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Objective evaluation of the pharyngoesophageal segment as a source of substitute phonation in patients after total laryngectomy 客观评估作为全喉切除术后患者替代发音源的咽食管段
Q4 Medicine Pub Date : 2024-01-02 DOI: 10.21294/1814-4861-2023-22-6-55-63
N. A. Daikhes, S. S. Reshulskiy, M. L. Isaeva, V. V. Vinogradov
The study aimed to identify objective predictors of the successful voice rehabilitation after total laryngectomy to select the optimal method of voice restoration.Material and Methods. The study included 60 laryngectomized male patients who were stratified into 2 equal groups depending on the patient’s choice of voice restoration: tracheoesophageal puncture or esophageal voice. A comprehensive assessment of the qualitative and quantitative parameters of the pharyngoesophageal segment was carried out using the diagnostic procedures, such as: fiberoptic endoscopic evaluation of swallowing, high-speed video endoscopy, and high-resolution pharyngoesophageal manometry. The results of examination of the pharyngoesophageal segment were compared with the results of voice rehabilitation.Results. A significant difference in the resting pressure in the pharyngoesophageal segment between patients with successful and unsuccessful voice rehabilitation was found. The resting pressure in the pharyngoesophageal segment was higher in patients with unsuccessful voice rehabilitation than in patients with successful voice rehabilitation. Among patients with failed voice rehabilitation, 64 % had pseudodiverticula, 25 % had cicatricial strictures and 11 % had pharyngospasm. Pseudodiverticula were found only in patients who underwent vertical or apparatus pharyngeal closure. We described vibrating patterns of substitute phonation in laryngectomized patients and identified 5 different types of pseudoglottis. No significant differences between the methods of substitute phonation were found.Conclusion. The state of pharyngoesophageal segment is an objective predictor of successful substitute phonation and depends on the surgical technique of pharyngeal closure, the volume of cancer treatment and the course of the postoperative period. A comprehensive assessment of the qualitative and quantitative parameters of the pharyngoesophageal segment using fiberendoscopic, fuoroscopic studies and highresolution pharyngoesophageal manometry allows prediction of voice rehabilitation outcomes.
该研究旨在确定全喉切除术后嗓音康复成功的客观预测因素,以选择最佳的嗓音恢复方法。该研究纳入了60名喉切除术后的男性患者,根据患者选择的嗓音恢复方法分为2组:气管食管穿刺术或食管复声术。通过纤维内窥镜吞咽评估、高速视频内窥镜和高分辨率咽喉食管测压等诊断程序,对咽喉食管段的定性和定量参数进行了综合评估。咽喉食管部分的检查结果与嗓音康复的结果进行了比较。结果发现,成功和不成功嗓音康复患者的咽喉食管段静息压力存在明显差异。嗓音康复失败患者的咽喉食管静息压高于嗓音康复成功患者。在嗓音康复失败的患者中,64%患有假性憩室,25%患有卡他性狭窄,11%患有咽痉挛。只有接受垂直或器械性咽闭合手术的患者才会出现假性憩室。我们描述了喉切除患者替代发音的振动模式,并确定了 5 种不同类型的假喉头。结论:咽喉切除患者的咽喉状态与假喉头的振动模式密切相关。咽喉食管节段的状态是替代发音成功与否的客观预测指标,它取决于咽部闭合的手术技巧、癌症治疗量和术后进程。使用纤维内窥镜、声带内窥镜研究和高分辨率咽喉食管测压法对咽喉食管段的定性和定量参数进行综合评估,可以预测嗓音康复的结果。
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引用次数: 0
Diagnostic value of ICG for sentinel lymph node mapping in patients with stage I endometrial cancer ICG 对 I 期子宫内膜癌患者前哨淋巴结绘图的诊断价值
Q4 Medicine Pub Date : 2024-01-01 DOI: 10.21294/1814-4861-2023-22-6-35-44
V. A. Alimov, S. Skugarev, D. N. Grekov, E. G. Novikova, D. S. Lantsov, A. M. Danilov, A. V. Sazhina, P. N. Afanasova
Background. Lymphatic spread is the main route of metastasis in early stage endometrial cancer. Considering its significance, three risk factors of lymph node metastasis were identified. At a high risk of lymph node metastasis in patients with stage I endometrial cancer, pelvic and lumbar lymph node dissection is recommended. In low-risk patients, lymph node dissection is not performed. Lymph node dissection in medium-risk patients is considered as a staging procedure. However, in patients with aggravating factors that prevent extended hysterectomy, lymph node biopsy with ICG mapping and subsequent microstaging may be an alternative to lymph node dissection. Purpose of the study: to analyze the effectiveness of surgical approaches for staging endometrial cancer at different risk factors for lymphatic metastasis.Material and Methods. The treatment outcomes were retrospectively analyzed in 565 patients with stage I endometrial cancer treated at the gynecological oncology department of Botkin City Clinical Hospital and at the gynecological oncology department of Kaluga Regional Clinical Oncology Center from 2021 to 2023. All women were divided into three groups according to the risk factors of lymph node metastasis. Patients underwent hysterectomy, hysterectomy combined with pelvic or