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A rare case of primary adenocarcinoma of the eyelid 一例罕见的眼睑原发性腺癌
Pub Date : 2022-12-14 DOI: 10.17650/2222-1468-2022-12-3-136-140
D. L. Rotin, O. Paklina, E. I. Zakurdaev, I. O. Tin’kova
Introduction. primary mucinous carcinoma of the eyelid skin is a rare adenocarcinoma of skin glands. This tumor rarely metastasizes but frequently recurs.The study objective is to describe a rare clinical case of primary mucinous carcinoma of the eyelid skin, present macroscopic, histological and immunohistological descriptions of this pathology.Clinical case. male, 66 years old, sought medical care due to a neoplasm of the lower eyelid. macroscopically a subcutaneous node 1.2 × 1.0 cm was observed, of yellow-brown color, gelatinous in section. microscopic examination showed that the tumor consists of islands of epithelial cells surrounded by mucinous “lakes”. Immunohistochemical examination showed Ck7, estrogen, p53 expression in the tumor cells, as well as absence of Ck20 expression. Based on the data of macro-, microscopic and immunohistochemical examinations, primary mucinous carcinoma of the eyelid skin was diagnosed. Observed morphological signs of this tumor allow to differentiate it from cancer metastasis.Conclusion. primary mucinous carcinoma of the skin should be differentiated from metastasis of mucinous carcinoma of the breast, lung, colon, et al. macro- and microscopic signs of this tumor are subjective. Immunohistochemical examination is a more reliable diagnostic tool.
介绍。摘要原发性眼睑皮肤黏液癌是一种罕见的皮肤腺癌。这种肿瘤很少转移,但经常复发。本研究的目的是描述一罕见的眼睑皮肤原发性黏液性癌的临床病例,并提出该病理的宏观、组织学和免疫组织学描述。临床病例。男,66岁,因下眼睑肿瘤求医。镜下见皮下淋巴结1.2 × 1.0 cm,黄褐色,切片呈胶状。显微镜检查显示肿瘤由黏液“湖”包围的上皮细胞岛组成。免疫组化检查显示肿瘤细胞中Ck7、雌激素、p53表达,Ck20不表达。根据肉眼、显微镜及免疫组化检查资料,诊断为原发性眼睑皮肤黏液癌。观察到的形态学征象可以将其与转移性肿瘤区分开来。原发性皮肤黏液性癌应与乳腺、肺、结肠等黏液性癌的转移相鉴别,这种肿瘤的宏观和微观征象是主观的。免疫组织化学检查是一种更可靠的诊断工具。
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引用次数: 0
Functional and oncological results of endolaryngeal laser resections of squamous-cell carcinomas of the voice box 喉内激光切除喉部鳞状细胞癌的功能及肿瘤结果
Pub Date : 2022-12-13 DOI: 10.17650/2222-1468-2022-12-3-37-43
N. A. Daikhes, V. V. Vinogradov, S. S. Reshulsky, R. I. Azizyan, M. L. Isaeva
Introduction. Treatment with the initial stage of the disease causes a high need for the use of organ-preserving treatment methods, which are actively developing and improving. One of the modern and promising methods is endolaryngeal resection of the larynx.Aim. To evaluate oncological effectiveness and functional results of endolaryngeal laser resections in cancers of the voice box.Materials and methods. The study included 139 patients with squamous-cell carcinoma of the voice box between the ages of 26 and 81 years who received treatment at the Department of Head and Neck Oncology of the federal medicalBiological Agency of the Russian federation between 2015 and 2020. All patients underwent standard examination to diagnose oncological diseases and were diagnosed in accordance with the Tumor, Node and metastasis (TNm) international system. In 90 (64.7 %) of 139 patients, squamous-cell laryngeal cancer T1N0m0 was diagnosed, in 49 (35.3 %) patients – T2N0m0. All patients underwent surgical treatment in the form of endolaryngeal laser resection according to the plan developed during an oncological council.Results. After endolaryngeal laser resections, 3-year recurrence-free survival for cancer of the voice box, stages т1 and т2, was 92 and 84.2 % respectively. Temporary disruption of separating function of the larynx in patients with stage T2N0m0 was observed in 6.1 % cases, decreased vocal function in 100 % of cases, granuloma formation in the postoperative period in 19.4 % of cases, formation of a scar narrowing the laryngeal lumen in 4.3 % of cases.Conclusion. High 3-year recurrence-free survival as well as small percentage of postoperative complications and severe functional abnormalities show high effectiveness of endolaryngeal laser resections in treatment of cancer of the voice box and recommend this technique for active use in daily practice of head and neck tumor specialists. 
