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MODERN ASPECTS IN ANESTHESIA OF SMALL LABORATORY ANIMALS 小实验动物麻醉的现代方面
Pub Date : 2022-08-31 DOI: 10.37748/2686-9039-2022-3-3-7
S. Gurova, M. V. Mindar, D. Khodakova
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引用次数: 0
D2, D3 LYMPH NODE DISSECTION IMPORTANCE IN COLON CANCER SURGERY D2、d3淋巴结清扫在结肠癌手术中的重要性
Pub Date : 2022-08-31 DOI: 10.37748/2686-9039-2022-3-3-6
E. Dzhenkova, E. Mirzoyan, A. Maslov, Y. Gevorkyan, D. Kharagezov, A. Milakin, O. N. Stateshniy, O. Y. Kaymakchi, A. Dashkov, G. V. Kaminskiy, V. E. Kolesnikov, S. Malinin, R. E. Tolmakh, L. K. Chalkhakhyan, D. A. Savchenko, M. V. Voloshin, A. V. Snezhko, N. Soldatkina
Colorectal cancer (CRC) is a relevant issue of modern oncology and ranks the third place among most common malignan-cies. Every year, more than 1 million new cases of CRC are diagnosed worldwide, with approximately the same frequency of prevalence among the male and female population. Colon cancer (CC) amounts for more than half of all cases of CRC, and it’s incidence and mortality remain rather high. Surgery remains the main method of CRC treatment, and determining the extent of surgery and lymph node dissection remains an urgent problem. For the first time in Japan, a classification of groups of lymph nodes (l.n.) was proposed depending on the level of lymph outflow and location in relation to the main vessels. According to the numbering of l.n. groups by the Japanese Society for Cancer of the Colon and Rectum (JSCCR), all lymph nodes are numbered with three digits. As a rule, lymphogenic metastasis occurs in one direction, bilateral spread is possible if the tumor is located at the same distance from two feeding vessels. With tumors of the right- sided localization, all groups of l.n. located along the branches of the superior mesenteric artery are removed, and with tumors of the left half of the colon, all l.n. located along the trunk of the inferior mesenteric artery are removed. The presence of affected l.n. is important for assessing the prognosis and further determining the need for adjuvant therapy. Some literature data demonstrate good results of surgical interventions performed in accordance with the concept of embryonic planes and complete mesocolonic excision. D3 lymph node dissection is not performed in daily practice in some European countries and North America, unlike a number of Eastern countries. However, the level of vessel ligation remains the subject of scientific discussion. The purpose of this review was to analyze the available literature on the problem of choosing the level of lymph node dissection in CC surgery.
结直肠癌(Colorectal cancer, CRC)是现代肿瘤学的相关课题,在最常见的恶性肿瘤中排名第三。每年,全世界诊断出的结直肠癌新病例超过100万例,男性和女性人群的患病率大致相同。结肠癌(CC)占所有结直肠癌病例的一半以上,其发病率和死亡率仍然很高。手术仍然是治疗结直肠癌的主要方法,确定手术和淋巴结清扫的程度仍然是一个迫切的问题。在日本,首次提出了根据淋巴流出水平和与主要血管相关的位置对淋巴结群进行分类。根据日本结直肠癌协会(JSCCR)的l.n.分组编号,所有淋巴结都用三位数字编号。通常,淋巴源性转移发生在一个方向,如果肿瘤位于距离两条供血血管相同的距离,则可能发生双侧转移。对于右侧定位的肿瘤,所有位于肠系膜上动脉分支的淋巴结均被切除;对于结肠左半部分的肿瘤,所有位于肠系膜下动脉干的淋巴结均被切除。受影响的l.n.的存在对于评估预后和进一步确定是否需要辅助治疗是重要的。一些文献资料表明,按照胚胎平面的概念进行手术干预并完全切除肠系膜的效果很好。与许多东方国家不同,在一些欧洲国家和北美的日常实践中不进行D3淋巴结清扫。然而,血管结扎的水平仍然是科学讨论的主题。本综述的目的是对CC手术中淋巴结清扫水平选择问题的现有文献进行分析。
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引用次数: 0
EVOLUTION OF DRUG THERAPY FOR CLASSICAL HODGKIN LYMPHOMA 经典霍奇金淋巴瘤的药物治疗进展
Pub Date : 2022-08-31 DOI: 10.37748/2686-9039-2022-3-3-5
Yu. Samaneva, I. Lysenko, N. Nikolaeva, E. Kapuza, I. Kamaeva, Y. Gaysultanova, A. V. Tishina, T. F. Pushkareva
