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Different studies indicate that cancer stem cells (CSCs) play an important role in the progression and therapy resistance in different cancer types. The aim of our study was to analyse the distribution of CSCs in different thyroid lesions, in reproductive, menopausal and post-menopausal women. Study included altogether 200 formalin-fixed and paraffin-embedded tissue material, with the diagnosis of NIFTP, Hashimoto's thyroiditis, papillary thyroid carcinoma (PTC) and PTC and Hashimoto's thyroiditis co-occurred cases. Normal thyroid gland was used as a control tissue. Stem cell marker - CD44, as well as other markers including Ki67, BCL2, CK19, CD56, ER were investigated with standard immunohistochemical procedure. The results of our study indicated that CD44 stem cell marker, as well as proliferation marker Ki67 is significantly upregulated in PTC cases in all age groups. However, the expression of CD44 and Ki67 is significantly higher in reproductive age patients, compared to patients in menopause and post-menopause. In addition, the expression of CD44 and Ki67 is significantly higher in PTC and Hashimoto's thyroiditis co-occurred cases, compared to cases with PTC only.

Apoptosis plays one of the major roles in the progression of human cancers including cervical carcinoma. The aim of our study was to analyse the expression of Cas3, Bax and their correlation with the proliferation index and ER expression status during the progression of cervical intraepithelial neoplasia (CIN). Study included altogether 140 specimens, divided into two major groups, such as: cervical lesions without co-infections and with co-infections. Standard immunohistochemistry was used to detect antigens: Ki67, Cas3, Bax and ER. The study results showed that the expression of Cas3 is significantly decreased whilst the expression of Bax is significantly increased during the progression of CIN in both groups with and without co-infections. The expression of Bax negatively correlates with the expression of Cas3 (r=-42.4, p0.05) and ER (r=-33.4, p0.05) and positively correlates with the expression of proliferation marker Ki67 (r=56.3, p0.05). The results indicate that the deregulated apoptosis measured as increased expression of Bax and Cas3 loss, as well as the increase in proliferation index measured as Ki67 expression is significantly related to the progression of CIN into cervical carcinoma. Therefore, the measuring of mentioned protein expression could be used as the markers of the CIN progression.

Statement of purpose Traumatic injuries account for significant global burden of disease, causing 9% of all deaths worldwide and substantial short- and long-term disability. Injury rates are disproportionately high in low- and middle -income countries (LMICs). However, despite the fact that more than 90% of injury related deaths occur in LMICs, most of the research comes from high- income countries. In spite of the overall impact and importance of the topic, emerging economies such as Georgia experience high injury rates yet have little research addressing incidence, characteristics, risk factors, and prevention strategies. Methods/Approach The aim of this research was to describe the epidemiological characteristics of injury in two tertiary teaching hospitals in Georgia. The data was extracted from the official database of the National Center for Disease Control and Public Health for 2018. Results A total of 1494 adults patients were admitted of whom 912 (61%) were males and 582 (39%) were - females. The highest prevalence was among the age group 25–44 years old (36%), followed by 45–64 years old (26%). The main mechanism of injuries were falls (61%) and road traffic incidents (22%). Over 17% of injuries resulted in death after hospitalization. These findings provide empirical bases for future studies. More research is needed to identify injury related factors useful for planning effective prevention strategies. Conclusion The study was conducted with the goal of providing the baseline data to policy makers and other stakeholders to help guide future research, policy and funding agendas.

Uterine leiomyoma represents the most common pelvic tumor in females, including numerous histological subtypes, from which smooth muscle tumors of uncertain malignancy potential (STUMP) represents the diagnostic challenge. On the other hand, the study of the relapse risk markers after laparoscopic myomectomy is of high interest. We investigated the molecular phenotype of different types of leiomyoma after hysterectomy or laparoscopic surgery in reproductive and menopausal women. Standard immunohistochemistry was used to detect proliferation markers Ki67 and cyclin D1, apoptotic markers Bcl2 and Cas3, and ER and PR. The results of our study indicated that ER expression is significantly higher in relapsed leiomyoma, compared to control group. In addition, relapsed leiomyomas are characterised with high proliferation and apoptotic index. With regard to STUMP despite histological homogeneity, this entity is characterised with the presence of three distinct molecular subtypes, based on proliferation and apoptotic marker expression, which should be used as diagnostic aid in these tumors.

