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Menopausal syndrome and its correction for oncogynecological patients

Menopausal syndrome and its correction for oncogynecological patients

Molchanov S.V., Kolomiets L.A., Gridneva T.D.

Статья научная

The review presents the problem of climacteric syndrome in reproductive-aged oncogynecological patients after antitumor treatment. A subject about correction of climacteric syndrome using substitutive hormonotherapy and non-hormonal methods (phytotherapy, phytohormones, homeopathy, vitamintherapy, behavior therapy and physical factors) was opened.

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Minimal invasive fertility sparing treatment of cervical cancer

Minimal invasive fertility sparing treatment of cervical cancer

Verheijen R.H.M.

Статья научная

This paper gives an overview of in particular surgical techniques that allow young women with cervical cancer to retain fertility.

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Monitoring of EGFR mutations in the circulating tumor DNA from blood plasma of patients with non-small cell lung cancer

Monitoring of EGFR mutations in the circulating tumor DNA from blood plasma of patients with non-small cell lung cancer

Shamanin Vladimir A., Karpov Igor V., Gervas Polina A., Cherdyntseva Nadezhda V., Simolina Elena I., Kozlov Vadim V., Kovalenko S.P.

Статья научная

Activating mutations of egfr are associated with sensitivity of non-small cell lung cancer (NSCLC) to tyrosine kinase inhibitors (TKI). Liquid biopsy using circulating cell-free tumor DNA (cfDNA) is proposed in cases when formalin fixed paraffin embedded (FFPE) tumor tissue is not available and for monitoring of egfr status. In the study we evaluated new qPCR assay for egfr mutations in plasma cfDNA. Sensitivity of the assay was 1 % of the mutant allele for L858R, L861Q, S768I mutations and deletions in exon 19, and 5 % of the mutant allele for G719X or T790M mutations Before surgery, mutation was detected in plasma of 4 out of 7 patients (57 %) with mutant egfr in FFPE tumor tissue. Mutations found in cfDNA completely matched those found in tumor tissue in 2 cases. In one case with G719X and S768I mutations in FFPE tissue, only S768I was found in cfDNA. In another case, T790M was detected in plasma in addition to L858R that was present in tumor tissue. No egfr mutations were detected in plasma DNA from 12 healthy volunteers and 13 cases of NSCLC with wt egfr suggesting 100 % specificity of the assay. Liquid biopsy detected egfr mutations in cfDNA in 8 of 16 cases of NSCLC with mutant egfr being under therapy with TKI. Among them, 7 cases had mutations in liquid biopsy that matched those in tumor tissue and another case had T790M in addition to L858R. In 3 cases increased mutant allele frequency was detected 212 months before clinical progression.

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Morphological heterogeneity of intratumoral macrophages in prostate tumors

Morphological heterogeneity of intratumoral macrophages in prostate tumors

Danilko K.V., Enikeeva K.I., Kabirov I.R., Maksimova S.Y., Vishnyakov D.S., Kzhyshkowska J.G., Pavlov V.N.

Статья научная

Background. Prostate cancer (PCa) is the most common human cancer worldwide. in the progression of prostate cancer, the total number of macrophages in the tumor tissue is associated with poor prognosis and increased risk of metastasis. However, the heterogeneity of intratumoral macrophages at various stages of PCa development, and the role of tumor-associated macrophages (TAMs) have been insufficiently investigated. The aim of the study was to analyze the morphological features, size and number of TAMs in PCa tissue samples, and to reveal their correlation with clinical data of patients. Material and Methods. immunohistochemical analysis of 36 paraffin blocks of patients with PCa (pT2a-3bN0-1M0) was performed using antibodies to the scavenger receptor CD68. Results. Foamy CD68+ macrophages were found in the tumor tissue. The indicator "number of macrophages per total number of fields of view with macrophages" was the lowest in patients with a Gleason score of 6 (5.8) (11.0 - in patients with a Gleason score > 8). Macrophages formed larger clusters in patients with severe PCa. Small but not large macrophages were significantly more common in patients with lymph node metastases (48 vs 24 in the N0 group; p=0.14). The number of small macrophages (smaller than 100 pm2) increased in a series of patients with Gleason scores of 6, 7 and > 8 (24, 47.5, 72, respectively, p=0.052). Conclusion. As the tumor process progressed and the risk of biochemical recurrence increased, there was a trend towards an increase in the total area of large, foamy TAMs, presumably rich in lipids, as well as wider distribution of small macrophages with a tendency to form clusters. We hypothesize that foamy macrophages are involved in the further recruitment of small TAMs, subsequently leading to metastasis and tumor progression.