Hodgkin's lymphoma is a malignant disease of the lymphatic system. Hodgkin's lymphoma was first described by Dr. Thomas Hodgkin in 1832 and later named “Hodgkin's disease” by Samuel Wilkes. Hodgkin's lymphoma accounts for about 24 % of all lymphomas. Hodgkin's lymphoma is classified as classical and nodular lymphoid- predominant (Nodular type of lymphoid-predominant Hodgkin's lymphoma). Classical Hodgkin's lymphoma includes the following histologic variants: nodular sclerosis variant (types I and II), mixed cell variant, classic lymphocyte-rich variant, and rare lymphoid depletion variant. Epidemiological and serological studies showed the involvement of the Epstein- Barr virus into Hodgkin's lymphoma etiology, since its genome was found in the study of the biopsy material samples from patients with Hodgkin's lymphoma. A relationship with the human immunodeficiency virus (HIV) was revealed as well, and patients infected with HIV have a significantly increased risk of developing Hodgkin's lymphoma compared to healthy people. An in-depth study of the Hodgkin's lymphoma pathophysiology revealed new therapeutic targets in the treatment of this disease. All these discoveries changed the understanding of the Hodgkin's lymphoma pathogenesis, and were important for the development of new methods of treatment. The history of therapy begins on the cusp of the 19th and 20th centuries. Over the past four decades, achievements in radiation therapy and combined chemotherapy have significantly improved overall survival of patients with Hodgkin's lymphoma. Currently, more than 80 % of patients under 60 years old with first diagnosed Hodgkin's lymphoma can be cured from this disease after first-line chemotherapy.
霍奇金淋巴瘤是淋巴系统的恶性疾病。霍奇金淋巴瘤最早是由托马斯·霍奇金博士于1832年描述的,后来被塞缪尔·威尔克斯命名为“霍奇金病”。霍奇金淋巴瘤约占所有淋巴瘤的24%。霍奇金淋巴瘤分为经典型和结节型淋巴显性淋巴瘤(淋巴显性霍奇金淋巴瘤的结节型)。经典霍奇金淋巴瘤包括以下组织学变体:结节硬化变体(I型和II型)、混合细胞变体、经典淋巴细胞丰富变体和罕见淋巴细胞枯竭变体。流行病学和血清学研究表明,爱泼斯坦-巴尔病毒与霍奇金淋巴瘤的病因有关,因为在研究霍奇金淋巴瘤患者的活检材料样本时发现了它的基因组。与人类免疫缺陷病毒(HIV)的关系也被揭示出来,与健康人相比,感染HIV的患者患霍奇金淋巴瘤的风险显著增加。对霍奇金淋巴瘤病理生理学的深入研究揭示了治疗此病的新靶点。这些发现改变了人们对霍奇金淋巴瘤发病机制的认识,对开发新的治疗方法具有重要意义。治疗的历史始于19世纪和20世纪的风口浪尖。在过去的四十年里,放射治疗和联合化疗的成就显著提高了霍奇金淋巴瘤患者的总生存率。目前,60岁以下首次诊断为霍奇金淋巴瘤的患者,80%以上在一线化疗后可以治愈。
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引用次数: 0
EFFECTIVE USE OF EXTRACORPOREAL MEMBRANE OXYGENATION IN SURGICAL TREATMENT OF KIDNEY CANCER PATIENT WITH TUMOR THROMBOSIS 体外膜氧合在肾癌合并肿瘤血栓的手术治疗中的有效应用
Pub Date : 2022-08-31 DOI: 10.37748/2686-9039-2022-3-3-4
D. A. Rozenko, N. D. Ushakova, S. N. Tikhonova, A. M. Skopintsev, N. Popova, E. A. Marykov, A. A. Smirnov, A. D. Rozenko
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引用次数: 0
Genes copy number variation in colorectal cancer patients as a marker of the disease clinical outcome and response to therapy 结直肠癌患者基因拷贝数变异作为疾病临床结局和治疗反应的标志
Pub Date : 2022-06-19 DOI: 10.37748/2686-9039-2022-3-2-6
A. А. Maslov, L. K. Chalkhakhyan, S. Malinin, G. Kaminsky, E. Mirzoyan
Abnormal gene copies, a special type of genetic polymorphism, is a hallmark of most solid tumors, including colorectal cancer. Abnormal copy number of genes leads to tumor-specific genomic imbalance, which manifests itself already in precancerous precursor lesions. The aim of this review was to systematize the scattered data on changes in gene copy number observed in colorectal cancer and their impact on the outcome of the disease and response to therapy. The data from 58 studies was analyzed on gene copy number changes and their expression in primary carcinomas, cell lines and experimental models. This review examines the spectrum of genetic changes that lead to