A Group of miRNA as Candidates for Prognostic Biomarkers of Gastric Cancer Metastasis.

An association was found between reduced expression of miR-34a, miR-146a with both metastasis to regional lymph nodes (relative risk RR=10.50 and RR=5.25, respectively) and the development of distant metastases (RR=9.50 and RR=4, 40, respectively) in gastric cancer. They are excellent classifiers: AUC>0.9 for both miRNAs. The association of miR-335 expression with metastasis to the lymph nodes is much weaker, but it is also a good classifier for identifying a group with distant metastasis (RR=5.90). A correlation was found between the expression of miR-34a and miR-146a during metastasis, which is absent in non-metastatic tumors. Thus, miR-34a, miR-146a, and miR-335 miRNAs can be proposed as candidates for biomarkers of the risk of gastric cancer metastasis.

[Short-term outcomes of complete mesocolic excision for right colon cancer]. / Neposredstvennye rezul'taty pravostoronnei gemikoléktomii s total'noi mezokolonéktomiei i D3 limfodissektsiei pri lechenii raka pravoi poloviny obodochnoi kishki.

PURPOSE: Complete mesocolic excision (CME) appears to be a relatively new concept for colon cancer. The purpose is to evaluate the results of CME with high vascular ligation (D3 lymph node dissection) for right colon cancer. The presented study identifies possible risks and advantages of the proposed method, as well as the role of the laparoscopic approach. MATERIAL AND METHODS: The article included data from 39 patients with right colon cancer, TNM stage I-III, operated on between November 2015 and December 2016 in the oncoproctology Department of the Blokhin Cancer Research Center. The analysis of main intraoperative parameters, morbidity and mortality was carried out. RESULTS: There was no postoperative mortality. 17 (43.6%) of operations were performed by open and 22 - by laparoscopic approach. The conversion for laparoscopic approach was 1 (4.5%) in 22. The median duration of the operation was 180 (130-260) minutes for laparoscopic approach and 120 (90-280) minutes for open approach, р=0.0056. Median intraoperative blood loss was 30 (30-300) ml for laparoscopic approach, and 300 (30-500) ml for open approach (р=0.0001). The duration of lymphorrhoea, time to first bowel movement, time to start liquid and solid food intake were 5.1±2.4, 1.3±0.5, 1.26±0.4 and 3.2±0.7 days, respectively. The median number of removed lymph nodes was 35.7 (6-68), the median number of metastatic lymph nodes was 1.9 (0-16). The median number of removed apical lymph nodes was 10.3 (0-24). Metastases did not affect any of the lymph nodes of the apical group. CONCLUSION: Right mesocolic excision with D3 lymphadenectomy for right colon cancer is technically safe, and the laparoscopic approach provides all the benefits of minimally invasive surgery and excellent early treatment outcomes. Preliminary data shows no metastasis in apical lymphnodes for right colon cancer. Nonetheless, it is necessary to study the long-term results for the evaluation of oncological outcomes.

[Using "Collegel" complex in combined therapy of rectum cancer].

The method of drug delivery to the site of lesion is an important component of drug effectiveness. To maximize the effectiveness of drugs LLC "Koletex" has developed and brought into practice the drug, "Collegel" for directed drug delivery. Hydrogel based composition "Collegel" is biopolymer consists of sodium alginate. In the gel-forming polymer one or more substance introduced on a specific technology. Studies have been conducted to examine the possibility of using hydrogel "Collegel" with 5-fluorouracil as radiomodifying agent in the treatment of rectal cancer. In the group of patients who received intrarectal introduction 5-fluorouracil, metastases were observed significantly less frequently (2.8%) than in the group of patients who received surgical treatment (15.2%) and preoperative radiotherapy in monoregimen (12.6%), as well as reduced doses capecitabine concomitantly with preoperative radiotherapy (11.4%), which gives the basis for the use of intrarectal way of introduction of therapeutic doses of 5-fluorouracil during preoperative chemoradiation therapy. The newly created method of complex treatment of patients with rectal cancer to ensure adequate local control of the disease. There is no local recurrence diagnosed over the 2-year follow-up period. We have considerable experience in the application of gel "Collegel" containing antioxidant and immunomodulator "Derinat" (deoxyribonuclease sodium) for the prevention and treatment of radiation damage to normal tissues during radiotherapy of malignant tumors. Patients can be treated without interruption and significantly reduces the incidence of adverse radiation damage.