介绍。疾病初期的治疗对器官保存治疗方法的使用有很高的需求,这些方法正在积极发展和改进。喉内切除术是一种现代和有前途的方法。目的:评价喉内激光切除治疗喉部肿瘤的肿瘤学效果和功能结果。材料和方法。该研究包括139名年龄在26岁至81岁之间的喉部鳞状细胞癌患者,他们在2015年至2020年期间在俄罗斯联邦医学生物机构头颈肿瘤科接受治疗。所有患者均接受肿瘤疾病诊断标准检查,并按照肿瘤、淋巴结和转移(TNm)国际体系进行诊断。139例患者中90例(64.7%)诊断为鳞状细胞喉癌T1N0m0, 49例(35.3%)诊断为T2N0m0。根据肿瘤委员会制定的计划,所有患者均接受了咽内激光切除术的手术治疗。经腔内激光切除后,3年无复发生存率的喉癌,т1期和т2期,分别为92%和84.2%。T2N0m0期患者喉分离功能暂时中断占6.1%,声带功能下降占100%,术后形成肉芽肿占19.4%,喉腔形成瘢痕狭窄占4.3%。高的3年无复发生存率以及术后并发症和严重功能异常的小百分比显示了喉内激光切除术治疗喉癌的高有效性,并推荐该技术在头颈部肿瘤专家的日常实践中积极使用。
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引用次数: 1
Personalized or unified approach in the prevention and treatment of oral mucositis in patients with malignant neoplasms of the head and neck organs: the choice of the optimal solution 头颈部器官恶性肿瘤患者口腔黏膜炎的个性化或统一防治:最佳解决方案的选择
Pub Date : 2022-12-13 DOI: 10.17650/2222-1468-2022-12-3-44-52
E. Gvozdikova, A. Avanesov, E. Khalil, E. Y. Kandakova, K. Avanesov
Introduction. The prevalence of oncological diseases of the oropharyngeal region continues to grow steadily, but there is an increase for a number of nosologies in the five-year survival rate of this category of patients, which naturally leads to the actualization of accompanying treatment programs and the desire to improve the quality of life of oncological patients. One of the areas of maintenance therapy in oncology is dental support, the choice of approaches and methods of which is not systematically organized.Aim. To determine the optimal method of dental support for patients with malignant neoplasms of the head and neck organs for the prevention and treatment of oral mucositis.Materials and methods. At the Russian Scientific Center of Roentgenoradiology, retrospective analysis of scientific clinical results of oral mycosis treatment in patients with malignant tumors of the head and neck receiving antitumor therapy was performed.Results. Two main approaches have been identified for the prevention and treatment of oral mucositis in patients with malignant neoplasms of the head and neck organs: personalized and unified approach. using personalized approach, maximal mean value of oral mycosis severity during the whole antitumor treatment period per the Radiation therapy Oncology group (RTOg) classification was 2.19 ± 0.13. The quality of life of patients is reduced by 26.1 %. using unified approach, maximal mean value of oral mycosis severity during the whole antitumor treatment period per the RTOg classification was 2.44 ± 0.05. The quality of life of patients is reduced by 51.5 %, but at the same time, absolutely all patients retain the ability to eat independently and take care of the oral cavity.Conclusion. Both personalized and unified approaches for the prevention and treatment of oral mucositis are possible for use in clinical practice.
介绍。口咽区肿瘤疾病的患病率持续稳定增长,但这类患者的5年生存率在一些病种中有所增加,这自然导致了伴随治疗方案的实现和提高肿瘤患者生活质量的愿望。肿瘤维持治疗的一个领域是牙齿支持,其途径和方法的选择没有系统的组织。探讨头颈部恶性肿瘤患者牙支持的最佳方法,以预防和治疗口腔黏膜炎。材料和方法。在俄罗斯放射科学中心,回顾性分析了头颈部恶性肿瘤患者接受抗肿瘤治疗的口腔真菌病的科学临床结果。头颈部恶性肿瘤患者口腔黏膜炎的防治主要有两种途径:个体化途径和统一化途径。采用个体化方法,整个抗肿瘤治疗期间口腔真菌病严重程度按放射治疗肿瘤组(RTOg)分类的最大平均值为2.19±0.13。患者的生活质量下降26.1%。采用统一方法,按RTOg分类,整个抗肿瘤治疗期间口腔真菌病严重程度的最大平均值为2.44±0.05。患者的生活质量下降了51.5%,但与此同时,绝对所有患者都保留了独立进食和照顾口腔的能力。个性化和统一的预防和治疗口腔黏膜炎的方法都有可能在临床实践中使用。
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引用次数: 0
The clinical significance of the features of the morphological study and immunohistochemical determination of pancytokeratin in the lymph nodes of the central zone in papillary thyroid cancer 甲状腺乳头状癌中心区淋巴结泛细胞角蛋白形态学研究及免疫组化检测的临床意义
Pub Date : 2022-12-13 DOI: 10.17650/2222-1468-2022-12-3-17-27
D. A. Galushko, H. Asmaryan, N. Melnikova, I. A. Lazukina