Stem cells represent the small subpopulation of healthy and cancerous tissues, which are characterised with increased proliferation and self-renewal properties. From the many different markers of stem cells, we have investigated the stem cell index during the progression of cervical intraepithelial neoplasia (CIN), based on the immunohistochemical expression of CD44 in total of 140 tissue samples from uterine cervix. In addition, we have performed the profound correlation analysis of CD44 with different epithelial-mesenchymal, proliferation, apoptosis and hormonal markers at both protein and mRNA level. The results of our study indicated that, stem cell index based on the CD44 detection is significantly increased with the progression of cervical intraepithelial neoplasia. In addition, CD44 expression significantly correlates with the epithelial-mesenchymal transition, proliferation-apoptotic features and ER status in both protein and mRNA level. Two, groups of cervical intraepithelial lesions as well as carcinoma can be identified based on the expression of CD44, Ki67, Cas3 and ER. To the best of our knowledge we are first to demonstrate such findings in CIN and cervical carcinoma and identified characteristics could be used for the early assessment of CIN patient prognosis and for the relevant clinical management.

Introduction: There are few published empirical data on the effects of COVID-19 on mental health, and until now, there is no large international study. ----- Material and methods: During the COVID-19 pandemic, an online questionnaire gathered data from 55,589 participants from 40 countries (64.85% females aged 35.80 ± 13.61; 34.05% males aged 34.90±13.29 and 1.10% other aged 31.64±13.15). Distress and probable depression were identified with the use of a previously developed cut-off and algorithm respectively. ----- Statistical analysis: Descriptive statistics were calculated. Chi-square tests, multiple forward stepwise linear regression analyses and Factorial Analysis of Variance (ANOVA) tested relations among variables. ----- Results: Probable depression was detected in 17.80% and distress in 16.71%. A significant percentage reported a deterioration in mental state, family dynamics and everyday lifestyle. Persons with a history of mental disorders had higher rates of current depression (31.82% vs. 13.07%). At least half of participants were accepting (at least to a moderate degree) a non-bizarre conspiracy. The highest Relative Risk (RR) to develop depression was associated with history of Bipolar disorder and self-harm/attempts (RR = 5.88). Suicidality was not increased in persons without a history of any mental disorder. Based on these results a model was developed. ----- Conclusions: The final model revealed multiple vulnerabilities and an interplay leading from simple anxiety to probable depression and suicidality through distress. This could be of practical utility since many of these factors are modifiable. Future research and interventions should specifically focus on them.

The incidence of papillary thyroid carcinoma is characterised with increasing tendency, with unknown reasons. Frequently the co-occurrence of papillary thyroid carcinoma and Hashimoto's thyroiditis has been observed. The aim of our study was to analyse the expression of hormone receptors, lymphocytic infiltration and thyreocyte/lymphocyte proliferation index in thyroid papillary carcinoma and in Hashimoto's thyroiditis. Study included 115 formalin-fixed and paraffin-embedded tissue material from the teaching, research and diagnostic laboratory of Tbilisi State Medical University. Study material was divided into following groups: normal thyroid gland (n=15), Non-invasive Follicular Thyroid Neoplasm with Papillary-Like Nuclear Features (NIFTP) (n=15), classic papillary carcinoma (CPC)(n=20), follicular variant of papillary carcinoma (FPC) (n=17), cylindric-cell variant of papillary carcinoma (CCPC)(n=9), Hashimoto's thyroiditis (HT) (n=25) and the co-occurrence of Hashimoto's thyroiditis and papillary carcinoma (HTPC) (n=14). Standard immunohistochemistry was used to detect ER, PR, Ki67, CK19, CD56. In addition, lymphocytic infiltration was evaluated in HE stained specimens. Study results showed that ER and PR expression is higher in FPC, CCPC and HTPC compared to CPC (p0.001), whilst lymphocytic infiltrate is lower in FPC and CCPC compared to CPC (p0.05). In addition, ER and PR expression is higher in HTPC compared to HT only (p0.001). The thyreocyte/lymphocyte proliferation index is increased in FPC and CCPC compared to CPC and it is also higher in HTPC compared to only HT and CPC (p0.05). The expression of sex steroid hormones plays an important role in the pathogenesis of papillary thyroid carcinoma. The expression level of ER and PR is even higher in cases where Hashimoto's thyroiditis and papillary carcinoma co-occur. Therefore, we can conclude that Hashimoto's thyroiditis may play an important role in the development of papillary thyroid carcinoma.