[New technologies in the diagnosis and treatment of patients with squamous cell carcinoma of the anal canal].

PURPOSE OF THE STUDY: The development of the rectum preservation treatment for the squamous-cell carcinoma of the anal canal. MATERIALS AND METHODS: The following scheme of the rectum preservation treatment for the squamous-cell carcinoma of the anal canal was developed and has been used in the Cancer Research Center RAMS since 1995. The irradiation is performed to the small pelvis, perineum and ilioinguinal lymph nodes, at a single dose 2 Gy, 22 sessions, total dose 44 Gy. Radiotherapy is associated with chemotherapy: cisplatin 20 mg/m2, twice a week, No 8; bleomycin 15 mg, twice a week, No 8. Irradiation is combined with 4-5 sessions of local hyperthermia. Local hyperthermia (about 42.5-43 degrees C in the tumor) was given for 60 minutes after irradiation. Local hyperthermia increases the effect of chemoradiotherapy in 1.5-2 times. If the tumor resorbtion exceeds 75%, intrarectal irradiation is performed at a single dose 3 Gy, 7-8 sessions, total dose 21-24 Gy. If the tumor resorbtion is less than 75%, abdomino-perineal resection is performed. RESULTS: This scheme was used in the treatment of 92 patients, rectum preservation treatment was performed in 76 cases (83%), abdomino-perineal resection--in 16 cases (17%). Local recurrences were in 10.0%, the overall 5-year survival was 75.2 +/- 8.5%.

[Clinical and morphological aspects of MALT-gastric lymphoma].

UNLABELLED: Mucosa-associated lymphoid tissue (MALT) conception has been extensively developing for last 20 years. THE AIM: The aim of this work was to elaborate clinico-morphological and immunohistochemical criteria of gastric MALT-lymphomas and to differentiate them from another with similar histology. MATERIALS AND METHODS: Between 1983 and 2007, 704 patients with diagnosis of extranodal lymphoma were observed in Russian Cancer Research Center. The work included biopsy and postoperation samples from 115 patients with primary gastric lymphoma, who were observed in Russian Cancer Research Center since 1995. On presented material with primary lymphomas were elaborated morphological criteria of MALT-lymphoma diagnosis for gastrobiopsy, based on histological, immunohistochemical and genetic examination. Also were devised differential diagnostic criteria of MALT-lymphoma. RESULTS: Follow morphological signs were estimated: cell composition, atypia of neoplastic elements, presence of plasmocellular differentiation of lymphoid cells, expression of plasmocytary infiltration, lymphoepithelial lesion and reactive lymphoid follicles with or without colonization, presence of blasts. So, in 35.2% cases part of neoplastic elements had the aspect of monocytoid B-lymphocytes. In the most of observations were revealed plasmatic cells. More often they were under integumentary epithelium as massive layer (46.47%), more rare they were scattered in superficial sections of lamina propria among cells of leukocyte row (39.43%). Lymphoepithelial lesions (LELs) are aggregates from three and more marginal zone cells, destroyed epithelium of glands, were revealed in half of cases. In 17.14% cases were ("blast") LELs, generated by large blasts. For reactive process T-lymphocytes predominate over B-lymhpocytes in the lymphocellular infiltrate, or T-lymphocytes and B-lymhpocytes are in equal ratio. The next important sign is coexpression T-cell marker CD43 on neoplastic B-cells. Cases of MALT-lymphoma with t(11; 18) are resistant to the antihelicobacter therapy. CONCLUSION: The most informative morphological, immunohistochemical features were ascertained as in diagnosis, as in differentiation with another neoplasms with similar morphology and reactive lymphoid infiltrates.

[Endoscopic criteria for diagnosis of various macroscopic variants of non-Hodgkin's gastric lymphoma].

