bluuebunny/crossref_metadata_2025_split huggingface dataset:
Pancreatic ductual carcinoma with isolated liver metastases: is it worth performing surgical resection?
Authors: Egorov V. I. , Kotelnikov A. G. , Kantieva D. M. , Bazin I. S. 
Published: November 2024

Pancreatic ductal cancer is one of the most aggressive malignancy with a high incidence of advanced stages at the time of diagnosis and unsatisfactory long-term treatment results. It is believed that pancreatic ductal cancer in the presence of distant metastases identified at the stage of intraoperative revision or before surgery is a contraindication to surgical treatment. There is currently renewed interest in surgical treatment of patients with oligometastatic pancreatic cancer.Material and Methods. The search for sources was carried out in the PubMed and Elibrary systems from January 1995 to January 2024. Of the 1321 sources found, 37 were used to write the review. Data from both retrospective and prospective clinical studies that focused on the results of combined modality treatment of pancreatic cancer with isolated liver metastases were included.Results. To date, a standard treatment strategy for patients with oligometastatic pancreatic cancer has not yet been established; there are no definitive criteria for selecting patients who may benefit from surgical treatment. The current selection criteria for surgery for metastatic pancreatic cancer are far from ideal, extremely heterogeneous and, as a rule, are based only on certain clinical and instrumental data. The starting point for developing selection criteria for surgical treatment of patients with metastatic pancreatic cancer is a common understanding of what “oligometastatic pancreatic cancer” is.
Pathogenetic and clinical signifcance of EpCАM expression features in tumors and circulating tumor cells
Authors: Perelmuter V. M. , Tashireva L. A. , Grigoryeva E. S. , Alifanov V. V. , Pudova E. S. , Buzenkova A. V. , Zavyalova M. V. , Cherdyntseva N. V. 
Published: November 2024

Purpose of the study: to summarize the available data on the structure and function of EpCAM and its domains, their roles in promoting proliferation and epithelial-mesenchymal transition (EMT), contributing to cell stemness, and facilitating interactions with cell adhesion and invasion molecules.Material and Methods. A comprehensive search was conducted for articles in Russian and English within the scientifc databases PubMed, Scopus, Web of Science, and E-library. A total of seventy-nine articles ranging from 1996 to 2024 were utilized to compile this review.Results. This review summarized the pathogenetic and clinical signifcance of various EpCAM expression variants: EpCAM^high, EpCAM^low, and EpCAM^loss. It described the causes and mechanisms behind the loss of membrane EpCAM expression, each holding distinct biological and clinical implications. Features of EpCAM expression in normal epithelial tissues, during regeneration, and in dysplasia/ neoplasia as well as carcinomas were carefully outlined. The clinical implications of EpCAM expression remain a subject of debate; overexpression of EpCAM has been linked to both unfavorable and favorable prognoses. Special emphasis was placed on the expression variants of EpCAM in circulating tumor cells, disseminated cells, and carcinoma metastases.Conclusion. The pathogenetic and clinical signifcance of EpCAM expression in various nosological forms of carcinoma is complex and multifaceted. Weak expression or absence of EpCAM acts as independent factors infuencing the unique progression patterns of these diseases. Achieving a deeper understanding of the role of EpCAM in disease progression necessitates the simultaneous examination of both its extracellular and intracellular domains.
Participation of retroelements in chromoanagenesis in cancer development
Authors: Mustafin R. N. 
Published: November 2024

