OVARIAN CANCER TREATMENT OPTIMIZATION: THE COMPLEX ANALYSIS OF THE RESULTS OF CYTOREDUCTIVE SURGERY, MICROSCOPIC MALIGNANCY AND T-LYMPHOCYTIC INFILTRATION OF THE TUMOR.

The paper discusses 64 cases of ovarian cancer (observed in 2016-2019). Patients underwent cytoreductive surgery. Both Shimizu/Silverberg system and the "Two-tier" system were used to grade the tumor differentiation of serous carcinomas. The grade of the differentiation was specified by expression of oncoprotein p53. The tumor infiltrating lymphocytes (TILs) labeled with immunohistochemical markers - CD2, CD3, CD4, CD8 - were evaluated for the intensity of expression in both - the ovarian tumor parenchyma and stroma. Quantitative assessment of expression was performed by a computer program ImageJ. The survival of patients with ovarian cancer was examined by using the Kaplan-Meier curves and calculations of Cox Hazard Ratio (HR). Multiple regression analyses of factors influencing surgical intervention was performed by a logarithmic regression method. According to the obtained data, the carcinogenesis of high-grade and low-grade serous ovarian carcinoma is different: low-grade forms are always preceded by serous cystadenoma and/or serous cystadenofibroma, which progresses to borderline serous carcinomas and then to low-grade invasive carcinoma; high-grade serous carcinomas are not developed from the progression of low-grade invasive carcinomas and are the product of the de novo formation. p53 may be used as an additional molecular-biological feature for specifying the grade of microscopic malignancy of the tumor in the cases, when the moderate differentiation is established by Shimizu/Silverberg system. The antineoplastic and/or prognostic role of the tumor-infiltrating T lymphocytes is not fully evident and needs further investigation. High-grade (G3) of ovarian carcinoma and the neoadjuvant chemotherapy are the factors having a significant impact in defining the effectiveness of the surgical treatment of ovarian cancer.

ON THE TOPIC OF SURGICAL DEBULKING OF EPITHELIAL OVARIAN CANCER (REVIEW).

Surgical debulking is a relatively new and promising treatment for epithelial ovarian cancer. The aim of the study was to analyze current literature data to identify the best algorithms in order to promote the wider adoption of cytoreductive treatment based on the principles of evidence-based medicine. Such an analysis is important, since different studies contain contradictory results and their authors often point out the need for additional data to develop reliable recommendations. The review is based on articles published in journals indexed in PubMed, Web of Science (Clarivate Analytics) and Scopus, with an impact factor (IF)> 1, H-index> 50 and Q1 or Q2 category (according to Scimago Journal & Country Ranking). The data is classified according to the National Comprehensive Cancer Network (NCCN) principles.

Unusual types of smooth muscle tumors of uterine corpus: case reports and literature review.

Classification of a smooth muscle neoplasm as benign or malignant is straightforward. Morphologic and biologic diversity makes smooth muscle neoplasia a diagnostic dilemma for pathologists but fascinating area of study. We report three cases of unusual types of smooth muscle tumors of uterine corpus: 1) highly cellular leiomyoma; 2) cotyledonoid dissecting leiomyoma (CDL) and 3) poorly differentiated leiomyosarcoma. Diagnostic pathology of the uterine smooth muscle tumors hides pitfalls. Some of the tumor type requires ancillary techniques to establish correct diagnosis. In case of CDL only gross and/or histopathologic features can clarify the question. There are number of cases, were the complex methods must be utilized.

[Morphological criterion in the spleen organ-preserving experimental surgery].