Introduction. papillary thyroid cancer is increasingly being detected at early stages when regional and distant metastases are absent per clinical examination. However, lymph nodes of the central zone can carry hidden metastases. frequency of such metastases is 22.3–46.7 %. maximally accurate identification of hidden metastases after lymph node dissection remains an important problem.Aim. тo evaluate the effect of histological examination characteristics and immunohistochemical measurement of pancytokeratin level on frequency of detection of papillary cancer hidden metastases in regional lymph nodes of the central zone in patients with clinical stage N0 papillary cancer.Materials and methods. The main group included 50 patients with stage ст1–2N0М0 primary papillary thyroid cancer. Dissected central lymph nodes of the patients prior to formalin fixation were extracted from the sample and inserted in individual paraffin blocks. Apart from standard histological examination, pancytokeratin level was measured immunohistochemically in the lymph nodes. The control group consisted of 200 patients for whom dissected central cell tissue was sectioned into blocks after formalin fixation. The number of lymph nodes in the dissected sample was measured by a pathomorphologist.Results. In the main group, the number of lymph nodes in the sample varied between 6 and 37 with mean of 20.7 ± 6.8; in the control group the number was lower: 3–25, mean 9.8 ± 5.1 (р = 0.000). In the main group, hidden metastases were detected more frequently than in the control group: in 30 (60 %) and 68 (34 %) cases, respectively (р = 0.001). In 20 (40 %) patients, immunohistochemical examination showed new metastases. use of this method allowed to detect 1 to 7 additional metastases (mean 2.4 ± 1.5 lymph node lesions).Conclusion. use of targeted dissection with extraction of lymph nodes led to significant increase in their numbers in the samples, and immunohistochemical examination allowed to detect a large number of hidden metastases in the central lymph nodes.
介绍。乳头状甲状腺癌越来越多地被发现在早期阶段,当区域和远处转移,每一个临床检查缺席。然而,中心淋巴结可携带隐藏的转移灶。此类转移的发生率为22.3 - 46.7%。淋巴结清扫后如何最大程度地准确识别隐藏转移瘤仍然是一个重要的问题。тo评价临床第0期乳头状癌患者组织学检查特点及泛细胞角蛋白免疫组化检测对中心区淋巴结隐匿转移检出率的影响。材料和方法。主要组包括50例ст1-2N0М0期原发性甲状腺乳头状癌患者。从标本中取出福尔马林固定前切除的患者中央淋巴结,并插入单个石蜡块。除标准组织学检查外,免疫组织化学法测定淋巴结中泛细胞角蛋白水平。对照组为200例患者,经福尔马林固定后,将切开的中央细胞组织切片。病理形态学检查结果显示淋巴结数目。主组淋巴结数在6 ~ 37个之间,平均20.7±6.8个;对照组较低:3 ~ 25例,平均9.8±5.1例(χ = 0.000)。主组隐匿性转移的检出率高于对照组:分别为30例(60%)和68例(34%)(p < 0.001)。在20例(40%)患者中,免疫组化检查显示新的转移灶。使用该方法可发现1 ~ 7个额外的转移灶(平均2.4±1.5个淋巴结病变)。采用有针对性的淋巴结清扫术,使样本中淋巴结数量显著增加,免疫组化检查可在中心淋巴结中发现大量隐匿转移灶。
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引用次数: 0
Features of the clinical course and prognosis of tongue cancer in young women 年轻女性舌癌的临床病程及预后特点
Pub Date : 2022-12-13 DOI: 10.17650/2222-1468-2022-12-3-28-36
M. Kropotov, L. Yakovleva, D. Safarov, O. A. Saprina, D. A. Peshko, A. V. Khodos
Introduction. In recent times, changes in epidemiology of tongue cancer have been observed. morbidity among nonsmoking and non-abusing alcohol young women have been rising. Currently, etiology and pathogenesis of tumor development in this nosological group are unclear and require detailed analysis of epidemiologic and clinical data.Aim. To analyze the clinical material on the incidence of tongue cancer among young women (under 45 years old) over a 10-year period and assess the prevalence of this pathology in this group, the methods of treatment and reconstruction used, and determine the prognosis.Materials and methods. The study included 68 female patients with squamous cell carcinoma of the tongue who received treatment between 2010 and 2020. mean age was 36.8 years (between 18 and 45 years; median – 39 years). None of the patients had history of alcohol abuse or smoking. In 32 (47.1 %) patients, primary diagnosis was made at stages I–II, in 36 (52.9 %) at stages III–Iv.Results. In the last 10 years, a trend towards increased morbidity of tongue cancer among young women have been observed. In 2010, 2 cases of the disease were detected, in 2019–13, in 2020–14. mean follow-up duration was 40 months (median 32 months). Overall 5-year survival in this period was 72.5 ± 6.5 %, recurrence-free 5-years survival was 66.5 ± 6.6 %. Conclusion. Increase on tongue cancer morbidity among young non-smoking women is a new epidemiological trend worldwide. Etiological and pathogenetic factors of this trend have not been studied and require large multicenter studies for obtaining statistically significant results. Early medical resource utilization in this social group allows to perform adequate surgical intervention but requires the head and neck tumor specialist to pay attention to reconstructive surgery, quality and early patient rehabilitation allowing to preserve high quality of life, capacity for work and social activity.
