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Bioimpedance and upper limb lymphedema index in the diagnosis of lymphedema in post-mastectomy syndrome 生物阻抗和上肢淋巴水肿指数在乳房切除术后综合征淋巴水肿诊断中的应用
Q4 Medicine Pub Date : 2024-05-12 DOI: 10.21294/1814-4861-2024-23-2-47-55
V. F. Baytinger, Y. Samoilova, O. S. Kurochkina, Yu. V. Magay, O. Oleinik, A. V. Altukhova, Ia. O. Damdinova
Methods for assessing post-mastectomy edema: bioimpedance and upper extremity lymphedema index (UEL index) are non-invasive, highly sensitive and easily feasible diagnostic methods, suitable for predicting the prospects of surgical treatment and analyzing the dynamics of edema. The purpose of the study was to study UEL index indicators and bioimpedance data at different stages of upper extremity lymphedema. Material and methods. The study included 64 patients with post-mastectomy edema who underwent bioimpedance, measurement of the circumference of the upper extremity and calculation of the UEL index. Results. The upper extremity lymphedema index and bioimpedance parameters (fluid volume in the limb and the ratio of extracellular fluid to total fluid volume) characterizing the liquid component significantly increased at stages II and III of lymphedema in comparison with the control group. a statistically significant correlation was revealed between the upper limb lymphedema index and bioimpedance parameters (R=0.41) and (R=0.49), respectively. Conclusion. Bioimpedance parameters and values of the upper extremity lymphedema index can be interchangeable. The reliability and high sensitivity of these methods for assessing post-mastectomy edema allows us to obtain quantitative criteria for evaluating the liquid component at different stages of lymphedema.
评估乳房切除术后水肿的方法:生物阻抗和上肢淋巴水肿指数(UEL 指数)是一种无创、高灵敏度和易行的诊断方法,适用于预测手术治疗的前景和分析水肿的动态变化。本研究旨在研究上肢淋巴水肿不同阶段的 UEL 指数指标和生物阻抗数据。材料和方法。研究纳入了 64 名乳房切除术后水肿患者,他们接受了生物阻抗、上肢周径测量和 UEL 指数计算。结果显示与对照组相比,淋巴水肿II期和III期患者的上肢淋巴水肿指数和表征液体成分的生物阻抗参数(肢体液体体积和细胞外液体与总液体体积之比)显著增加。上肢淋巴水肿指数和生物阻抗参数之间分别存在统计学意义上的显著相关性(R=0.41)和(R=0.49)。结论生物阻抗参数和上肢淋巴水肿指数值可以互换。这些方法在评估乳房切除术后水肿方面的可靠性和高灵敏度使我们能够获得在不同淋巴水肿阶段评估液体成分的量化标准。
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引用次数: 0
Association of adipose tissue mediators with the development of cancer in patients with metabolic syndrome 脂肪组织介质与代谢综合征患者罹患癌症的关系
Q4 Medicine Pub Date : 2024-05-12 DOI: 10.21294/1814-4861-2024-23-2-101-110
E. Sereda, A. L. Chernyshova, T. Y. Mamonova, G. Kakurina, N. Yunusova, E. Sidenko, D. Korshunov, I. V. Kondakova
The aim of the study was to summarize the available data on the relationship between adipose tissue mediators and cancer in patients with metabolic syndrome. Material and methods. A literature search was conducted using the PubMed and eliBRARY databases. Of the 400 articles published over the past 20 years, 58 studies were included in the review. Results. There is evidence of an unfavorable course of cancer in patients with metabolic syndrome that is explained by the presence of common pathogenetic pathways. In this review, special attention is paid to adipose tissue mediators that regulate the course of inflammation. The involvement of adipose tissue mediators in the pathogenesis of cancer is discussed. The relationship between adipokines of adipose tissue and the effects of specialized pro-resolving mediators (SpRM), which are metabolites of polyunsaturated fatty acids (resolvins, protectins and maresins), are considered. the associations of mediators that regulate the intensity of inflammation with the metabolic syndrome and cancer are discussed. Conclusion. Further studies will contribute to a better understanding of the relationship between metabolic syndrome and cancer and the search for adequate predictive markers to select the most effective drug strategy for correcting metabolic syndrome.
