[Prognistic value of a study of the expression of argyrophilic nucleolar organizer region associated proteins in case of papillary thyroid cancer].

The prognosis in papillary thyroid cancer (PTC) is usually good. Ten-year survival can be seen in 90-98% of patients. Immunohistochemical study (antigen K-67) ascertained that a female patient with PTC had a low number of proliferating cells, which is usually seen in the favorable course of the disease. However, in the presented case, PTC was highly aggressive and showed a significant invasive growth, provided regional and distant metastases, rapidly progressed and, despite the performed surgical treatment, the patient died due to disease progression 3 months after surgery. This discrepancy between the number of proliferating cells and the aggressive course of PTC should be explained by the high expression of argyrophilic nucleolar organizer region associated proteins nucleofozmin and nucleolin, detected by immunohistochemical study, which is known to cause an increase in the rate of a mitotic cycle rate and to promote intercellular adhesion and enhancement of invasive growth and metastatic spread. Various factors involved in the regulation of proliferation of cells and their capacity for invasion and metastasis should be studied to make the most objective estimation of the degree of malignancy of a tumor and its prognosis.

[Evaluation of the diagnostic significance of cytologic studies in pancreatic tumors].

The study was undertaken to specify cytomorphological criteria for prostatic duct adenocarcinoma (PDAC), by assessing fine-needle aspiration biopsy (FNAB) specimens. Histologically verified cases were selected and the archival cytological material that constituted Leishman stained smears obtained by percutaneous FNAB under ultrasound guidance from 72 patients with PDAC (n = 50) or ductal hyperplasia (DP) (n = 22) was revised. For statistical analysis, the authors selected the following cytological signs of malignancy: anisonucleosis, increased nuclei, hyperchromia, uneven chromatin distribution, enucleation, uneven nuclear outline, apocytes; increased nucleoli, nucleolar polymorphism, multiple nucleoli, increased cells, anisocytosis (polymorphism of the size and shape of a cell, mitoses, piled nuclei, papillary structures, slightly glandular structures. The statistical analysis identified three most important cytological criteria for PDAC: anisocytosis, anisonucleosis, and piled nuclei. Keeping in mind all three signs at once increases the probability of detecting of PDAC up with 90%. The detection of only anisocytosis in the cytological specimen showed a 40% probability of the presence of PDAC. Three additional cytological signs of PDAC were also identified: increased nuclei, uneven nuclear outline, and slightly adhesive structures. The probability of PDAC was 100% if the specimen contained three most significant signs and any of the additional signs. By taking into account the indicators of diagnostic efficiency (DE), the best criteria were as follows: anisonucleosis, uneven nuclear outline, anisocytosis. The optimal indicators of DE for anisonucleosis were 95.83% diagnostic sensitivity (DSen), 95.83% diagnostic specificity (DSp), and 95.83% DE. When two indicators (anisonucleosis and uneven nuclear outline) were simultaneously used, DSen was 93.42; DSp, 98.53% (the highest); DE, 95.83%. Thus, the following cytological signs are defined as important for differentiation of PH and PDAC: anisocytosis, anisonucleosis, piled nuclei, increased nuclei, uneven nuclear outline, slightly adhesive structures.

[Laser DNA-flow cytofluorometry in the differential diagnosis and prognosis of the cervix uteri cancer].

Laser DNA-flow cytofluorometry (DNA-FC) was used to examine 102 primary patients with morphologically verified pathology of the epithelium of the cervix uteri. There was a significant reduction in the count of cells in the cellular cycle phase (CCP) G0/1 and its increase in the CCP S and G2 + M, as well as a rose in the cell proliferation index (PI) in actually invasive (n=45) and microinvasive cancer of the cervix uteri (CCU) (n=21) as compared with the baseline values (n=8), CIN I-II (n=7), and CIN III (21 patients with severe dysplasia and cancer in situ; their DNA-FC parameters were close and significantly indistinguishable). With unfavorable clinical and morphological factors of CCU prognosis (age over 50 years, postmenopause, stages II-III, high-grade tumor, more than 3 mm stromal invasion, more than 4 cm in size, lymphovascular invasion in the regional lymph nodes, the endophytic form of growth, and a primary focus in the endocervix), aneuploid tumors were more significantly frequently found. The poor CCU prognostic factors significantly decreasing total and relapse-free 4-year survival included tumors of aneuploid type, those containing greater than 40% of aneuploid cells, those containing less than 70% of tumor cells in CCP G0/1, those having 10% of tumor cells or more in CCP S or more than 30% cell PI. While predicting CCU, the DNA index (DNAI) and PI with 0.09 and 0.05 informative value coefficients, respectively are the most significant DNA-FC parameters (after Shenon). By using them, the risk of progressive disease may be predicted with 67.9% probability. When DNAI and PI are used in combination with the most significant clinical and morphological factors of CCU, the likelihood of the latter increases up to 89.3%.

[Her-2/neu, Ki-67 expression and ploidy in breast carcinoma]. / Ekspressiia Her-2/neu, Ki-67 i ploidnost' pri rake molochnoi zhelezy.

Expression of the markers was studied immunocytochemically on cytological preparations of breast tumor, ploidy was assessed by flow cytofluorimetry. The material was divided into 2 groups: diploid--41.4% cases and aneuploid--58.6%. Hyperexpression of Her-2/neu in the first group was observed in 54.5%, in the 2nd group in 48.6% cases. Expression of Ki-67 in 63.4% and in 68.9%, respectively. Tumours with high proliferative activity were numerous in aneuploid tissues, and in diploid tumours moderate activity prevailed (p = 0.006). Direct correlation between the markers was observed, high expression of Ki-67 more frequently was associated with positive expression of Her-2/neu. Thus, aneuploid tumours with high proliferative activity and hyperexpression of Her-2/neu are more aggressive tumours of a large size.