介绍。近年来,人们观察到舌癌流行病学的变化。不吸烟和不酗酒的年轻妇女的发病率一直在上升。目前,本组肿瘤的病因和发病机制尚不清楚,需要详细分析流行病学和临床资料。目的:分析近10年年轻女性(45岁以下)舌癌发病率的临床资料,评估该组舌癌的患病率、治疗方法和重建方法,并确定预后。材料和方法。该研究包括68名患有舌鳞状细胞癌的女性患者,她们在2010年至2020年期间接受了治疗。平均年龄36.8岁(18 - 45岁;中位数- 39岁)。这些患者都没有酗酒或吸烟史。在32例(47.1%)患者中,首次诊断是在I-II期,36例(52.9%)是在iii - iv期。在过去十年中,已经观察到年轻妇女舌癌发病率增加的趋势。2010年、2019 - 2013年、2020 - 2014年共发现2例病例。平均随访时间40个月(中位32个月)。总5年生存率为72.5±6.5%,无复发5年生存率为66.5±6.6%。结论。年轻非吸烟女性舌癌发病率上升是世界范围内流行病学的新趋势。这一趋势的病因和发病因素尚未得到研究,需要大型多中心研究才能获得统计上显著的结果。在这个社会群体中,早期医疗资源的利用允许进行充分的手术干预,但需要头颈部肿瘤专科医生关注重建手术、质量和早期患者康复,以保持高质量的生活、工作和社会活动能力。
{"title":"Features of the clinical course and prognosis of tongue cancer in young women","authors":"M. Kropotov, L. Yakovleva, D. Safarov, O. A. Saprina, D. A. Peshko, A. V. Khodos","doi":"10.17650/2222-1468-2022-12-3-28-36","DOIUrl":"https://doi.org/10.17650/2222-1468-2022-12-3-28-36","url":null,"abstract":"Introduction. In recent times, changes in epidemiology of tongue cancer have been observed. morbidity among nonsmoking and non-abusing alcohol young women have been rising. Currently, etiology and pathogenesis of tumor development in this nosological group are unclear and require detailed analysis of epidemiologic and clinical data.Aim. To analyze the clinical material on the incidence of tongue cancer among young women (under 45 years old) over a 10-year period and assess the prevalence of this pathology in this group, the methods of treatment and reconstruction used, and determine the prognosis.Materials and methods. The study included 68 female patients with squamous cell carcinoma of the tongue who received treatment between 2010 and 2020. mean age was 36.8 years (between 18 and 45 years; median – 39 years). None of the patients had history of alcohol abuse or smoking. In 32 (47.1 %) patients, primary diagnosis was made at stages I–II, in 36 (52.9 %) at stages III–Iv.Results. In the last 10 years, a trend towards increased morbidity of tongue cancer among young women have been observed. In 2010, 2 cases of the disease were detected, in 2019–13, in 2020–14. mean follow-up duration was 40 months (median 32 months). Overall 5-year survival in this period was 72.5 ± 6.5 %, recurrence-free 5-years survival was 66.5 ± 6.6 %. Conclusion. Increase on tongue cancer morbidity among young non-smoking women is a new epidemiological trend worldwide. Etiological and pathogenetic factors of this trend have not been studied and require large multicenter studies for obtaining statistically significant results. Early medical resource utilization in this social group allows to perform adequate surgical intervention but requires the head and neck tumor specialist to pay attention to reconstructive surgery, quality and early patient rehabilitation allowing to preserve high quality of life, capacity for work and social activity.","PeriodicalId":12937,"journal":{"name":"Head and neck tumors (HNT)","volume":"73 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-12-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"86003084","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Radiotherapy for cutaneous squamous cell carcinoma: current standards and outlooks 皮肤鳞状细胞癌的放射治疗:目前的标准和前景
Pub Date : 2022-12-13 DOI: 10.17650/2222-1468-2022-12-3-53-70
A. Gevorkov, A. Boyko, A. Polyakov, A. Chernichenko, V. Gerasimov, I. A. Meshcheryakova, A. Kaprin
Cutaneous squamous cell carcinoma accounts for 20 % of all malignant non-melanoma skin tumors, which is one of the most common cancers worldwide. Antitumor treatment is usually very effective: cure rate reaches 90 %, while local recurrence rate is 25 %. The main treatment option for primary skin cancers is surgery. The most significant risk factors for locoregional recurrence include tumor location (head and neck), size (>2 cm), depth of invasion (>4 mm), tumor differentiation grade, perineural invasion, immune system disorders (immunosuppression), severe concomitant diseases, and previous treatment.In patients with advanced cutaneous squamous cell carcinoma, 1-year, 2-year, and 3-year survival rates are 50–80, 30–35 and 15–16 %, respectively. Radiotherapy is a radical treatment option that increases the 5-year survival rate to 90 % and ensures good cosmetic results in 80 % of cases. There are 3 main variants of radiotherapy for cutaneous squamous cell carcinoma: sole radiotherapy according to a radical program, adjuvant radiotherapy in combination with surgery, and palliative radiotherapy. most frequently, radiotherapy is used as part of adjuvant postoperative treatment and is not initially considered as a sole conservative treatment for cutaneous squamous cell carcinoma patients below 45 years of age with resectable tumors, especially high-risk tumors. palliative radiotherapy is an affordable and effective method for combating painful symptoms; moreover, it often provides long-term local control. 