Purpose of the study: to determine the role of retroelements in chromoanagenesis mechanisms in cancer etiopathogenesis.Material and Methods. The search for relevant sources was carried out in the Scopus, Web of Science, PubMed, Elibrary systems, including publications from February 2002 to December 2023. Of the 864 scientifc articles found, 60 were used to write a systematic review.Results. According to original works and meta-analyses results, the cause of complex chromosomal rearrangements during cancer development may be retroelement pathological activation. Chromoanagenesis involves LINE1, SVA, Alu, HERV, which cause double-stranded DNA breaks, insertions in tumor suppressor genes region, the formation of chimeric oncogenes due to retroelement use as new promoters, and function as molecular “band-aids” in non-homologous end junctions and form bridges of distal DNA fragments. Global structural rearrangements of chromosomes observed during chromoanagenesis may be consequences of retroelements activation, which participate in non-allelic homologous recombination and in microhomology-mediated joining of ends characteristic. Certain types of neoplasms, such as colon cancer, are characterized by both high levels of chromothripsis and retroelement activity. In head and neck squamous cell carcinoma, chromoplexy is specifc, the sources of sequences at the breakpoints of which are retroelements. During chromoanagenesis, activation of proto-oncogenes and inactivation of tumor suppressor genes are observed, which is also a consequence of retroelement activation. This is due to the presence of retroelement sequences in proto-oncogenes promoter regions and introns (which become the basis for chimeric oncogene formation) and hot spots of insertional mutagenesis in tumor suppressor genes (transpositions into these regions inactivate these genes).Conclusion. The results obtained on the driver effect of retroelements in chromothripsis, chromoplexy and chromoanasynthesis mechanisms, which are the basis for the formation of clonal evolution of tumors, indicate promise of targeted therapy aimed at silencing the activity of retroelements in cancer patients treatment. For this purpose, it is possible to use microRNAs complementary to retroelements, which are also involved in tumor development, as tools.
Epithelioid Hemangioendothelioma of the Azygos Vein
Authors: Pikin O. V. , Moldomusaev T. S. , Dotdaev A. A. , Bagrov V. A. 
Published: November 2024

Background. Epithelioid hemangioendothelioma (EHE) is a malignant vascular tumor of mesenchymal origin. In the mediastinum, EHE originates from the large venous vessels of the superior vena cava.The purpose of the study was to describe a rare clinical case of EHE of the unpaired vein and analyze literature data to improve diagnosis and treatment of this disease.Case presentation. We present a rare case of EHE of the unpaired vein in a 23-year-old male patient who admitted to the Herzen Moscow Oncology Research Institute with a posterior mediastinal tumor detected in August 2022. It was known from the medical history that the patient had undergone diagnostic right-sided thoracotomy and tumor biopsy at the place of residence. Morphologically, the tumor was an epithelioid hemangioendothelioma. The histological re-assessment of biopsy specimens at the Herzen Moscow Oncology Research Institute confrmed the diagnosis of EHE. Computed tomography of the chest organs revealed a mass in the posterior mediastinum (in the projection of the lumen of the unpaired vein), measuring 16×14×41 mm, with relatively clear even contours, close to the posterior wall of the trachea at the bifurcation level, the posterior wall of the right main bronchus, the left semicircle of the esophagus (without signs of invasion). Based on the data on the presence of a vascular tumor in the posterior mediastinum on the right, a multidisciplinary medical consilium recommended surgical treatment: right thoracotomy, removal of a posterior mediastinal tumor with resection of the azygos vein, marginal resection of the superior vena cava, and thrombectomy from its lumen. The duration of surgery was 180 minutes, blood loss was 200 ml. Morphological examination confrmed EHE of the unpaired vein. No complications were observed in the postoperative period. The patient was discharged from the hospital on the 8th day after surgery in a satisfactory condition.Conclusion. EHE of the unpaired vein is an extremely rare vascular tumor. The clinical feature of EHE of the unpaired vein is the absence of any pathognomonic signs, which complicates differential diagnosis of mediastinal tumors. Surgery is currently the optimal treatment approach.
Advanced treatment-resistant ovarian germ cell tumor (yolk sac tumor) with successful fertility realization 20 years after combined treatment: a case report
Authors: Ulrikh E. A. , Chekina Yu. A. , Safronova K. V. , Teletaeva G. M. , Dzharbaeva A. D. , Urmancheeva A. F. 
Published: November 2024

Background. Yolk sac tumors (YST) are classified as rare malignant germ cell tumors of the ovaries, most commonly found in young patients interested in preserving fertility. YST is characterized by large size, predominantly unilateral involvement, and increased production of alpha-fetoprotein, which can be used as an important diagnostic criterion for this condition. Among all germ cell tumors, YST has the least favorable prognosis. The primary goals of YST treatment are not only to improve prognosis and quality of life but also to enable the patient to fulfill her reproductive plans in the future.Description of the clinical case. We present a clinical case of an aggressive course of yolk sac tumor in the ovary of a 15-year-old girl, requiring multiple surgeries, repeated courses of high-dose drug therapy, and bone marrow transplantation.Conclusion. This is a rare case of YST with successful preservation of reproductive function due to modern medical technologies despite aggressive treatment.
Orbital metastases from breast cancer: three case reports
Authors: Danilova L. A. , Anokhina E. P. , Toneev E. A. , Shagdaleev R. F. , Ponomarenko A. M. , Glumnushina D. V. , Krymzalova N. D. 
Published: November 2024

