Optimization of the extent of surgical treatment in patients with stage I in cervical cancer

The study included 26 patients with FIGO stage Ia1–Ib1 cervical cancer who underwent fertility-sparing surgery (transabdominaltrachelectomy). To visualize sentinel lymph nodes, lymphoscintigraphy with injection of 99mTc-labelled nanocolloid was performed the day before surgery. Intraoperative identification of sentinel lymph nodes using hand-held gamma probe was carried out to determine the radioactive counts over the draining lymph node basin. The sentinel lymph node detection in cervical cancer patients contributes to the accurate clinical assessment of the pelvic lymph node status, precise staging of the disease and tailoring of surgical treatment to individual patient

Optimization of the extent of surgical treatment in patients with stage I in cervical cancer

The study included 26 patients with FIGO stage Ia1–Ib1 cervical cancer who underwent fertility-sparing surgery (transabdominaltrachelectomy). To visualize sentinel lymph nodes, lymphoscintigraphy with injection of 99mTc-labelled nanocolloid was performed the day before surgery. Intraoperative identification of sentinel lymph nodes using hand-held gamma probe was carried out to determine the radioactive counts over the draining lymph node basin. The sentinel lymph node detection in cervical cancer patients contributes to the accurate clinical assessment of the pelvic lymph node status, precise staging of the disease and tailoring of surgical treatment to individual patient

The use of {99m}Tc-Al[2]O[3] for detection of sentinel lymph nodes in cervical cancer patients

The purpose of the study was to evaluate the feasibility of using {99m}Tc-Al[2]O[3]- based radiopharmaceutical, a novel molecular imaging agent for sentinel lymph node detection in patients with invasive cervical cancer. The study included 23 cervical cancer patients (TlaNxMx- T[2]bNxMx) treated at the Tomsk Cancer Research Institute. At 18 hours before surgery, 80 MBq of the {99m}Tc-Al[2]O[3] were injected peritumorally, followed by single-photon emission computed tomography (SPECT) of the pelvis and intraoperative SLN identification. Twenty-seven SLNs were detected by SPECT, and 34 SLNs were identified by intraoperative gamma probe. The total number of identified SLNs per patient ranged from 1 to 3(the mean number of SLNs was 1.4 per patient). The most common site for SLN detection was the external iliac region (57.2%), followed by the internal iliac, obturator, presacral and retrosacral regions (they amounted to 14%, respectively),and the parametrial region (1%). Sensitivity in detecting SLNs was 100% for intraoperative SLN identification and 79% for SPECT image

The first experience of using {99m}Tc-Al[2]O[3]-based radiopharmaceutical for the detection of sentinel lymph nodes in cervical cancer patients

The purpose of the study was to evaluate the feasibility of using {99m}Tc-Al[2]O[3]-based radiopharmaceutical,a novel molecular imaging agent for sentinel lymph node detection in patients with invasive cervical cancer. The study included 23 cervical cancer patients (T1aNxMx-T2bNxMx) treated at the Tomsk CancerResearch Institute. In the 18 hours before surgery, 80 MBq of the {99m}Tc-Al[2]O[3] in peritumoral injected, followed by single-photon emission computed tomography (SPECT) of the pelvis and intraoperative SLN identification. Twenty-seven SLNs were detected by SPECT, and 34 SLNs were identified by intraoperative gamma probe. The total number of identified SLNs per patient ranged from 1 to 3 (the mean number of SLNs was 1.4 per patient). The most common site for SLN detection was the external iliac region (57.2%), followed by the internal iliac (14%), obturator (14%), presacral and retrosacral regions (14%), and the parametrial region (1%). Sensitivity in detecting SLNs was 100% for intraoperative SLN identification and 79% for SPECT image

Clinical Significance of Sentinel Lymph Node Detection in Patients with Invasive Cervical Cancer

The clinical significance of determining sentinel lymph nodes (SLN) in patients with invasive cervical cancer was studied. From 2013 to 2014, 30 cervical cancer patients (T1a1NxM0-T1b1NxM0) were treated at the Gynecological Oncology Department of the Cancer Research Institute. The day before surgery, four submucosal injections of 99mTc Al2O3 at a total dose of 80 MBq were made in each quadrant around the cervical tumor. Patients were submitted to preoperative lymphoscintigraphy and intraoperative SLN detection. The feasibility of preserving the reproductive potential in patients after radical abdominal trachelectomy was assessed. The 3-year, overall, disease-free and metastasis-free survival rates were analyzed. Thirty-four SLNs were detected by single-photon emission computed tomography (SPECT) and 42 SLNs were identified by intraoperative gamma probe. The sensitivity in detecting SLNs was 100% for intraoperative SLN identification and 80% for SPECT image. The reproductive potential was preserved in 86% of patients. The 3-year overall and metastases-free survival rates were 100%. Recurrence occurred in 8.6% of cases