pelvic and lumbar lymphadenectomy, as well as hysterectomy with ICG mapping and sentinel lymph node biopsy.Results. A total of 334 endometrial cancer patients underwent surgery at Botkin City Clinical Hospital. In the medium-risk group patients (n=94), who underwent hysterectomy with pelvic (n=36) and pelvic + lumbar lymphadenectomy (n=31), lymph node metastases were detected in 4 (11.1 %) and 6 (19.4 %) patients, respectively. In the high-risk group (n=50) with similar surgeries, metastatic lymph nodes were identified in 2 (10.5 %, n=19) and 6 (26.1 %, n=23) patients, respectively. At Kaluga Regional Oncology Center, 231 patients underwent hysterectomy with sentinel lymph node biopsy. The low-risk group, the medium-risk group, and the high-risk group showed lymph node metastases in 7 (5.47 %), 6 (10.2 %), and 6 (13.6 %) patients, respectively.Conclusion. In stage I endometrial cancer patients with a low risk of lymph node metastasis, hysterectomy with sentinel lymph node biopsy is recommended. For medium-and high-risk groups, hysterectomy with systemic lymphadenectomy is recommended. If it is not possible to remove the pelvic and lumbar lymph nodes, their biopsy with ICG mapping and microstaging can be recommended. A combination of systemic lymphadenectomy with sentinel lymph node biopsy is a promising technique that could hypothetically demonstrate better results in terms of disease staging.
背景。淋巴扩散是早期子宫内膜癌转移的主要途径。考虑到淋巴结转移的重要性,研究人员确定了淋巴结转移的三个风险因素。对于淋巴结转移风险较高的 I 期子宫内膜癌患者,建议进行盆腔和腰部淋巴结清扫。低风险患者不进行淋巴结清扫。中危患者的淋巴结清扫被视为一种分期手术。然而,对于有加重病情因素而无法进行扩大子宫切除术的患者,进行淋巴结活检并绘制 ICG 图谱,然后进行微分期,可能是淋巴结清扫术的替代方法。研究目的:分析不同淋巴转移风险因素下子宫内膜癌分期手术方法的有效性。对2021年至2023年期间在博特金市临床医院妇科肿瘤科和卡卢加地区临床肿瘤中心妇科肿瘤科接受治疗的565名I期子宫内膜癌患者的治疗结果进行回顾性分析。根据淋巴结转移的风险因素,所有妇女被分为三组。患者分别接受了子宫切除术、子宫切除术联合盆腔或盆腔和腰部淋巴结切除术,以及子宫切除术联合 ICG 图谱和前哨淋巴结活检。共有 334 名子宫内膜癌患者在博特金市临床医院接受了手术。中危组患者(94 人)接受了子宫切除术,并进行了盆腔淋巴结切除术(36 人)和盆腔+ 腰椎淋巴结切除术(31 人),其中分别有 4 人(11.1%)和 6 人(19.4%)发现淋巴结转移。在进行类似手术的高风险组(50 人)中,发现淋巴结转移的患者分别为 2 人(10.5%,19 人)和 6 人(26.1%,23 人)。在卡卢加地区肿瘤中心,231 名患者接受了子宫切除术,并进行了前哨淋巴结活检。低风险组、中风险组和高风险组分别有7例(5.47%)、6例(10.2%)和6例(13.6%)患者出现淋巴结转移。对于淋巴结转移风险较低的 I 期子宫内膜癌患者,建议在进行前哨淋巴结活检的同时进行子宫切除术。对于中、高危人群,建议进行子宫切除术,同时进行全身淋巴结切除术。如果无法切除盆腔和腰部淋巴结,则建议进行活检,并绘制 ICG 图谱和进行微分期。将全身淋巴结切除术与前哨淋巴结活检术结合起来是一种很有前景的技术,有可能在疾病分期方面取得更好的效果。
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引用次数: 0
Personalized adjuvant chemotherapy for stage II–III non-small cell lung cancer 针对 II-III 期非小细胞肺癌的个性化辅助化疗
Q4 Medicine Pub Date : 2024-01-01 DOI: 10.21294/1814-4861-2023-22-6-45-54
E. O. Rodionov, S. Miller, M. Tsyganov, L. Zhuikova, L. V. Pikalova, O. Pankova, V. Perelmuter, D. V. Podolko, A. A. Mokh, O. Ananina, D. Pismenny, V. A. Markovich, D. Loos, N. Litvyakov
Surgery is the standard of care for non-small cell lung cancer (NSCLC). The overall survival rates especially in patients with locally advanced lung cancer are low. The resistance of cancer cells to chemotherapeutic drugs reduces the efficacy of treatment. Special attention is paid to the feasibility of assessing the tumor sensitivity to certain chemotherapy drugs. Currently, the most studied predictors are monoresistance and multidrug resistance genes, such as ABCC5, RRM1, ERCC1, BRCA1, TOP1, TOP2a, TUBB3 and TYMS.The aim of the study was to analyze the outcomes of combined modality treatment using radical surgery and personalized adjuvant chemotherapy for stage II–III NSCLC.Material and Methods. The study included 120 patients with stage II–III NSCLC, who underwent radical lung resection with mediastinal ipsilateral lymph node dissection. The patients were then divided into two groups. The main group consisted of 60 patients who received personalized platinum-based adjuvant chemotherapy based on the expression levels of the genes, such as ABCC5, RRM1, ERCC1, BRCA1, TOP1, TOP2a, TUBB3 and TYMS. The control group consisted of 60 patients who received postoperative chemotherapy empirically.Results. In the main group, disease progression occurred in 14 out of 60 patients, three-year disease-free survival (DFS) was 76.7 % (the median was not reached). In the control group, DFS was 53.3 % (28 out of 60 patients), the median was 31.0 (4–36 months); the differences were statistically significant: Logrank test χ2 =4.382 p=0.036. The overall three–year survival rate was 90.0 % in the main group (6/60 patients died) and 61.7 % in the control group (23/60 patients died), the differences were statistically signifcant: Logrank test χ2 =6.915, p=0.009.Conclusion. The personalized adjuvant chemotherapy resulted in the improved three-year relapse-free and overall survival rates in NSCLC patients.
