Gynecologic Oncology

Gynecologic Oncology 2018 #4


Tchevkina E.M., Zborovskaya I.B., Galetskiy S.A., Akselrod M.E.
Prospects For The Use Of Exosomal MicroRNA In The Diagnosis Of Ovarian Cancer
Objective of the study — is to conduct an analytical overview of literature data on molecular composition of exosomes in ovarian cancer.
Materials and Methods. The overview comprises the results of international screening and experimental studies published over the past 20 years.
Results. The work reports the data on the change of the number and molecular composition of exosomes, including microRNA, associated with ovarian cancer pathogenesis.
Conclusion. The analysis, that had been performed, revealed a number of microRNA and their combinations as potential markers of ovarian cancer, but, based on diverse sources in the literature, data on specifi c molecules vary considerably. Searching and identifying the most sensitive microRNA will improve early detection of ovarian cancer, and respectively, the prognosis for such patients.
Keywords: exosomes, extracellular vesicles, microRNA, ovarian cancer, diagnosis.
 Full text (in Russian)
Sviridova S.P., Kashiya Sh.R., Obukhova O.A., Rubanskaya M.V., Sotnikov A.V.
The Role Of Thrombocytes In Tumor Growth And Metastasis
Objective of the study is to conduct an analysis of the data available in current literature on the relationship between cancer and coagulation system as well as on the use of platelet aggregation inhibitors including aspirin, as non-specifi c prevention and targeted cancer therapy.
Materials and Methods. The analytical overview comprises the data of academic articles written by English language authors and Russian authors.
Results. The work shows the role of platelets both in the development of thrombotic complications of oncologic pathology and in the development, progression and metastasis of malignant process, as well as the therapeutic effect of acetylsalicylic acid in integrated antitumor treatment.
Conclusion. Further research which will enable a better understanding of chemopreventive properties of aspirin and its role in the prevention and treatment of oncologic diseases is required.
Keywords: oncology, thrombocytes (platelets), tumor-associated platelet activation.
 Full text (in Russian)
Zabotina T.N., Chertkova A.I., Korotkova O.V., Borunova A.A., Zakharova E.N., Tabakov D.V., Slavina E.G., Khakimova Sh.G., Vorotnikov I.K., Kadagidze Z.G.
The Relationship Between Immune Parameters And Age And Expression Of Hormone Receptors In Patients With Primary Operable Breast Cancer
Objective of the study is to determine the relationship between the contents of the cells of effector and regulatory lymphocyte populations of peripheral blood of innate and adaptive immunity and age and the level of expression of estrogen and progesterone receptors (ER and PgR) in patients with primary operable breast cancer.
Materials and Methods. Immunophenotyping of peripheral blood lymphocytes of patients with primary operable breast cancer was performed on fi ve-parameter fl uorescence-based fl ow cytometer.
Results. Deviations in composition of lymphocyte subpopulation of peripheral blood from the control criteria were revealed in patients with primary operable breast cancer before the treatment. The number of cells of adaptive and innate immunity was different in patients younger than 40 years old and patients 40 years of age and older. Composition of lymphocyte subpopulations of peripheral blood was different in patients with estrogen receptors/progesterone receptors (ER/PgR) — positive and estrogen receptors/progesterone receptors (ER/PgR) — negative status.
Conclusion. The results obtained in the study indicate the existing dependence of systemic immune response indicators in patients with primary operable breast cancer on patient age and expression of estrogen and progesterone receptors on tumor cells.
Keywords: primary operable breast cancer, breast cancer, immunophenotyping, lymphocytes of peripheral blood, patient age, estrogen receptors/progesterone receptors (ER/PgR)-status/
 Full text (in Russian)
Vysotskaya I.V., Letyagin V.P., Kim E.A., Pogodina E.M., Kirsanov V.Yu., Levkina N.V.
Breast Cancer: From Pathogenesis To Prevention
Objective of the study is to analyze the current state of chemoprevention of breast cancer in women of high-risk groups, including those with atypical hyperplasia and to determine the signifi cance of the method, based on the specifi c properties of pathogenesis of the disease.
Materials and Methods. The review comprises the data from foreign and Russian scholarly articles found in PubMed on the subject published over the past 10 years.
