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SIMULTANEOUS SURGICAL MANAGEMENT OF CONGENITAL BICUSPID AORTIC VALVE AND GASTRIC CANCER: A CASE REPORT 同时手术治疗先天性双尖瓣主动脉瓣和胃癌:病例报告
Pub Date : 2023-12-29 DOI: 10.52532/2521-6414-2023-4-70-23-27
A. Abdikarimov, A. Bashabayev
Relevance: Gastric cancer is the second leading cause of malignancies of the gastrointestinal tract and the fifth leading cause in overall cancer statistics. Diseases of the cardiovascular system are the leading cause of death worldwide. A high prevalence of both diseases increases the chances of their co-morbidity. The article aimed present a case where a patient undergoes two simultaneous procedures for two diseases and discuss possible surgical tactics, advantages, and disadvantages. Results: In this case report, we present simultaneous surgical procedures performed on a 49-year-old male with a history of congenital bicuspid aortic valve and gastric cancer, found incidentally on upper gastrointestinal (GI) endoscopy. Since the patient was a good fit, he qualified for simultaneous surgery on the heart and abdomen. The surgery results were good, and the patient was discharged 8 days after surgery. Conclusion: Performing simultaneous surgery for both the abdomen and heart can be a safe procedure that allows people with malignant diseases to receive adjuvant therapy faster by minimizing the interval between surgeries.
相关性:胃癌是胃肠道恶性肿瘤的第二大病因,也是癌症统计中的第五大病因。心血管系统疾病是导致全球死亡的主要原因。这两种疾病的高发病率增加了它们并发的几率。 本文旨在介绍一个病人因两种疾病同时接受两种手术的病例,并讨论可能的手术策略、优点和缺点。 结果:在这篇病例报告中,我们介绍了同时为一名 49 岁男性患者实施的手术,该患者有先天性双尖瓣主动脉瓣和胃癌病史,是在上消化道内镜检查中偶然发现的。由于患者情况良好,符合同时进行心脏和腹部手术的条件。 手术效果良好,患者术后 8 天即可出院。 结论同时进行腹部和心脏手术是一种安全的手术方式,可以缩短手术间隔时间,让恶性疾病患者更快地接受辅助治疗。
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引用次数: 0
ENDOSCOPIC TREATMENT FOR EARLY COLORECTAL CANCER 早期大肠癌的内窥镜治疗
Pub Date : 2023-12-29 DOI: 10.52532/2521-6414-2023-4-70-34-38
K. Batyrbekov, A. Galiakbarova
Relevance: In recent years, significant breakthroughs have occurred in the endoscopic treatment of cancerous and precancerous lesions of the gastrointestinal tract. Endoscopic mucosal resection (EMR) is a simple and effective method of treating most benign gastrointestinal tract lesions. However, with the introduction of endoscopic submucosal dissection (ESD) and full-thickness endoscopic resection (EFTR), the ЛЕЧЕНИЕ 38 Онкология и Радиология Казахстана, №4 (70) 2023 volume of lesions subject to endoscopic treatment has significantly expanded even in the colon. Currently, these methods are regularly used not only for the treatment of benign tumors but also for complex resection of early stages of colorectal cancer. For the first time in Kazakhstan, the presented article analyzed the cases of endoscopic removal of epithelial formations of the large intestine performed at an oncological clinic from 2020 to 2023. The aim was to evaluate the use of endoscopic treatment of early colorectal cancer. Methods: The article presents a retrospective analysis of 68 cases of endoscopic removal of epithelial formations of the colon performed from 2020 to 2023 at the Center of Expert Endoscopy and Interventional Radiology of the National Scientific Cancer Center (Astana, Kazakhstan). Results: In 2020-2023, 68 endoscopic extractions of colon tumors were performed, including 25 outpatient and 43 inpatient manipulations. Out of 43 inpatient cases, endoscopic dissection in the submucosal layer was performed in 9 cases, and endoscopic mucosal resection of tumors of the large intestine was performed in 34 cases. Morphologically, we found hyperplastic polyps in 11 cases, lipomas in 2 cases, tubulovillous adenomas with mild dysplasia – 43 cases, tubulovillous adenomas with severe dysplasia – 11 cases, carcinoma in situ – 3 cases, and adenocarcinoma with invasion – 3 cases. Conclusion: When detecting benign neoplasms with dysplasia and early colorectal cancer, minimally invasive technologies (EMR, ESD, EFTR) should be the first preferred treatment method and only if they cannot be performed and there is a high risk of invasion into the underlying layers, and therefore, if endoscopic treatment is not radical, clinicians should choose surgical radical treatment. Patients should be informed about the availability of the latest methods of local treatment in the Republic through the financing of the Compulsory Medical Insurance Fund (CMIF)