Traumatic brain injury (TBI) is a leading cause of death and permanent disability in children and adolescents. Study of TBI with reliable and high-quality data represents the basis for effective strategies for injury prevention. The database of the National Center for Disease Control and Public Health of Georgia for 2018 was studied to identify TBI cases treated at the largest children's hospital in Georgia. Cases were included based on the S06 diagnosis coded of ICD-10. Descriptive statistics were used to describe traumatic brain injuries. М. Iashvili Childrens'hospital treated 296 pediatric brain injuries in 2018. TBIs were more common in boys (n=180, 61,1%) than in girls (n=116, 38,9%), and patients aged 10 -14 were most frequent. 8 (4,4%) of male patients and 2 (1,7%) of female patients required more than 15 days of in-patient treatment. More than two thirds of children had suffered TBI due to falling 198 (66.6%), followed by road traffic injuries 56 (18.9%) and other type of blunt force 42 (14.2%). 54.3% of all TBI patients required at least one day of hospital stay. Most of the TBI patients 220 (74,3%) were brought to the hospital by private transportation. In-patient treatment was completed in 293 (98.9%) of cases, three (1%) male patients died. In all three cases of lethal outcome, the cause of injury wasroad traffic. Based on existing data, it was possible to study just part of TBI epidemiological properties. TBI national reporting formats do not cover information about location and time of injuries, place of occurrence, therapeutical treatment and severity of the illness. To study the full epidemiological picture of TBI, retrospective studies based on the medical history in hospitals are needed.

Human papilloma virus (HPV) infection, especially with high risk types, represent the major etiological factor for the development of cervical precancerous and cancerous lesions. However, other factors including cell proliferation index, epithelial-mesenchymal transition and the presence of co-infections might also influence the progression of cervical intraepithelial neoplasia (CIN). The aim of our study was to analyse, the expression of cell proliferation markers and epithelial-mesenchymal transition markers during the progression of cervical intraepithelial neoplasia, in cases with and without co-infections. Standard immunohistochemistry was used to detect, Ki67, cyclin D1, phosphohiston-H3, p63, E-cadherin, β-catenin and vimentin. The results of our study indicated that the expression of Ki67, phosphohiston-H3 and p63 is significantly increased during the progression of CIN disease, whilst the expression of E-cadherin and β-catenin are progressively lost. The expression of mesenchymal marker vimentin is also increased in CINIII and in invasive carcinoma. Proliferation index based on Ki67 labelling is significantly higher in cases with co-infections and the expression on E-cadherin is significantly lower in cases with co-infections compared to cases without co-infections. In conclusion, the measurement of proliferation index, based on Ki67 labelling, as well as mitotic index based on phosphohiston-H3 detection can reliably indicate high and low risk groups of the progression of CIN. Similarly, higher p63 expression, loss of E-cadherin and β-catenin and higher vimentin expression can indicate the progression risk of CIN. The presence of co-infections is associated with the increased expression of proliferation marker Ki67 and the loss of E-cadherin and therefore it can be considered as an additional marker of CIN progression.

Background:Over 90% of morbidity and mortality associated with traumatic brain injury (TBI) occurs in low-and middle-income countries. Lack of reliable, high-quality data regarding TBI prevention and care hinders the ability to reduce TBI burden. We sought to identify current TBI data collection practices and capacity in Georgia, focusing on pre-hospital, hospital, and rehabilitation treatment. Methods:The eight level I and two level II Trauma Hospitals in Georgia with the highest number of TBI admissions in 2017 were selected for study. A semi-structured survey about various aspects of TBI care was designed and semi-structured interviews of healthcare providers treating TBI patients (e.g. neurologists, neurosurgeons) were conducted based on this survey. Results:Pre-hospital triage protocols were not routinely used to match patient treatment needs with hospital capacity. All hospitals provided specialist care for TBI 24 hours/day. MRI was available at only three (30%) centers, and in-hospital rehabilitation units were available in only one (10%). No center used a defined protocol for treating TBI patients and no national protocol exists. Conclusion:Even among the largest, most highly specialized hospitals in Georgia, TBI care varies in terms of diagnostic and treatment protocols. While TBI specialists are available, diagnostic equipment often is not. Gaps in pre-hospital coordination and access to rehabilitation services exist and provide areas of focus for future investment in reducing TBI burden

Toll like receptors (TLRs), NK cells, Langerhans cells and T cells play an important role in the protection of host organism from human papilloma virus (HPV) infection. The aim of our study was to analyse TLR9 expression, Langerhans cell density and NK cell and Lymphocytic infiltration in the progression of cervical intraepithelial neoplasia (CIN). By using standard immunohistochemistry, we have investigated TLR9, CD1a Langerhans cell marker, CD56 NK cell marker, CD3 general T cell marker, CD4 T helper cell marker and CD8 cytotoxic T cell marker. We have introduced NK cell epithelial index and Langerhans cell epithelial index. In addition, we have introduced proliferation apoptotic index of lymphocytes using Ki67 and BCL2 markers. The results of our study showed that TLR9 expression, T cell infiltration and NK epithelial index is significantly increased during the progression of CIN disease. Whilst Langerhans cell epithelial index is significantly decreased. Proliferation apoptotic index of lymphocytes is also significantly decreased during the progression of CIN. Based on our study results we recommend the assessment of TLR9 and proliferation apoptotic index as an additional markers for defining CIN progression potential.

