Arkhiv patologii最新文献

The degree of pathologic response in non-small cell lung cancer (NSCLC) after neoadjuvant therapy (NAT) has prognostic impact as well as influence on patient's management. It was shown that the best survival rates were achieved in patients with equals or less than 10% of residual carcinoma (major pathologic response) or with complete absence of invasive carcinoma (complete pathologic response). In 2020 the International Association for the Study of Lung Cancer has published Multidisciplinary Recommendations for pathologic assessment of NSCLC resection specimens after NAT. In this article, we present the main points of the Recommendations taking into account our own experience in evaluating post-therapeutic changes in NSCLC. The article is intended primarily for pathologists practicing in oncological hospitals, but may also be of interest to other practitioners involved in the diagnostics and treatment of lung cancer patients.

The question of the degree of influence of uterine artery embolization (UAE) on fertility is open. It is important to evaluate the pathomorphological structure and functional activity of the endometrium, the disruption of which can lead to infertility.

Objective: To study morpho-functional changes in the endometrium of patients with uterine fibroids before and after UAE.

Material and methods:

116 patients were divided into 2 groups depending on the type of the leading fibroid node: 1^st - 54 patients examined with uterine fibroid (UF) types 2, 2-5, 3, 2^nd - 62 patients observed with UM types 4, 5, 6.

The comparison group - 30 healthy women. Aspiration biopsy of the endometrium was performed in the middle stage of the secretory phase before and 6-12 months after UAE. The percentage and maturity of pinopodes, the expression level of estrogen (ER), progesterone (PR) receptors in the glands, endometrial stroma, inflammatory markers (CD56+, CD138+) were determined.

Results: The negative impact of UF on the morpho-functional state of the endometrium was determined. Changes were more pronounced in patients of 1^st group. Stroma indices before and after UAE corresponded to comparison group in most patients. After UAE, the number of mature pinopodes decreased in 1^st group, but not in 2^nd group. ER and PR expression levels in the glandular component decreased in all patients, being consistently higher in 1^st group. An increase in proinflammatory markers was observed only in 1^st group.

Conclusion: UF and UAE can disturb morpho-functional state of the endometrium. The impact assessment should be made taking into account the topographic and anatomical location of the myomatous node.

This lecture provides data on the role of philosophy in modern pathologic anatomy. Subjects and activities, objects, methods of lifetime and postmortem studies are consecutively considered.

Malakoplakia is a rare chronic inflammatory disease that mainly affects the genitourinary system. A case of malakoplakia in the retroperitoneal space in a 53-year-old female patient with abdominal pain syndrome is presented. According to the results of computed tomography and magnetic resonance imaging of the abdominal organs and retroperitoneal space, the changes were assessed as nonspecific. Diagnostic biopsy revealed specific microscopic signs - the presence of inflammatory cell infiltration in the soft tissues of the retroperitoneal space with an abundance of CD68-positive macrophages containing PAS-positive cytoplasmic inclusions - Michaelis-Gutman bodies. Morphological examination allows differential diagnosis of malakoplakia with other pathological processes.

Immunohistochemical study is an integral component of modern morphologic diagnostics, providing accurate marker detection and identification of molecular subtypes of malignant neoplasms. A quality control system is fundamental in the aspect of standardizing laboratory protocols, ensuring reproducibility of results and increasing the reliability of diagnostic conclusions.

Objective: To conduct a comprehensive assessment of the quality of immunohistochemical studies at the successive stages of the laboratory process (pre-analytical, analytical, post-analytical) in medical organizations that are participants of the external quality control program of the IHC Quality Control Center of Russian Medical Academy of Continuous Professional Education for 2024.

Material and methods: The present study analyzed the results of external quality control rounds initiated by the Quality Control Center. The nature and frequency of errors at all stages of immunohistochemical study, including procedures for fixation of biological material, methodology of immunohistochemical staining, and interpretation of the results obtained were evaluated. Analytical evaluation was carried out by experts in accordance with the criteria of international standards (CAP, NordiQC).

Results: The analysis of the pre-analytical stage revealed methodological inconsistencies related to the processes of fixation of biological material, to the degree of DNA degradation and to the qualitative characteristics of histologic processing. At the analytical stage, the main errors were inadequate selection of antibodies and detection systems, and insufficient validation of diagnostic protocols.

The postanalytic phase was characterized by a predominance of factors of incorrect conclusions, including errors in interpretation of HER2 status and molecular genetic subtypes of breast carcinoma. Repeated rounds of follow-up demonstrate that implementation of expert recommendations contributes to statistically significant improvements in diagnostic quality.

Conclusion: The system of external quality control of immunohistochemical studies represents a key tool to optimize the accuracy and reproducibility of morphological diagnostics. Systematic participation of laboratories in control programs, standardization of methodological approaches and improvement of professional qualification of specialists ensure minimization of diagnostic errors and increase of clinical significance of research results.

