Pub Date : 2023-09-13DOI: 10.17650/2222-1468-2023-13-2-57-64
E. E. Tyagunova, V. Z. Dobrokhotova, A. O. Dushina
Introduction. Astrocytes in the brain of a healthy person perform a number of protective functions, contribute to maintaining the functional activity of neurons and their synapses. However, in some pathological conditions, they change their phenotype to a reactive one and can both remodel damaged areas and contribute to increased aggression and invasiveness of gliomas. Aim. To comprehensively study the features of reactive astrocytes and the chemo- and radioresistance of gliomas associated with reactive astrocytes. Materials and methods . The authors analyzed articles from the databases Elsevier, pubmed, Scopus, google Scholar, Embase, web of Science, The Cochrane Library, global Health, CyberLeninka and RSCI. when selecting articles, the indexing systems of journals and the citation of articles, the scientific novelty of research, the statistical significance of the results obtained in them were taken into account, publications with duplication of the results of previous studies were excluded. In the course of the study, data on the mutual influence of reactive astrocytes and glioma cells were systematized. Results. Astrocytes of the brain of healthy people are highly variable and heterogeneous, which further complicates the interpretation of published studies. At the same time, reactive astrocytes contribute to an increase in the chemoresistance and radioresistance of gliomas of different degrees of malignancy. At the same time, the exact mechanisms for controlling the interaction between reactive astrocytes and glioma cells, which contributed to less progression and invasion of the tumor or its regression, have not yet been established. However, this direction is now actively developing and is promising due to the possibility of additional effects on gliomas. Conclusion . At the moment, there is no effective treatment that can cope with gliomas, all existing treatment methods are aimed only at increasing the life expectancy of patients with gliomas. The results of recent studies suggest that, probably, the current insufficient effectiveness of chemo- and radiotherapy may be associated with a very close relationship between tumor cells and tumor-associated reactive astrocytes due to their mutual supportive effect. Therefore, the solution to the problem of incurable patients with gliomas may lie in a complex effect on both tumor cells and their microenvironment.
介绍。健康人大脑中的星形胶质细胞具有多种保护功能，有助于维持神经元及其突触的功能活动。然而，在某些病理条件下，它们将其表型改变为反应性表型，既可以重塑受损区域，又可以增加胶质瘤的攻击性和侵袭性。的目标。全面研究反应性星形胶质细胞的特点及与反应性星形胶质细胞相关的胶质瘤的化疗和放疗耐药情况。材料和方法。作者分析了来自Elsevier、pubmed、Scopus、google Scholar、Embase、web of Science、The Cochrane Library、global Health、CyberLeninka和RSCI等数据库的文章。在选择文章时，考虑了期刊的索引系统和文章的引用情况、研究的科学新颖性、研究结果的统计显著性，排除了与前人研究结果重复的出版物。在研究过程中，对反应性星形胶质细胞和胶质瘤细胞相互影响的数据进行了系统整理。结果。健康人大脑的星形胶质细胞是高度可变和异质性的，这进一步使已发表的研究的解释复杂化。同时，反应性星形胶质细胞有助于不同程度恶性胶质瘤的化疗耐药和放射耐药的增加。同时，控制反应性星形胶质细胞与胶质瘤细胞之间相互作用的确切机制尚未确定，这种相互作用有助于肿瘤的进展和侵袭或消退。然而，这个方向现在正在积极发展，并且由于可能对胶质瘤有额外的影响而前景光明。结论。目前，还没有有效的治疗胶质瘤的方法，所有现有的治疗方法都只是为了提高胶质瘤患者的预期寿命。最近的研究结果表明，目前化疗和放疗的有效性不足可能与肿瘤细胞和肿瘤相关反应性星形胶质细胞之间由于相互支持作用而非常密切的关系有关。因此，解决胶质瘤患者无法治愈的问题可能在于对肿瘤细胞及其微环境的复杂作用。
{"title":"Reactive astrocytes and glioblastoma: are there new targets for more effective antitumor therapy?","authors":"E. E. Tyagunova, V. Z. Dobrokhotova, A. O. Dushina","doi":"10.17650/2222-1468-2023-13-2-57-64","DOIUrl":"https://doi.org/10.17650/2222-1468-2023-13-2-57-64","url":null,"abstract":"Introduction. Astrocytes in the brain of a healthy person perform a number of protective functions, contribute to maintaining the functional activity of neurons and their synapses. However, in some pathological conditions, they change their phenotype to a reactive one and can both remodel damaged areas and contribute to increased aggression and invasiveness of gliomas. Aim. To comprehensively study the features of reactive astrocytes and the chemo- and radioresistance of gliomas associated with reactive astrocytes. Materials and methods . The authors analyzed articles from the databases Elsevier, pubmed, Scopus, google Scholar, Embase, web of Science, The Cochrane Library, global Health, CyberLeninka and RSCI. when selecting articles, the indexing systems of journals and the citation of articles, the scientific novelty of research, the statistical significance of the results obtained in them were taken into account, publications with duplication of the results of previous studies were excluded. In the course of the study, data on the mutual influence of reactive astrocytes and glioma cells were systematized. Results. Astrocytes of the brain of healthy people are highly variable and heterogeneous, which further complicates the interpretation