colorectal cancer, describes the most frequent changes in the number of gene copies at different stages of the disease, and changes in the number of gene copies that can potentially affect the outcome of the disease of individual patients or their response to therapy. In fact, aberrant gene copy number as a form of chromosomal imbalance affects a number of genes that provide a metabolic selective advantage for a tumor cell. Changes in the genes copy number in colorectal cancer patients not only positively correlate with changes in their expression, but also affect the levels of gene transcription at the genome-wide scale. Aberrant gene copy numbers are closely related to disease outcome and response to treatment with 5 fluorouracil, irinotecan, cetuximab and bevacizumab. Nevertheless, the possibility of translating the genes copy number index into clinical practice requires further research.
异常基因拷贝是一种特殊类型的基因多态性,是大多数实体肿瘤的标志,包括结直肠癌。基因拷贝数异常导致肿瘤特异性基因组失衡,这种失衡已经在癌前病变中表现出来。本综述的目的是将结直肠癌中观察到的基因拷贝数变化及其对疾病结局和治疗反应的影响的分散数据系统化。分析了58项研究的基因拷贝数变化及其在原发性癌、细胞系和实验模型中的表达。本综述研究了导致结直肠癌的遗传变化谱,描述了疾病不同阶段基因拷贝数最常见的变化,以及可能影响个体患者疾病结局或其对治疗反应的基因拷贝数的变化。事实上,作为染色体失衡的一种形式,基因拷贝数异常影响了许多为肿瘤细胞提供代谢选择优势的基因。结直肠癌患者基因拷贝数的变化不仅与其表达的变化呈正相关,而且在全基因组范围内影响基因转录水平。基因拷贝数异常与疾病结局和对5氟尿嘧啶、伊立替康、西妥昔单抗和贝伐单抗治疗的反应密切相关。然而,将基因拷贝数指数转化为临床应用的可能性还有待进一步研究。
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引用次数: 0
Modern treatment of ALK-positive non-small cell lung cancer alk阳性非小细胞肺癌的现代治疗
Pub Date : 2022-04-28 DOI: 10.37748/2686-9039-2022-3-2-5
D. Kharagezov, Y. Lazutin, E. Mirzoyan, A. Milakin, O. Stateshny, I. Leyman, M. A. Gappoeva, V. N. Vitkovskaya, K. D. Iozefi
Lung cancer (LC) takes the first place in the structure of overall oncology in males. More than 1.8 million of new cases of lung cancer (LC) are registered each year worldwide. LC is the leading cause of cancer death in both developing and developed countries, and the 5 years survival rate is as low as 19 %. Many factors explain such unsatisfactory outcomes, including the LC diagnosis at an advanced stage, when the currently available treatments can rarely provide cure. Non-small cell lung cancer (NSCLC) with chromosomal rearrangement of anaplastic lymphoma kinase (ALK) is sensitive to targeted therapy with tyrosine kinase inhibitors (TKIs). Tumor cells containing ALK fusion are sensitive to TKIs – targeted drugs that have significantly improved the results of treatment of patients with ALK-positive NSCLC, half of whom survive more than 6.8 years after diagnosis. The number of patients with ALK-positive NSCLC varies, so ALK rearrangements are detected in about 3–7 % of lung adenocarcinomas, which accounts for up to 60.000 new cases of the disease annually worldwide. ALK-positive NSCLC is observed almost exclusively in adenocarcinomas associated with persons of younger age, male and never smoked or smoked a little. Patients with ALK-positive stage I–III NSCLC are shown treatment similar to patients with wild-type NSCLC, including surgery, radiation therapy, chemotherapy or multimodal treatment, depending on the stage of the tumor process. Numerous ALK TKIs have been developed in recent years, including alectinib, which is the current preferred first-line agent for patients who haven’t received therapy. The study of the mechanisms of resistance has led to the development of next-generation ALK inhibitors that better penetrate the central nervous system, actively affecting brain metastases. This review highlights the current state and prospects for the development of ALK-positive NSCLC therapy.
