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A malignant tumor is an independent risk factor for the development of surgical site infections (SSIs), and the risk of postoperative complications in patients is 3 times higher than in patients without a malignant process. Unfortunately, even with perfect adherence to the rules of asepsis and antiseptics, the contamination of the surgical wound is inevitable during surgery. In patients with malignant liver tumors the infection can be caused by malignant obstruction, bile stasis, preoperative manipulations of the biliary tract (drainage or stenting). The objective: to analyze the spectrum of bacterial infections and their pathogens in patients with primary malignant tumors of the liver and biliary tract with obstruction of the biliary tract compared to patients without obstruction of the biliary tract after extended liver resections (ELRs). Materials and methods. 70 statistically homogeneous patients in terms of age and gender took part in the study: 32 persons with hepatocellular carcinoma (HCC) and 38 persons with cholangiocarcinoma (CC). Patients were divided into groups. The 1st (main one) group included 35 patients with primary liver tumors after ELRs with biliary obstruction, the 2nd (control one) group included 35 patients with primary liver tumors after ELRs without biliary obstruction. The age of the patients was 61.2 ± 10.7 years and 64.5 ± 11.4 years, respectively. Objective data, laboratory and instrumental examinations were used to establish the diagnosis and complications that occurred in patients after surgery. Results. In patients with HCC and CC with biliary obstruction after ELRs (main group) the infectious complications occurred in 100% of cases, versus to patients with HCC and CC without biliary obstruction (control group). Opportunistic microorganisms, which were represented by a sufficiently wide spectrum of gram-negative and gram-positive bacteria, were determined in patients after ELRs. Pneumonia (17.1% of cases), cholangitis (14.3%), SSIs (28.6%), SSIs combined with cholangitis (11.4%), and SSIs in combination with infections of the central circulation (11.4%) were significantly more common in patients with HCC and CC with biliary obstruction after ELRs. Conclusions. The results of the study should be used to develop a strategy to reduce postoperative bacterial complications and additional financial costs after ELRs in the future. [ABSTRACT FROM AUTHOR]

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.

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.

The aim of the research is to study the epidemiological situation of malignant tumors of the gastrointestinal tract in Ukraine and worldwide. Material and Methods. The study was performed on the basis of data analysis of the National Cancer Registry of Ukraine during 2015-2019. Statistical methods, structural-logical analysis and system approach are used. Results and Discussion. The research confirmed that mortality-to-incidence ratio for rectal MT in Ukraine is higher than worldwide, which indicates the need to primarily improve screening measures for colorectal cancer. Four nosological units (pancreas, stomach, pharynx, liver), characterized by extremely high level of neglected conditions, namely every third case among the first detected were identified. Based on the analysis of neglected cancer cases, trend equations were derived, which can be used to predict the degree of neglect of malignant tumors of the gastrointestinal tract. A study of one-year survival of patients showed that 40.1-45.5% patients with a newly diagnosed pharyngeal MT, 38.8-41% patients with MT of the oral cavity and 30.7-35% patients with MT of the colon do not survive for 1-year period from the moment of diagnosis. The most critical values of the rate of coverage of cancer patients with special treatment are typical for people with MT of the pancreas and MT of the liver: only one in four patients with MT of the pancreas and one in five patients with MT of the liver received special antitumor treatment within a year from the date of diagnosis. Conclusions. Ensuring effective medical care for patients with malignant tumors remains a priority of the health care system of Ukraine. The solution to this problem lies at the intersection of the clinical part, economic, organizational and social planes.

Purpose: To assess the diagnostic information value of chlorin e6 fluorescence visualization of cancer lesion margins in the radical surgical removal of malignant lesions of the external nose. Material and Methods: Thirty patients were examined and underwent surgery for malignant cancer lesions of the external nose at the department for ear, nose and throat cancer during 2017 to 2020. Half of these patients (group 2) received and the rest (group 1) did not receive a preoperative injection of Klein solution and fluorescence visualization of cancer lesion margins. Results: Cancer lesion margins were visualized by fluorescence with chlorin e6 via deep green staining of tumor tissue. The tumor focus appeared violet, and the tumor periphery, crimson when chlorine-e6 fluorescence was excited with 630-633 nm light from a HeNe laser. Because there was no change in tumor lesion margins when compared with visualization without exposing the lesion to laser radiation, exposing the lesion to laser radiation is not mandatory. At three years after surgery, the non-recurrence rate was for 100% for the group of patients who underwent surgery with preoperative injection of Klein solution and fluorescence visualization of cancer lesion margins, and 73.4% for the group of patients who underwent surgery without chlorin e6 fluorescein visualization. Two years after primary surgery, 4 (26.6%) of group 1 patients were diagnosed with recurrent superficial cancer of the skin at the cartilage-bone interface. Conclusion: First, the recurrence rate was 26.6% (4 of 15 patients) for the group of patients who underwent surgery without chlorin e6 fluorescein visualization, which was significantly higher than for the group of patients who underwent surgery with chlorin e6 fluorescein visualization (0 of 15 patients, z = 2.091; р = 0.037). Second, the use of chlorin e6 fluorescein visualization of the margins of a skin lesion of the external nose in patients with malignant tumors of the external nose with tumor spread to the tissues of the medial angle of the eye and eyelid enabled a radical approach to surgical treatment to be employed in 100% of cases.