手术是治疗非小细胞肺癌(NSCLC)的标准方法。总体生存率较低,尤其是局部晚期肺癌患者。癌细胞对化疗药物的耐药性降低了治疗效果。评估肿瘤对某些化疗药物敏感性的可行性受到了特别关注。目前,研究最多的预测因子是单耐药基因和多耐药基因,如ABCC5、RRM1、ERCC1、BRCA1、TOP1、TOP2a、TUBB3和TYMS。该研究旨在分析采用根治性手术和个性化辅助化疗的联合模式治疗II-III期NSCLC的效果。研究纳入了 120 例 II-III 期 NSCLC 患者,他们均接受了根治性肺切除术和纵隔同侧淋巴结清扫术。然后将患者分为两组。主组包括60名患者,他们根据ABCC5、RRM1、ERCC1、BRCA1、TOP1、TOP2a、TUBB3和TYMS等基因的表达水平接受个性化的铂类辅助化疗。对照组由 60 名术后接受经验性化疗的患者组成。主治组 60 例患者中有 14 例出现疾病进展,三年无病生存率(DFS)为 76.7%(未达到中位数)。对照组的无病生存期为 53.3%(60 例患者中有 28 例),中位数为 31.0(4-36 个月);差异有统计学意义:Logrank 检验 χ2 =4.382 p=0.036。主治组的三年总生存率为 90.0%(6/60 患者死亡),对照组为 61.7%(23/60 患者死亡),差异有统计学意义:Logrank检验 χ2 =6.915,P=0.009。个性化辅助化疗提高了 NSCLC 患者的三年无复发生存率和总生存率。
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引用次数: 0
Prediction of pancreatic fstula after pancreatoduodenectomy using machine learning 利用机器学习预测胰十二指肠切除术后的胰腺囊肿
Q4 Medicine Pub Date : 2024-01-01 DOI: 10.21294/1814-4861-2023-22-6-25-34
V. A. Suvorov, S. Panin, N. V. Kovalenko, V. Zhavoronkova, M. Postolov, S. Tolstopyatov, A. E. Bublikov, A. V. Panova, V. O. Popova
Objective: to analyze the results of pancreatoduodenectomy (PD) and identify predictive risk factors for postoperative pancreatic fistula (PF) using machine learning (ML) technology.Material and Methods. A nonrandomized study of treatment outcomes in 128 patients, who underwent PD for periampullary carcinoma between 2018 and 2023, was conducted. To predict PF, the ML models based on the multilayer perceptron and binary logistic regression (BLR) in SPSS Statistics v.26, were used. The Receiver Operator Characteristics (ROC) analysis was used to assess the accuracy of the models. To compare ROC curves, the DeLong test was used.Results. Clinically significant PF occurred in 19 (14.8 %) patients (grade B according to ISGPS 2016 – in 16 (12.5 %), grade C – in 3 (2.3 %)). The data of 90 (70.3 %) patients were used to train the neural network, and 38 (29.7 %) were used to test the predictive model. In multivariate analysis, the predictors of PF were a comorbidity level above 7 points on the age-adjusted Charlson scale, a diameter of the main pancreatic duct less than 3 mm, and a soft pancreatic consistency. The diagnostic accuracy of the ML model estimated using the area under the ROC curve was 0.939 ± 0.027 (95 % CI: 0.859–0.998, sensitivity: 84.2 %, specificity; 96.3 %). The predictive model, which was developed using BLR, demonstrated lower accuracy: 0.918±0.039 (95 % CI: 0.842–0.994, sensitivity: 78.9 %, specificity: 94.5 %) (p=0.02).Conclusion. The use of machine learning technologies makes it possible to increase the probability of a correct prediction of the occurrence of pancreatic fistula after pancreatoduodenectomy.
