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INTERNATIONAL EXPERIENCE IN APPLYING THE SYSTEM OF PEDIATRIC EARLY WARNING SIGNS OF CRITICAL CONDITIONS IN ONCOLOGICAL CHILDREN: A LITERATURE REVIEW 儿童肿瘤危重症早期预警信号系统应用的国际经验:文献综述
Pub Date : 2023-06-29 DOI: 10.52532/2521-6414-2023-2-68-69-75
Ye. Kurakbayev, B. Turdaliyeva, L. Manzhuova, K. Omarova, G. Abdilova, A. Kusainov, S. Saparbayev, V. Schukin
Relevance: Oncological diseases remain the main cause of death in children, increasing the need for intensive care. Hospitalized children suffering from oncological diseases are at high risk for sudden deterioration of their condition, both for the underlying disease and due to infectious complications and the toxic effects of medications. This review highlights information on the Pediatric Early Warning Signs (PEWS) system in oncological patients to detect clinical deterioration promptly. The study aimed to analyze international literature on the use of pediatric early warning signs (PEWS) for clinical deterioration in pediatric oncology. Methods: Current literature on using the PEWS of clinical deterioration in pediatric oncology was studied. Results: The published data show the important role of using the PEWS system in cancer patients for early detection of deterioration of the condition with subsequent provision of emergency medical care. Conclusion: The analysis of international experience has shown that using the PEWS system in children with oncological diseases is an effective method of early recognition of signs of clinical deterioration, which, in turn, allows the timely initiation of complex intensive therapy.
相关性:肿瘤疾病仍然是儿童死亡的主要原因,增加了对重症监护的需求。患有肿瘤疾病的住院儿童病情突然恶化的风险很高,这既是由于潜在的疾病,也是由于感染并发症和药物的毒性作用。这篇综述强调了儿科早期预警信号(PEWS)系统在肿瘤患者中及时发现临床恶化的信息。本研究旨在分析国际上关于使用儿科早期预警信号(PEWS)诊断儿科肿瘤临床恶化的文献。方法:对目前应用PEWS诊断小儿肿瘤临床恶化的文献进行分析。结果:已发表的数据表明,在癌症患者中使用PEWS系统对于早期发现病情恶化并随后提供紧急医疗护理具有重要作用。结论:通过对国际经验的分析表明,在儿童肿瘤疾病中使用PEWS系统是早期识别临床恶化迹象的有效方法,从而可以及时启动复杂的强化治疗。
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引用次数: 0
DWI CAPACITY IN PROSTATE CANCER DIAGNOSING Dwi诊断前列腺癌的能力
Pub Date : 2023-06-29 DOI: 10.52532/2521-6414-2023-2-68-36-42
K. Karakoishin, Z. Zholdybay, A. Aynakulova, D. Toleshbaev, G. Muhit, Ye. Ayserbay
Relevance: Prostate cancer is one of the leading causes of cancer deaths in men worldwide. Transrectal ultrasound-guided (TRUS) prostate biopsy is the most important diagnostic step, without which a definitive diagnosis cannot be made. Despite this, TRUS-guided prostate biopsy has a high rate of false negatives and is often accompanied by various clinical complications. Multiparametric MRI (mpMRI) is now widely used in routine urological and oncological practice. An element of mpMRI is diffusion-weighted imaging (DWI), which is successfully used in detecting and localizing clinically significant prostate cancer. The study aimed to evaluate the DWI capacity in diagnosing prostate cancer. Methods: 52 patients, 48-86 years old, with suspected prostate cancer, underwent mpMRI. DWI sequences obtained using T2-weighted imaging (T2WI) were compared with each other and compared with the anatomical structure of the prostate. Suspicious prostate cancer sites were marked as regions of interest, for which an apparent diffusion coefficient (ADC) was calculated. A 12-point TRUS-guided biopsy confirmed the presence or absence of prostate cancer. Results: When analyzing quantitative measurements, ADC showed low values for cancer in the central gland (transitional zone and central zone) – 0.610±0.157×10-3 mm2/s, p=0.0001, and for cancer in the peripheral zone – 0.651±0.228×10-3 mm2/s, p=0.0004, compared to normal tissue. It was found that the highest sensitivity value (87.5%) is typical for ADC central gland, and the lower value for ADC peripheral zone is 75%. The highest specificity value (90.9%) was observed in ADC peripheral zone, and a lower value in ADC central gland – was 84.1%. Conclusion: DWI is an effective non-invasive method for detecting and localizing prostate cancer, providing a qualitative (visual) and quantitative assessment of prostate cancer.