皮肤鳞状细胞癌占所有恶性非黑色素瘤皮肤肿瘤的20%,是世界上最常见的癌症之一。抗肿瘤治疗通常非常有效:治愈率达90%,而局部复发率为25%。原发性皮肤癌的主要治疗选择是手术。局部复发最重要的危险因素包括肿瘤位置(头颈部)、肿瘤大小(> 2cm)、浸润深度(> 4mm)、肿瘤分化程度、神经周围浸润、免疫系统障碍(免疫抑制)、严重伴发疾病和既往治疗。在晚期皮肤鳞状细胞癌患者中,1年、2年和3年生存率分别为50 - 80%、30 - 35%和15 - 16%。放射治疗是一种根治性的治疗选择,可将5年生存率提高到90%,并确保80%的病例具有良好的美容效果。皮肤鳞状细胞癌的放疗有三种主要的变体:根据根治性方案的单独放疗,手术联合辅助放疗和姑息性放疗。最常见的是,放疗作为术后辅助治疗的一部分,最初并不被认为是45岁以下可切除肿瘤的皮肤鳞状细胞癌患者,特别是高危肿瘤的唯一保守治疗方法。姑息性放射治疗是治疗疼痛症状的一种负担得起的有效方法;此外,它经常提供长期的本地控制。
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引用次数: 0
The effectiveness of the method for determining the level of thyroglobulin in needle washouts of fine-needle aspiration biopsy in the differential diagnosis of metastases of highly differentiated thyroid cancer in the lymph nodes of the neck 细针穿刺活检中甲状腺球蛋白水平测定方法在鉴别诊断高分化甲状腺癌颈部淋巴结转移中的有效性
Pub Date : 2022-12-13 DOI: 10.17650/2222-1468-2022-12-3-10-16
E. Stanyakina, I. Romanov, E. K. Gogieva, A. V. Ignatova, Y. Alymov, K. D. Ilkaev
Introduction. Thyroid cancer is one of the most common malignant neoplasms of the endocrine system. well-differentiated thyroid cancer constitutes about 90 % of all malignant tumors of the thyroid gland. Despite growing morbidity and high incidence of this pathology, in case of timely diagnosis and treatment well-differentiated thyroid cancer has favorable prognosis.Aim. using clinical examples, to demonstrate the possibility of thyroglobulin measurement in needle washouts of fineneedle aspiration biopsy in the detection of cervical metastases of highly differentiated thyroid cancer.Materials and methods. five patients (2 patients with combined oncological pathology, 2 patients with nodes in the thyroid gland, 1 patient after a thyroidectomy) with cervical adenopathy measured the level of thyroglobulin in the wash out fluid of lymph-nodes biopsy using the immunoradiometric method using the commercial kits of the Institute of Isotopes-IRmA (Hungary).Results. Cervical metastases of highly differentiated thyroid cancer were detected or excluded by the determination of fine-needle aspiration biopsy in patients with non-informational cytological studies. The determination of fineneedle aspiration biopsy is a useful diagnostic method in the differential diagnosis of cervical metastases in patients who have other morphological forms of cancer in addition to well-differentiated thyroid cancer, as well as for the differential diagnosis of cervical adenopathy in patients with a history of highly differentiated thyroid cancer.Conclusion. Determination of thyroglobulin level in puncture needle washout is a simple and useful diagnostic method for differential diagnosis of metastases in lymph nodes of the neck in patients with several morphological forms of malignant tumors.
