[Morpho-densitometric researches of cell nuclei at atypical hyperplasia and initial breast cancer].

There were performed researches on morphometric (the nuclear area, perimeter, the maximum and minimum diameters) and densitometric (optical density, integrated optical density) parameters of nuclei of cells on the cytologic smears received from 28 patients with atypical hyperplasia and an initial breast cancer. Significant reduction of measured nuclei parameters was noted among: moderately - and high-grade ductal carcinoma in situ, atypical ductal hyperplasia, lobular carcinoma in situ, an invasive papillary cancer, intraductal papilloma. The lowest value of the measured parameters was noted at love-grade ductal carcinoma in situ and intraductal papillary cancer. It was established that morphometric and densitometric indicators at atypical hyperplasia of an epithelium and an initial breast cancer in some cases overlap each other that is at the bottom of difficulties of differential cytomorphological diagnostics and quite often forces to formulate the cytologic conclusion in the presumable form.

Effectiveness of cytological diagnosis of breast cancer metastases in regional lymph nodes.

Results are presented of preoperative and intraoperative cytological diagnosis of breast cancer metastases in regional lymph nodes in 84 patients. Of them in 42 there was studied material of fine-needle aspiration biopsy, in 42 - smears of sentinel lymph nodes. In all cases cytohistological comparisons were carried out. The effectiveness of cytological examination of material of fine-needle aspiration biopsy was 90.5%. Urgent cytology of smears of sentinel lymph nodes allowed revealing metastases in 5 of 10 patients. The use of immunohistochemical examination increases the likelihood of detection of micrometastases and isolated tumor cell clusters.

[An evaluation of effectiveness of cytological method in diagnostics of breast tumors].

This paper presents an analysis of the results of cytological diagnostics of breast tumors in 3415 patients who underwent tests in the Laboratory of Cytology for 2009-2013. In 1434 patients there were performed cytohistological correlations. Sensitivity of cytology was 99.1%, specificity--93.5%, predictive value of the positive test--98.5%, predictive value of the negative test--95.9%, accuracy--98%. Non-informative material was obtained in 13.5% of cases. The main factors that reduced effectiveness of cytological method were non-informative and little informative material and also difficulties in conducting of differential cytomorphological diagnostics.

[Assessment of applicability of archived cytological lung cancer specimens for molecular genetic analysis].

Molecular genetic analysis of lung tumors is often essential for the proper choice of therapy. EGFR mutation is a well-known marker of sensitivity to gefitinib, erlotinib and afatinib; ALK-translocations make tumor sensitive to several ALK inhibitors; low intratumoral expression of DNA repair genes (ERCC1, BRCA1, etc.) may increase the therapeutic index of platinum-based drugs. Usually these markers are evaluated using formalin-fixed paraffin-embedded tumor tissues. The goal of this work was to assess utility of archived cytological lung cancer specimens as an alternative source of material for molecular genetic testing. We analyzed paired histological and cytological lung adenocarcinoma specimens. Comparison of results within the pairs showed that cytological material can be used instead of histological material for qualitative analyses (detection of EGFR mutations or ALK-translocations); however, gene expression measurements, obtained by quantitative real-time PCR, may differ significantly in histological and cytological samples from the same patient.

[Cervical intraepithelial neoplasia combined in pregnancy: diagnosis, management, outcomes].

Cervical cancer is the leading gynecological tumor associated with pregnancy accounting for 1.2-4.5 cases per 10,000 births. Precancerous diseases of the cervix, which include cervical intraepithelial neoplasia of high severity (H-SIL) combined with pregnancy, are even more relevant since the frequency of their occurrence can achieve 5.0%. Besides the peak of dysplastic cervical changes occurs in the mean age at delivery in the Russian Federation (28 years). The features of diagnosis and management of these patients during pregnancy, delivery and postpartum require a multidisciplinary approach from doctors of different specialties.

[Verification of histologic diagnosis in cervical carcinoma in situ with contradictory morphological data].

