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Background. Amputation was historically the primary surgical intervention for children with limb bone sarcomas. However, the development and refinement of chemotherapy and radiotherapy protocols, along with advances in surgical techniques and implants, have significantly altered the treatment landscape for these patients. Currently, limb-sparing oncologic arthroplasty is the preferred surgical approach for treating limb sarcomas in children. The aim of the systematic review is to analyse the outcomes of oncologic arthroplasty in children and adolescents. Methods. A comprehensive literature search was performed in Google Scholar, PubMed, ScienceDirect, and eLIBRARY databases focusing on the keywords “endoprostheses, tumors, children”, from 2000 to 2024. Data collection included patient demographics (number of patients, gender, age), follow-up period, disease diagnosis, tumor location, type of endoprosthesis, complications, functional outcomes based on the Musculoskeletal Tumor Society score (MSTS) in percentage, overall survival rates, and prosthesis survival rates. Results. The review included the data from 30 articles on a total of 792 patients aged 2 to 18 years, with 422 males and 370 females. The average age was 11.4 years, and the average follow-up period was 6.5 years. Osteosarcoma was the most common diagnosis, accounting for 716 (88.8%) cases, followed by Ewing sarcoma with 67 (8.3%) cases. Distal femoral arthroplasties were performed most frequently (573 cases, 71.1%), followed by proximal tibial arthroplasty (148 cases, 18.3%). The most commonly used type of endoprosthesis was the non-invasively extendable type (540 cases, 67%). A total of 756 complications were recorded, resulting in a complication rate of 96%. The complications were predominantly oncologic (188 cases, 25%) and pediatric orthopedic (166 cases, 22%). The 5-year and 10-year overall survival rates were 81.68% and 77.63%, respectively, with an average prosthesis survival rate of 53.93%. Conclusion. The data obtained indicate an extremely high frequency of complications during oncologic arthroplasty in children, mainly of an orthopedic profile, which requires analysis and development of measures to prevent them, as well as organizational solutions for the correction of these disorders.

Aim – assessment of the effectiveness of complex therapy to reduce the development of early cardiovascular complications. Materials and methods. Information from medical histories and outpatient follow-up cards of 139 patients with invasive breast cancer was analyzed: in the G.V. Bondar Republican Cancer Center 64 patients (main and control groups); as an additional comparison group, the study included 75 patients of the Samara Regional Clinical Oncology Dispensary. Patients in the control group (33 people) and the Samara Regional Clinical Oncology Dispensary group (75 people) received standard therapy (RUSSCO, recommendations, 2023): doxorubicin 60 mg/m2 IV on day 1 + cyclophosphamide 600 mg/m2 IV on day 1 Day 4 – 4 courses. In 31 patients of the main observation group, in addition to similar drug treatment, in order to prevent the development of early cardiovascular complications, the method was used, which included 7 courses before the start of 1 cycle of chemotherapy + 3 courses of interval normobaric hypoxic therapy (INHT) before the start of each subsequent cycle of chemotherapy. Results. When analyzing the total effectiveness of treatment between the groups of patients, statistically significant differences were obtained: the control and main groups were compared (χ2=5.4, p=0.03), the group of the Samara Regional Clinical Oncology Dispensary group and the main group (χ2=3.45, p=0.076). Conclusions. Hypoxic therapy significantly affects the quality of life of patients. For all indicators reflecting quality of life, traditional treatment was inferior to combination drug therapy with INHT.

Background. Real-world data studies are an important source of knowledge on malignant tumors and their treatment. This knowledge is a tool for making decisions by health care professionals and patients. Regarding this, authors conducted literature search to identify real-world data studies published in the Russian scientific journals.Objective. The study aim was finding and analyzing publications on real-world evidence studies in oncology therapeutic area.Materials and methods. Full-text articles published in the Russian peer-reviewed medical scientific journals of 2022 and 2023 were systematically relieved and analyzed.Results. 119 publications were selected. The following types of study data were identified: 1) data on patients management practice; 2) survival and other oncology outcomes regardless of treatment approach; 3) survival and other oncology outcomes depending on treatment approach; 4) efficacy of a concrete therapy; 5) treatment safety (toxicity) data; 6) clinical and demographic prognostic factors; 7) tumor (morphological, molecular and genetic) prognostic factors; 8) tumor characteristics (morphological, molecular and genetic) regardless of their prognostic significance; 9) oncology disease characteristic (e. g., comorbidities) regardless of its prognostic significance. The most common types of study data were the following: clinical and demographic prognostic factors — 24 studies; tumor (morphological, molecular and genetic) prognostic factors — 36 studies; tumor characteristics (morphological, molecular and genetic) regardless of their prognostic significance — 38 studies.Conclusion. The modern real-world data studies in oncology therapeutic area are a very important source of knowledge on malignant tumors and their treatment.

The study of the human microbiome is one of the most pertinent areas of science and medicine today. The impact of changes in the microbiome is widely discussed in the context of new approaches to the diagnosis, treatment and prevention of many diseases. At the same time, approaches to the management of patients with precancerous and cancerous diseases are changing along with the discovery of new approaches to the management of this category of patients. Scientists all over the world are studying changes in the vaginal microbiome and its role in the female oncological pathology. This article contains the latest information in this direction. It is known that the vaginal microbiome is predominantly composed of anaerobic and facultative anaerobic flora. Normally, the dominant bacteria in the vagina are lactobacilli. A decrease in the number of lactobacilli facilitates the penetration of pathogenic bacteria and the development of sexually transmitted diseases and precancerous transformations. Studies on the effectiveness of chemotherapy have shown that interventions in the vaginal-cervical microbiome can improve patient response to platinum-based drugs and enhance the therapeutic effect of chemotherapy. Several studies have reported an increased prevalence of Sneаthia spp. in the vaginal microbiome of patients with high-risk human papillomaviruses, cervical intraepithelial neoplasia and invasive cervical carcinoma. Further research is needed on microbiome changes in vaginal and vulvar cancer. The composition and functions of the vaginal microbiome have been shown to change in women with human papillomavirus. In future studies, it is necessary to conduct analyses in larger samples and more complex populations, taking into account differences in the clinical characteristics of women and focusing on dynamic changes in cancer occurrence, in order to understand the overall development of the disease and the general trend of microbiome changes in gynecological cancer. In addition, close attention should be paid to the development of individualized screening and treatment, and by studying differences in populations, screening and treatment plans can be more precisely formulated and have better results.

Introduction. The discovery of two EBV types (EBV-1 and EBV-2) has stimulated the study of their prevalence in populations and association with malignancies. Objective. To study the prevalence of EBV-1 and EBV-2 types among ethnic groups in Russia, to analyze PCR products of the LMP1 gene in virus isolates, and to evaluate the contribution of EBV types to the incidence of malignant neoplasms. Materials and methods. EBV isolates from oral lavages of the Republics Adygea, Kalmykia, Tatarstan and the Moscow Region (MR) representatives were studied by nested PCR for the belonging to EBV-1 and EBV-2 types. LMP1 amplicons obtained by real-time PCR from viral isolates DNA were classified and sequenced on an automatic DNA sequencer ABI PRISM 3100-Avant (USA). The sequencing results were analyzed using Chromas 230 and Vector NT programs (Invitrogen, USA). The reliability of the obtained data was assessed using statistical packages Statistica for Windows, 10.0. Results. The prevalence rates of EBV-1 and EBV-2 in representatives of four ethnic groups were compared with the incidence rates of some tumors in the population of three Republics and MR. The dominant persistence of the transforming in vitro EBV-1 type in representatives of the Republic of Tatarstan and MR correlated with a high incidence of gastric cancer and lymphomas in the population of these territories. On the contrary, predominant infection of the non-transforming in vitro EBV-2 type and both types of the virus in approximately the same percentage of representatives of Adygea and Kalmykia, respectively, correlated with a lower level incidence of above tumors in populations of these Republics. The differences between the incidence rates of neoplasms in the compared ethnic populations were statistically insignificant (p 0.05). LMP1 variants of viral isolates did not reflect either the level of EBV persistence types or the incidence of tumors. Conclusion. Infection of ethnic groups with EBV-1 and EBV-2 may vary significantly under the influence of various factors. The predominance of the in vitro transforming EBV-1 type in the population did not increase the incidence of tumors due to cases associated with the dominant virus type.