介绍。甲状腺癌是内分泌系统最常见的恶性肿瘤之一。高分化甲状腺癌约占所有甲状腺恶性肿瘤的90%。尽管高分化甲状腺癌的发病率越来越高,但在及时诊断和治疗的情况下,预后良好。结合临床实例,探讨细针穿刺活检中甲状腺球蛋白测定在检测高分化甲状腺癌宫颈转移中的可能性。材料和方法。5例宫颈腺病患者(2例合并肿瘤病理,2例甲状腺淋巴结,1例甲状腺切除术后),采用匈牙利同位素- irma研究所的商用试剂盒,采用免疫放射法测定了淋巴结活检洗出液中甲状腺球蛋白的水平。高分化甲状腺癌的宫颈转移是通过细针穿刺活检检测或排除无信息细胞学研究的患者。细针穿刺活检在鉴别鉴别除高分化甲状腺癌外还存在其他形态癌的患者宫颈转移,以及鉴别鉴别有高分化甲状腺癌病史的患者宫颈腺病方面具有重要意义。穿刺针冲洗法检测甲状腺球蛋白水平对多种形态恶性肿瘤患者颈部淋巴结转移的鉴别诊断是一种简单而有用的诊断方法。
{"title":"The effectiveness of the method for determining the level of thyroglobulin in needle washouts of fine-needle aspiration biopsy in the differential diagnosis of metastases of highly differentiated thyroid cancer in the lymph nodes of the neck","authors":"E. Stanyakina, I. Romanov, E. K. Gogieva, A. V. Ignatova, Y. Alymov, K. D. Ilkaev","doi":"10.17650/2222-1468-2022-12-3-10-16","DOIUrl":"https://doi.org/10.17650/2222-1468-2022-12-3-10-16","url":null,"abstract":"Introduction. Thyroid cancer is one of the most common malignant neoplasms of the endocrine system. well-differentiated thyroid cancer constitutes about 90 % of all malignant tumors of the thyroid gland. Despite growing morbidity and high incidence of this pathology, in case of timely diagnosis and treatment well-differentiated thyroid cancer has favorable prognosis.Aim. using clinical examples, to demonstrate the possibility of thyroglobulin measurement in needle washouts of fineneedle aspiration biopsy in the detection of cervical metastases of highly differentiated thyroid cancer.Materials and methods. five patients (2 patients with combined oncological pathology, 2 patients with nodes in the thyroid gland, 1 patient after a thyroidectomy) with cervical adenopathy measured the level of thyroglobulin in the wash out fluid of lymph-nodes biopsy using the immunoradiometric method using the commercial kits of the Institute of Isotopes-IRmA (Hungary).Results. Cervical metastases of highly differentiated thyroid cancer were detected or excluded by the determination of fine-needle aspiration biopsy in patients with non-informational cytological studies. The determination of fineneedle aspiration biopsy is a useful diagnostic method in the differential diagnosis of cervical metastases in patients who have other morphological forms of cancer in addition to well-differentiated thyroid cancer, as well as for the differential diagnosis of cervical adenopathy in patients with a history of highly differentiated thyroid cancer.Conclusion. Determination of thyroglobulin level in puncture needle washout is a simple and useful diagnostic method for differential diagnosis of metastases in lymph nodes of the neck in patients with several morphological forms of malignant tumors.","PeriodicalId":12937,"journal":{"name":"Head and neck tumors (HNT)","volume":"143 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-12-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"86777646","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Atypical teratoid rhabdoid tumor with intratumoral advancement: significance of active surgical approach in long-term disease (109 months) with metastatic cascade 非典型畸胎瘤样横纹肌样肿瘤伴瘤内进展:伴有转移级联的长期疾病(109个月)积极手术入路的意义
Pub Date : 2022-12-13 DOI: 10.17650/2222-1468-2022-12-3-127-135
V. Karakhan, E. Prozorenko, G. Mentkevich, I. Dolgopolov, N. V. Sevyan, D. M. Belov
The article presents a clinical case of atypical teratoid rhabdoid tumor with one of the longest catamnesis described in literature (109 months) and high quality of life. first, a giant tumor of the frontal lobe with advancement into a lateral ventricle was found in a female patient and totally removed. It was histologically diagnosed as primitive neuroectodermal tumor. Combination treatment consisting of radiotherapy, high-dose polychemotherapy and cellular immunotherapy including intrathecal therapy led to 4-year recurrence-free period. Recurrence of the tumor was resected. The period of the 2nd remission was 34 months. Subsequently, multistage metastasis of the tumor through cerebrospinal fluid tracts of the brain and spinal cord was observed. Twice microsurgical treatment with removal of symptomatic metastases in ventricles Iv and III was performed. In repeat morphological examinations, the tumor was verified as atypical teratoid rhabdoid tumor. The presented clinical case shows the role of active surgical tactics in effective long-term combination treatment of this severe pathology.