Microenvironment plays central role in the development of cervical precancerous and cancerous lesions. Cervical intraepithelial neoplasia (CIN) represents a group of precancerous lesions, divided into three degrees. We investigated the distribution of intraepithelial lymphocytes and macrophages in different grades of CIN. We analysed lymphocyte marker CD103, macrophage marker CD68 and proliferation marker Ki67 using standard immunohistochemistry. In addition, we investigated the distribution of lymphocytes using standard haematoxylin and eosin method. The results of our study indicated thatgrade I CIN which subsequently progressed into grade II CIN was characterised with low lymphocytic infiltration, low lympho-epithelial index and low lymphocyte proliferation index. Similar results were seen in cases of CINII which were later progressed into CINIII or in carcinoma. Therefore, we would like to recommend the analysis of microenvironment alterations in CIN lesions, in order to assess their progression potential.

Histone modifications represent one of the types of epigenetic changes. Histones, undergo different types of epigenetic modifications, including the phosphorylation of serine residues. pHH3 antibodies specifically detect histon-3 protein, when phosphorylated at 10th and 28th serine residues. Traditionally pHH3 antibodies are used as proliferation marker, as it detects cells in late G2 and M phase. We studied the distribution of phosphor-histon-3 in epithelial tumors of the ovary and its relationship with ER, PR, Ki67, p53 and BCL2. Altogether, we investigated postoperative material from 160 patients. Standard immunohistochemistry was used to detect, phosphohistone-H3 (pHH3), ER, PR, Ki67, p53 and BCL2. The results of our study showed that phosphohistone-H3 expression is negatively associated with the expression of ER and PR expression, as well as with BCL2 expression, on the other hand it positively correlates with Ki67 and mutant p53 (p0.05). In addition, the expression of phosphohistone-H3 is detected in Ki67 negative cases and its expression is increased along with the increase of malignancy grade. Our study results indicate that PHH3 might be used as an additional marker for the assessment of proliferation and malignancy potential of epithelial tumors of the ovary.

Hydatidiform mole represents the major cause of the molar pregnancy, which is a special cause of spontaneous abortions. We analysed phenotypic characteristics of epithelial hyperplasia and tumor microenvironment alterations in different types of hydatidiform moles. Standard immunohistochemistry was used for the detection of Ki67, Cyclin D1, p53, BCL2, E-cadherin, p63, Vimentin, CD34, CD3, CD4, CD8 and CD68. In addition, epithelial hyperplasia has been assessed in standard diagnostic haematoxylin and eosin stained tissue specimens. The results of our study indicated that both cytotrophoblast and sincitiptrophoblast layers are characterised with marked epithelial hyperplasia and high proliferation index in partial and complete moles, whilst apoptotic index is minimal. Early complete mole resembles the partial mole, rather than complete mole. Lymphocyte infiltration, marked by CD3, CD4 and CD8 is also higher in complete and partial moles, whilst macrophage infiltration is relatively lower. Macrophage infiltration marked by CD68 correlates with microvessel density marked by CD34. The evaluation of proliferation and apoptotic markers, as well as microenvironment, might serve as additional diagnostic markers in patients with hydatidiform moles and hydropic abortions.

Borderline ovarian tumors (BOTs) represent particular challenge for diagnosis and clinical management as they are characterized with the features of both benign cystadenomas and malignant carcinomas. The aim of our study was to investigate histomorphological and immunohistochemical characteristics of ovarian serous-papillary borderline tumors, compared to serous cystadenomas and low- and high-grade serous carcinomas. Altogether, 80 formalin fixed and paraffin embedded tissue specimens, distributed in four groups, including serous cystadenoma (group I), serous BOTs (group II), Low (group III) and high (group IV) grade serous carcinomas, were investigated by standard immunohistochemistry, using antibodies against CK7 CK20, WT1, Vimentin, CDX2, CEA, ER, cyclin D1, BCL2, E-cadherin, calretinin, СA125, Ki67, P53. Study results showed, that ovarian serous BOTs are characterized with slightly increase proliferative potential compared to benign cystadenomas, whilst apoptotic potential is retained with the difference from malignant serous carcinomas. p53 mutation is not present, as well as the expression of Vimentin. Overall, ovarian serous BOTs are characterized with highly variable immunohistochemical phenotype and the use of multiple immunohistochemical markers are recommended for the differential diagnosis from low grade serous carcinomas and benign cystadenomas.