of published studies. At the same time, reactive astrocytes contribute to an increase in the chemoresistance and radioresistance of gliomas of different degrees of malignancy. At the same time, the exact mechanisms for controlling the interaction between reactive astrocytes and glioma cells, which contributed to less progression and invasion of the tumor or its regression, have not yet been established. However, this direction is now actively developing and is promising due to the possibility of additional effects on gliomas. Conclusion . At the moment, there is no effective treatment that can cope with gliomas, all existing treatment methods are aimed only at increasing the life expectancy of patients with gliomas. The results of recent studies suggest that, probably, the current insufficient effectiveness of chemo- and radiotherapy may be associated with a very close relationship between tumor cells and tumor-associated reactive astrocytes due to their mutual supportive effect. Therefore, the solution to the problem of incurable patients with gliomas may lie in a complex effect on both tumor cells and their microenvironment.","PeriodicalId":19610,"journal":{"name":"Opuholi Golovy i Šei","volume":"50 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-09-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135735409","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}
Pub Date : 2023-09-13DOI: 10.17650/2222-1468-2023-13-2-70-74
A. A. Ilyin, V. V. Polkin, P. A. Isaev, N. V. Severskaya, N. V. Zhelonkina, A. K. Plugar, S. A. Ivanov, A. D. Kaprin
Fine needle aspiration biopsy is a routinely used technique to determine the nature of thyroid and parathyroid nodules. The complications and side effects associated with this procedure are minimal. At the same time, the histological alterations resulting from its use are well documented. Their range is quite w, however, from a clinical point of view, the most striking and catastrophic in their consequences are extensive heart attacks and necrosis. Such changes more often than in formations of a different morphological nature occur in tumors from oxyphilic cells. It should be noted that a lot of works devoted to post-biopsy changes are naturally focused on the morphological aspects of this problem, or are presented in the form of a presentation of individual clinical observations. This report presents the observation of necrosis in the parathyroid adenoma, which developed before fine needle aspiration biopsy.
{"title":"Spontaneous necrosis of parathyroid adenoma: clinical observation","authors":"A. A. Ilyin, V. V. Polkin, P. A. Isaev, N. V. Severskaya, N. V. Zhelonkina, A. K. Plugar, S. A. Ivanov, A. D. Kaprin","doi":"10.17650/2222-1468-2023-13-2-70-74","DOIUrl":"https://doi.org/10.17650/2222-1468-2023-13-2-70-74","url":null,"abstract":"Fine needle aspiration biopsy is a routinely used technique to determine the nature of thyroid and parathyroid nodules. The complications and side effects associated with this procedure are minimal. At the same time, the histological alterations resulting from its use are well documented. Their range is quite w, however, from a clinical point of view, the most striking and catastrophic in their consequences are extensive heart attacks and necrosis. Such changes more often than in formations of a different morphological nature occur in tumors from oxyphilic cells. It should be noted that a lot of works devoted to post-biopsy changes are naturally focused on the morphological aspects of this problem, or are presented in the form of a presentation of individual clinical observations. This report presents the observation of necrosis in the parathyroid adenoma, which developed before fine needle aspiration biopsy.","PeriodicalId":19610,"journal":{"name":"Opuholi Golovy i Šei","volume":"22 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-09-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135735407","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}
Pub Date : 2023-09-13DOI: 10.17650/2222-1468-2023-13-2-75-78
K. A. Kretova, O. S. Nazarko, E. V. Kopeikina, O. G. Goncharova, D. A. Obukhova, D. V. Morozov, S. V. Sergeeva, S. V. Sidorov, S. P. Shevchenko
Metastases of malignant tumors of the internal organs into the skin rarely occur, on average in 1–10 % of cases. They can be the first manifestation of malignant process in the absence of signs of the main disease or show progression of confirmed cancer. The article presents clinical cases of metastases of renal cell carcinoma and adenocarcinoma into the skin of the head and neck which currently is rare. Skin metastases are variable in their clinical manifestation. In the presented cases, resection of the lesions was required as symptomatic treatment.