This review discusses the uniqueness of mitochondria providing normal cellular functions and at the same time involved in many pathological conditions, and also analyzes the scientific literature to clarify the effectiveness of mitochondrial transplantation in cancer treatment. Being important and semi-autonomous organelles in cells, they are able to adapt their functions to the needs of the corresponding organ. The ability of mitochondria to reprogram is important for all cell types that can switch between resting and proliferation. At the same time, tumor mitochondria undergo adaptive changes to accelerate the reproduction of tumor cells in an acidic and hypoxic microenvironment. According to emerging data, mitochondria can go beyond the boundaries of cells and move between the cells of the body. Intercellular transfer of mitochondria occurs naturally in humans as a normal mechanism for repairing damaged cells. The revealed physiological mitochondrial transfer has become the basis for a modern form of mitochondrial transplantation, including autologous (isogenic), allogeneic, and even xenogenic transplantation. Currently, exogenous healthy mitochondria are used in treatment of several carcinomas, including breast cancer, pancreatic cancer, and glioma. Investigation of the functional activity of healthy mitochondria demonstrated and confirmed the fact that female mitochondria are more efficient in suppressing tumor cell proliferation than male mitochondria. However, tissue-specific sex differences in mitochondrial morphology and oxidative capacity were described, and few studies showed functional sex differences in mitochondria during therapy. The reviewed studies report that mitochondrial transplantation can be specifically targeted to a tumor, providing evidence for changes in tumor function after mitochondrial administration. Thus, the appearance of the most interesting data on the unique functions of mitochondria indicates the obvious need for mitochondrial transplantation.

Rationale. The discovery of two Epstein–Barr virus (EBV) types, EBV-1 and EBV-2, which differ in their transforming abilities stimulated their study in various populations in order to elucidate the relationship with malignant neoplasms.Aim. To study EBV-1 and EBV-2 in representatives of four ethnic groups of Russia, sequence analysis of the LMP1 oncogene in virus isolates, and search for a correlation between the types of EBV and the incidence of certain types of malignant tumors in four ethnic groups.Materials and methods. From total DNA obtained from oral washings of Adygeans, Kalmyks, Tatars and Slavs, representatives of 3 Russian republics and the Moscow region, EBV DNA was amplified; its presence and concentration were analyzed by nested PCR, and each product was examined for the virus type and LMP1 variant. Types of EBV found in representatives of In four ethnic groups were compared with the incidence rates of malignant tumors, among which EBV-associated cases may occur, in population of three republics and the Moscow region.Results. It was observed that higher gastric cancer and lymphomas morbidity among Tatarstan and Moscow region populations (compared to populations of Adygea and Kalmykia) correlated with predominance in these ethnic groups – Tatars and Slavs – EBV-1 type having transforming potential in vitro. In Adygeis, non-transforming EBV-2 type was prevalent, and Kalmyks were infected with both types in approximately equal proportion. however, differences between tumor morbidities between the compared groups were statistically insignificant (p >0.05). The identified spectrum of LMP1 variants, as well as the results of their sequencing, show genetic relations between EBV strains circulating in the studied ethnic groups.Conclusion. Study of EBV isolates for the first time performed in 4 ethnic groups of this country showed differences in distribution of the types of this virus but there was no correlation with tumor morbidity.

Introduction. Head and neck squamous cell carcinoma is the 6th most common malignant tumor. It is characterized by immune response evasion and drug resistance. To stimulate antitumor immune response, antibodies against such cell cycle checkpoints as programmed cell death 1 (pD-1) and programmed death-ligand 1 (pD-L1) are used. However, effectiveness of monotherapy with these checkpoint inhibitors turned out to be low, and combinations with other antitumor drugs have high risk of adverse events.Aim. To determine the most practical ways to influence epigenetic factors in treatment of head and neck squamous cell carcinoma.Materials and methods. Scientific literature published between 2011 and 2022 and indexed in the eLIBRARY, Scopus, woS, NCBI databases (398 articles, of which 76 were used) was analyzed.Results. prospects of development of epigenetic stimulation of expression of retroelements located in tumor genomes through inhibition of DNA methyltransferases, deacetylases and histone methyltransferases were considered. when retroelements are activated, their transcripts form double-stranded RNA stimulating T killers and interferon response (virus mimicry). for DNA methyltransferase inhibitors, restoration of tumor suppressor genes which are hypermethylated in squamous cell carcinoma is also observed. However, retroelement activation is a driver mechanism of carcinogenesis, and their nonspecific expression can lead to tumor progression and formation of secondary tumors. Therefore, in the virus mimicry method it is practical to use as targets microRNA complementary to retroelements which recruit epigenetic factors to their loci (RNA-directed DNA methylation), as well as antisense oligonucleotides against oncogenic microRNA associated with retroelements. These approaches allow to inhibit retroelements participating in carcinogenesis. Nonspecific method of retrotransposon activity suppression is being developed in antitumor therapy, but data show successful application of only reverse transcriptase inhibitors preventing insertions and progression of genomic instability. we have performed analysis of scientific literature on transposable elements-derived microRNA associated with head and neck squamous cell carcinoma. As a result, 31 microRNAs were identified, derived from: LINE: miR-1249, -151a, -211, -2355, -28, -31, -3144, -374a, -374b, -421, -450b, -511, -576, -577, -582, -708, -769, -887, -95; HERv: miR-1269a, -1911, -3200, -495; non-autonomous SINE: miR-335, -342, -378a, -3934, -487b; DNA transposons: miR-224, -584, -652. These microRNAs can serve as the basis for epigenetic therapy of head and neck squamous cell carcinoma.

Objective ‒ to improve reconstructive and plastic methods of treatment of patients with malignant tumors that spread beyond the brain skull to ensure a decent quality of life. Materials and methods. The results of a comprehensive clinical examination and surgical treatment (with a reconstructive component) of 21 patients with scalp and skull tissue defects operated on in the extracerebral tumor clinic of Romodanov Institute of Neurosurgery of NAMS of Ukraine in the period from 2018 to 2021. There were 9 women and 12 men among the patients. The age of the patients is from 36 to 80 years old. All patients underwent clinical, neurological and instrumental examinations. The diagnosis was verified by the results of histopathomorphological examination. Statistical methods (discriminant analysis (MANOVA)) were used for data processing. Statistical significance was tested using the Pearson test (χ²). Results. The patients were divided into two groups. The main group (n=16) – operated on using adapted patented plastic techniques that take into account the optimal angle of direction of stress vectors in the tissue of skin-aponeurotic flaps in the postoperative period during stress relaxation. The comparison group was made up of 5 people operated on using traditional methods of mobilization and fixation of skin-aponeurotic flaps. Using the patient’s own tissues is the most reliable and effective method of cosmetic restoration of the head after radical treatment for locally advanced tumors. Active tactics (postoperative monitoring of the flap) make it possible to detect blood circulation disorders in the transplanted tissues at an early stage and to carry out a timely revision of the anastomoses. Performing simultaneous reconstructive operations is an integral part of complex treatment of patients with malignant tumors, expands the indications for performing gentle operations, allows to obtain «excellent» and «good» functional and aesthetic results in 85 % of cases. Simultaneous microsurgical reconstructive operations are possible in patients after complex treatment, although the frequency of thrombotic complications in this group was higher (12.5 %) than in the comparison group (7.5 %). Conclusions. The perspective of plastic-reconstructive replacement of defects for clinical application has been proven and the method has been improved using the latest technologies. Key words: malignant tumors; intracranial/extracranial spread; surgical treatment; reconstruction; quality of life.

Computed tomography (CT) of the brain has changed diagnostic neuroradiology significantly over the past 50 years since it was firstly used back in 1971 to visualize suspected frontal lobe tumour. The safety of head CT is determined by the small amount of radiation and the low sensibility of brain tissue to cytotoxic damage due to ionizing radiation compared to other organs. However, some population groups may be at increased risk. Thus, children are more susceptible to radiation cancer than adults and lifelong attributive risk (LAR) can be more than 10 times higher for an infant than for a middle-aged adult. The authors have reviewed published studies that examined the prevalence and mortality of intracranial tumors in children undergoing head CT in comparison to unaffected individuals. Electronic search of publications in the PubMed database from 1966 to date was carried out. We have carried out intersectoral search for documents containing keywords or medical subject headings (MeSH) related to three wide categories: 1) computed tomography, 2) radiation-induced tumors, 3) risk, morbidity or epidemiology. Further search was performed in manual mode. Available epidemiological data generally confirmed correlation between head CT and tumor growth induction. Thus, current epidemiological data accept the opinion that the risk of tumor induction associated with head CT in children is very small (one tumor per 3,000–10,000 studies). The minimal estimated risk of tumor induction due to head CT in children is mostly offset by its diagnostic imaging benefits considering the clinical indications to minimize radiation dose. Understanding and quantitative risk assessment of carcinogenesis associated with CT imaging led to dose reduction in pediatric CT protocols. This trend should continue and should be implemented in all age groups. Although the decision to perform head CT is often undeniable (injury or hemorrhage), careful assessment of studies frequency is required, especially in patients who need disease monitoring. Cumulative effect in such cases may increase the minimal risk of carcinogenesis. Larger and advanced epidemiological studies are required to better understand these risks.