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Neoadjuvant chemoradiotherapy for thoracic esophageal squamous cell carcinoma: does everyone need it?

Neoadjuvant chemoradiotherapy for thoracic esophageal squamous cell carcinoma: does everyone need it?

Chichevatov D.A., Sinev E.N., Glukhov A.E., Seliverstova O.M.

Статья научная

Objective. In accordance with clinical guidelines, neoadjuvant chemoradiotherapy (nCRT) is recommended as a beneficial option for treatment of thoracic esophageal squamous cell carcinoma (TESCC). However, some studies did not demonstrate potential benefits of nCRT. In this paper we compared treatment outcomes of surgery alone with preoperative CRT followed by surgery. Material and Methods Group 1 (n=147) consisted of patients who underwent surgery alone. Group 2 (n=3,337) was formed in the framework of the present systematic review and meta-analysis (15 publications captured 20 separate subgroups for analysis). Patients of group 2 received nCRT followed by esophagectomy. Overall survival (OS) and median OS were estimated.

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New mutation of the TP53 gene associated with the hereditary breast cancer in a young tuvinian woman

New mutation of the TP53 gene associated with the hereditary breast cancer in a young tuvinian woman

Gervas Polina A., Molokov Aleksey Yu., Zarubin Aleksei A., Ponomareva Anastasia A., Babyshkina Nataliya N., Belyavskaya Valentina A., Pisareva Lubov F., Choynzonov Evgeny L., Cherdyntseva Nadezda V.

Статья научная

Background. The identification of the ethnospecific mutations associated with hereditary breast cancer remains challenging. Next generation sequencing (NGS) technology fully enables the compilation of germline variants associated with the risk for inherited diseases. Despite the success of the NGS, up to 20 % of molecular tests report genetic variant of unknown significance (VUS) or novel variants that have never been previously described and their clinical significances are unknown. To obtain extended information about the variants of the unknown significance, it is necessary to use an alternative approach for the analysis of the NGS data. To obtain extended characteristic about the unknown significance variants, it is necessary to search for additional tools for the analysis of the NGS data. Material and Methods. We reclassified the mutation of the unknown significance using the ActiveDriveDB database that assessed the effect of mutations on sites of post-translational modifications, and the ProteinPaint tool that complemented the existing cancer genome portals and provided a comprehensive and intuitive view of cancer genomic data. Results. in this study, we report a 44-year-old Tuvinian woman with a family history of breast cancer. Based on the NGS data, mutational analysis revealed the presence of the LRG_321t1: c.80C>T heterozygous variant in exon 2, which led to the proline to leucine change at codon 27 of the protein. in the dbPubMed database, this mutation was determined as unknown significance due to data limitation. According to the data of the ActiveDriverDB tool, this mutation is located distally at the site of post-translational protein modification, which is responsible for binding to kinases that regulate genes of the cell cycle, etc. (ATM, CHEK2, CDK, MAPK). in accordance with ProteinPaint tool, the LRG_321t1: c.80C>T mutation is located in functionally specialized transactivation domains and codon of the TP53 gene, where the pathogenic mutation associated with Li-Fraumeni syndrome has been earlier described. Conclusion. This report is the first to describe a new variant in the TP53 gene (rs1555526933), which is likely to be associated with hereditary cancer-predisposing syndrome, including Li-Fraumeni syndrome, in a Tuvinian BC patient with young-onset and familial BC.

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Nivolumab monotherapy in metastatic colorectal cancer: current approaches to response evaluation

Nivolumab monotherapy in metastatic colorectal cancer: current approaches to response evaluation

Babyshkina N.N., Dronova T.A., Gervas P.A., Popova N.O., Dobrodeev A.Yu., Kostromitskiy D.N., Afanasyev S.G., Goldberg V.E., Cherdyntseva N.V.

