Use of ultrasound examination in evaluation of the size and advancement of laryngeal and hypopharyngeal tumors to the neighboring anatomical structures

The study objectiveis to establish the capabilities of ultrasound (US) examination in evaluation of the advancement of squamous-cell carcinoma of the larynx and hypopharynx compared to histological examination and other diagnostic methods.Materials and methods.US examination was performed in 86 patients with squamous-cell carcinoma of the larynx and hypopharynx. The study included 14 (16.3 %) patients with stage I disease, 29 (33.7 %) patients with stage II, 19 (22.1 %) patients with stage III and 24 (27.9 %) patients with stage IV. Patients with primary tumors of the larynx and hypopharynx comprised 75.6 % of the study population, patients with recurrent tumors – 24.4 %. During diagnosis advancement of tumors to the anatomical structures in the laryngeal space and beyond was evaluated. In all cases histological verification of the diagnosis was performed. Comparison of the data on advancement of laryngeal and hypopharyngeal tumors from different diagnostic methods with the results of histological examination depending on the T-category (TNM) was performed.Results.For small tumors (Т1), frequency of agreement between advancement of laryngeal and hypopharyngeal tumors measured by US examination and histological examination was 66.7 %, by endoscopic laryngoscopy (ELS) – 80.0 %; for T2 tumors, results of US examination and ELS were identical, frequency of agreement with histological examination data was 87.2 % for both methods; for T3 tumors, US examination data agreed with histological examination data in 83.3 % of cases, ELS data – in 75.0 %; for T4 tumors, frequency of agreement between US examination and histological examination data was only 44.4 %, between ELS and histological examination – 66.7 %. Therefore, US examination was more accurate for evaluation of advancement of T2 and T3 tumors. Results of evaluation of advancement of laryngeal and hypopharyngeal tumors by US examination, computed tomography and magnetic resonance tomography were close, comparable and weren't statistically different. For T1 and T2 tumors frequency of agreement between the results of histological examination and US examination data was higher than between the results of histological examination and computed tomography data.Conclusions.High accuracy and value of US examination in evaluation of advancement of primary and recurrent tumors of the larynx and hypopharynx were shown

Up-to-date opportunities of cervical lymph nodes ultrasound investigation in patients, suffering from oral cavity cancer

Background. Incidence of oral cancer in Russia is 4.52 and mortality – 2.44. Head and neck cancer is characterized by the high risk of development of metastases in regional lymph nodes. Lymph nodes status exerts influence on the treatment plan and appears to be the major predictive factor. Regional metastases result into two-fold decrease of five-year survival. Therefore, evaluation and treatment of metastatic lymph nodes is of prime importance. Objective. The aim of this manuscript was to illustrate and summarize publications devoted to modern methods of ultrasound evaluation of cervical lymph node status in patients with squamous cell carcinoma of the oral cavity. Results. Numerous studies have demonstrated, that standard ultrasound investigation (in B-mode) is characterized by high sensitivity and specificity (specificity varies from 71.0 to 96.4 %, and specificity – from 46.6 to 91.0 %, according to different studies). In addition, ultrasound efficiency exceeds that of CT. Accuracy of ultrasound as the method of cervical lymph node investigation has increased after implementation of such methods, as elastography and elastometry (this techniques allow to achieve sensitivity of 98.1 % and specificity of 100 %)

RESULTS OF ORTHOPEDIC TREATMENT IN CANCER PATIENTS WITH MAXILLOFACIAL DEFECTS

The fates of 450 patients with different defects of the upper jaw and midfacial tissues were traced after maxillofacial replacement were traced. The follow-up was 1 to 15 years. The immediate and late results of orthopedic treatment were studied using the follow-up and assessed from both the underlying disease and the degree of functional and cosmetic efficiency of orthopedic apparatuses

