Экспрессия тирозинкиназных рецепторов на субпопуляциях лимфоцитов периферической крови больных почечно-клеточным раком и здоровых добровольцев

Introduction: tyrosine kinases receptors (RTKs) play an important role in the pathogenesis of renal cell carcinoma (RCC). RTKs were studied on tumor and endothelial cells, but the presence of these receptors on lymphocytes was not confirmed. The objective of this study was to investigate the expression of tyrosine kinases receptors on lymphocyte subpopulations in healthy volunteers and RCC patients before and after removal of the primary tumor.Materials and methods: the study included 19 patients with pT1‑T3N0 / N+M0 / M+ RCC, subjected to nephrectomy, and 10 healthy volunteers. Blood samples were collected once from healthy donors and twice from RCC patients, immediately before and 180 days after surgery. Isolation of lymphocytes and flow cytometry were carried out using standard methods. A comparative analysis of RTKs expression levels in peripheral lymphocytes from healthy volunteers and RCC patients, as well as in RCC patients before and after the operation, was carried out. A search was performed for correlations between the initial RTKs expression on lymphocytes from RCC patients and characteristics of the tumor development, as well as the disease prognosis.Results: VEGFR-1, -2, -3, FGFR2, PDGFRα, β RTKs are expressed on CD45+ peripheral blood mononuclear cells, as well as subpopulations of CD3+ and CD8+ lymphocytes in healthy volunteers and untreated patients with RCC. No differences in the expression levels of all studied RTKs between subpopulations of lymphocytes were found in RCC patients (p > 0.05 for all). The level of RTKs expression on CD45+ peripheral cells in RCC patients before treatment is significantly lower than in healthy volunteers (p < 0.05 for all). The degree of a decrease in RTKs expression correlated with the pT status and the presence of tumor-associated venous thrombosis. A significant increase in the expression levels of VEGFR1 (on CB45+) and VEGFR2 (on CD8+, CD3+) (p < 0.05 for all) was noted 180 days after the removal of the primary tumor in patients with RCC. No other significant changes in RTKs production were identified. We were not able to determine the effect of RTKs expression on the RCC outcome.Conclusions: lymphocytes express RTKs, their expression is more pronounced in healthy people than in patients with RCC. After surgical treatment, the RTKs expression becomes restored.Введение: тирозинкиназные рецепторы (ТКР) играют важную роль в патогенезе почечно-клеточного рака (ПКР). ТКР изучались на клетках опухоли и эндотелия, однако наличие данных рецепторов на лимфоцитах не было показано. Целью настоящего исследования было изучение экспрессии рецепторных тирозинкиназ на субпопуляциях лимфоцитов у здоровых добровольцев и больных ПКР до и после удаления первичной опухоли.Материалы и методы: в исследование были включены 19 больных ПКР рТ1-Т3N0/N+M0/M+, подвергнутых нефрэктомии, и 10 здоровых добровольцев. Образцы крови собирали однократно у здоровых доноров и дважды у больных ПКР непосредственно перед и через 180 дней после хирургического вмешательства. Выделение лимфоцитов и проточная цитометрия выполнялись по стандартным методикам. Проводился сравнительный анализ уровней экспрессии ТКР на периферических лимфоцитах здоровых добровольцев и больных ПКР, а также при ПКР в динамике до и после операции. Выполнялся поиск корреляций между исходной экспрессией ТКР на лимфоцитах больных ПКР и характеристиками опухолевого процесса, а также прогнозом заболевания.Результаты: на CD45+ мононуклеарных клетках периферической крови, а также субпопуляциях лимфоцитов CD3+ и CD8+ у здоровых добровольцев и больных ПКР, не получавших лечение, экспрессируются ТКР VEGFR-1, -2, -3, FGFR2, PDGFRα, β. Различий уровней экспрессии всех изученных ТКР между субпопуляциями лимфоцитов у пациентов с ПКР не выявлено (p > 0,05 для всех). Уровень экспрессии ТКР на периферических клетках CD45+ у больных ПКР до лечения достоверно ниже, чем у здоровых добровольцев (р < 0,05 для всех). Степень снижения экспрессии ТКР коррелировала с категорией рТ и наличием опухолевого венозного тромбоза. Через 180 дней после удаления первичной опухоли у больных ПКР отмечено достоверное увеличение уровней экспрессии VEGFR1 (на СВ45+) и VEGFR2 (на CD8+, CD3+) (р < 0,05 для всех). Других значимых изменений продукции ТКР не выявлено. Выявить влияние экспрессии ТКР на исход ПКР не удалось.Выводы: лимфоциты экспрессируют ТКР, их экспрессия более выражена у здоровых людей, чем у больных ПКР. После хирургического лечения наблюдается восстановление экспрессии ТКР

Экспрессия ростовых факторов и рецепторных тирозинкиназ в клетках первичной опухоли опухолевого тромба у больных почечно-клеточным раком