Особенности гормонального фона и рецепции половых гормонов у больных с гиперпластическими процессами и раком эндометрия

The integrated study of the level of hormones in systemic circulation, estrogen reception and metabolism in patients with endometrial hyperplasia and endometrial cancer has shown that the urinary level of estrogen metabolites in patients with hyperplastic and malignant endometrium depends on the level of steroid hormones in systemic circulation. The study showed that the changes in hormonal status were characterized by a high frequency of disturbances with development of hyperestrogenemia, hypertestosteronemia. Moreover, the LH level and LH/FSH index were increased and FSH and progerterone levels were decreased. Correlation between the level of steroid hormone receptors and the level of estrogen metabolites has been identified. It confirms the theory of “estrogen” stimulation recommended for patients with proliferative endometrium.Комплексное изучение гормонального уровня в системном кровотоке, рецепции и метаболизма эстрогенов у больных с гиперпластическими процессами и раком эндометрия показало, что у больных раком эндометрия вследствие повышения активности гипоталамуса наблюдаются выраженные нарушения в гормональной системе. Выявлено, что изменения гормонального статуса характеризуются высокой частотой нарушений с развитием состояния гиперэстрогенемии, гипопрогестеронемии, гипертестостеронемии, а уровень метаболитов эстрогенов в моче у больных с гиперплазированным и малигнизированным эндометрием зависит от уровня половых стероидов в системном кровотоке. Определены взаимосвязи между уровнем рецепторов стероидных гормонов и количеством метаболитов эстрогенов, что подтверждает теорию «эстрогенной» стимуляции, предложенную для больных пролиферативными процессами эндометрия

The use of {99m}Tc-Al[2]O[3] for detection of sentinel lymph nodes in cervical cancer patients

The purpose of the study was to evaluate the feasibility of using {99m}Tc-Al[2]O[3]- based radiopharmaceutical, a novel molecular imaging agent for sentinel lymph node detection in patients with invasive cervical cancer. The study included 23 cervical cancer patients (TlaNxMx- T[2]bNxMx) treated at the Tomsk Cancer Research Institute. At 18 hours before surgery, 80 MBq of the {99m}Tc-Al[2]O[3] were injected peritumorally, followed by single-photon emission computed tomography (SPECT) of the pelvis and intraoperative SLN identification. Twenty-seven SLNs were detected by SPECT, and 34 SLNs were identified by intraoperative gamma probe. The total number of identified SLNs per patient ranged from 1 to 3(the mean number of SLNs was 1.4 per patient). The most common site for SLN detection was the external iliac region (57.2%), followed by the internal iliac, obturator, presacral and retrosacral regions (they amounted to 14%, respectively),and the parametrial region (1%). Sensitivity in detecting SLNs was 100% for intraoperative SLN identification and 79% for SPECT image

МОДЕЛЬ РЕШЕНИЯ ОПТИМИЗАЦИОННЫХ ЗАДАЧ

The article refers to main outlines of mathematical model of rail transport. The authors substantiate the necessity to use dynamic programming method to optimize the parameters of the rail sector state. They argue the utility to use rail car department as a sort of department that is a «vehicle» of a key model idea. The authors suggest requirements concerning objective function, its formulae, and a tool to transform it into additive function via solving auxiliary optimization problem. They prove the necessity to realize a new paradigm of car designing model, which is mandatory for effective use of achieved optimum parameters of rail sector state. The management system for rail sector, as it is considered by the authors, is deemed to be multilevel and hierarchic, allowing there-by to analyze problems relevant to local conditions and objectives and according new possibilities to assess transit capacity of Russia and to create globally railway nets with scientifically bases management system. The implementation of such project might permit to achieve advantages for railway transportation, notably taking into account the maintenance of ecological balance and reduction of carriage costs, to gain part of market of truck, air and sea haulage.В статье представлены основные положения математической модели железнодорожного транспорта, обоснована целесообразность использования метода динамического программирования для оптимизации параметров состояния отрасли. Сформулированы требования к целевой функции, предложено средство превращения её в аддитивную функцию с помощью решения вспомогательной оптимизационной задачи. Доказывается необходимость в реализации новой парадигмы методики проектирования вагона, без чего невозможно эффективное использование получаемых оптимальных параметров состояния отрасли. Рассматриваемая система управления является многоуровневой и иерархической, что позволяет анализировать ту или иную проблему в проекции на локальные условия и адресные цели. Это открывает новые возможности в оценке транзитных возможностей России и создании сети железных дорог планетарного уровня с научно обоснованной системой управления. Реализация такого проекта позволит потеснить на рынке перевозок не только автомобильный и авиационный, но и морской транспорт с точки зрения сохранения экологического баланса на планете и снижения себестоимости транспортных услуг

