Vol 22, No 2 (2017)

Articles

MUTATIONAL STATUS AND SOME CLINICO-MORPHOLOGICAL FEATURES OF CUTANEOUS MELANOMA

Mazurenko N.N., Tsyganova I.V., Lushnikova A.A., Anurova O.A., Ponkratova D.A., Vikhrova A.N., Utyashev I.A.

Abstract

Cutaneous melanoma is characterized by molecular heterogeneity. The work is devoted to the analysis of mutational status of genes involved in MAPK signaling in primary and metastatic cutaneous melanoma for the detection of tumor sensitivity to the specific targeted therapy as well as possible links of genetic alterations in cutaneous melanoma with some clinical and morphological features. BRAF, NRAS and KIT mutations were found in 60.6%, 13.8% and 1% of cutaneous melanoma cases correspondingly. Mutational status of cutaneous melanoma is differed depending on tumor localization, chronic UV insolation and patients’ age. Thus the rate of the BRAF mutation in melanomas of trunk and extremities (64.7%) was higher than in melanomas of face and head (42.8%). The rate of BRAF mutation was shown to be not associated with pigmentation and tumor growth while NRAS mutation frequency in amelanotic melanoma was lower and in noddle melanoma - higher if compared with pigmented cutaneous melanoma in the radial growth phase. The trend in the association of mutations with melanoma histological type was shown for the first time, the highest rate of BRAF mutation was found in epithelioid melanoma. The obtained results are important for the treatment of cutaneous melanoma as mutational status determines the sensitivity of metastatic melanoma to specific targeted therapy in patients with BRAF, NRAS and KIT mutations.
Russian Journal of Oncology. 2017;22(2):60-65
pages 60-65 views

NUTRIENT CORRECTION OF FUNCTIONAL AND METABOLIC DISORDERS IN CHILDREN WITH CEREBRAL MEDULLOBLASTOMA

Korchagina Y.A., Dolgikh V.T., Leonov O.V., Erschov A.V.

Abstract

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
Russian Journal of Oncology. 2017;22(2):66-71
pages 66-71 views

NEUROENDOCRINE CARCINOMA OF THE THYMUS

Chekini A.K., Polotskiy B.E., Machaladze Z.O., Hasbulatov A.M.

Abstract

Diagnosis and treatment of neuroendocrine carcinoma of the thymus (NECT) is the significant problem in oncology. On the clinical course these tumors are much more aggressive than epithelial tumors of the thymus. In most of observations in NECTs there is pronounced macro- and microinvasion in the mediastinal tissue and in 30% of patients there are reveled remote metastases. The study included 17 NECT patients. Surgery is the only radical method in the treatment of such patients. 17 NECT patients were operated, 3 of them were operated again due to incomplete operations in other clinics. The vast majority of patients (58.8%) at the time of visiting had advanced stage of the disease. Out of the entire group in 7 patients NECT was associated with ectopic syndrome of varying severity. According to long-term results after surgical treatment of the overall 5-year survival rate was 62.2%.
Russian Journal of Oncology. 2017;22(2):72-75
pages 72-75 views

EFFECTS OF CORRECTION OF ENDOTHELIAL DYSFUNCTION IN PATIENTS OPERATED FORGASTRIC CANCER

Olzhayev S.T., Shoykhet Y.N., Lazarev A.F.

Abstract

The purpose of the study is the assessment of the effect of the correction of endothelial dysfunction on the indices of the function of vascular endothelium and hemostasis system in gastric cancer patients. There were examined 102 patients with advanced gastric cancer at the II (T1-3N1-2M0) and III (T2-4N2-3M0) clinical stage. The control group included 40 healthy subjects matched by age and gender. We evaluated the relationship degree of endothelial dysfunction and its correction results with the outcomes of the treatment after surgery. Patients were divided into 2 groups - the standard of reference (55) and the additional use of means of vascular endothelial function correction (47 patients). Compared group had no significant difference in general and oncological parameters. Additional treatment included the use of the drug L-arginine at a dose of 1.0 g / day in combination with an ACE inhibitor. Statistical analysis envisaged the determination of the degree of significance of differences between groups of indices on the method of Mann-Whitney. As an boundary indication of the presence of the statistical significance there was accepted p < 0.05. There was revealed the presence of significant differences in the degree of damage (the number of circulating endothelial cells) and violations of the functional state of the vascular endothelium in patients exposed standard (main group) treatment and the use of other methods of correction of endothelial dysfunction. In the study group there was also achieved significant correction of hemostasis.
Russian Journal of Oncology. 2017;22(2):76-79
pages 76-79 views