相关性:近年来,消化道癌症和癌前病变的内镜治疗取得了重大突破。内镜粘膜切除术(EMR)是治疗大多数胃肠道良性病变的一种简单而有效的方法。然而,随着内镜下粘膜下剥离术(ESD)和全厚内镜下切除术(EFTR)的引入、然而,随着内镜黏膜下剥离术(ESD)和全厚内镜切除术(EFTR)的引入,即使在结肠,内镜治疗的病变范围也显著扩大。目前,这些方法不仅经常用于良性肿瘤的治疗,还用于早期大肠癌的复杂切除术。本文首次在哈萨克斯坦分析了 2020 年至 2023 年在肿瘤诊所进行的大肠上皮细胞内窥镜切除病例。 目的是评估早期大肠癌内镜治疗的使用情况。 方法:文章对2020年至2023年期间在国家科学癌症中心(哈萨克斯坦阿斯塔纳)内窥镜和介入放射学专家中心进行的68例大肠上皮形态内窥镜切除术进行了回顾性分析。 结果:2020-2023年,共进行了68例结肠肿瘤内镜摘除术,包括25例门诊手术和43例住院手术。 在 43 例住院病例中,9 例进行了内镜下粘膜下层剥离,34 例进行了内镜下大肠肿瘤粘膜切除。从形态上看,我们发现增生性息肉 11 例,脂肪瘤 2 例,轻度发育不良的管状腺瘤 43 例,严重发育不良的管状腺瘤 11 例,原位癌 3 例,浸润性腺癌 3 例。 结论在发现良性肿瘤伴发育不良和早期结直肠癌时,微创技术(EMR、ESD、EFTR)应作为首选治疗方法,只有在无法进行微创技术且极有可能侵犯底层的情况下,临床医生才应选择手术根治。应通过强制医疗保险基金(CMIF)的资助,让患者了解在共和国可以获得最新的局部治疗方法。
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引用次数: 0
THE RESULTS OF THE JAPANESE GASTRIC CANCER SOCIETY MORPHOLOGICAL CLASSIFICATION ADAPTATION FOR THE KAZAKH POPULATION 日本胃癌协会形态学分类法对哈萨克斯坦人的适应性研究结果
Pub Date : 2023-12-29 DOI: 10.52532/2521-6414-2023-4-70-12-17
S. Menbayev, E. Izhanov, D. Kaidarova, T. Goncharova, E. Saparova, T. Belikhina, A. Borombayev, R. Raskaliev, A. Kabdrakhieva, K. Soltangazin, E. Nasibullin
Relevance: Gastric cancer (GC) morbidity is growing in Kazakhstan every year. In 2022, 2 915 new GC cases were detected (15 per 100,000 population), making GC the third most common cancer. The early detection rate of GC does not exceed 10-20%, and advanced forms of GC are over 40%. Mortality increases in the first year after the diagnosis (up to 40%). The best way of solving early detection of gastric cancer is carrying out diagnostics at the stage of pre-tumor stomach diseases. Timely diagnosis and treatment of surgical and borderline diseases of the upper gastrointestinal tract (metaplastic and dysplastic changes in the mucous ОРГАНИЗАЦИЯ ЗДРАВООХРАНЕНИЯ Онкология и Радиология Казахстана, №4 (70) 2023 17 membrane of the esophagus, stomach, and duodenum and adenocarcinomas and early cancer arising against this background) are a complex medical and social problem. Endoscopic methods for diagnosing esophagus, stomach, and duodenum diseases are the most highly informative nowadays. However, precancerous changes (atrophy, metaplasia, and dysplasia) in conventional endoscopic examination may not have specific features. It is necessary to improve the results of endoscopic diagnosis. The chromoscopy method may be one of the methods used to identify precancerous pathology and GC methods. The study aimed to increase the efficiency of gastric cancer early detection by adapting the morphological classification of the Japanese Gastric Cancer Society (JGCA) for the Kazakh population. Methods: We conducted endoscopic studies of 500 residents of the Republic of Kazakhstan using chromoscopy and morphological studies of the biopsy obtained during endoscopic examination. These patients had digestive system problems but previously did not have a GC diagnosis. We formed the risk groups according to JGCA (editions 13th and 14th). Results: We identified 3(0.6%) morbidity of severe dysplasia according to the results of 500 patients’ biopsy samples morphological study. This morphological structure is classified as a well-differentiated adenocarcinoma. We recommended a surgical treatment for identified patients. Conclusion: The identified cases of obligate pre-cancer with an extremely high probability of degeneration into a malignant neoplasm prove the importance of using JGCA for the early diagnosis of gastric cancer and allow us to recommend the use of chromoscopy in stomach endoscopic examination.
