Vol 15, No 3 (2010)

The authors present their data on endobronchial treatment of 374 patients with malignant stenotic tumors of the trachea and bronchi (n = 150; 187 tumors), central lung cancer (CLC) (n = 119; 162 tumors), benign tumors (n = 47), and scarring stenosis (n = 58). A complex of diagnostic studies was developed, which comprised video-assisted high-resolution endoscopy, fluorescence and NBI bronchoscopy, endosonography, spiral computed tomography, and a morphological study. Indications for various endoscopic treatment options were defined. The basic techniques for tumor removal were electrocoagulation, Nd:YAG-laser thermodestruction (1984-1994), photodynamic therapy, and argon-plasma coagulation (1992-2008). In patients with stenotic tumors, complete or partial luminal recovery could be achieved in 96% of cases just after endoscopic treatment. Endoscopic treatment as a preparatory stage was performed in 24 (16%) patients before open surgery and in 81 (54%) patients prior to radiotherapy. In CLC, complete tumor regression was achieved in 89% and in 100% when tumors sized under 1 cm along the plane. A follow-up lasted as long as 8 years. A recurrence was diagnosed in 175 of cases; metachronic CLC was found in 21%. The developed endoscopic treatment options can be occasionally regarded as the only possible treatment modality or as an alternative to surgical treatment.

The authors selected a combination of serological tumor-associated markers for each histological type of tumors to enhance the sensitivity of clarifying laboratory diagnosis and monitoring of patients with lung cancer (LC). The serum levels of carcinogenic embryonic antigen (CEA), SCC, Cyfra 21-1, and ProGRP were studied in 57 primary patients with Stages I-IV LC of various histological types (squamous-cell and small-cell carcinoma, adenocarcinoma), in 12 patients with noncancer lung diseases, and in 13 healthy individuals. The highest sensitivity was demonstrated by the combined determination of Cyfra 21-1 and SCC for squamous-cell LC (88.2%) and that of CEA and Cyfra 21-1 for lung adenocarcinoma (57.1%). On a small sample of patients, the new serological marker ProGRP showed not only a high sensitivity (75%) for small-cell LC, but also a high specificity (94.3%) for non-small-cell LC. These results agree with few data in the foreign literature and suggest that the marker should be used for the specifying differential diagnosis of small-cell LC and the monitoring of patients with type of LC.

The systemic toxic and local irritant effects of the new drug Hexasens used for the fluorescence diagnosis of malignancies were studied on small laboratory animals: mice, rats, and rabbits. The acute and chronic toxicities of the agent were investigated when orally used and its local irritant effect was examined when intravesicularly injected. The conducted studies indicated that Hexasens was a lowly toxic pharmacological agent. Its oral administration in rats at a 5% concentration or less produced no local irritant effect on the esophagus (esophagospasm). Intravesicular injection of Hexasens in rabbits at a 0.01% concentration (containing 1.0 mg of the agent in 10 ml of an injectable solution) or less exerted no local irritant effect on the urinary bladder mucosa.

Treatment for gastric cancer remains to be an unsolved problem of modern oncology. The purpose of the present investigation was to study the safety and tolerance of multimodality treatment for operable gastric cancer with endolymphatic chemotherapy being supplemented in the early postoperative period, and systemic multidrug therapy. The authors conclude that combination drug treatment is accompanied by few local and systemic complications; endolymphatic polychemotherapy does not increase the frequency and severity of postoperative complications. Complex therapy performed by the chosen demonstrated safety and a good tolerability.

The objective of the investigation was to study the results of the organizational structure of screening measures to improve the early diagnosis of breast cancer, which was commissioned in the Khanty-Mansi Autonomous District in 2007. A total of 117,465 women were examined using mammography and ultrasonography over 1.5 years; 63,924 (20.4% of the women in the age group of over 20 years) subjects were studied within the screening program. During screenings, the incidence of breast cancer increased from 28.7 to 35.5% in the district in 2007 (versus 2006). In the Khanty-Mansi Autonomous and Surgut District, the breast cancer detection rate was generally 0.45% of the total number of screenings amongst women over 40 years of age.

The authors describe a case of desmoid fibroma of rare site. They outline the existing treatments for this pathology and their uses in this female patient. Due to ineffective medical treatment, surgery has been performed using a displaced muscle flap to close the formed defect.

The paper describes a case of a rare combination of extragonadal yolk sac tumor with kidney cancer spreading to the lung. It shows a problem in the preoperative diagnosis of germinogenic mediastinal tumor that mimics a metastasis from renal cancer.

The paper details worldwide clinical experience with intraluminal endobronchial surgery over the 19th-20th centuries, the original objective of which was to deliver palliative care to incurable patients and at present it has ensured not only the timely detection of early forms of respiratory malignancies, but also their early stage treatment. The state-of-the-art of the endoscopic diagnosis and treatment of disseminated tracheal and bronchial tumors and early central lung cancer (ECLC). A complex of diagnostic studies has been studied in detail to detect ECLC, which presently includes fluorescence bronchoscopy, NBI bronchoscopy, endosonography, spiral computed tomography.

The paper provides the morphological characteristics and analyzes the basic criteria used for the classification of in situ ductal cancer. Today's classification schemes and the diagnostic significance of their used morphological characteristics are compared. Differentially diagnostic criteria for different types of in situ intraductal carcinoma are given.