Vol 18, No 4 (2013)

The parameters of coagulation hemostasis in 37 patients with gastric cancer, 65 patients with colon cancer, 17 patients with prostate cancer and in 8 patients with lung cancer were analyzed. The aggregation of platelets in 119 patients with tumors of the breast, 17 — stomach cancer, 11 — colon cancer, 17 — prostate cancer and 8 — lung cancer also were analyzed. It was found that cancer patients have hyperthrombinemia, hyperfibrinogenemia, violation of the protein C system, reduction of the antithrombin III concentration, increase of induced platelet aggregation, which contributes to the formation of the thrombophilic status in cancer patients, is significant in the progression of the tumor and its metastasis. The use of anticoagulants and antiplatelets by these patients can not only lead to a decrease in the risk of thrombotic complications, but also to improve the survival of cancer patients.

Screening tumors of breast are detected by instrumental methods of diagnosis, such as mammography (MG), ultrasonography (USG) and magnetic resonance imaging (MRI) only; typically have a size to 2.0 cm (T1) and need support (MG or USG control) at biopsy for morphological study. In the present study the clinical symptoms were analyzed using a large clinical data (1,347 patients with stage-I breast cancer), the rate of screening tumors and the possibility of pre-surgical biopsy of these tumors. The proportion of screening cancer, identified by instrumental methods of diagnosis was only 12.8%, which means the insufficient level of screening programs for all age groups women. Screening methods had the maximum diagnostic value in microcarcinomas (tumors less than 5 mm) which had no clinical symptoms and almost non-palpable. Young patients (<40 years) found breast cancer themselves and went to oncologist (more than 90% of cases; patients 50 years older - in 78% cases, p <0,05). Surgical biopsy with USG or MG control has improved the effectiveness of a biopsy from 74.4% (without instrumental control) to 93%; core-biopsy of tumors has helped to determinate of morphological diagnosis more exactly and plan treatment algorithm in these patients.

In hereditary MTC recommended age surgery in carriers of the mutation depends on its localization in the gene RET, which determines the probable age of tumor onset, aggressiveness and prognosis of its clinical course. The optimal treatment of the carrier RET mutation is generally recognized preventive thyroidectomy in childhood before the possible onset of malignancy. The only radical treatment of MTC in operable patients is surgical. Regardless of the etiology ( sporadic, familial) MTC is prone to early and extensive metastatic dissemination. The minimum volume of transactions in medullary carcinoma is total thyroidectomy, supplemented with central lymph node dissection. When tumor is operable and in the absence of data for distant metastases should seek to limit the surgical radicality. Clinical supervision with recurrent dinamics assessment of basal and stimulated calcitonin and carcinoembryonic antigen level after the surgery is indicated. In inoperable cases and after progression of distant metastases treatment options are extremely limited. MTC is a radiosensitive tumor. Chemotherapy has shown very limited effectiveness under high toxicity and therefore is not assigned. Satisfactory anti-tumor effect in moderate toxicity showed some tyrosine kinase inhibitors on the results of recent randomized clinical trials.