Выбор объема хирургического лечения у больных раком шейки матки

The study included 26 patients with stage Ia1 – Ib1 cervical cancer who underwent organ-preserving surgery (transabdominal trachelectomy). To visualize sentinel lymph nodes, lymphoscintigraphy with injection of radioactive lymphotropic isotope, 99mTc-labelled nanocolloid, was performed the day before surgery. Intraoperative identification of sentinel lymph nodes using gamma probe was carried out to assess which lymph nodes had taken up the radionuclide. Detection of sentinel lymph nodes in cervical cancer patients can accurately predict the pelvic lymph node status, assess the stage of the disease, individualize the extent of surgery and determine indications for organ-preserving surgery.В исследование включено 26 больных с Ia1 – Ib1 стадией рака шейки матки, которым проводилось органосохраняющее лечение в объеме радикальной трансабдоминальной трахелэктомии. Для визуализации «сторожевых» лимфатических узлов вводился радиоактивный лимфотропный нанноколлоид, меченный 99mTc за сутки до операции. Сцинтиграфическое исследование проводилось в режиме однофотонной эмиссионной компьютерной томографии (ОЭКТ) области таза. Поиск сторожевых лимфатических узлов интраоперационно осуществлялся при помощи гамма-зонда, путем измерения уровня гамма-излучения во всех лимфатических коллекторах. Исследование «сторожевых» лимфатических узлов у больных раком шейки матки способствует точной клинической оценке состояния регионарных лимфатических узлов, уточнению стадии заболевания, индивидуализации объема оперативного вмешательства, в том числе определения показаний к органосохраняющему лечению, а также объективизации целенаправленного применения адъювантной терапии

Первый опыт клинического применения нового отечественного радиофармпрепарата99тТс-гамма-оксид алюминия для визуализации сторожевых лимфатических узлов при злокачественных новообразованиях

Purpose: To study the possibility of using new domestic radiopharmaceuticals based on99mTc-aluminum gammaoxide to render the SLN in breast cancer and cervical cancer Materials and methods. The study included two groups of patients: I group - 34 (59.6%) patients with breast cancer (T1-2N0-1M0), II group - 23 (40.4%) patients with cervixcancer (T1A-2BN0-1M0). All patients were administered original radiopharmaceutical99mTc-Al2O3 a day before the operationfor visualization of sentinel lymph nodes. Results. In the first group of patients identified 37 sentinel lymph nodes. The number of identified SLN per patient ranged from 1 to 2 (the average number of identified SLN - 1.08). The most frequently detected by us in SLE axillary region 36 (97.2%). The intensity of the inclusion of99mTc-Al2O3 in SLE SpECT at 18 hours after administration is 7-11% of the injection site, with radiometry 17-31%. In the second group of sentinel lymph nodes were detected in all 23 patients of the second group. The intensity of the inclusion of99mTc-Al2O3 in SLN with SpECT at 18 hours after administration is 3-6% of the injection site, with radiometry 14-26%. Conclusions. Designed on the basis of radiopharmaceutical99mTc-Al2O3 5-10 times more accumulated in the sentinel lymph nodes, firmly seating them, without further redistribution around the lymphatic collectors. Sensitivity and specificity of application of99mTc-Al2O3 with single photon emission computed tomography and intraoperative radiometric display sentinel lymph nodes was 100%.Цель исследования: изучение возможности применения нового отечественного радиофармпрепарата (РФП) на основе меченного технецием-99m гаммаоксида алюминия для визуализации сторожевых лимфатических узлов (СЛУ) при раке молочной железы и раке шейки матки. Материал и методы. В исследование вошло 57 пациенток, которых разделили на 2 группы: I группа - 34 (59,6%) пациентки с раком молочной железы (T1-2N0-1M0), II группа - 23 (40,4%) пациентки с раком шейки матки (T1A-2BN0-1M0). Всем пациенткам для визуализации СЛУ за сутки до операции вводили оригинальный РФП99mTc-Al2O3. Результаты. В I группе пациенток определено 37 СЛУ. Количество выявленных СЛУ на одну пациентку составило от 1 до 2 (среднее количество выявленных СЛУ - 1,08). Наиболее часто СЛУ выявляли в аксиллярной области - 36 (97,2%). Интенсивность включения99mTc-Al2O3 в СЛУ при ОФЭКТ через 18 ч после введения составляла 7-11% от места введения, при радиометрии - 17-31%. Во II группе СЛУ узлы выявлены у всех 23 пациенток. Интенсивность включения99mTc-Al2O3 в СЛУ при ОФЭКТ через 18 ч после введения составляла 3-6% от места введения, при радиометрии - 14-26%. Выводы. Разработанный РФП на основе99mTc-Al2O3 в 5-10 раз сильнее аккумулируется в СЛУ, прочно фиксируясь в них, без дальнейшего перераспределения по всему лимфатическому коллектору. Чувствительность и специфичность применения99mTc-Al2O3 при ОФЭКТ и интраоперационной радиометрической индикации СЛУ составила 100%

колективна монографія

Кримінальний процесуальний кодекс 2012 року: ідеологія та практика правозастосування: колективна монографія / за заг. ред. Ю. П. Аленіна ; відпов. за вип. І. В. Гловюк. - Одеса : Видавничий дім «Гельветика», 2018. - 1148 с

