Статьи журнала - Сибирский онкологический журнал
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Efficacy of overnight intubation in oral oncological surgeries a retrospective study
Статья научная
Objective. In the post-operative period of maxillofacial oncological operations, tracheostomy is the most commonly used method for securing the airway. These untoward complications made practitioners choose alternative modalities like submental intubation, but literature support on alternatives to tracheostomy for oral oncologic cases is limited. The aim of this observational study is to ascertain whether the use of overnight intubation is a safer and cost-effective practice and if it can be considered an alternative to tracheostomy. material and methods. 30 patients, 23 males and 7 females in the age group of 34-80 years who underwent treatment for head and neck cancer with major intraoral resection and a unilateral or bilateral neck dissection were included in the study. The following variables were recorded: age, sex, site of tumour, type of neck dissection, use of mandibulotomy/ mandibulectomy, type of reconstruction, duration of stay in ICU, mean hospital stay and Mallampati classification. Postoperative complications, associated with the airway, if any, were recorded simultaneously. results. None of the 30 patients required re-intubation nor did they develop any respiratory distress post extubation. conclusion. The purpose of this study is to raise the conscience of every surgeon to cogitate his/her choice of procedure for his/her patients and advocate the use of overnight intubation, as it is a virtuous alternative to tracheostomy.
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Статья научная
The purpose of the study was to analyze the ability of five antitumor drugs from the pharmaceutical group of protein kinase inhibitors (gefitinib, imatinib, pazopanib, ponatinib and enzastaurin) to reactivate the expression of the epigenetically silenced GFP in HeLa TI cells, and to estimate the effect of epigenetically active drugs on: 1) acetylation and methylation of histones H3 and H4; 2) integral DNA methylation; 3) activity of HAT and HDAC1 enzymes; 4) expression levels of the genes encoding epigenetic regulation enzymes (DNMT1, DNMT3A, DNMT3B; SIRT1, HDAC1; SETD1A, SETD1B, SUV420H1, SUV420H2, SUV39H1, SUV39H2). Material and Methods. The epigenetic activity of antitumor drugs was determined using the HeLa TI test system, a population of HeLa cells with the retroviral vector containing the epigenetically silenced GFP. The level of integral DNA methylation was analyzed using MspI/HpaII methyl-sensitive restriction analysis. Histone modifications were analyzed by Western blotting with antibodies to acetylated and methylated histones H3 and H4. The total activity of HAT enzymes was analyzed using Histone Acetyltransferase Activity Assay Kit. Expression of the epigenetic enzyme genes was analyzed using real-time quantitative RT-PCR. Results. It was shown that only the enzyme inhibitor Cp protein kinase enzastaurin had the ability to reactivate the expression of epigenetically silenced GFP in the HeLa TI cells. We showed that under the action of enzastaurin, the level of integral DNA methylation and expression of DNMT3A and DNMT3B DNA methyltransferase genes decreased. It was also found that enzastaurin reduced the expression levels of histone deacetylases HDAC1 and SIRT1, but did not affect the activity and expression levels of histone acetylases, the level of histone methylation (H3K4me3, H3K9me3, H3K27me3, H4K20me3), and the level of expression of the histone methyltransferases (SUV39H1, SUV39H2, SUV420H1, SUV420H2, SETD1A и SETD1B). Conclusion. The data obtained are important for clarifying the mechanisms of action of 5 protein kinase inhibitors, in particular with respect to enzastaurin, the protein kinase Cp inhibitor, for which the ability to reactivate epigenetically silent genes due to the effect on DNA methylation and histone acetylation was demonstrated.
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Evaluation of biopsychosocial model for pain management in post-oral cancer therapy patients
Статья научная
Background. Approximately 50 % of cancer patients have pain in their daily lives, which is multifaceted sensation goes beyond basic biochemical signal of pain. Oral mucositis is one of the negative consequences with intense pain, discomfort, challenges in speaking and eating. These components collectively influence patient's total quality of life across mental, biological, social aspects. Biopsychosocial model (BPS) is an effective technique for understanding and addressing conceptualization and treatment of pain in cancer patients. The aim of this study is to assess efficacy of the BPS in managing post-cancer distress and potential to improve quality of life for individuals with cancer. Material and Methods. This study evaluated 30 cancer patients who completed radiotherapy and were referred from cancer hospital. The examination encompasses three distinct categories: biological, psychological, and social components. The biological aspect was documented based on mucosal lesions and VAS scores for individuals; followed by photo-biomodulation was given. Palliative care was provided in psychological aspect through implementation of exercise, meditation, music therapy. The social component encompasses community engagement, social activities, counseling services for family members. Patients were categorized into 3 groups - A, B, C. All three components were carefully evaluated and one-month follow-up was done.