The review contains information about the most common pathogens of infective endocarditis (IE) in certain categories of patients. Basing on analysis of current national and foreign sources concerning IE study there are description of conditions favoring to dominance of various microorganisms in intravenous drug users, HIV-infected patients, patients on hemodialysis, with valve prostheses, diabetes mellitus and malignant neoplasm patients, elderly patients, and pregnant women.Distribution of both as typical for IE (staphylococci, streptococci, enterococci) and rare microorganisms as well polymicrobial endocarditis in mentioned above groups is considered. There is discussion about possible reasons of prevalence of methicillin-sensitive or methicillin-resistant Staphylococcus aureus species in different IE patient categories, disease development initiated by rare forms of microbial agents in immunosuppressive patients, microbial flora features depending on terms valvular infection after valve prosthetics. Despite on consideration about predominance of one or another microorganism as an etiologic agent of IE in given clinical situation, during medical help providing it should strive for precise verification of an etiologic factor for choice of effective antibacterial treatment.

Pruritus is one of the subjective sensations that significantly reduces the quality of life of patients. In patients with malignancies, itch can be caused by different universal or specific pathophysiological factors. This article discusses disorders that cause pruritus in cancer patients: the tumor growth on its own; pathophysiological changes associated with a number of malignancies, paraneoplastic itch, anticancer therapy, concomitant dermatoses, systemic diseases, psychosomatic disorders. Known or proposed mechanisms of the development of pruritus are presented for each of the mentioned provoking factors, and methods of treatment are described, according to the etiological factor. At the end of the article, universal methods for the correction of itching are presented, applicable in cancer patients, regardless of the pruritogenic factor. Special attention is paid to the correction of xerosis as a universal cause of itching in oncological patients.

Purpose of the study: Analysis of available data on geno-phenotypic correlations and atypical forms of neurofibromatosis type 1. Material and methods. We searched for relevant sources in the Scopus, Web of Science, PubMed systems, including publications from May 1993 to October 2021. Of the 318 studies we identified, 59 were used to write a systematic review. Results. We found studies describing atypical forms of neurofibromatosis type 1 with an erased course without manifestation of a tumor syndrome, which are caused by specific mutations in the NF1 gene (causing substitutions of amino acids in neurofibromin: p.Arg1038, p.Met1149, p.Arg1809, or deletion of amino acids: p.Met990del, p.Met992del). NF1 patients with microdeletions are characterized by more severe disease symptoms (more often facial dysmorphism, skeletal and cardiovascular abnormalities, learning difficulties, and symptomatic spinal neurofibromas). mutations of splicing sites and extended deletions of the NF1 gene are associated with early manifestation of tumors, mutations at the 5’-end of the gene, causing a shortening of the protein product, are associated with optic nerve gliomas. the mutation c.3721C>T (p.R1241*) correlated with structural brain damage, and c.6855C>A (p.Y2285*) with endocrine disorders. the manifestations of NF1, similar to lipomatosis and Jaffe-Campanacci syndrome, not associated with a specific type of mutation are described. Conclusion. In spite of pronounced clinical variability of the disease, even among members of the same family, several studies have described genotype-phenotype correlations. Therefore, the role of modifier genes and epigenetic factors in the pathogenesis of NF1 is assumed, since the neurofibromin protein has a complex structure with several functional domains. It has been shown that the severity of the tumor syndrome is influenced by the methylation characteristics of NF1 gene and adjacent areas. in addition, NF1 gene is associated with a variety of microRNAs. therefore, targeted therapy aimed at specific non-coding RNAs to restore normal expression of NF1 gene can become a promising treatment for NF1.

The EGFR mutation is one of the most common mutations in malignant neoplasms. The epidermal growth factor receptor (EGFR) is a growth factor receptor that induces cell differentiation and proliferation when activated by binding one of its ligands. The receptor is located on the cell surface, where ligand binding activates a tyrosine kinase in the intracellular region of the receptor. The tyrosine kinase phosphorylates a number of intracellular substrates and further activates pathways leading to cell growth, DNA synthesis and oncogene expression. Gene amplification is a process characterized by an increase in the copy number of a restricted region in the chromosome shoulder, which is associated with overexpression of the corresponding amplified gene. Amplification of the EGFR gene is detected in about 40% of glioblastoma cases. It should be noted that EGFR gene amplification is accompanied by the acquisition of many mutations, which include intragenic deletions and point mutations. The most common EGFR mutation in glioblastomas of the brain is a deletion in exon 2-7 (EGFRvIII) frame, which occurs in 50% of all cases of EGFR-amplified glioblastoma. Despite great advances in molecular biology and targeted therapies, patients with non-small cell lung cancer (NSCLC) and glioblastoma still lead in mortality. Most of them have “classical” EGFR mutations (deletions in exon 19 and 21), but 15-20% of patients have rare mutations, which most often include point mutations, deletions and insertions in exon 18 and 25. Thus, rare EGFR mutations are a promising diagnostic and therapeutic target in cancer. This review summarizes data on the role of EGFR in the carcinogenesis of NMPL and glioblastoma. The literature search was performed using the Pubmed database.

Background. Epidemiological surveillance is crucial for the development and implementation of anticancer programs. According to GLOBOCAN 2019 data, colorectal cancer (CRC) is the third most deadly and fourth most commonly diagnosed cancer worldwide.Materials and methods. We used the state reporting form No. 7 of the Ministry of Health of the Republic of Uzbekistan “Information on malignant diseases”, as well as data on the average annual population from the State Statistics Committee of the Republic of Uzbekistan.Results. CRC is the fifth most common malignancy and fourth leading cause of mortality in the Republic of Uzbekistan. The CRC incidence among men and women is 5.3 and 4.3 per 100 000 population, respectively. A total of 5.2 % of all registered cancer cases were CRC cases. The proportion of patients with advanced disease decreased from 21.3 % to 16.5 % over the last 5 years. CRC is the fourth most common cause of cancer mortality with an incidence of 2.9 per 100 000 population.Conclusion. Our findings suggest that CRC is one of the most common and deadly malignancies in Uzbekistan and its incidence and mortality are constantly growing. Given the high proportion of patients diagnosed at late stages, early diagnosis of CRC is highly relevant.

Purpose: to determine the real state of cancer care in Russia for the identifcation of patients with postmortem diagnosis of cancer using the population-based cancer registry. Material and Methods. Data from the offcial reports of the cancer service (f. No. 7) and the database of the population-based cancer registry of the Northwestern Federal District of the Russian Federation with a volume of more than 1,350,000 cases of cancer were presented. Standard methods of cancer statistics were used. Results. The problem of the quality of registration of primary patients with cancer includes three main components: active cancer detection, including screening programs and medical survey; providing citizens with optimal conditions for free access to medical institutions, including cancer centers; improving the pathoanatomical service to detect cancer in deceased patients. The proportion of patients registered postmortemly, according to offcial data, may be several times less than the real value. At the same time, it should be noted that for 2 periods (1997–1999 and 2017–2019), according to the database of the Northwestern Federal District of the Russian Federation, the proportion of postmortemly registered patients decreased from 15.72 to 8.16 %, and in St. Petersburg from 24.46 to 9.76 %. During the period from 2017 to 2019, 2973 patients with bronchial and lung cancer (C34) – 15.17 %, 1708 patients with colon cancer – 10.32 %, 1640 patients with stomach cancer – 12.17 %, about 20 % of patients with pancreatic cancer and 29.43 % of patients with liver cancer were unaccounted for in the Northwestern Federal District of the Russian Federation. Conclusion. Thus, for the frst time in Russia, our study made it possible to identify the real state of cancer care for patients with post-mortem diagnosis of cancer, to determine the magnitude of the discrepancy between state reporting data and database of population-based cancer registry, to note the improvement in one-year and fve-year observed survivals. In recent years, the one-year mortality rate, subject to posthumously registered patients, loses 5.6 years, fve-year – 4.4 years. It is important to note that since 2000, due to improved registration of patients with a frst-time diagnosis of malignant tumors, the one-year and fve-year survivals of patients with posthumously registered increased by 18.5 % and 20.7 %, respectively.