相关性:哈萨克斯坦的胃癌(GC)发病率逐年上升。2022 年,新发现胃癌病例 2 915 例(每 10 万人中有 15 例),使胃癌成为第三大常见癌症。GC 的早期发现率不超过 10-20%,晚期 GC 的发现率超过 40%。确诊后第一年的死亡率会上升(高达 40%)。 解决胃癌早期发现的最佳方法是在肿瘤前胃病阶段进行诊断。及时诊断和治疗上消化道的外科疾病和边缘疾病(粘膜的变性和发育不良变化黏膜的移行性和增生性变化)的及时诊断和治疗、食管、胃和十二指肠膜以及在此背景下产生的腺癌和早期癌症)是一个复杂的医学和社会问题。 目前,诊断食道、胃和十二指肠疾病的内窥镜方法信息量最大。然而,传统内窥镜检查中的癌前病变(萎缩、变性和发育不良)可能没有特异性。因此有必要改进内窥镜诊断的结果。色镜检查法可能是用于鉴别癌前病变和 GC 方法的方法之一。 本研究旨在通过调整日本胃癌协会(JGCA)的形态学分类,提高哈萨克斯坦人群胃癌早期检测的效率。 研究方法我们对哈萨克斯坦共和国的 500 名居民进行了内窥镜检查,使用了色内窥镜并对内窥镜检查中获得的活检组织进行了形态学研究。这些患者都有消化系统问题,但之前并未确诊为消化道癌症。 我们根据 JGCA(第 13 版和第 14 版)划分了风险组。 结果根据 500 例患者活检样本的形态学研究结果,我们发现了 3 例(0.6%)严重发育不良的病例。 这种形态结构被归类为分化良好的腺癌。我们建议对发现的患者进行手术治疗。 结论已发现的具有极高变性为恶性肿瘤可能性的强制性癌前病变病例证明了使用 JGCA 进行胃癌早期诊断的重要性,并使我们能够建议在胃内窥镜检查中使用色镜。
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引用次数: 0
DNA DOUBLE-STRANDED BREAKS AND REPAIRS IN ACUTE LEUKEMIA 急性白血病中DNA双链断裂和修复
Pub Date : 2023-06-29 DOI: 10.52532/2521-6414-2023-2-68-22-27
M. Bulegenova, A. Dunayeva, S. Saliyeva, A. Uskenbayeva
Relevance: Double-strand Relevance: Errors in the damage repair system, such as double-stranded DNA breaks, can lead to mutations that will be passed on to subsequent generations of cells, and some of these mutations may have oncogenic potential. The study aimed to evaluate the number of double-stranded breaks and DNA repairs of peripheral blood lymphocytes in a group of conditionally healthy children and in patients diagnosed with acute leukemia (AL) to develop a method for predicting the outcome of the disease and determining the effectiveness of therapy. Methods: peripheral blood lymphocytes were studied: a) 38 conditionally healthy children (control group); b) 100 patients diagnosed with acute leukemia (AL); c) 14 children with relapse of the disease. Double-stranded DNA breaks/repairs were examined using the Aklides system (MEDIPAN, Germany), consisting of a fluorescent analyzer and the AKLIDES Nuk software. Results: In patients with T-lymphoblastic leukemia, both at admission and the end of Day 7 at the hospital, the number of 53BPI repair foci was, on average, three times higher than the number of DNA damages. In most cases, the ratio of breaks/repairs indicators during treatment did not change among patients with B-line leukemia. Double-stranded DNA breaks prevailed over repairs, with the newly established disease on the 7th, 15th day, and 3rd month of treatment. Overall, 22 samples were tested using RT-PCR, and results were considered as follows:1 (4%) – positive, 13 (59%) – negative, 8 (37%) -– invalid. Conclusion: The level of lymphocyte DNA damage in patients with B-ALL was higher than expected. In addition, the ratio of double-strand breaks to repairs remained unchanged at all stages of therapy in patients with B-ALL. The changes we suggest in these patients can be observed during and/or after maintenance therapy. Monitoring double-strand breaks/reparations was the initial step in developing a method of predicting the disease outcome and determining the therapy efficacy. The results obtained are of direct interest and require further research.
相关性:损伤修复系统中的错误,如双链DNA断裂,可导致突变,这些突变将传递给后代的细胞,其中一些突变可能具有致癌潜力。该研究旨在评估一组条件健康儿童和诊断为急性白血病(AL)的患者外周血淋巴细胞双链断裂和DNA修复的数量,以开发一种预测疾病结局和确定治疗效果的方法。方法:外周血淋巴细胞研究:a)条件健康儿童38例(对照组);b)诊断为急性白血病(AL)患者100例;C)疾病复发的14名儿童。使用Aklides系统(MEDIPAN,德国)检测双链DNA断裂/修复,该系统由荧光分析仪和Aklides Nuk软件组成。结果:t淋巴细胞白血病患者入院时和入院第7天结束时,53BPI修复病灶的数量平均是DNA损伤数量的3倍。在大多数情况下,b系白血病患者在治疗期间的断裂/修复指标的比例没有改变。双链DNA断裂优于修复,在治疗的第7、15天和第3个月出现了新建立的疾病。总体而言,使用RT-PCR检测了22个样本,结果如下:1个(4%)阳性,13个(59%)阴性,8个(37%)无效。结论:B-ALL患者淋巴细胞DNA损伤水平高于预期。此外,在B-ALL患者的所有治疗阶段,双链断裂与修复的比例保持不变。我们建议这些患者的变化可以在维持治疗期间和/或之后观察到。监测双链断裂/修复是开发预测疾病结果和确定治疗效果方法的第一步。所得结果具有直接意义,需要进一步研究。
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引用次数: 0
QUANTIFICATION OF DNA DOUBLE-STRAND BREAKS IN BENIGN AND MALIGNANT BREAST DISEASES 乳腺良恶性疾病DNA双链断裂的定量分析
Pub Date : 2023-06-29 DOI: 10.52532/2521-6414-2023-2-68-28-35
G. Smagulova, M. Aitmagambetova, G. V. Veklenko, N. Kereeva, A. Zheksenova, A. Amanzholkyz, A. Tulyaeva, G. Bakytzhanov