肺癌(LC)在男性整体肿瘤结构中占据首位。全世界每年登记的肺癌新病例超过180万例。无论在发展中国家还是发达国家,LC都是癌症死亡的主要原因,其5年生存率低至19%。许多因素解释了这种令人不满意的结果,包括晚期LC诊断,而目前可用的治疗方法很少能治愈。具有间变性淋巴瘤激酶(ALK)染色体重排的非小细胞肺癌(NSCLC)对酪氨酸激酶抑制剂(TKIs)的靶向治疗敏感。含有ALK融合的肿瘤细胞对TKIs靶向药物敏感,这些药物显著改善了ALK阳性NSCLC患者的治疗结果,其中一半患者在诊断后存活超过6.8年。ALK阳性NSCLC患者的数量各不相同,因此在约3 - 7%的肺腺癌中检测到ALK重排,每年在全球范围内新发病例高达6万例。alk阳性非小细胞肺癌几乎完全发生在年龄较小、从不吸烟或少量吸烟的男性腺癌患者中。alk阳性I-III期NSCLC患者的治疗与野生型NSCLC患者相似,包括手术、放疗、化疗或多模式治疗,具体取决于肿瘤进程的阶段。近年来已经开发了许多ALK TKIs,包括alectinib,它是目前未接受治疗的患者首选的一线药物。对耐药机制的研究导致了下一代ALK抑制剂的发展,这些抑制剂可以更好地穿透中枢神经系统,积极影响脑转移。本文综述了alk阳性NSCLC治疗的现状和发展前景。
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引用次数: 0
Presepsin as a marker of sepsis in oncological patients after surgical interventions Presepsin作为肿瘤患者手术后脓毒症的标志物
Pub Date : 2022-04-28 DOI: 10.37748/2686-9039-2022-3-2-1
N. Guskova, A. A. Morozova, D. A. Rozenko, A. Alyoshkina, A. M. Skopintsev, O. Selyutina, N. Golomeeva, E. A. Guskova, A. Donskaya, I. Tselishcheva, A. Nozdricheva
Purpose of the study. Analysis of the possibility of using presepsin in the early diagnosis of sepsis in cancer patients after extensive surgical interventions for tumors of the thoraco-abdominal localization.Materials and methods. The study included 27 people: 10 healthy individuals (control) and 17 patients who received surgical treatment at the National Medical Research Center of Oncology for malignant neoplasms of thoraco-abdominal localization. In the blood of all patients, studies of sepsis markers were performed: presepsin (P-SEP), highly sensitive CRP (hsCRP) (PATHFAST, Japan), procalcitonin (PCT), interleukin 6 (IL6) (Cobas e 411, Germany), as well as lactate, total leukocyte count (WBC) with a leukocyte formula, a blood culture test for suspected septic complications included in a routine examination. The studies were carried out before and on the 2nd day after the operation. Data were assessed by comparing P-SEP levels with hsCRP, PCT, IL6, lactate, WBC, blood culture test results, and the clinical status of patients. Depending on the data obtained, 2 groups were distinguished: I – patients with confirmed sepsis (3 people), II – without sepsis (14 people). Statistical processing was performed using STATISTICA 13.0.Results. In the control group, the level of P-SEP was 182.7 ± 11.9 pg/ml. In patients before surgery, the marker values were 213.7 ± 47.7 pg/ml, which did not differ statistically from the control data and did not go beyond the reference values, as did the content of PCT, hsCRP, IL6. On the 2nd day after surgery, all patients showed unidirectional changes, characterized by an increase in the levels of the studied parameters, but with varying degrees of intensity. The most significant was the increase in the concentration of presepsin. At the same time, it was noted that the level of presepsin on the 2nd day after surgery in patients of group I patients with confirmed sepsis averaged 2577.5 ± 1762.5 pg/ml