Purpose of the study. Investigation of morphological characteristics of changes in the epithelium of foregut in experimental animals put under conditions of provoked carcinogenesis.Materials and methods. The method of chronic experiment on animals is applied: 40 female non-linear white rats, which are divided into 4 equal groups (n = 10). The first (I) and second (II) control groups of animals were exposed to mechanical trauma of the oral mucosa with additional application of 0.9 % NaCl solution and 1 % aqueous dimethyl sulfoxide (DMSO) solution with a frequency of 2 times a week. The third group of animals, i.e. the main group (4-NQO), was subjected to mechanical traumatization of the oral mucosa with additional application of 1 % DMSO aqueous solution containing 0.1 mg/ml of 4 nitroquinoline-N-oxide, with a frequency of 2 times a week. The fourth group of animals was intact. On the 1st, 7th, 10th, 14th day from the beginning of the experiment, and then every 14 days, cytological material was taken from the oral mucosa and stained with Papanicolaou stain. To compare the emerging changes, the histological picture of the organs of the foregut was studied.Results. Animals from the main group (4-NQO) showed a lag in body weight gain over the standard variance in the control (I and II) and intact groups. Atypical cells of indeterminate significance appeared in smears starting from 42 days of the experiment. Starting from the 56th day of the experiment, atypical cells (1–2 in the field of view), described in Bethesda terms as low-grade intraepithelial lesions, were detected in smears obtained from the main group of animals (4-NQO). Parabasal cells of the squamous epithelium with atypical large (more than 3 times compared to the reference) nuclei, anisonucleosis, with variable contours of the nuclear membrane within one cell, coarse chromatin were recognized as diagnostically significant.Conclusion. The severity of morphological changes in foregut epithelium in the direction of the precancerous state is significantly higher in the main group with prolonged exposure to carcinogenic factor, compared with the control and intact groups (р < 0.05). Thus, the effectiveness of modeling the conditions of provocation of carcinogenesis of the epithelium of the upper digestive tube in experimental animals was studied and proved by mechanical traumatization of the oral mucosa with additional application of carcinogen (4-NQO). This model of provocation of carcinogenesis will be used in the next study of neoplastic processes of the female reproductive system.

Currently, in the structure of mortality in the Russian Federation and a number of other countries, oncological diseases occupy a leading position among other causes. Melanoma of the skin is one of the most aggressive malignant tumors, with rapid progression, often leading to death in a fairly short time. Early detection and rationally organized refferral of patients with diagnosed skin melanoma in primary health care settings is aimed at reducing morbidity and mortality from malignant diseases, and improving the quality of life of patients. Research results suggest that the increased incidence of skin melanoma is due to both overdiagnosis. and an increase in the alertness of doctors and the population in relation to pigmented skin formations. The article discusses the proven risk factors for the development of skin melanoma, since this disease is potentially reversible. Attention is paid to modern clinical methods for predicting the course of skin melanoma. The review article examines computer-based methods for screening and diagnosing skin melanoma, applicable in primary health care settings. A separate section is devoted to dermatoscopy or epiluminescence microscopy, which refers to the study of pigmented skin lesions using surface microscopy. A list of studies is presented in case of suspicion of a malignant neoplasm of the skin / melanoma of the skin in a patient who sought medical help at a medical and prophylactic institution. The significance of the criteria of the ABCDE algorithm, the “Argenziano” algorithm in the study of pigmented skin lesions with further analysis of the results by artificial intelligence for decision-making is discussed.

Lung cancer remains the leading cause of cancer mortality worldwide. Solid organ transplant recipients are at risk of developing malignant tumors, including lung cancer, due to long-term use of immunosuppressive drugs. Development of cancer, including lung cancer, in this patient cohort, has a number of peculiarities. Moreover, malignant tumors in these patients are difficult to treat and have a poorer prognosis. This review presents a study of the issues concerning the mechanisms of lung cancer development, screening methods and treatment in solid organ transplant recipients.

The paper presents the key milestones and outcomes of 65-year studies of the carcinogenic consequences of accidental radiation exposure of the population of the Urals region. The radioactive contamination of the Techa River and the 1957accident at the Mayak PA were the reasons for the long-term exposure of the population at a wide range of doses. The most important tasks of the study were the reconstruction of individual doses, follow-up of the health and life status of cohort members. The research results have shown that chronic human exposure, in comparison to acute exposure, does not reduce the risk of developing malignant tumors and leukemias, and the value of the dose-rate factor does not exceed “one”. Thus, according to our data, the current recommendations of the International Commission on Radiological Protection underestimate the radiation risk of malignant tumors and leukemias in case of chronic exposure of the population by a factor of two. Prospects for further radio-epidemiological studies in the Urals are associated with the analysis of the cohort of Southern Urals Populations Exposed to Radiation (SUPER), which includes about 63 thousand exposed people and makes it possible to assess the radiation risk of solid cancers of certain localizations, certain types of leukemia, and non-cancer effects.

DNA methylation is a chromatin modification that plays an important role in the epigenetic regulation of gene expression. Changes in DNA methylation patterns are characteristic of many malignant neoplasms. DNA methylation is occurred by DNA methyltransferases (DNMTs), while demethylation is mediated by TET family proteins. Mutations and changes in the expression profile of these enzymes lead to DNA hypo- and hypermethylation and have a strong impact on carcinogenesis. In this review, we considered the key aspects of the mechanisms of regulation of DNA methylation and demethylation, and also analyzed the role of DNA methyltransferases and TET family proteins in the pathogenesis of various malignant neoplasms.During the preparation of the review, we used the following biomedical literature information bases: Scopus (504), PubMed (553), Web of Science (1568), eLibrary (190). To obtain full-text documents, the electronic resources of PubMed Central (PMC), Science Direct, Research Gate, CyberLeninka were used. To analyze the mutational profile of epigenetic regulatory enzymes, we used the cBioportal portal (https://www.cbioportal.org / ), data from The AACR Project GENIE Consortium (https://www.mycancergenome.org / ), COSMIC, Clinvar, and The Cancer Genome Atlas (TCGA).

Objective. In February 2019, we completed work on creating a unified database of the population cancer registry of the NorthWestern Federal district of the Russian Federation. The development of data on the material of a large area significantly increases the reliability of the material under study, especially for RARE localities of malignant tumors, which include tumors of the eye and and adnexa.For the first time in Russia to present an analysis of the effectiveness of anti-cancer activities in relation to malignant tumors of the eye and adnexa (C69) at the Federal district level with calculations of 5-year survival rates of patients taking into account sex, age and histological structure of tumors.Methods. The development of the 5-year survival rate of patients with malignant tumors of the eye (C69) included information from the database created by us Population cancer register of all administrative territories of the North-Western Federal district of Russia for the period from 1999 to 2013, more than 1000 observations (1022).Results. The study revealed a positive dynamics of survival in patients of the North-Western Federal district of Russia with malignant tumors of the eye. The 5-year survival rate increased among males from 58.8 to 63.1 %, and among females from 64.7 to 69.6 %. A significant overestimation of the proportion of early stages among primary patients with malignant tumors of the eye and adnexa (C69) was found, which may be due to medical errors. Calculations of patient survival (with careful tracking of the deceased) allow us to get a more objective picture.Conclusion. Excellent achievements in the treatment of patients of advanced research centers and institutes can be welcomed only if similar successes are recorded at the population level and are available to all patients. Our in-depth development of population data in the Federal district confirmed the success in the treatment of patients with the malignant tumors of the eye and adnexa (C69), and the patterns we found first in the database of the Population cancer register of St. Petersburg, and now in the North-Western Federal district of the Russian Federation. Similar studies in other Federal districts could be an important component in the planning, monitoring and evaluation of anti-cancer measures in relation to the malignant tumors of the eye and adnexa (C69).