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Background. Esophageal cancer is the eighth most common cancer in the world. The antitumor effects of medicinal plants have been shown as a therapeutic strategy to treat esophageal cancer. This study aimed to evaluate in vitro effects of Cuscuta epithymum extract on the survival and apoptosis of esophageal cancer cell line. Material and Methods. Here, the hydroalcoholic Soxhlet extract of C. epithymum plant was prepared. The cell viability of esophageal cancer cell line KYSE-30 was evaluated by MTT assay after 24 h treatment with concentrations of 50, 100, 200, 400, 600, 800 and 1000 μg/ml of the extract. Then, the apoptotic effect of extract was evaluated by flow cytometry using Propidium Iodide (PI) staining and sub-G1 peak analysis, and Annexin V-FITC/PI staining in cells treated with concentrations of 125, 250, 500 and 750 μg/ml as well as morphological change of healthy cells to apoptotic and necrotic form.
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Статья научная
Introduction. The esophagus cancer patients needs early diagnosis to achieve better prognosis. The delay barriers increase progression of diseases to higher stages. The aim of work was to identify and explore the barriers in diagnosis of esophagus cancer and chart the time duration in this process. Material and Methods. The study was conducted in Jinnah Hospital Lahore (JHL), a teaching care hospital of Allama Iqbal Medical College, during a period of one year from July 2019 to July 2020. There were 49.42 % female and 50.57 % male patients.
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Feasibility of simultaneous integrated boost for high-dose treatment of high-risk prostate cancer
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Background. Radiation therapy for high-risk prostate cancer presents a challenge for cancer radiotherapists. The improvement of treatment outcomes is associated with radiation dose escalation and prophylactic irradiation of lymph nodes, therefore, the development of the new treatment schemes is needed. Simultaneous integrated boost technique based on the volumetric modulated arc therapy is the most efficient treatment option. Material and Methods. The anatomical data of 10 patients with high-risk prostate cancer was used for dosimetry-based treatment planning. Both simultaneous integrated boost and sequential boost technique were considered. The treatment planning goal was to deliver the equivalent dose of 96 Gy at 2 Gy per fraction (EQD2=96 Gy) (α/β=1.5 Gy) to the prostate, EQD2=62.5 Gy to the seminal vesicles and EQD2=50 Gy to lymph nodes avoiding damaging the organs at risk, mainly the bladder and rectum. The irradiation was based on volumetric modulated arc therapy with two partially coplanar arcs and two rotations at each arc. The obtained dose distributions were compared with respect to dose-volume histograms and equivalent uniform doses (EUD). Results. In the case of sequential boost, the minimal dose delivered to the prostate was equal to2cc95.9 ± 2.1 Gy, EUD=104.9 ± 1.7 Gy. The dose delivered to 2 cm3 ( D ) bladder was 97.4 ± 2.0 Gy. Normal tissue2cccomplication probability (NTCP) was 1.64 %. The dose delivered to 2 cm3 ( D ) rectum was 103.4 ± 9.2 Gyand NTCP was 27.4 %. In the case of simultaneous integrated boost, the minimal dose delivered to the prostate was equal to 90 . 4 ± 2 . 3 Gy, EUD= 103 . 9 ± 1 . 3 Gy. The bladder dose was as high as D 2cc = 96 . 1 ± 5 . 2 Gy, NTCP= 0 . 176 ± 0 . 132 %, the rectum dose - D 2cc = 81 . 1 ± 6 . 0 Gy, NTCP= 2 . 34 ± 1 . 92 %. Conclusion. Volumetric modulated arc therapy along with simultaneous integrated boost have shown the feasibility of simultaneous irradiation of the prostate, seminal vesicles and lymph nodes up to the prescribed dose values without significant over irradiation of the organs at risk (OARs). Dose values in the tumor as high as EUD= 103 . 9 ± 1 . 3 Gy along with prophylactic irradiation of lymph nodes may result in higher tumor control probability value and should be considered for clinical trials.