Thrombosis and inflammatory complications are concomitant to the post-surgery period of splenectomy due to the traumatic damage to the spleen. Therefore morphological analysis of the spleen residue after the partial spleen resection is of particular theoretical and practical interest. Total of 36 white rats, male, body mass 130-150 g., underwent partial resection of the spleen under the ether narcosis. Rats were withdrawn from the experiment on the first, 7-th, 15-th, 30-th, 90-th and 180-th day after the surgery. Spleen tissue samples were fixed in the 10% formaldehyde solution and stained with the use of routine methods. Homory method was used to reveal the argyrofilous fibers and ink injection was used to reveal blood vessels respectively. Spleen parameters were calculated morphometrically. Microsoft Excel program was used for statistical analysis of the data obtained. Partial disorder of blood microcirculation in the spleen after partial splenectomy was registered and in same time relative increase in the mass of the spleen and lymphatic follicles was shown concomitant to these disorders. The presence of the clusters of macrophages and lymphocytes capable of phagocytosis, as well as haemociderosis is considered as morphological criterion of the immune reaction. We can suppose that remainder spleen cells can induce immune response as regards autoantigens as response to the operational trauma and directed to restore the homeostasis.

[Specific features of neovascularization of dysplastic invasiveness and cancer of the breast].

There are shown the results of study related to angioarchitechtonices of displastic pre-cancer outgrows, fibroadenoma and carcinoma of the breast (non-proliferative and proliferative forms of fibro-cystic disease - 35 cases, fibroadenoma - 32 cases, cancer - 55 cases) using histological (hematoxylin and eosin and picrofuxin staining) and immunohistochemical (angiogenesis marker - CD31 and marker of proliferation - Ki67) methods. It was estimated that the character and intensity of vascularization as well as neoangiogenesis of above-named pathologic conditions and breast cancer could be determined by the differentiation of tissue structures and neoplastic cells. The microangioarxitectonics pre-cancer outgrowths and cancer of the breast is so peculiar and characteristic for each concrete case that it should be considered for morphological diagnosing and determining the tactic of treatment.

[Breast cancer immunohistochemical features in different age groups].

We investigated 52 incidents of the breast cancer to determine their immunological profile in the different age groups. Breast tissue-specific and at the same time oncologically important immunohistochemical markers: estrogen- and progesterone receptors (ER, PR), oncoprotein HER-2/neu, protein PS2, markers of angiogenesis CD31 and mitotic activity Ki-67 were investigated. Patients were divided into 3 group: I - patients under 45 years (23), II - from 46 to 55 (14), III - 56 year and older (15). Investigations showed that expression of the immunohistochemical markers was dissimilar in the different age groups. In the I group of the estrogen- and progesterone receptors (ER, PR) and protein PS2 was lower, in contrast to the expression of HER-2/neu, CD31 and Ki-67 were higher then in the elder group. Expression of the estrogen- and progesterone receptors (ER, PR) and protein PS2 markers was increasing with the patient age, and significant decrease of the HER-2/neu, CD31 and Ki-67 was observed. This indicates that in younger patients cancer is more aggressive.

Diagnostic value of C-reactive protein test at early-onset sepsis in preterm infants.

Bacterial sepsis of preterm infants is an urgent problem of pediatrics, as this population is at high risk for the development of sepsis. The aim of the present investigation was the evaluation of significance of C-reactive protein (CRP) test for identification of early-onset sepsis and assessment of the severity of infectious process. A total of 250 preterm infants, referred to the neonatal intensive care unit of M. Iashvili Central Pediatric Clinic at the first hours of life, have been studied during the period of 2002-2005. Level of C-reactive protein (CRP) was determined at first 24, 48 and 72 hours from the birth using the method of latex agglutination. Two groups of patients were separated. The first group was comprised of patients diagnosed with sepsis at the first hours of life on the basis of determination of CRP level, which was significantly elevated as compared with norm. Quantitative increase of CRP corresponded to the severity of the disease. The diagnosis has been confirmed by positive hemoculture later, after 72 hours. In patients of the second group CRP level corresponded to the normal values and the results of other examinations also indicated the absence of sepsis. In this group treatment with antibiotics was discontinued. The results of investigation allow to conclude that quantitative index of CRP is a rapid, sensitive diagnostic marker for identification of early-onset sepsis in preterm infants. Elevation of CRP level on the background of active therapy of sepsis is a negative prognostic sign. It is advisable to determine CRP level in dynamics to assess severity of the course of the disease.