本研究旨在总结代谢综合征患者脂肪组织介质与癌症之间关系的现有数据。材料和方法使用 PubMed 和 eliBRARY 数据库进行文献检索。在过去 20 年发表的 400 篇文章中,有 58 项研究被纳入综述。结果。有证据表明,代谢综合征患者的癌症病程较长,这是因为存在共同的致病途径。本综述特别关注调节炎症过程的脂肪组织介质。讨论了脂肪组织介质参与癌症发病机制的问题。还讨论了调节炎症强度的介质与代谢综合征和癌症之间的关系。结论。进一步的研究将有助于更好地理解代谢综合征与癌症之间的关系,并寻找适当的预测标志物,以选择最有效的药物策略来纠正代谢综合征。
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引用次数: 0
Isolated liver chemoperfusion in a patient with mesenteric leiomyosarcoma and liver metastasis 肠系膜利奥米肉瘤肝转移患者的孤立肝脏化学灌注疗法
Q4 Medicine Pub Date : 2024-05-12 DOI: 10.21294/1814-4861-2024-23-2-126-132
I. V. Reshetov, V. Manukovsky, A. Demko, V. Cheremisov, A. V. Osipov, S. S. Taniya, M. A. Privalov, A. I. Babich
Background. Treatment for inoperable secondary liver cancer remains challenging especially in patients with colorectal cancer. Traditional systemic drug therapy is often ineffective, and the use of transarterial chemoembolization is limited due to the systemic toxicity of some drugs. Combining high efficacy and low systemic toxicity, isolated chemoperfusion is a promising treatment option for patients with liver metastasis. Case report. A patient with mesentery leiomyosarcoma underwent several surgeries and chemotherapy courses, but liver metastases continued to grow. Isolated liver chemoperfusion with melphalan was performed after resection of liver segment and mobilization of liver vessels. To reduce the tumor volume and prevent complications, atypical liver resection was also performed. Conclusion. Isolated liver chemoperfusion for the treatment of liver cancer remains a subject of debate and is not included in the standards for treatment of primary and metastatic liver tumors. This technique was shown to be safe and promising in treating liver metastasis from leiomyosarcoma. However, further research is required to assess the role of this procedure in overall survival.
背景。无法手术的继发性肝癌的治疗仍然具有挑战性,尤其是结直肠癌患者。传统的全身药物治疗往往效果不佳,经动脉化疗栓塞术的使用也因某些药物的全身毒性而受到限制。孤立化疗灌注兼具疗效高和全身毒性低的特点,是肝转移患者的一种很有前景的治疗选择。病例报告。一名肠系膜白肌瘤患者接受了多次手术和化疗,但肝转移灶仍在继续生长。在切除肝段并移除肝脏血管后,患者接受了美法仑孤立肝化疗灌注。为了缩小肿瘤体积和预防并发症,还进行了非典型肝切除术。结论孤立肝脏化学灌注治疗肝癌仍是一个争论的话题,并没有被纳入原发性和转移性肝脏肿瘤的治疗标准中。事实证明,这种技术在治疗细肌瘤肝转移方面是安全和有前景的。然而,还需要进一步的研究来评估这种方法在总体生存率方面的作用。
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引用次数: 0
Proton therapy in pediatric neuro-oncology. Potential advantages and the relationship between cost and results 质子疗法在儿科神经肿瘤学中的应用。潜在优势以及成本与疗效之间的关系
Q4 Medicine Pub Date : 2024-05-12 DOI: 10.21294/1814-4861-2024-23-2-92-100
O. Regentova, O. Shcherbenko, E. Kumirova, F. Antonenko, V. Solodkiy
The aim of study: to analyze the accumulated experience and try to identify those clinical situations in which the use of protons will be economically and clinically more effective than photon radiation therapy. Material and methods. The articles devoted to the study of the evaluation and comparison of the effectiveness of proton and photon radiation beams in the treatment of tumors of the central nervous system and published over the past 25 years were searched in the Medline, Embase and the Cochrane Library databases. Results. the analysis of available publications has shown that accelerated protons do not improve survival rates and disease-free rates in all forms of brain tumors compared with photon therapy. However, protons can significantly increase the level of dose distribution conformity and reduce the dose to critical structures (pituitary gland, cochlea, eye lenses, hypothalamus), thus reducing the risk of hearing and visual impairment as well as hormonal and cognitive disorders. All this is critically important for potentially curable malignant tumors, such as medulloblastoma and germinoma, for low malignant potential tumors (grade 1–2 glioma) or tumors with decreased metastatic potential, since proton therapy compared to photon therapy reduces the risk of late side effects that worsen the quality of life of cured children. Conclusion. central nervous system tumors are one of the most common solid malignant neoplasms in children. Radiation therapy (RT) is recognized as an important therapeutic component of treatment and is often used in strategies for multimodal therapy of tumors of the central nervous system in children. Proton radiation therapy is one of the attractive methods of radiotherapy with minimal dose distribution to normal tissues and a decrease in the absorbed dose. The precision of protons reduces the risk of long-term side effects associated with this type of treatment and the induction of secondary malignancies, which is of particular importance for the quality of life.