Esthesioneuroblastoma: clinical course, long-term results of treatment

This rare tumor from a group of neuroendocrine neoplasms was studied. The material for the study was the data of 78 patients with esthesioneuroblastoma who had been treated and followed up at the N.N. Blokhin Russian Cancer Research Center in the period 1965 to 2014. Information on hospital statistics, clinical features, methods, and treatment results were presented. The possibilities of using the TNM classification for the nasal cavity, ethmoidal sinuses, and nasopharynx were assessed to determine the anatomic extent of primary tumor. The findings contribute to the solution of problems in the diagnosis and treatment of esthesioneuroblastoma at the present stage

Epidemiological and clinical features of lymphoproliferative diseases in the head and neck region

Background. Lymphomas are a heterogeneous group of the lymphoid and hematopoietic system tumors. Neoplastic process often develops in head and neck area, including the integumentary tissues, orbit, nasal cavity, paranasal sinuses, oral cavity, pharynx, salivary glands, thyroid gland, as well as neck lymph nodes. The difficulties of head and neck lymphomas diagnosis are significant, since very often there is a combined non-tumor pathology. The high heterogeneity of lymphomas in the head and neck area requires structuring knowledge about their epidemiology and clinical manifestations.Objective: to study the epidemiological and clinical features of the head and neck lymphoproliferative diseases, which will lead to an improvement in diagnostic quality of this nosology's.Materials and methods. The frequency of head and neck lymphoproliferative diseases detection was estimated based on the study of epicrisis and clinical data of 174 patients hospitalized at the N.N. Blokhin National Medical Research Center of Oncology in the period from 2000 to 2020.Results. Taking into account the modern clinical and morphological classification of lymphomas of the World Health Organization (2017), information about the features of localization, characteristic signs of extranodal foci and lymph nodes is presented. Detection frequency of various subtypes non-Hodgkin's and Hodgkin's lymphomas were determined on a sufficient cohort of patients.Conclusion. Based on the analysis of clinical and morphological features of head and neck lymphomas, epidemiological and clinical features are described in detail, and differences in the symptoms and clinical manifestations of non-Hodgkin's and Hodgkin's lymphomas with a predominant head and neck involvement are revealed

Диагностическая значимость уровней ДНК и антител к капсидному антигену вируса Эпштейна–Барр в плазме крови больных раком носоглотки в неэндемическом регионе

Epstein–Barr virus (EBV), a representative of the herpesvirus family, is the etiological agent for a number of benign and malignant human neoplasms. Among the latter, the nasopharyngeal carcinoma (NPC) occupies a special place. In NPC development EBV plays a key role stimulating the progression of the pathological process from precancerous lesions to the cancer development. For most NPC patients, elevated levels of humoral IgG and IgA antibodies against capsid and early EBV antigens are characteristic and their antibody titers rise to high levels long before the diagnosis of cancer. Using this phenomenon, virus-specific antibodies are used for many years as markers for NPC screening, especially in cases of undiagnosed primary lesion. In recent years, in endemic for NPC regions (South China, South-East Asia) a great attention has been paid to the use of quantitative determination of EBV DNA copies in the blood plasma of patients with NPC as a method of early cancer detection and monitoring.The aim of this study was to compare clinical significance of EBV DNA and humoral antibodies levels in blood plasma of NPC patients in non-endemic region, Russia. The results obtained indicate that both markers DNA / EBV and IgA antibodies against capsid EBV antigens can be successfully used for diagnosis of NPC in non-endemic region. However, in comparison with the virus-specific antibody titers, the viral DNA levels in the patients plasma are more sensitive and specific as NPC marker reflecting the efficacy of the therapy, and the state of remission or relapse.Вирус Эпштейна – Барр (ВЭБ), представитель семейства герпес-вирусов человека, является этиологическим агентом для ряда доброкачественных и злокачественных новообразований человека. Среди последних особое место занимает рак носоглотки (РНГ). В его возникновении ВЭБ играет ключевую роль, стимулируя прогрессирование патологического процесса от предраковых поражений до появления злокачественной опухоли. Для большинства больных РНГ характерны повышенные уровни гуморальных IgI- и IgA- антител к капсидному и раннему антигенам ВЭБ, причем титры этих антител поднимаются до высоких уровней задолго до диагностического рака. При учете этого феномена уже многие годы вирусоспецифические антитела используются в качестве маркеров для диагностики РНГ, особенно в случаях невыявленного первичного очага. В последние годы в эндемичных для РНГ регионах (Южный Китай, страны Юго-Восточной Азии) проявлен большой интерес к использованию количественного определения копий ДНК ВЭБ в плазме крови больных РНГ в качестве метода раннего выявления рака и мониторинга опухолевого процесса.Цель исследования – сравнительная оценка клинической значимости уровней ДНК ВЭБ и гуморальных антител к вирусу в плазме крови больных РНГ в неэндемичном регионе (России). Полученные результаты свидетельствуют о том, что оба маркера: ДНК ВЭБ и IgA- антитела к капсидному антигену ВЭБ могут быть успешно использованы для диагностики РНГ в неэндемичном регионе. Однако по сравнению с вирусоспецифическими антителами число копий вирусной ДНК в плазме крови больных является более чувствительным и специфическим маркером, отражающим эффективность проведенной терапии, а также состояние ремиссии или рецидива болезни