Results. The work analyses the results obtained in various research studies in terms of the peculiarities of carcinogenesis in patients with dishormonal dysplasia of the breast.
Conclusion. There are currently no standards for the use of chemoprevention in risk groups. Correction of the changes which comprise precancerous conditions and neoplastic process based on the status of tumor markers — is one of possible variants of early prevention.
Keywords: breast cancer, chemoprevention, anti-estrogens, dishormonal dysplasia.
 Full text (in Russian)
Olimov B.P., Streltsova O.N., Panichenko I.V., Panov V.O., Zhordania K.I., Tyurin I.E.
Imaging Methods Of Diagnosis Of Uterine Adnexal Tumors
Objective of the study is to carry out the analysis of literature data on magnetic resonance diagnostics of ovarian tumors.
Materials and Methods. The overview comprises the data from foreign and Russian scholarly literature sources published over the past 10 years.
Results. The work presents MRI algorithms in differential diagnosis of uterine adnexal tumors.
Conclusion. It is necessary to develop and implement an algorithm of MRI protocols in a certain sequence to increase effectiveness of differential diagnosis of uterine adnexal tumors.
Keywords: malignant uterine adnexal tumors, ultrasonography (medical ultrasound), magnetic resonance imaging, algorithm, recommendation.
 Full text (in Russian)
Savostikova M.V., Korolenkova L.I., Fedoseeva E.S., Pimenova V.V.
The Experience Of The Use Of Liquid-Based Technology BD SurePathTM For Early Diagnosis And Screening For Cervical Precancerous Lesions And Cervical Cancer In Rostov Region
Objective of the study is to determine the effectiveness of liquid-based cytology BD SurePathTM using automated image analysis system for cervical screening in comparison with a conventional technique.
Materials and Methods. Cytology specimens collected from 54 medical institution of Rostov region were analyzed. 188641 conditionally healthy women were examined within the screening program using liquid-based cytology BD Sure- PathTM. 10563 women who came to see a gynecologist with their health issues or who had been diagnosed with cervical pathology in the anamnesis underwent conventional cytology test. Cervical cytology smears for conventional cytology were obtained using cervical brush and cytobrush — endobrush with further staining with Pappenheim method. Standard cytobrushes Cervex-Brush Rovers® or Cervex-Brush Combi Rovers® were used to perform liquid-based cytology tests, preparations were stained with Papanicolaou technique with further scanning of cytology slides with BD FocalPoint GS imaging system.
Results. From the study sample it was possible to compare cytological and histological fi ndings of 534 patients (441 of them were examined with liquid-based cytology technique, 93 — with conventional cytology). Thereby sensitivity, specifi - city and accuracy of cytology examination with liquid-based cytology technique were respectively 78,3%, 95,9% and 85%, whereas with a conventional method — 80, 96,2 and 89,2% respectively.
Conclusion. Liquid-based technology BD SurePathTM using BD FocalPoint GS imaging system has a number of advantages compared to conventional cytology and can be recommended for early diagnostics and for the screening for cervical precancerous lesions and cervical cancer.
Keywords: cervical screening, early diagnosis, liquid-based cytology, BD SurePathTM, BD FocalPointTM, cervical cancer.
 Full text (in Russian)
Ulrikh E.A., Urmancheeva A.F., Gurkin Yu.A., Semiglazova D.V., Ulrikh D.G., Khalimbekova D.I., Balasanyan V.G., Kutusheva G.F.
Primary Prevention Of Cervical Cancer. Effectiveness, Safety, Economic Feasibility Of Vaccination
Objective of the study is to evaluate effectiveness, safety and economic feasibility of vaccination against papillomavirus infection as the primary prevention of cervical cancer by analyzing data available in current literature.
Materials and Methods. The overview comprises the data of foreign and Russian scholarly articles found in PubMed on the subject published over the past 14 years.
Results. Analysis of the results of several randomized multicenter studies of phases II and III proved high effectiveness of vaccination in reducing the spread of human papillomavirus infection and prevention of cervical cancer. At the same time, the evaluation of safety of more than 183 million doses of vaccines didn’t show any serious side effects. Economic feasibility and projected effectiveness of vaccination directly depends on the population coverage. As a result of various vaccination programs undertaken for schoolgirls, both developed and developing countries can boast signifi cant immunization rates of coverage.