Bone cancers occur mainly in adolescents and young adults, and benign lesions are more frequent than malignant ones. The most common malignant tumors include osteosarcoma, Ewing's sarcoma and chondrosarcoma. The course of the disease may not be obvious and symptoms may be ambiguous, so it is important to catch them early and take appropriate action. Laboratory tests such as CRP, ESR, LDH, ALP may prove useful in the diagnosis of bone neoplasms in children. All children with suspected malignant bone cancer should undergo an x-ray examination. MRI, CT scans are performed to expand the diagnosis and determine the extent of the disease. The basis of diagnosis is histopathological examination. The result of this study is very important in the selection of therapeutic procedures, it influences decisions regarding the scope and degree of radicality of the operation. It is crucial that the entire diagnostic process is carried out in highly specialized centers that have extensive experience in the diagnosis and treatment of malignant bone tumors in children. It is most beneficial to conduct diagnosis and treatment at the same center, and preferably by the same team of specialists. This team should include doctors from orthopedics, radiology, oncology, radiation therapy and pathomorphology. Conducting diagnosis and treatment in highly specialized centers has a positive effect on the prognosis and quality of life of patients. The purpose of this article is to highlight the early and uncharacteristic symptoms of bone cancer in children and to present the complexity of the diagnostic process, as well as the importance of carrying it out in highly specialized centers with extensive experience in treating pediatric bone malignancies.

For all tumors, regardless of type and tissue, there are a number of common features. These include high proliferative activity, disturbances in the mechanisms of apoptosis and "invisibility" for the cells of the immune system. At the basis of all these disorders lies a malfunction in the interaction between signaling proteins inside the cell, due to a violation of the expression of genes responsible for their synthesis. The aim of the review is to study the molecular biological mechanisms of carcinogenesis, characteristics and features of tumor cells that affect the development of the disease, progression, drug resistance and clinical results and the possibilities of targeted therapy of oncological diseases. Material and methods. The search for literature sources was carried out using PubMed, CyberLeninka, eLibrary, Google Scholar databases; the search depth was 15 years. Results. Recent works have shown the evolution of views on the classification of tumors from the point of view of the mechanisms of damage to the processes of cellular regulation and histogenesis, as well as the development of the modern theory of carcinogenesis, ideas about the mechanisms of development of tumor diseases and the prospects of modern therapies. Conclusion. The study of molecular biological mechanisms of carcinogenesis, characteristics and features of tumor cells is not only fundamental, but also of applied importance in order to predict the development of the disease, progression, drug resistance, clinical results and the possibilities of targeted therapy.

As the survival rate of cardiac recipients improves, higher incidence of malignancy in the late postoperative period becomes essential for their prognosis. Immunosuppressive therapy is one of the key prerequisites for successful transplantation. However, long-term use of immunosuppressive agents increases the incidence of malignant tumors compared to the general population. The risk of their development after organ transplantation increases by 2–4 times compared to the general population. For patients who have undergone transplantation since 2000, the risk of developing malignant neoplasms 1–5 years after surgery is estimated at 10–12%. Timely comprehensive examination of patients, development of new immunosuppression schemes, treatment of those predisposing to the development of malignant neoplasms and giving up harmful habits will reduce the risk of malignant tumors and help diagnose these serious complications at an early stage, which, in turn, will increase the life expectancy of solid organ (particularly the heart) recipients.

Recently, minimally invasive treatment modalities based on the application of various physical factors have been widely used in anticancer therapy. Electrochemical lysis is a method in which tumor cells are destroyed by local exposure to a constant low voltage electric current.Purpose: to present the current results of using electrochemical lysis in the treatment of various tumors, to describe the mechanism of tumor destruction and methods of delivering electric current to the tumor, as well as to evaluate the electrical parameters and positioning of the electrodes.Material and Methods.aliterature search included the Medical literatureanalysis and Retrieval system Online (Medline), the excerpta Medica data Base (embase), Web of science, scopus, Russian citation index. All articles were published before december 2019. The review included studies on the investigation electrochemical lysis in vitro, in vivo, as well as clinical observations and clinical studies in which electrochemical lysis has been used as an independent treatment, or in combination with other methods of anticancer treatment since 1984.Results. This review provides information regarding the electrochemical mechanisms of tumor destruction, anti-tumoral effects of electrochemical therapy, methodology for planning and distributing the dose of electrical lysis and positioning of electrodes. We have evaluated complications and oncological results. Electrochemical lysis is a safe, simple, effective, and relatively non-invasive method of antitumor treatment.Conclusion. The electrochemical lysis is a promising minimally invasive method which can be used for the treatment of tumors. However, long-term data are needed to validate this treatment before it can be included into clinical recommendation for the treatment of cancer patients.

Bone metastases are a common complication of cancer. Patients with bone metastases may have experienced skeletal-related events, such as hypercalcemia, pathological fractures, pain syndrome of varying intensity, spinal cord compression with negative effects on the quality of life. Current diagnostic tools have some limitations, such as high cost and limited availability in the distant areas, as well as falls negative and falls positive results. In this aspect, non-invasive sensitive markers of bone metabolism might give additional valuable information. Bone remodeling markers (N-terminal propeptide of type 1 collagen, osteocalcin, C-terminal telopeptide of type 1 collagen, etc.) have been used for a long time to predict the effectiveness of osteoporosis treatment; as additional risk factors for treatment initiation in patients with osteoporosis, in diagnostic search for secondary forms of osteoporosis; and as predictors of fracture in population studies. This review summarizes the clinically relevant biochemical markers of bone remodeling and the available evidence for their use in the metastatic bone disease in particularly in the diagnosis and prognosis of bone metastases risk and skeletal complications, predicting clinical outcomes, bone disease progression and overall survival. It has been shown that a sufficient suppression of bone remodeling biochemical markers while on treatment with bisphosphonates is associated with an improvement in survival and a decrease in the risk of skeletal complications in patients with bone metastases. New data may become a rational basis for wider use of bone metabolism markers in oncological practice. However, it is necessary to standardize and validate the determination of bone markers and verification of cut-off diagnostic values for their introduction into the routine clinical practice of patients with malignancy.

Immuno-oncology is a rapidly developing field in medicine. Drug combination therapies have already been studied in many clinical trials of different types of tumours. In recent years, a checkpoint inhibition therapy with monoclonal antibodies that target cytological T-lymphocytes has been developed. Thus, inhibition of two regulator genes CTLA 4 and PD1 or PD-L1 ligand to it is able to restore mediated T-cell tumour regression in its many localizations. The article considers a number of key fields of immunology and immunotherapy through a specific example of breast cancer (BC): the role of T-lymphocytes, vaccines, biomarkers of immunotherapy. The treatment used by the authors was based on an innovative technology of autologous dendritic cell-based vaccine based on highly immunogenic cancer/testis antigens (CTA) for immunotherapy of malignant tumours. The technology of specific CTA+-activated autologous dendritic cells (DC)-based immunotherapy was chosen as an innovative solution for the treatment of breast cancer patients. The treatment results showed that a clinically significant anti-tumour effect was achieved in 73.7% of patients. Median disease-free survival was 8.3 months (95% Cl 6.5-9.9 months), no grade 3-4 complications were recorded, grade 1-2 complications were observed in 57% of patients. The immunological effect in laboratory tests was recorded in 92% of patients. Thus, autologous DCs loaded with cancer/testis antigens can be considered as palliative dendritic vaccine therapy in patients with metastatic breast cancer who have exhausted standard treatment options. Also, the authors presented the results of immunological studies of the prognostic and predictive significance of the immunological response from the perspective of pathomorphology and general immunology, including tumour-infiltrating T-lymphocytes (TILs, CD3, CD4, CD8), their quantitative ratio and correlation with regulatory genes (PD-1, PD- L1, FOX-P3). The results of overall analysis comprising data of 2,148 patients from 9 centers confirmed the strong prognostic role of stromal tumour-infiltrating lymphocytes (sTILs) in early triple-negative breast cancer.

Introduction. Diagnosis verification in patients with malignant tumors developed in the context of chronic inflammation is technically complex with a high percentage of false negative results of histological examination. None of the methods provides sufficiently accurate results necessary for ruling out or confirming a diagnosis.The study objective is to test a new patented method of pre- and intraoperative differential diagnosis of oncological pathology of the ent-organs using the "InSpektr-M" hardware and software system.Materials and methods. The study included 30 patients with suspected malignant tumors of the larynx. The study excluded patients with previously verified diagnosis of malignant tumor of the larynx. A diagnostic probe emitting laser light with wavelength 350 nm and radiation power density 25 mW/cm2 was introduced through an additional channel of a fiberscope for a period of time sufficient for excitation of intrinsic tissue fluorescence (from 10-6 to 10-9 ms). Fluorescence intensity in the range of wavelengths between 600 and 650 nm was measured. This intensity was conditionally labelled "epithelial proliferative activity index". Spectrometric analysis of the intact points allowed to evaluate normal values for an individual patient; in the areas with the maximal increase in the index, targeted biopsy was performed.Results. Values obtained during examination of various types of tumors (epithelial and non-epithelial) are different while tumor location has a negligible effect. In patients with malignant tumors containing non-squamous epithelium, increased protoporphyrin IX and decreased FAD fluorescence were observed in the direction from intact tissues to the center of the suspected tumor; in patients with malignant tumors containing squamous epithelium: increased protoporphyrin IX fluorescence with maximum at 635 nm and dynamic increase in FAD fluorescence in the direction from intact tissues to the tumor center.Conclusion. Fluorescent spectroscopy can be used for pre- and intraoperative differential diagnosis of squamous and non-squamous cancers of the ENT-organs. Further studies for establishment of reference values of fluorescence intensity in intact and affected tissues are necessary.