The medical technology of in situ cervical carcinoma cytological verification using computer-assisted morphometric and density analysis of atypical cells nuclei was developed. The technology is aimed at diagnosis verification in cases with contradictory morphological data. The malignant transformation of cervical epithelium undetectable by conventional morphology methods can be diagnosed using the Felgen-stained samples nuclear DNA distribution data. The right DNA distribution diagram shift with modal class 4C or higher, mean DNA contents higher than 4C, the ratio between aneuploidic and polyploidic cells higher than 0.2 are the signs of cervical epithelium malignant transformation.

[Organ-preserving interventions in combined therapy of children and adolescents with osteosarcoma].

An analyzed cohort consists of 50 pediatric patients with osteosarcoma receiving combined therapy in N. N. Petrov Research Institute for Oncology (1999-2010). Thirty nine of them had localized disease, 11 patients had distant metastases. The treatment scheme included neoadjuvant therapy with cisplatin and doxorubicin, surgical treatment and adjuvant therapy depended on initial response and could include cisplatin, doxorubicin, high-dose methotrexate, ifosfamide, etoposide. Four-year overall and relapse-free survival in children with localized disease was 74.3% and 69.2% accordingly. In 62% of patients were performed organ-preserving surgical interventions, in 22 patients was performed endoprosthetics, in 4 patients the defect was replaced by a bone autograft on a vascular bundle. The effectiveness of initial treatment and secondary endoprosthetics were analyzed. Six patients with lung metastases received normotermic lung chemoperfusion, 4 of them are alive and disease-free for 8 to 24 months.

Morphological changes in human skin melanoma treated by high-energy pulsed neodymium laser radiation.

PURPOSE: The neodymium (Nd) laser irradiation has been successfully applied to the treatment of slightly elevated skin melanoma. At the same time the histologic aspects of such a treatment have not been precisely investigated. The aim of this study was to retrace the histological features in human primary cutaneous melanomas after 1060 nm high energy mono pulsed Nd laser treatment in the dynamic healing of the affected tissues. METHODS: Histologic analysis of cutaneous melanomas irradiated by Nd laser was carried out. Tissue specimens were taken before and immediately after exposure to laser and 1 hour, and 1, 2 and 3 days after wards. Also the wounds that appeared after the scab fell off and the scars formed following laser irradiation were also the subject of histologic analysis at 2, 4 and 6 months post-treatment. RESULTS: The Nd laser irradiation caused coagulation necrosis of melanoma, epidermis and dermis with skin appendices and superficial layers of subcutaneous fatty tissue. Foci of laser destruction were characterized by strict locality and efficient separation from the adjacent tissues, by the presence of stasis, thrombosis and coagulation of blood and lymphatic vessels. There was an increase of lymphocytes, macrophages and histiocytes in the area damaged by laser as well as in wounds and scars. CONCLUSION: The pulsed Nd laser induces acute photothermal damages of melanoma tissue, which differs from the usual thermal lesions and the most critical difference of the effect of this modality is gain of immunocompetent cells in the affected tissue after laser beam application.

[Application of automated quantitative cytometry in diagnosis of lung cancer].

The paper deals with evaluation of the literature data and our experience with automated quantitative cytometric examination of sputum for diagnosis of lung cancer and, in particular, early one. This novel procedure uses measurement of quantitative indices which characterise tumors-induced alterations. The LungSign computerized system was employed to scan cellular nuclei. The results were evaluated by linear discriminative analysis with the aid of ROC-curves and underlying areas. The procedures were run in 248 cases and its sensitivity was significantly higher that of a standard cytological one (36.6% and 13.3%, respectively; p = 0.033), albeit a slight decrease in specificity (93.7% and 100%, respectively; p = 0.003). Automated quantitative cytometric indices varied significantly in cohorts of patients with confirmed (-0.275871) and false (-1.24990) diagnosis of lung cancer (p = 0.0001).

[Clinico-morphological diagnosis of adenocarcinoma in situ of the cervix uteri].