相关性:前列腺癌是全球男性癌症死亡的主要原因之一。经直肠超声引导(TRUS)前列腺活检是最重要的诊断步骤,没有它就不能做出明确的诊断。尽管如此,超声引导下的前列腺活检假阴性率高,且常伴有各种临床并发症。多参数磁共振成像(mpMRI)已广泛应用于泌尿外科和肿瘤学的常规实践。mpMRI的一个组成部分是弥散加权成像(DWI),它成功地用于检测和定位具有临床意义的前列腺癌。本研究旨在评估DWI诊断前列腺癌的能力。方法:52例48 ~ 86岁疑似前列腺癌患者行mpMRI检查。利用t2加权成像(T2WI)获得的DWI序列相互比较,并与前列腺解剖结构进行比较。可疑的前列腺癌部位被标记为感兴趣的区域,计算表观扩散系数(ADC)。12点超声引导活检证实前列腺癌的存在或不存在。结果:与正常组织相比,ADC在中心腺(过渡区和中心区)的肿瘤值较低,为0.610±0.157×10-3 mm2/s, p=0.0001,外周区肿瘤值为0.651±0.228×10-3 mm2/s, p=0.0004。结果发现,ADC中心腺的灵敏度最高,为87.5%,ADC外围区灵敏度较低,为75%。ADC外周区特异性最高(90.9%),中心腺特异性较低(84.1%)。结论:DWI是一种有效的无创检测和定位前列腺癌的方法,可对前列腺癌进行定性(视觉)和定量评估。
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引用次数: 0
THE ROLE OF CLINICAL-HEMATOLOGICAL AND CYTOGENETIC CHARACTERISTICS IN THE PROGRAM THERAPY OF B-CELL LEUKEMIA IN CHILDREN IN THE REPUBLIC OF KAZAKHSTAN 临床血液学和细胞遗传学特征在哈萨克斯坦共和国儿童b细胞白血病方案治疗中的作用
Pub Date : 2023-06-29 DOI: 10.52532/2521-6414-2023-2-68-43-52
L. Manzhuova, G. Tashenova, A. Tulebayeva, E. Sarsekbaev, A. Zhailaubaeva, G. Omarova, D. Yeginbergenova
Relevance: The study of immunological and molecular genetic characteristics of leukemia in children and the influence of biological features of the tumor population of acute B-cell lymphoblastic leukemia (B-ALL) on the effectiveness of therapy is particularly relevant for the Republic of Kazakhstan. The study aimed to evaluate the effectiveness of modern program chemotherapy in children depending on the biological characteristics of B-cell leukemias. Methods: The study analyzed the data of 154 children aged six months to 15 years with primary B-ALL on inpatient treatment at the Scientific Center of Pediatrics and Pediatric Surgery JSC (Almaty, the Republic of Kazakhstan) in 2016-2018. When determining events, we were guided by the criteria of the protocols of the ALL-BFM group. Results: The age groups most exposed to B-ALL were 3-7 years old (43.5%), reflecting the so-called infant peak. In the clinical picture of this type of ALL, intoxication syndrome accompanying the period of manifestation was present in 75.3% of patients. The clinical polymorphism of the debut period determined the most diverse list of diagnoses of “masks.” Damage to organs and systems, in the form of liver failure, was detected in 41 (26.6%) children, with the development of respiratory failure in 12 (7.8%), cardiovascular failure in 5 patients (3.2%), acute kidney injury in 3 (1.9%), CNS damage in 5 (3.2%) patients. With B-ALL, the distribution of immunological variants was determined as follows: B1 – 9 (5.8%), B2 – 123 (79.8%), B3 – 18 (11,7%), B4 – 4 (2,6%) and leukemia of B-cell lymphoma was noted in one (0.6%) patient. From the group of quantitative anomalies, hyperploidy was detected in 12 (7.8%) cases. Among qualitative anomalies, t(12;21) (p13;q22) was determined in 6 (3.9%) patients and was a favorable prognostic factor (remission was recorded). Trisomy of chromosome 21 with Down syndrome in 3 (1.9%) patients with combined anomalies (isochromosome 7, trisomy 4, 6, 15, 17, translocation t(9; 22)(q34;q11) was detected in 1.3%. Translocations t(1;19)(q23;p13.3) in 5.8% and del 9-chromosome defect in 3.2% of cases. Conclusion: The response to therapy and long-term prognosis are largely determined by biological factors such as cytogenetic features of the tumor, sensitivity to prednisone, as well as the degree of aggressiveness, which manifests itself in the form of pronounced symptoms of lymphoproliferation and hyperleukocytosis. The research has shown the high efficiency of modern ALL-BFM program therapy in children.