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Статья научная
Background. Subungual squamous cell carcinoma (SCC) of thumb is a rare disease. However, it is the most common malignancy affecting the nail bed. Early recognition is crucial and important for prompt diagnosis and effective treatment. Often this tumour needs to be treated surgically with wide local resection, which results in a defect in the thumb. If not handled appropriately, such defects render restriction in functionality of the involved thumb as well as a poor aesthetic outcome. In the worst-case scenario, it may result in a poor function of involved hand. Thus, reconstruction of the involved thumb is necessary. The main aim of reconstruction is to regain the hands’ function and preserved the thumbs’ sensation. Secondarily, to have an aesthetically pleasing hand. Our hands carry out delegate job and important duty for daily function. Especially, the thumb working together with the other fingers to carry out the hand function as one unit. Loss of thumb function affects the whole performance of the hand. Case descriptions. We report a case of recurrent subungual squamous cell carcinoma of thumb, which had wide local resection and subsequently underwent soft tissue coverage with an islanded first dorsal metacarpal artery (FDMA) perforator flap. One month after surgery, the patient was able to regain a good functional outcome of the hand. In this report, we discussed the procedures that had been done. Conclusion. The patient regained full functional hand after reconstruction with preserved sensation over distal thumb. The aesthetic outcome is satisfactory. The FDMA perforator flap is a very pliable and robust flap for reconstruction of distal thumb defect.
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Статья научная
Introduction. Radiation therapy (RT) has been widely used since the 1970s in the treatment of Hodgkin’s lymphoma. RT increases the risk of secondary malignancies and heart disease including coronary artery disease, noncoronary atherosclerotic valvular disease, valvular dysfunction, pericardial disease and radiation induced vasculopathy. Case Presentation. We describe a case of a patient with 4 secondary malignancies due to previous RT including parotid mucoepidermoid carcinoma, breast multicentric infiltrating ducta, thyroid papillary microcarcinoma with follicular pattern and lung adenocarcinoma that later presented with severe constrictive pericarditis, which led to an emergency pericardiectomy - all of these were complications of her previous radiotherapy. She received a prompt diagnosis and treatment. Discussion. Radiation-induced vascular disease (RIVD) occurs due to endothelial injury following RT; patients have up to 3-4 fold increase in risk of myocardial infarction due to CAD, therefore screening of CAD with a CT coronary angiography is recommended to begin 5 years after receiving RT in patients 45 and older and 10 years after RT in patients
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Giant foam-like macrophages in advanced ovarian cancer
Статья научная
Introduction. Ovarian cancer (OC) is the third most common gynecological cancer with the worst prognosis and highest mortality rate. The progression of OC can be accompanied by the detrimental functions of the components of the tumor microenvironment, including tumor-associated macrophages (TAMs). The purpose of the study to analyze distribution and morphological phenotype of TAMs in tumor tissue of patients with high-grade serous ovarian cancer (HGSOC). Material and Methods. Formalin fixed paraffin embedded tissue sections were obtained from ovarian cancer patients after tumor resection. The protein expression of general macrophage marker CD68 and M2-like markers CD206, CD163 and stabilin-1, belonging to scavenger receptors, was analysed by immunohistochemical staining in tumor tissue. Histological assessment of TAM distribution was performed by pathologist. Immunofluorescent analysis/confocal microscopy was applied to establish the co-expression of CD68 with the main macrophage scavenger receptors. Results. We were able to find giant CD68-positive macrophages with foamy cytoplasm in ovarian tumor tissue. The accumulation of these TAMs was specific only for patients with advanced stage (IIIC and IV stages). The presence of foam-like TAMs had a statistical tendency to be associated with ovarian cancer progression, including metastasis and recurrence. The distribution of stabilin-1-positive macrophages was matched to CD68 expression in almost all cases, as was shown by IHC. Confocal microscopy confirmed that stabilin-1 was expressed in at least 50 % of giant TAMs. IF analysis of tumor samples also demonstrated co-expression of other scavenger receptors, CD163 and CD36, in foam-like cells. Similar to IHC, in most samples the expression of CD206 in TAMs of foam-like morphology was limited. Conclusion. For the first time we demonstrated the accumulation of giant macrophages with fluffy foam cytoplasm in the tumor tissue of treated patients with advanced ovarian cancer. Such macrophages express diverse scavenger receptors (stabilin-1, CD163, CD36), thus indicating a high clearance activity of giant TAMs.