目的:分析胰十二指肠切除术(PD)的结果,并利用机器学习(ML)技术识别术后胰瘘(PF)的预测风险因素。对2018年至2023年间因胰周腺癌接受胰十二指肠切除术的128名患者的治疗结果进行了非随机研究。为了预测 PF,使用了基于 SPSS Statistics v.26 中的多层感知器和二元逻辑回归(BLR)的 ML 模型。采用接收器特征(ROC)分析来评估模型的准确性。为了比较 ROC 曲线,使用了 DeLong 检验。19例(14.8%)患者出现了有临床意义的PF(根据2016年ISGPS标准,16例(12.5%)为B级,3例(2.3%)为C级)。90名(70.3%)患者的数据被用于训练神经网络,38名(29.7%)患者的数据被用于测试预测模型。在多变量分析中,预测 PF 的因素包括合并症水平在年龄调整后的夏尔森量表中超过 7 分、主胰管直径小于 3 毫米以及胰腺软一致性。根据 ROC 曲线下面积估算,ML 模型的诊断准确率为 0.939 ± 0.027(95 % CI:0.859-0.998,灵敏度:84.2 %,特异性:96.3 %)。使用 BLR 开发的预测模型准确率较低:0.918±0.039(95 % CI:0.842-0.994,灵敏度:78.9 %,特异性:94.5 %)(P=0.02)。使用机器学习技术可以提高胰十二指肠切除术后胰瘘发生率的正确预测概率。
{"title":"Prediction of pancreatic fstula after pancreatoduodenectomy using machine learning","authors":"V. A. Suvorov, S. Panin, N. V. Kovalenko, V. Zhavoronkova, M. Postolov, S. Tolstopyatov, A. E. Bublikov, A. V. Panova, V. O. Popova","doi":"10.21294/1814-4861-2023-22-6-25-34","DOIUrl":"https://doi.org/10.21294/1814-4861-2023-22-6-25-34","url":null,"abstract":"Objective: to analyze the results of pancreatoduodenectomy (PD) and identify predictive risk factors for postoperative pancreatic fistula (PF) using machine learning (ML) technology.Material and Methods. A nonrandomized study of treatment outcomes in 128 patients, who underwent PD for periampullary carcinoma between 2018 and 2023, was conducted. To predict PF, the ML models based on the multilayer perceptron and binary logistic regression (BLR) in SPSS Statistics v.26, were used. The Receiver Operator Characteristics (ROC) analysis was used to assess the accuracy of the models. To compare ROC curves, the DeLong test was used.Results. Clinically significant PF occurred in 19 (14.8 %) patients (grade B according to ISGPS 2016 – in 16 (12.5 %), grade C – in 3 (2.3 %)). The data of 90 (70.3 %) patients were used to train the neural network, and 38 (29.7 %) were used to test the predictive model. In multivariate analysis, the predictors of PF were a comorbidity level above 7 points on the age-adjusted Charlson scale, a diameter of the main pancreatic duct less than 3 mm, and a soft pancreatic consistency. The diagnostic accuracy of the ML model estimated using the area under the ROC curve was 0.939 ± 0.027 (95 % CI: 0.859–0.998, sensitivity: 84.2 %, specificity; 96.3 %). The predictive model, which was developed using BLR, demonstrated lower accuracy: 0.918±0.039 (95 % CI: 0.842–0.994, sensitivity: 78.9 %, specificity: 94.5 %) (p=0.02).Conclusion. The use of machine learning technologies makes it possible to increase the probability of a correct prediction of the occurrence of pancreatic fistula after pancreatoduodenectomy.","PeriodicalId":21881,"journal":{"name":"Siberian journal of oncology","volume":" 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139393410","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
A study to identify novel biomarkers associated with multiple myeloma 一项旨在确定与多发性骨髓瘤相关的新型生物标记物的研究
Q4 Medicine Pub Date : 2023-11-16 DOI: 10.21294/1814-4861-2023-22-5-134-144
Bhaskar Kalarani Iyshwarya, Veerabathiran Ramakrishnan
Background. multiple myeloma (mm) is a plasma cell cancer that affects white blood cells. plasma cells from the bone marrow grow abnormally, as a consequence of which patients have high amounts of monoclonal immunoglobulin in their blood and urine, poor renal function, and recurring infections due to this condition. osteolytic bone lesions and immunodeficiency also impact multiple myeloma patients’ longevity and quality of life. The disease accounts for 13 % of all hematological malignancies worldwide, making it the second most common blood cancer.Material and Methods. The studies investigating mm biomarkers from 2000 to 2021 are collected from various databases. “multiple myeloma”, “biomarkers”, “genetic markers”, “prognostic markers”, “epidemiology of multiple myeloma”, and “risk factors for multiple myeloma” are the key phrases utilized to gather the articles.Results. The scientific and medical research progressed into mm, and the number of cases increased over time and continues to rise, prompting researchers and clinicians to discover new consequences of the disease and new markers for prognosis, diagnosis, detection, and treatment of cancer in the earliest stages. Prognostic and predictive signs for illness recurrence and response to medication may be detected adequately by innovative potential biomarkers, which are more accurate than current approaches.Conclusion. treatment for multiple myeloma includes a variety of chemotherapeutic medicines, including immune modulators and proteasome inhibitors; however, most patients still experience recurrence after completing treatment. There have been numerous novel techniques for managing multiple myeloma, and this review summarises the most commonly used and the new ones that have appeared in the previously published articles.