相关性:研究儿童白血病的免疫学和分子遗传学特征以及急性b细胞淋巴细胞白血病(B-ALL)肿瘤群体的生物学特征对治疗有效性的影响,对哈萨克斯坦共和国具有特别重要的意义。该研究旨在根据b细胞白血病的生物学特性评估现代方案化疗在儿童中的有效性。方法:本研究分析了2016-2018年在哈萨克斯坦阿拉木图儿科外科科学中心JSC (Almaty, Republic of Kazakhstan)住院治疗的154名6个月至15岁原发性B-ALL患儿的数据。在确定事件时,我们以ALL-BFM组的协议标准为指导。结果:B-ALL暴露最多的年龄组为3-7岁(43.5%),反映了所谓的婴儿高峰。在这类急性淋巴细胞白血病的临床表现中,75.3%的患者在表现期伴有中毒综合征。首发期的临床多态性决定了“面具”的诊断最多样化。41例(26.6%)患儿出现肝脏功能衰竭,12例(7.8%)患儿出现呼吸衰竭,5例(3.2%)患儿出现心血管功能衰竭,3例(1.9%)患儿出现急性肾损伤,5例(3.2%)患儿出现中枢神经系统损伤。B-ALL的免疫变异分布如下:B1 - 9 (5.8%), B2 - 123 (79.8%), B3 - 18 (11.7%), B4 - 4(2.6%), 1例患者有b细胞淋巴瘤白血病(0.6%)。在定量异常组中,12例(7.8%)检测到高倍体。在定性异常中,6例(3.9%)患者出现t(12;21) (p13;q22),这是一个有利的预后因素(有缓解记录)。合并异常3例(1.9%)21号染色体三体合并唐氏综合征(7号同染色体,4、6、15、17号三体,易位t(9;22)(q34;q11)的检出率为1.3%。易位t(1;19)(q23;p13.3)占5.8%,9号染色体缺陷占3.2%。结论:对治疗的反应和长期预后在很大程度上取决于肿瘤的细胞遗传学特征、对强的松的敏感性以及侵袭程度等生物学因素,表现为明显的淋巴细胞增生和白细胞增多症。研究表明,现代ALL-BFM方案治疗儿童的疗效很高。
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引用次数: 0
PROGNOSTIC VALUE OF LIQUID BIOPSY IN CRC: A LITERATURE REVIEW 液体活检在结直肠癌中的预后价值:文献综述
Pub Date : 2023-06-29 DOI: 10.52532/2521-6414-2023-2-68-76-81
T. Nasrytdinov
Relevance: Liquid biopsy is a modern, quite appropriate, and promising method for diagnosing malignant neoplasms for oncology. The method allows us to determine the level of freely circulating tumor cells – micrometastases, tumor DNA, microRNA, and exosomes in blood plasma- and detect various genetic changes. A literature review of current scientific publications on liquid biopsy techniques, indexed in Medline, PubMed, and Medscape, was carried out as part of the work. The study aimed to review is to assess the prognostic significance of liquid biopsy, to determine the place of the method in current recommendations, and its expediency from the point of view of the practice. Methods: The information search was conducted in the Medline, PubMed, and Medscape databases, with a search depth of 8 years. Data from randomized controlled trials, clinical trials, reviews, systematic reviews, and meta-analyses were analyzed. The review includes both full-fledged articles in the public domain and abstracts to obtain complete information on the problem. Results: Liquid biopsy surpasses tissue biopsy in simplicity and speed of research, easy repeatability, and minimal invasiveness, as well as the possibility of dynamic monitoring of progression – the overall clonal transformation of the tumor and the emergence of resistance to treatment. The disadvantages of this method are low sensitivity, difficulty in correctly interpreting biomarkers and determining their specificity, and high risk of false positive and false negative results due to dormant tumor cells. Conclusion: At present, the Liquid biopsy method is relevant and in demand, but it needs to be tested on a validated sample of the main population, and in order to achieve effective clinical use, important work needs to be done to standardize both preanalytical and analytical procedures and generalize them for all components of liquid biopsy.