{"title":"Review of clinical cases of internal organ metastases into the skin of the head and neck","authors":"K. A. Kretova, O. S. Nazarko, E. V. Kopeikina, O. G. Goncharova, D. A. Obukhova, D. V. Morozov, S. V. Sergeeva, S. V. Sidorov, S. P. Shevchenko","doi":"10.17650/2222-1468-2023-13-2-75-78","DOIUrl":"https://doi.org/10.17650/2222-1468-2023-13-2-75-78","url":null,"abstract":"Metastases of malignant tumors of the internal organs into the skin rarely occur, on average in 1–10 % of cases. They can be the first manifestation of malignant process in the absence of signs of the main disease or show progression of confirmed cancer. The article presents clinical cases of metastases of renal cell carcinoma and adenocarcinoma into the skin of the head and neck which currently is rare. Skin metastases are variable in their clinical manifestation. In the presented cases, resection of the lesions was required as symptomatic treatment.","PeriodicalId":19610,"journal":{"name":"Opuholi Golovy i Šei","volume":"8 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-09-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135735403","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}
Pub Date : 2023-09-13DOI: 10.17650/2222-1468-2023-13-2-65-69
D. M. Fatkullin, A. O. Guz, A. C. Zaharov, A. V. Garev, M. I. Sokolova
Oral cavity squamous cell carcinoma is one of the leading localizations in the structure of head and neck cancers in the Russian federation and in the world. Neck metastases are the key criterion which influence to survival, recurrence, and distant metastases in patients with oral squamous cell carcinoma. Neck dissection is a main step in the surgical treatment of oral squamous cell carcinoma. This literature review analyzes data on possible methods for assessing the quality of neck dissection in squamous cell carcinoma of the oral cavity. Evaluation criteria can be conditionally divided into prognostic (lymph node extracapsular extension, the size of the largest neck metastasis, lymph node yield, lymph node ratio, metastasis topography) and qualitative (lymph node yield, lymph node ratio). Nowadays, there are some prognostic factors of surgical specimen after neck dissection which we use in clinical practice except for lymph node yield, lymph node ratio. This paper analyzes the criteria for an objective assessment of the quality of the operation “neck dissection”. The clinical and prognostic significance of these parametrs is considered.
{"title":"Evaluation of the quality of neck dissection in patients with oral cavity squamous cell carcinoma","authors":"D. M. Fatkullin, A. O. Guz, A. C. Zaharov, A. V. Garev, M. I. Sokolova","doi":"10.17650/2222-1468-2023-13-2-65-69","DOIUrl":"https://doi.org/10.17650/2222-1468-2023-13-2-65-69","url":null,"abstract":"Oral cavity squamous cell carcinoma is one of the leading localizations in the structure of head and neck cancers in the Russian federation and in the world. Neck metastases are the key criterion which influence to survival, recurrence, and distant metastases in patients with oral squamous cell carcinoma. Neck dissection is a main step in the surgical treatment of oral squamous cell carcinoma. This literature review analyzes data on possible methods for assessing the quality of neck dissection in squamous cell carcinoma of the oral cavity. Evaluation criteria can be conditionally divided into prognostic (lymph node extracapsular extension, the size of the largest neck metastasis, lymph node yield, lymph node ratio, metastasis topography) and qualitative (lymph node yield, lymph node ratio). Nowadays, there are some prognostic factors of surgical specimen after neck dissection which we use in clinical practice except for lymph node yield, lymph node ratio. This paper analyzes the criteria for an objective assessment of the quality of the operation “neck dissection”. The clinical and prognostic significance of these parametrs is considered.","PeriodicalId":19610,"journal":{"name":"Opuholi Golovy i Šei","volume":"5 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-09-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135735622","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}
Pub Date : 2023-09-13DOI: 10.17650/2222-1468-2023-13-2-44-56
D. Sh. Polatova, A. Yu. Madaminov, A. V. Savkin, A. I. Nurzhabov, N. K. Asamedinov, D. A. Ibragimova, R. R. Davletov, S. K. Nasirov
Introduction. High-risk human papilloma virus (Hpv), especially genotype 16, causes oropharyngeal squamous cell carcinoma (OSCC). It is detected in about 70 % of tumors developing from lymphoid tissue of the tonsils or the base of the tongue. Due to the increased number of Hpv-positive OSCC, Hpv status is considered a marker of OSCC clinical outcome. Easy testing, low cost, reliability, and high sensitivity of immunohistochemical analysis for p16INk4a allowed to widely use this method for Hpv status determination. Aim. To determine the association between programmed death-ligand 1 (pD-L1) and p53 expression and presence of indirect Hpv marker – p16INk4a – in patients with OSCC. Materials and methods . The study included 76 patients with OSCC т1–4N0–3m0 who received treatment at the Republican Specialized Scientific and practical medical Center of Oncology and Radiology (n = 37) and its Tashkent branch (n = 39) between 2015 and 2020. for all selected patients, retrospective immunohistochemical analysis for the presence of p16INk4a, pD-L1 and р53 in tumor samples fixed with formalin in paraffin blocks was performed. In our work, immunohistochemical examination for p16INk4a was the only relevant tool for Hpv status determination. To reinforce its prognostic significance, we used additional molecular markers pD-L1 and p53 which play an important role in carcinogenic transformation and OSCC progression. Results. The results of immunohistochemical analysis showed that p16INk4a overexpression was accompanied by positive pD-L1 reaction in 46 % (6/13) of cases; there were no cases of positive expression of mutant type p53. wild type p53 was identified in only 1 (3 %) case in combination with p16INk4a overexpression. Conclusion. The developed panel consisting of 3 molecular markers (p16INk4a, pD-L1 and р53) may open new horizons in accurate prognosis, risk stratification and understanding of OSCC molecular signature. This, in turn, will help clinicians in selection of individual therapy strategies for treatment de-escalation and outcome optimization.
