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Introduction. A multimodal approach to the treatment of locally advanced gastric cancer with the addition of systemic or local treatment methods, such as chemotherapy and radiation therapy, reduces the risk of cancer recurrence, thus improving survival of patients. Advances in anticancer therapy dictate the need to develop systems for assessing tumor response to new treatment modalities.Material and Methods. The study included 162 patients with locally advanced gastric cancer who received treatment at the N.N. Petrov National Medical Research Center of Oncology from 2015 to 2018. All patients underwent subtotal gastric resection or gastrectomy with lymph node dissection and previously received neoadjuvant polychemotherapy. Patients were in the age range 30 to 80 years old. The tumor pathomorphological response to chemotherapy was assessed in all patients using a pathomorphological response rate system according to the classification of the Japanese Gastric Cancer Association (JGCA, 3rd English edition). All patients underwent computed tomography with pneumogastrography before neoadjuvant chemotherapy and immediately before surgery. For each of 162 patients, 96 qualitative and quantitative biomarkers of tumor and paragastric lymph node imaging were analyzed.Results. The accuracy of determining the tumor response rate using computed tomography with pneumogastrography was 82.6 % for TRG-0/1, 90 % for TRG-1/2, and 88 % for TRG-2/3. Discussion. The tumor pathomorphological response to treatment is a predictor of long-term results; however, it can be assessed only after analyzing the surgical specimen, and this marker cannot be used in inoperable cases and for correction of palliative chemotherapy. The study of imaging biomarkers based on quantitative and qualitative data reflecting the histopathological features of the tumor and lymph nodes can help determine the tumor regression grade and optimize treatment.Conclusion. The proposed algorithm for assessing the response grade of locally advanced gastric cancer to chemotherapy using imaging biomarkers is a promising prognostic marker and requires further study.

Objective: to reveal technical nuances for obtaining high-quality images using a computed tomography protocol with pneumogastrography and virtual gastroscopy, which contribute to the detection and assessment of the morphological type of gastric cancer and to the determination of its localization and invasion depth.Material and methods. The investigation enrolled 250 patients with both early (24.8%) and locally advanced (75.2%) gastric cancer treated in Petrov National Medical Research Center for Oncology from 2015 to 2018. Preoperative chemotherapy was performed in 142 (56.8%) patients and was not done in 108 (43.2%). All the patients underwent preoperative computed tomography with pneumogastrography and virtual gastroscopy. All the patients were radically operated on through subtotal or total gastric resection.Results. Computed tomography with pneumogastrography and virtual gastroscopy was used to detect gastric cancer in 98.4% of patients; the cases with early T1a and T1b invasion depth cancers were 23.2%. The tumor could not be significantly differentiated in 4 (1.6%) patients. This group consisted of: 3 (1.2%) and 1 (0.4%) patients with pT1a and pT1b invasion depth tumors, respectively. All non-visualized tumors had a superficial morphological type of growth (Type 0–II (3 cases with 0–IIa and 1 case with 0–IIb); their sizes were less than 2 cm. Three tumors were localized in the antral portion of the stomach; one was in its cardiac portion.Conclusion. Computed tomography with pneumogastrography and virtual gastroscopy is an effective technique to detect gastric cancer, including its early types of category T1, which makes it possible to assess its localization, morphological type, and invasion depth.

Are submitted the data about typical and atypical options of a trunk Genle, to his arhitectonics, topography, existing classifications, morphometric characteristics and cclinical value of anatomic features. It shown, that the anatomy of a trunk of Genle and his inflows has the expressed variability, and practically it isn’t described in Russian-speaking literature. Appreciable number of various options of formation of a trunk of Genle, various frequency of occurrence of these options, morphometric indicators, apparently, depends on the size of selection of the studied objects, a sex and other reasons. Classification is created, reflecting results of a research, and presenting data in foreign literature. It reveal, that, despite a large number of the described versions of the description of this anatomical structure, there is no uniform idea of the veins forming this trunk. Nosological examples are analyzed, showing need of control of options of formation of a trunk of Genle and his morphometric features at expeditious and diagnostic manipulations on organs and vessels of a peritoneal cavity. Without comprehension arhitectonics of roots and inflows of a portal vein, there is a great risk of a surgical mistake which can lead to lethal complications. In general, cases in point are important for surgical practice, in particular, for abdominal surgery and an onkokhirurgiya.

Data on variant anatomy of the celiac trunk, typical and atypical variants of its architectonics, topography, existing classifications, morphometric characteristics, development of the vessels of abdominal aorta in embryogenesis and the clinical significance of anatomical features is presented. The issues under consideration are important for surgical practice, in particular, for abdominal surgery, transplantology, interventional X-ray endovascular surgery and oncosurgery. It is shown that the anatomy of the celiac trunk and its branches have a pronounced variability, and more than 15% of the population have significant deviations from the typical branching variant. A significant number of different variants of the celiac trunk dividing, a different frequency of occurrence of these variants, morphometric indices, apparently depends on the size of the sample of the investigated objects, gender and other reasons. Data on the development of branches of the abdominal aorta in embryogenesis and the causes of atypical variants is presented. In a comparative aspect, existing classifications of the most authoritative authors are considered. It is shown that, despite the large number, there is no universal, simplest in practice, classification of variants of the celiac trunk branching. Nosological examples that demonstrate the need to take into account the variant of formation of the celiac trunk and its morphometric features in operative and diagnostic manipulations on the organs and vessels of the upper floor of the peritoneal cavity are analyzed. Certainly without understanding the architectonics of the gastrosplenicpancreatoduodenal zone arteries, there is a significant risk of error, which can even lead to lethal complications.

Inherited mutations in the BRCA1 and BRCA2 genes more often provoke the development of metachronous tumors compared to the general population. Women who carry inherited BRCA1 mutations have an increased risk of developing not only breast and ovarian cancers, but they have also increased risks of developing other types of cancers, such as cervical cancer, endometrial (uterine), ovarian, pancreatic, prostate, and salivary gland cancers. Common views on the pathogenesis of hereditary cancers imply that the development of the tumor is always preceded by the loss of the remaining (normal) allele of the involved gene. Nevertheless, there is reliable information that some BRCA1-associated ovarian cancers demonstrate retention of the second BRCA1copy. We report a rare case of the development of neuroendocrine cell carcinoma- metachronous ovarian cancer and lung carcinoid tumor in the patient with the BRCA1 gene mutation. In addition, the tumor demonstrated loss of heterozygosity at the BRCA1 locus (loss of the wild-type allele).