相关性:液体活检是一种现代的、非常合适的、有前途的肿瘤诊断方法。该方法使我们能够确定自由循环肿瘤细胞的水平-微转移,肿瘤DNA, microRNA和血浆中的外泌体-并检测各种遗传变化。在Medline、PubMed和Medscape中检索了当前关于液体活检技术的科学出版物,并对其进行了文献回顾,作为工作的一部分。本研究旨在评估液体活检的预后意义,确定该方法在当前推荐中的地位,以及从实践的角度来看其便利性。方法:在Medline、PubMed和Medscape数据库中进行信息检索,检索深度为8年。我们分析了随机对照试验、临床试验、综述、系统综述和荟萃分析的数据。该综述包括公共领域的完整文章和摘要,以获得有关该问题的完整信息。结果:液体活检优于组织活检的简单性和研究速度,易于重复性和最小的侵入性,以及动态监测进展的可能性-肿瘤的整体克隆转化和治疗耐药性的出现。该方法的缺点是灵敏度低,难以正确解释生物标志物并确定其特异性,并且由于肿瘤细胞处于休眠状态,存在假阳性和假阴性结果的高风险。结论:目前液体活检方法是相关的,也是有需求的,但需要在主要人群的验证样本上进行测试,为了实现有效的临床应用,需要做重要的工作来规范分析前和分析过程,并推广液体活检的所有组成部分。
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引用次数: 0
ENDOCRINE TOXICITY OF IMMUNE CHECKPOINT INHIBITORS IN CLINICAL PRACTICE 免疫检查点抑制剂在临床应用中的内分泌毒性
Pub Date : 2023-06-29 DOI: 10.52532/2521-6414-2023-2-68-59-63
S. Safina, G. Mukhamed’yarova, V. Dimitrieva
Relevance: Immunological control points significantly changed cancer therapy worldwide after a new class of inhibitor drugs was registered. Based on clinical studies, this type of treatment was associated with better survival in sensitive patients than cytostatic therapy. Checkpoint inhibitors exert their effect by regulating the immune response to malignant cells, blocking the usual inhibitory pathways of T-cell regulation. The receptors of cytotoxic T-lymphocytic antigen-4 (CTLA-4) and programmed cell death protein (PD-1) or its associated ligand (PD-L-1) are the target of inhibitors. CTLA-4 acts at an early stage of triggering an antigenic response, and PD-1 and PD-L-1 act by modulating interaction with peripheral tissue However, treatment with checkpoint inhibitors (ICTs) is accompanied by a wide range of immune mediated adverse events associated with the activation of the immune system. Despite the positive effect on survival, side effects with endocrine effects were noted in about 10% of patients. The study aimed to assess the incidence of immune mediated adverse events from the thyroid gland in clinical practice in patients with different localization of malignant tumors in the first and subsequent lines of therapy with checkpoint inhibitors. Methods: The study utilized anamnestic, laboratory, and instrumental tests. Laboratory analysis included determining the blood levels of TSH, T3, T4, ACTH, and cortisol. Data analysis was carried out using the Microsoft Excel program. Results: The frequency of development of immune mediated thyroiditis against the background of therapy with blockers of control points of the immune pathway in our observation was 29%. The debut of thyroid disorders was diagnosed in the first 12-16 weeks of therapy, beginning with hyperthyroidism against the background of thyroid destruction, followed by a transition to persistent hypothyroidism after 1-3 months. Conclusion: When analyzing the safety profile of ICTs in patients in our study, immune mediated adverse reactions did not differ in frequency and spectrum from world practice. The spectrum of toxicity did not depend on the localization of the tumor. Early diagnosis of thyroid lesions necessary for optimal and effective treatment can be carried out using laboratory tests. Knowing the timing of the development of adverse events during ICT therapy allows timely diagnosing and correcting complications from the thyroid to continue effective therapy.
相关性:一类新的抑制剂药物注册后,免疫控制点显著改变了全球范围内的癌症治疗。根据临床研究,与细胞抑制剂治疗相比,这种治疗在敏感患者中具有更好的生存率。检查点抑制剂通过调节对恶性细胞的免疫反应来发挥作用,阻断t细胞调节的通常抑制途径。细胞毒性t淋巴细胞抗原-4 (CTLA-4)和程序性细胞死亡蛋白(PD-1)或其相关配体(PD-L-1)的受体是抑制剂的靶点。CTLA-4在触发抗原反应的早期阶段起作用,PD-1和PD-L-1通过调节与外周组织的相互作用而起作用。然而,使用检查点抑制剂(ict)治疗伴随着与免疫系统激活相关的广泛的免疫介导的不良事件。尽管对生存有积极的影响,但在约10%的患者中发现了内分泌影响的副作用。该研究旨在评估临床实践中不同部位恶性肿瘤患者在一线和后续使用检查点抑制剂治疗时甲状腺免疫介导的不良事件的发生率。方法:采用记忆法、实验室法和仪器法。实验室分析包括测定血液中TSH、T3、T4、ACTH和皮质醇的水平。使用Microsoft Excel程序进行数据分析。结果:在我们的观察中,免疫途径控制点阻滞剂治疗背景下发生免疫介导性甲状腺炎的频率为29%。甲状腺疾病的首次诊断是在治疗的前12-16周,以甲状腺破坏为背景的甲状腺功能亢进开始,随后在1-3个月后过渡到持续性甲状腺功能减退。结论:在我们的研究中分析ict患者的安全性时,免疫介导的不良反应在频率和频谱上与世界惯例没有差异。毒性谱不依赖于肿瘤的定位。早期诊断甲状腺病变需要最佳和有效的治疗可以使用实验室检查进行。了解ICT治疗过程中不良事件发生的时机,可以及时诊断和纠正甲状腺并发症,以继续有效治疗。
{"title":"ENDOCRINE TOXICITY OF IMMUNE CHECKPOINT INHIBITORS IN CLINICAL PRACTICE","authors":"S. Safina, G. Mukhamed’yarova, V. Dimitrieva","doi":"10.52532/2521-6414-2023-2-68-59-63","DOIUrl":"https://doi.org/10.52532/2521-6414-2023-2-68-59-63","url":null,"abstract":"Relevance: Immunological control points significantly changed cancer therapy worldwide after a new class of inhibitor drugs was registered. Based on clinical studies, this type of treatment was associated with better survival in sensitive patients than cytostatic therapy. Checkpoint inhibitors exert their effect by regulating the immune response to malignant cells, blocking the usual inhibitory pathways of T-cell regulation. The receptors of cytotoxic T-lymphocytic antigen-4 (CTLA-4) and