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Статья научная
Актуальность. Дефицит гомологичной рекомбинации (HRD) - это важный предиктивный маркер эффективности препаратов платины и ингибиторов поли (АДФ-рибоза)-полимеразы (PARP). Наследственные или соматические мутации генов BRCA1 или BRCA2 являются наиболее частой причиной HRD в карциномах яичника . Однако в некоторых случаях у носителей патогенных наследственных мутаций BRCA1/2 в опухоли сохраняется нормальная копия соответствующего гена и фенотип HRD не формируется. Цель исследования - описание морфологического и молекулярного портрета карциномы яичника высокой степени злокачественности у пациентки с наследственной мутацией BRCA2, не демонстрирующей дефицита гомологичной репарации ДНК. Описание клинического случая. Представлено наблюдение пациентки, 48 лет, с синхронными первично-множественными злокачественными новообразованиями: high-grade карциномой яичника и колоректальной аденокарциномой. У пациентки выявлен известный патогенный вариант BRCA2 c.658_659delGT [rs80359604]. Учитывая неопределенный гистологический вариант низкодифференцированной карциномы, а именно, отсутствие экспрессии маркеров серозной или эндометриоидной дифференцировки, а также высокую экспрессию HER2, выполнено дополнительное молекулярное исследование метастатических очагов в лимфатические узлы. Обнаружено, что в данной опухоли профиль хромосомной нестабильности не соответствует HRD и наблюдается делеция мутантного аллеля BRCA2, что исключает BRCA-подобный фенотип.
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Hereditary diffuse gastric cancer: genetic aspects and prophylactic total gastrectomy
Статья научная
For patients with an identified germline E-cadherin-1 ( CDH1 ) mutation, prophylactic gastrectomy is the treatment of choice to eliminate the high risk of developing diffuse gastric cancer. The case report describes a rare case of hereditary diffuse gastric cancer (HDgC) associated with CDH1 gene mutation, which is reported in the Russian population for the first time. In 2013, a 28-year-old woman was referred to Clinical Oncogenetics Laboratory with a family history of gastric cancer. Molecular genetic analysis revealed CDH1 gene mutation. The lifetime risk of cancer in mutation positive members is more than 80. Histological examination of gastric biopsy specimens obtained during endoscopy revealed isolated signet ring cells in the lamina propria. Spleen-preserving D2-lymphodissection and total gastrectomy with Roux-en-Y reconstruction with a jejunal reservoir formation were performed at the Abdominal Oncology Surgery Department.
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IFN-индуцированные дендритные клетки у больных множественной миеломой
Статья научная
Проведено сравнительное исследование фенотипических и функциональных свойств дендритных клеток (ДК), генери- рованных in vitro в присутствии GM-CSF и IFN-α, у здоровых доноров (n=34) и больных множественной миеломой (n=12). Показано, что по своему составу (количеству зрелых/незрелых ДК и клеток промежуточной степени зрелости) популяция ДК больных в целом была сопоставима с ДК здоровых доноров. ДК больных множественной миеломой (ММ) не отличались от ДК доноров по уровню продукции IFN-γ и TNF-α. В то же время ДК больных характеризовались более низким содержанием активированных CD25+клеток в сочетании с повышенной продукцией IL-10, что, по-видимому, обусловливало ослабление их стимуляторной активности в СКЛ. Тем не менее ДК больных ММ сохраняли свою способность к запуску Th1-ответа, что проявлялось 5-кратным увеличением количества CD3+IFN-γ+ Т-клеток. Полученные данные аргументируют возмож- ность клинического применения ДК у больных ММ в качестве клеточных вакцин (особенно в сочетании с адъювантной цитокинотерапией) с целью повышения эффективности противоопухолевого иммунного ответа.
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Impact of obesity on the oncological and surgical outcomes of thigh soft tissue sarcoma
Статья научная
Background. malignant soft tissue tumors are a heterogeneous group with variable prognosis and with a tendency to recurrence and distant spread, mainly to the lungs. also, obesity is a known risk factor for many diseases and cancers and is currently a global problem. While the thigh is one of the main fat deposition areas, it is one of the commonest sites for the incidence of soft tissue sarcoma. We tried to illustrate the impact of obesity on the outcomes of thigh soft tissue sarcoma patients. material and methods. We retrospectively recruited data of extremity sarcomas treated at our hospital from January 2008 to January 2020. the epidemiological and clinical data of all the included patients was analyzed, then the surgical and oncological outcomes between obese and non-obese patients were compared (defining obesity as Bmi more than 30). We hypothesized that fat deposition in the thigh in obese patients may delay the diagnosis of soft tissue sarcoma, lead to the discovery of the masses at a larger size and stage, and hence may affect the disease-free survival and the overall survival. Results. obese patients had significantly larger size tumors (median: 14.7 vs 9.9 cm) and as such significantly higher t stage. another significant finding was that the mean diameter of liposarcoma tumours was 15.1 cm, while that of non-liposarcomas was 11.3 cm (p-value=0.023). also, although they did not have a higher prevalence of distant metastasis at initial diagnosis, their metastasis tends to be isolated in the lung. postoperative complications occurred more frequently in obese patients in comparison to non-obese patients (p-value=0.025). Neither overall nor disease-free survivals were different among both groups, although obese patients tend to have shorter dFs. conclusion. obesity added complexity to the diagnosis and treatment of extremity sarcoma, but seems not to affect survival.