研究目的:分析积累的经验,并尝试确定在哪些临床情况下使用质子比光子放射治疗更经济、更有效。材料和方法。在 Medline、Embase 和 Cochrane 图书馆数据库中搜索了过去 25 年间发表的专门研究质子和光子辐射束治疗中枢神经系统肿瘤的有效性评估和比较的文章。结果表明,与光子疗法相比,加速质子并不能提高所有形式脑肿瘤的存活率和无病率。不过,质子能显著提高剂量分布的一致性,减少关键结构(垂体、耳蜗、眼球晶状体、下丘脑)的剂量,从而降低听力和视力受损以及荷尔蒙和认知障碍的风险。这一切对于可能治愈的恶性肿瘤(如髓母细胞瘤和胚芽瘤)、低恶性潜能肿瘤(1-2 级胶质瘤)或转移潜能较低的肿瘤至关重要,因为质子疗法与光子疗法相比,可降低晚期副作用的风险,而晚期副作用会恶化治愈儿童的生活质量。结论:中枢神经系统肿瘤是儿童最常见的实体恶性肿瘤之一。放射治疗(RT)被认为是治疗的重要组成部分,经常被用于儿童中枢神经系统肿瘤的多模式治疗策略中。质子放疗是一种极具吸引力的放疗方法,其对正常组织的剂量分布最小,吸收剂量也较低。质子的精确性降低了与这类治疗相关的长期副作用和诱发继发性恶性肿瘤的风险,这对生活质量尤为重要。
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引用次数: 0
Unravelling the complex interplay: environmental mixtures and breast cancer risk 揭示复杂的相互作用:环境混合物与乳腺癌风险
Q4 Medicine Pub Date : 2024-05-12 DOI: 10.21294/1814-4861-2024-23-2-111-118
M. Jabran, I. Rangraze
Background. Globally, breast cancer ranks as the fourth most frequent reason for mortality when it comes to fatalities from cancer. The worrisome increases in rates of occurrence and death observed during the previous thirty years or more can be linked to several factors, such as changes in risk factor profiles, advancements in cancer registration, and the development of more effective detection technology. A strong association exists between the progression of metastasis and the mortality rate in breast cancer, with environmental pollutants seemingly contributing to this phenomenon. This association prompts a significant inquiry into the mechanisms that regulate the formation of metastases due to environmental and chemical contaminants. The impact of pollutants and chemical substances on communication pathways, which are essential for the growth and spread of tumor cells, among the numerous possible risk factors is gaining increasing focus. Material and methods. scientific research on environmental variables and additional factors linked to breast carcinoma was located and reviewed using engines such as the PubMed database, the MEDLINE database the Scopus database, and Google Scholar, among others, with search terms like “Breast Cancer”, “Risk components”, “Chemical exposures”, “Environmental toxic exposure”, “Disease progression”, “Bisphenol-A”, “Heavy metallic materials”, and “Food preparations”. Results. This literature aimed to present a thorough overview of the existing data on the impact of environmental and chemical toxins on breast cancer and as a result, a significant relationship between these toxins and breast cancer and its metastatic potential was discovered in more depth. Conclusion. In conclusion, breast cancer's complexity demands a holistic approach encompassing genetic, environmental, and early detection strategies. advancements in stem cell biology and gene identification enhance our understanding. Yet, dissemination remains a key challenge. Environmental toxins play a significant role, necessitating further epidemiological and molecular investigations to mitigate breast cancer's global impact.
背景。在全球范围内,乳腺癌位居癌症死亡原因的第四位。在过去三十多年里,乳腺癌的发病率和死亡率都出现了令人担忧的增长,这与多种因素有关,如风险因素的变化、癌症登记的进步以及更有效检测技术的发展。转移的进展与乳腺癌的死亡率之间存在着密切的联系,而环境污染物似乎是造成这一现象的原因之一。这种关联促使人们对环境和化学污染物导致转移的形成机制进行深入探究。在众多可能的风险因素中,污染物和化学物质对肿瘤细胞生长和扩散所必需的通讯途径的影响日益受到关注。使用 PubMed 数据库、MEDLINE 数据库、Scopus 数据库和 Google Scholar 等引擎,以 "乳腺癌"、"风险因素"、"化学暴露"、"环境毒物暴露"、"疾病进展"、"双酚 A"、"重金属材料 "和 "食品制剂 "等为检索词,查找并审查了与乳腺癌相关的环境变量和其他因素的科学研究。结果。该文献旨在全面概述环境和化学毒素对乳腺癌影响的现有数据,从而更深入地发现这些毒素与乳腺癌及其转移潜力之间的重要关系。结论总之,乳腺癌的复杂性要求我们采取包括遗传、环境和早期检测策略在内的综合方法。然而,扩散仍然是一个关键挑战。环境毒素在其中扮演着重要角色,因此有必要开展进一步的流行病学和分子研究,以减轻乳腺癌对全球的影响。
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引用次数: 0
Analysis of survival rates and evaluation of prognostic factors in patients with lung metastases from renal cell carcinoma 肾细胞癌肺部转移患者生存率分析及预后因素评估
Q4 Medicine Pub Date : 2024-05-12 DOI: 10.21294/1814-4861-2024-23-2-37-46
D. V. Semyonov, R. V. Orlova, V. I. Shirokorad, S. V. Kostritsky, N. A. Karlova
In patients with lung metastases from renal cell cancer (RCC), it is necessary to search for new prognostic factors influencing survival rates. Aim: To analyze survival rates and identify prognostic factors in patients with lung metastases from RCC. Material and methods. We retrospectively analyzed the data from 655 patients with lung metastases from RCC, who were treated at Moscow city oncology Hospital No. 62 (Moscow) and city clinical oncology center (Saint Petersburg) from 2006 to 2022. Of these patients, 241 (36.8 %) were classified into the intermediate prognosis group, and 278 (42.2 %) into the unfavorable prognosis group. The study investigated clinical and morphologic prognostic factors influencing survival rates in patients with lung metastases from RCC. Statistical analysis was performed using Statistica 10.0 software packages (StatSoft, USA) by constructing Kaplan-Meier curves and survival tables, building a mathematical model of survival. Results. The 3- and 5-year OS rates in patients with lung metastases from RCC (N=655) were 48 % [95 % ci 45–53 %] and 27 % [95 % ci 23–31 %], respectively, with a median OS of 34.9 months [95 % ci 30.4–37.4]. in univariate analysis, ECOG status (p<0.001), histological subtype (p<0.001), Fuhrman grade of tumor differentiation (p<0.001), type and number of metastases (p<0.001), metastases to the bones and liver (p<0.001), lymph nodes (p=0.001), prognosis according to IMDC(p<0.001), nephrectomy and metastasectomy (p<0.001) had a negative impact on OS in patients with lung metastases from RCC. In multivariate analysis, ECOG status 3.66 (2.10–6.39, p<0.001), histological subtype 1.49 (1.10–2.01, p=0.009), grade of tumor differentiation according to Fuhrman 1.54 (1.13–2.09, p=0.006), number of metastases 3.63 (1.44–9.16, p=0.006), prognosis according to IMDC2.27 (1.63–3.17, p<0.001), and nephrectomy 1.87 (1.29–2.70, p=0.001) and metastasectomy 0.69 (0.53–0.88, p=0.003) were additional factors influencing OS rates in patients with lung metastases from RCC. Conclusion. In our study, ECOG status, histologic subtype of RCC, Fuhrman grade of tumor differentiation, number of metastases, IMDC prognosis, and nephrectomy and metastasectomy were additional independent prognostic factors affecting OS in patients with lung metastases from RCC. Further studies are needed to investigate prognostic factors in patients with RCC lung metastases to improve the effectiveness of personalized treatment and survival rates.