{"title":"PD-L1 and p53 expression in squamous cell carcinoma of the oropharynx depending on human papilloma virus status","authors":"D. Sh. Polatova, A. Yu. Madaminov, A. V. Savkin, A. I. Nurzhabov, N. K. Asamedinov, D. A. Ibragimova, R. R. Davletov, S. K. Nasirov","doi":"10.17650/2222-1468-2023-13-2-44-56","DOIUrl":"https://doi.org/10.17650/2222-1468-2023-13-2-44-56","url":null,"abstract":"Introduction. High-risk human papilloma virus (Hpv), especially genotype 16, causes oropharyngeal squamous cell carcinoma (OSCC). It is detected in about 70 % of tumors developing from lymphoid tissue of the tonsils or the base of the tongue. Due to the increased number of Hpv-positive OSCC, Hpv status is considered a marker of OSCC clinical outcome. Easy testing, low cost, reliability, and high sensitivity of immunohistochemical analysis for p16INk4a allowed to widely use this method for Hpv status determination. Aim. To determine the association between programmed death-ligand 1 (pD-L1) and p53 expression and presence of indirect Hpv marker – p16INk4a – in patients with OSCC. Materials and methods . The study included 76 patients with OSCC т1–4N0–3m0 who received treatment at the Republican Specialized Scientific and practical medical Center of Oncology and Radiology (n = 37) and its Tashkent branch (n = 39) between 2015 and 2020. for all selected patients, retrospective immunohistochemical analysis for the presence of p16INk4a, pD-L1 and р53 in tumor samples fixed with formalin in paraffin blocks was performed. In our work, immunohistochemical examination for p16INk4a was the only relevant tool for Hpv status determination. To reinforce its prognostic significance, we used additional molecular markers pD-L1 and p53 which play an important role in carcinogenic transformation and OSCC progression. Results. The results of immunohistochemical analysis showed that p16INk4a overexpression was accompanied by positive pD-L1 reaction in 46 % (6/13) of cases; there were no cases of positive expression of mutant type p53. wild type p53 was identified in only 1 (3 %) case in combination with p16INk4a overexpression. Conclusion. The developed panel consisting of 3 molecular markers (p16INk4a, pD-L1 and р53) may open new horizons in accurate prognosis, risk stratification and understanding of OSCC molecular signature. This, in turn, will help clinicians in selection of individual therapy strategies for treatment de-escalation and outcome optimization.","PeriodicalId":19610,"journal":{"name":"Opuholi Golovy i Šei","volume":"26 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-09-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135736426","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}
Pub Date : 2023-09-13DOI: 10.17650/2222-1468-2023-13-2-79-84
A. O. Guz, A. V. Garev, D. M. Fatkullin, A. S. Zaharov, M. I. Sokolova
Surgical treatment of patients with locally advanced squamous cell carcinoma of the oral mucosa is a complicated problem requiring maximal surgical radicality and, at the same time, single-stage reconstruction to preserve organ function and achieve acceptable esthetic results. One of modern reconstruction techniques is the use of free flaps. Application of this technique requires microsurgical skills from the surgeon. unfortunately, it is not always possible to achieve the result after single-stage postoperative defect closure. Sometimes unforeseen complications are observed: necrosis of the moved flaps, formation of large postoperative defects, orostomas, pharyngostomas. In such cases, oncologists face a more complicated problem: defect reconstruction in the conditions of pronounced scarring process in the intervention area, development of post-radiation fibrosis and soft tissue edema. The presented clinical case demonstrates the capabilities of repeat microsurgical reconstruction in patients with orostoma developed after unsuccessful primary reconstruction.
