Breast cancer and body weight index: the role of L-carnitine in prediction of answer to treatment and outcome of tumor in patients with obesity (review of literature).

Increasing the effectiveness of antitumor therapy in breast cancer patients who take L-carnitine during preoperative systemic antitumor therapy compared with patients receiving standard neoadjuvant systemic antitumor therapy served as a prerequisite for studying possible antitumor mechanisms of L-carnitine. The positive effect of L-carnitine is due to the transfer of palm-n-fatty acid through the inner membrane into the mitochondrial matrix, which contributes to the formation of a significant number of ATP molecules. It has also been shown that L-carnitine can have a double protective effect, enhancing the energy dynamics of the cell and inhibiting the hyperexcitability of the cell membrane, making it an ideal tool for the prevention and treatment of complications of antitumor therapy and concomitant metabolic disorders. This work summarizes the results of epidemiological and clinical studies on the use of L-carnitine in the treatment of breast cancer

Distance learning: opportunities and challenges in quarantine.

The urgent introduction of distance education into the learning process due to the COVID-19 pandemic has become a spontaneous experiment, requiring urgent decisions, effective mechanisms to implement into the educational process and analysis of ongoing educational process. The possibilities of modern digital technologies made it possible to quickly set up the information component of education and to controle student’s knowledge. A detailed analysis of the communication between the faculty members of the department among themselves and analysis of the features of teaching and self-education of students in the field of medical radiology and oncology based on answers and comments with using Google classroom, Socrative, Messenger Telegram, etc. was made. Issues of communicative interaction between faculty members and students, psychological aspects of distance communication, language of instruction, logistics of distance education and methodological problems are described in details. It has been suggested that distance education may be equally effective for theoretical subjects in full-time study form, but when studying clinical disciplines, the priority should be given to traditional methods of teaching, involving student's bedside training. Taking into account technical possibilities and high risk of development of extreme and emergency situations, it is suggested to introduce permanent readiness for distance education, to create all – Ukrainian distance imitation service of patients’ follow-up. The importance of using the state language in training as the basis for mastering the professional Ukrainian and English language as the basis for mastering international medical experience is indicated

Rare Clinical Case: Solid Pseudopapillary Tumor of Pancreas.

Solid pseudopapillary tumor of the pancreas (Frantz's tumor) is a very rare disease with uncertain Malignant potential. This tumor occurs in young women at the age before 35 years. Asymptomatic disease course leads to growth of tumor up to the huge size. Surgery is the only treatment method applied. Histological diagnostic is complicated with similarity of tumor with neuroendocrine tumor of the pancreas. Disease is characterized with favorable prognosis. Paper shows our own clinical observation of Frantz's tumor. During control ultrasound examination of woman aged 34 years, echo-signs of mass lesion in extraperitoneal area near the lower pole of the left kidney were diagnosed. During physical examination in the left hypochondrium a soft, atropic mass lesion 5.5x5 cm in size was diagnosed. Lesion presence is confirmed by CT assessment. Distal resection of the pancreas and splenectomy was performed. Diagnosis was verified histologically and immunohistochemically. Postoperative period is complications free. The results of CT assessment, detailed description of gross specimen and the results of histological and immunohistochemical examination are presented

Pattern of protein production by mammary epithelial cells cultured on membrane inserts

Pattern of protein production by mammary epithelial cells cultured on membrane inserts. Can. J. Anim. Sci. 81: 285-287. Protein and plasminogen activator (PA) production by bovine mammary epithelial cells cultured on inserts and the effect of calcium were studied. The cells cultured on inserts coated with a bovine extracellular matrix established a stable trans-epithelial resistance, and secreted apically \u3b1s1-casein and PA. Extracellular calcium increased (P < 0.01) \u3b1s1-casein and total proteins, but not PA activity

Прогностична цінність клінічних, лабораторних та молекулярних предикторів у формуванні персонифікованих підходів до лікування раку молочної залози.