Objective: to assess the expression and prognostic value of vascular endothelial growth factor A (VEGF-A), fibroblast growth factor 2 (FGF-2) and their receptors VEGFR-1, -2; FGFR-1, -2, as well as platelet-derived growth factor receptors (PDGFR-α, PDGFR-β) in paired samples of primary tumors and tumor thrombi in renal cell carcinoma (RCC).Materials and methods. Expression of VEGF-A, FGF-2, VEGFR-1, -2; FGFR-1, -2; PDGFR-α, -β was studied in paired surgical samples of primary tumors and tumor thrombi in 25 patients with clear cell RCC pT3a–T4N0–1M0–1 and tumor venous thrombosis by immunohistochemical assay using the appropriate Abcam/Santa Cruz Biotech antibodies from the immunohistochemical staining kit Invitrogen. Expression levels were evaluated by a semi-quantitative method (H-score). The analysis of the correlation between expression levels of VEGF-A, FGF-2, VEGFR-1, -2; FGFR-1, -2; PDGFR-α, -β and RCC characteristics, as well as evaluation of their influence on the outcome of RCC were performed.Results. VEGF-A, FGF-2, as well as VEGFR-1, -2; FGFR-1, -2; PDGFR-α, -β were expressed in the cytoplasm and on the membrane of the primary tumor and tumor thrombus cells in RCC patients. Tumor thrombus cells were characterized by lower expression of VEGFR-1, VEGFR-2, PDGFR-α (p <0.05 for all) and tendency to lower expression of VEGF-A (p = 0.060), FGF-2 (p = 0.046), FGFR-1 (p = 0.077) and FGFR-2 (p = 0.090) compared with primary tumor cells. RCC Furman grade correlated with the expression levels of VEGFR-1 (p = 0.035) and FGFR-1 (p = 0.022) in the primary tumor cells, tumor invasion into venous wall correlated with the expression levels of VEGFR-1 (p = 0.023) and FGFR-2 (p = 0.005) on the thrombus cells. VEGFR-2 overexpression in the primary tumor cells was associated with significant decrease of overall survival (OS) rate (p = 0.011). There was a tendency to OS deterioration in cases with overexpression of VEGFR-2 (p = 0.093) and VEGF-A (p = 0.095) in the tumor thrombus cells. One-year OS in patients with ³2 identified risk factors was 27.3 %, <2 risk factors – 87.5 % (p = 0.004).Conclusion. Tumor thrombus cells in RCC patients expressed VEGF-A, FGF-2, VEGFR-1, -2; FGFR-1, -2; PDGFR-α, -β less active than the cells of the primary tumor. Overexpression of growth factors and tyrosine kinases correlated with RCC Furman grade and tumor venous wall invasion. Overexpression of VEGFR-2 in both primary tumor and thrombus cells in combination with hypoexpression of VEGF-A in the thrombus negatively influenced on OS.Цель исследования – провести изучение экспрессии и прогностической значимости фактора роста эндотелия сосудов (VEGF-A), фактора роста фибробластов 2 (FGF-2) и их рецепторов VEGFR-1, -2; FGFR-1, -2, а также рецепторов фактора роста тромбоцитарного происхождения (PDGFR-α, PDGFR-β) в клетках парных образцов первичной опухоли и опухолевого тромба у больных почечно-клеточным раком (ПКР).Материалы и методы. Экспрессию VEGF-A, FGF-2, VEGFR-1, -2; FGFR-1, -2; PDGFR-α, -β изучали в парных операционных образцах опухоли почки и опухолевого тромба 25 больных светлоклеточным ПКР рТ3а–Т4N0–1M0–1, осложненным опухолевым венозным тромбозом, при помощи иммуногистохимического окрашивания с полуколичественной оценкой. Провели анализ корреляции выявленных уровней экспрессии ростовых факторов и рецепторных тирозинкиназ с характеристиками опухолевого процесса и оценку их влияния на исход ПКР.Результаты. В цитоплазме и на мембране клеток первичной опухоли и опухолевого тромба у больных ПКР экспрессировались VEGF-A, FGF-2, а также VEGFR-1, -2; FGFR-1, -2; PDGFR-α, -β. Клетки опухолевого тромба характеризовались более низкой экспрессией VEGFR-1, -2, PDGFR-α (р <0,05 для всех) и тенденцией к более низкой экспрессии VEGF-A (p = 0,060), FGF-2 (р = 0,046), FGFR-1 (p = 0,077) и FGFR-2 (p = 0,090) по сравнению с клетками первичной опухоли почки. Была выявлена прямая корреляция между степенью дифференцировки G и уровнями экспрессии VEGFR-1 (р = 0,035) и FGFR-1 (р = 0,022) в клетках первичной опухоли, а также между инвазией опухолевого тромба в венозную стенку и уровнями экспрессии VEGFR-1 (р = 0,023) и FGFR-2 (р = 0,005) на клетках тромба. Было отмечено неблагоприятное влияние на общую выживаемость (ОВ) больных ПКР гиперэкспрессии VEGFR-2 в клетках первичной опухоли (р = 0,011), а также тенденция к снижению ОВ при гиперэкспрессии VEGFR-2 (р = 0,093) и гипоэкспрессии VEGF-A (р = 0,095) в клетках опухолевого тромба. Однолетняя ОВ пациентов с ³2 выделенными факторами риска – 27,3 %, <2 факторами риска – 87,5 % (р = 0,004).Заключение. Клетки опухолевого тромба у больных ПКР экспрессируют VEGF-A, FGF-2, VEGFR-1, -2; FGFR-1, -2; PDGFR-α, -β менее активно, чем клетки первичной опухоли. Гиперэкспрессия ростовых факторов и тирозинкиназ коррелирует со степенью дифференцировки G и инвазией венозной стенки. Гиперэкспрессия VEGFR-2 в первичной опухоли и тромбе в сочетании с гипоэкспрессией VEGF-A в тромбе ассоциирована со снижением ОВ