背景:多发性骨髓瘤(mm)是一种影响白细胞的浆细胞癌症。骨髓中的浆细胞生长异常,因此患者的血液和尿液中含有大量单克隆免疫球蛋白,肾功能低下,并因此反复感染。溶骨性骨病变和免疫缺陷也影响多发性骨髓瘤患者的寿命和生活质量。该病占全球所有血液恶性肿瘤的 13%,是第二大常见血癌。从各种数据库中收集了 2000 年至 2021 年有关毫米生物标志物的研究。"多发性骨髓瘤"、"生物标志物"、"遗传标志物"、"预后标志物"、"多发性骨髓瘤的流行病学 "和 "多发性骨髓瘤的危险因素 "是收集文章的关键词。随着科学和医学研究的发展,多发性骨髓瘤的病例数不断增加并持续上升,这促使研究人员和临床医生不断发现该疾病的新后果以及用于预后、诊断、检测和早期治疗癌症的新标志物。疾病复发的预后和预测征兆以及对药物治疗的反应可通过创新的潜在生物标记物充分检测出来,这些标记物比目前的方法更准确。多发性骨髓瘤的治疗包括多种化疗药物,包括免疫调节剂和蛋白酶体抑制剂;然而,大多数患者在完成治疗后仍会复发。治疗多发性骨髓瘤的新技术层出不穷,本综述总结了以前发表的文章中最常用的技术和新技术。
{"title":"A study to identify novel biomarkers associated with multiple myeloma","authors":"Bhaskar Kalarani Iyshwarya, Veerabathiran Ramakrishnan","doi":"10.21294/1814-4861-2023-22-5-134-144","DOIUrl":"https://doi.org/10.21294/1814-4861-2023-22-5-134-144","url":null,"abstract":"Background. multiple myeloma (mm) is a plasma cell cancer that affects white blood cells. plasma cells from the bone marrow grow abnormally, as a consequence of which patients have high amounts of monoclonal immunoglobulin in their blood and urine, poor renal function, and recurring infections due to this condition. osteolytic bone lesions and immunodeficiency also impact multiple myeloma patients’ longevity and quality of life. The disease accounts for 13 % of all hematological malignancies worldwide, making it the second most common blood cancer.Material and Methods. The studies investigating mm biomarkers from 2000 to 2021 are collected from various databases. “multiple myeloma”, “biomarkers”, “genetic markers”, “prognostic markers”, “epidemiology of multiple myeloma”, and “risk factors for multiple myeloma” are the key phrases utilized to gather the articles.Results. The scientific and medical research progressed into mm, and the number of cases increased over time and continues to rise, prompting researchers and clinicians to discover new consequences of the disease and new markers for prognosis, diagnosis, detection, and treatment of cancer in the earliest stages. Prognostic and predictive signs for illness recurrence and response to medication may be detected adequately by innovative potential biomarkers, which are more accurate than current approaches.Conclusion. treatment for multiple myeloma includes a variety of chemotherapeutic medicines, including immune modulators and proteasome inhibitors; however, most patients still experience recurrence after completing treatment. There have been numerous novel techniques for managing multiple myeloma, and this review summarises the most commonly used and the new ones that have appeared in the previously published articles.","PeriodicalId":21881,"journal":{"name":"Siberian journal of oncology","volume":"4 ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-11-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139270242","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
Takotsubo cardiomyopathy in locally advanced rectosigmoid junction cancer: a case report 局部晚期直肠乙状结肠交界癌中的塔克次氏心肌病:病例报告
Q4 Medicine Pub Date : 2023-11-16 DOI: 10.21294/1814-4861-2023-22-5-161-172
I. E. Alekseev, N. L. Lysovolenko, E. V. Gavrilyuk, V. V. Khvostovoi, N. V. Lazareva, А. M. Bykanova, E. N. Grebenkin, I. V. Stanoevich
Background. takotsubo cardiomyopathy (tcm) occurs more frequently in cancer patients than in the general population. The triggers for tcm in cancer patients include not only the inflammatory state of the cancer itself, but also the significant emotional stress of a cancer diagnosis and the physical stress associated with invasive diagnostic and treatment procedures.Case presentation. We describe the case of a 54-yearold woman with histologically verified rectosigmoid junction cancer (cT4bcN2M0) complicated by acute intestinal obstruction. In the early postoperative period, a sudden drop in blood pressure, t-wave inversion and Qt-interval prolongation on ecg, decrease in the left ventricle contractility and presence of wall motion abnormalities on echocardiography (ecHo), as well as an increase in biomarkers of myocardial damage were initially regarded as acute coronary syndrome, which was subsequently excluded according to the findings of coronary angiography, which did not reveal coronary artery obstruction. taking into account the rapid and complete inverse dynamics of changes, acute myocardial infarction without coronary artery obstruction and acute myocarditis were excluded. Ultimately, the diagnosis of takotsubo cardiomyopathy was established.Conclusion. this case report indicates that cancer can be a trigger for the development of tcm; therefore, the assessment of cardiological status and timely detection of cardiac complications in cancer patients during cancer treatment is extremely important and is aimed at increasing the overall survival in this category of patients.