with a maximum level 4340.0 pg/ml, and in group II with In the absence of confirmed bacteremia, there was an increase in the level of presepsin 1205.0 pg/ml. The data obtained correlated with the dynamics of changes in the concentration of other sepsis markers – hsCRP, PCT, IL6. Thus, the study of the level of presepsin, along with widely used markers – hsCRP, PCT, IL6, allows diagnosing sepsis in the early postoperative period in cancer patients.Conclusion. In patients with malignant neoplasms of thoracoabdominal localization, changes in the levels of sepsis markers in the early postoperative period can be used as a basis for prescribing antibiotic therapy. Presepsin may be recommended for use as an early marker of sepsis in patients with oncological pathology.
研究目的:应用抑菌素早期诊断胸腹部肿瘤广泛手术后脓毒症的可能性分析。材料和方法。本研究共纳入27人:10名健康人(对照组)和17名在国家肿瘤医学研究中心接受胸腹部恶性肿瘤手术治疗的患者。在所有患者的血液中,进行脓毒症标志物的研究:presepsin (P-SEP),高敏感CRP (hsCRP) (PATHFAST,日本),降钙素原(PCT),白细胞介素6 (IL6) (Cobas e 411,德国),以及乳酸,白细胞总数(WBC),常规检查中包括怀疑脓毒症并发症的血培养试验。研究分别于术前和术后第2天进行。将P-SEP水平与hsCRP、PCT、il - 6、乳酸、WBC、血培养试验结果及患者临床状况进行比较。根据获得的数据,分为两组:I -确诊脓毒症患者(3人),II -无脓毒症(14人)。使用STATISTICA 13.0.Results进行统计处理。对照组P-SEP为182.7±11.9 pg/ml。术前患者标志物为213.7±47.7 pg/ml,与对照无统计学差异,PCT、hsCRP、IL6含量均未超过参考值。术后第2天,所有患者均出现单向变化,表现为研究参数水平升高,但强度不同。最显著的是抑菌素浓度的增加。同时,我们注意到确诊脓毒症的I组患者术后第2天的presepsin水平平均为2577.5±1762.5 pg/ml,最高水平为4340.0 pg/ml,而在没有确诊菌血症的II组患者中,presepsin水平升高1205.0 pg/ml。所获得的数据与其他脓毒症标志物hsCRP、PCT、il - 6的浓度变化动态相关。因此,研究presepsin的水平,以及广泛使用的标志物- hsCRP, PCT, IL6,可以在癌症患者术后早期诊断脓毒症。在胸腹恶性肿瘤患者中,术后早期脓毒症标志物的变化可作为处方抗生素治疗的依据。Presepsin可能被推荐作为肿瘤病理患者脓毒症的早期标志物。
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引用次数: 0
Modeling of multiple primary malignant tumors in experiment 多原发恶性肿瘤的实验建模
Pub Date : 2022-04-28 DOI: 10.37748/2686-9039-2022-3-2-2
E. Frantsiyants, I. Kaplieva, V. A. Bondovkina, E. Surikova, I. Neskubina, L. Trepitaki, Y. Pogorelova, N. Cheryarina, E. Sheiko, I. Kotieva, K. Shumarin
Purpose of the study. Creation and study of models of primary multiple malignant tumors (MMPT model) under experimental conditions.Materials and methods. The study was carried out involving male and female BALB/c Nude mice (n = 42). Experimental groups of mice: with melanoma B16/F10 (B16/F10), males (control 1) and females (control 3) by n = 7; control 2 – with sarcoma 45 (C45), males n = 7; control 4 – with Guerin carcinoma (KG), females n = 7; basic: MMPT model No. 1 – B16/F10 and S45, males n = 7, and MMPT model No. 2 – B16/F10 and GC, females n = 7. 