Статья научная

Aim of the study: a systematic analysis of the modern literature data on the nivolumab monotherapy efficacy in patients with metastatic colorectal cancer (mCRC). Material and Methods. The review summarizes the results of clinical studies of the nivolumab efficacy in patients with mCRC between 2012 and 2022. The current approaches to assessing the tumor response in patients treated with immune checkpoint inhibitors are considered, including response patterns and criteria. Results. Data analysis showed that the use of nivolumab in mCRC patients had significant clinical benefits. Nivolumab monotherapy was shown to improve survival in patients with high microsatellite instability (MSi) or deficiencies in mismatch repair (dMMR) that progressed during standard chemotherapy. Numerous clinical studies indicate the atypical response to nivolumab. Traditional response criteria, such as RECiST do not always adequately assess the therapeutic efficacy of nivolumab in patients with mCRC. conclusion. To improve the efficacy of mCRC treatment, standardized approaches based on the proposed specific criteria for response to immunotherapy, including immune related RECiST, immune RECiST, and immune-modified RECiST must be developed.

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PLA полиморфизм гена GP3A как фактор прогноза при раке почки

PLA полиморфизм гена GP3A как фактор прогноза при раке почки

Серегин А.В., Кашинцев К.Ю., Енгай В.А., Шустицкий Н.А., Серегин А.А.

Статья

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Phenotypic profile of monocyte-macrophage lineage cells as a function of respiratory epithelium status

Phenotypic profile of monocyte-macrophage lineage cells as a function of respiratory epithelium status

Fedorov A.A., Ermak N.A., Topolnitskiy E.B., Shefer N.A., Rodionov E.O., Pankova O.V., Cherdyntseva N.V., Stakheyeva M.N.

Статья научная

The mechanism of the relationship between pretumor changes in the bronchial respiratory epithelium and the risk of progression of non-small cell lung cancer (NSCLC) remains unclear. It has been suggested that the relationship between reactive changes in the bronchial mucosa and NSCLC progression may be caused by the functional status of monocytic-macrophage cells as important participants in inflammation, which determines both the risk of premalignant changes in the epithelium and malignant progression. The purpose of the study was to investigate the phenotypic profile of peripheral blood monocytes and macrophages induced from monocytes in vitro depending on the state of respiratory epithelium in NSCLC patients. Material and Methods. The study included 39 patients with newly diagnosed NSCLC. Based on the morphological examination of small bronchi taken at the distance of 3-5 cm from the tumor, patients were divided into the following groups depending on the type of pretumor changes: no pretumor changes (n=6), isolated basal cell hyperplasia (BCH) (n=13), combination of BCH and squamous metaplasia (SM) (n=3), combination of unchanged epithelium and focal BCH (n=17). The phenotypic features of peripheral blood monocytes and in vitro-induced macrophages were assessed before treatment using flow cytometry. Results. The state of the respiratory epithelium in NSCLC patients prior to the start of anticancer treatment was associated with the phenotypic features of peripheral blood monocytes, but not with the profile of macrophages induced from them. Distortion of the response of induced macrophages to the polarizing stimuli was observed in NSCLC patients: the cultured cells responded to both M1 and M2 inducers (LPS and IL-4, respectively) with a phenotype shift to M2, while the CD206 marker expression varied depending on the presence and type of pretumor changes. Conclusion. The phenotypic profile of peripheral blood monocytes was associated with the state of the respiratory epithelium in NSCLC patients before anti-tumor treatment, but not with the phenotypic features of induced macrophages.

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Predicting the site of distant metastases in breast cancer

Predicting the site of distant metastases in breast cancer

Grigoryeva E.S., Ivanyuk E.E., Choinzonov E.L., Cherdyntseva N.V.

Статья научная

Background. Distant organ tumor dissemination is a major cause of breast cancer-related deaths. Breast cancer can metastasize to several organs, and the most frequent metastatic sites include the bones, lungs and liver. There is a question what factors can influence the direction of spread of tumor cells to a particular organ. Material and Methods. We summarized the data available in the world literature on methods for prediction of the localization of distant metastases in breast cancer patients. Results. We divided the factors associated with the localization of distant metastases into two main groups: clinicopathological parameters of breast cancer patients and molecular features of tumor microenvironment and tumor cells (primary tumor and circulating tumor cells) or its derivates - exosomes. From our point of view, the most powerful clinicopathological factor predicting the distant metastasis site is a molecular subtype of primary tumor. We can conclude that luminal (HR+/HER2-) tumors are often characterized by single metastases and bones are the most common metastatic site, while TNBC and HER2-enriched tumors often metastasize to multiple sites, most commonly brain and liver. However, several authors did not reveal these associations in their studies. It likely indicates the existence of other factors that significantly affect the organotropism of metastasis. Numerous studies demonstrate the association of different molecules expressed on tumor cells with organotropic metastasis. However, these data are very fragmentary and rather contradictory. Conclusion. The found associations are common to all participants of metastatic cascade, but remains unclear which factors are essential and crucial in determining the direction of metastasis.