Ультразвуковая диагностика рака языка. Определение глубины инвазии опухоли

В статье приведен анализ результатов ультразвукового исследования 26 пациентов с опухолью языка, получавших хирургическое и комбинированное лечение. Сравнение результатов ультразвукового исследования в определении глубины инвазии и расположения опухоли относительно средней линии языка с данными гистологического исследования. Наибольшее увеличение медианы общей выживаемости достигается у пациентов с хорошим функциональным статусом, ограниченным метастатическим поражением головного мозга и метастазами радиочувствительных опухолей

КЛИНИЧЕСКИЕ РЕКОМЕНДАЦИИ. ДИАГНОСТИКА И ЛЕЧЕНИЕ РАКА РОТОГЛОТКИ

Клинические рекомендации подготовлены на основании материалов научно-практической конференции Проблемной комиссии «Опухоли головы и шеи» Научного совета по злокачественным новообразованиям Отделения медицинских наук Российской академии наук и Министерства здравоохранения РФ, посвященной памяти профессора Александра Ильича Пачеса, «Актуальные вопросы диагностики и лечения рака ротоглотки» (25 июня 2015 г., г. Архангельск).Клинические рекомендации подготовлены на основании материалов научно-практической конференции Проблемной комиссии «Опухоли головы и шеи» Научного совета по злокачественным новообразованиям Отделения медицинских наук Российской академии наук и Министерства здравоохранения РФ, посвященной памяти профессора Александра Ильича Пачеса, «Актуальные вопросы диагностики и лечения рака ротоглотки» (25 июня 2015 г., г. Архангельск)

New-generation mutitargeted tyrosine kinase inhibitors in the treatment of radioactive iodine-refractory differentiated thyroid cancer

Background. Thyroid cancer (TC) is one of the common oncological disease of the head and neck. However, its treatment is sharply restricted in a locally advanced and metastatic cancer process. In the past decade, there have been fundamental changes in the understanding of the molecular bases of thyroid carcinogenesis, resulting in the design of novel targeted drugs aimed at disseminated and refractory TC control. Multikinase inhibitors that are able to block the processes of proliferation, invasion, and neoangiogenesis are being intensively studied worldwide. Performed placebo-controlled trials have culminated in the registration of the antitumor drugs that is highly active against disseminated medullary and differentiated TC, which will make a change in the situation in treating radioactive iodine-refractory differentiated TC in the near future. Objective: to review recent advances in the targeted therapy of TC with particular emphasis on lenvatinib, a multikinase inhibitor