Epigenetic changes in breast cancer patients have long been believed to be a promising marker for clinical management - early detection, prognostication, etc. Various approaches are available to test global DNA or target gene methylation status. We used some of them in different tissues of patients with breast cancer to analyze possible links between epigenetic parameters and their value for predicting clinicopathological characteristics (most importantly stage and lymph node status) of tumors. Patients with ductal and lobular invasive carcinoma were included in the study along with age-matched controls. Blood, tumor tissue and normal breast ductal epithelial cells were investigated using MS-HRM technique (for BRCA1 gene promoter methylation assessment), COBRA-PCR (for Alu element methylation quantification) and ELISA-based method (for global DNA methylation estimation). These parameters were analyzed in comparison to clinical, histologic and phenotypic characteristics of the tumors. BRCA1 promoter methylation was detected exclusively in tumor tissues and in only two cases, both of which had aggressive phenotype. Alu and global DNA methylation showed markedly low levels in all tissues of cancer patients compared to healthy controls, with extreme hypomethylation in tumor tissue. Changes in these two parameters were not always concordant. Methylation levels detected in blood showed rather weak relationship with clinicopathological characteristics of tumors. We could conclude that tested parameters are not useful for preoperative determination of tumor stage or lymph node status, neither any other clinicopathological characteristics of tumors. Epigenetics signatures of different tissues of the same patient are not homogenous. Given the uniform picture of DNA methylation in blood in some of investigated groups, additional data and very careful approach are required when considering using it as a diagnostic or predictive tool.

The aim of the study was to explore and identify the relationship between endometrial proliferative/stem cell index and phenotypic characteristics under proliferative processes of endometrium using statistical correlation analysis. The study represents a retrospective research. The coded and depersonalized material data from Acad. N. Kipshidze Central University Clinic was used in the study. 5 study groups (83 cases) were selected from routine histopathology tissue specimens of uterus. Hematoxilyn-eosin technology and immunohistochemistry with markers ki67, CD146, PTEN was performed. The proliferative/stem cell index (PR/ST index) was calculated by the ratio of Ki67-positive cell percentage value divided by CD146-positive cell percentage value. PTEN expression score was evaluated by next scheme - PTEN positive cell numbers10% - conditional negative, PTEN positive cell numbers 10-50 % - heterogenic, PTEN positive cell numbers50% - conditional positive. The study showed that, PR/ST index in 1st study group Endometrial Hyperplasia ranges within the interval 15-23, PTEN is diffusely positive with focal heterogeneity 11.1%. 2nd study group Endometrial Dysplasia, the PR/ST index ranges within the interval 16.5-23.3. PTEN heterogeneity is 18.3%, negativity - 6.3%. 3rd study group Endometrioid Carcinoma Grade 1, the PR/ST index ranges between 21.7 and 25.5. PTEN is heterogenic in 35.7% of cases, negative in 14.3% of cases. 4th study group Endometrioid Carcinoma Grade 2, the PR/ST index ranges within the interval 23.2-27.8. PTEN is heterogenic in 43.5% of cases, negative in 30.4% of cases. 5th study group Endometrioid Carcinoma Grade 3, the PR/ST index ranges within the interval 25.8-29.4. PTEN is heterogenic in 33.3% of cases, negative in 41.7% of cases. It was found that, in endometrial hyperplasia and dysplasia cases the PR/ST index do not correlate with phenotypic characteristics, while in the cases of endometrial carcinoma different degrees of malignancy the PR/ST Index and phenotypic characteristics intensely and directly correlates. The high attention should be given to the fact that heterogeneity peak of PTEN expression takes place in the cases of endometrial carcinoma G2, but the negativity of PTEN protein is increasing in parallel with the malignancy increasing process and reaches peak performance in cases of endometrial carcinoma G3.