{"title":"Capabilities of delayed microsurgical reconstruction in patients with squamous cell carcinoma of the buccal mucosa: clinical case","authors":"A. O. Guz, A. V. Garev, D. M. Fatkullin, A. S. Zaharov, M. I. Sokolova","doi":"10.17650/2222-1468-2023-13-2-79-84","DOIUrl":"https://doi.org/10.17650/2222-1468-2023-13-2-79-84","url":null,"abstract":"Surgical treatment of patients with locally advanced squamous cell carcinoma of the oral mucosa is a complicated problem requiring maximal surgical radicality and, at the same time, single-stage reconstruction to preserve organ function and achieve acceptable esthetic results. One of modern reconstruction techniques is the use of free flaps. Application of this technique requires microsurgical skills from the surgeon. unfortunately, it is not always possible to achieve the result after single-stage postoperative defect closure. Sometimes unforeseen complications are observed: necrosis of the moved flaps, formation of large postoperative defects, orostomas, pharyngostomas. In such cases, oncologists face a more complicated problem: defect reconstruction in the conditions of pronounced scarring process in the intervention area, development of post-radiation fibrosis and soft tissue edema. The presented clinical case demonstrates the capabilities of repeat microsurgical reconstruction in patients with orostoma developed after unsuccessful primary reconstruction.","PeriodicalId":19610,"journal":{"name":"Opuholi Golovy i Šei","volume":"34 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-09-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135736430","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}
Pub Date : 2023-09-12DOI: 10.17650/2222-1468-2023-13-2-10-17
E. Kh. Gogieva, I. S. Romanov, V. Yu. Bokhyan, A. V. Ignatova, M. M. Gabrava, A. K. Zarenkova, A. B. Safonova, K. A. Batyrov
Introduction . Thyroid cancer is the most common malignant tumor of the endocrine system and comprises 33 % of malignant neoplasms of the head and neck. first echelon lymph nodes affected by this pathology are located in the central area of the neck. The metastatic process further advances into the lymph nodes in the lateral tissues of the neck. Currently, there is no consensus on the effectiveness of prophylactic central lymph node dissection and no conclusive criteria determining the risk of recurrence in the central zone. Aim. The assessment of factors influencing the risk of regional recurrence in the central zone. Materials and methods. The study included 30 patients with highly differentiated thyroid cancer, in whom metastatic nodes in the central zone were identified and verified during primary treatment. All patients previously underwent unilateral or 2-sided central lymph node dissection in various institutions. During the period of dynamic observation, these patients revealed regional recurrence in the central zone. patients were observed and treated for recurrence at the National medical Research Center of Oncology named after N.N. Blokhin of the ministry of Health of Russia. Results. primary surgical treatment in a specialized oncological institution was performed in 21 (70 %) patients, in a general surgical medical institution – in 7 (23.3 %), in an endocrinological institution – in 2 (6.7 %) patients. when assessing the influence of the morphological type and variant of thyroid cancer on the risk of developing regional recurrence, no statistical significance was found. No statistically significant factors were found in the analysis of the influence of characteristics of the primary tumor, such as tumor size, multifocal lesion, vascular invasion, extrathyroidal spread, on the risk of regional recurrence. In 16 (53.3 %) patients, recurrence occurred in the paratracheal zone of the ipsilateral side, in 7 (23.3 %) patients in the paratracheal zone of the contralateral side, bilateral lesions were observed in 2 (6.67 %) cases. 3 (10 %) patients were diagnosed with transient parathyroid insufficiency, 1 (3.3 %) – permanent parathyroid insufficiency, 1 (3.3 %) – hematoma in the area of the postoperative wound, patient, 2 (6.6 %) – injury to the recurrent laryngeal nerve. Conclusion . Residual metastatic lymph nodes after previous surgical treatment are the reason for performing a second operation, which carries both the risks of postoperative complications and the psychological burden on the patient. Thus, an adequate and radically performed primary surgical intervention is the key to reducing regional recurrences.
