Vol 18, No 3 (2013)

The clinical efficacy and tolerability of intrapleural sclerotherapy using a binary catalyst system "teraftal + ascorbic acid" and intrapleural immunotherapy with allogeneic LAK cells and low-dose recombinant interleukin-2 (roncoleukin) in patients with tumor (metastatic) pleurisy at various chemoresistant malignancies was studied. The results showed that this treatment is highly effective (objective response when sclerotherapy was 82%), and immunotherapy (IL-2/ LAK - 92.4% and IL-2 - 80%), relatively rarely give recurrences and satisfactorily tolerated patients .

Perifocal tissue of malign tumor and polyps of the colon lower part were studied. It has been determined that trypsin- like proteinases which are moderately activated in perifocal area of polyps can perform sanitation and protection functions for this area, preventing free penetration of metabolites from the polyp head into surrounding tissues. In the studied areas of polyps, kinin system is physiological type activated, with increased content of prekallikrein and growing activity of carboxypeptidases. The conclusion has been made that the turning point in change of neoplasm status may prove to be keeping or disturbing balance of the trypsin-like proteinases and kinin system interacting with the adjacent organ homeostasis regulation systems. Supposedly, disturbing the physiological balance in activity of kinin system and trypsin-like proteinases of perifocal tissue of polyps can entail malignization thereof.

Investigated argyrophilic proteins associated with nucleolar organizer regions (Ag-NOR proteins) and Ki-67 antigen in lung adenocarcinoma. Defined tumor with low and high content of Ag-NOR proteins and proliferation index (PI) Ki-67. The content of Ag-NOR proteins had a relationship with the clinical and morphological parameters: parameters T, N, tumor size to 3 cm or more, stage of the disease. Survival of patients with lung adenocarcinoma is better in tumors with a low content of Ag-NOR proteins or PI Ki-67. High survival rate associated with low content of Ag-NOR proteins and PI Ki-67, low - with high content of Ag-NOR proteins and PI Ki-67, intermediate - with opposite values of the content of Ag-NOR proteins and PI Ki-67. Tumor size, parameter N and content of Ag-NOR proteins had an independent effect on survival. In lung adenocarcinoma with no metastasis to lymph nodes survival related to the size of the tumor, with metastases - with content of Ag-NOR proteins. Mutual study of Ag-NOR proteins and antigen Ki-67 has differential diagnostic and prognostic value in lung adenocarcinoma.

Lung cancer is a "world leader" in structure incidence and mortality from malignant disease. Surgery is the main treatment that can completely treat patient. But, nearly 50% of patients had disease progression after operation due to presents of micro metastases in time of operation. That’s why necessary to indicate group of patients who needs adjuvant chemotherapy for increasing survival of patients. It is possible to indicate group of patients with the help of molecular markers. The aim of our study is to investigate effectiveness of adjuvant chemotherapy in early non-small cell lung cancer patients due to expression of HER2-Neu in primary tumor. Evaluation of HER2-Neu expression was conducted in 243 patients. HER2-Neu hyperexpression was detected in 70 (28,8%) patients, and absence of HER2-Neu expression in 173 patients (71,2%). We did not identify relationships between HER2-Neu expression in primary tumor and sex, age of patients, location, histologic form, morphologic differentiation of tumor, T criteria. However, patients with N1 and accordingly stage II more frequently defined HER2-Neu hyper expression (р=0,0001 and р=0,001). Moreover, decrease survival was defined in patients with early stages non-small cell lung cancer with HER2-Neu hyper expression in primary tumor (р<0,0001). There is a significant effect after adjuvant chemotherapy in patients with low HER2-Neu expression. It helps to individualize adjuvant chemotherapy and avoid groundless toxic therapy prescription.

The authors have developed a method of reservoir jejunogastroplasty after total gastroectomy during cancer of the stomach. The peculiarities of the digestive system function after total gastroectomy with various methods of esophagojejunostomy after lymphadenectomy D1, D2-3 were studied. The results show the advantages of jejunogastroplasty over standard variants of esofagoenterostomy.

The purpose of the study - the restoration of patency during recurrent stenosing esophageal cancer. 69 years old patients with relapsed cardio-esophageal cancer, accompanied by stenosis of the anastomosis were examined. Successfully performed balloon dilatation, stenting self-expanding stent Hanarostent HEV-18-90-070, restored the possibility of enteral nutrition. Stenting for recurrent cancer can be recommended as an alternative to re-operation.

Melanoma of a skin is thought to be one of the most aggressive tumors with unpredictable prognosis because of a high potency of local growth, local and remote metastases, and dissemination. Regarding this point very important aspect is an adequate assessment of patients and proper therapy administration according to a disease stage. Options for effective diagnosis is to create a single user registration card will allow to create the uniform Russian Federation register of patients with a skin melanoma and will help to introduce an international treatment standard with distribution of patients on stages and substages.