0.5 ml suspension of murine B16/F10 melanoma tumor cells diluted in the saline proportions 1:20 was injected under the skin of the left dorsal side to all animals with MMPT model, as well as 0.5 ml of a suspension containing 0.50 × 106 S45 or GC tumor cells in the saline under the skin on the right dorsum. Control groups received the same amount of tumors as the MMPT model.Results. Tumors in male mice in MMPT model No. 1 appeared simultaneously and significantly earlier than in controls: В16/ F10 melanoma by 3 times, S45 by 2 times. Tumor zises in MMPT model No. 1 were larger than in the corresponding controls: by 8.5 times at the area of В16/F10 melanoma inoculation and by 2.2 times at the area of S45 inoculation. Melanoma metastasized under the S45 capsule. Tumor at the area of GC transplantation in MMPT model No. 2 grew 5 times faster than at the area of В16/F10 melanoma injection; both tumors appeared on average 3 times earlier than in control groups 3 and 4. Tumor volumes in MMPT model No. 2 were larger than in the corresponding controls: by 7.5 times at the area of В16/F10 melanoma inoculation and by 2.2 times at the area of GC inoculation. However, almost the entire volume of the tumor node in the area of B16/F10 melanoma transplantation was represented by GC tumor tissue due to metastasis from the primary GC tumor. Melanoma remained as a small black spot with a diameter of 5–6 mm at the area of its inoculation under the skin. The average survival of mice in MMPT models No. 1 and No. 2 was 1.5–2 times (p < 0.05) lower than in the corresponding controls.Conclusions. Sequential subcutaneous transplantation of mouse B16/F10 melanoma and rat sarcoma 45 to BALB/c Nude mice increased the malignant potential of each tumor: the time of their onset was shorter, and the growth rate of tumors increased which decreased the survival of animals. Sequential subcutaneous transplantation of mouse B16/F10 melanoma and Guerin's rat carcinoma to female BALB/c Nude mice suppressed tumor growth of B16/F10 melanoma and increased the malignant potential of rat GC.
研究目的:实验条件下原发性多发性恶性肿瘤(MMPT)模型的建立与研究。材料和方法。本研究采用雄性和雌性BALB/c裸鼠(n = 42)。实验组:黑色素瘤小鼠B16/F10 (B16/F10),雄性(对照1),雌性(对照3),每组n = 7;对照组2 -伴有肉瘤45 (C45),男性n = 7;对照组4 -合并Guerin癌(KG),女性7例;基本:MMPT模型1 - B16/F10和S45,雄性n = 7; MMPT模型2 - B16/F10和GC,雌性n = 7。所有MMPT模型动物左背皮下注射按1:20盐水稀释的小鼠B16/F10黑色素瘤肿瘤细胞悬液0.5 ml,右背皮下注射含0.50 × 106 S45或GC肿瘤细胞的悬液0.5 ml。对照组给予与MMPT模型相同数量的肿瘤。MMPT 1号模型雄性小鼠肿瘤同时出现且明显早于对照组:В16/ F10黑色素瘤出现3倍,S45黑色素瘤出现2倍。MMPT模型1的肿瘤大小比相应的对照组大:В16/F10黑色素瘤接种面积大8.5倍,S45接种面积大2.2倍。黑色素瘤在S45囊下转移。MMPT 2号模型GC移植区肿瘤生长速度比В16/F10黑色素瘤注射区快5倍;两种肿瘤的出现时间平均比对照组3和对照组4早3倍。MMPT模型2的肿瘤体积比相应的对照组大:В16/F10黑色素瘤接种面积大7.5倍,GC接种面积大2.2倍。然而,在B16/F10黑色素瘤移植区,由于原发胃癌的转移,几乎整个肿瘤淋巴结的体积都被胃癌组织所代表。黑素瘤在皮下接种处仍是一个直径5-6毫米的小黑点。1号和2号模型小鼠的平均存活率比相应对照组低1.5-2倍(p < 0.05)。小鼠B16/F10黑色素瘤和大鼠肉瘤45序次皮下移植BALB/c裸鼠后,各肿瘤的恶性潜能增加:发病时间缩短,肿瘤生长速度加快,降低动物存活率。小鼠B16/F10黑色素瘤和Guerin大鼠癌序次皮下移植雌性BALB/c裸鼠可抑制B16/F10黑色素瘤的肿瘤生长,增加大鼠GC的恶性潜能。
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引用次数: 3
Modern diagnostic and treatment methods in paranasal sinus malignant tumors 鼻窦恶性肿瘤的现代诊断与治疗方法
Pub Date : 2022-04-28 DOI: 10.37748/2686-9039-2022-3-2-4
Yulia Ulianova, M. Engibaryan, V. L. Volkova, N. A. Chertova, I. V. Aedinova, M. V. Bauzhadze, I. V. Pustovaya