对于肾细胞癌(RCC)肺转移患者,有必要寻找影响生存率的新预后因素。目的:分析RCC肺转移患者的生存率并确定预后因素。材料与方法我们回顾性分析了2006年至2022年期间在莫斯科市第62肿瘤医院(莫斯科)和市临床肿瘤中心(圣彼得堡)接受治疗的655名RCC肺转移患者的数据。在这些患者中,有241人(36.8%)被归为预后中等组,278人(42.2%)被归为预后不良组。该研究调查了影响 RCC 肺转移患者生存率的临床和形态预后因素。使用Statistica 10.0软件包(StatSoft,美国)进行统计分析,构建Kaplan-Meier曲线和生存表,建立生存数学模型。结果在单变量分析中,ECOG状态(P<0.001)、组织学亚型(P<0.001)、肿瘤分化的Fuhrman分级(p<0.001)、转移灶的类型和数量(p<0.001)、骨和肝转移(p<0.001)、淋巴结(p=0.001)、根据IMDC的预后(p<0.001)、肾切除术和转移灶切除术(p<0.001)对RCC肺转移患者的OS有负面影响。在多变量分析中,ECOG状态3.66(2.10-6.39,p<0.001)、组织学亚型1.49(1.10-2.01,p=0.009)、根据Fuhrman的肿瘤分化等级1.54(1.13-2.09,p=0.006)、转移灶数量3.63(1.44-9.16,p=0.006)、IMDC2.27(1.63-3.17,p<0.001)、肾切除术1.87(1.29-2.70,p=0.001)和转移灶切除术0.69(0.53-0.88,p=0.003)是影响RCC肺转移患者OS率的其他因素。结论在我们的研究中,ECOG状态、RCC组织学亚型、肿瘤分化的Fuhrman分级、转移灶数量、IMDC预后、肾切除术和转移灶切除术是影响RCC肺转移患者OS的其他独立预后因素。需要进一步研究RCC肺转移患者的预后因素,以提高个性化治疗的有效性和生存率。
{"title":"Analysis of survival rates and evaluation of prognostic factors in patients with lung metastases from renal cell carcinoma","authors":"D. V. Semyonov, R. V. Orlova, V. I. Shirokorad, S. V. Kostritsky, N. A. Karlova","doi":"10.21294/1814-4861-2024-23-2-37-46","DOIUrl":"https://doi.org/10.21294/1814-4861-2024-23-2-37-46","url":null,"abstract":"In patients with lung metastases from renal cell cancer (RCC), it is necessary to search for new prognostic factors influencing survival rates. Aim: To analyze survival rates and identify prognostic factors in patients with lung metastases from RCC. Material and methods. We retrospectively analyzed the data from 655 patients with lung metastases from RCC, who were treated at Moscow city oncology Hospital No. 62 (Moscow) and city clinical oncology center (Saint Petersburg) from 2006 to 2022. Of these patients, 241 (36.8 %) were classified into the intermediate prognosis group, and 278 (42.2 %) into the unfavorable prognosis group. The study investigated clinical and morphologic prognostic factors influencing survival rates in patients with lung metastases from RCC. Statistical analysis was performed using Statistica 10.0 software packages (StatSoft, USA) by constructing Kaplan-Meier curves and survival tables, building a mathematical model of survival. Results. The 3- and 5-year OS rates in patients with lung metastases from RCC (N=655) were 48 % [95 % ci 45–53 %] and 27 % [95 % ci 23–31 %], respectively, with a median OS of 34.9 months [95 % ci 30.4–37.4]. in univariate analysis, ECOG status (p<0.001), histological subtype (p<0.001), Fuhrman grade of tumor differentiation (p<0.001), type and number of metastases (p<0.001), metastases to the bones and liver (p<0.001), lymph nodes (p=0.001), prognosis according to IMDC(p<0.001), nephrectomy and metastasectomy (p<0.001) had a negative impact on OS in patients with lung metastases from RCC. In multivariate analysis, ECOG status 3.66 (2.10–6.39, p<0.001), histological subtype 1.49 (1.10–2.01, p=0.009), grade of tumor differentiation according to Fuhrman 1.54 (1.13–2.09, p=0.006), number of metastases 3.63 (1.44–9.16, p=0.006), prognosis according to IMDC2.27 (1.63–3.17, p<0.001), and nephrectomy 1.87 (1.29–2.70, p=0.001) and metastasectomy 0.69 (0.53–0.88, p=0.003) were additional factors influencing OS rates in patients with lung metastases from RCC. Conclusion. In our study, ECOG status, histologic subtype of RCC, Fuhrman grade of tumor differentiation, number of metastases, IMDC prognosis, and nephrectomy and metastasectomy were additional independent prognostic factors affecting OS in patients with lung metastases from RCC. Further studies are needed to investigate prognostic factors in patients with RCC lung metastases to improve the effectiveness of personalized treatment and survival rates.","PeriodicalId":21881,"journal":{"name":"Siberian journal of oncology","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2024-05-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140986881","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
