[Significance of comorbidity for patients with chronic lymphocytic leukemia].

BACKGROUND: Chronic lymphocytic leukemia (CLL) remains an uncurable disease, in which the age, number and severity of comorbidities primarily determine the choice of therapeutic tactics and objectives. AIM: To evaluate actual comorbidity and polymorbidity in patients with CLL and a possible relationship between the diseases and comorbidities that are considered concurrent and side effects of the administered treatment. MATERIALS AND METHODS: The study consisted of two parts. In a retrospective study, we analyzed records of patients with CLL from the Registry for Diagnostics and Treatment of Lymphoproliferative Diseases. In addition, we thoroughly evaluated and prospectively followed up 124 patients in the course of their preparation to a new stage of CLL tratement. RESULTS: Examining data from the Russian Registry for Diagnostics and Treatment of Lymphoproliferative Diseases (n=1361) showed that in Russia, the age of patients with newly diagnosed CLL has increased in the recent decade with the increase in life span, which might change the comorbidity structure. Comparing retrospective and our own data (n=124) showed that diagnoses of concurrent diseases are often recorded formally (p3 suggested a poor prognosis for patients with CLL. CONCLUSION: Diagnosis and treatment of comorbidities in patients with CLL require participation of different medical specialists working in a close contact with oncohematologists.

[Carcinosarcomas of the uterus: molecular-genetic and morphological features].

13 cases of uterine carcinosarcomas have been studied by molecular-genetic method. The impairment of some genes (K-RAS gene in the first exon, TP53 in the 5th-9th exons, PTEN in the 5th and 8th exons) has been found out. The loss of heterozygosity of TP53 gene in epithelium and mesenchyme of the uterus has been detected. According to the estimation of impairment the studied tumors was divided into monoclonal and biclonal ones. This stratification could be use as prognostic criteria of uterine carcinosarcomas clinical presentation.

[Carcinosarcoma of the corpus uteri: potential of p53, PTEN and COX-2 expression for survival].

Clinico-morphological and immunohistochemical examinations were carried out in 46 patients with carcinocarcinoma of the corpus uteri to evaluate p53, PTEN and cyclooxygenase-2 (COX-2) expression in mesenchymal and epithelial cells of tumor. p53 expression in the epithelium and that of COX-2 in both compartments appeared to be unfavorable prognosticators of survival while that of PTEN is a lesser one in significance.

[The morphology of triple negative breast cancer].

Triple negative breast cancer (TNBC) does not express estrogen and progesterone receptors and amplified Her2/neu gene. Examining 90 cases of TNBC by traditional, histological, and immunohistochemical studies (70 patients) has indicated the heterogeneity of this group of breast neoplasms. It is represented by a great variety of the histological types of mainly high-grade breast cancer. The markers of basaloid differentiation (cytokeratins 14, 5/6, 17, and p63) in the tumor cells were revealed in various ratios in 49 patients. The above markers were absent in 21 cases. Poor prognosis in TNBC seems to be largely associated with the presence of the basal-like phenotype rather than that of the triple negative phenotype. Much work to determine specific quantitative parameters is to be done to define the nosological specificity of mainly the basal-like subtype of TNBC.

[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.

[PTEN gene in triple-negative breast cancer].

The paper gives the results of studying the expression of the PTEN gene product by an immunohistochemical method, as well as deletion of the gene by fluorescence in situ hybridization in the tumor cells of 80 patients with triple-negative breast cancer (TNBC). The gene product was absent in the tumor cell nuclei in 56 products. The bulk of the remaining patients who showed a positive response had lobular carcinomas or tumors with an unidentified microscopic variant due to secondary posttherapeutic changes. Lobular carcinomas in a control group presented by patients without TNBC also contained the PTEN gene product. Therefore, all positively responding tumor cells failed to express basaloid markers and androgen receptors. The immunohistochemically detectable absence of the PTEN gene product is usually coupled with deletion at locus 10q23; however, in several cases the negative immunohistochemical reaction is associated with no deletion at the above locus, which suggests that there are mechanisms for PTEN gene dysregulation other than deletion in TNBC. The presence of the PTEN gene product in the tumor cells is associated with good prognosis in patients with TNBC.