programmed cell death protein (PD-1) or its associated ligand (PD-L-1) are the target of inhibitors. CTLA-4 acts at an early stage of triggering an antigenic response, and PD-1 and PD-L-1 act by modulating interaction with peripheral tissue \u0000However, treatment with checkpoint inhibitors (ICTs) is accompanied by a wide range of immune mediated adverse events associated with the activation of the immune system. Despite the positive effect on survival, side effects with endocrine effects were noted in about 10% of patients. \u0000The study aimed to assess the incidence of immune mediated adverse events from the thyroid gland in clinical practice in patients with different localization of malignant tumors in the first and subsequent lines of therapy with checkpoint inhibitors. \u0000Methods: The study utilized anamnestic, laboratory, and instrumental tests. Laboratory analysis included determining the blood levels of TSH, T3, T4, ACTH, and cortisol. Data analysis was carried out using the Microsoft Excel program. \u0000Results: The frequency of development of immune mediated thyroiditis against the background of therapy with blockers of control points of the immune pathway in our observation was 29%. The debut of thyroid disorders was diagnosed in the first 12-16 weeks of therapy, beginning with hyperthyroidism against the background of thyroid destruction, followed by a transition to persistent hypothyroidism after 1-3 months. \u0000Conclusion: When analyzing the safety profile of ICTs in patients in our study, immune mediated adverse reactions did not differ in frequency and spectrum from world practice. The spectrum of toxicity did not depend on the localization of the tumor. Early diagnosis of thyroid lesions necessary for optimal and effective treatment can be carried out using laboratory tests. Knowing the timing of the development of adverse events during ICT therapy allows timely diagnosing and correcting complications from the thyroid to continue effective therapy.","PeriodicalId":19480,"journal":{"name":"Oncologia i radiologia Kazakhstana","volume":"36 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-06-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"82184540","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
ENDOSCOPIC REMOVAL OF A RARE LARGE OCCLUSIVE TRACHEAL TUMOR WITH LIMITED TECHNICAL CAPABILITIES 内镜下切除罕见的气管大闭塞性肿瘤,技术能力有限
Pub Date : 2023-03-31 DOI: 10.52532/2521-6414-2023-1-67-26-29
K. Batyrbekov, A. Galiakbarova, A. Ualikhanov
Relevance: Tracheal tumors often do not cause symptoms until they grow to a size that causes significant airway obstruction, which is the reason for the delay in diagnosis. Diagnosis may also be delayed due to non-specific symptoms, such as cough, wheezing, and shortness of breath, which can occur in other conditions such as asthma and chronic obstructive pulmonary disease. The symptoms that appear may vary depending on the type and location of the tumor. The literature does not sufficiently cover the experience of treating large occlusive tracheal tumors using segmental tracheal resection, endoscopic treatment, or radiation therapy. In scientific literature, the number of published studies with long-term results of endoscopic treatment or radiation therapy of such occlusive tracheal tumors is limited, and this problem requires further study. This article describes the first recorded case of endoscopic removal of a large occlusive tracheal tumor. The study aimed to show the possibility and effectiveness of endoscopic treatment using a minimum set of endoscopic equipment. Methods: This article presents a case of successful minimally invasive endoscopic treatment of a large occlusive tracheal tumor. Results: A large obstructing tumor of the trachea that almost completely blocked the trachea lumen was removed in one block by endoscopic loop resection. Conclusion: The presented clinical case describes the experience of successful endoscopic removal of a rare occlusive tumor of the trachea, which caused shortness of breath at rest and during exercise. For the first time in Kazakhstan, based on the National Scientific Cancer Center, we performed a unique minimally invasive operation to remove a tracheal tumor, while other clinics offered thoracotomic surgical resection methods
相关性:气管肿瘤通常不会引起症状,直到它们生长到足以引起气道阻塞的大小,这是诊断延迟的原因。诊断也可能因非特异性症状而延迟,如咳嗽、喘息和呼吸短促,这些症状可能出现在其他情况下,如哮喘和慢性阻塞性肺病。出现的症状可能因肿瘤的类型和位置而异。文献没有充分地涵盖使用气管节段性切除、内镜治疗或放射治疗治疗大闭塞性气管肿瘤的经验。在科学文献中,对此类闭塞性气管肿瘤进行内镜治疗或放射治疗的长期疗效的已发表研究数量有限,这一问题有待进一步研究。这篇文章描述了第一个记录的病例内镜切除一个大的阻塞性气管肿瘤。该研究旨在展示使用最少的内窥镜设备进行内窥镜治疗的可能性和有效性。方法:本文报告一例成功的微创内镜治疗大的气管闭塞性肿瘤。结果:经内镜环切术,成功切除气管内一大块几乎完全阻塞气管腔的气管梗阻性肿瘤。结论:本病例描述了一个罕见的气管闭塞性肿瘤经内镜成功切除的经验,该肿瘤在休息和运动时引起呼吸短促。在哈萨克斯坦,我们第一次以国家科学癌症中心为基础,进行了独特的微创手术切除气管肿瘤,而其他诊所提供开胸手术切除方法