[Laser DNA flow cytometry in patients with ovarian epithelial tumors]. / Vozmozhnosti ispol'zovaniia lazernoi DNK-protochnoi tsitometrii u bol'nykh s épitelial'nymi opukholiami iaichnikov.

Despite the use of new drugs in therapy of ovarian cancer, remote results remain unsatisfactory. Traditional prognostic factors, which are often subjective, do not reflect the individual features of a tumor in a certain patient. The authors compare classical prognostic factors, the data of laser DNA flow cytometry, and the receptor status of the tumor. Tumor ploidy is the most informative independent prognostic factor: the period without relapses in patients with aneuploid tumors is significantly shorter in comparison with patients with diploid tumors. Study of tumor cell distribution by the cell cycle phases can also provide additional information for predicting the disease course in ovarian cancer.

[Comparison of immunocytochemical and immunohistochemical methods for biomarker detection in breast cancer]. / Sravnenie immunotsitokhimicheskogo i immunogistokhimicheskogo metodov opredeleniia biomarkerov pri rake molochnoi zhelezy.

The detection of the biological parameters of the tumor before the treatment beginning becomes of more importance. The present study aimed to carry out the comparative analysis of the molecular markers expression (P53, Ki-67, Her-2/neu, Bcl-2, Bax, ER, FasL and CD95) at the cytologic and the correspondent histologic samples. The 18 tissue samples of the breast cancer were investigated. The immunocytochemical and the immunohistochemical methods of the molecular markers determination were used. Our study showed the correlation between two methods and the possibility of the use of the immunocytochemical staining as routine method of the molecular markers expression determination.

[Differential diagnosis of hepatocellular carcinoma using laser DNA-cytofluorometry]. / Differentsial'no-diagnosticheskie kriterii gepatotselliuliarnogo raka, opredelennye metodom lazernoi DNK-protochnoi tsitofliuorometrii.

Because of insufficient amount of material obtained in many cases of puncture biopsy, Differential diagnosis of hepatocellular carcinoma (HCC) with benign tumors and focal cirrhotic lesions of the liver is difficult. The study was aimed at development of additional criteria for HCC differential diagnosis of the basis of a comparison of morphological data (histological and cytological) with DNA content in the cells of focal lesion of the liver and is based on the research of biopsy material from 111 patients with focal liver lesions. Laser DNA flow cytometry (DNA-FCM) was carried out in 59 samples using laser flowing cytometer FACScan (Becton Dickinson, USA). The complex of three HCC histological criteria was established (trabecular histoarchitecture, increased nuclear-cytoplasmatic rate and nuclear crowding) for comparison with puncture biopsy of the liver (diagnostic efficiency 93.7%). Optimal quantitative parameters for HCC diagnosis were the following: reduction of the number of cells in a GO/1 phase of the cell cycle (< 77.5%), appearance of aneuploid clone of cell DNA index > 1.0 and decreased percent of binucleated cells (< 10%). Very high diagnostic specificity of the research was found (98.3%). Usage of quantitative parameters in the complex with histological criteria of HCC increased efficiency of the diagnosis up to 98%.

[Cytomorphological diagnosis of granulosa cell tumor of the ovary]. / Tsitomorfologicheskaia diagnostika granulezokletochnoi opukholi.

The cytology of granulosa cell tumor in children and adults is studied. Cytological smears of ascitic fluid and fresh tissue smears were examined. The tumor was diagnosed in 9 patients aged 11 to 73 years. All patients had symptoms of hyperestrogenia. Adequate treatment of the condition requires the tumor to be differentiated from other tumors (thecoma, low-grade and small-cell carcinomas, carcinoid, yolk-sac tumor, and lymphoma) before or during surgery.

[Therapeutic pathomorphism of Ewing's tumor]. / Terapevticheskii patomorfoz opukholi Iunga.

Pathomorphosis of Ewing's tumors after the combined treatment is studied with the use of light and electron microscopy, DNA-flow cytometry. Necrosis and apoptosis of tumor cells produced by the therapy are characterized. Therapeutic forms of tumor cells representing hyperaneuploid population delayed at the G2-level of the cell cycle are described.

[Possible use of parameters of tumor cell ploidies and carcinoembryonic antigen levels in the prognostication of epidermoid lung cancer]. / Vozmozhnost' ispol'zovaniia parametrov ploidnosti kletok opukholi i urovnia rakovo-émbrional'nogo antigena dlia prognozirovaniia ploskokletochnogo raka legkogo.

Whether the DNA index (DNAI) of tumor cells and serum carcinoembryonic antigen (CEA) may be used to make prognosis in 78 patients with epidermoid lung cancer at the stage of T1-3 N(o) Mo was studied. There was a direct correlation between tumor ploidy and CEA levels. The two-year relapse- free survival among the operated-on patients at the stage T1-2 N(o) Mo was not shown to be associated with DNAI. At the same time in the T1-3 M1-2 Mo patients radically operated on, the two-year survival correlates with DNAI: it is significantly (p < 0,05) higher in patients with diploid tumors (DNAI = 1.0) than in those with aneuploid cancer (DNAI > 1.05). The patients with low preoperative CEA levels ( < 10 micrograms/l) have a more favourable prognosis after radical surgical treatment.