Time to treatment start as a survival predictor for reproductive system cancer: a population-based study 作为生殖系统癌症生存率预测指标的开始治疗时间:一项基于人群的研究
Q4 Medicine Pub Date : 2024-05-12 DOI: 10.21294/1814-4861-2024-23-2-5-14
D. D. Gromov, A. Agaeva, O. V. Chemakina, M. A. Zayarnaya, K. D. Zhurova, E. Potekhina, D. Bogdanov, M. Valkov
Objective: To evaluate the effect of the time from morphological confirmation of the diagnosis to the start of specialized treatment (time to treatment start: TTS) on cancer-specific survival (CSS) of patients with cancer of the female reproductive system (CFRS) using the data from the regional cancer registry of the Arkhangelsk region (ARCR) over the period 2000 to 2022. Material and methods. depersonalized data on all cases of breast (BC), cervical (CC), corpus uteri (CUC) and ovarian (OC) cancers were obtained from the ARCR for the period 2000–2022. We compared survival with TTS of 0–7 days (recommended by the state guarantee program), 2–4, 5–8, 9–12 weeks, and 3–6, 7–12 months. Cancer-specific survival was calculated using the life tables and Kaplan-Meier methods. The Cox proportional hazard model was used to correct for other prognostic factors. Results. A total of 19321 cases were analyzed. The ministerial recommended TTS of ≤7 days was observed in 61.9 %, 28.5 %, 27.3 % and 55.9 % of patients with BC, CC, CUC and OC, respectively. the five-year CSS for BC, CC, CUC and OC was 73.9 %, 66.5 %, 73.0 % and 52.1 %, respectively. The TTS of ≤7 days compared to longer TTS was associated with the highest 5-year CSS rate in breast cancer (74.3 vs 45–4-67.0 %) and CC (80.2 vs 63.1–75.0 %); no significant differences were found in CUC and OC. The risk of death from CFRS was the same for TTS of ≤2 months in breast cancer and ≤12 months in other CFRS. Conclusion. Clinical practice shows that the time before the start of special treatment in accordance to state guarantees may be insufficient. early treatment initiation is often possible in the early stages of CFRS. The time to treatment start of < 8 weeks after morphological verification does not worsen survival. The identification of individual groups of patients who need earlier treatment is warranted.
目的利用阿尔汉格尔斯克州地区癌症登记处(ARCR)2000-2022 年间的数据,评估从形态学确诊到开始专业治疗的时间(开始治疗时间:TTS)对女性生殖系统癌症(CFRS)患者癌症特异性生存率(CSS)的影响。材料和方法:我们从阿尔汉格尔斯克地区癌症登记处获得了 2000-2022 年期间所有乳腺癌(BC)、宫颈癌(CC)、子宫体癌(CUC)和卵巢癌(OC)病例的非个人化数据。我们比较了 0-7 天(国家保障计划建议)、2-4、5-8、9-12 周和 3-6、7-12 个月的 TTS 存活率。癌症特异性生存率采用生命表和 Kaplan-Meier 方法进行计算。采用考克斯比例危险模型对其他预后因素进行校正。结果共分析了 19321 个病例。在 BC、CC、CUC 和 OC 患者中,分别有 61.9%、28.5%、27.3% 和 55.9% 的患者达到了部级推荐的 TTS ≤7 天的标准,BC、CC、CUC 和 OC 的五年 CSS 分别为 73.9%、66.5%、73.0% 和 52.1%。在乳腺癌(74.3% vs 45-4-67.0%)和CC(80.2% vs 63.1-75.0%)中,与较长的TTS相比,≤7天的TTS与最高的5年CSS率相关;在CUC和OC中未发现显著差异。乳腺癌TTS≤2个月和其他CFRS≤12个月的CFRS死亡风险相同。结论临床实践表明,按照国家保障开始特殊治疗前的时间可能不够。形态学验证后开始治疗的时间小于 8 周不会降低生存率。需要确定哪些患者需要更早地接受治疗。
{"title":"Time to treatment start as a survival predictor for reproductive system cancer: a population-based study","authors":"D. D. Gromov, A. Agaeva, O. V. Chemakina, M. A. Zayarnaya, K. D. Zhurova, E. Potekhina, D. Bogdanov, M. Valkov","doi":"10.21294/1814-4861-2024-23-2-5-14","DOIUrl":"https://doi.org/10.21294/1814-4861-2024-23-2-5-14","url":null,"abstract":"Objective: To evaluate the effect of the time from morphological confirmation of the diagnosis to the start of specialized treatment (time to treatment start: TTS) on cancer-specific survival (CSS) of patients with cancer of the female reproductive system (CFRS) using the data from the regional cancer registry of the Arkhangelsk region (ARCR) over the period 2000 to 2022. Material and methods. depersonalized data on all cases of breast (BC), cervical (CC), corpus uteri (CUC) and ovarian (OC) cancers were obtained from the ARCR for the period 2000–2022. We compared survival with TTS of 0–7 days (recommended by the state guarantee