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Predictive and prognostic significance of loss of heterozygosity in ABC transporter genes in breast cancer

Predictive and prognostic significance of loss of heterozygosity in ABC transporter genes in breast cancer

Tsyganov M.M., Ibragimova M.K., Garbukov E.Yu., Bragina O.D., Zdereva E.A., Usynin E.A., Litvyakov N.V.

Статья научная

ABC-transporter family genes have been well studied and their involvement in the development of drug resistance has been assessed. The presence of aberrant conditions in these genes can affect the treatment and prognosis of the disease. Loss of heterozygosity (LOH) is one of these conditions; it is a common event in cancer development. Therefore, the aim of this study was to investigate the relationship between LOH in ABC transporter genes in breast cancer and response to chemotherapy and disease prognosis. Material and Methods. A total of 130 breast cancer patients were included in the study. Microarray analysis was performed on Affymetrix CytoScan™ HD Array high-density DNA chips to assess LOH status. Chromosome Analysis Suite 4.1 software (Affymetrix, USA) was used to process microarray results. Results. Forty-nine ABC transporter genes were evaluated for LOH. The frequency of LOH ranged from 6.9 % to 90 %. An association analysis identified two genes: ABCG5 and ABCG8, in which the presence of LOH was associated with a lack of objective response to neoadjuvant chemotherapy. The presence of LOH in the ABCA5, ABCA6, ABCA8, ABCA9, ABCA10 and ABCC3 genes was associated with high rates of metastasis-free survival (log-rank test, p

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Predictors of local recurrence of renal cell cancer. Our experience

Predictors of local recurrence of renal cell cancer. Our experience

Gaas M.Y., Kaprin A.D., Vorobyev N.V., Kalpinsky A.S., Kozlov V.V., Inozemtsev R.O.

Статья научная

Risk factors for renal cell cancer (Rcc) recurrence, including its local form, include stage and high Fuhrman grading system score, regional lymph node involvement, microvascular invasion, tumor necrosis, positive surgical margin, and sarcomatoid or rhabdoid tumor differentiation. Objective. the study analyzes data from moscow Research oncological institute named by pa Herzen to determine the predictors of local recurrence of kidney cancer based on the data from surgically treated patients with local recurrent Rcc. material and methods. We analyzed retrospectively data from 87 patients who were divided into 2 groups: 1-st, patients with detected local recurrence of kidney cancer (n=43), and 2-nd, control group (n=44). the following predictors were evaluated: tumor size, tumor histotype, tumor stage, Fuhrman grading system, surgical margin status, tumor necrosis, sarcomatoid and rhabdoid changes, microvascular invasion, hemorrhage and invasion of collecting system components (css), renal capsule, and perirenal cellular tissue and primary treatment. Results. the risk of local recurrence was higher in the primary tumor, over 40 mm in diameter (oR=5.8, p function show_abstract() { $('#abstract1').hide(); $('#abstract2').show(); $('#abstract_expand').hide(); }

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Primary liver cancer in the Republic of Sakha (Yakutia)

Primary liver cancer in the Republic of Sakha (Yakutia)

Bugaeva T.T., Ivanov P.M., Alekseeva M.N., Odintsova I.N., Boyarkina A.P.

Статья научная

Territorial and ethnic features of the prevalence of primary liver cancer in the republic of Sakha have been studied. The republic has been shown to be a high-risk area for primary liver cancer, which is the 2-nd most common form of cancer in males and the 3-rd most common form of cancer in females among all digestive system malignancies. The standard liver cancer incidence rates are 5 times higher than the average incidence rates in Russia. Primary liver cancer is more oftern registered in the age group of 70 years and more. Incidence rates are mainly raised due to indigenous and rural populations. The liver cancer incidence rates show a tendency to stabilization all over the republic.

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Prostate specific antigen density as a prognostic factor in patients with prostate cancer treated with combined hormonal radiation therapy

Prostate specific antigen density as a prognostic factor in patients with prostate cancer treated with combined hormonal radiation therapy

Kneev A.Y., Shkolnik M.I., Bogomolov O.A., Zharinov G.M.

