Vol 23, No 1 (2018)
- Year: 2018
- Articles: 10
- URL: https://journal-vniispk.ru/1028-9984/issue/view/2397
Articles
ANALYSIS OF PROTEIN EXPRESSION OF PD-L1 IN MALIGNANT PLEURAL MESOTHELIOMA
Abstract
Malignant pleural mesothelioma is associated with poor prognosis and resistance to chemotherapy. This gives reason to search for as well new effective methods of treatment as predictive factors. Programmed cell death receptor PD-1 and its ligands PD-L1 and PD-L2 are the representatives of the system of the «immunologic checkpoint» whose main function is the regulation and modulation of immune response, the decrease of the immune cell damage in organs and tissues and also prevention running of an autoimmune process. Tumor cells are able to use a PD-1/PD-L1-signaling pathway to evade the immune system. The assessment of the level of expression of PD-L1 is regarded as a prognostic marker of the life expectancy, but also as a predictor of response to anti-PD-1/PD-L1 immunotherapy.
Russian Journal of Oncology. 2018;23(1):4-9
4-9
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
Abstract
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.
Russian Journal of Oncology. 2018;23(1):10-13
10-13
SOME FEATURES OF CHOLESTASIS IN CANCER PATIENTS DURING THE REDUCTION OF LIVER FUNCTIONAL RESERVES
Abstract
Purpose. To determine the indications for the supra - and transpapillary externally-internal drainaging of the biliary tree in case of jaundice syndrome. Material and methods. The results of minimally invasive treatment of 246 patients with external-internal drainage of the biliary tree were analyzed. Among patients with proximal tumor block the external-internal drainage is made in 92 cases, in 42 (45,7%) out of them in suprapapillary embodiment and in 50 (54,3%) - via transpapillary approach. In 154 cases with distal tumor (obstruction peripapillary cancer) transpapillary drainage was performed. Results. The technical success of the external-internal drainaging was achieved in 242 patients (98,4%). It was failed to pass the duodenum in 4 patients with the cancer of common bile duct (3) and cancer of papilla of Vater (1). There was no complications related to the technique of external-internal drainage. In 18 patients (8,8%) out of 204 with transpapillary location of the drainage, we were forced to temporarily return to full outer bile outflow because of acute cholangitis. The syndrome of an acute blockade of the papilla of Vater arising after transpapillary external-internal drainaging required endoscopic papillosphincterotomy in 42 (84%) out of 50 patients with proximal tumor block bile outflow and in 7 (4.5%) out of 154 patients with peripapillary cancer. Conclusion. Suprapapillary and transpapillary embodiment of the drainage are equivalent in terms of the efficacy of cholestasis elimination. Syndrome of an acute blockade of papilla of Vater is the most often complication of the transpapillary external-internal drainage requiring the carrying out of endoscopic papillotomy «on drainage». This syndrome arises very frequently in a case of transpapillary external-internal drainage due to the proximal tumor obstruction of the biliary tree. The risk of acute cholangitis due to regurgitation after manipulation is absent in the suprapapillary location of the external-internal drainage, and with its transpapillary position is realized only with a concomitant violation of the outflow of bile.
Russian Journal of Oncology. 2018;23(1):14-19
14-19
CLINICAL CASE: NEUROENDOCRINE TUMOR OF THE SMALL INTESTINE - METASTASES IN THE LIVER, PANCREAS AND KINDEY. THE RARITY OF OBSERVATION
Abstract
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.
Russian Journal of Oncology. 2018;23(1):20-23
20-23
EXPERIENCE IN GRANT-MANAGEMENT GAINED BY THE SERVICE OF OPERATIVE INFORMATIONAL SUPPORT FOR RESEARCH AT THE FEDERAL STATE BUDGET INSTITUTION «NATIONAL MEDICAL RESEARCH CENTER OF RADIOLOGY» OF THE HEALTH MINISTRY OF RUSSIAN FEDE-RATION IN 2015-2016
Abstract
This paper describes the work experience gained at the Federal State Budget Institution «National Medical Research Center of Radiology» (FSBI «NMRC of Radiology») of the RF Health Ministry in 2015-2016. Information about 94 grants received by researchers by means of the use of domestic and international information resources stored on electronic and print media is presented. The results of processing and analysis of databases enabled to characterize the personnel activity in branches to receive financial support for research in the areas of medical radiology, radiobiology, radiation epidemiology and oncology as well as to make a decision and highlight problems in funding of projects.