SOME FEATURES OF CHOLESTASIS IN CANCER PATIENTS IN THE COURSE O THE IMPAIRMENT OF LIVER FUNCTIONAL RESERVES

Okhotnikov O.I., Yakovleva M.V., Grigoriev S.N., Pakhomov V.I.

Abstract

Purpose. To discuss the possible causes of discrepancies in results of laboratory and X-ray methods of diagnostics of surgical cholestasis without a concomitant dilatation of the bile ducts, as well as features of X-ray-surgical tactics in such cases. Material and methods. In 2015-2016, 271 percutaneous transhepatic cholangiostomies were performed, including 23 cases - on unexpanded bile ducts, 7 these cancer patients with the laboratory evidence of cholestasis. The criteria for the absence of dilatation of the intrahepatic bile ducts were considered as not only an obvious non-visualized biliary tree on ultrasound, but also the diameter of the peripheral intrahepatic bile ducts less than 2 mm, which must be significantly less than similar peripheral branches of the portal vein. Results.Outside bile-outflow was effective, but only in two cases it provided the relief due to cholestasis performance. In 3 cases, blood bilirubin levels decreased by more than half of the initial ones. 5 out of 7 patients after external drainage of unexpanded bile ducts had evident signs of the liver failure. Two patients with malignant lesions of the biliary tree and baseline bilirubinemia over 450 umol/L died because of progressive liver failure. Conclusion. Mechanical jaundice corresponds to the concept of surgical cholestasis, which is associated with surgical diseases stipulating the violation of the outflow of bile and requires biliary decompression. By reducing the functional reserves of liver surgical cholestasis may not be accompanied by the significant expansion of the bile duct, which can be considered as a predictor of hepatic failure, which nevertheless requires cholangiostomy.
Russian Journal of Oncology. 2017;22(2):80-83
pages 80-83 views

THE ADVANTAGE OF THE TRANSRADIAL APPROACH FOR PROSTATE ARTERY EMBOLIZATION

Khayrutdinov E.R., Vorontsov I.M., Zharikov S.B., Arablinskiy A.V., Ignatiev Y.T., Leonov O.V.

Abstract

Treatment of benign prostatic hyperplasia is an important and challenging problem of modern medicine. One of the most modern methods of the treatment of this disease is prostatic artery embolization. This procedure is most often done through transfemoral approach. Transradial vascular access has many advantages over the transfemoral access. Our study presents a comparative analysis of the use of transradial and transfemoral approach in this type of interventions. Transradial access was used in 13 patients, and transfemoral access - in 12 patients. The success of the procedure was 100% in both groups. The total duration of the procedure, the time needed for catheterization of internal iliac and prostatic arteries and the radiation exposure were significantly lower in the transradial approach group. There were no significant differences in the incidence of complications between two groups. The use of the transradial access was associated with a significant reduction of the frequency and severity of the discomfort associated with the procedure. Transradial approach has numerous advantages over the transfemoral approach and may have great clinical significance.
Russian Journal of Oncology. 2017;22(2):84-88
pages 84-88 views

EFFICACY OF AN TRANSARTERIAL CHEMOEMBOLIZATION (TACE) WITH MICROSPHERES FROM POLY(VINYL ALCOHOL) LOADED OF DOXORUBICIN AGAINST ANAPLASTIC CARCINOMA VX2 IN RABBITS

Yakunina M.N., Fadeev A.Y., Kalishjan M.S., Raihlin N.T., Smirnova E.A., Treshalina H.M., Dolgushin B.I.

