ОСОБЕННОСТИ ДИАГНОСТИКИ СЛИЗИСТОГО РАКА МОЛОЧНОЙ ЖЕЛЕЗЫ

The paper presents the diagnostic results of 27 patients with mucinous breast cancer, which is a rare type of invasive ductal breast cancer accounting for less than 2% of all breast cancers. The role of radiological, histological and cytological examination in the diagnosis of mucinous breast cancer is evaluated. In cases with large tumors, it was difficult to differentiate mucinous breast cancer from fibrocystic and other benign breast lesions.Представлены результаты обследования 27 больных слизистым раком молочной железы, который является редкой формой заболевания, он встречается примерно в 2 % случаев. Описаны особенности лучевой, цитологической и гистологической диагностики. Отмечено, что при слизистом раке больших размеров имеются трудности в дифференциальной диагностике с поликистозными и другими доброкачественными образованиями молочной железы

Combination of Endobronchial Ultrasound and Modern Cytological Diagnosis in Patients With Intrathoracic Lesions

Objective: To evaluate the effectiveness of endobronchial (EBUS) and endoscopic ultrasound (EUS) in cytomorphological verification of a malignant process using the transbronchial needle aspiration (TBNA) of the lymph nodes and mediastinal organs.Materials and methods: In 2017–2019 we analyzed the cytological samples (standard and cell block) of 172 patients (115 males and 57 females) with an average age of 61 years (25–82 years) in the clinical diagnostic laboratory of Scientific Research Institute – Ochapovsky Regional Clinical Hospital No. 1 (Krasnodar, Russian Federation). Of them 111 were used for immunocytochemical analysis. The majority of the studies (77) were performed in patients with lung cancer in order to identify the stage of the disease. We used combined bronchoscopy under general anesthesia in the operating room with high-frequency ventilation and a rapid on-site evaluation (ROSE).Results: We found the lymph node and mediastinal invasion in 140 (81%) patients who underwent EBUS-EUS TBNA. The non-diagnostic results were obtained in 32 (19%) patients. The combination of EUS and EBUS with TBNA showed the highest effectiveness in the mentioned clinical cases. The sensitivity, specificity, and accuracy of the cytologic analysis during EBUS and EUS with TBNA and no ROSE were 89%, 100%, and 90%, respectively. ROSE reduced the rate of non-diagnostic results and increased the sensitivity (96%), specificity (100%), and accuracy (97%) of the cytologic evaluation.Conclusions: According to the obtained results, we recommend using EBUS-EUS TBNA modalities for morphological verification of the mediastinal lymph nodes as a routine invasive diagnosis component of the preoperative evaluation in patients with lung cancer

Множественная постлучевая ангиосаркома молочной железы: редкий клинический случай

This article describes the rare clinical case of multiple radiation-induced angiosarcoma of the breast. Angiosarcoma is a rare, aggressive tumor originating from the endothelial cells of blood vessels that can affect internal organs, but the most common localization is the skin. The frequency of angiosarcoma development in the mammary gland is less than 1% of all malignant tumors of this localization. There are primary and radiation-induced (secondary) angiosarcomas. The reason for describing this clinical case is the rarity of this pathology, relatively little experience in the diagnosis and treatment of radiation-induced angiosarcoma both in our country and abroad.В данной статье описано редкое клиническое наблюдение множественной радиоиндуцированной ангиосаркомы молочной железы (РИАС). Ангиосаркома — редкая, агрессивная опухоль, происходящая из эндотелиальных клеток кровеносных сосудов, которая способна поражать внутренние органы, но наиболее частой локализацией является кожа [1]. Частота развития ангиосарком молочной железы составляет менее 1% от всех злокачественных новообразований данной локализации. Различают первичную и радиоиндуцированную (вторичную) ангиосаркому (РИАС). Основанием для написания данного клинического случая является редкость данной патологии, сравнительно небольшой опыт по диагностике и лечению радиоиндуцированной ангиосаркомы как в нашей стране, так и за рубежом

DIAGNOSIS OF MUCINOUS BREAST CANCER

The paper presents the diagnostic results of 27 patients with mucinous breast cancer, which is a rare type of invasive ductal breast cancer accounting for less than 2% of all breast cancers. The role of radiological, histological and cytological examination in the diagnosis of mucinous breast cancer is evaluated. In cases with large tumors, it was difficult to differentiate mucinous breast cancer from fibrocystic and other benign breast lesions

