in “Children’s oncology”, was registered in the North Caucasus Federal District and the Volga Federal District - 50%, the lowest - Urals - 14.2%. Total in Russia 51 children’s oncological department operate, while the number of beds in which we treat these patients, including beds in non-core branches is 2021. 390 doctors treat children with cancer, out of which 252 (64, 6%) did not have a certificate in pediatric oncology. In 2013, 33 78 children were registered with the External testing, 1705 (50.5%) of them were directed for the management in federal clinics. Conclusion. It is necessary to improve further the existing vertical provision of high-tech medical care for children with cancer, the creation of regional cancer registers, certification of specialists and the quality control of medical care through the implementation of internal and external audit.
Plasminogen and PAI-1 activators in tissues of adenocarcinoma and squamous cell carcinoma of the esophagus
Authors: Kit O. I , Kolesnikov E. N , Frantsiyants E. M , Kozlova Larisa S. , Pogorelova Yu. A , Cheryarina N. D , Chugunova N. S
Published: September 2020

Aim. The purpose of the study was to perform the comparative analysis of the components ofplasminogen activation system - uPA and tPA, and their inhibitor PAI-1 in tissues of esophageal adenocarcinoma (EA) and squamous cell carcinoma (SCC). Tissues of removed primary both EA (n=9, st II, G2, T2-3N0-1M0-1) and SCC (n=27, st II, G2, T2-3N0-1M0-1) were studied by ELISA. Results. EA and SCC tumor tissues showed a sharp increase in both uPA forms and in PAI-1, in EA tissue there was noted a decrease in all tPA and in SCC tissue there was seen a decline in tPA-act, compared to the resection line (RL). Perifocal zone of EA showed diminished uPA-Ag, all tPA, increased uPA-act and all PAI-1, compared to the RL. uPA and PAI-1 play an important role in progression of both SCC and EA. The role of tPA requires the further studying, but in SCC perifocal zone its impact may be rather harmful than protective. tPA-Ag/tPA-act balance was increased in SCC tissue only, while in other samples it was decreased (p
Cancer as the cause of disability in the Novosibirsk region
Authors: Zakharyan Aleksandr G.
Published: September 2020

Cancer rate remains to be one out of the highest in Siberian Federal District for many years and it significantly exceeds the mean data across Russian Federation. Besides, it obviously tends to increase. This type of disease has become the first cause of primary disability since 2013 leaving behind cardio-vascular diseases and this ratio is still increasing. Disability caused by cancer is characterized by both the high severity (the share of I-II group disability amounts for 83.9%) and significant percentage of working-age people (37.9%). In spite of high mortality rate caused by cancer, in case of the implementation of the definitive therapy at early stages of the disease rehabilitation indices in these patients remain to be the highest that necessitates for the improvement of the rehabilitation system of cancer patients, including their efficient job placement.
Social and hygienic characteristics of the disability and the need in the measures of rehabilitation of the contingent of invalids with lower limbs atherosclerotic arterial disease
Authors: Nepomnyashchaya Olga V. , Doronina O. E , Karasaeva L. A , Tuarsheva C. M
Published: September 2020

There has been presented information about social-hygienic description of 356 invalids with lower limbs atherosclerotic arterial disease with taking into account gender, age-related groups, severity of disability. There were investigated individual programs of rehabilitation of the given contingent ofpatients, dynamics has been followed up for the period from 2010 to 2014 with the analysis of the need for measures of rehabilitation.
Principles and criteria for detection of the persistence of disorders of functions of the organism in the practice of the medical and social expertise
Authors: Goncharenko Aleksandr G. , Akimov E. I
Published: September 2020

Actuality of the theme offered to the discussion in the real article is conditioned by the absence of legislative and normative documents through this question from one side and by a necessity every day to estimate the persistence of disorders offunctions of the organism in the execution of the medical and social examination, because it is a starting pointfor taking away of expert decision at detection of disability and establishment of the degree of loss ofprofessional ability to work due to industrial accidents and professional diseases. Authors offer the point of view on this issue in a hope on an active discussion with colleagues from a number practicing experts and holding positions which allow to go forward with legislative initiatives.