Clinical and morphological investigation involved 57 patients with adenocarcinoma in situ of the cervix uteri (poorly-differentiated (precancerous) cell carcinoma in situ (PAIS)--30; adenocarcinoma in situ (AIS)--27). Morphometric measurements using microimaging technique were carried out on 31 cytological patterns. Clinical symptoms appeared non-specific. Cytological examination of smears detected tumor cells in all patients. Predictions for PAIS histotype were confirmed in 83%, cytological findings--78%; AIS--52% and 58%, respectively. Accuracy for PAIS and AIS biopsy was 52% and 32%, respectively. The most accurate data were obtained by histological examination of resected material. However, our procedure failed to detect malignant process in 17.5% (PAIS--6 cases and AIS--4) which was established by use of smears (Feulgen).

[Analysis of morphometric data and ploidy of nuclear DNA from the bronchial epithelial cells in benign processes and different histological forms of lung cancer].

Morphometric data and the ploidity of bronchial epitheliocytic nuclear DNA were studied in benign processes and different histological forms of lung cancer (LC), by using smears taken from 42 patients at fibrobronchoscopy. There were certain differences in the mean values of the area and content of DNA between basal-cell hyperplasia, squamous-cell metaplasia and dysplasia, small-cell and non-small-cell LC, which may be used in the differential cytological diagnosis in difficult cases.

[Prognostic significance of tumor cell ploidy in advanced ovarian carcinoma].

A micro-imaging retrospective investigation of tumor cell ploidy using exudates smears from 52 patients with serous ovarian adenocarcinoma (stage III-IV) showed survival in those with diploid tumor to be significantly longer (38 months) than in cases of aneuploid malignancies (16 months). Significant differences in survival versus ploidy, stage, residual tumor size, therapy modality and age were established with the aid of univariate analysis (Caplan-Meyer) of 5-year survival. Multivariate step-by-step regressive analysis (Cox) was carried out on the prognostic significance of such factors as residual tumor size (p=0.013), stage (p=0.019) and tumor ploidy (p=0.035). Further study showed ploidy to be a fully independent factor like any other factors of ovarian carcinoma development.

[Cytological diagnosis and prognosis in Ewing's sarcoma in children].

143 cytological studies of the material obtained from 98 children aged from 2 to 18 years with tentative diagnosis of Ewing's sarcoma were made. Histocytological correlations showed 96.2% cases to be of informative value, 87% of them with precise cytological diagnosis of the above sarcoma. The analysis of images specified mean values of square (S) and ploidity (P) of tumor cell nuclei in 21 children with a good (10), and bad (11) outcome of the disease. It was established that if ploidy is higher than expected one (p = 0.0357 S), bad prognosis can be supposed and a good prognosis in the opposite case. In case of good prognosis differentiated tumor cells with large clear nuclei are seen in the smears, and poorly differentiated cells with hyperchromic nuclei are observed in cases with bad prognosis.

[New potential of estrogen and progesterone receptor assay in cytological smears sampled from breast cancer patients]. / Vozmozhnosti opredeleniia retseptorov éstrogenov i progesterona v rake molochnoi zhelezy na tsitologicheskikh mazkakh.

Estrogen (ER) and progesterone (PR) receptors were assayed immunohistochemically in cytological smears and histological samples from 30 breast cancer patients. Since the results reported by the two research centers matched by 73%, it is suggested that running ER and PR determinations on cytological smears in cases of inoperable cancer, preoperative therapy and monitoring may be recommended. Therefore, the 3-4 year old records on ER and PR determinations should be regarded as null and void.

[Correlation of cytologic and DNA ploidy evidence and prognosis in childhood Wilm's tumor]. / Sopostavleniia dannykh tsitologicheskogo issledovaniia i opredeleniia ploidnosti DNK s iskhodom zabolevaniia pri opukholi Vil'msa u detei.