Relevance: Double-strand DNA breaks are the most dangerous DNA damage. Analysis of foci of phosphorylated histone protein H2AX (γH2AX) is currently the most sensitive method for detecting DNA double-strand breaks. This protein modification can become a biomarker of cellular stress, especially in diagnosing and monitoring neoplastic diseases. In this study, we utilized novel pattern recognition algorithms on the AKLIDES® platform to automatically analyze immunofluorescent images of γH2AX foci and compare the results with visual scores. The γH2AX foci formation on peripheral blood mononuclear cells of women with breast cancer or benign breast tumors was studied. The article aimed to quantify DNA double-strand breaks in peripheral blood lymphocytes in women with breast cancer and benign breast masses to identify a possible biomarker. Methods: γ-H2AX foci in lymphocytes were analyzed using the automated AKLIDES system in patients with breast cancer (n=29) and benign breast tumors (n=24). Results: When comparing the indicators of the main and control groups in the channel of ruptures “FITC,” a statistically significant difference was found in the indicators “Foci dia” (p=0.0382), “Focilnt mean” (p=0.0166), “Colocalisation” (p=0.0486). In the repair channel “AРС,” significant differences were found in the indicators “Nuclei BGInt” (p=0.0166) and the indicator “Focilnt mean” (p=0.0118). Conclusion: The revealed changes of DNA double-strand breaks along the FITC break channels and APC repair between the main and control groups can possibly serve as a breast cancer diagnostic marker.
相关性:双链DNA断裂是最危险的DNA损伤。磷酸化组蛋白H2AX (γH2AX)的焦点分析是目前检测DNA双链断裂最敏感的方法。这种蛋白修饰可以成为细胞应激的生物标志物,特别是在诊断和监测肿瘤疾病方面。在这项研究中,我们利用新颖的模式识别算法在AKLIDES®平台上自动分析γ - h2ax焦点的免疫荧光图像,并将结果与视觉评分进行比较。研究了乳腺癌和乳腺良性肿瘤患者外周血单个核细胞γ - h2ax灶的形成。本文旨在量化乳腺癌和乳腺良性肿块患者外周血淋巴细胞DNA双链断裂,以确定可能的生物标志物。方法:采用自动AKLIDES系统对29例乳腺癌患者和24例乳腺良性肿瘤患者淋巴细胞中γ-H2AX灶进行分析。结果:主、对照组骨折通道“FITC”指标比较,“Foci dia”指标(p=0.0382)、“Focilnt mean”指标(p=0.0166)、“Colocalisation”指标(p=0.0486)差异有统计学意义。在修复通道“AРС”中,“nucleus BGInt”指标(p=0.0166)和“Focilnt mean”指标(p=0.0118)存在显著差异。结论:各组与对照组间FITC断裂通道DNA双链断裂及APC修复的变化可能作为乳腺癌的诊断标志。
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引用次数: 0
CERVICAL CANCER INCIDENCE AND MORTALITY IN ALMATY IN 2005-2022 2005-2022年阿拉木图的宫颈癌发病率和死亡率
Pub Date : 2023-06-29 DOI: 10.52532/2521-6414-2023-2-68-9-14
N. Izbagambetov, D. Kaidarova, R. Bolatbekova, A. Shinbolatova, T. Valieva, A. Aidarov, G. Bagatova, A. Sarmenova, D. Zhaksylykova, A. Akkasova, A. Yestaeva, A. Satanova
Relevance: In Kazakhstan, the standardized incidence rate of cervical cancer for 2022 was 19 per 100,000 women, and the mortality rate was 5.9 per 100,000 female population. The overall survival of cervical cancer in the Republic of Kazakhstan for 2022 was 59.6% (95% CI: 50.7-54.2). Since 2008, in Kazakhstan, there has been a National Screening Program for cervical cancer for women from 30 to 70 years old with an interval of 4 years. Almaty is the largest city in Kazakhstan, with a high incidence and mortality from all types of cancer. The study aimed to analyze the cervical cancer incidence and mortality in Almaty in 2005-2022. Methods: Epidemiological analysis of cervical cancer incidence in Almaty for 2005-2022 was provided with analyzing reporting forms of documentation. Statistical processing was carried out using the SPSS v. 23.0 software. Results: Over the past 18 years (2005 to 2022), there has been an increase in the incidence rate from 16 to 18.3 per 100,000 female population and a consistently high mortality rate, which was 6.6 per 100,000 female population in 2022. In 2005, 108 women with cervical cancer were identified, of which 70% were patients with the first and second stages. In 2022, 198 cases of cervical cancer were registered, where the first stage accounts for 56.5%. In recent years, there has been an increase in the frequency of registration of new cases of cervical cancer starting from 30-34 years old, with a noticeable increase up to 40-44 years old. Conclusion: The results of this epidemiological study of cervical cancer incidence and mortality in Almaty indicate the need to improve and intensify screening among women of reproductive age, and introduce a vaccination and screening program using HPV testing.