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引用次数: 0
S-DETECT SOFTWARE AS A TOOL FOR ULTRASOUND DIAGNOSIS OF THYROID LESIONS S-detect软件作为超声诊断甲状腺病变的工具
Pub Date : 2023-03-31 DOI: 10.52532/2521-6414-2023-1-67-19-25
A. Kultaev, I. Zakiryarov, D. Abdieva, A. Imambetova, A. Akhmetbayeva
Relevance: Thyroid cancer (TC) is the most common oncological pathology of the endocrine organs. According to the International Agency for Research on Cancer (IARC), 567,233 new cases of thyroid cancer were registered worldwide in 2018. According to IARC, in 2018, 486 new cases were detected in Kazakhstan, which accounted for 1.4% of all cases in Asian countries. TC ranks 10th in the overall structure of cancer incidence globally; TC accounts for 3.1% of all cases of primary malignant tumors. Despite the relatively low incidence, the problems of pathogenesis have been extremely relevant in recent decades due to the increasing prevalence of thyroid cancer. Samsung Medison introduced AI-based S-Detect to improve sensitivity, specificity, and accuracy in the differential diagnosis of thyroid masses. The study aimed to explore the S-Detect program capacities in differential diagnostics of thyroid masses. Methods: 75 patients with focal lesions in the thyroid gland were examined using the Samsung Medison RS85 ultrasound machine equipped with the S-Detect program; additionally, Doppler and non-Doppler methods were used. Results: The S-Detect program made it possible to make a correct diagnosis in 97% of patients (73 of 75), which was confirmed by the results of morphological verification (histology, cytology). The sonoelastography method showed correct results in 91% of patients (68 of 75). Conclusion: The use of the S-Detect program for thyroid examination positively affects the diagnostic value of ultrasound in the differential diagnosis of thyroid masses, increasing the sensitivity, specificity, and accuracy of diagnosis, as well as avoiding redundant biopsies.
相关性:甲状腺癌(TC)是内分泌器官最常见的肿瘤病理。根据国际癌症研究机构(IARC)的数据,2018年全球新登记的甲状腺癌病例为567,233例。据国际癌症研究机构称,2018年,哈萨克斯坦发现了486例新病例,占亚洲国家所有病例的1.4%。TC在全球癌症发病率总体结构中排名第10位;TC占所有原发性恶性肿瘤病例的3.1%。尽管发病率相对较低,但近几十年来,由于甲状腺癌的发病率不断上升,发病机制的问题已经非常重要。三星麦迪森推出了基于人工智能的S-Detect,以提高甲状腺肿块鉴别诊断的敏感性、特异性和准确性。本研究旨在探讨S-Detect程序在甲状腺肿块鉴别诊断中的能力。方法:对75例甲状腺局灶性病变患者,采用安装S-Detect程序的三星麦迪森RS85超声机进行检查;此外,采用多普勒和非多普勒方法。结果:S-Detect程序使97%的患者(75例中的73例)能够做出正确的诊断,这得到了形态学验证(组织学、细胞学)结果的证实。超声弹性成像方法在91%的患者(75例中的68例)中显示正确结果。结论:应用S-Detect程序进行甲状腺检查,可积极影响超声在甲状腺肿块鉴别诊断中的诊断价值,提高诊断的敏感性、特异性和准确性,避免重复活检。
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引用次数: 0
THE VALUE OF METHODS FOR DIAGNOSING ALVEOLAR RHABDOMYOSARCOMA: A CLINICAL CASE 肺泡横纹肌肉瘤临床诊断方法的价值
Pub Date : 2023-03-31 DOI: 10.52532/2521-6414-2023-1-67-40-45
K. Baktikulova, S. Kurmangalieva, V. Toimanova, A. Zhumasheva, G. Kuatova
Relevance: Laparoscopic surgery supplies many benefits due to lower postoperative sequelae. Laparoscopic radical prostatectomy has become a first-line treatment for patients with localized prostate cancer worldwide. The study aimed to compare outcomes after traditional laparoscopic extraperitoneal radical prostatectomy with modified laparoscopic extraperitoneal radical prostatectomy (MLERPE). Methods: All information about patient treatment for this historical cohort study was obtained from the “Electronic In-patient Registry” of the Republic of Kazakhstan. The study included case records of 94 patients who underwent laparoscopic extraperitoneal radical prostatectomy from 2017 to 2021. Of them, 45 underwent a modified laparoscopic prostatectomy, and 49 – a traditional laparoscopic prostatectomy. Data are presented as the means ± standard deviation or as frequencies and percentages. Pearson’s Chi-square was used for qualitative data. T-test and Mann-Whitney U test were used to compare the means of the two groups. The statistical significance level was 0.05. Results: We revealed significant differences between the laboratory parameters of both groups after surgery. The mean difference in hemoglobin level between the two groups was 14.04, the mean difference in erythrocyte level was 0.69, the mean difference in leukocyte level was 1.26, and the mean difference in ESR level was 2.01. All differences were statistically significant (p=0.000). We found a statistical difference in the duration of operation and hospital stay between the two groups (p=0.000). Conclusion: The modified laparoscopic technique avoids adverse worse outcomes such as bleeding, pneumoperitoneum, and decreasing oxygen saturation. This technique is also beneficial in the early postoperative period for excluding peritonitis, and the late postoperative period avoids adhesive processes.