Methylation is an epigenetic alteration proved to be involved in many disease processes including cancer. This change affects mainly gene promoters and repetitive sequences in genome. Long Interspersed Nuclear Element-1 (LINE-1) is a family of retrotransposons - repetitive elements that modify gene activity and can themselves be targeted by epigenetic mechanisms. LINE-1 methylation level is a surrogate marker for global methylation. In many conditions this parameter is found to be altered not only in affected cell groups, but also throughout other tissues. The aim of our study was to compare LINE-1 methylation pattern in DNA extracted from blood of the patients with benign and malignant breast tissue. In addition, we investigated correlation of LINE-1 methylation in blood and tissues of same patients and relationship of all variables with histopathologic and phenotypic characteristics of tumors. Patients with biopsy-proved ductal invasive carcinoma of breast and no preoperative chemo/radiotherapy were chosen for the study group. Another pool of patients with various benign breast lesions represented controls. Blood samples from both group members were collected preoperatively. Tumor tissue sections were processed for pathology report and part of remaining tissue was used for methylation study. LINE-1 methylation level was quantified using ELISA-based assay. It was analyzed in combination with histologic and phenotypic tumor parameters and compared between different tissues and different study groups. LINE-1 was found to be significantly hypomethylated in breast cancer tissue compared to blood. Blood samples of patients with malignant tumors showed slightly lower methylation level, than samples obtained from control group members. Lymphovascular invasion was the only aggressiveness-determining factor that was found to be at least weakly correlated with LINE-1 hypomethylation in blood. We can conclude, that global hypomethylation measured by LINE-1 methylation level is significant in tumor tissue. But there is no significant difference between LINE-1 methylation levels in blood of patients with benign and malignant breast tumors; therefor LINE-1 hypomethylation in blood cannot be used as a marker for early tumor detection. Neither is it valid for determination of tumor behavior.

Endometrial neoplasia is the most common malignant tumor of female genital system in developed countries. The incidence of endometrial cancer has increased in the last years and despite advances in diagnosis and treatment, the death rates have steadily been increasing over the past 20 years. Therefore aspects of endometrial cancer development, pathogenesis and effective treatment is especially urgent to this day, as much of the risk for endometrial cancer development is influenced by the environment and lifestyle. Endometrial stem cells take the special place among somatic stem cells of female reproductive system-the detection of them and identification of their location in the complex cellular hierarchy still remains challenging. Further study of endometrial stem cells will clarify their role in gynecologic pathologies associated with hyper-proliferative states of endometrium. The aim of our study was to explore the specificities of endometrial proliferative/stem cell index distribution under endometrioid carcinoma of different grade of malignancy. The study represents a retrospective research. The coded and depersonalized material data from Acad. N. Kipshidze Central University Clinic was used in the study. 3 study groups - 1st study group "Endometrioid Carcinoma Grade 1" (14 cases), 2nd study group "Endometrioid Carcinoma Grade 2" (23 cases) and 3rd study group "Endometrioid Carcinoma Grade 3" were selected from routine histopathology tissue specimens of uterus. Hematoxilyn-eosin technology and immunohistochemistry with proliferation marker ki67 and stem cell marker CD146 was performed. The proliferative/stem cell index was calculated by the ratio of Ki67-positive cell percentage value divided by CD146-positive cell percentage value. The study showed that in the 1st study group labeled as "Endometrioid Carcinoma Grade 1", the proliferative/stem cell index ranges between 21.7 and 25.5. Its mean average value in the age distribution subgroups accounts for: 1.1) reproductive age - 22.4; 1.2) menopause - 23.5; 1.3) post-menopause - 24.8. Proliferative/stem cell index reaches its maximum in the samples retrieved from post-menopause age, and decreases significantly in reproductive age individuals. In the 2nd study group labeled as "Endometrioid Carcinoma Grade 2", the proliferative/stem cell index increases and ranges within the interval 23.2-27.8. Its mean average value in the age distribution subgroups accounts for: 2.1) reproductive age -23.7; 2.2) menopause - 24.2; 2.3) post-menopause - 25.8. In the 3rd study group labeled as "Endometrioid Carcinoma Grade 3", the proliferative/stem cell index markedly increases and ranges within the interval 25.8-29.4. Its mean average value in the age distribution subgroups accounts for: 3.1) reproductive age - 28.4; 3.2) menopause - 28.5; 3.3) post-menopause - 28.5. It was found that average value of proliferative/stem cell index in the 1st and 2nd study groups (EC Grade 1/2) keeps the same tendencies of increase in age subgroups as well as at endometrial hyperplasia conditions - in particular in both study groups increase in value of the proliferative/stem cell index in age subgroups makes about 1% (1st study group-0,97%, 2nd study group-0,96%). What about 3rd study group (EC Grade 3) average value of proliferative/stem cell index in age subgroups is almost the same. It was found that average value of proliferative/stem cell index in endometrioid carcinoma most markedly differs from the norm in post-menopause period. The study showed that average value of proliferative/stem cell index in endometrioid carcinoma cases (EC Grade 1/2) tends to increase with age like endometrial hyperplasia conditions, in contrast with the norm, where it is observed to progressively decrease with aging. The attention should be given to the fact that the mean average value of proliferative/stem cell index in endometrioid carcinoma Grade 3 is almost constant.