本文报告一例非典型畸胎瘤样横纹肌样肿瘤,其病程最长(109个月),生活质量高。首先,在一名女性患者身上发现了一个巨大的额叶肿瘤,肿瘤进展到侧脑室,并被完全切除了。病理诊断为原始神经外胚层肿瘤。经放疗、高剂量多药化疗和细胞免疫治疗(包括鞘内治疗)联合治疗,4年无复发。复发的肿瘤切除。第二次缓解期为34个月。随后,观察到肿瘤通过脑和脊髓的脑脊液束多期转移。两次显微手术治疗,去除症状性转移的脑室Iv和III。经反复形态学检查,证实为非典型畸胎瘤样横纹肌样瘤。所提出的临床病例表明,积极的手术策略在有效的长期联合治疗这种严重的病理的作用。
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引用次数: 0
Oral microbiota in patients with oropharyngeal cancer with an emphasis on Candida spp. 口咽癌患者的口腔微生物群,重点是念珠菌。
Pub Date : 2022-12-13 DOI: 10.17650/2222-1468-2022-12-3-71-85
N. S. Bagirova, I. N. Petukhova, Z. Grigorievskaya, A. Sytov, P. V. Slukin, E. A. Goremykina, O. Khokhlova, N. Fursova, A. Kazimov
Introduction. Interactions between the 2 microbiota components – bacteria and fungi – are of interest as diagnostic and prognostic markers in selection of treatment tactics for oncological patients.Aim. To study microbiota of the oral cavity in patients with primary squamous cell carcinoma of the oropharyngeal area before and after surgical intervention to find biomarkers for rational selection of antifungal drugs.Materials and methods. At the Surgical Department of Head and Neck Tumors of the N. N. Blokhin National Research Center of Oncology, three-component study was performed: investigations of spectrum of Candida spp. isolates, Candida spp. strains’ resistance to antifungals, and oral washes in primary patients before and after surgery. mALDI-Tof microflex LT (Biotyper, Bruker Daltonics, germany) was used for strain identification; Sensititre Yeast ONE, YO10 (Trek Diagnostic System, united kingdom) plates were used for determination of minimal inhibiting concentrations of anti fungals. values of minimal inhibiting concentrations were evaluated based on the European Committee on Antimicrobial Susceptibility Testing (EuCAST) criteria (version 10.0).Results. four-year observation of patients at the surgical department of head and neck tumors of the N. N. Blokhin National Research Center of Oncology showed that the most common species of Candida is C. albicans (73.5 % of cases). Candida spp. resistance to antifungals was detected only for fluconazole (9.3 % of cases) and micafungin (8.0 % of cases), mostly among C. albicans strains. In 31.8 % of primary patients, oral washes prior to surgery showed growth of Candida spp. (probably, tissue colonization). After surgical intervention, Candida spp. growth was detected in 36.4 % of cases, only 1 of which was diagnosed as invasive mycosis. In 54.5 % of cases before and in 72.7 % of cases after surgery, gram-negative rods were detected. After surgical intervention, percentage of enterobacteria and non-fermenters significantly increased: 59.1 % versus 27.3 % (p <0.05) and 63.6 % versus 27.3 % (p <0.02), respectively. prior to surgery, non-fermenting gram-negative bacteria were represented only by P. aeruginosa; after surgery, the spectrum of non-fermenting gram-negative bacteria became wider but percentage of P. aeruginosa remained high: 71.4 %. ERG11 gene was identified only in 1 strain: C. albicans. FKS1 gene also was identified only in 1 strain: C. inconspicua. virulence factor genes were detected in 57.1 % of strains.Conclusion. Surgical intervention is associated with changes in bacterial microbiota but not fugal microbiota. presence of virulence factor genes and resistance genes in Candida spp. strains should be considered a biomarker allowing to differentiate between colonization and candida infection and can be used for rational selection of antifungal drugs in prevention and treatment of invasive candidiasis, especially in the absence of criteria for interpretation of measured minimal inhibitin