Background. The death rate from breast cancer in the past 10 years has increased steadily and has won first place in frequency among women. Despite advances in modern oncofarmakology, there is a heterogeneous tumor response to treatment between different patients. The objectives of our study were to evaluate the relationship between tumor response to systemic therapy and general and histological characteristics of patient’s tumors, including molecular subtypes of breast cancer, identify patterns between antropometric parameters of patients, comorbidities, and tumor response to the treatment; to study the effect of hematological, blood biochemical parameters on the results of the treatment of breast cancer. Methods. Molecular subtypes of breast cancer were established among 7521 patients, their changebility or stability in 67. Overall survival data was available for 491 patients with metastatic disease, peculiarities of development of metastases based on RECIST 1.1. criteria - 306. Retrospectively reviewed medical records of 110 patients with inoperable breast cancer (breast cancer) who received systemic therapy for the standard scheme. In the course of treatment were studied indicators such as: medical history of patients, life history, hematology, blood biochemistry, the results of primary and repeated histological and immunohistochemical studies of tumors, determination of molecular subtypes of breast cancer. Results. The distribution of the molecular subtypes of patients were as follows: A luminal - 69% luminal B - 9%, HER-2 / neu-positive - 7%, triple negative - 15%. Accounting factor Ki-67 (≥14%) led to an increase in the frequency of luminal B subtype from 9% to 19% by reducing the luminal A. In 44.8% of patients it was noted a change of molecular subtypes. Targeted therapy (Herceptin) in these patients allowed to overcome unfavorable prognostic background - results in median survival from them (41,3±4,5 months) were higher than in the group without Herceptin (27,4±3,4 months) and higher than the HER-2 / neu-negative patients (38,1±3,0 months). The value of coefficient Spearman rank correlation to tumor response and the factor of menopause, age, general condition of the patient were - 0.174; -0.222; -0.250 (P &lt;0.05), in accordance. The status of regional nodes N and tumor response have the correlation coefficient: - 0,265; (P &lt;0.05), the status of the primary tumor T and metastases M - 0.107; and -0.071 (p&gt; 0.05), in accordance. In the presence of neutropenia at 1 week after treatment it has been revealed significantly better tumor response to treatment - the correlation coefficient: 0.204 (p &lt;0.05). Conclusion. Molecular subtypes detection had shown that HER-2/neu-positive and tripple negative breast cancer demonstrated the most aggresive course of disease. It was found that a more pronounced tumor response to combination chemotherapy can be expected in young patients, pre-menopausal, high ECOG status. The presence of neutropenia has a significantly positive impact on the results of treatment of patients with metastatic breast cancer.Несмотря на достижения современной онкофармакологии, в клинической практике отмечается гетерогенный ответ опухоли на лечение у различных пациентов, что диктует необходимость персонифицированного лечения. В данном исследовании было изучено влияние стадии, анамнеза болезни, гистологических характеристик опухолевого процесса, молекулярных подтипов опухоли, антропометрических показателей пациентов, гематологических, биохимических показателей крови на результаты полихимиотерапии неоперабельного рака молочной железы, что является практически значимым при подборе оптимальных схем системного лечения.Незважаючи на досягнення сучасної онкофармакологіі, в клінічній практиці відзначається гетерогенна відповідь пухлини на лікування у різних пацієнтів. В даному дослідженні було вивчено вплив стадії, анамнезу хвороби, гістологічних характеристик пухлинного процесу, молекулярних підтипів пухлини, антропометричних показників пацієнтів, гематологічних, біохімічних показників крові на результати поліхіміотерапії неоперабельного раку молочної залози, що має важливе практичне значення при підборі оптимальних схем системного лікування

Prognostic value of clinical, laboratory and molecular predictors in the formation of personalized approaches to breast cancer treatment.