[The of gamma-radiation for induction of apomixis in sea-buckthorn (Hippophaë rhamnoides L.)].

The results of studying of the induced apomixis in pollen of sea-buckthorn irradiated by the 60Co gamma-Radiation are considered. Was established that the most effective dose for pollination of the experimental plants is 50 k Gy. In total, from 46 seedlings 19 cases of apomictic origin were revealed, 7 individuals were found to be haploid (n = = 12) and 19 ones were diploid (2n = 24) of maternal origin. Was supposed that apomictic plants (19 seedlings) have parthenogenetic origin. The reason for such conclusion is that the irradiated anomalous pollen tubes despite not having spermia, are entering embryo sac and stimulate the development of apomictic embryo from non-fertilized female gametes. Apparently, pollen tubes cause the induction of DNA replication in the ovules and the development of parthenogenetic plants. Consequently, the described method can be used for the regulation of parthenogenesis in sea-buckthorn to change natural ratio (1 : 1) of male to female plants in desirable quantity.

[Diagnostic and prognostic value of the oncoprotein her-2/neu in the breast cancer tissue].

49 breast cancer tissues were investigated by imunnohistochemical method, to reveal the expression and distribution of the oncoprotein HER-2/neu. It was found, that expression of the oncoprotein HER-2/neu in the tumor tissues is very variable, which depends on the cancer histogenesis, histological form, differentiation and stage of tumor development. Intensity of expression of the oncoprotein HER-2/neu is higher in the ductal forms of the cancer, there is reciprocal relationship between the intensity of the expression of the oncoprotein HER-2/neu and steroid hormones. Using these data we can define histogenesis, rate of maturation and other tumor features in more objective manner. This is very important for selection of the breast cancer treatment methods.

[Immunohistochemical investigation of steroid hormones (ER, PR) in breast cancer].

Immunohistochemical investigations were performed in 22 cases of breast cancer. The objective of this study was to assess the presence and distribution of ER and PR in the cancer tissue. We found that expression of the ER and PR in the cancer tissue is variable, which depends on cancer histogenesis (lobular, ductal), histological form, differentiation grade, and stage of its development. Level of the expression of ER and PR was higher in the ductal form than in the lobular form of breast cancer. Expression of the ER was significantly higher than expression of PR in the case of the lobular form. There were no similar differences seen in cases of ductal form of breast cancer.

[Tyrosine inhibition of anaphylactic shock in guinea pigs]. / Ingibitsiia anafilakticheskogo shoka tirozinom u morskikh svinok.

Experimental investigations on guinea-pigs were carried out to study the role of tyrosine in the prevention of anaphylaxis. It should be noted that the intensity of clinical manifestations of anaphylactic shock was reduced in 5 out of 24 L-tyrosine fed guinea-pigs (20.83%), while in 9 animals (37.5%) anaphylactic shock did not develop. 100% death of control animals was registered. The effect of tyrosine was absent only in 10 guinea-pigs. Positive effect of tyrosine was followed by tyrosine-aminotransferase activation with a tendency towards the decrease in tyrosine plasma level and the rise in cortisol blood level. It is suggested that tyrosine increases glucocorticoid secretion of the adrenal cortex: Glucocorticoids in their turn, enhance tyrosine-aminotransferase activity in the animal liver.

[Effect of papain and levamisole on the body's immunological indices and oxidation-reduction processes in experimental sensitization]. / Vliianie papaina i levamizola na immunologicheskie pokazateli i okislitel'no-vosstanovitel'nye protsessy organizma v usloviiakh éksperimental'noi sensibilizatsii.

The effect of papain on sensitized animals was evident from activation of oxidation processes in the liver and adrenal glands, increased ability of the host to develop cellular immunity reactions, a moderate decrease in the level of humoral antibodies and inactivation of the monooxygenase system of the liver and adrenal glands. Levamisol had a favourable effect on the immunological reactions and monooxygenase system. However, it induced an increase in tissue hypoxia of the organs.