{"title":"Features of regional relapses in the central zone after surgical treatment of highly differentiated thyroid cancer","authors":"E. Kh. Gogieva, I. S. Romanov, V. Yu. Bokhyan, A. V. Ignatova, M. M. Gabrava, A. K. Zarenkova, A. B. Safonova, K. A. Batyrov","doi":"10.17650/2222-1468-2023-13-2-10-17","DOIUrl":"https://doi.org/10.17650/2222-1468-2023-13-2-10-17","url":null,"abstract":"Introduction . Thyroid cancer is the most common malignant tumor of the endocrine system and comprises 33 % of malignant neoplasms of the head and neck. first echelon lymph nodes affected by this pathology are located in the central area of the neck. The metastatic process further advances into the lymph nodes in the lateral tissues of the neck. Currently, there is no consensus on the effectiveness of prophylactic central lymph node dissection and no conclusive criteria determining the risk of recurrence in the central zone. Aim. The assessment of factors influencing the risk of regional recurrence in the central zone. Materials and methods. The study included 30 patients with highly differentiated thyroid cancer, in whom metastatic nodes in the central zone were identified and verified during primary treatment. All patients previously underwent unilateral or 2-sided central lymph node dissection in various institutions. During the period of dynamic observation, these patients revealed regional recurrence in the central zone. patients were observed and treated for recurrence at the National medical Research Center of Oncology named after N.N. Blokhin of the ministry of Health of Russia. Results. primary surgical treatment in a specialized oncological institution was performed in 21 (70 %) patients, in a general surgical medical institution – in 7 (23.3 %), in an endocrinological institution – in 2 (6.7 %) patients. when assessing the influence of the morphological type and variant of thyroid cancer on the risk of developing regional recurrence, no statistical significance was found. No statistically significant factors were found in the analysis of the influence of characteristics of the primary tumor, such as tumor size, multifocal lesion, vascular invasion, extrathyroidal spread, on the risk of regional recurrence. In 16 (53.3 %) patients, recurrence occurred in the paratracheal zone of the ipsilateral side, in 7 (23.3 %) patients in the paratracheal zone of the contralateral side, bilateral lesions were observed in 2 (6.67 %) cases. 3 (10 %) patients were diagnosed with transient parathyroid insufficiency, 1 (3.3 %) – permanent parathyroid insufficiency, 1 (3.3 %) – hematoma in the area of the postoperative wound, patient, 2 (6.6 %) – injury to the recurrent laryngeal nerve. Conclusion . Residual metastatic lymph nodes after previous surgical treatment are the reason for performing a second operation, which carries both the risks of postoperative complications and the psychological burden on the patient. Thus, an adequate and radically performed primary surgical intervention is the key to reducing regional recurrences.","PeriodicalId":19610,"journal":{"name":"Opuholi Golovy i Šei","volume":"17 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-09-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135885567","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}
Pub Date : 2023-09-12DOI: 10.17650/2222-1468-2023-13-2-35-43
Yu. V. Alymov, I. S. Romanov, A. V. Ignatova
Recurrent and metastatic head and neck squamous cell carcinoma is a hard-to-treat pathology. median overall survival for standard chemotherapy regimens does not exceed 11 months. One of the factors decreasing treatment effectivenessis frequency of severe adverse events which are observed in every 2nd patient during standard therapy regimens. moreover, even if notable tumor regression is achieved, this effect is transient. Development of immunotherapy drugs, namely pembrolizumab, helps solve these problems. Clinical trials and real-world use of the drug show that in the 1st and 2nd therapy lines for recurrent and metastatic head and neck squamous cell carcinoma, pembrolizumab allows to achieve persistent treatment response, increase overall survival, and decrease the frequency of adverse events.
{"title":"Pembrolizumab in treatment of head and neck squamous cell carcinoma: clinical cases and real-world practice","authors":"Yu. V. Alymov, I. S. Romanov, A. V. Ignatova","doi":"10.17650/2222-1468-2023-13-2-35-43","DOIUrl":"https://doi.org/10.17650/2222-1468-2023-13-2-35-43","url":null,"abstract":"Recurrent and metastatic head and neck squamous cell carcinoma is a hard-to-treat pathology. median overall survival for standard chemotherapy regimens does not exceed 11 months. One of the factors decreasing treatment effectivenessis frequency of severe adverse events which are observed in every 2nd patient during standard therapy regimens. moreover, even if notable tumor regression is achieved, this effect is transient. Development of immunotherapy drugs, namely pembrolizumab, helps solve these problems. Clinical trials and real-world use of the drug show that in the 1st and 2nd therapy lines for recurrent and metastatic head and neck squamous cell carcinoma, pembrolizumab allows to achieve persistent treatment response, increase overall survival, and decrease the frequency of adverse events.","PeriodicalId":19610,"journal":{"name":"Opuholi Golovy i Šei","volume":"41 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-09-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135885562","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}