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Impact of transcription factors, VEGF and proteases on kidney cancer progression
Статья научная
Introduction. The efficacy of anticancer treatment depends on biological factors of tumor. the aim of the study was to determine the activity of proteasomes and calpains and to reveal their association with VEgF, HIF-1α and NF-κΒ expressions in normal, primary and metastatic renal cell carcinoma (RCC) tissues. methods. Ninety-three patients with renal cell carcinoma were included into the study. The expression levels of transcription factor and VEgF were measured using ELISA kits. The levels of proteasome subunits were measured by Western blotting. Proteasome and calpain activities were determined using specific fluorogenic substrates. results. We revealed inactivation of proteolysis in patients with kidney cancer. Disease advance was associated with a significant depression of cellular proteolysis and increase in transcription and growth factor levels in primary kidney cancer tissues. The proteolysis activation was found in metastatic tissues. Conclusions. Our results suggest that NF-κΒ, HIF-1α and VEgF transcription factors and intracellular proteolytic systems are involved in kidney cancer progression.
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Статья научная
Введение. Низкотемпературная плазма в настоящее время находит применение в медицине, в том числе в терапии опухолей. Активированные плазмой биологические растворы предложены в качестве потенциальных реагентов для лечения рака. Однако биологические эффекты в клетках, вызываемые воздействием холодной плазмы, остаются неизученными. Исследование молекулярных механизмов воздействия холодной плазмы на клетки имеет важное значение для ее клинического применения. Целью исследования явилась оценка влияния воздействия холодной плазмы на особенности изменения жизнеспособности, активности каталазы, содержания малонового диальдегида в культурах клеток рака молочной железы MCF-7 по сравнению с нормальными клетками фибробластов подкожно-соединительной ткани мыши 3T3. Материал и методы. В качестве объектов исследования использовали клетки эпителия молочной железы млекопитающих MCF-7, в качестве сравнения - клетки эмбриональных фибробластов мыши NIH/3T3. Обработку клеточных суспензий проводили при помощи низкотемпературной плазмы атмосферного разряда с убегающими электронами. Для количественной оценки жизнеспособности клеточных линий использовали аннексин V и пропидия йодид. Содержание малонового диальдегида определяли по развивающейся окраске его раствора с 2-тиобарбитуровой кислотой при высокой температуре в кислой среде. Активность каталазы оценивали по скорости разложения перекиси водорода за определенное время инкубации смеси.
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Статья научная
Using DIC and confocal microscopy, changes in morphology, migratory characteristics and adherence junctions (AJs) were analyzed in the mammary carcinoma cell line MCF-7-SNAI1 after activation of the EMT transcription factor SNAI1. Western blot analysis showed that after removal of tetracycline from the cell culture medium expression of SNAI1 reached its peak in 24 hours and then plateaued for 7 days. During the 7 days the cells continued to express E-cadherin; however, tangentialAJs typical for cells with stable cell-cell adhesion, changed into radial AJs. The radial AJs continued to accumulate E-cadherin during 24-72 hours after tetracycline removal. As a result of SNAI1 activation, the cells underwent epithelial-mesenchymal transition (EMT) and became migratory. On a two-dimensional substrate, cells exhibited both individual and collective migration. As the tetracycline washout period progressed, the fraction of the cells capable of migrating through migration chamber membranes increased; on the contrary, cells’ ability to invade an epithelial monolayer decreased. These results demonstrate that retaining a hybrid epithelial/mesenchymal phenotype and accumulation of E-cadherin in AJs during early stages of EMT do not impede disruption of stable cell-cell adhesion and cells’ acquisition of migratory activity.
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KRAS-мутированный немелкоклеточный рак легкого: новые стратегии терапии
Статья научная
Рак легкого остается одним из наиболее опасных и распространенных видов онкологических заболеваний, требующих постоянного совершенствования методов диагностики и лечения. легкого В попытке добиться большей эффективности для отдельных групп пациентов генетическая неоднородность рака заставляет искать новые терапевтические мишени. Цель исследования - обновление текущих знаний об аденокарциноме легкого с мутацией в гене KRAS, рассмотрение новых возможностей персонализированного лечения KRAS-мутированного НМРЛ и формирование образа российского пациента, которому потенциально показана таргетная терапия. Материал и методы. Проведен поиск доступных литературных источников, опубликованных в базе данных Pubmed, Cochrane Library, Elibrary, включались публикации, относящиеся к 2008-2023 гг.
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