Capabilities of interventional radiology in the treatment of portal vein stenosis after pediatric liver transplantation

The paper describes 2 cases of correction of portal vein stenosis after pediatric liver transplantation using interventional radiology techniques. Its long-term result is analyzed. X-ray endovascular correction of portal vein stenosis after left lateral liver bisegment transplantation demonstrates a high clinical efficiency, yielding good long-term results

Expression of growth factors and tyrosine kinase receptors in the primary tumor and tumor thrombus cells in patients with renal cell carcinoma

Objective: to assess the expression and prognostic value of vascular endothelial growth factor A (VEGF-A), fibroblast growth factor 2 (FGF-2) and their receptors VEGFR-1, -2; FGFR-1, -2, as well as platelet-derived growth factor receptors (PDGFR-α, PDGFR-β) in paired samples of primary tumors and tumor thrombi in renal cell carcinoma (RCC).Materials and methods. Expression of VEGF-A, FGF-2, VEGFR-1, -2; FGFR-1, -2; PDGFR-α, -β was studied in paired surgical samples of primary tumors and tumor thrombi in 25 patients with clear cell RCC pT3a–T4N0–1M0–1 and tumor venous thrombosis by immunohistochemical assay using the appropriate Abcam/Santa Cruz Biotech antibodies from the immunohistochemical staining kit Invitrogen. Expression levels were evaluated by a semi-quantitative method (H-score). The analysis of the correlation between expression levels of VEGF-A, FGF-2, VEGFR-1, -2; FGFR-1, -2; PDGFR-α, -β and RCC characteristics, as well as evaluation of their influence on the outcome of RCC were performed.Results. VEGF-A, FGF-2, as well as VEGFR-1, -2; FGFR-1, -2; PDGFR-α, -β were expressed in the cytoplasm and on the membrane of the primary tumor and tumor thrombus cells in RCC patients. Tumor thrombus cells were characterized by lower expression of VEGFR-1, VEGFR-2, PDGFR-α (p <0.05 for all) and tendency to lower expression of VEGF-A (p = 0.060), FGF-2 (p = 0.046), FGFR-1 (p = 0.077) and FGFR-2 (p = 0.090) compared with primary tumor cells. RCC Furman grade correlated with the expression levels of VEGFR-1 (p = 0.035) and FGFR-1 (p = 0.022) in the primary tumor cells, tumor invasion into venous wall correlated with the expression levels of VEGFR-1 (p = 0.023) and FGFR-2 (p = 0.005) on the thrombus cells. VEGFR-2 overexpression in the primary tumor cells was associated with significant decrease of overall survival (OS) rate (p = 0.011). There was a tendency to OS deterioration in cases with overexpression of VEGFR-2 (p = 0.093) and VEGF-A (p = 0.095) in the tumor thrombus cells. One-year OS in patients with ³2 identified risk factors was 27.3 %, <2 risk factors – 87.5 % (p = 0.004).Conclusion. Tumor thrombus cells in RCC patients expressed VEGF-A, FGF-2, VEGFR-1, -2; FGFR-1, -2; PDGFR-α, -β less active than the cells of the primary tumor. Overexpression of growth factors and tyrosine kinases correlated with RCC Furman grade and tumor venous wall invasion. Overexpression of VEGFR-2 in both primary tumor and thrombus cells in combination with hypoexpression of VEGF-A in the thrombus negatively influenced on OS

Surgical aspects of obtaining a right liver lobe graft from a live related donor

Seven years' experience in obtaining hepatic fragments from 104 live related donors (RD) is pooled to perform orthotopic transplantations in patients with terminal stages of chronic and diffuse diseases of the liver. The main principles in the selection of RD are outlined. Surgical techniques and a spectrum of postoperative complications, such as bleeding [n = 1 (0.95%)], herniation [n = 1 (0.95%)], and bile leakage [n = 3 (2.85%)], are described. All RDs operated on were sociomedically rehabilitated entirely