THE ROLE OF BRAF MUTATION STATUS IN SURGICAL TREATMENT OF WELL-DIFFERENTIATED THYROID CANCER

Background. Papillary thyroid carcinoma (PTC) accounts for 80 % of all well-differentiated thyroid cancers. Mutation of the BRAF gene (V600E) is one of the most common prognostic factors for PTC. Various studies showed different degree of correlation between BRAF (V600E) mutation and other prognostic factors.Materials and methods. 60 patients with PTC treated in P.A. Herzen Moscow Oncology Research Institute during 2014–2016 were included in this prospective study. Selection of patients was based on the results of fine-needle aspiration biopsy and polymerase chain reaction. Study participants were randomized into 2 groups: the first one included 45 patients harboring BRAF V600E mutation, the second one included 15 patients who lack this mutation. The following prognostic factors were evaluated in postoperative period: histological subtype of PTC, tumor invasion into the capsule of thyroid gland, multicentricity, presence of metastases in regional lymph nodes and distant metastases, TNM stage. Statistical data analysis was carried out using GraphPad Prism software.Results. Papillary thyroid cancer was diagnosed in 40 % of the patients, follicular thyroid cancer – in 60 % in both groups. Tumor invasion into the capsule of thyroid gland was identified in 88 and 40 % of the cases in the first and second group respectively; thyroid capsular invasion – in 26 and 10 %; multicentricity – in 20 and 10 %; microcarcinomas (0.3–1.0  cm) – in 57 and 60 %, metastasis to regional lymph nodes – in 40 and 30 %. 51 % of the patients in the first group were found to have pT1 thyroid cancer with tumor capsular invasion without spreading beyond. After surgical treatment 23 % of the patients from the first group had changes in tumor stage from cT1–2  to pT3 according to routine histological examination results. Distant metastases were observed in 5 % of the cases in the first group and in 10 % in the second group. We found a statistically significant association between BRAF (V600E) mutation and tumor invasion into the capsule of thyroid gland (p < 0.05). At the same time neither multicentricity nor metastases in regional lymph nodes were associated with BRAF-mutation (p > 0.05). Conclusions. BRAF mutation in patients with PTC is associated with tumor invasion into the capsule of thyroid gland; this should imply the use of more aggressive treatment strategy (surgery). Further studies are needed to clarify the existing data

The CIMP-high phenotype is associated with energy metabolism alterations in colon adenocarcinoma

Abstract Background CpG island methylator phenotype (CIMP) is found in 15–20% of malignant colorectal tumors and is characterized by strong CpG hypermethylation over the genome. The molecular mechanisms of this phenomenon are not still fully understood. The development of CIMP is followed by global gene expression alterations and metabolic changes. In particular, CIMP-low colon adenocarcinoma (COAD), predominantly corresponded to consensus molecular subtype 3 (CMS3, “Metabolic”) subgroup according to COAD molecular classification, is associated with elevated expression of genes participating in metabolic pathways. Methods We performed bioinformatics analysis of RNA-Seq data from The Cancer Genome Atlas (TCGA) project for CIMP-high and non-CIMP COAD samples with DESeq2, clusterProfiler, and topGO R packages. Obtained results were validated on a set of fourteen COAD samples with matched morphologically normal tissues using quantitative PCR (qPCR). Results Upregulation of multiple genes involved in glycolysis and related processes (ENO2, PFKP, HK3, PKM, ENO1, HK2, PGAM1, GAPDH, ALDOA, GPI, TPI1, and HK1) was revealed in CIMP-high tumors compared to non-CIMP ones. Most remarkably, the expression of the PKLR gene, encoding for pyruvate kinase participating in gluconeogenesis, was decreased approximately 20-fold. Up to 8-fold decrease in the expression of OGDHL gene involved in tricarboxylic acid (TCA) cycle was observed in CIMP-high tumors. Using qPCR, we confirmed the increase (4-fold) in the ENO2 expression and decrease (2-fold) in the OGDHL mRNA level on a set of COAD samples. Conclusions We demonstrated the association between CIMP-high status and the energy metabolism changes at the transcriptomic level in colorectal adenocarcinoma against the background of immune pathway activation. Differential methylation of at least nine CpG sites in OGDHL promoter region as well as decreased OGDHL mRNA level can potentially serve as an additional biomarker of the CIMP-high status in COAD

Upregulation of NETO2 gene in colorectal cancer

Abstract Background Neuropilin and tolloid-like 2 (NETO2) is a single-pass transmembrane protein that has been shown primarily implicated in neuron-specific processes. Upregulation of NETO2 gene was also detected in several cancer types. In colorectal cancer (CRC), it was associated with tumor progression, invasion, and metastasis, and seems to be involved in epithelial-mesenchymal transition (EMT). However, the mechanism of NETO2 action is still poorly understood. Results We have revealed significant increase in the expression of NETO2 gene and deregulation of eight EMT-related genes in CRC. Four of them were upregulated (TWIST1, SNAIL1, LEF1, and FOXA2); the mRNA levels of other genes (FOXA1, BMP2, BMP5, and SMAD7) were decreased. Expression of NETO2 gene was weakly correlated with that of genes involved in the EMT process. Conclusions We found considerable NETO2 upregulation, but no significant correlation between the expression of NETO2 and EMT-related genes in CRC. Thus, NETO2 may be involved in CRC progression, but is not directly associated with EMT