UNLABELLED: BACKGROUND; Many investigators account that a stomach is the most often localization of gastrointestinal lymphomas. But endoscopic semiotics and diagnostic of those lesions is elaborated insufficiently. PURPOSE: The purpose of our investigation was working out of non-Hodgkin's gastric lymphoma endoscopic criteria. MATERIALS AND METHODS: We examinated 250 patients with gastric lymphoma, from those primary and secondary lesions were in 160 (64%) cases and 90 (36%) cases, respectively. All patients was performed standard videoendoscopy, which included magnified endoscopy with NBI (Narrow Band Imaging), followed by chromoendoscopy with indigocarmine (0.4% solution) and EUS. Diagnosis of lymphoma was confirmed by morphology and immunohistochemistry. RESULTS: According to our observations gastroenterological pathology duration to diagnosis of tumor was very variable: diagnosis was established during first 3 months in 30.6% cases (49 patients), during 6 month in 18.1% cases (29 patients), from 6 to 12 months in 15.6% cases (25 patients). Separately should was noted, that almost in one third cases primary gastric lymphoma was diagnosed after one year. Macroscopic form of gastric tumor was represented by follow variants: exophytic--22 cases (8.8%), infiltrative--54 cases (21.6%), ulcerous--37 cases (14.8%), infiltrative-ulcerous--71 cases (28.4%), similar to gastritis--36 cases (14.4%), mixed--30 cases (12%). The second endpoint of our work was detection of macroscopic features depending on morphological variant of lymphoma. Analysis of represented data demonstrated prevalence similar to gastritis form (33.4%) for MALT-lymphoma, infiltrative-ulcerous form as for diffuse large-cell B-cell lymphoma of MALT-type, as for diffuse large-cell B-cell lymphoma--45.0% and 41.1%, respectively. Infiltrative form was more often in group of patients with follicular lymphoma--31.8%, and ulcerous form predominated for Burkett's lymphoma--60.0%. CONCLUSION; Were established the most informative endoscopic criteria for diagnosis non-Hodgkin's gastric lymphoma.

[Non-Hodgkin's lymphomas of the stomach: modern state of the problem].

In article epidemiological aspects NHL are shined, the basic attempts of kliniko-morphological ordering lymphomas are described, opened them morphimmunological aspects. As clinical value of various histologic classifications of NHL is shined. On the basis of studying of all displays of NHL are noted by the most significant factors of the adverse forecast, taken as a principle international prognostics index, risks of early progressing of NHL are described also. Results of 5-year-old survival rate reveal at NHL depending on morphimmunological variant.

[Endosonographic criteria for indolent and aggressive non-Hodgkin's lymphoma of the stomach].

UNLABELLED: At the present stage use only standard visual endoscopy and a radiological method of research of a pathology of a stomach does not meet the requirements of oncologists. In spite of the fact that these techniques continue to remain base and prime in inspection of a digestive tract, the leading part in specification of character of pathology of GI tract is taken now endosonography method. A research objective: to establish endoscopic ultrasonic criteria of diagnostics indolentics and aggressive NHL of stomach. MATERIALS AND METHODS: For studying of possibilities endosonography in diagnostics NHL of a stomach 46 patients have been analysed, during the period since 2005 for 2009 to all patients after videogastroscopy was carried out endoscopic scanning, and the tumour biopsy further was made. RESULTS: Are defined by us endosonography criteria NHL of a stomach: the tumor starts with deep layers mucous and submucosal layer, extends mainly on submucosal layer, it is marked multicentrial defeats, echoic tumors is always lowered or heteroechoic with hypo echoic inclusions. On the basis of this data by us are defined endosonography criteria various morphoimmunological variants of NHL of a stomach. Estimating possibilities endoscopic ultrasonic diagnostics it has been revealed that its diagnostic accuracy makes 87.7%. In 84.9% at use EUS it is possible to assume authentically presence lymph proliferative process of a stomach and in 94.7% endosonography will allow to exclude authentically pathological process in a stomach.

[Endoscopic resection of mucosal and submucosal stomach layers as the diagnostic and medical procedure in oncology].

Owing to introduction in a daily practice of modern medical technologies there was real improvement of duly diagnostics of early forms of a cancer of a gastroenteric path. In this connection interest to endoscopic methods of its treatment has increased. According to the world literature, parameters of a radical resection of a mucous membrane of a stomach in occasion of early cancer vary in a range of 75-98% depending on the macroscopical form of growth and the sizes of a tumors. There is one more very important parameter on which efficiency of a method EMR depends, it is the fact of use of a technique of removal of pathological formation by the uniform block or by parts. As us, with the purpose of all-round studying opportunities of a EMR and ESR was carried out as diagnostic procedure at infiltrative forms of a cancer and lymphomas of stomach.Thus, the purpose of our research is studying true value and the importance of application of EMR and ESR, as with the purpose of specifying diagnostics, and a curative method in oncology.