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.

Pheochromoblastoma is a tumor developing from adrenal medulla and characterizing the severe course and high mortality level (15 %). Its severity is due to presence of not only malignancy but also catecholamine hyperproduction. The authors analysed the results of surgical treatment of 60 patients with pheochromoblastoma who were treated in surgical clinic in 1968–2017. The most effective method of treatment is surgery. The method of choice is a lumbotomic extraperitoneal access. The oncological radicality demands the complete tumor removal in a single capsule with the adrenal gland and revision of paranephric, paracaval and paraaortal tissues. Thirty eight (63.3 %) of 60 patients had 38 radical surgical procedures with following long-term remission. Three (5 %) patients had disease remission only after repeated surgery. Two patients live with the disease persistence, the drug ma­nagement of which is easier than before surgery. Eight (13.3 %) patients had widespread metastatic process and they were referred for the symptomatic treatment. The recurrence after the primary surgery is a poor prognostic factor. The majority of patients (55.8 %) with the recurrence were incurable. In the rest of the cases, the operative treatment led to the long-term remission only in 71.9 % patients.

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.

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.

Objective. Study the nature of structural and functional changes in the thyroid gland in patients with malignant tumors of the mammary glands that have suffered from the Chornobyl accident. Materials and methods. Examination of 80 patients with malignant tumors of the mammary glands at the age of 27-85 years. In 78 patients were diagnosed with breast cancer with different stages of the spread of the tumor process. The participants in the aftermath of the accident were 12 people, living in radioactive contaminated areas - 68. Mammography was performed with the help of mammographs Senographe 700 T and 800 Tsm. Echographic study of the structure of the mammary gland and the thyroid gland was performed on the ultrasound devices Nemio XG SSA-580. Computed tomography was performed on a multi-detector computed tomography 64 KT «LightSpeed VCT». MRI was performed on a magnetic resonance imager «Magnetom Vision Plus 1,5 T». For trepan biopsies, special needles were used in combination with a biopsy system gun «Magnum». The functional state of the thyroid gland was studied by studying the level of the thyroid hormone in peripheral venous blood. Results. The results of the ultrasound study on the structural changes in the thyroid gland (TG) and markers that characterize the functional state of the TG in women with breast cancer, show that 60 out of 80 patients who asked for help with various forms of breast cancer and examined in the clinic, revealed the presence of structural changes in the thyroid gland, which is 75 %. Conclusions. Structural changes in the thyroid gland in patients with breast cancer, who are considered victims of the Chornobyl Nuclear Power Plant accident, were diagnosed in 75 %, of which 71.25 % of patients did not know about the presence of pathological changes in the thyroid gland before the examination in the clinic. In the structure of the identified pathological changes in the thyroid gland, 47.5 % accounted for the nodular goiter, 10 % for small hydrophilic and small fibrous areas, 3.75 % for previously undergone surgery for thyroid removal, 3.75 % for chronic thyroiditis, 7.5 % - CAIT, 2.5 % - cystic changes in the thyroid gland, 3.75 % - nodular goiter and CAIT. [ABSTRACT FROM AUTHOR]

Hypoxia is one of powerful inducers of expression of a large group of genes, including genes which control glycolysis, angiogenesis and proliferation supportingcell surviving at low oxygen condition. However, in tumor cells hypoxia was observed at normal oxygen tension condition as a result of its decreased utilization. Moreover, hypoxia is an obligate component of malignant tumor growth and substantially controls glycolysis, angiogenesis and proliferation processes. Data concerning molecular mechanisms of activation of hypoxia inducible transcription factor HIF in cells at hypoxia and in malignant tumors, as well as its role of in the regulation of gene expressions have been analyzed. The mechanisms of interaction of the transcription factor HIF with specific hypoxic regulatory elements in the promoter region of genes activated by hypoxia were examined.