相关性:在哈萨克斯坦,2022年宫颈癌的标准化发病率为每10万名妇女19例,死亡率为每10万名妇女5.9例。哈萨克斯坦共和国2022年宫颈癌的总生存率为59.6% (95% CI: 50.7-54.2)。自2008年以来,哈萨克斯坦为30至70岁妇女开展了一项宫颈癌国家筛查计划,每隔4年进行一次。阿拉木图是哈萨克斯坦最大的城市,各种癌症的发病率和死亡率都很高。本研究旨在分析2005-2022年阿拉木图地区宫颈癌发病率和死亡率。方法:采用文献分析报告表对2005-2022年阿拉木图地区宫颈癌发病率进行流行病学分析。采用SPSS v. 23.0软件进行统计处理。结果:在过去18年中(2005年至2022年),发病率从每10万名女性人口中的16人增加到18.3人,死亡率一直很高,2022年为每10万名女性人口中的6.6人。在2005年,共有108名妇女确诊患上子宫颈癌,其中70%为第一及第二阶段的病人。二零二二年,本港共有198宗子宫颈癌登记个案,其中处于第一阶段的个案占56.5%。近年,从30至34岁开始,新登记的子宫颈癌个案数目有所增加,其中40至44岁的个案数目明显增加。结论:阿拉木图地区宫颈癌发病率和死亡率的流行病学研究结果表明,需要改进和加强育龄妇女的筛查,并引入HPV检测的疫苗接种和筛查计划。
{"title":"CERVICAL CANCER INCIDENCE AND MORTALITY IN ALMATY IN 2005-2022","authors":"N. Izbagambetov, D. Kaidarova, R. Bolatbekova, A. Shinbolatova, T. Valieva, A. Aidarov, G. Bagatova, A. Sarmenova, D. Zhaksylykova, A. Akkasova, A. Yestaeva, A. Satanova","doi":"10.52532/2521-6414-2023-2-68-9-14","DOIUrl":"https://doi.org/10.52532/2521-6414-2023-2-68-9-14","url":null,"abstract":"Relevance: In Kazakhstan, the standardized incidence rate of cervical cancer for 2022 was 19 per 100,000 women, and the mortality rate was 5.9 per 100,000 female population. The overall survival of cervical cancer in the Republic of Kazakhstan for 2022 was 59.6% (95% CI: 50.7-54.2). Since 2008, in Kazakhstan, there has been a National Screening Program for cervical cancer for women from 30 to 70 years old with an interval of 4 years. Almaty is the largest city in Kazakhstan, with a high incidence and mortality from all types of cancer. \u0000The study aimed to analyze the cervical cancer incidence and mortality in Almaty in 2005-2022. \u0000Methods: Epidemiological analysis of cervical cancer incidence in Almaty for 2005-2022 was provided with analyzing reporting forms of documentation. Statistical processing was carried out using the SPSS v. 23.0 software. \u0000Results: Over the past 18 years (2005 to 2022), there has been an increase in the incidence rate from 16 to 18.3 per 100,000 female population and a consistently high mortality rate, which was 6.6 per 100,000 female population in 2022. In 2005, 108 women with cervical cancer were \u0000identified, of which 70% were patients with the first and second stages. In 2022, 198 cases of cervical cancer were registered, where the first stage \u0000accounts for 56.5%. In recent years, there has been an increase in the frequency of registration of new cases of cervical cancer starting from 30-34 \u0000years old, with a noticeable increase up to 40-44 years old. \u0000Conclusion: The results of this epidemiological study of cervical cancer incidence and mortality in Almaty indicate the need to improve and intensify screening among women of reproductive age, and introduce a vaccination and screening program using HPV testing.","PeriodicalId":19480,"journal":{"name":"Oncologia i radiologia Kazakhstana","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2023-06-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"80418477","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
EVALUATION OF THE EFFECTIVENESS OF NEOADJUVANT CHEMOTHERAPY IN BREAST CANCER 乳腺癌新辅助化疗的疗效评价
Pub Date : 2023-06-29 DOI: 10.52532/2521-6414-2023-2-68-53-58
A. Omar, N. Kabildina, E. Kruk, A. Telmanov, Zh. Kabildin
Relevance: Breast cancer is the most common cancer among women. Modern treatment of locally advanced breast cancer requires a multidisciplinary approach, including local treatment: surgical and radiotherapy, systemic treatment, and a wide range of medications. The importance of systemic therapy is to improve relapse-free survival based on the control of micrometastases with the potential to spread throughout the body. Systemic therapy for operable breast cancer includes adjuvant therapy and neoadjuvant therapy. Hormone therapy, chemotherapy, and targeted therapy represent systemic therapy, which can be prescribed individually or in combination. For the most effective breast cancer treatment, tumors are classified into subtypes depending on the expression of biological markers. The presence of expression of the estrogen receptor (ER), progesterone receptor (PR), human epidermal growth factor receptor 2 (HER2), and the rate at which tumor cells divide are determined by determining the Ki67. It is known that neoadjuvant chemotherapy (NCT) has clinical significance in locally advanced and inoperable breast cancer. NCT increases the frequency of organ-preserving operations and the overall survival rate when a complete pathomorphological regression of the tumor (pCR) is achieved. The study aimed to conduct a literature review of previously published publications on the effectiveness and expediency of neoadjuvant chemotherapy for breast cancer. Methods: The search and analysis of scientific publications were carried out in the databases Web of Science, Pubmed, and Scopus for ten years, from 2013 to 2023. According to the search, about 3000 articles were found, and 39 sources were left during the selection according to the inclusion and exclusion criteria Results: Efficiency of NСT depending on different immunophenotypes in breast cancer patients was established. Tumor response was assessed according to RECIST criteria. A complete pathological response was observed more often in more aggressive subtypes of breast cancer – Her2-positive and triple-negative cancer. The relationship between pCR and long-term outcomes – OS and DFS have also been established. Conclusion: Neoadjuvant chemotherapy is a systemic treatment of breast cancer, the main purpose of which is to reduce the size of the tumor for the possibility of performing organ-preserving surgery, as well as to increase the overall and relapse-free survival rates. NCT allows for evaluating the effectiveness of therapy in vivo and using alternative treatment regimens without tu-mor response to the therapy.
相关性:乳腺癌是女性中最常见的癌症。局部晚期乳腺癌的现代治疗需要多学科方法,包括局部治疗:手术和放疗、全身治疗和广泛的药物治疗。全身治疗的重要性在于通过控制可能扩散全身的微转移来提高无复发生存率。可手术乳腺癌的全身治疗包括辅助治疗和新辅助治疗。激素治疗、化疗和靶向治疗代表全身治疗,可单独或联合使用。为了最有效地治疗乳腺癌,肿瘤根据生物标志物的表达被分为不同的亚型。雌激素受体(ER)、孕激素受体(PR)、人表皮生长因子受体2 (HER2)的表达以及肿瘤细胞的分裂速率是通过检测Ki67来确定的。新辅助化疗(NCT)在局部晚期不能手术的乳腺癌中具有重要的临床意义。当肿瘤病理形态完全消退(pCR)时,NCT增加了器官保存手术的频率和总生存率。本研究旨在对先前发表的关于乳腺癌新辅助化疗的有效性和便捷性的文献进行综述。方法:2013 - 2023年,对Web of Science、Pubmed、Scopus等数据库进行10年的科学出版物检索和分析。根据检索结果,共检索到约3000篇文献,根据纳入和排除标准,在选择过程中只剩下39篇文献。结果:建立了NСT根据不同免疫表型在乳腺癌患者中的效率。根据RECIST标准评估肿瘤反应。在侵袭性更强的乳腺癌亚型(her2阳性和三阴性)中更常观察到完全的病理反应。pCR与长期预后- OS和DFS之间的关系也已建立。结论:新辅助化疗是乳腺癌的一种全身性治疗,其主要目的是缩小肿瘤体积,为保留器官手术提供可能,提高总生存率和无复发生存率。NCT允许在体内评估治疗的有效性,并使用替代治疗方案,而不会对治疗产生肿瘤反应。
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引用次数: 0
DEVELOPING AND IMPLEMENTING THE QUALITY CONTROL PROGRAM ON A LINEAR ACCELERATOR 制定和实施直线加速器的质量控制程序
Pub Date : 2023-06-29 DOI: 10.52532/2521-6414-2023-2-68-4-8
T. Antropova, K. Datbayev, E. Ishkinin, B. Latypova, O. Seitov, Z. Khudaibergenov
Relevance: The article deals with modern problems in the field of ensuring the quality of services provided on linear accelerators from the point of view of the regulatory framework, as well as from the point of view of the frequency of control procedures. The scientific novelty lies in elaborating a linear accelerator quality control program with detailed procedure descriptions and testing frequency recommendations. The study aimed to – develop and test a set of simple methods for controlling the linear accelerator’s mechanical and dosimetric parameters, which would meet the minimum requirements for high-tech radiation therapy following IAEA and AAPM international recommendations. Methods: In developing the quality control program for the TrueBeamSTx linear accelerator (Varian, USA) installed at the Almaty Oncological Center (AOC, Kazakhstan), we relied on the recommendations of the International Atomic Energy Agency (IAEA) and the American Association of Physicists in Medicine (AAPM), taking into account that intensity-modulated radiotherapy (IMRT, VMAT), stereotactic radiosurgery and stereotactic radiotherapy (SRS, SRT), using image-guided radiation therapy (IGRT) will be performed on the accelerator, which imposes more stringent requirements for control of both mechanical and dosimetry characteristics Results: Over three years of operation, the TrueBeamSTx accelerator shows good stability of mechanical and dosimetric characteristics, verified using systematic tests according to the quality control program developed by the authors of this article. The IAEA/WHO mail dose monitoring program using radiophotoluminescent detectors, implemented in 2019-2022, showed high dosimetric measurements and calculations accuracy of 0.1-1.7%, at a tolerance of 5%. Conclusion: A quality control program for a high-energy linear accelerator has been developed; the results obtained for all characteristics correspond to the permissible values. The effective and safe use of radiotherapy requires the development of a quality control program for all radiotherapy equipment specifically for each institution and independent verification of the implementation of this program.