背景:与普通人群相比,癌症患者中发生塔克次博心肌病(takotsubo cardiomyopathy,tcm)的频率更高。癌症患者诱发 Tcm 的因素不仅包括癌症本身的炎症状态,还包括癌症诊断带来的巨大精神压力以及侵入性诊断和治疗过程带来的身体压力。我们描述了一例经组织学证实患有直肠乙状结肠交界癌(cT4bcN2M0)并发急性肠梗阻的 54 岁女性病例。术后早期,血压突然下降,心电图出现 t 波倒置和 Qt 间期延长,左心室收缩力下降,超声心动图(ecHo)出现室壁运动异常,心肌损伤的生物标志物增加,最初被认为是急性冠状动脉综合征,但随后根据冠状动脉造影的结果排除了这一病例,因为造影并未发现冠状动脉阻塞。考虑到变化的快速和完全反向动态,排除了无冠状动脉阻塞的急性心肌梗死和急性心肌炎。结论:本病例报告表明,癌症可能是诱发拓扑型心肌病的导火索;因此,在癌症治疗期间对癌症患者的心脏状况进行评估并及时发现心脏并发症极为重要,其目的在于提高这类患者的总体生存率。
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引用次数: 0
Endocrine disruptors as promoters of biosphere carcinogenic background 作为生物圈致癌背景促进因素的内分泌干扰物
Q4 Medicine Pub Date : 2023-11-16 DOI: 10.21294/1814-4861-2023-22-5-145-160
G. A. Belitsky, K. Kirsanov, E. Lesovaya, E. Zhidkova, I. A. Khitrovo, M. Yakubovskaya
The main aim of the study is to analyze modern knowledge on endocrine disruptors, non-genotoxic carcinogens, contributing significantly to the total level of contamination of the biosphere by anthropogenic blastomogens.Material and Methods. For the review preparation, we analyzed articles on molecular mechanisms of the effects of endocrine disruptors, available at biomedical literature databases sciVerse scopus, pubmed, Web of science, Rsci. The review cited 65 recent publications, 21 of them being published over the past three years, 3 papers being the official documents on hazards associated with the use of endocrine disruptors, and 10 papers presenting a background to separate endocrine disruptors into the group of compounds with specific functional activity.Results. The role of endocrine disruptors involves the development of the tumors of reproductive organs. They may reveal the properties of strong agonists or antagonists disrupting the hormonal balance by inhibition of the synthesis of natural hormones, their secretion, transport, metabolism, binding or degradation. In addition, they activate alternative proliferation signaling pathways by activating g-proteincoupled receptors, estrogen-bound eRRγ or/and β-adrenergic receptors. The main mechanism of action of endocrine disruptors is the induction of epigenetic modifications, in particular, methylation/demethylation of cpg dNa islands, histone modifications and changes in expression of non-coding RNa. since the effects of endocrine disruptors are nonlinear, they can be caused by concentrations corresponding to the real content in the biosphere and detected in the umbilical blood and breast milk. In addition, they contribute to the metabolic activation of the procarcinogens, the main component of air pollution, by activation of the cytochrome p450 isoforms.Conclusion. Endocrine disruptors can underlie the development of tumors of hormone-dependent organs both at direct and transplacental exposure.