Pub Date : 2023-09-12DOI: 10.17650/2222-1468-2023-13-2-18-25
A. V. Karpenko, R. R. Sibgatullin, A. A. Boyko, O. M. Nikolayeva
Introduction . In the last decades, a discernable trend towards more frequent use of endoscopic laser surgery in operative treatment of cancer of the middle part of the larynx is observed. Smaller operative trauma, absence of tracheostomy, short hospitalization time, and better functional outcomes without compromising oncological outcomes are significant reasons for transition to endoscopic methods. However, local recurrence involving anterior commissure develops in every 4th patient. This can explain attempts to return to analysis of possibilities of a surgical alternative – open laryngectomies. Aim . To retrospectively analyze the oncologic effectiveness of open partial vertical laryngectomy in the treatment of early glottic cancer. Materials and methods . Results of treatment of 66 patients aged between 39 and 72 years (mean age 61.4 ± 8.7 years) with cT1–2N0m0 glottic cancer were analyzed. 33 patients had T1 tumors and 33 – T2. Anterior commissure was involved in 14 cases. Surgery was the only mode of treatment in 92.4 % of cases. Oncologic effectiveness was assessed with the following parameters: the rate of local, regional recurrence and kaplan–meyer overall survival. Results . mean follow up was 58.64 ± 28.33 months (range 8–120 months). The rate of local recurrence for the whole cohort, T1 and T2 cases was 4.5; 3.0 and 6.1 %. The difference in local recurrence rate between T1 and T2 cases was statistically insignificant. The anterior commissure involvement did not affect negatively the rate of local recurrence. Regional recurrence was detected in 3 (4.5 %) patients. Larynx was preserved in 63 patients (92.4 %). 5 year overall survival was 86.12 %. Conclusion . Open partial vertical laryngectomy is characterized by low rate of local recurrence and acceptable functional results. The method may be the optimal choice of treatment for certain subgroup of patients with more advanced and invasive tumors.
{"title":"Oncologic effectiveness of open partial vertical laryngectomy in the treatment of early glottic cancer","authors":"A. V. Karpenko, R. R. Sibgatullin, A. A. Boyko, O. M. Nikolayeva","doi":"10.17650/2222-1468-2023-13-2-18-25","DOIUrl":"https://doi.org/10.17650/2222-1468-2023-13-2-18-25","url":null,"abstract":"Introduction . In the last decades, a discernable trend towards more frequent use of endoscopic laser surgery in operative treatment of cancer of the middle part of the larynx is observed. Smaller operative trauma, absence of tracheostomy, short hospitalization time, and better functional outcomes without compromising oncological outcomes are significant reasons for transition to endoscopic methods. However, local recurrence involving anterior commissure develops in every 4th patient. This can explain attempts to return to analysis of possibilities of a surgical alternative – open laryngectomies. Aim . To retrospectively analyze the oncologic effectiveness of open partial vertical laryngectomy in the treatment of early glottic cancer. Materials and methods . Results of treatment of 66 patients aged between 39 and 72 years (mean age 61.4 ± 8.7 years) with cT1–2N0m0 glottic cancer were analyzed. 33 patients had T1 tumors and 33 – T2. Anterior commissure was involved in 14 cases. Surgery was the only mode of treatment in 92.4 % of cases. Oncologic effectiveness was assessed with the following parameters: the rate of local, regional recurrence and kaplan–meyer overall survival. Results . mean follow up was 58.64 ± 28.33 months (range 8–120 months). The rate of local recurrence for the whole cohort, T1 and T2 cases was 4.5; 3.0 and 6.1 %. The difference in local recurrence rate between T1 and T2 cases was statistically insignificant. The anterior commissure involvement did not affect negatively the rate of local recurrence. Regional recurrence was detected in 3 (4.5 %) patients. Larynx was preserved in 63 patients (92.4 %). 5 year overall survival was 86.12 %. Conclusion . Open partial vertical laryngectomy is characterized by low rate of local recurrence and acceptable functional results. The method may be the optimal choice of treatment for certain subgroup of patients with more advanced and invasive tumors.","PeriodicalId":19610,"journal":{"name":"Opuholi Golovy i Šei","volume":"38 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-09-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135885564","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}
Pub Date : 2023-09-12DOI: 10.17650/2222-1468-2023-13-2-26-34
R. N. Mustafin