Malignant tumors of the head and neck are still one of the most challenging problems of treatment in modern oncology. The disease affects mainly the capable people (from 30 to 60 years old). Tumor lesions of the paranasal sinuses lead to disability and have a high mortality rate. Head and neck tumors comprise of 20–30 % of all cancer cases. People with early paranasal sinus cancer have minor complaints, their general condition doesn’t get affected so they don’t seek for medical care in a while. As a result, patients start on treatment at tumor grades III–IV. This article provides the most complete information about the causes, frequency and special features of the course of paranasal sinus cancer, as well as about modern methods of it’s diagnosis and combination treatment. Despite the great advances in the treatment of these malignant tumors the three and five year survival rates remain unsatisfactory, which requires a research for new effective treatments. Currently the main treatment methods for these malignant tumors are combination and complex (involving surgery, radiotherapy and chemotherapy) treatments. The standard treatment approach includes radical surgical removal of the primary tumor and metastatic lymph nodes followed by radiation or chemoradiation therapy. Chemotherapy as monotherapy is administered in non-resectable primary or recurrent tumors, distant metastases or when a patient refuses the radical surgery. Improvement of existing treatment methods and development of new ones are an essential need. Earlier detection of the disease requires primary care physicians to be trained to diagnose tumor lesions of the paranasal sinuses, and highly specialized physicians (dentists, otorhinolaryngologists, maxillofacial surgeons, dermatologists) to express their cancer alertness.
头颈部恶性肿瘤仍然是现代肿瘤学治疗中最具挑战性的问题之一。这种疾病主要影响有能力的人(30至60岁)。鼻窦肿瘤病变可导致残疾,死亡率高。头颈部肿瘤占所有癌症病例的20 - 30%。患有早期鼻窦癌的人会有轻微的不适,他们的总体状况不会受到影响所以他们在一段时间内不会寻求医疗护理。因此,患者在肿瘤分级为III-IV级时开始接受治疗。本文就副鼻窦癌的病因、发病频率、病程特点、现代诊断和综合治疗方法等方面作了较为全面的介绍。尽管这些恶性肿瘤的治疗取得了很大的进步,但3年和5年的生存率仍然令人不满意,这需要研究新的有效治疗方法。目前这些恶性肿瘤的主要治疗方法是联合治疗和复杂治疗(包括手术、放疗和化疗)。标准的治疗方法包括根治性手术切除原发肿瘤和转移性淋巴结,然后进行放疗或放化疗。化疗作为单一疗法用于不可切除的原发性或复发性肿瘤、远处转移或当患者拒绝根治性手术时。改进现有的治疗方法和开发新的治疗方法是必不可少的。早期发现这种疾病需要初级保健医生接受培训,以诊断副鼻窦的肿瘤病变,并要求高度专业化的医生(牙医、耳鼻喉科医生、颌面外科医生、皮肤科医生)表达他们对癌症的警觉性。
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引用次数: 0
Post-radiation complications in children with acute lymphoblastic leukemia who underwent a course of cranial radiation 急性淋巴细胞白血病儿童接受颅脑放射治疗后的并发症
Pub Date : 2022-04-28 DOI: 10.37748/2686-9039-2022-3-2-3
T. S. Rogova, P. G. Sakun, V. I. Voshedskii, S. Vlasov, Y. Kozel, V. V. Dmitrieva, O. V. Kozyuk, K. Aslanyan, E. Vasileva