[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.

[Investigation of biological features of uterine carcinosarcoma].

Results of clinico-morphological and immunohistochemical studies of 44 cases of carcinosarcoma of the uterus are presented in an attempt to provide pathogenetic rationale for prognosticators of the disease. Immunohistochemical reactions were used to evaluate the expression of genes and mediators p53 and PTEN and cyclooxigenase (COX-2) in cells of mesenchyme and epithelium of tumor to gauge the influence of either component on its biological behavior. All patients were divided into two groups depending on whether they revealed expression of p53, PTEN and cyclooxigenase or not. The end results--overall survival and complete remission duration--were compared in both groups. No dominance of either component of carcinosarcoma was established.

[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.

[Long-term impact of breast reconstruction on quality of life among breast cancer patients].

Psychological impact of modified radical mastectomy carried out simultaneously with breast reconstruction (n=45) was compared with that in controls who underwent similar surgery for cancer alone (n=50). After 12 months, depression was less frequent in group 1 and indices such as being a good mixer, joyfulness, activity, happiness, job satisfaction and access to leisure and entertainment were significantly higher than among controls (p< or =0.05). However, deep depression persisted in group 1 (13%) as long as for 12 months and intense angst in 17.8%.

[Histiocytic lesions of the orbit and eye appendages]. / Gistiotsitarnye porazheniia orbity i pridatkov glaza.

2 cases of sinus histiocytosis with massive lymphadenopathy are reported. The disease belongs to non-neoplastic lesions associated with proliferation of histiocytes with antigen-treating function. A case of sarcoma is also described. It consisted of follicular dendritic cells related to histiocytes with the antigen-representing function.

[Combination of taxotere and doxorubicin in chemotherapy of disseminated breast cancer]. / Kombinatsiia taksotera i doksorubitsina v khimioterapii disseminirovannogo raka molochnoi zhelezy.

Chemotherapy (taxotere + doxorubicin) was given to 46 patients with disseminated breast cancer: first line--27 (group A) and second line (including treatment after anthracycline-containing combinations and taxol--19) (group B). Average effectiveness in group A was 70.4% (10/27); group B--42.1% (8/19). The highest response was shown by metastases to the lung, liver, peripheral lymph nodes and primary tumors; least response--metastases to bones and soft tissues. Remission duration ranged 3-26 months. Median remission duration in group A was significantly longer than in group B (13.3 +/- 1.0 and 7.0 +/- 1.4 months, respectively) (p(0 < 05). Remission is still on in 11 patients (more than 26 months). Toxic poisoning was moderate: neutropenia stage III-IV was reported in 82/225 cycles (36.4%) lasting more than 7 days in 4/225 cycles (1.7%), febrile neutropenia stage 1-II--10/225 cycles (4.4%); stomatitis and diarrhea stage III-IV--1/225 cycles (0.44%). Treatment was suspended because of hypertension in one patient. No other side effects stage III-IV were registered.

[Cytomorphological differentiation diagnosis and evaluation of p53mut, bcl-2, CD95 in peripheral B-cell small cell lymphomas]. / Tsitomorfologicheskaia differentsial'naia dignostika i otsenka p53mut, bcl-2, CD95 pri perifericheskikh B-kletochnykh melkokletochnykh limfomakh.

Basing on the analysis of the cytological evidence, the authors suggest criteria for differential diagnosis of peripheral small-cell B-cell lymphomas including position of the tumor cells in cytological preparations and cell composition of the tumor. A high level of p53mut and bcl-2 expression in centrofollicular lymphomas and lymphomas originating from small lymphocytes may serve an additional criterion in differential diagnosis with reactive changes in the lymph nodes.