program), 2–4, 5–8, 9–12 weeks, and 3–6, 7–12 months. Cancer-specific survival was calculated using the life tables and Kaplan-Meier methods. The Cox proportional hazard model was used to correct for other prognostic factors. Results. A total of 19321 cases were analyzed. The ministerial recommended TTS of ≤7 days was observed in 61.9 %, 28.5 %, 27.3 % and 55.9 % of patients with BC, CC, CUC and OC, respectively. the five-year CSS for BC, CC, CUC and OC was 73.9 %, 66.5 %, 73.0 % and 52.1 %, respectively. The TTS of ≤7 days compared to longer TTS was associated with the highest 5-year CSS rate in breast cancer (74.3 vs 45–4-67.0 %) and CC (80.2 vs 63.1–75.0 %); no significant differences were found in CUC and OC. The risk of death from CFRS was the same for TTS of ≤2 months in breast cancer and ≤12 months in other CFRS. Conclusion. Clinical practice shows that the time before the start of special treatment in accordance to state guarantees may be insufficient. early treatment initiation is often possible in the early stages of CFRS. The time to treatment start of < 8 weeks after morphological verification does not worsen survival. The identification of individual groups of patients who need earlier treatment is warranted.","PeriodicalId":21881,"journal":{"name":"Siberian journal of oncology","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2024-05-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140986441","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
Comparative analysis of morphological changes in the mucosa of the small and large bronchi in non-small cell lung cancer 非小细胞肺癌患者小支气管和大支气管粘膜形态变化的对比分析
Q4 Medicine Pub Date : 2024-05-12 DOI: 10.21294/1814-4861-2024-23-2-64-71
O. Pankova, V. Perelmuter, D. Pismenny, A. Fedorov, D. Loos, E. Rodionov, M. Zavyalova, S. Miller
Background. Despite advances in surgical and therapy techniques, non-small cell lung cancer (NSCLC) is one of the most common cancers and the leading cause of cancer-related death. Therefore, it is increasingly important to search for markers that predict the risk of tumor progression. The study of the morphology of the epithelium of the bronchi of different calibers has great potential for solving this problem. The aim of the study was to comparatively evaluate the characteristics and frequency of occurrence of various combinations of morphological changes in the epithelium of the bronchi of large and small calibers in patients with lung squamous cell carcinoma and lung adenocarcinoma. Material and methods. lung samples were collected from 151 NSCLC patients (stage T1–4N0–3M0), who underwent surgery at the cancer Research institute, TNRMC. Various morphological changes in the bronchial epithelium were analyzed. Results. The study of the frequency of occurrence of various morphological changes in small-caliber bronchi showed that basal cell hyperplasia occurred in 90.8 % of cases. Diffuse isolated basal cell hyperplasia was observed in 33.8 % of cases. Focal basal cell hyperplasia was diagnosed in 38.4 % of cases. A combination of basal cell hyperplasia with squamous metaplasia was observed in 18.5 % of cases. The study of the frequency of occurrence in large-caliber bronchi demonstrated that basal cell hyperplasia was the most common morphological variant (93.4 %, including diffuse isolated basal cell hyperplasia in 33.8 % and focal basal cell hyperplasia in 38.4 %). The combination of basal cell hyperplasia and squamous metaplasia was found in 19.8 %. The combination of basal cell hyperplasia with squamous metaplasia and dysplasia was found in 1.3 % compared to the epithelium of small-caliber bronchi. Conclusion. The obtained results on the frequency of occurrence of morphological changes in large-caliber bronchi are of theoretical interest for further research to identify groups at high risk of progression of non-small cell lung cancer.
