MORPHOLOGICAL PECULIARITIES OF THE SKIN GRANULATION TISSUE IN PATIENTS WITH MALIGNANT NEOPLASMS OF THE ABDOMINAL ORGANS.

OBJECTIVE: The aim: To examine morphological peculiarities of the skin granulation tissue from the laparotomy wound in patients with malignant neoplasms of the abdominal organs. PATIENTS AND METHODS: Materials and methods: 36 bodies of deceased people were examined after midline laparotomy performed for surgical treatment of diseases of the abdominal organs. The main group included 22 bodies of deceased people suffering from malignant neoplasms of the abdominal organs, mostly in ІІІ-IV stages of diseases. The group of comparison included 14 bodies of deceased individuals suffering from acute surgical diseases of the abdominal organs. An average length of the laparotomy wound was 24,5 ± 0,28 cm. An average distance from the reticular elements to the external border of the granulation tissue was measured by means of computed histometry (mcm), the optical density (OD) of staining of the collagen fibers was determined by means of computed microdencitometry (expressed in OD absorbance coefficient - the absorbance of the solution per unit length per mole of solute), the specific volume of the blood vessels in the granulation tissue - by means of computed histostereometry (%), the granulation tissue cells were calculated by means of the score test (within eyeshot 10000 mcm2). The specimens were stained with hematoxylin, eosin and methylene blue/Chromotrop 2B. RESULTS: Results: The obtained results of the investigation conducted are indicative of more prominent chromotropic properties in the samples of the main group, confirming certain biochemical changes and features of the collagen fibers respectively. Moreover, slide mounts of the main group possess reliably lower optic density of staining of the collagen fibers which is indicative of their slow formation. It may suggest a reduced solidity of the postoperative scar on the laparotomy wound skin promoting easier wound disruption, that is, occurrence of subcutaneous eventration in patients with malignant neoplasms of the abdominal organs. CONCLUSION: Conclusions: Oncological process in the body results in the aggravation of swelling and chromotropophilia in the deep layers of derma during more remote terms after surgery and reduced optic density of the collagen fibers staining, which promotes easier laparotomy wound disruption and occurrence of true postoperative eventration.

Distinctive characteristics of granulation tissue in laparotomy wounds with underlying oncological processes.

This study aimed to investigate the effects of malignant neoplasms on the morphological characteristics of laparotomy wound granulation tissue in the muscular-aponeurotic layer. The study involved a sample of 34 deceased individuals who had undergone abdominal organ surgery. Biopsy samples were taken from the muscular-aponeurotic layer of the anterior abdominal wall and subjected to histological examination, including staining with hematoxylin and eosin and methylene blue/Chromotrope 2B using N.Z. Slinchenko's method. Descriptive methods and morphometry were used to evaluate pathomorphological changes. The results suggest that malignant neoplasms significantly impede and decelerate the maturation of laparotomy wound granulation tissue. Surgeries performed at the late stages of abdominal organ malignant neoplasms result in an uneven and slow maturation of the tissue, characterized by a higher prevalence of lymphoid cells, increased blood vessel volume, reduced optical density of stained collagen fibers, and pronounced chromotropophilia of collagen fibers. These distinct features should be considered to prevent postoperative eventration, a complication that is more likely to occur in this patient group. Clinicians should be aware of the possible consequences of malignant neoplasms on laparotomy wound granulation tissue, which may require additional measures to prevent postoperative complications in these patients.

Trilaciclib prior to chemotherapy and atezolizumab in patients with newly diagnosed extensive-stage small cell lung cancer: A multicentre, randomised, double-blind, placebo-controlled Phase II trial.

Trilaciclib is an intravenous CDK4/6 inhibitor administered prior to chemotherapy to preserve haematopoietic stem and progenitor cells and immune system function from chemotherapy-induced damage (myelopreservation). The effects of administering trilaciclib prior to carboplatin, etoposide and atezolizumab (E/P/A) were evaluated in a randomised, double-blind, placebo-controlled Phase II study in patients with newly diagnosed extensive-stage small cell lung cancer (ES-SCLC) (NCT03041311). The primary endpoints were duration of severe neutropenia (SN; defined as absolute neutrophil count <0.5 × 109 cells per L) in Cycle 1 and occurrence of SN during the treatment period. Other endpoints were prespecified to assess the effects of trilaciclib on additional measures of myelopreservation, patient-reported outcomes, antitumour efficacy and safety. Fifty-two patients received trilaciclib prior to E/P/A and 53 patients received placebo. Compared to placebo, administration of trilaciclib resulted in statistically significant decreases in the mean duration of SN in Cycle 1 (0 vs 4 days; P < .0001) and occurrence of SN (1.9% vs 49.1%; P < .0001), with additional improvements in red blood cell and platelet measures and health-related quality of life (HRQoL). Trilaciclib was well tolerated, with fewer grade ≥3 adverse events compared with placebo, primarily due to less high-grade haematological toxicity. Antitumour efficacy outcomes were comparable. Administration of trilaciclib vs placebo generated more newly expanded peripheral T-cell clones (P = .019), with significantly greater expansion among patients with an antitumour response to E/P/A (P = .002). Compared with placebo, trilaciclib administered prior to E/P/A improved patients' experience of receiving treatment for ES-SCLC, as shown by reduced myelosuppression, and improved HRQoL and safety profiles.