Oropharyngeal tumor is the eight most common cause of cancer death worldwide. Among the causes of oropharyngeal carcinoma significant are cigarette smoking, abuse of alcohol, multi-partners, high risk HPV (Human Papillomavirus) and etc. Cytological material (oral Pap smear) was taken from oral fundus and cheek mucous by the cytobrush. 47 participants with cervix pathology and 42 participants of the control group were investigated. Oral smears were stained by the Papanicolaou method and were diagnosed by a double blind method. After the cytological examination, we carried out detecting low and high risk HPV by chromogenic in-situ hy-bridization (CISH method) to use a positive and negative control. The quantitative statistical analysis was performed by SPSS V.19.0. Numeral data were processed using Pearson correlation and X2 tests. Confidence interval of 95% was regarded statistically significant. Study group’s oral pap smear with atypical cytology was detected in 61.7%. Atypical cytological changes in the control group were confirmed in 38.0%. High risk HPV detection by the CISH, in study group, showed positivity in 46.8% and in the control group—in 4.8%. Participants with cervix pathology will be considered as a risk-group to develop oropharyngeal tumor. Screening program for oropharyngeal cancer combines Pap smear and high risk HPV test together. For the control group, it is recommended to use oral pap smear and in the case of atypical changes using high risk HPV test too.

Major problems haunt the physicians who need to delineate the best management strategy for their patients with thyroid nodule is the identification of the most aggressive cases, especially among papillary thyroid cancers, which would benefit from more aggressive therapy and follow up. Beyond its strong correlation with PTC, the BRAF mutation is well described to associate with poor prognosis. The aim of our study was to identify BRAF antibody expression in different hystotypes of the thyroid nodules and assessment of it expression according to the tumor aggressiveness. Immunohistochemical staining was performed in 54 of surgically resected thyroid nodules, including malignant and benign cases, grouped according to the tumor aggressiveness. We have used selected thyroid specific markers: BRAF antibody, CD-56, CK-19, HBME-1 and KI-67. Adenomatous hyperplasia's and follicular lesions doesn't reveal positivity to the expression of BRAF antibody. Encapsulated papillary carcinomas included in our work revealed negative or very poor positivity of BRAF antibody. This fact strengthen the hypothesis that encapsulated papillary carcinomas have an indolent behavior and is genetically distinct from infiltrative tumors. We revealed 55,5% positivity of BRAF antibody in the cases of papillary microcarcinomas, this fact creates a need for more cautious approach to this type of tumors. The degree of BRAF antibody expression increased with a rising of tumor aggressiveness in our histopathologic groups (P0,005). All cases of papillary carcinoma with multinodular involvement and extrathyroid extension revealed moderate or strong positivity of BRAF antibody expression.

Endometrial stem cells take the special place among somatic stem cells of female reproductive system, since their essence and nature still remains unclear - cellular complexity of endometrium, its hormone-dependence and cycling remodeling makes the study of endometrial stem cells exclusively complicated. Consequently, the detection of endometrial stem cells and identification of their location in the complex cellular hierarchy still remains challenging. The aim of our study was to explore the age-related specificities of endometrial proliferative / stem cell index distribution under normal and hyperplasia conditions. The study represents a retrospective research. The coded and depersonalized material data from Acad. N. Kipshidze Central University Clinic was used in the study. 2 study groups - 1st study group "Norm" (12 cases) and 2nd study group "Endometrial Hyperplasia" condition (18 cases) were selected from routine histopathology tissue specimens of uterus. Hematoxilyn-eosin technology and immunohistochemistry with proliferation marker Ki67 and stem cell marker CD146 was performed. The proliferative/stem cell index was calculated by the ratio of Ki67-positive cell percentage value divided by CD146-positive cell percentage value. The study showed that in the 1st study group labeled as "norm", the proliferative/stem cell index ranges between 8 and 16.5. Its mean average value in the age distribution subgroups accounts for: 1.1) reproductive age - 10.6; 1.2) menopause - 4.5; 1.3) post-menopause - 1. In the 2nd study group labeled as "endometrial hyperplasia", the proliferative/stem cell index markedly increases and ranges within the interval 15-23. Its mean average value in the age distribution subgroups accounts for: 2.1) reproductive age - 18; 2.2) menopause - 18.2; 2.3) post-menopause - 18.5. It was found that proliferative/stem cell index in the 1st study group labeled as "Norm" progressively decreases with aging, while in the 2nd study group labeled as "Endometrial Hyperplasia" it behaves opposite and increases with age. Moreover, it must be noted that proliferative/stem cell index in endometrial hyperplasia cases with regard to norm increases significantly, namely in the subgroups 1.1/1.2 (which is reproductive age) it increases 1.5 times, and in the subgroups 1.2/2.2 (which is menopause age) it increases 2.5 times, while in the subgroups 1.3/2.3 (which is post-menopause age) it increases 18.5 times. The high attention should be given to the fact that the mean average value of proliferative/stem cell index in endometrial hyperplasia most markedly differs from the norm in post-menopause period.