The research theme of angiogenesis: the development of blood vessels from preexisting ones is one of the most financially supported medical scientific topics in the world. It is connected with the fact, that 500 000 000 people require the therapeutic correction of the pathological processes of angiogenesis. In the review article only the brightest research articles knowingly predominantly Russian are systematized. The paper is well illustrated, to provide the understandable educational resource. The biochemical and pathophysiological questions of angiogenesis are discussed in close relation to the modern angiogenic pharmacotherapy. The purpose of the article is to present to the reader an opportunity to discover the biomedical research challenge of the 21 century: the pathological blood supply, vascularization and the associated phenomena.

Objective: Study the nature of structural and functional changes in the thyroid gland in patients with malignant tumors of the mammary glands that have suffered from the Chornobyl accident., Materials and Methods: Examination of 80 patients with malignant tumors of the mammary glands at the age of 27-85 years. In 78 patients were diagnosed with breast cancer with different stages of the spread of the tumor process. The participants in the aftermath of the accident were 12 people, living in radioactive contaminated areas - 68. Mammography was performed with the help of mammographs Senographe 700 T and 800 Tsm. Echo- graphic study of the structure of the mammary gland and the thyroid gland was performed on the ultrasound devices Nemio XG SSA-580. Computed tomography was performed on a multi-detector computed tomography 64 КТ «LightSpeed VCT». MRI was performed on a magnetic resonance imager «Magnetom Vision Plus 1,5 T». For trepan biopsies, special needles were used in combination with a biopsy system gun «Magnum». The functional state of the thyroid gland was studied by studying the level of the thyroid hormone in peripheral venous blood., Results: The results of the ultrasound study on the structural changes in the thyroid gland (TG) and markers that characterize the functional state of the TG in women with breast cancer, show that 60 out of 80 patients who asked for help with various forms of breast cancer and examined in the clinic, revealed the presence of structural changes in the thyroid gland, which is 75 %.Сonclusions. Structural changes in the thyroid gland in patients with breast cancer, who are considered victims of the Chornobyl Nuclear Power Plant accident, were diagnosed in 75 %, of which 71.25 % of patients did not know about the presence of pathological changes in the thyroid gland before the examination in the clinic. In the struc- ture of the identified pathological changes in the thyroid gland, 47.5 % accounted for the nodular goiter, 10 % for small hydrophilic and small fibrous areas, 3.75 % for previously undergone surgery for thyroid removal, 3.75 % for chronic thyroiditis, 7.5 % - CAIT, 2.5 % - cystic changes in the thyroid gland, 3.75 % - nodular goiter and CAIT., (D. A. Basyka, O. O. Lytvynenko, S. G. Bugaicov, G. F. Shakhrai, I. I. Daniluk.)

Objective. The goal of this study was to define levels and dynamic trends of cancer incidence at whole and some separate sites in groups of Ukrainian population affected by the Chornobyl accident during a long period of observation. Materials and methods. Those groups were Chornobyl accident recovery operation workers (CRW) of 1986-1987 years of participation, evacuees from Prypyat town and 30-km zone and residents of the most contaminated territories of Ukraine. Analysis was carried out with the standard methods of descriptive epidemiology: calculation of crude, age-specific and age-adjusted incidence rates with standard errors and confidence intervals. Results, discussion and conclusions. This study showed that all cancer incidences exceeded the national level only in CRW group. Decrease of cancer incidence rate in the recent years might be caused by shortened average life expectancy in Ukrainian population, especially in males. Statistically significant increase of leukemia incidence in CRW group was registered as well. Besides, in all three main affected groups there was revealed significant excess of thyroid cancer. Irradiation of thyroid due to radioactive iodine fallouts might be a main cause of this phenomenon. Increase of thyroid cancer incidence was registered not only in children, but also in adolescents and adults. Appearance of excess thyroid cancer cases as an effect of radiation exposure tends to increase during the time. Significant excess was also revealed for breast cancer in female CRW group. Because latency period for different nosological forms of radiation-induced malignant tumors varies widely, profound attention in further studies should be drawn not only to thyroid, breast cancers and leukemia, but also to malignancies with longer latent period: lung, stomach, colon, ovary, urinary bladder, kidney cancer and multiple myeloma., (A. Ye. Prysyazhnyuk, D. A. Bazyka, A. Yu. Romanenko, N. A. Gudzenko, M. M. Fuzik, N. K. Trotsyuk, Z. P. Fedorenko, L. O. Gulak, K. M. Slipenyuk, N. G. Babkina, O. M. Khukhrianska, Ye. L. Goroh, Zh. M. Berestyana.)