本研究的主要目的是分析有关内分泌干扰素的现代知识,内分泌干扰素是非遗传毒性致癌物质,对生物圈受人为爆炸性致癌物质污染的总水平有重大影响。在撰写综述时,我们分析了生物医学文献数据库 sciVerse scopus、pubmed、Web of science 和 Rsci 中有关内分泌干扰素影响分子机制的文章。综述引用了 65 篇近期发表的论文,其中 21 篇是在过去三年中发表的,3 篇论文是关于使用内分泌干扰物的危害的官方文件,10 篇论文介绍了将内分泌干扰物分为具有特定功能活性的化合物组的背景。内分泌干扰素的作用涉及生殖器官肿瘤的发展。通过抑制天然激素的合成、分泌、运输、代谢、结合或降解,它们可能会显示出强激动剂或拮抗剂的特性,从而破坏激素平衡。此外,它们还通过激活 g 蛋白偶联受体、与雌激素结合的 eRRγ 或/和 β 肾上腺素能受体,激活替代性增殖信号通路。内分泌干扰物的主要作用机制是诱导表观遗传修饰,特别是 cpg dNa 岛的甲基化/去甲基化、组蛋白修饰和非编码 RNa 表达的变化。由于内分泌干扰物的影响是非线性的,因此其浓度可与生物圈中的实际含量相当,并可在脐血和母乳中检测到。此外,内分泌干扰素还能通过激活细胞色素 p450 同工酶,促进致癌物质(空气污染的主要成分)的代谢活化。结论:内分泌干扰素可导致激素依赖器官肿瘤的发生,无论是直接接触还是经胎盘接触。
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引用次数: 0
Robotic surgery in the treatment of oropharyngeal cancer: a case report 机器人手术治疗口咽癌:病例报告
Q4 Medicine Pub Date : 2023-11-16 DOI: 10.21294/1814-4861-2023-22-5-190-196
O. A. Saprina, M. Kropotov, E. A. Zanozina
Background. The incidence of HpV-associated oropharyngeal squamous cell carcinoma (oscc) is steadily increasing. given the better prognosis in patients with HpV-positive cancer compared to HpV-negative cancer, attempts were made to reduce the therapeutic effect in patients with early-stage oscc to improve the quality of life of these patients. early-stage oscc can currently been treated with radiation therapy or surgery used alone or in combination. Currently, the concept of transoral surgery includes both transoral laser microsurgery and robot-assisted surgeries (da Vinci, medrobotics Flex system). Case description. We report a case of using the da Vinci robot-assisted system in the combined modality treatment of oropharyngeal cancer. The patient underwent surgery followed by chemoradiotherapy. At a follow-up of 10 months, no evidence of disease progression was found. The patient experienced no any pain on swallowing.Conclusion. The use of the da Vinci robot-assisted surgical system in the combined modality treatment of oropharyngeal cancer, especially in such a hard-to-reach area as the root of the tongue, makes it possible to better visualize and determine the boundaries of the lesion, followed by en block resection, as well as to improve functional and aesthetic results. However, careful selection of patients for this type of treatment is necessary.
背景。HpV相关口咽鳞状细胞癌(oscc)的发病率正在稳步上升。鉴于HpV阳性癌症患者的预后优于HpV阴性癌症患者,人们试图降低早期oscc患者的治疗效果,以改善这些患者的生活质量。早期oscc目前可单独或联合使用放射治疗或手术治疗。目前,经口手术的概念包括经口激光显微手术和机器人辅助手术(达芬奇、medrobotics Flex系统)。病例描述。我们报告了一例使用达芬奇机器人辅助系统联合治疗口咽癌的病例。患者接受了手术和放化疗。在 10 个月的随访中,没有发现疾病进展的迹象。患者在吞咽时没有任何疼痛感。使用达芬奇机器人辅助手术系统进行口咽癌联合治疗,尤其是在舌根这种难以触及的部位,可以更好地观察和确定病灶的边界,然后进行全切,并改善功能和美观效果。不过,有必要谨慎选择接受此类治疗的患者。
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引用次数: 0
A case report of early detection of rare femoral shaft bone metastasis in a penis cancer patient 阴茎癌患者罕见股骨干骨转移的早期发现病例报告
Q4 Medicine Pub Date : 2023-11-16 DOI: 10.21294/1814-4861-2023-22-5-173-179
Kumar Yadav Ajay, Kumar Mandal Sandip, Gnawali Suman, Dutta Adhikari Ganga, Sharma Nitu, Shailesh Kumar Pandey, Deepika Dhakal, Pandit Anil
Background. Bone metastasis is very common in the advanced stage of numerous carcinomas. In penile carcinoma, lymph nodes metastasis is somehow common but it is very rare reported to be secondary from penile cancer. till the date, there are only few cases of penis carcinoma reported bone metastasis in literature worldwide.Case Presentation. Herein, We presented a 51-year-old Nepalese male with squamous cell carcinoma of penis. computed tomography (ct) scan of the patient revealed that there was carcinoma involving glans penis and precure with bilateral external & internal inguinal lymphadenopathies. After then, the patient was under gone for partial penectomy and bilateral inguinal lymphadenectomy and complete 6-cycle chemotherapy. After one year of treatment, patient developed thigh pain and headache and he advised to have magnetic Resonance imaging (mRi) of brain, 99mTc-MDP whole body bone scan and ct scan of pelvis and thigh. The examination report reveals that there was a sclerotic change in vertex of skull bone and moderate 99mTc-MDP uptake in right proximal shaft of femur just below the neck d/d metastasis. The histopathological examination of the true cut biopsy taken from the lesion of the femur showed metastatic keratinizing squamous cell carcinoma which is rare case of femoral shaft bone metastasis secondary from penile carcinoma. Then patient was sent for surgical reconstruction of femur. Based on the case studies review femur shaft bone metastasis from penile cancer is extremely rare.Conclusion. The best of our knowledge; this is the first early detected bone metastases to shaft of the femur in a patient with penile cancer. early diagnosis helps to radical treatment as well as palliative treatment. surgery is the preferred option of the treatments, especially for metastatic foci in the long bones.