相关性:由于较低的术后后遗症,腹腔镜手术提供了许多好处。腹腔镜根治性前列腺切除术已成为世界范围内局限性前列腺癌患者的一线治疗方法。本研究旨在比较传统腹腔镜腹膜外根治性前列腺切除术与改良腹腔镜腹膜外根治性前列腺切除术(MLERPE)的疗效。方法:本历史队列研究的所有患者治疗信息均来自哈萨克斯坦共和国“电子住院患者登记处”。该研究包括2017年至2021年接受腹腔镜腹膜外根治性前列腺切除术的94例患者的病例记录。其中45人接受了改良的腹腔镜前列腺切除术,49人接受了传统的腹腔镜前列腺切除术。数据以平均值±标准差或频率和百分比表示。定性数据采用皮尔逊卡方法。采用t检验和Mann-Whitney U检验比较两组的均数。统计学显著性水平为0.05。结果:两组术后实验室参数差异有统计学意义。两组患者血红蛋白水平的平均差异为14.04,红细胞水平的平均差异为0.69,白细胞水平的平均差异为1.26,ESR水平的平均差异为2.01。差异均有统计学意义(p=0.000)。我们发现两组手术时间和住院时间有统计学差异(p=0.000)。结论:改进的腹腔镜技术避免了出血、气腹、血氧饱和度降低等不良后果。该技术也有利于术后早期排除腹膜炎,术后后期避免粘连。
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引用次数: 0
ACCELERATED HIGH-TECH RADIOTHERAPY DURING THE COVID-19 2019冠状病毒病期间加速高科技放疗
Pub Date : 2023-03-31 DOI: 10.52532/2521-6414-2023-1-67-10-13
Y. Ishkinin, R. Raimbekov, K. Datbayev, A. Goncharova, R. Akhunova, A. Omarova, S. Ossikbayeva, F. Khozhamkul, M. Omirzaq, O. Seitov, Z. Khudaibergenov, N. Omarbayeva
Relevance: COVID-19 impacts the course of cancer depending on the status and volume of cancer patient vaccination against COVID-19. The study aimed to assess the impact of accelerated high-tech radiation therapy on the course of the oncological process, depending on the status and volume of COVID-19 vaccinations. Methods: This quantitative and qualitative prospective randomized controlled scientific study was conducted as part of the implementation of the scientific project, “Innovative approach to managing patients with cancer in the context of the COVID pandemic-19,” Reg. No. AP13068657. The study involved 221 cancer patients. Results: COVID-19 was diagnosed in 54/221 (24.4%) of the study participants, 24 (22.4%) in the standard radiotherapy group, and 30 (26.3%) in the experimental radiotherapy group. 49/221 (22.2%) of the participants were vaccinated. COVID-19 was detected in one breast cancer patient in the experimental group (1.5%) two months after vaccination and two patients with prostate cancer (2.4%) four months after vaccination. Relapse-free survival was registered in 59 (85.5%) breast cancer patients in the standard group and 58 (85.3%) in the experimental group. The overall survival of breast cancer patients was 69 (100.0%) in the standard group and 68 (97.0%) in the experimental group. Relapse-free survival was registered in 32 (84.2%) prostate cancer patients in the standard group and 41 (89.1%) patients in the experimental group. The overall survival among prostate cancer patients was 34 (89.5%) in the standard group and 45 (97.8%) in the experimental group. The deaths were not related to COVID-19. The average treatment duration for breast cancer was less by 12.9 days, with prostate cancer– by 18.2 days. Conclusion: In Kazakhstan, 4.8% of cancer patients with COVID-19 died in 2020-2021. The use of accelerated high-tech radiotherapy is justified in the context of the COVID-19 pandemic. Vaccination can prevent COVID-19 development in cancer patients
相关性:COVID-19对癌症病程的影响取决于癌症患者接种COVID-19疫苗的状况和数量。该研究旨在评估加速高科技放射治疗对肿瘤过程的影响,具体取决于COVID-19疫苗接种的状态和数量。方法:本定量和定性前瞻性随机对照科学研究是科学项目“COVID -19大流行背景下癌症患者管理的创新方法”的一部分,Reg。不。AP13068657。这项研究涉及221名癌症患者。结果:221例研究对象中有54例(24.4%)被诊断为COVID-19,标准放疗组24例(22.4%),实验放疗组30例(26.3%)。49/221(22.2%)的参与者接种了疫苗。接种疫苗2个月后,实验组1例乳腺癌患者(1.5%)检出COVID-19,接种疫苗4个月后,实验组2例前列腺癌患者(2.4%)检出COVID-19。标准组59例(85.5%)乳腺癌患者无复发生存率,实验组58例(85.3%)。标准组乳腺癌患者总生存率为69例(100.0%),实验组为68例(97.0%)。标准组32例(84.2%)前列腺癌患者无复发生存,实验组41例(89.1%)前列腺癌患者无复发生存。标准组前列腺癌患者总生存率为34例(89.5%),试验组为45例(97.8%)。这些死亡与COVID-19无关。乳腺癌的平均治疗时间缩短了12.9天,前列腺癌的平均治疗时间缩短了18.2天。结论:在哈萨克斯坦,4.8%的COVID-19癌症患者在2020-2021年死亡。在COVID-19大流行的背景下,使用加速高科技放射治疗是合理的。接种疫苗可以预防癌症患者发生COVID-19