介绍。细菌和真菌这两种微生物群之间的相互作用是肿瘤患者选择治疗策略时的诊断和预后指标。目的研究原发性口咽区鳞状细胞癌患者手术干预前后口腔微生物群的变化,寻找生物标志物,为合理选择抗真菌药物提供依据。材料和方法。在N. N. Blokhin国家肿瘤研究中心头颈部肿瘤外科,对原发患者手术前后的念珠菌菌株谱、念珠菌菌株对抗真菌药物的耐药性和口腔洗液进行了三组分研究。mALDI-Tof microflex LT (Biotyper, Bruker Daltonics, germany)用于菌株鉴定;使用Sensititre Yeast ONE, YO10 (Trek诊断系统,英国)板测定抗真菌的最低抑制浓度。根据欧洲抗菌药物敏感性试验委员会(EuCAST)标准(10.0版)评估最小抑制浓度值。对N. N. Blokhin国家肿瘤研究中心头颈部肿瘤外科患者四年的观察表明,念珠菌最常见的种类是白色念珠菌(73.5%)。念珠菌仅对氟康唑(9.3%)和米卡芬宁(8.0%)耐药,以白色念珠菌为主。在31.8%的原发患者中,术前口腔清洗显示念珠菌生长(可能是组织定植)。手术干预后,36.4%的病例检出念珠菌生长,其中只有1例诊断为侵袭性真菌病。术前54.5%的病例和术后72.7%的病例检出革兰氏阴性杆状体。手术干预后,肠杆菌和非发酵菌的比例分别显著增加:59.1%比27.3% (p <0.05)和63.6%比27.3% (p <0.02)。手术前,非发酵革兰氏阴性菌仅为铜绿假单胞菌;手术后,非发酵革兰氏阴性菌谱变宽,但铜绿假单胞菌的比例仍然很高,为71.4%。ERG11基因仅在1株白色念珠菌中检测到。FKS1基因也只在1株C. inua中被鉴定出来。毒力因子基因检出率为57.1%。手术干预与细菌微生物群的变化有关,但与真菌微生物群无关。念珠菌菌株中毒力因子基因和耐药基因的存在应被视为区分定植和念珠菌感染的生物标志物,可用于合理选择抗真菌药物以预防和治疗侵袭性念珠菌病,特别是在缺乏抗真菌药物最低抑制浓度解释标准的情况下。
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引用次数: 1
Adaptive immune response in pathogenesis and treatment of head and neck squamous cell carcinoma: the influence of immunosuppression factors and gender 适应性免疫反应在头颈部鳞状细胞癌发病和治疗中的作用:免疫抑制因子和性别的影响
Pub Date : 2022-12-13 DOI: 10.17650/2222-1468-2022-12-3-114-126
A. I. Stukan, R. Murashko, N. A. Tsygan, A. Goryainova, O. N. Nefedov, V. Porkhanov
An obvious trend of the last decade in head and neck squamous cell carcinoma pathogenesis evaluation is awareness of the impact of immune response disorders on disease manifestation. The review presents an analysis of the differences in the type and degree of immunosuppression, as well as treatment response in head and neck squamous cell carcinoma patients in accordance with influencing carcinogenic factor, gender, age of the patient and concomitant diseases. An increase in CD8+ T-lymphocytes and a decrease of memory T-cells has been evaluated in smoking and alcohol abusing patients with head and neck squamous cell carcinoma, and a smaller number of CD8+ T-lymphocytes were detected in the tumor microenvironment compared to non-smoking and non-drinking patients. Studies have shown that the improved prognosis of patients with human papillomavirus (Hpv) – associated head and neck squamous cell carcinoma is largely due to the presence of antibodies against Hpv E6 and E7, E7-specific CD8+T lymphocytes in periphe ral blood and a high level of tumor-infiltrating T lymphocytes. The issue of gender differences in the type of immune response is widely discussed. It has been shown that the use of immune response checkpoint inhibitors is more effective in improving survival rates in men, and the use of these drugs in combination with chemotherapy is more effective in women. In addition, in elderly cancer patients, numerous age-associated T-lymphocyte’s function changes were revealed, including a decrease in the number of naive T-lymphocytes due to age-related involution of the thymus and an in crease in the relative number of memory cells and effector cells. Thus, it is clear that immunosuppression type, as well as treatment response, differ depending on the influencing factor, gender, age of the patient, as well as comorbidities.
近十年来,头颈部鳞状细胞癌发病机制评价的一个明显趋势是认识到免疫反应障碍对疾病表现的影响。本文根据影响癌变因素、性别、患者年龄及伴发疾病的不同,分析了头颈部鳞状细胞癌患者免疫抑制的类型、程度及治疗反应的差异。吸烟和酗酒的头颈部鳞状细胞癌患者CD8+ t淋巴细胞增加,记忆t细胞减少,肿瘤微环境中CD8+ t淋巴细胞的数量比不吸烟和不饮酒的患者少。研究表明,人乳头瘤病毒(Hpv)相关的头颈部鳞状细胞癌患者预后的改善主要是由于外周血中存在针对Hpv E6和E7的抗体,E7特异性CD8+T淋巴细胞和高水平的肿瘤浸润T淋巴细胞。免疫反应类型的性别差异问题被广泛讨论。研究表明,使用免疫反应检查点抑制剂在提高男性生存率方面更有效,而这些药物与化疗联合使用在女性中更有效。此外,在老年癌症患者中,发现了许多与年龄相关的t淋巴细胞功能变化,包括由于胸腺衰老相关的幼稚t淋巴细胞数量减少,记忆细胞和效应细胞的相对数量增加。因此,很明显,免疫抑制类型以及治疗反应因影响因素、性别、患者年龄以及合并症而异。
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引用次数: 0
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Head and neck tumors (HNT)
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