Accounting for children with cancer is characterized by low reliability of statistics. In addition, the available data do not have significant scientific value., Since they represent only an approximate number of patients identified annually and some general information (incidence, prevalence, etc.). Moreover, subsequent analysis of the accumulated information is of particular importance. An electronic database of children with cancer has been developed that meets these requirements and has been introduced into the clinical practice of pilot medical organizations.Purpose of the study. Our aim was to study the opinions of pediatric oncologists on the issues of registration of children with oncological diseases.Materials and methods. In order to assess the results of the implementation of the electronic database, a "Questionnaire for a survey of a pediatric oncologist to assess the effectiveness of the implementation of an electronic database" was developed, which contained 15 questions. For objectivity, the questionnaires were filled in anonymously by the respondents.Results. The medico- social study involved 187 pediatric oncologists. The majority of respondents (71.3 ± 3.3%) noted that currently there is no register of children with cancer in the Russian Federation, 15.4 ± 2.6% noted the regional register, 9.1 ± 2.1% – independent in individual medical organizations, 1.7 ± 0.9% is a single register for the Russian Federation and 2.5 ± 1.1% are not aware of this. Among respondents, 81.9 ± 2.8% noted that the electronic database is an effective tool for recording children with cancer, while as an advantage, 15.1 ± 2.6% noted an increase in the reliability of statistical data, 9.2 ± 2.1% – reduction of time for searching patient information, 4.4 ± 1.5% – optimization of working time, 71.3 ± 3.3% – a combination of the above options.Conclusion. A medical and social study showed the feasibility of introducing an electronic database of children with cancer into the clinical practice of pediatric oncologists.

Currently, the age of primiparous women is increasing, but the risk of cancer, which is sometimes found during gestation, is also increasing. This article discusses the problems of diagnosis and treatment of cancer during pregnancy, which occurs under the guise of gestational complications. Two cases of malignant neoplasms first discovered during pregnancy are described. The first observation illustrates cholangiocarcinoma in a 37-year-old multiparous, and the second is a case of colorectal cancer in a 40-year-old primiparous. The timely identification of such women is an important challenge of the outpatient, which in the future can help maintain the quality of life of the mother and child.

The purpose of the study was to systematize and summarize modern ideas about the role of hypoxia in the development of tumor radioresistance.Material and Methods. PubMed, eLibrary and Springer databases were used to identify reviews published from 1953 to 2020, of which 57 were selected to write our review.Results. Radiation therapy is one of the most important components in cancer treatment. The major drawback of radiation therapy is the development radiation resistance in cancerous cells and secondary malignancies. The mechanisms of cancer radioresistance are very complicated and affected by many factors, of which hypoxia is the most important. Hypoxia is able to activate the mechanisms of angiogenesis, epithelial-mesenchymal transformation and contribute to the formation of the pool of cancer stem cell, which are characterized by chemo- and radioresistance. In turn, the severity of hypoxia largely dependent on tumor blood flow. Moreover, not only the quantitative but also the qualitative characteristics of blood vessels can affect the development of tissue hypoxia in the tumor.Conclusion. A comprehensive assessment of the severity of hypoxia, as well as characteristics of angiogenesis and EMT can contribute to a better understanding of the mechanisms of development of cancer radioresistance.

The purpose of the study was to analyze the antitumor effects of the extract of mycelium from Duddingtonia flagrans (strain F-882) on xenografts of human C33a cervical cancer cells.Material and Methods. To evaluate the antitumor effect, we used the absolute values of xenograft volumes and calculated the tumor growth inhibition and the index of tumor growth.Results. At the first stage of the experiment, a 4-week subcutaneous injection of the water extract of F-882 resulted in an almost twofold slowdown in xenograft growth, with the tumor growth inhibition value of 50.6 %. In the second stage of the experiment, a 2.5-week subcutaneous injection followed by a 1.5-week intratumoral injection of F-882 also caused the tumor growth inhibition. After completing F-882 injections, the effect of tumor growth inhibition continued for 2.5 weeks and the tumor growth inhibition value was 58.7 %.Conclusion. The mycelium extract F-882 was shown to have an antitumor effect on subcutaneous xenografts of human C33a cervical carcinoma cells.

Malignant tumors of the eye and its adnexa (C69) relates to rare tumors. Until 2011, this group of tumors was not included to the official cancer report in Russia.Purpose: to investigate the incidence of malignant tumors of eye and its adnexa (C69) in the population of St. Petersburg, to consider the dynamics of a complex of analytical indicators. Standard methods of statistical analysis, state reporting materials and data from the St. Petersburg Population Cancer Register were used. Malignant tumors of the eye and its adnexa (С69) were started to be officially registered only from 2011 onwards, however not in full as only Form 7 that allows to calculate morbidity was filled in. Other information could be obtained from the databases of the Population Cancer Registers (PRR), organized in the country in the late 90’s. Each year, more than 1,000 thousand (e.g.1977–2017 year) cases of malignant tumors of eye and its adnexa (С69) are detected in the whole country. In 2011, 925 cases were diagnosed. In Russia, the crude rate of malignant tumors of the eye and its adnexa (С69) has increased from 2011 to 2017 years from 0.65/100,000 in 2011 to 0.73/100,000 in 2017, respectively, +12.3 % (both sexes), standardized, eliminating the difference in the age composition of the population, remained almost unchanged –0.54 0/0000 and 0.53 0/0000. The standardized incidence rate in men of malignant tumors of eye and its adnexa (С69) in 2017 was 0.58 0/0000, women –0.49 0/0000. The state reporting for malignant tumors of eye and its adnexa (С69) does not provide for the distribution of these patients by age, stage and other parameters. State mortality statistics do not provide for the review of the C-69 heading ICD-10. All of this led us to conduct in-depth analysis of the dynamics of morbidity and mortality of eye cancer on the basis of the PRR database of SaintPetersburg. An insignificant increase in the incidence rate of the Russian population of the eye cancer, completely associated with the aging of the population, has been established. Positive increase in the observed and relative survival of patients has been also revealed.

The review presents data on the role of ionizing radiation/hyperthermia as modulating factors in exosome secretion/composition. Tumor-derived exosomes are important participants in the formation of the tumor microenvironment. They modulate the inflammatory response in the tumor, influence the capability of fibroblasts and mesenchymal cells to differentiate into myofibroblasts, trigger the angiogenic process, promote epithelial to mesenchymal transformation of tumor cells and form the pre-metastatic nisches. The review describes the mechanisms of behavior of the recipient tumor cells receiving exosomes from irradiated cells, including activation of akt signaling, stabilization of MMP9/MMP2, and enhancement of exosome-mediated motility. In vitro models demonstrate the efficacy of exosomes from mesenchymal stem cells (MsC) to modulate both direct and abscopal effects of radiation therapy/hyperthermia. Exosomes derived from MsC are the most attractive carriers for the delivery of proteins, miRNAs, drugs, and metals to the recipient tumor cells. MsC-derived exosomes potentiate the efficacy of both radiotherapy and hyperthermia in vitro studies. However, some important aspects regarding a) the most effective options for administering MsC/MsC exosomes to modulate radiotherapy/hyperthermia; b) radiation dose; c) options of hyperthermia; d) detailed mechanisms of the effect of irradiated MsC-derived exosomes on the tumor microenvironment and cancer cells, still remain poorly understood.