背景。尽管手术和治疗技术不断进步,但非小细胞肺癌(NSCLC)仍是最常见的癌症之一,也是导致癌症相关死亡的主要原因。因此,寻找能预测肿瘤进展风险的标志物变得越来越重要。对不同口径支气管上皮细胞形态的研究具有解决这一问题的巨大潜力。本研究旨在比较评估肺鳞状细胞癌和肺腺癌患者大、小口径支气管上皮各种形态变化组合的特征和发生频率。材料和方法:收集了在 TNRMC 癌症研究所接受手术的 151 名 NSCLC 患者(T1-4N0-3M0 期)的肺部样本。分析支气管上皮细胞的各种形态变化。结果对小口径支气管各种形态变化发生频率的研究显示,90.8%的病例发生了基底细胞增生。33.8%的病例出现弥漫性孤立基底细胞增生。38.4%的病例被诊断为局灶性基底细胞增生。18.5%的病例合并有基底细胞增生和鳞状化生。对大口径支气管发病频率的研究表明,基底细胞增生是最常见的形态变异(93.4%,包括弥漫孤立性基底细胞增生(33.8%)和局灶性基底细胞增生(38.4%))。19.8%的患者合并有基底细胞增生和鳞状化生。与小口径支气管上皮相比,发现基底细胞增生、鳞状化生和发育不良的比例为 1.3%。结论关于大口径支气管形态变化发生频率的研究结果对进一步研究确定非小细胞肺癌高危人群具有理论意义。
{"title":"Comparative analysis of morphological changes in the mucosa of the small and large bronchi in non-small cell lung cancer","authors":"O. Pankova, V. Perelmuter, D. Pismenny, A. Fedorov, D. Loos, E. Rodionov, M. Zavyalova, S. Miller","doi":"10.21294/1814-4861-2024-23-2-64-71","DOIUrl":"https://doi.org/10.21294/1814-4861-2024-23-2-64-71","url":null,"abstract":"Background. Despite advances in surgical and therapy techniques, non-small cell lung cancer (NSCLC) is one of the most common cancers and the leading cause of cancer-related death. Therefore, it is increasingly important to search for markers that predict the risk of tumor progression. The study of the morphology of the epithelium of the bronchi of different calibers has great potential for solving this problem. The aim of the study was to comparatively evaluate the characteristics and frequency of occurrence of various combinations of morphological changes in the epithelium of the bronchi of large and small calibers in patients with lung squamous cell carcinoma and lung adenocarcinoma. Material and methods. lung samples were collected from 151 NSCLC patients (stage T1–4N0–3M0), who underwent surgery at the cancer Research institute, TNRMC. Various morphological changes in the bronchial epithelium were analyzed. Results. The study of the frequency of occurrence of various morphological changes in small-caliber bronchi showed that basal cell hyperplasia occurred in 90.8 % of cases. Diffuse isolated basal cell hyperplasia was observed in 33.8 % of cases. Focal basal cell hyperplasia was diagnosed in 38.4 % of cases. A combination of basal cell hyperplasia with squamous metaplasia was observed in 18.5 % of cases. The study of the frequency of occurrence in large-caliber bronchi demonstrated that basal cell hyperplasia was the most common morphological variant (93.4 %, including diffuse isolated basal cell hyperplasia in 33.8 % and focal basal cell hyperplasia in 38.4 %). The combination of basal cell hyperplasia and squamous metaplasia was found in 19.8 %. The combination of basal cell hyperplasia with squamous metaplasia and dysplasia was found in 1.3 % compared to the epithelium of small-caliber bronchi. Conclusion. The obtained results on the frequency of occurrence of morphological changes in large-caliber bronchi are of theoretical interest for further research to identify groups at high risk of progression of non-small cell lung cancer.","PeriodicalId":21881,"journal":{"name":"Siberian journal of oncology","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2024-05-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140986796","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
Prediction of combination therapy efficacy in patients with locally advanced squamous cell oropharyngeal carcinoma 局部晚期鳞状细胞口咽癌患者的联合疗法疗效预测
Q4 Medicine Pub Date : 2024-05-12 DOI: 10.21294/1814-4861-2024-23-2-56-63
I. A. Bakhronov, G. Kakurina, L. Zhuykova, I. V. Kondakova, E. Choynzonov
Background. Oropharyngeal squamous cell carcinoma (OPSCC) is characterized by late-stage diagnosis and high rate of mortality. Combined modality treatment including preoperative chemoradiotherapy (CRT) is the standard of care for OPSCC. The search for criteria for predicting the efficacy of preoperative chemoradiotherapy with a view to prescribe it to those patients for whom it is really indicated and will be effective remains challenging. The aim of the study was to identify serum actin-binding proteins that can predict preoperative therapy efficacy in patients with OPSCC. Material and methods. Blood serum from 45 patients with stage II–IV OPSCC was studied. all patients received preoperative chemotherapy with paclitaxel and carboplatin. Radiation therapy in a standard mode was given 2 weeks after chemothetapy. serum levels of actin-binding proteins (CAP1, fascin, ezrin, gelsolin, and profiling) were determined before treatment using ELISA. Results. complete or partial response to preoperative CRT was achieved in 27 patients. Disease progression or stabilization was observed in 18 patients. A comparison of the serum levels of actin-binding proteins before treatment with those obtained after preoperative CRT showed that the serum level of ezrin was lower in patients who did not respond to preoperative CRT than in patients with partial or complete response to therapy. ROC-analysis showed that the serum level of ezrin of less than 2.50 ng/ml can predict the tumor response to CRT as unfavorable (less than 75 % according to the RECIST scale). The sensitivity was 72 % and the specificity was 71 %. Conclusion. Determination of the serum level of ezrin in patients with OPSCC has a predictive value in relation to preoperative chemoradiotherapy.