Purpose: to describe rare cases of orbital metastases from breast cancer.Material and Methods. Three cases of Luminal A(1) and B(2) breast cancer with orbital metastases were identified and studied during the period from 01.01.2018 to 01.05.2024. Metastasis to the orbit was detected 5, 2 and 1.5 years after radical mastectomy for breast cancer. Patients received chemotherapy and radiation therapy.Results. Cases of orbital metastasis originating from breast cancer were found to have a low frequency, but may be associated with a long period between cancer diagnosis and initiation of treatment. Early detection of breast cancer and its active treatment with chemotherapy and radiation therapy are important factors in preventing orbital metastasis.Conclusion. A routine follow-up surveillance after radical treatment of breast cancer is important because there is an increase risk of developing orbital metastasis. Comprehensive strategies for treating breast cancer metastases can provide long-term disease control.
Photodynamic therapy in the treatment of recurrent nasal cavity and paranasal sinus cancer
Authors: Vusik M. V. , Shtin V. I. , Cheremisina O. V. , Menshikov K. Yu. , Novikov V. A. 
Published: November 2024

The purpose of the study was to evaluate the effectiveness of treatment of patients with recurrent nasal cavity and paranasal sinus cancer using photodynamic diagnosis (PDD) and photodynamic therapy (FDT).Material and Methods. The study included 40 patients with locally advanced nasal cavity and paranasal sinus cancer, who were admitted to the clinics of the Cancer Research Institute of Tomsk National Research Medical Center with disease progression or recurrence. All patients were divided into the study group (n=20) and the control group (n=20). Patients in both groups received chemotherapy combined with radiotherapy, chemotherapy combined with surgery or a combination of chemotherapy, radiotherapy and surgery. Treatment of patients included intraoperative assessment of resection margin using a laser electron spectral analyzer LESA-01 BIOSPEC. The bed of the removed tumor was examined to detect residual tumor tissues. Photodynamic therapy of the bed of the removed tumor was then performed using Photoditazine at a dose of 1 mg/kg body weight. Radiotherapy at a dose of 300–350 J per feld was given using a Latus–T apparatus, the feld diameter ranged from 1 to 2 cm. The power density varied from 0.4 W/cm2 to 0.5 W/cm2.Results. Nonparametric tests revealed a statistically signifcant difference in disease-free survival: 3.10, p=0.001 by Gehan-Wilcoxon test and 3.03, p=0,002 by Log-Rank test. When assessing overall survival, there were 10 (50.0 %) completed cases in the control group, 4 (20.0 %) in the study group, and 10 (50.0 %) and 16 (80.0 %) censored cases, respectively. Gehan-Wilcoxon test – -2.02 p=0.04. Log-Rank test –2.10 p=0.04. The results of the study showed that according to any of the criteria, there were statistically signifcant differences in survival between the control and study groups.Conclusion. Inclusion of intraoperative PDD and PDT in the treatment algorithm for nasal cavity and paranasal sinus recurrent carcinomas signifcantly increases the disease-free and overall survival of patients.
Whole exome sequencing: the search for mutations associated with hereditary breast cancer in ethnic groups of Siberia
Authors: Gervas P. A. , Molokov A. Yu. , Babyshkina N. N. , Ivanova F. G. , Nikolaeva T. I. , Tikhonov D. G. , Choynzonov E. L. , Cherdyntseva N. V. 
Published: November 2024