The purpose of the study was to analyze the cancer incidence among the population living in siberia and Russian Far East. material and methods. cancer incidence and mortality data collected from populationbased cancer registries of the Russian cancer statistics, covering the period 2005–2018, were used. the crude and age-standardized cancer incidence rates were analyzed. Results. During the study period, 1 336 260 new cases of cancer were diagnosed in the regions of siberia and Russian Far East. Of them, 77.2 % new cancer cases were registered in the siberian Federal District. the highest percent of increase in the number of cancer cases in the siberian Federal District was observed in the republics of Khakassia (84.8 %), tuva (61.9 %), Buryatia (52.8 %), and Krasnoyarsk Krai (82.4 %). In the Far Eastern Federal District, the highest cancer incidence rates were registered in the sakhalin Region (43.6 %) and Kamchatka Krai (41.8 %). the average age of patients in 2018 was 55.7 years (57.9 years for men and 53.7 years for women) compared to 57.4, 59.1 and 55.9 years, respectively in 2005. Lung cancer was the most commonly diagnosed cancer in men (19.5 %), whereas cancer of the female reproductive system was the most prevalent in women (38.4 %). the highest age-standardized cancer incidence rates in the siberian Federal District in 2018 were observed in the Irkutsk region, altai and Krasnoyarsk territories. In the Far Eastern Federal District, the highest agestandardized cancer incidence rates were observed in the sakhalin and Magadan regions. Conclusion. the number of new cancer cases and age-standardized cancer incidence rate were shown to increase in siberia and Russian Far East. the average age of men and women diagnosed with cancer decreased. the percent of increase in the age-standardized cancer incidence rate was higher in women than in men. Many of the most prevalent cancers were associated with the «westernized lifestyle» of developed countries.

Neurofibromatosis type 1 (NF1) is a hereditary disease with the high frequency of neuroendocrine tumors. This article represents a clinical case of the diagnosed NF1 in a 40-year old patient with the history of bilateral pheocromocytoma and malignant gastrointestinal stromal tumor of the jejunum. Clinical diagnosis NF1 was suspected on the basis of the typical skin manifestations.The timely diagnosis of NF1 has practical significance as it enables physicians persistently search for neuroendocrine lesions in a such cohort of patients.

A description is given of a patient with a latent tumor process that has developed recurrent thrombosis of the superficial and deep veins of the lower extremities, common iliac veins, PE, a blood clot in the right ventricle, and a spleen infarction. The examination revealed bronchogenic lung cancer with metastases to the bronchopulmonary lymph nodes and liver, confirmed by an autopsy.

One of the most important achievements of diabetology in the second decade of the 21st century is undoubtedly the introduction of sodium-glucose cotransporter (SGLT2) inhibitors into clinical practice as a new class of glucose-lowering agents for type 2 diabetes. In addition to the glucosuria induced by these agents, which is their main pathway for achieving ‘antidiabetic recovery’, other consequences accompany the intake of SGLT2 inhibitors. These pathways, particularly in oncology, have not been extensively studied. Considering the analysis of the previous studies, this report demonstrates, although not significantly, that cancer morbidity in patients with T2DM treated with SGLT2 inhibitors may be organ-specific. In addition, agents within the class of SGLT-2 inhibitors may be useful in several variants of antitumor therapy, but this theory requires further study.

Objective: to develop tactics for the differential diagnosis of paraneoplastic neuromuscular syndromes in patients at the outpatient level.Materials and methods: the study included 50 patients with classical neuromuscular paraneoplastic syndromes (experimental group) and 50 patients with neuromuscular syndromes of non-paraneoplastic nature (control group). All patients underwent a comprehensive laboratory and instrumental examination at the Regional Consultative and Diagnostic Center of the Ministry of Health of the Rostov Region from 2014 to 2018.Results: the evaluation of clinical differences in patients of the experimental and control groups was created. When comparing the laboratory parameters, it was revealed that the SFMC, D-dimer, CRP-2 levels significantly increased in patients with paraneoplastic lesions (p 5.25 mV) was noted. Based on obtained data, differential diagnosis algorithms for patients with studied neuromuscular lesions at the outpatient level have been developed.Conclusions: the conducted study allows the implementation of non-serological diagnostics algorithms for classical neuromuscular paraneoplastic syndromes in outpatient practice.

Background. Cancer remains a difficult disease to prevent, detect, treat or manage it. The mortality rate is one of the most important criteria for assessing the health of the population. Nevertheless, the correct use of analytical indicators is important, especially when assessing time series. The crude cancer mortality rate is closely related to the proportion of elderly patients. All international publications (WHO, IARC, territorial cancer registries) assess the morbidity and mortality using the standardized indicators that eliminate the difference in the age structure of the compared population groups. The purpose of the study was to analyze cancer mortality in Russia and to calculate the medium-term mortality prognosis in crude and standardized rates up to 2025, as well as to highlight the main factors related to cancer mortality. Material and Methods. We used standard methods for estimating time series, including the moving average method. Results. We calculated the share of the elderly population in Russia (retirement age). It was found that from 1960 to 2017, the proportion of pensioners (men aged 60 and older and women aged 55 years and older) increased from 6.2 % to 15.8 % and from 16.2 % to 32.9 %, respectively, thus excluding the assessment of mortality by a crude mortality rate. From 2000 to 2017, the crude mortality rate of the population of Russia decreased by 2.7 %, while the standardized rate decreased by 20 % (19.6 %). The reduction in the mortality rate of the Russian population was significantly affected by a favorable change in the structure of mortality, the proportion of localizations of cancer with a high mortality rate decreased significantly. Conclusion. The calculations of the medium-term prognosis show that by 2025 the crude mortality rate will decrease to 195 ± 5.1 0/0000, and standardized rate to 100 ± 3.2 0/0000.

Background: fever of unknown origin is one of the diagnoses more difficult in our area, because it involves monitoring of a complex algorithm of several procedures to establish its cause and con frequently takes too long before any explanation. Therefore, the objective is to get to your diagnosis etiologic and to do a particular series of steps.Objective: to describe the most frequent causes of classical fever of unknown origin in the hospital setting and make a simplified diagnostic search algorithm for this pathology.Methods: a case-series study of 85 patients admitted to the Hospital Obispo Polanco with a diagnosis of fever of unknown origin conducted from 2013 to 2018 in the therapeutic services except for pediatrics and surgery units. The study variables included age, sex, complementary studies (variables from humoral, microbiological and biopsies), results obtained, diagnosis of each patient, treatment.Results: of all patients, 23 (27 %) had infections, of which 14 (16 %) of respiratory focus, 6 (7 %) of urinary focus, 2 (2 %) of abdominal focus and 1 (1 %) of the skin focus. Seven patients (8 %) had neoplasms, three of which (3 %) of respiratory origin, three of digestive tract (3 %) and one of prostatic origin (1 %). In four patients (5 %) were diagnosed of the rheumatic diseases. In 51 (60 %) patients not be could diagnose any cause of fever of unknown origin.Conclusions: the first cause of fever of unknown origin is diseases of unknown etiology with 60 % (51 cases) without being able to identify the clear focus. Among the known etiologies, the most private pathology is infectious bacterial diseases of the respiratory and urinary tracts (27 % — 23 patients). The third place is occupied by oncological diseases with a predominance of malignant pulmonary neoplasms (8 % — 7 patients). Rheumatological diseases occupy the last place and, in this study, accounted for only 5 % (4 patients).

Background. Planning the organization of medical care for children diagnosed with cancer as well as assessing the quality of care is based on the statistical data analysis.The purpose of the study was to analyze the main parameters characterizing medical care for children with cancer in the central Federal district.Material and methods. The reports of the executive authorities in the sphere of health protection of 18 subjects of the Russian Federation included into the central Federal district were analyzed for 2017.Results. The number of children aged 0–17 years was 6 824 049, the number of pediatric oncology departments was 9, the number of hospital beds for children with cancer was 464, the number of bed-days per year was 319.3. the number of physicians providing pediatric cancer care was 91, of them 64 (70.3 %) had a certificate of a pediatric oncologist. in 11 subjects of the Russian Federation, there were no departments of pediatric oncology, and in 1of them, there were no hospital beds for children with cancer. the number of patients newly diagnosed with cancer was 821. the number of patients who died of cancer was 156, of them 66 were diagnosed with cancer in 2017. the cancer incidence rate was 12 per 100,000 children aged 017 years; the mortality rate was 2.3 per 100,000 children aged 017 years. the one-year mortality rate was 8 %. the mean time taken to establish the diagnosis and the time interval between diagnosis and initiation of treatment was unknown, since the reports did not contain precise information. twelve (1.5 %) patients left the territory of the Russian Federation for receiving treatment outside the Russian Federation.Conclusion. The information provided in most reports was not statistically reliable. the cancer incidence rates were significantly lower than those in countries with high statistical reliability. For reliable estimation of the number of inpatient beds for children with cancer and the percentage of children referred for the treatment to the federal medical centers, it is necessary to implement a unified database for pediatric oncology in the Russian Federation.