背景:口咽鳞状细胞癌(OPSCC口咽鳞状细胞癌(OPSCC)的特点是诊断晚、死亡率高。包括术前放化疗(CRT)在内的综合治疗是治疗口咽鳞癌的标准方法。寻找预测术前放化疗疗效的标准,以便将其用于真正适用且有效的患者,仍然具有挑战性。本研究旨在确定可预测 OPSCC 患者术前疗效的血清肌动蛋白结合蛋白。材料和方法。所有患者均接受了紫杉醇和卡铂的术前化疗。治疗前使用 ELISA 方法测定血清中肌动蛋白结合蛋白(CAP1、fascin、ezrin、gelsolin 和 profiling)的水平。结果:27 名患者对术前 CRT 取得了完全或部分反应。18名患者的病情出现进展或稳定。将治疗前与术前 CRT 治疗后的血清肌动蛋白结合蛋白水平进行比较后发现,术前 CRT 治疗无效患者的血清 ezrin 水平低于对治疗部分或完全应答的患者。ROC分析显示,血清中ezrin水平低于2.50 ng/ml可预测肿瘤对CRT的反应为不利(根据RECIST量表,低于75%)。灵敏度为 72%,特异度为 71%。结论测定OPSCC患者血清中的ezrin水平对术前放化疗具有预测价值。
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引用次数: 0
Challenges during pancreatoduodenectomy and ways to overcome them 胰十二指肠切除术中的挑战和克服挑战的方法
Q4 Medicine Pub Date : 2024-05-12 DOI: 10.21294/1814-4861-2024-23-2-82-91
F. Akhmetzyanov, A. Kotelnikov, M. D. Ter-Ovanesov, V. I. Egorov, T. D. Gostyunin, O. A. Karpeeva
Background. Pancreaticoduodenal resection (PDR) is the surgical procedure for cancer of the head of the pancreas, distal common bile duct, duodenum and ampulla of Vater. This surgery is associated with a high risk of complications, the development of which can be influenced by various factors. since pancreatic fistula is a key complication of PDR, the choice of the method for pancreatic anastomosis becomes especially important. Material and methods. The search for publications was carried out using the PubMed and Elibrary systems from January 1980 to January 2024. of the 2,300 sources found, 69 were used to write the review. We included data from both retrospective and prospective clinical trials that were devoted to pancreatoduodenectomy for malignant neoplasms, the difficulties encountered in performing this surgery and ways to solve them. Results. Currently, there are more than 60 types of pancreatico-digestive anastomosis, which indirectly indicates the absence of a universal one that ensures the prevention of pancreatic fistula. The treatment outcomes may be influenced by the nature of neoadjuvant treatment, concomitant diseases, anatomical features, presence of obstructive jaundice and methods of its relief. The main mechanisms of influence of negative factors on the development of complications are considered. an individual approach to the patient, taking into account all factors, can significantly reduce the risk of complications.
背景。胰十二指肠切除术(PDR)是治疗胰头癌、远端胆总管癌、十二指肠癌和瓦特氏门癌的外科手术。由于胰瘘是 PDR 的主要并发症之一,胰腺吻合方法的选择就变得尤为重要。材料和方法。我们使用 PubMed 和 Elibrary 系统对 1980 年 1 月至 2024 年 1 月期间的出版物进行了搜索。在找到的 2300 篇资料中,有 69 篇用于撰写本综述。我们收录了回顾性和前瞻性临床试验的数据,这些试验主要涉及恶性肿瘤的胰十二指肠切除术、实施该手术时遇到的困难以及解决这些困难的方法。结果。目前,胰十二指肠吻合术有 60 多种类型,这间接表明缺乏一种确保预防胰瘘的通用吻合术。治疗效果可能受到新辅助治疗的性质、并发疾病、解剖特征、是否存在阻塞性黄疸以及缓解方法的影响。考虑到所有因素,对患者采取个体化的治疗方法,可以大大降低并发症的风险。
{"title":"Challenges during pancreatoduodenectomy and ways to overcome them","authors":"F. Akhmetzyanov, A. Kotelnikov, M. D. Ter-Ovanesov, V. I. Egorov, T. D. Gostyunin, O. A. Karpeeva","doi":"10.21294/1814-4861-2024-23-2-82-91","DOIUrl":"https://doi.org/10.21294/1814-4861-2024-23-2-82-91","url":null,"abstract":"Background. Pancreaticoduodenal resection (PDR) is the surgical procedure for cancer of the head of the pancreas, distal common bile duct, duodenum and ampulla of Vater. This surgery is associated with a high risk of complications, the development of which can be influenced by various factors. since pancreatic fistula is a key complication of PDR, the choice of the method for pancreatic anastomosis becomes especially important. Material and methods. The search for publications was carried out using the PubMed and Elibrary systems from January 1980 to January 2024. of the 2,300 sources found, 69 were used to write the review. We included data from both retrospective and prospective clinical trials that were devoted to pancreatoduodenectomy for malignant neoplasms, the difficulties encountered in performing this surgery and ways to solve them. Results. Currently, there are more than 60 types of pancreatico-digestive anastomosis, which indirectly indicates the absence of a universal one that ensures the prevention of pancreatic fistula. The treatment outcomes may be influenced by the nature of neoadjuvant treatment, concomitant diseases, anatomical features, presence of obstructive jaundice and methods of its relief. The main mechanisms of influence of negative factors on the development of complications are considered. an individual approach to the patient, taking into account all factors, can significantly reduce the risk of complications.","PeriodicalId":21881,"journal":{"name":"Siberian journal of oncology","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2024-05-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140986652","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
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Siberian journal of oncology
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