Purpose of the study. To analyze the physical and neuropsychiatric development of pediatric patients who underwent cranial irradiation in the period from 2015 to 2020 in the radiotherapy department of the National Research Center of Oncology and to assess the risk of post-radiation complications.Materials and methods. 17 children aged from 3 to 17 years were hospitalized under medical supervision in the department of pediatric oncology of the National Medical Research Centre for Oncology. All the children underwent a course of conformal radiation therapy totally on the brain area and the first two cervical vertebrae in the radiotherapy department of the National Medical Research Centre for Oncology. 13 patients (76.7 %) underwent radiation therapy due to the prevention of neuroleukemia with a total dose of 12 Gy (a dose per fraction was 2 Gy), 2 patients with a confirmed relapse of acute lymphoblastic leukaemia (ALL) (11.65 %), 1 patient with a confirmed diagnosis of neuroleukemia (5.8 %) and 1 patient from the high-risk group (5.8 %) – with a total dose of 18 Gy (a dose per fraction was 2 Gy). Further 75 month regular medical checkup was carried out on the basis of the Regional Children's Clinical Hospital for.Results. None of the surviving patients showed growth retardation. Two patients (11.65 %) complained of increased fatigue, decreased concentration; one patient (5.8 %) showed unmotivated irritability and aggression during the examination. Intellectual development corresponded to age in all patients (100 %). One patient (5.8 %) experienced episodes of nausea and vomiting (grade 1 on the CTCAE scale), three patients (17.7 %) suffered from headache (grade 2 on the CTCAE scale), three patients (17.7 %) complained of fever up to 38 °C (1 degree on the CTCAE scale). Two out of 17 ALL patients died due to disease progression.Conclusion. Taking into account the different time intervals between treatment and the moment of the study (from 9 to 75 months), cranial irradiation demonstrates relative safety for patients undergoing treatment during critical periods of development of both physical and neuropsychic spheres. However, an objective assessment of the development prospects is difficult due to the relatively short time after undergoing therapy (from 9 to 75 months) and a small sample of patients.
研究目的:分析2015 - 2020年在国家肿瘤研究中心放疗科接受颅脑放疗的儿童患者的生理和神经精神发展情况,并评估放疗后并发症的风险。材料和方法。17名年龄在3岁至17岁之间的儿童在国家肿瘤医学研究中心儿科肿瘤科的医疗监督下住院。所有患儿均在国家肿瘤医学研究中心放射治疗科接受了全脑及前两段颈椎适形放射治疗,其中13例(76.7%)因预防神经性白血病而接受放射治疗,总剂量为12 Gy(每分数剂量为2 Gy), 2例确诊急性淋巴细胞白血病(All)复发(11.65%)。1名确诊为神经白血病的患者(5.8%)和1名来自高危组的患者(5.8%)-总剂量为18 Gy(每部分剂量为2 Gy)。此外,还在地区儿童临床医院进行了为期75个月的定期体检。存活的患者均未出现生长迟缓。2例患者(11.65%)主诉疲劳加重、注意力下降;1例患者(5.8%)在检查时表现为无动机的烦躁和攻击性。所有患者的智力发育都与年龄相符(100%)。1例患者(5.8%)出现恶心和呕吐发作(CTCAE等级为1级),3例患者(17.7%)出现头痛(CTCAE等级为2级),3例患者(17.7%)主诉发烧高达38°C (CTCAE等级为1度)。17例ALL患者中2例因疾病进展死亡。考虑到治疗和研究之间的不同时间间隔(从9个月到75个月),在身体和神经精神领域发育的关键时期接受治疗的患者,颅照射显示出相对安全性。然而,由于接受治疗后的时间相对较短(9 - 75个月),且患者样本较少,很难对其发展前景进行客观评估。
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引用次数: 0
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South Russian Journal of Cancer
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