背景。骨转移在许多癌症的晚期阶段非常常见。在阴茎癌中,淋巴结转移在某种程度上很常见,但继发于阴茎癌的淋巴结转移报告却非常罕见。在此,我们介绍了一名患有阴茎鳞状细胞癌的 51 岁尼泊尔男性患者。患者的计算机断层扫描(ct)显示,癌细胞累及龟头阴茎,并伴有双侧腹股沟内外淋巴结病。随后,患者接受了阴茎部分切除术和双侧腹股沟淋巴结切除术,并完成了 6 个周期的化疗。治疗一年后,患者出现大腿疼痛和头痛,医生建议他进行脑部磁共振成像(mRi)、99m锝-MDP全身骨扫描以及骨盆和大腿ct扫描。检查报告显示,颅骨顶端出现硬化性改变,右股骨近端颈部下方出现中度 99mTc-MDP 摄取,d/d 转移。从股骨病变处提取的真切活检组织病理学检查显示为转移性角化鳞状细胞癌,这是阴茎癌继发股骨干骨转移的罕见病例。随后,患者被送去进行股骨重建手术。根据病例研究回顾,阴茎癌引起的股骨干骨转移极为罕见。据我们所知,这是第一例早期发现股骨干骨转移的阴茎癌患者。早期诊断有助于根治性治疗和姑息治疗。手术是治疗的首选方案,尤其是对于长骨转移灶。
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引用次数: 0
Blood mononuclear cell molecular landscape associated with tumor progression in triple-negative breast cancer 与三阴性乳腺癌肿瘤进展相关的血单核细胞分子图谱
Q4 Medicine Pub Date : 2023-11-16 DOI: 10.21294/1814-4861-2023-22-5-197-204
M. Patysheva, A. A. Frolova, O. Bragina, A. A. Fedorov, M. A. Vostrikova, E. Garbukov, P. Iamshchikov, M. Vashisth, N. Cherdyntseva, T. S. Gerashchenko, М.Р. Патышева, А. А. Фролова, О.Д. Брагина, А. А. Федоров, М.С. Вострикова, Е. Ю. Гарбуков, П.С. Ямщиков, М. Вашитш, Н. В. Чердынцева, Т.С. Геращенко, M. A. Vostrikova, Pavel S. Iamshikov
Introduction. triple negative breast cancer is an aggressive clinical phenotype characterized by poor prognosis. immune system plays an important role in the development, treatment response, and progression of solid tumor. The search for immune-related markers associated with the prediction of treatment efficacy and disease prognosis, and based on the use of high-resolution molecular techniques, is a promising area of research, the results of which can be translated into clinical practice. Case description. The molecular profile of blood mononuclear cells in a 48-year-old female patient with histologically proven triple negative breast cancer (estrogen Receptor – 0; progesteron Receptor – 0; Her2/neu – 0; gata-3 – 0, androgen Receptor – 0 and Ki67 – 70 %) was described. The patient did not response to neoadjuvant chemotherapy with 4 cycles of paclitaxel + carboplatin followed by 2 cycles of adriamycin + cyclophosphamide. The patient underwent surgery. disease progression (pelvic bone metastases) occurred 2 months after surgery. The features of blood lymphocytes and monocytes associated with a lack of response to neoadjuvant chemotherapy and disease progression were described.Conclusion. This clinical case demonstrates that sequencing of peripheral blood mononuclear cells can be used as a method for identifying predictive markers of therapy efficacy and developing personalized treatments for patients with triple negative breast cancer.
导言:三阴性乳腺癌是一种侵袭性临床表型,其特点是预后不良。免疫系统在实体瘤的发展、治疗反应和进展中发挥着重要作用。利用高分辨率分子技术寻找与预测疗效和疾病预后相关的免疫相关标记物是一个前景广阔的研究领域,其结果可转化为临床实践。病例描述该病例描述了一名 48 岁女性患者血液单核细胞的分子特征,该患者经组织学证实患有三阴性乳腺癌(雌激素受体-0;孕激素受体-0;Her2/neu-0;gata-3-0;雄激素受体-0;Ki67-70%)。患者对紫杉醇+卡铂 4 个周期的新辅助化疗无反应,随后接受了阿霉素+环磷酰胺 2 个周期的化疗。患者接受了手术治疗。术后 2 个月出现了疾病进展(盆腔骨转移)。文中描述了与新辅助化疗无反应和疾病进展相关的血液淋巴细胞和单核细胞特征。该临床病例表明,外周血单核细胞测序可作为一种方法,用于确定疗效预测标志物,并为三阴性乳腺癌患者开发个性化治疗方案。
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引用次数: 0
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Siberian journal of oncology
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