FNA biopsy is well known method for the first step evaluation of thyroid nodules, it is the "gold standard" for diagnosis and surgical approach of nodular goiter. Despite the high sensitivity and specificity of the method there are grey zone in the diagnosis of thyroid nodules, mainly due to the heterogeneous group of Bethesda category AUS/FLUS. There are also some difficulties in diagnosis of PTC, especially FVPTC, even on histologic sections. The limited studies exist that specifically address details of cytologic features associated with cytohistologic discrepancy. Cell-block is very helpful in the diagnosis of papillary thyroid carcinoma and the carcinoma of undefined category; as the papillary configuration and nuclear features were more obvious, also immunocytochemical markers are applicable for ancillary studies. The BRAF mutation detection, which is associated with papillary microcarcinomas and cancer, can be yield for preoperative diagnosis, as well as for prognostic marker and as therapeutic target for farther management.

We aimed to analyze the diagnostic criteria proposed by the Bethesda System for reporting thyroid Fine needle aspiration biopsy (FNAB) results. FNABs of 600 patients were performed during 1-year period (2013-2014) in Georgian hospitals (Tbilisi Cancer Center, New Hospitals, National Screening Center). Based on our clinical, ultrasound, FNAB and histology results we define how each diagnostic category of the Bethesda System is distributed among age and sex groups of the cases included in this work. The patient age range was from 20- to 80 years and grouped them in four age groups: I group 20-35 years (n=87), II group 36-50 (n=243), III group 51-65 (n=206) and IV group 66-80(n=64). Histologic correlation was made, defined rate of malignancy. Each diagnostic category conveys specific risk of malignancy, which offers guidance for patient management. Our study showed that the probability of benign nodules is high in our cases, encountered 63,3%. Benign nodules are most commonly found in the group II and III, which are middle age groups. Bethesda class 3 or AUS/FLUS category, which is the most heterogeneous class, carries the rate of malignancy 20,4% and most commonly encountered in group II and III. According to our study particularly noteworthy and interesting was the first age group (20-35 years) because most of the diagnosis of Bethesda class 6 or malignant category was encountered in this age group. Based on our data, it should be noted that there are very high probability of cancer in young age group and it carries high risk of malignancy.

The pathological examination is one of the longest in the list of medical tests. Most of this time is spent on preparation of the microslide, which involves the following phases: fixation, processing, cutting and staining. Our objective was to develop optimal regime of fixation and processing (namely, 1 and 2 stage of processing) by applying Nano composites for the development of quick, cheap and qualitative protocol of material processing. 24 various types and concentration Nano composite fixation device were used in study, made by applying single-layer, surface modified carbon nanotubes in the conditions of ultrasound treatment by UP200HT device. Also was developed Nano tubular network integration method in bio-material in the conditions of ultrasound treatment, when besides Nano composite fixation devices various Nano composite reagents (namely, 0.003% and 0.005% Nano composite alcohols) were used in material processing. There were carried out 126 experiments in sum and experiments were checked through standard processing. Fixation devices produced from formalin and alcohol base showed good result of fixation - by using them in the conditions of ultrasound treatment, practically 24 times decreased the period of fixation (as a standard of fixation was applied minimal rate of ASCO/Cap guideline dated by 2008 - 6 hours). The best way was considered Nano composite fixation device of NH2 functionalization of the 0.002% concentration on alcohol base A19 (according to the fixation rate 15 minutes with ultrasound maintenance). Nano tubular network integration method enabled us to have decreased the number of alcohols of ascending concentration and delay time in them. High time efficiency factor - Tk = 47.5% (time of new processing/ standard processing time X100) and high efficiency factor of the expense of reagents - Rk = 33% (number of reagents spent at the time of new processing/number of spent reagents at the time of standard processing X100) is obtained as a result of Nano integrated processing, so almost 2 times less time is spent and 1/3 times less reagents needed.