Background. The death rate from breast cancer in the past 10 years has increased steadily and has won first place in frequency among women. Despite advances in modern oncofarmakology, there is a heterogeneous tumor response to treatment between different patients. The objectives of our study were to evaluate the relationship between tumor response to systemic therapy and general and histological characteristics of patient’s tumors, including molecular subtypes of breast cancer, identify patterns between antropometric parameters of patients, comorbidities, and tumor response to the treatment; to study the effect of hematological, blood biochemical parameters on the results of the treatment of breast cancer. Methods. Molecular subtypes of breast cancer were established among 7521 patients, their changebility or stability in 67. Overall survival data was available for 491 patients with metastatic disease, peculiarities of development of metastases based on RECIST 1.1. criteria - 306. Retrospectively reviewed medical records of 110 patients with inoperable breast cancer (breast cancer) who received systemic therapy for the standard scheme. In the course of treatment were studied indicators such as: medical history of patients, life history, hematology, blood biochemistry, the results of primary and repeated histological and immunohistochemical studies of tumors, determination of molecular subtypes of breast cancer. Results. The distribution of the molecular subtypes of patients were as follows: A luminal - 69% luminal B - 9%, HER-2 / neu-positive - 7%, triple negative - 15%. Accounting factor Ki-67 (≥14%) led to an increase in the frequency of luminal B subtype from 9% to 19% by reducing the luminal A. In 44.8% of patients it was noted a change of molecular subtypes. Targeted therapy (Herceptin) in these patients allowed to overcome unfavorable prognostic background - results in median survival from them (41,3±4,5 months) were higher than in the group without Herceptin (27,4±3,4 months) and higher than the HER-2 / neu-negative patients (38,1±3,0 months). The value of coefficient Spearman rank correlation to tumor response and the factor of menopause, age, general condition of the patient were - 0.174; -0.222; -0.250 (P 0.05), in accordance. In the presence of neutropenia at 1 week after treatment it has been revealed significantly better tumor response to treatment - the correlation coefficient: 0.204 (p <0.05). Conclusion. Molecular subtypes detection had shown that HER-2/neu-positive and tripple negative breast cancer demonstrated the most aggresive course of disease. It was found that a more pronounced tumor response to combination chemotherapy can be expected in young patients, pre-menopausal, high ECOG status. The presence of neutropenia has a significantly positive impact on the results of treatment of patients with metastatic breast cancer

Breast cancer. From molecular biology to personified therapy.

Advances in molecular biology had changed approaches to systemic treatment of breast cancer. Clinical decisions on the choice of optimal treatment regimens are performing on the basis of immunohistochemical and molecular genetic classifications. Their increasing uses have contributed changes of paradigm for cancer treatment - from the empirical to the individualized and personalized. The basis for such approaches is knowledge of molecular epidemiology, heterogeneity of expression of molecular subtypes, prognostic and predictive biomarkers of breast cancer. Breast cancer is a widely heterogeneous disease with 20 histological types, 8, molecular-genetic, 6 genomic subtypes, which are characterized by specific molecular and biochemical properties, different clinical course and different outcomes. Molecular genetic classification, created not on the basis of clinical, anatomical and morphological heterogeneity of tumor cells, and on the basis of their molecular-genetic heterogeneity is widely used in clinical practice. This allowed to separate the patients with breast cancer to molecular 4 subtypes - luminal A, luminal B, HER / 2 positive and triple-negative. The significant role of immunohistochemical tissue tumor markers, estrogen and progesterone receptors, HER / 2-neu, Ki-67, p53 for selection the optimal treatment strategy is analyzing in this review. To increase the effectiveness of breast cancer treatment is possible, using a differentiated and personalized approach based on new molecular genetic classification of breast cancer (gene profiling) or to its analogue - expression classification of breast cancer, based on the principle of diversity of immunohistochemical tumor tissue. Personification of cancer treatment involves a therapy based on the study of individual characteristics of tissue is not only the primary tumor but also its metastases

ЦИТОРЕДУКТИВНАЯ МАСТЭКТОМИЯ В ЛЕЧЕНИИ ДЕСТРУКТИВНЫХ ФОРМ РАКА ГРУДНОЙ ЖЕЛЕЗЫ

Обобщен опыт лечения в клинике 72 пациенток, у которых по поводу деструктивных форм рака грудной железы (ГЖ) выполнена циторедуктивная мастэктомия. Выполнение операции способствовало уменьшению частоты гнойно–воспалительных осложнений, рецидивирующего кровотечения, улучшению качества жизни пациенток, их социально–психологической адаптации

Possibilities of Immunogistochemical Investigation in Respons Prognosis to Treatment and Modification of Treatment Activities at Luminal Breast Cancer (Literature Review).

This article is concerned with both standard (estrogen and progesterone receptors, Her2/neu and Ki67) immu­nohistochemical investigation in hormonal therapy tactics decision for luminal breast cancer and additional in­vestigation of such hormonal sensibility marker as cyclin D1, Bcl-2, AIB1, Her1, p53, IGF-IR, COX-2 and its influence on modified hormonal therapy impact on tumor. It was shown that tumors expressing Her2/neu, AIB1, Her1, p53 or tumors, that have more than 30% expression of cyclin D1 are resistant to antiestrogen but sensible to aromatase inhibitors. IGF-IR and COX-2 tumors are resistant to aromatase inhibitors. Metformin usage for IGF-IR hyperexpression and oxygenase selective inhibitors for COX-2 expression promotes sensibility increase for aromatase inhibitors