Conclusion. Though vaccines, overall, are safe, immunogeneous and effective in the prevention of human papillomavirus infections and conditions, preceding cervical cancer, as well as other benign and malignant human papillomavirus (HPV) — associated neoplasms, but only inclusion of vaccination of adolescents of both genders into the national immunization calendar along with the introduction of possible screening programs will guarantee signifi cant progress in managing the problem of incidence and mortality from human papillomavirus (HPV) — associated diseases in the Russian Federation.
Keywords: human papillomavirus (HPV), cervical cancer, prevention, vaccination.
 Full text (in Russian)
Morikov D.D., Mikhailova V.V., Ushakova I.V., Ponomarenko D.M.
Renal Replacement Therapy In Patients With Cervical Cancer Complicated By Acute Renal Failure
Objective of the study — is an analysis of the course and outcome of cervical cancer, complicated by acute renal failure after performing renal replacement therapy and percutaneous nephrostomy.
Materials and Methods. Analysis of the results of treatment of 46 patients with cervical cancer who had been under observation at the State Budgetary Healthcare Institution «Regional Oncologic Dispensary» in Irkutsk for the period from 2013 to 2017 was conducted. The course of oncologic disease in that group of women was complicated by acute renal failure of post-renal genesis. To evaluate the extent and severity of ureterohydronephrosis the patients underwent ultrasound examination of renal pelvicalyceal system. All patients underwent sessions of renal replacement therapy (RRT) at the Department of Anaesthesiology, Resuscitation and Intensive Care Medicine №4 of Irkutsk Regional Oncologic Dispensary. The pattern of treatment for cervical cancer was taken into consideration in the analysis of its long-term outcomes.
Results. The patients were admitted to the Department of Anaesthesiology and Resuscitation №4 with the symptoms of acute renal failure. The leading symptoms presenting at admission were: uremia (100%), edema (80,4%), arterial hypertension (63%), nausea (56,5%), oliguria (52,2%), anuria (47,8%), hemorrhagic syndrome (47,8%), electrolyte disorders (43,5%), cardiac arrhythmia (43,5%), vomiting (26,1%). Disequilibrium syndrome occurred after the fi rst session of renal replacement therapy (RRT), and preventive initial hemodialysis performed in 23,9% of cases, proved ineffective. Subsequently renal replacement therapy (RRT) was performed in individual regimen with Kt/V-1.3-1.5. Overall 46 women underwent 119 sessions of intermittent hemodialysis. After clinical symptoms of azotemia subsided (levels of urea nitrogen decrease to 17,01±14,983, of creatinine — up to 603,405±208,386) the method of choice for urinary diversion was percutaneous nephro stomy by direct puncture technique which was attributed to progressing extensive neoplastic narrowing of upper urinary tract and ineffi ciency of ureteral stenting. After the resolution of urinary retention disorders in 26 patients (56,5% of cases), a stage of polyuria developed, in other cases daily urine output remained within normal ranges. After restoring adequate daily urine output and upon achieving averaged values of serum creatinine — 355,3 mmol/, blood urea — 12,9 mmol/L, potassium — 4,01 mmol/L, urine volume — 3553,9 ml per day patients were transferred into the specialized department. The life span level in the group of patients (N-7), who had undergone renal replacement therapy (RRT), percutaneous nephrostomy and combined chemoradiation therapy ranged from 6 to 30 months. The mean level was — 13,4±3,2 months, interquartile range — 7–16 months. In the group of patients (N-39) who received only the treatment for acute renal failure (renal replacement therapy and nephrostomy), the mean level of life span made up 3,1±0,36 months, and the level of life span — from 1 to 8 months, interquartile range was 1–5 months.
Conclusion. Acute renal failure occurring as the result of progression of cervical cancer, is a severe complication and it affects the outcome of the disease. The use of renal replacement therapy and the drainage of upper urinary tract ensure that the symptoms of uremia effectively subside and increases the life expectancy of patients on 3,1 months. Renal replacement therapy (RRT) combined with nephrostomy for patients who undergo treatment based on radical program allows to keep up with the regimen of treatment of major pathology shifting the median of life expectancy to 13,4 months.
Keywords: cervical cancer, acute renal failure of post-renal genesis, renal replacement therapy, chemoradiation therapy.
 Full text (in Russian)