background. The analysis of the quality of medical care for children with cancer is based on statistical data. Evaluation of the results obtained is also the basis of the strategy for the development of medical care for this category of patients. aim: analysis of the main parameters characterizing medical care for children with cancer in the Siberian Federal District. material and methods. The reports for 2017 on the health protection of 11/12 (91.6 %) constituent entities of the Russian Federation belonging to the Siberian Federal District were analyzed (Irkutsk Region did not provide data). results. In 2017 the number of children aged 0–17 years was 3 722 470, the number of pediatric hospital beds for children with cancer (ages 0–17 years) was 260 (0,7 per 10,000), and the average number of bed-days per year was 342.2. In 3 (25 %) constituent entities of the Russian Federation, there were no departments of pediatric oncology and in 1 (8,3 %) there were no hospital beds for children with cancer. The number of physicians, who specialized in children’s cancer was 49, of them 32 (65,3 %, 0,08 per 10,000, ages 0–17 years) had a certificate of a pediatric oncologist. In 1 (8,3 %) constituent entity of the Russian Federation, there were no pediatric oncologists. For children aged 0–17 years, the cancer incidence rate was 11.7 per 100,000 children, the cancer mortality rate was 2,2 per 100,000, and one-year mortality rate was 7,4 %. 188 (43,2 %) primary cancer patients were referred to medical institutions of the Federal District, and 17 (3,9 %) primary patients left the territory of the Russian Federation. conclusion. The low incidence and mortality rates can be explained by the lost of reliable follow-up data. It is advisable to introduce electronic health record systems. For reliable estimation of hospital bed supply for children with cancer and percent of patients referred to medical centers for treatment, it is necessary to carry out a clinical audit. Deficiency of pediatric oncologists should be eliminated by reforming the training of medical personnel.

The purpose of the study was to analyze the incidence of primary-multiple cancer (PMC) of the female reproductive system according to the population cancer register of the Chelyabinsk region for 15 years (1999-2013) using the example of PMC of the cervix. Carry out an analysis of the adjusted cumulative survival in the group of patients with PMC of the cervix as compared with solitary cervical cancer.Material and methods. The material was processed using the classification of Zisman I. F. and Kirichenko G. D. (1978) on the sequence of tumors: metachronous, synchronous, mechatronic-synchronous and synchronous-metachronous. The interval of metachronousness is 6 months. The survival rates of cancer patients in the Chelyabinsk region were calculated automatically with the use of the computer program "Calculation of survival rates" — an application to the population-based cancer registry of OOO Novell-SPb. Using the method of continuous sampling, we carried out a retrospective analysis of the case histories of patients with PMC of the female reproductive system treated in the SBEO CRCOD for 15 years (1999-2013).Results. During the period under review, 82 patients with PMC of the cervix uteri were examined, metachronous tumors prevailed in 55 (67.1%), synchronous tumors developed in 27 (33.75%). In the group of metachronous tumors in 12 (21.8%) patients had a combination of three tumors. Three (5.45%) patients had a combination of four tumors. Analysis of combinations of cervical cancer showed that more often, the cervical cancer metachronically met with breast cancer 35% (14 patients), endometrial cancer 17.5% (7 patients), ovarian cancer 7.5% (3 patients). Synchronously cervical cancer was more often combined with breast cancer 42.8% (9 patients), endometrium 28.6% (6 patients), ovaries 23.8% (5 patients) and rectal cancer 4.8% (1 patient).The results of calculation of the index of the adjusted cumulative survival of the study group of the PMC of the cervix showed that in the group of metachronous tumors, survival rates were significantly higher than in the group of synchronous tumors: single-year survival was 84.8 ± 6.3% against 82.4 ± 9.2, three-year survival — 66.8 ± 7.8% against 47, 1 ± 12.1, and five years after the diagnosis, 53.8 ± 8.6% of patients survived.Conclusion. Thus, patients with cervical cancer are at risk of developing cancer of other localizations that share common etiopathogenetic factors, such as HPV infection in women, hormonal disorders.

Currently, there is a global trend of growing frequency of concurrent lung malignant tumors and cardiac vascular pathology, in particular, ischemic heard disease. The literature review demonstrates, that development of surgery, anesthesiology and intensive care allows expanding limits for treatment of such patients through simultaneous surgery when lungs and heart are operated at the same time.The article analyzes the personal experience of the authors and international publications, it contemplates on safe performance of simultaneous and multi-organ surgeries, involving respiratory and blood circulation systems, different approaches to surgery, its specific features, benefits, and limitations. Specialists from Russian Surgery Research Center named after B.V. Petrovsky find it preferable to perform simultaneous staged surgery of the lungs, mediastinum and cardiac vascular system. There is a certain sequence of stages. It demonstrates that the first stage may include isolation of abnormal masses of the lung (mediastinum) and lung hilus, if necessary. After that cardiac surgery is performed, and as a final stage, the whole abnormal focus is isolated and resected.

The article presents an unusual case of a metastatic lesion of the right ventricle with malignant neoplasm. Its nature and size was definitively determined during the operation. The surgical treatment of this lesion by valve-preserving operation on the tricuspid valve is discussed. Since 1970, surgical treatment of 62 patients with various types and localization of malignant heart tumors was performed, corresponding to 6.8 % of 912 patients with cardiac tumors. This case is an unusual example of secondary damage to the malignant tumor of the right ventricle. Its primary focus was seminoma (low-grade embryonic G3 cancer). Metastatic malignant tumors of the heart affect its walls, but may also spread to valve structures, requiring correction of valvular lesions. During surgical removal of the tumor it is necessary, as far as possible, to preserve valvular and sub-valvular structures in order to avoid valve prosthetics.

Autotransplantation of immune cells to induce immunological rejection of tumors can be a useful approach in tumor treatment. Despite the low efficiency of this approach demonstrated in the past, the active development of cell technologies and genetic engineering has led to the significant improvement in clinical outcomes. A great success was achieved in adoptive immunotherapy with the T-lymphocytes specific to tumor antigens. This review describes the clinical experience in application of various antigen-specific adoptive immunotherapy methods including tumor-infiltrating T-lymphocytes, T-lymphocytes with redirected transgenic T-cell and chimeric antigenrecognizing receptors. The possibilities and limitations of these biomedical technologies are also analyzed in the article.

The published during last few years data concerning communicative role of lectins (proteins and their complexes which recognize carbohydrates, glycoconjugates and their patterns) in on-duty supporting and increasing anticancer status of human immunity are analyzed. Examples of lectin-(glycoconjugate pattern) strategies, approaches and tactic variants in study and development of anticancer treatments, principle variants of therapy, possible vaccines in 35 cases of blood connected tumors (leukemia, lymphomas, others), solid tumors (carcinomas, sarcoma, cancers of vaginal biotopes, prostate, bladder, colon, other intestinal compartments, pancreas, liver, kidneys, others) and cancer cell lines are described and systemized. The list of mostly used communicative lectins (pattern recognition receptors, their soluble forms, other soluble lectins possessing specificities of importance) involving in key intercellular cascades and pathway co-functioning is presented. The regulation of resulting expression of distinct active lectins (available and hetero/di/oligomeric forms) and their interaction to adequate glycoconjugate patterns as well as influence distribution of co-functioning lectins and antigens CD between populations and subpopulations of antigen-presented cells (dendritic cells cDC, mDC, moDC, pDC; macrophages M2 and M1), mucosal M-cells, NK-cells play key role for choice and development of anticancer complex procedures increasing innate and innate-coupled immune responses. Prospects of (receptor lectin)-dependent intercellular communications and targeting glycoconjugate constructions into innate immunity cells for therapy of cancer and development of anticancer vaccines are evaluated and discussed.

The aim of the study was to present an unusual case of secondary lesion of right ventricular with malignant neoplasm, the character and size of which was finally established during surgery, as well as peculiarities of the surgical treatment of such lesion. In the M.M. Amosov National Institute of Cardiovascular Surgery of NAMS of Ukraine since 1970 surgical treatment of 62 patients with various types and localization of malignant heart tumors was performed. This amounted 6.8 % of 912 patients with cardiac tumors. The clinical observation presented by the patient with secondary tumorous lesion of right ventricular is of practical interest, taking into account the complexity of diagnosis, the unusual path of metastasis and peculiarities of surgical treatment. Metastases in the heart usually arise through hematogenous or lymphogenous spread or due to direct invasion. Malignant tumors of the heart can affect not only its walls, but also spread to valve structures, requiring surgical correction. It is impossible to exclude the presence of thrombus in heart chambers, considering the violation of hemodynamics associated with presence of tumors.