相关性:本文从监管框架的角度以及从控制程序频率的角度处理确保线性加速器提供的服务质量领域的现代问题。其科学新颖之处在于制定了一套线性加速器质量控制方案,并对其进行了详细的程序描述和测试频率建议。这项研究的目的是开发和测试一套简单的方法来控制直线加速器的机械和剂量参数,这些方法将满足原子能机构和AAPM国际建议的高科技放射治疗的最低要求。方法:在为安装在阿拉木图肿瘤中心(AOC,哈萨克斯坦)的TrueBeamSTx直线加速器(Varian,美国)制定质量控制程序时,我们参考了国际原子能机构(IAEA)和美国医学物理学家协会(AAPM)的建议,同时考虑到调强放疗(IMRT, VMAT)、立体定向放射外科和立体定向放疗(SRS, SRT)、结果:经过三年的运行,TrueBeamSTx加速器显示出良好的机械和剂量特性稳定性,并根据本文作者制定的质量控制程序进行了系统测试。2019-2022年实施的原子能机构/世卫组织使用放射性光致发光探测器的邮件剂量监测方案显示,剂量学测量和计算精度为0.1-1.7%,容差为5%。结论:制定了高能直线加速器的质量控制方案;所得结果均符合允许值。放射治疗的有效和安全使用需要制定针对每个机构的所有放射治疗设备的质量控制程序,并对该程序的执行情况进行独立验证。
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引用次数: 0
THE PROSPECTS AND CHALLENGES OF CRISPR/CAS9 GENE EDITING IN CANCER THERAPY: A LITERATURE REVIEW crispr / cas9基因编辑在癌症治疗中的前景与挑战:文献综述
Pub Date : 2023-06-29 DOI: 10.52532/2521-6414-2023-2-68-64-68
D. Abdussadyk, A. Beisenova
Relevance: Cancer remains one of the leading causes of death in Kazakhstan, and CRISPR/Cas9 offers possible solutions to treat it. Clustered, regularly interspaced short palindromic repeats/CRISPR-associated protein 9 (CRISPR/Cas9) is a system bacteria use to cleave foreign in-vaders. This system has been considered promising for cancer therapeutics by allowing researchers to edit cancer cell genes. The system requires more trials, so it is essential to raise awareness of this technique for stu-dents and potential investors and highlight the current challenges that could be research opportuni-ties for researchers. The study aimed to analyze and provide up-to-date information from reputable scientific journals on the current use of the CRISPR/Cas9 system in cancer therapeutics for medical students and researchers. This research paper also highlights the challenges associated with implementing CRISPR/Cas9 in clinical settings for cancer therapeutics. Methods: The scientific literature and databases (PubMed and the Nature Journal) were searched and analyzed using the CRISPR/Cas9 system in cancer therapy. Results: The results of this research indicate that scientists should focus on improving the types and structure of the Cas protein as well as the delivery methods, including the non-viral deliv-ery methods (liposome-based particles, hybrid vectors, gold nanoparticles, and extracellular vesicles) to contribute to improving the current status of cancer therapeutics. Conclusion: CRISPR/Cas9 is an important technique that is still fraught with challenges and should be turned into research opportunities. The current challenges include the form and structure of the Cas nuclease, the types of engineering (in vivo vs. ex vivo), and the varieties of delivery methods. Each delivery method type has pros and cons and requires further research. In particular, future studies should focus on non-viral vectors, such as liposome-based particles, extracellular vesi-cles, hybrid vesicles, and gold nanoparticles.