A retrospective evaluation of the clinical features, cytological, biological (DNA) and histological data on 29 children with Wilms' tumor. Two prognosis-related groups were identified: (1) good outcome (17)--all children, aged 4-15, had survived by end of follow-up; (2) bad outcome (12)--all children died within 4 months--4 years. Cytological examination by fine-needle biopsy of smears was carried out prior to preoperative neoadjuvant therapy in all 29 patients; in addition, print smears from resected tumor were taken from 21. Blastemal, stromal, epithelial and anaplastic cells levels were estimated by the semi-quantitative procedure (0, 1+, 2+, 3+). DNA ploidy was determined by image cytometry after destaining slides and re-staining them according to Feulgen. It was shown that favorable outcome could be expected when fine-needle biopsy of print smears identified DNA diploidy and marked drug-related pathomorphosis involving fewer blastemal cells and signs of cell dystrophy and tumor necrosis. When anaplastic and aneuploid cells were detected, matched by the absence of therapeutic pathomorphosis, outcome was poor.

[Study of the antioxidant drug "Karinat" in patients with chronic atrophic gastritis]. / Izuchenie antioksidantnogo preparata "Karinat" kak sredstva dlia lecheniia bol'nykh s khronicheskim atroficheskim gastritom.

A randomized double blind placebo-controlled trial of the drug karinat was carried out in patients with chronic multifocal atrophic gastritis. Karinat contains beta-carotene 2.5 mg, alpha-tocopherol 5 mg, ascorbic acid 30 mg and garlic powder 150 mg per tablet. Out of 66 patients, 34 received karinat, 32--placebo. Both karinat and placebo were administered for 6 months, one tablet twice a day. Karinat therapy improved digestion, the fibrogastroscopic pattern of mucosa, inhibited Helicobacter pylori infection, stimulated stomach activity, mitigated intestinal metaplasia and interfered with the epithelial proliferation of gastric mucosa. These therapeutic effects were more pronounced in the study group. On the whole, the effectiveness of the drug was significantly higher (29%). Karinat should be recommended for the management of chronic atrophic gastritis, a precursor of stomach cancer.

[A comparative evaluation of treatment methods for a genital papillomavirus infection in women with different viral genotypes]. / Sravnitel'naia otsenka nekotorykh sposobov lecheniia genital'noi papillomavirusnoi infektsii u zhenshchin s razlichnymi genotipami virusa.

Such genotypes of human papilloma virus (HPV) as "malignant" (180), "benign" (49) and indeterminate (127) were identified in 356 females by PCR and cytological procedures. The following therapeutic techniques were compared: cryodestruction of the uterine cervix (60), antiviral medication (AVM) (19), combination of AVM and cryodestruction (224), and combination of AVM and laser destruction (54). In the "malignant" HPV group, AVM in conjunction with cryo- or laser destruction was significantly more effective than cryodestruction or AVM alone. Both cryodestruction alone and in combination with AVM were more effective in treating "benign" genotypes. Repeat courses showed the same tendency.

[Investigation of nucleolar organizer region activity in epithelial cells of hyperplastic endometrial carcinoma tissue]. / Issledovanie aktivnosti iadryshkoorganizuiushchikh zon v épitelial'nykh kletkakh pri giperplaziiakh i rake éndometriia s ispol'zovaniem analiza izobrazheniia.

Such characteristics of nucleolar organizer regions (NORs) as nucleolar and intra-nucleolar grain counts, NOR mean area, mean total NOR area in nucleus, nuclear area and nucleolus/nucleus ratio were identified using vaginal aspirate-smears from 34 patients with histologically verified diagnosis (adenocarcinoma--10, atypical hyperplasia (ATH)--10, glandular endometrial hyperplasia (GEH)--4); silver-staining and micro-imaging analyzer techniques were employed. Atypical hyperplasia and nucleolar count in nucleus progressively and significantly increased in the following sequence: proliferative phase--GEH--adenocarcinoma. Mean and total area of NORs showed a significant rise in ATH and adenocarcinoma. Those indices of endometrial cell proliferation and GEH were identical. Nuclear area and nucleolus/nucleus ratio offered most information for differentiating GEH, ATH and carcinoma. A highly reliable correlation was established between intra-nucleolar grain count and microscopically-assayed silver concentration, on the one hand, and NOR area, on the other.