Spheroid Formation and Peritoneal Metastasis in Ovarian Cancer: The Role of Stromal and Immune Components

Ovarian cancer (OC) is one of the most common gynecological cancers, with the worst prognosis and the highest mortality rate. Peritoneal dissemination (or carcinomatosis) accompanied by ascites formation is the most unfavorable factor in the progression and recurrence of OC. Tumor cells in ascites are present as either separate cells or, more often, as cell aggregates, i.e., spheroids which promote implantation on the surface of nearby organs and, at later stages, metastases to distant organs. Malignant ascites comprises a unique tumor microenvironment; this fact may be of relevance in the search for new prognostic and predictive factors that would make it possible to personalize the treatment of patients with OC. However, the precise mechanisms of spheroid formation and carcinomatosis are still under investigation. Here, we summarize data on ascites composition as well as the activity of fibroblasts and macrophages, the key stromal and immune components, in OC ascites. We describe current knowledge about the role of fibroblasts and macrophages in tumor spheroid formation, and discuss the specific functions of fibroblasts, macrophages and T cells in tumor peritoneal dissemination and implantation

Performing a radical trachelectomy with uterine transposition in a patient with stage IB2 cervical cancer: A case report

We describe a case of a woman with invasive IB2 cervical cancer who desired to maintain fertility and required complex treatment. The suggested surgical approach with uterine transposition improves the existing radical trachelectomy procedure. Oncologic outcomes are encouraging, and no perioperative complications were noted. This report may represent a “milestone” in fertility-sparing surgeries, supporting the feasibility and safety of the opted method in stage IB2 cervical cancer with tumors about or smaller than 2 cm

Comparative Analysis of Tumor-Associated microRNAs and Tetraspanines from Exosomes of Plasma and Ascitic Fluids of Ovarian Cancer Patients

Ovarian cancer (OC) is one of the most common and fatal types of gynecological cancer. In the early phase of OC detection, the current treatment and diagnostic methods are not efficient and sensitive enough. Therefore, it is crucial to explore the mechanisms of OC metastasis and discover valuable factors for early diagnosis of female cancers and novel therapeutic strategies for metastasis. Exosomes are known to be involved in the development, migration, and invasion of cancer cells, and their cargo could be useful for the non-invasive biopsy development. CD151- and Tspan8-positive exosomes are known to support the degradation of the extracellular matrix, and are involved in stroma remodeling, angiogenesis and cell motility, as well as the association of miR-24 and miR-101 with these processes. The objective of this study was to explore the relationship of these components of exosomal cargo, in patients with OC, to clarify the clinical significance of these markers in liquid biopsies. The levels of tetraspanins Tspan8+ and CD151+ exosomes were significantly higher in plasma exosomes of OC patients compared with healthy females (HFs). The relative levels of miR-24 and miR-101 in plasma exosomes of HFs were significantly higher than in plasma exosomes of OC patients, while the levels of these microRNAs in exosomes from plasma and ascites of ill females showed no difference. Our study revealed a strong direct correlation between the change in the ascites exosomes CD151+Tspan8+ subpopulation level and the expression levels of the ascites (R = 0.81, p p < 0.05) in OC patients, which confirms the assumption that exosomal cargo act synergistically to increase cellular motility, affecting cellular processes and signaling. Bioinformatics analysis confirmed the involvement of CD151 and Tspan8 tetraspanins and genes controlled by miR-24-3p and miR-101 in signaling pathways, which are crucial for carcinogenesis, demonstrating that these tetraspanins and microRNAs are potential biomarkers for OC screening, and predictors of poor clinicopathological behavior in tumors

Fertility-Sparing Surgery Using Knitted TiNi Mesh Implants and Sentinel Lymph Nodes: A 10-Year Experience

Objectives The aim of this cohort study is to improve the procedure of fertility-sparing surgery and to assess oncological and reproductive follow-up outcomes after radical trachelectomy (RT) for cervical cancer (T1a2-1bNxM0). Methods We have suggested the method combining sentinel lymph nodes (SLNs) and cervicoisthmic cerclage using a superelastic knitted TiNi mesh (KTNM) implant to facilitate the primary biomechanical/retention function of the uterus. Sixty-eight consented patients, who underwent fertility-sparing surgery using both transabdominal and laparoscopic route from 2009 through 2019, were recruited in the study and prospectively followed for a mean of 69 months. Results There were no intraoperative or postoperative complications. No cervical stenoses or mesh failures were noted in all cases. The 5‐year overall and recurrence‐free survival rates were 100% and 97%, respectively. Two patients indicated recurrence, it occurred in 3 and 36 months. There were 19 (28%) spontaneous pregnancies, 6 resulted in full-term delivery, whereas 2 and 11 ended in miscarriage and early abortion, respectively. Conclusions This sparing-surgery technique is turned out to be feasible and efficient as allows to achieve well oncologic and fertility outcomes, mimicking the effect of the cervix. It complements existing surgical approaches and may provide further insight into how to overcome challenges even in aggravated cases or previously failed procedures