相关性:癌症仍然是哈萨克斯坦人死亡的主要原因之一,CRISPR/Cas9为治疗癌症提供了可能的解决方案。聚集的、有规律间隔的短回文重复序列/CRISPR相关蛋白9 (CRISPR/Cas9)是细菌用来切割外来入侵者的系统。该系统允许研究人员编辑癌细胞基因,因此被认为有望用于癌症治疗。该系统需要更多的试验,因此必须提高学生和潜在投资者对该技术的认识,并强调当前的挑战可能是研究人员的研究机会。该研究旨在分析和提供来自知名科学期刊的关于当前CRISPR/Cas9系统在癌症治疗中的使用的最新信息,供医学生和研究人员使用。这篇研究论文还强调了在癌症治疗的临床环境中实施CRISPR/Cas9所面临的挑战。方法:检索科学文献和数据库(PubMed和Nature Journal),分析CRISPR/Cas9系统在癌症治疗中的应用。结果:本研究结果表明,科学家应致力于改进Cas蛋白的类型和结构以及递送方法,包括非病毒递送方法(脂质体颗粒,杂交载体,金纳米颗粒和细胞外囊泡),以改善癌症治疗的现状。结论:CRISPR/Cas9是一项仍然充满挑战的重要技术,应该转化为研究机会。目前的挑战包括Cas核酸酶的形式和结构、工程的类型(体内与体外)以及递送方法的多样性。每种交付方式都有优缺点,需要进一步研究。特别是,未来的研究应集中在非病毒载体上,如脂质体基颗粒、细胞外囊泡、杂交囊泡和金纳米颗粒。
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引用次数: 0
OPTIMIZATION OF MOLECULAR GENETIC DIAGNOSTICS OF PATIENTS WITH ADVANCED NON-SMALL CELL LUNG CANCER BY INTRODUCING ROS1 TESTING IN THE REPUBLIC OF KAZAKHSTAN 通过在哈萨克斯坦共和国引入ros1检测来优化晚期非小细胞肺癌患者的分子遗传学诊断
Pub Date : 2023-06-29 DOI: 10.52532/2521-6414-2023-2-68-15-21
O. Shatkovskaya, D. Kaidarova, M. Orazgaliyeva, E. Satbayeva, S. Ossikbayeva, A. Koishibaeva
Relevance: Currently, molecular diagnosis in NSCLC in Kazakhstan includes detection of EGFR, ALK driver mutations status, and PD-L1-status, but not ROS1, what limits the access of patients with this driver mutation to vital therapy. The study aimed to optimize the methods of molecular genetic diagnosis of patients with NSCLC by introducing ROS1 testing in the Republic of Kazakhstan. Methods: The biopsy and surgical material of non-small cell lung cancer (NSCLC) fixed in 10% buffered formalin was studied. After the initial morphological diagnosis of adenocarcinoma, EGFR, and ALK mutation status determination, EGFR, and ALK-negative tumor assays were sent for further determination of ROS1 mutation status. First, we performed immunohistochemistry (IHC) using the Ventana BenchMark Ultra platform using the ROS1 antibody (SP283) and the OptiView DAB Detection Kit imaging system. After that, samples with positive and doubtful IHC results were sent for RT-PCR (reverse transcriptase polymerase chain reaction) to confirm the ROS1 mutation status. Results: A total of 99 tumor samples from patients with EGFR-negative and ALK-negative lung adenocarcinoma were studied by IHC from January 01 till September 30, 2022. The results of IHC staining were assessed as: 0 (negative) – 59 samples, 1+ (negative) – 25 samples, 2+ (doubtful) – 12 samples, 3+ (positive) – 3 samples. Cases with ≥70% immunostaining were considered positive. Samples with an IHC stain score of 2+ (doubtful), 3+ (positive), and a few samples of 1+ were sent for confirmation by PCR. Overall, 22 samples were tested using RT-PCR, and results were considered as follows:1 (4%) – positive, 13 (59%) – negative, 8 (37%) -– invalid. Conclusion: A large proportion of positive and questionable results were obtained when determining ROS1 mutation status using IHC, and a large proportion of invalid results during subsequent RT-PCR testing. Choosing methods for nationwide ROS1 implementation, one should evaluate the economics of the methods to be implemented and compare them with a standard validated FISH method.
相关性:目前,哈萨克斯坦NSCLC的分子诊断包括检测EGFR、ALK驱动突变状态和pd - l1状态,但不包括ROS1,这限制了该驱动突变患者获得重要治疗的机会。本研究旨在通过在哈萨克斯坦共和国引入ROS1检测,优化NSCLC患者的分子遗传学诊断方法。方法:对非小细胞肺癌(NSCLC) 10%缓冲福尔马林固定活检及手术材料进行研究。在腺癌的初步形态学诊断、EGFR和ALK突变状态测定后,进行EGFR和ALK阴性肿瘤检测,进一步测定ROS1突变状态。首先,我们使用Ventana BenchMark Ultra平台使用ROS1抗体(SP283)和OptiView DAB Detection Kit成像系统进行免疫组织化学(IHC)。之后,将IHC结果呈阳性和可疑的样本进行RT-PCR(逆转录酶聚合酶链反应),以确认ROS1突变状态。结果:于2022年1月1日至9月30日对egfr阴性和alk阴性肺腺癌患者共99例肿瘤样本进行免疫组化研究。免疫组化染色结果评估为:0(阴性)- 59例,1+(阴性)- 25例,2+(可疑)- 12例,3+(阳性)- 3例。免疫染色≥70%的病例为阳性。IHC染色评分为2+(可疑)、3+(阳性)和少量1+的样本送PCR确认。总体而言,使用RT-PCR检测了22个样本,结果如下:1个(4%)阳性,13个(59%)阴性,8个(37%)无效。结论:利用免疫组化检测ROS1突变状态时,获得的阳性和可疑结果占很大比例,后续RT-PCR检测中无效结果占很大比例。选择在全国范围内实施ROS1的方法时,应该评估要实施的方法的经济性,并将其与经过标准验证的FISH方法进行比较。
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引用次数: 0
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Oncologia i radiologia Kazakhstana
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