Abstract

The research is devoted to the study of the efficacy of new Russian microspheres loaded by (MC/DOX) of 0.4-0.6 mm diameter on a basis of cryogel with poly(vinyl alcohol) intended for a transarterial chemoembolization (TACE). MC/DOX in dose of of 0.5-1.0 ml contained Doxorubicin of 16 mg or 32 mg were transarterially injected in a single dose to rabbits (n = 24) with the VX2 anaplastic carcinoma of the moderate volume of 3-5 cm2 which developed in femur muscles (the pool of a femoral artery). The time of complete released of DOX was 16 days up to dose (a cumulative dose) 16 and 32 mg, respectively. The efficacy was controlled with the decrease of the tumor growth rate and significant inhibition through embolization of turnpike blood of a tumor zone under radiological monitoring. MC/DOX were shown both to give rise in the regression of tumor nodes and reduce the growth rate by 2.0-2.5 times in dependence on the dose value. The reliable therapeutic prize of MC/DOX against embolization effect of 0.5 ml MC that achieved at the maximal DOX cumulative dose of 32 mg consists in the achievement of regression of VX2 up to 50% at 5 of 6 rabbits with the development of the cure pathomorphological effect of III degree which is characterized by the gain in the area of a necrosis by 1.5-3.0 times. The maximal efficient cumulative dose of 32 mg Doxorubicin exceeds value of Maximum Planned Dose (MPD) of Doxorubicin by 6 times for systemic injection to rabbits. The embolizing effect of MC/DOX in the form of blocking of shallow arterioles at preservation of turnpike blood supply did not depend on the size of the applied dose. The reliable antineoplastic effect revealed on this model allows good out perspective for a transarterial chemoembolization of a tumor with MC/DOX.
Russian Journal of Oncology. 2017;22(2):89-92
pages 89-92 views

CHARACTERISTICS OF STEROID METABOLISM IN MALE RATS AT STAGES OF EXPERIMENTAL LIVER METASTASIS

Kaplieva I.V., Frantsiyants E.M., Trepitaki L.K., Cheryarina N.D., Pogorelova Y.A.

Abstract

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.
Russian Journal of Oncology. 2017;22(2):93-100
pages 93-100 views

CURRENT APPROACHES TO DIAGNOSTICS AND COMPREHENSIVE TREATMENT OF TUMORS OF THE MAXILLOFACIAL REGION

Kochurova E.V., Nikolenko V.N., Kochurov V.A.

Abstract

Statistics says about the severity of the situation with cancer best of all. Despite a good visualization, and significantly expanding knowledge about the prevention and treatment of tumors of the maxillofacial region, the number of new cases is constantly increasing. Tumors of this region are the most difficult health and social problems in prosthetic dentistry. The morbidity rate of tumors of the maxillofacial region is constantly increasing, and the clinical diagnosis is based on visual inspection and palpation, biopsy and/or histopathological evaluation. Also, the lack of the treatment, late detection of tumors and the complexity of the anatomical structures of this region are the cause of volume of destructive interferences, leading to the complexity of the treatment and subsequent rehabilitation.
Russian Journal of Oncology. 2017;22(2):101-106
pages 101-106 views

THE HISTORY OF PEDIATRIC ONCOLOGY IN THE USSR-RUSSIA: THE 40TH ANNIVERSARY OF THE INSTITUTE OF PEDIATRIC ONCOLOGY AND HEMATOLOGY OF THE N.N. BLOKHIN RUSSIAN CANCER RESEARCH CENTER AND THE 20TH ANNIVERSARY OF PEDIATRIC ONCOLOGY

Rykov M.Y., Polyakov V.G.

Abstract

The article describes the history of the selection of pediatric oncology as a separate specialty, the organization of first oncological departments and the creation of the first in the USSR Research Institute of Pediatric Oncology and Hematology. There is described the role of academician L.A. Durnov as the founder of oncopediatrics in the national health care
Russian Journal of Oncology. 2017;22(2):107-112
pages 107-112 views

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