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引用次数: 0
UPGRADING OF LAPAROSCOPIC INTERVENTION OF THE PROSTATE GLAND TUMORS 腹腔镜前列腺肿瘤介入治疗的新进展
Pub Date : 2023-03-31 DOI: 10.52532/2521-6414-2023-1-67-36-39
K. Umurzakov, D. Kaidarova, A. Nurzhanova, D. Saidualiev, A. Khaitmat, S. Sagidullin, G. Shalgumbayeva
Relevance: Laparoscopic surgery supplies many benefits due to lower postoperative sequelae. Laparoscopic radical prostatectomy has become a first-line treatment for patients with localized prostate cancer worldwide. The study aimed to compare outcomes after traditional laparoscopic extraperitoneal radical prostatectomy with modified laparoscopic extraperitoneal radical prostatectomy (MLERPE). Methods: All information about patient treatment for this historical cohort study was obtained from the “Electronic In-patient Registry” of the Republic of Kazakhstan. The study included case records of 94 patients who underwent laparoscopic extraperitoneal radical prostatectomy from 2017 to 2021. Of them, 45 underwent a modified laparoscopic prostatectomy, and 49 – a traditional laparoscopic prostatectomy. Data are presented as the means ± standard deviation or as frequencies and percentages. Pearson’s Chi-square was used for qualitative data. T-test and Mann-Whitney U test were used to compare the means of the two groups. The statistical significance level was 0.05. Results: We revealed significant differences between the laboratory parameters of both groups after surgery. The mean difference in hemoglobin level between the two groups was 14.04, the mean difference in erythrocyte level was 0.69, the mean difference in leukocyte level was 1.26, and the mean difference in ESR level was 2.01. All differences were statistically significant (p=0.000). We found a statistical difference in the duration of operation and hospital stay between the two groups (p=0.000). Conclusion: The modified laparoscopic technique avoids adverse worse outcomes such as bleeding, pneumoperitoneum, and decreasing oxygen saturation. This technique is also beneficial in the early postoperative period for excluding peritonitis, and the late postoperative period avoids adhesive processes.
相关性:由于较低的术后后遗症,腹腔镜手术提供了许多好处。腹腔镜根治性前列腺切除术已成为世界范围内局限性前列腺癌患者的一线治疗方法。本研究旨在比较传统腹腔镜腹膜外根治性前列腺切除术与改良腹腔镜腹膜外根治性前列腺切除术(MLERPE)的疗效。方法:本历史队列研究的所有患者治疗信息均来自哈萨克斯坦共和国“电子住院患者登记处”。该研究包括2017年至2021年接受腹腔镜腹膜外根治性前列腺切除术的94例患者的病例记录。其中45人接受了改良的腹腔镜前列腺切除术,49人接受了传统的腹腔镜前列腺切除术。数据以平均值±标准差或频率和百分比表示。定性数据采用皮尔逊卡方法。采用t检验和Mann-Whitney U检验比较两组的均数。统计学显著性水平为0.05。结果:两组术后实验室参数差异有统计学意义。两组患者血红蛋白水平的平均差异为14.04,红细胞水平的平均差异为0.69,白细胞水平的平均差异为1.26,ESR水平的平均差异为2.01。差异均有统计学意义(p=0.000)。我们发现两组手术时间和住院时间有统计学差异(p=0.000)。结论:改进的腹腔镜技术避免了出血、气腹、血氧饱和度降低等不良后果。该技术也有利于术后早期排除腹膜炎,术后后期避免粘连。
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引用次数: 0
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Oncologia i radiologia Kazakhstana
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