Introduction . Head and neck squamous cell carcinoma is the 6th most common malignant tumor. It is characterized by immune response evasion and drug resistance. To stimulate antitumor immune response, antibodies against such cell cycle checkpoints as programmed cell death 1 (pD-1) and programmed death-ligand 1 (pD-L1) are used. However, effectiveness of monotherapy with these checkpoint inhibitors turned out to be low, and combinations with other antitumor drugs have high risk of adverse events. Aim. To determine the most practical ways to influence epigenetic factors in treatment of head and neck squamous cell carcinoma. Materials and methods . Scientific literature published between 2011 and 2022 and indexed in the eLIBRARY, Scopus, woS, NCBI databases (398 articles, of which 76 were used) was analyzed. Results. prospects of development of epigenetic stimulation of expression of retroelements located in tumor genomes through inhibition of DNA methyltransferases, deacetylases and histone methyltransferases were considered. when retroelements are activated, their transcripts form double-stranded RNA stimulating T killers and interferon response (virus mimicry). for DNA methyltransferase inhibitors, restoration of tumor suppressor genes which are hypermethylated in squamous cell carcinoma is also observed. However, retroelement activation is a driver mechanism of carcinogenesis, and their nonspecific expression can lead to tumor progression and formation of secondary tumors. Therefore, in the virus mimicry method it is practical to use as targets microRNA complementary to retroelements which recruit epigenetic factors to their loci (RNA-directed DNA methylation), as well as antisense oligonucleotides against oncogenic microRNA associated with retroelements. These approaches allow to inhibit retroelements participating in carcinogenesis. Nonspecific method of retrotransposon activity suppression is being developed in antitumor therapy, but data show successful application of only reverse transcriptase inhibitors preventing insertions and progression of genomic instability. we have performed analysis of scientific literature on transposable elements-derived microRNA associated with head and neck squamous cell carcinoma. As a result, 31 microRNAs were identified, derived from: LINE: miR-1249, -151a, -211, -2355, -28, -31, -3144, -374a, -374b, -421, -450b, -511, -576, -577, -582, -708, -769, -887, -95; HERv: miR-1269a, -1911, -3200, -495; non-autonomous SINE: miR-335, -342, -378a, -3934, -487b; DNA transposons: miR-224, -584, -652. These microRNAs can serve as the basis for epigenetic therapy of head and neck squamous cell carcinoma.
{"title":"Prospects of epigenetic therapy of head and neck squamous cell carcinoma","authors":"R. N. Mustafin","doi":"10.17650/2222-1468-2023-13-2-26-34","DOIUrl":"https://doi.org/10.17650/2222-1468-2023-13-2-26-34","url":null,"abstract":"Introduction . Head and neck squamous cell carcinoma is the 6th most common malignant tumor. It is characterized by immune response evasion and drug resistance. To stimulate antitumor immune response, antibodies against such cell cycle checkpoints as programmed cell death 1 (pD-1) and programmed death-ligand 1 (pD-L1) are used. However, effectiveness of monotherapy with these checkpoint inhibitors turned out to be low, and combinations with other antitumor drugs have high risk of adverse events. Aim. To determine the most practical ways to influence epigenetic factors in treatment of head and neck squamous cell carcinoma. Materials and methods . Scientific literature published between 2011 and 2022 and indexed in the eLIBRARY, Scopus, woS, NCBI databases (398 articles, of which 76 were used) was analyzed. Results. prospects of development of epigenetic stimulation of expression of retroelements located in tumor genomes through inhibition of DNA methyltransferases, deacetylases and histone methyltransferases were considered. when retroelements are activated, their transcripts form double-stranded RNA stimulating T killers and interferon response (virus mimicry). for DNA methyltransferase inhibitors, restoration of tumor suppressor genes which are hypermethylated in squamous cell carcinoma is also observed. However, retroelement activation is a driver mechanism of carcinogenesis, and their nonspecific expression can lead to tumor progression and formation of secondary tumors. Therefore, in the virus mimicry method it is practical to use as targets microRNA complementary to retroelements which recruit epigenetic factors to their loci (RNA-directed DNA methylation), as well as antisense oligonucleotides against oncogenic microRNA associated with retroelements. These approaches allow to inhibit retroelements participating in carcinogenesis. Nonspecific method of retrotransposon activity suppression is being developed in antitumor therapy, but data show successful application of only reverse transcriptase inhibitors preventing insertions and progression of genomic instability. we have performed analysis of scientific literature on transposable elements-derived microRNA associated with head and neck squamous cell carcinoma. As a result, 31 microRNAs were identified, derived from: LINE: miR-1249, -151a, -211, -2355, -28, -31, -3144, -374a, -374b, -421, -450b, -511, -576, -577, -582, -708, -769, -887, -95; HERv: miR-1269a, -1911, -3200, -495; non-autonomous SINE: miR-335, -342, -378a, -3934, -487b; DNA transposons: miR-224, -584, -652. These microRNAs can serve as the basis for epigenetic therapy of head and neck squamous cell carcinoma.","PeriodicalId":19610,"journal":{"name":"Opuholi Golovy i Šei","volume":"4 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-09-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135885566","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}
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