Hereditary breast cancer (HBC) is a heterogeneous disease caused by mutations in genes characterized by ethnic specifcity. The clinical heterogeneity of this disease signifcantly complicates its diagnosis. The use of high-throughput sequencing is one of the approaches that allow the search for genes and their variants associated with the development of HBC. The purpose of the study was to search for new genes associated with HBC in the understudied ethnic groups of Siberia by using whole exome sequencing (WES).Material and Methods. WES was performed on a cohort of 16 probands with BC (Tuvan, Yakut, Altai ethnos). The study material was genomic DNA isolated from peripheral blood leukocytes. Libraries were prepared using a BGI Optimal DNA Library Prep kit. An Agilent SureSelect Human All Exon V6 kit was used for hybridization. High-throughput sequencing was performed on a DNA nanoball sequencing platform (DNBSeq-G400).Results. In the overall group of patients with signs of HBC, pathogenic variants were detected in 12.5 % of cases (2/16). For the frst time, BRCA1 (rs80357635) pathogenic variant was identified in a young patient with metachronous BC (Yakut ethnic group). A pathogenic variant of the ATM gene (rs780619951 NM_000051:exon16:c.C2413T:p.R805X) was identified in a young patient with BC (Tuvinian ethnic group). A pathogenic variant of the TDP2 c.G4T:p.E2X, rs770844602 gene (DNA repair gene) was identified for the frst time in a Tuvan BC patient (metachronous) with a family history, but its contribution to HBC remains to be proven. The TDG gene variant (rs764159587 NM_001363612:exon7:c.536dupA:p.E179fs) found in the Tuvan ethnic group and affecting splicing (SpliceAI: 0.580) requires special attention.Conclusion. This report is the frst to describe the germinal variant in the BRCA1 (rs80357635) gene in the Yakut ethnic group. Further studies are required to confrm pathogenicity of germinal variants in non-well studied genes TDP2, TDG in ethnic BC patients.
Immunomorphological specifcity of HER2-low breast cancer
Authors: Mikhailov I. V. , Eremeeva E. R. , Glazkov A. A. , Telezhnikova I. M. , Setdikova G. R. , Balkanov A. S. 
Published: November 2024

Assessment of tumor infltrating lymphocytes (TiLs) has been recognized as an additional tool for predicting survival in triple negative (TN) and HER2/neu positive (HER2+) subtypes of breast cancer (BC). Recently, BC, including the above-mentioned subtypes and characterized by low/undefined expression of HER2/neu, has been isolated into a separate group, designated HER2-low BC. The relationship between clinical and morphological parameters of HER2-low breast cancer and infiltration by immunocompetent cells, including tumor associated macrophages (TAM), has not been studied to date. The purpose of the study was to identify significant relationships between the level of subpopulations of immunocompetent cells (Tils + TAM) and the clinical and morphological parameters of HER2-low BC.Material and Methods. The study examined the surgical specimens of 33 patients with HER2-low BC. Visual counting of TILs and assessment (IHC) of the level of T-helpers, T-killers, M1 and M2 macrophages were carried out in intratumor sites and the invasive edge of the primary tumor.Results. The study of mastectomy specimens showed that infiltration of Tils (Me=5 [5; 10] %) was observed in all 33 patients. The level of M2 of macrophages was found to be the highest both in the invasive margin and in the intratumor sites (CD163inv: Me=20 [10; 40] %; CD163c: Me=15 [7; 30] %, respectively). In patients with high (≥20 %) levels of M2 macrophages in the invasive margin, there was also a high level of other immunocompetent cells, and perineural invasion was detected significantly more often (р=0.019).Conclusion. A high level of infiltration by M2 macrophages of the invasive margin is combined with the detection of perineural invasion in primary HER2-low breast cancer, which is one of the predictors of a high risk of progression. In combination with other clinical and morphological parameters, the level of M2 macrophages in HER2-low breast cancer may become another factor in predicting disease prognosis.
Experience of applying convolutional neural network for binary classifcation of microphotographs of thyroid cytology specimens
Authors: Solopov M. V. , Kavelina A. S. , Popandopulo A. G. , Turchyn V. V. , Pashchenko S. A. , Bagdasarov K. M. 
Published: November 2024

