[A tool to assess functional communication skills and its correspondence with traditional language testing in patients with brain tumors]. / Instrument izmereniya funktsional'nykh kommunikativnykh navykov i sopostavlenie ego s traditsionnym rechevym testirovaniem u patsientov s opukholyami golovnogo mozga.

OBJECTIVE: To identify the relationship between speech impairment as measured by the Russian Aphasia Test (RAT) and functional communication as assessed by the Communicative Effectiveness Index (CETI). MATERIAL AND METHODS: RAT and CETI were administered to 87 patients at two time points, before surgery and in 3 months after brain tumor resection surgery. RESULTS: There were significant correlations between CETI and the total scores on RAT subtests for speech comprehension and production before surgery but not in the follow-up period. CONCLUSION: The present research is the first to present the Russian version of CETI and to confirm the relationship between speech disorders measured by the comprehensive standardized battery for evaluating speech function RAT and functional communication as measured by CETI.

Personalized Medicine in Brain Gliomas: Targeted Therapy, Patient-Derived Tumor Models (Review).

Gliomas are the most common type of primary malignant brain tumors. The choice of treatments for these tumors was quite limited for many years, and therapy results generally remain still unsatisfactory. Recently, a significant breakthrough in the treatment of many forms of cancer occurred when personalized targeted therapies were introduced which inhibit tumor growth by affecting a specific molecular target. Another trend gaining popularity in oncology is the creation of patient-derived tumor models which can be used for drug screening to select the optimal therapy regimen. Molecular and genetic mechanisms of brain gliomas growth are considered, consisting of individual components which could potentially be exposed to targeted drugs. The results of the literature review show a higher efficacy of the personalized approach to the treatment of individual patients compared to the use of standard therapies. However, many unresolved issues remain in the area of predicting the effectiveness of a particular drug therapy regimen. The main hopes in solving this issue are set on the use of patient-derived tumor models, which can be used in one-stage testing of a wide range of antitumor drugs.

Prospects for the use of blood elemental status to assess the molecular genetic profile of gliomas.

It has been established that blood element homeostasis is related to gliomagenesis which increases the attractiveness of the analysis of its components as a promising preoperative mediated characteristics of the molecular genetic profile of gliomas. The aim of this work is to analyze the relationship between mineral metabolism parameters and immunohistochemical characteristics of glial tumors and evaluate the clinical significance of blood element homeostasis analysis for preoperative assessment of the molecular profile of gliomas. The levels of cancer specific markers MGMT, Ki-67, p-53, IDH1 were determined immunohistochemically using the corresponding antibody clones. Micronutrient levels were analyzed by inductively coupled plasma atomic emission spectrometry recalculating the results per 1 g of protein which was determined by the Lowry method. The data on cancer-specific marker levels obtained in primary brain tumors (20) and in blood plasma of gliomas patients (20) and practically healthy subjects (5) were compared using a number of statistical programs. We found significant differences in the levels of sodium, potassium, zinc and copper depending on the value of the mitotic index Ki-67 and IDH1 isocitrate dehydrogenase gene mutation. For the first time, a significant correlation showing the consistency between the level of glial tumor cancer-specific markers and blood mineral metabolism was observed. The revealed correlations provide new insights into understanding of gliomagenesis mechanisms and can be used as a predictive preoperative assessment of molecular genetic markers of gliomas.

Clinical significance of acetylcholinesterase activity in brain tumors.

It has been established that the non-neuronal cholinergic system is related to the oncogenesis which increases the attractiveness of its components as the promising markers of oncologic diseases. The purpose of this work is to evaluate the clinical significance of the analysis of the activity of acetyl cholinesterase as a new marker of gliomas. The activity of acetyl cholinesterase was assessed by photo colorimetric analysis according to the Hestrin method recalculating the activity of the enzyme in the tumor tissue per 1 g of protein, and in the blood - by 0.1 g of hemoglobin. The data obtained in the primary tumors of the brain (28) in the tissue of the brain of persons who died as a result of injury (6) and in whole blood of patients with gliomas (28) and practically healthy people (10) were compared with the use of a number of statistical programs. A significant decrease in the activity of acetyl cholinesterase in tumor tissue and in whole blood is revealed as the degree of anaplasia of tumors increases, starting with Grade II. It is for the first time that a significant direct correlation was noted showing the consistency between the decrease in the activity of acetyl cholinesterase in the tumor tissue of the brain and blood. Bioinformatic analysis showed the connection of the enzyme of acetyl cholinesterase with proteins of the PI3K-AKT and Notch signaling pathways providing antiapoptotic and proliferative effects. The found dependences provide new insights into understanding of the mechanisms of gliomas genesis and can be used for selection of new diagnostic markers of brain tumors.

[Cytologic control of the resection margins of hemispheric gliomas and metastases]. / Tsitologicheskii kontrol' granits rezektsii polusharnykh gliom i metastazov.

INTRODUCTION: Postoperative MRI is the conventional method for assessing the radicalness of hemispherical tumors excision, but the method has limitations on sensitivity in the assessment of tumor infiltration of the peritumoral zone. The 'gold standard' for detecting tumor cells is the microscopic visualisation. AIM: To study the possibilities of a cytological study of the excision margins of glial and metastatic tumors for an objective assessment of the radical nature of the operation. MATERIAL AND METHODS: The study included 35 patients with intracerebral tumors who underwent open surgery at a university clinic of Volga Research Medical University in 2018-2019: 15 patients with metastasis, 13 patients with MRI-contrasting gliomas Grade III-IV and 7 patnents with non-MRI-contrasting gliomas Grade II-III. During the surgery, samples for cytological examination were taken from the following sites: from the tumor, from the nearest perifocal zone, and at a distance of 5-7 mm, along the border of the extended resection. 154 samples were examined: from 2 to 5 for each patient. RESULTS: The data on the radicalness of the operation, obtained by methods of cytological analysis of the resection margins and postoperative MRI, are not only consistent (p=0.001), but also complement each other, in particular, in some cases, tumor cells were found even in those areas where the tumor tissue was not detected with MRI. In cases of cerebral metastases excision, tumor cells in the nearest perifocal zone were found in 8 out of 28 samples (28.6%), at the extended resection margins - in 3 out of 29 (10.3%). In cases of resection of MRI-contrasting gliomas Grade III-IV, tumor cells in the nearest perifocal zone were found in 22 out of 32 samples (68.8%), at the extended resection margins - in 14 out of 20 (70%). In cases of excision of diffuse gliomas Grade II-III, tumor cells in the nearest perifocal zone were found in 10 out of 17 samples (58.9%), at the extended resection margins - in 4 out of 11 (36.4%). CONCLUSION: The first data obtained demonstrated sufficient informativeness of the cytologic examination of the peritumoral zone as an additional tool for assessing the radicalness of glioma and metastasis surgery. Cytologic analysis of the perifocal zone shows that the extension of the borders of the removal of Grade III-IV gliomas has no advantages, because tumor cells were found both in the nearest perifocal zone and at the extended resection margins with with approximately the same frequency.