Objective: To characterize infectious diseases of the respiratory system in Irkutsk based on autopsy data for 2023.

Material and methods: The results of 1166 autopsies of those who died in multidisciplinary hospitals in Irkutsk in 2023 were analyzed. The data of macro- and microscopic, immunohistochemical, bacterioscopic, microbiological studies, and PCR were evaluated.

Results: The total number of deaths from infectious diseases of the respiratory system was 683 - 59% of the total number of autopsies. Of these, acute pneumonia, including secondary, was 557 (48%). The etiology of secondary pneumonia is in most cases associated with Klebsiella pneumoniae, including in various combinations with other pathogens. The largest number of registered secondary pneumonias occurred during the period of increased incidence of acute respiratory viral infections and influenza. Among those who died from tuberculosis, HIV-infected individuals predominated; in 67% of cases, the etiology of the disease was associated with the Beijing genotype.

Conclusions: Infectious diseases of the respiratory system remain one of the most pressing problems in medicine, and acute secondary pneumonia is the most common complication and the most common cause of death of patients in somatic hospitals in Irkutsk.

Objective: To define the diagnostic value of eosinophilic cells for the detection of BRAF-mutated serous borderline ovarian tumors.

Material and methods: The study included 42 cases of serous borderline ovarian tumor, each of which was analyzed by 3 pathologists for the presence of eosinophilic cells. Genetic profiling using Sanger sequencing was performed to identify the BRAF^V600E mutation. Comparisons between two groups were performed using the Mann-Whitney test, Fisher's exact test. Fleiss's kappa was used to assess the interobserver agreement. To assess the diagnostic value of eosinophilic cells, sensitivity and specificity were assessed.

Results: According to the results of a genetic study, the BRAF^V600Emutation was found in 19 of 42 tumors. When analyzing interobserver agreement, the Fleiss's kappa values allowed us to determine the reliability of the test as sufficient (ϰ=0.7). The sensitivity and specificity for predicting BRAF^V600Emutation for eosinophilic cells were 78.9% and 91.3%, respectively. Patients with the BRAF^V600E mutation were significantly younger than patients without it. Thus, the average age of patients in the group with the BRAF^V600E mutation was 33.6±15.6 years, while in the group of tumors without the mutation the average age of patients was 43.9±12.7 years (p=0.002). Non-invasive implants were less frequently found in tumors with the BRAF^V600E mutation compared to tumors without the mutation: 11.76% (2/17) versus 33.3% (6/18), respectively, but these differences were not statistically significant (p=0.228).

Conclusion: Eosinophilic cells in ovarian serous borderline tumors may sufficiently reflect the BRAF^V600E mutation, thereby correlating with disease prognosis (low risk of progression to low-grade serous carcinoma).

Adenocarcinoma and adenosquamous carcinoma of the cervix together account for up to 20% of all cervical cancers. These histologic subtypes are characterized by a worse prognosis compared with squamous cell cancer of the same grade and have specific epidemiologic, morphologic and molecular features. Despite fundamental differences, therapeutic approaches for cervical cancer are similar regardless of tumor histology. This article discusses promising companion diagnostic markers for cervical cancer treatment, including MSI, PD-L1 and TIL's, that may find application in the therapy of prognostically unfavorable subtypes of cervical cancer. The literature review revealed that despite the low frequency of immunotherapy markers among adenocarcinomas and adenosquamous carcinomas of the cervix, analyzing them will allow us to identify a group of patients who will benefit most from immunotherapy, a key step towards improving treatment outcomes.

On December 5, 2024 it was 100 years since the birth of Viktor Viktorovich Serov, Doctor of Medical Sciences, Professor, Academician of the Russian Academy of Medical Sciences.

The development of drugs with the ability to increase differentiation and reduce tumor malignancy is one of the promising directions in the treatment of breast cancer (BC). As such, Human Leukemia Differentiation Factor (HLDF), a protein consisting of 54 amino acids and contributing to an increase in the degree of differentiation of invasive ductal breast carcinoma cells, can be used. The key disadvantage of the full-size HLDF is its rapid biodegradation. In this connection, the acetylamide form of the peptide (HLDF-6) was synthesized to protect against hydrolysis.

Objective: To evaluate the effect of HLDF-6 on cell differentiation in various molecular biological subtypes of breast cancer.

Material and methods: The relative content of tumor cells of various degrees of differentiation in biopsies of 33 women with breast cancer when exposed to HLDF-6 tumor was evaluated.

Results: HLDF-6 significantly increases the relative content of differentiated cells in the luminal B HER2-negative subtype of breast cancer, without significantly affecting the cells of patients with luminal A and basal-like subtypes.

Conclusion: The study revealed the prospects of using HLDF-6 as part of differentiating therapy in patients with luminal B HER2-negative subtype of breast cancer.