БЕЛКИ КЛЕТОЧНОЙ ПОДВИЖНОСТИ В КАРЦИНОМЕ ЭНДОМЕТРИЯ И ЭНДОМЕТРИАЛЬНОЙ ГИПЕРПЛАЗИИ: СВЯЗЬ С РИСКОМ РАЗВИТИЯ РАКА

Introduction. Proteins associated with cellular motility are known to play an important role in invasion and metastasis of cancer, however there is no evidence of their association with the development of malignant tumors including endometrial cancer (EC).The aim of the present study was to investigate the levels of actin-binding proteins, p45-Ser-β-catenin, and calpain activity in endometrial hyperplasia and in EC.Material and Methods. Total calpain activity, p45-Ser β-catenin, Arp3, gelsolin, cofillin and thymosin β-4 levels were evaluated in 43 postmenopausal patients with stage I–II endometrioid EC and 40 endometrial hyperplasia patients. Flow cytometry and Western blotting were used for expression determination of p45 Ser β-catenin and actin-biding proteins. Total calpain activity was estimated by fluorimetric method.Results. Levels of cofilin-1, thymosin β-4 and calpain activity were higher in cancer tissues than in endometrial hyperplasia. Cofilin-1 and thymosin β-4 levels were associated with the depth of myometrial invasion. The thymosin β-4 expression was correlated with the presence of tumor cervical invasion. Revealed correlations between the actin-binding proteins, p45-Ser-β-catenin and total calpain activity in endometrial hyperplasia tissue, but not in the tissue of cancer, is evidence of the involvement of these proteases in regulation of cell migration in endometrial hyperplasia. Levels of thymosin β-4, cofilin and total calpain activity are independent cancer risk factors in patients with endometrial hyperplasia.Conclusion. The level of actin-binding proteins as well as the total calpain activity were enhanced in endometrium carcinoma tissues compared to endometrial hyperplasia. The levels of thymosinβ-4, cofilin and total calpain activity in endometrial hyperplasia tissues are associated with a hyperplasia transition to cancer and may be considered as predictive biomarkers. Введение. Известно, что белки, связанные с клеточной подвижностью, играют важную роль в инвазии и метастазировании злокачественных опухолей, тем не менее нет данных об их связи с развитием новообразований, в том числе рака эндометрия (РЭ).Целью исследования было изучение уровня актин-связывающих белков, p45-Ser-β-катенина и активности кальпаинов при гиперплазии эндометрия и при РЭ.Материал и методы. Общая активность кальпаинов, уровни p45-Ser β-катенина, Arp3, гельзолина, кофиллина и тимозина β-4 были оценены у 43 больных раком эндометрия I–II стадии в постменопаузе и у 40 пациенток с гиперплазией эндометрия. Проточную цитометрию и вестерн-блоттинг использовали для определения экспрессии p45 Ser β-катенина и актин-связывающих белков. Общая активность кальпаинов оценивалась флуориметрическим методом.Результаты. Уровни кофилина-1, тимозина β-4 и активность кальпаинов были выше в тканях злокачественных опухолей, чем при гиперплазии эндометрия. Уровни кофилина-1 и тимозина β-4 были связаны с глубиной инвазии рака эндометрия в миометрий. Содержание тимозина β-4 коррелировало с наличием инвазии опухоли в шейку матки. Выявленные корреляции между актин-связывающими белками, р45-Ser-β-катенином и общей активностью кальпаинов в ткани гиперплазии эндометрия, но не в ткани рака свидетельствуют об участии этих протеаз в регуляции клеточной миграции при гиперплазии эндометрия. Уровни тимозина-4, кофилина и общая активность кальпаинов являются независимыми факторами риска развития рака у пациентов с гиперплазией эндометрия.Заключение. Уровень актин-связывающих белков, а также общая активность кальпаинов были повышены в тканях карциномы эндометрия по сравнению с гиперплазией эндометрия. Уровни тимозина-4, кофилина и общая активность кальпаинов в тканях гиперплазии эндометрия могут быть независимыми факторами риска развития рака.

Редкий случай сочетания рака шейки матки с односторонней полной аплазией придатков

We  present  a  rare  case  of  the  combination   of  cervical  cancer  and  unilateral complete   aplasia  of  the uterine  adnexa.    Female  genital  tract anomalies  account  for  about  4% of all congenital  malformations.Congenital  malformations  of the  adnexa  are  very  rare,  accounting  for  less than  0.5%. In  the  presented case, this abnormality was found incidentally during surgery for cervical cancer. Medical genetic counseling confirmed  the presence  of the isolated congenital  pathology.В статье  представлен  случай редкого  сочетания  рака  шейки матки  с врожденной патологией  придатков – полной односторонней аплазией  маточных придатков.  Пороки  развития  женских  половых органов  составляют   около  4% всех  врожденных   аномалий  развития,   при  этом  пороки  развития придатков  очень редки (менее 0,5%). В данном случае это была случайная  находка  при оперативном вмешательстве по поводу рака шейки матки. При проведении медико-генетического консультирования сделано  заключение  о наличие изолированной врожденной патологии