Objective: to evaluate the effectiveness of a convolutional neural network model for automated cytologic diagnosis of papillary thyroid cancer and benign thyroid nodules.Material and Methods. The convolutional neural network was developed in the Python programming language using the TensorFlow 2.15.0 open source library. For the study, a dataset that included two categories of pathologies was generated: 1597 microphotographs of papillary carcinoma and 767 microphotographs of benign nodules (colloid goiter and adenomatous nodules). To form a training sample and evaluate the model’s performance metrics on the test sample, the dataset was divided in a ratio of 80/20.Results. In classifying papillary carcinoma, the model achieved precision of 89.3 %, recall of 92.4 %, specifcity of 77.4 % and F1 score of 91.4 %. When identifying benign nodules, the presicion, recall, specifcity and F1 score were 83.3 %, 77.4 %, 92.4 %, and 80.3 %, respectively, indicating a higher rate of false-positive and false-negative predictions. The AUC was 0.91 at the individual microphotograph level and 0.94 at the serial microphotograph level from one patient, indicating the high ability of the trained model to differentiate between malignant and benign thyroid lesions based on microphotographs of fne-needle aspiration biopsy specimens.Conclusion. Further improvement of the neural network model by training on larger and more diverse datasets of microphotographs of cytological specimens of the thyroid gland will help improve its diagnostic range and performance. The developed model can be used to develop software for identifying thyroid pathologies.
Analysis of surgical treatment outcomes for renal cell carcinoma with inferior vena cava tumor thrombosis: a singlecenter experience
Authors: Gamayunov S. V. , Ashimov E. A. , Kiselev N. M. , Karov V. A. , Spiridonov M. A. , Zarechnova N. V. , Zagainov V. E. 
Published: November 2024

The purpose of the study was to analyze surgical treatment outcomes for renal cell carcinoma (RCC) with inferior vena cava tumor thrombosis (IVC-TT) on the basis of one cancer center.Material and Methods. A retrospective analysis of treatment outcomes of 25 patients with locally advanced and metastatic RCC with IVC-TT, who underwent surgery from 01.2021 to 12.2022, was carried out. The median follow-up was 21 months (95 % CI 14.3–33 months). The patients were divided into groups according to the Mayo IVC-TT classifcation: Type I: 8 patients, type II: 8 patients, and type III: 9 patients.Results. Tangential IVC resection was done in 20 (80 %) cases, circular-in 3 (12 %) cases, and IVC extirpation was done in 2 (8 %) cases. The median intraoperative blood loss was 600 ml (from 250 to 1700 ml). The incidence of postoperative complications was 28 %, distribution by Clavien–Dindo classes was: III – 4, IV – 2, V – 1, an increase in the incidence of complications of class III–IV was revealed in patients with Mayo type III, however, no statistically signifcant differences were found (p=0.153). The most common complication was acute kidney injury. Two (8 %) patients required repeated surgical intervention. One patient died due to sepsis. Statistically signifcant differences were obtained in blood loss (p=0.003), the number of erythrocyte suspension blood transfusions (p=0.006), and the time of surgery (p=0.014) and prevailed in the group with the Mayo III level. However, the median length of hospital stay did not differ in the subgroups (p=0.978) and amounted to 6 bed days in the range from 4 to 20 days in the general group. The 30-day postoperative mortality rate was 4 %.Conclusion. Our experience has shown that surgical treatment of RCC with IVC-TT is feasible and provides acceptable surgical and oncological outcomes. However, the complication rate and postoperative mortality are higher in patients with Mayo III thrombus levels, requiring careful patient selection.
Cerebral disorders as a complication of whooping cough in a child under one year old
Authors: Puzyreva L. V. , Larkin V. I. , Mishkin V. V. , Pimov S. G. , Larkin I. I. , Schaefer E. P. , Paimanovа L. N. , Gashina E. A. , Lobova E. F. , Sabaeva N. A. 
Published: November 2024

Whooping cough is a widespread infectious disease, the manifestations of which vary from nonspecific cough to life-threatening conditions with the development of apnea, hypoxic damage to the central nervous system, and respiratory failure, especially in young children. Against the background of a severe form of whooping cough, hemorrhages of various types can be observed, including in the brain. The team of authors describes a clinical case of cerebral impairment in a child under one year of age, which is associated with whooping cough. A day after discharge from the infectious diseases hospital, the child developed a generalized convulsive attack. Clinical, instrumental and objective data allowed us to establish a diagnosis: acute disorder of cerebral and spinal circulation of the hemorrhagic type. Subarachnoid hemorrhage. Severe anemia. Convulsive syndrome. Whooping cough. Subsequently, the development of signs of hydrocephalus was observed over time, with the further formation of multiple cysts and hemiatrophy of the right hemisphere of the brain.