Статья научная

Purpose. to evaluate prostate specific antigen density (psad) as a predictor of overall (os) and cancer-specific survival (css) in patients with prostate cancer (pc) who have undergone combined hormonal-radiation therapy. material and methods. in order to assess the prognostic significance of psad we retrospectively analyzed outcomes of 714 pca patients who received combined hormonal-radiation therapy at the a.m. granov Russian scientific center of Radiology and surgical technologies, ministry of Healthcare of Russia, between January 1996 and december 2016. since the prognosis and management differ according to the extent of tumor involvement, patients were categorized into localized (n=272), locally advanced (n=231) and metastatic (n=211) pc groups. We equentially applied Roc-analysis, Kaplan-meier product limit estimator and cox proportional hazards model to assess the prognostic relevance and establish threshold values of psad that had a significant impact on survival rates. results. in the localized pc group, psad threshold values of 0.34 ng/ml/cc and 0.36 ng/ml/cc were associated with a decrease in os and css, respectively. patients with “low” psad had significantly better os and css survival rates in both uni- and multivariate analyses. in locally advanced pc group, psad threshold values were 0.28 ng/ml/cc and 0.63 ng/ml/cc for os and css, respectively. However, exceeding the specified values, in the locally advanced pc group, was not accompanied by a statistically significant decrease in survival rates. Finally, in the metastatic pc group, established psad threshold values were 2.25 ng/ml/cc and 2.30 ng/ml/cc for os and css, respectively. according to the results of univariate analysis, patients with “low” psa tend to demonstrate statistically significant better os and css rates. the results of multivariate analysis, however, failed to prove psad as an independent prognostic factor within the metastatic pc cohort. conclusion. psa density is a reliable tool for assessing survival rates in patients with localized pc who have undergone combined hormonal-radiation therapy.

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Psychological rehabilitation and life quality assessment for patients with thyroid cancer

Psychological rehabilitation and life quality assessment for patients with thyroid cancer

Dubskiy S.V., Kupriyanova I.E., Choinzonov E.L., Balatskaya L.N.

Статья научная

Life quality values of thyroid cancer patients are characterized by reduction in psychological vector in early postoperative period and greatly in social vector. The detected damages are completely resolved within 6 months. Compensation of physical characteristics of life quality occurs more completely. High level of personal anxiety having preferably psychical and neurovascular character is observed in patients of the studied group. Comprehensive systematic psycho-therapeutic correction in early postoperative period taking account individual characteristics of the patients significantly increases the treatment efficacy. A high social-labor adaptation of the studied group patients has been found.

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ROR1 and BMI-1 proteins as potential predictors of the effectiveness of hormone therapy in luminal breast cancer

ROR1 and BMI-1 proteins as potential predictors of the effectiveness of hormone therapy in luminal breast cancer

Tarakanova V.O., Krakhmal N.V., Patalyak S.V., Tarasov M.N., Babyshkina N.N., Vtorushin S.V.

Статья научная

The purpose of the study was to generalize information regarding the molecular and biological mechanisms involved in the resistance to endocrine therapy with aromatase inhibitors in patients with luminal breast cancer. material and methods. the literature search was conducted using medline, cochrane library, elibrary and pubmed databases. results. the review highlights the results of international studies on molecular and biological characteristics of breast tumors and their relationship with the effectiveness of hormone therapy. particular attention was paid to the description of modern studies on RoR1 and Bmi-1 proteins and their contribution to the development of tumor resistance to treatment. conclusion. the analysis of the world literature confirms the relevance of studying the molecular and genetic characteristics of tumor tissue in patients with luminal breast cancer. the data obtained were compared to the clinical course and response to hormone therapy in order to standardize them for implementation in everyday practice as the “gold standard of diagnosis”.

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Radical prostatectomy and robotic radiosurgery as treatment options for localized prostate cancer

Radical prostatectomy and robotic radiosurgery as treatment options for localized prostate cancer

Kipriyanov Evgeny A., Karnaukh Peter A., Vazhenin Ilya A., Vazhenin Andrey V.

