Vol 24, No 3-6 (2019)
- Year: 2019
- Articles: 9
- URL: https://rjonco.com/1028-9984/issue/view/2541
Basic Science - Practical Health Care
Diagnostic errors in patients with diseases of the chest cavity and ways to reduce them
Abstract
This paper presents an algorithm for reducing the risk of errors in the diagnosis of diseases of the chest cavity within 14 days after treatment of patients. The developed algorithm, based on multivariate analysis of the integrated assessment of clinical and radiological descriptors (signs) of diseases, determination of the probability coefficient of errors, software for comparing individual integral data with established typical characteristics for differentiable pathological processes, improved diagnostics, aimed the doctor at an adequate examination, and reduced the risk of error by 20.1%.
96-101
Possibilities of differential diagnostics of histologicalforms of primary lung cancer with multi-spiral computed tomography based on artificial intelligence
Abstract
The problem of lung cancer, visualized including spherical formation of the lung, is becoming increasingly important every year. In the structure of the oncological morbidity of the Russian population among men in 2018, this pathology occupied the leading position – 16.9% (in women – 4.0%). When analyzing the distribution of patients with lung cancer of various age groups depending on the histotype of the tumor, it was found that in most cases it is adenocarcinoma and squamous lung cancer – 85%. MSCT was performed in 342 patients with spherical formation of the lung aged 45 to 80 years using computed tomographs Aquillion 64 and Asteion 4 (Toshiba Medical Systems). Digital analysis of scans was performed using the X-ray + program (Russia, Barnaul), which allows direct sampling of average pixel densities in a tabular form in selected areas of interest from DICOM files for subsequent analysis and statistical processing. The obtained densitometric indicators were received at the inputs of an artificial neural network. The effectiveness of differential diagnosis of histological forms: sensitivity – 35.7 + 2.6%, specificity – 40.6 + 2.6%, accuracy –76.3 + 2.3%.
102-104
Clinical investigations
Malignant neoplasms in the urban and rural population of the tomsk region
Abstract
Progress In the prevention and treatment of infectious diseases,” aging “ of the population, environmental, economic and other factors cause changes in the structure of morbidity and mortality. Malignant neoplasms (ZNO), serving as one of the main causes of disability and occupying one of the leading places in the structure of mortality of the population, are one of the main problems of health care in Russia. The growth of cities radically changes the environment and human lifestyle, has an impact on the level and structure of morbidity of the population. A person in an urban environment is exposed to a complex of social and environmental factors. According to statistics, the incidence of ZNO urban population in Russia, higher than rural [1-5]. However, as the adverse effects of urbanization penetrate into the countryside, the introduction of the rural population to the “urban” way of life and the aging of the rural population, it is possible to predict an increase in morbidity among them. For the development of anti-cancer programs and adoption of reasoned management decisions, information on the spread of ZNO among the population of various administrative-territorial entities is needed, especially for areas with low population density, where, as a rule, the rural population lives. At the present stage, the study of epidemiological features of the prevalence of cancer in the Tomsk region is the most urgent organizational issue in connection with the need to plan anti – cancer measures in the framework of the regional program “Fight against cancer” (hereinafter-the Program). Given that the financing of the Program is provided from 2019 to 2024, it seems appropriate to determine the structure of morbidity in the context of municipalities for adequate planning and ensuring the availability of specialized medical care. The aim of the study was to study the incidence of malignant neoplasms of urban and rural population of Tomsk region. The study used data from the population cancer register of the regional Oncology dispensary of the Tomsk region for the period from 2007 to 2017. and the Federal state statistics service of the Russian Federation on the population living in the region. The analysis of the epidemiological situation was carried out by extensive, intensive, standardized (direct method) indicators. Statistical processing of the material was carried out using the program “ONCOSTAT”.
68-73
Comparative analysis of the receptor status of the primary focus and synchronous axillary metastases in breast cancer patients
Abstract
The aim of the investigation. To study concordance of surrogate molecular subtype in the pairs of primary and synchronous axillary metastases in patients with invasive breast cancer (IBC).
Materials and methods. Retrospective analysis included 80 patients aged 28 to 90 years (average age 40.3±5.3 years) with a first-time diagnosed IBC who underwent surgical treatment at the N.N. Blokhin National Medical Research Center of Oncology during 2016–2018 years. None of the patients received any neoadjuvant drug therapy. The pathological evaluation of the estrogen receptors (ER), progesterone receptor (PR), HER2 expression and estimation of proliferative activity (Ki-67 index) with subsequent assignment to surrogate subtypes were performed according to ASCO/CAP protocols and the recommendations of the 2013–2019 San-Gallen Conference on treatment of Early Breast Cancer.
Results. Preliminary results of our study revealed therapeutically significant changes in hormone receptor status, HER2-status and proliferative activity in 12.5% of cases of Luminal A type IBC, 20% of Luminal B/HER2-positive and 4% of Luminal B/Her2-negative subtypes of IBC.
74-78
Diagnostic difficulties in patients with pneumonia and central lung cancer
Abstract
This work presents an analysis of x-ray, clinical, laboratory methods for the study of patients with pneumonia and central lung cancer, in order to study the main causes of diagnostic errors.
It was established that the causes of diagnostic errors of patients with pneumonia and central lung cancer were the insufficient severity of the leading clinical signs of the course of the disease, the lack of an integrated approach in determining the volume and methods of examination, the inadequacy of accounting for the main radiological signs (localization, density, structure of formation, cavity of decay); lack of an algorithm in the stages of the diagnostic process and the late availability of specialized medical care.
79-83
Reviews
105-112
Skin melanoma. State of the problem. Review
Abstract
Skin melanoma, being the deadliest form of skin tumor, contributes significantly to cancer mortality and carries a significant and growing public health burden. The incidence of MK is growing steadily throughout the world and is in the nature of a “silent epidemic”. The critical mortality rate is due to the high metastatic potential of the tumor and the low efficiency of systemic therapy of disseminated forms of the disease. Thanks to a breakthrough in understanding the genetic mechanisms of the appearance of a tumor, the spread and tolerance to treatment, the emergence of a number of targeted and immunological drugs, patients with advanced MK have the hope of prolonging life and even complete cure. However, many diagnostic problems remain; treatment standards; emerging tolerance to therapy. All these questions compel further research into the diagnosis and treatment of this disease.
113-120
Case Reports
Primary-multiple gastrointestinal stromal tumor of the stomach
Abstract
The result of the radical treatment for multiple gastrointestinal stromal tumors of large size (GIST) coming from the anterior wall of the stomach has been represented.
Conducted researches at the prehospital stage are not indicated on the GIST of the stomach. The GIST presence was confirmed by the immunohistochemical study.
84-88
Positron emission tomography, combined with computed tomography, in resistent lesions of gestational trofoblastic tumors topical diagnostics
Abstract
Introduction. Gestational trophoblastic neoplasias are rare tumors, which consist of about 1% of gynecological cancers. High rate of diagnostic and treatment mistakes leads to late diagnosis, metastatic appearance, resistance to chemotherapy, poor prognosis.
Aim. To demonstrate possibilities of 18F-FDG PET/CT to find resistant lesions of gestational trophoblastic neoplasias.
In the article, we analyze several medical reports to illustrate advantages of 18F-FDG PET/CT for evaluation of resistant gestational trophoblastic neoplasias.
89-95
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