Russian Journal of Oncology. 2018;23(1):24-30
24-30
DIGITAL TECHNOLOGIES IN ONCOLOGICAL EDUCATION
Abstract
The problem of modern oncology is not the correspondence between the achievements of medical science and technology and the understanding of general practitioners to conduct a survey and the ability to apply them and to detect cancer at a stage when the cure rate can be of 80-100%. It is necessary to train doctors who do not know so much, how much can determine the optimal diagnostic tactics. The semiotics of the cancer of individual localizations in the educational literature is usually described at the stage of the clinical phase, without having a specific system. The goal is to systemize the manifestation of heart failure in the form of signal (pathogenetic) supporting symptoms, taking into account the phase of tumor development and using digital technologies to conduct objective testing of knowledge to improve cancer literacy and efficiency of screening. The proposed signal system of basic symptoms of development of malignant neoplasms (MN) and described in the textbook and training manual [Сherenkov V.G., 2017], allow the student or general practitioner to remember them «not on their fingers», but from the position of the visual system. The examination of patients is directed, first of all, to the exclusion of direct and indirect signs of «reference symptom number 1», factors and reasons for the possible development of MN. The application of the Russian system «Votum» with a set of consoles, software developed by ourselves for «Oncology» test control with visualization elements in the application «presentation» - shortens the time for the survey and increases it to learn practical skills. The interactive system allows you to solve tactical tasks, conduct lessons more vividly with the visual perception, and carry out instantly objective and transparent control of knowledge for participants, present them in the form of graphs and time spent on answers. Preliminary experience of combining traditional forms of education and modern digital technologies testifies to the effectiveness of the increase of the oncological literacy and alertness of students and general practitioners.
Russian Journal of Oncology. 2018;23(1):31-34
31-34
MORBIDITY RATE OF MALIGNANT NEOPLASMAS AND ANALYSIS OF THE ECOLOGICAL STATE OF THE TERRITORY OF THE REPUBLIC OF BURYATIA
Abstract
The authors analyzed the incidence rate of malignant neoplasms in the population of the Republic of Buryatia without division into separate locations by regions over a long period, beginning from 1995 to 2015 in comparison with that in the Russian Federation, using a comparative-geographical method. According to statistical data, the growth of general oncopathology has been revealed every year, in connection with which the aim of the work was to search for its causes in the analysis of environmental factors in the region. There was established a high morbidity rate in the population during analyzed four periods: over 1995-2000; 2001-2005; 2006-2010; 2011-2015 in the same regions of the republic, as Bountov, Tarbagataysky, Kabansky, Pribaikalsky, Zaigraevsky, North Baikal, Barguzin and Ulan-Ude. The authors explain this pattern by the abnormal natural conditions of the region, the development of the mining industry, in particular the development of powerful reserves of uranium and polymetallic ores. And the city of Ulan-Ude, where the entire industrial hub and fuel and energy complex is concentrated, is one of the ten most polluted cities in Russia due to the location in a closed basin of a mountainous country. In the first three analysis periods until 2011 there was a low incidence in the high-altitude region of Okinsk, and in Tunkinsky until 2006, in Muisky until 2001, however, in their territories in the last five years, sharp gain was seen respectively from 147%, 205% in relation to 231% initial period. This is probably due to the fact that the development of natural raw materials, begun in the 1960s by the Soviet authorities, is still a handicraft way, leaving a pathological “trace” on the health of the population, manifested in tens of years. The gradual gain of oncopathology is observed in Dzhidinsk, Kizhinginsky, Mukhorshibirsky, Selenginsky, Khorin, Kyakhta districts. However, there are territories of the regions of the republic, like Eravnensky and Ivolginsky, where the incidence is insignificant.
Russian Journal of Oncology. 2018;23(1):35-42
35-42
CARDIOVASCULAR COMPLICATIONS OF ANTICANCER THERAPY: CLINICAL FEATURES, DIAGNOSIS, TREATMENT, PREVENTION (PART II)
Abstract
The given review is devoted to the problem of the cardiotoxicity of chemotherapeutic agents. Many of chemotherapeutic agents can cause cardiovascular complications such as left ventricular dysfunction and heart failure development, myocardial ischemia, arterial hypertension, thromboembolism, QT prolongation and arrhythmias. The toxic influence of the most often used chemotherapeutic agents on heart (such as antimetabolites, alkylating agents, platinum compounds, taxanes, vinca alkaloids, monoclonal antibodies, anthracycline antibiotics, topoisomerase and protein kinase inhibitors, immunomodulatory agents and cytokines) has been described. The results of recent studies on etiology, pathogenesis and clinical features of chemotherapy-induced cardiotoxicity were present in the first part of review. The clinical features, diagnosis, treatment and prevention of the cardiotoxicity of chemotherapeutic agents, are described in the second part of the review
Russian Journal of Oncology. 2018;23(1):43-49
43-49
TYROSINE KINASE INHIBITORS OF THE EPIDERMAL GROWTH FACTOR RECEPTOR IN THE TREATMENT OF NON-SMALL CELL LUNG CANCER
Abstract
Considering the findings regarding the excellent frequency response (approximately 70%), survival without disease progression (median approximately of 9 months), better safety profile and the superior quality of life for patients compared with standard chemotherapy, EGFR TKIs in EGFR mutation positive non-small cell lung cancer patients can be now considered as first-line treatment in these patients. Evaluation of epidermal growth factor receptor mutations is necessary for all non-small cell lung cancer patients as the effective prognostic marker of the response to tyrosine kinase inhibitors of EGFR.
Russian Journal of Oncology. 2018;23(1):50-54
50-54
VAZhENIN ANDREY VLADIMIROVICh (K 60-LETIYu SO DNYa ROZhDENIYa)
Russian Journal of Oncology. 2018;23(1):55-56
55-56