Статья научная

Purpose: to compare immediate, short-term and long-term treatment outcomes after radical prostatectomy and robotic radiosurgery in patients with localized prostate cancer. Material and Methods. The study included 2 groups of patients. Group I patients (n=80) underwent radical surgery (nerve-sparing prostatectomy). Group II patients (n=102) underwent KiberKnife stereotactic robotic radiotherapy. Results. Immediate treatment outcomes after both radical prostatectomy and robotic radiosurgery did not demonstrate increased number of postoperative complications and severe radiation-induced injuries. The PSA level decreased and reached a nadir PSA level immediately after radical prostatectomy. After stereotactic radiation therapy, the PSA level decreased gradually every three months, reaching a nadir within a year. In the group of patients receiving CyberKnife treatment, changes in the prostate volume affected the quality of urination, which was confirmed by the assessment of the volume of residual urine. When comparing the quality of urination in treatment groups using the IPSS scale, the values were comparable. No differences in the 1-year disease-free survival rates between groups were found. However, 60 months later, disease free survival rate was higher by 8.2 % in patients treated with radiosurgery than in patients who underwent radical prostatectomy (p function show_abstract() { $('#abstract1').hide(); $('#abstract2').show(); $('#abstract_expand').hide(); }

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Requirements for efficient PCR clamping by locked nucleic acid oligonucleoties for simple and sensitive detection of somatic mutations

Requirements for efficient PCR clamping by locked nucleic acid oligonucleoties for simple and sensitive detection of somatic mutations

Shamanin Vladimir A., Karpov Igor V., Pisareva Еkaterina E., Gutkina Nadezhda I., Kovalenko Sergey P.

Статья научная

PCR clamping/wild-type blocking PCR with non-extendable locked nucleic acid (LNA) oligonucleotides is used for sensitive detection of somatic mutations in tumors. Various versions of the technique use different DNA polymerases and LNA oligonucleotides with and without additional phosphorothioate modifications. Here we studied requirements for successful PCR clamping with LNA oligonucleotides and Taq DNA polymerase for analysis of mutations in KRAS and bRAF genes by means of real-time PCR and Sanger sequencing. We found that addition of phosphorothioate linkages at the 5’-end of LNA oligonucleotide to protect from 5’-exonuclease activity of Taq DNA polymerase did not improve clamping. For most target sequences, efficient clamping was observed at melting temperature of LNA oligonucleotide 20-25°C above annealing/extension temperature of the PCR with a 2-step protocol. Under such conditions, simple and sensitive detection of mutations in KRAS and bRAF genes was feasible using real-time PCR with TaqMan probes or Sanger sequencing.

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Short-term results of surgical treatment of non-organic retroperitoneal tumors

Short-term results of surgical treatment of non-organic retroperitoneal tumors

Zubkov R.A., Rasulov R.I.

Статья научная

Comparative analysis of short-term results of combined operations and isolated removal of non-organic retroperitoneal tumors has been carried out. The study included 97 patients with malignant primary and recurrent tumors adjacent to surrounding organs. A total of 106 operations were performed, 56 of them were combined operations (52 patients were operated on), and isolated tumor removal was performed in 50 cases (45 patients were operated on). It has been found that the hemorrhage volume and surgery duration are significantly increased during the combined operations resulting in the increase in the rate of postoperative complications, however, these differences are not significant.

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Single vein resection in surgery for pancreatic ductal carcinoma as a criterion of resectability

Single vein resection in surgery for pancreatic ductal carcinoma as a criterion of resectability

Chichevatov D.A., Kalentjev V.V., Glukhov A.E.

Статья научная

Background. pancreatic ductal carcinoma (pdc) with involvement of the superior mesenteric vein (smV) or/and portal vein (pV) remains a discussible subject. We have evaluated vein invasion as a criterion of borderline resectability and long-term outcome. material and methods. in our center, 68 patients underwent either 65 standard pancreatoduodenal resections or 3 pancreatoduodenectomies for pdc. Resection of smV/pV was performed in 18 cases (26.5 %). three patients received neoadjuvant chemotherapy (Nact), and adjuvant chemotherapy (act) was assigned to 37 patients (54.4 %). Results. morbidity (42.0 vs 50.0 %, р=0.590) and mortality rates (4.0 vs 16.7 %, р=0.111) had no significant differences in groups of standard and angioplasty operations respectively. act was completed in 10 (16.7 %) patients only. there was true vein invasion in 12 of 18 patients with vein resection. рN+ (р=0.012) and angioplasty by itself (р

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