[Tumor infiltrating lymphocytes (TILs) in triple negative breast cancer]. / Infil'triruyushchie opukhol' limfotsity (TILs) pri trizhdy negativnom rake molochnoi zhelezy.

BACKGROUND: Tumor infiltrating lymphocytes (TILs) are a promising inexpensive prognostic and predictive biomarker in breast cancer. High levels of TILs are associated with improved survival and higher probability to achieve pathological complete response in triple-negative breast cancer (TNBC). OBJECTIVE: To assess the level of TILs in TNBC samples and analyze the association between the level of TILs and the main pathological parameters, to identify their impact on long-term results. MATERIAL AND METHODS: The study included information on 140 patients with I-III stage TNBC and estrogen receptors <10%. Tumor tissue samples at baseline biopsies were evaluated the histological type, HER2 expression, estrogen expression levels, Ki-67 and TILs. The pathological response was evaluated according to the ypTNM, Miller-Payne, and RCB classifications. RESULTS: The average level of TILs in biopsy specimens before NACT was 29.3±23.1%. Low levels of TILs (<10%) were defined in 21% of cases, intermediate levels (≥10% to ≤40%) in 55% of cases, and high levels (>40%) in 24% of cases. Using the two-tiered system, low TILs (≤40%) were defined in 76% and high TILs (>40%) in 24% of cases. The level of TILs was correlated with histological grade (R=0.187; p=0.027) and estrogen receptor expression level (R=0.211; p=0.012). There were no significant differences depending on the level of TILs and other pathological parameters. Three-year event-free survival (EFS) in patients with high TILs levels was 95% versus 65% in the low TILs group (p=0.037). CONCLUSION: Stromal TILs are an important prognostic biomarker in TNBC. Using a cutoff of 40%, high TILs are significantly associated with longer EFS.

[Analysis of the work of the Immunohistochemical Quality Control Center of the Russian Medical Academy of Continuous Professional Education of the Ministry of Health of Russia in 2023]. / Analiz raboty Tsentra kontrolya kachestva immunogistokhimicheskikh issledovanii FGBOU DPO «RMANPO¼ Minzdrava Rossii v 2023 godu.

The article demonstrates a detailed analysis of the results of the rounds of quality control of immunohistochemical studies conducted by the Central Committee of the Immunohistochemical Quality Control Center of the Russian Medical Academy of Continuous Professional Education of the Ministry of Health of Russia in 2023. Typical shortcomings and errors in the immunohistochemical examination of various tumors have been identified and ways to eliminate them are given. Particular attention is paid to defining a panel of standard breast cancer markers and eliminating the shortcomings of immunohistochemical examination of markers of accompanying diagnosis.

[Interim results and safety assessment of indocyanine green peritumoral injection for regional lymphatic outflow area mapping in colon cancer as a part of the ISCAPE TRIAL]. / Promezhutochnye rezul'taty i otsenka bezopasnosti paratumoroznogo vvedeniya indotsianina zelenogo dlya kartirovaniya zony regionarnogo limfoottoka pri rake obodochnoi kishki v ramkakh ISCAPE trial.

The individual approach to determining colon resection extension, known as tailored surgery, has been actively discussed for several years. However, despite the consistency and validity of the idea, it still has few followers, primarily due to the lack of high-level evidence confirming the validity of this approach. OBJECTIVE: To determine whether the boundaries of the lymphatic outflow area, mapped with indocyanine green, match the lymphogenic metastasis area according to the surgical specimens' pathological study. MATERIALS AND METHODS: From 26.07.2022 to 13.02.2023, 27 patients with resectable colon cancer were included in the study; 25 of them underwent intraoperative imaging of the lymphatic outflow from the affected area of the intestine using the peritumoral injection of indocyanine green, assessment of infrared light fluorescence, followed by a comparison of the glow area with a pathologically defined zone of lymphogenic metastasis. RESULTS: Of the 25 mapping procedures, 17 (68%) were typical (no deviations from the standard injection schedule and solution extraperitonization); in 8 (32%) cases, there were technique defects. No allergic reactions to indocyanine or side effects were observed. Of the 25 patients who received peritumoral indocyanine green, 17 (68%) had no complications during the postoperative period. There were no postoperative deaths. Technique defects during the injection did not interfere with the outcome interpretations: all patients showed the indocyanine green fluorescence within the paracolic basin proximal and distal to the tumor; fluorescence along the main feed vessel was recorded in 24 (96%) patients. Fluorescence of the aberrant lymphatic vessels was reported in 3 (12%) cases and required extension of the resection in 1 patient. The time to the indocyanine green appearance in the D1 basin lymphatic vessels and along the main feed vessel varied widely (from 15 minutes to 1 hour or more). It was also noted that the boundaries of indocyanine distribution varied significantly (from 3 to 16.3 cm) depending on individual characteristics. The analysis of pathological data showed no cases of secondary involved lymph nodes beyond the boundaries of indocyanine distribution. In most cases, secondary altered paracolic lymph nodes were localized directly in the projection of the tumor, and concomitant lesions of mesocolic nodes were more common than metastatic lesions of D1 nodes located laterally from the tumor. CONCLUSIONS: The study results show that mapping the regional lymphatic basin is a reproducible and feasible technique. It does not increase the rate of complications and contributes to identifying individual lymphatic outflow characteristics to ensure oncological radicality in non-standard lymphatic anatomy.

[Challenges of expert assessment of injury to health in the case of iatrogenic mastectomy due to erroneous histological verification of an oncological condition]. / Problemy ekspertnoi otsenki vreda zdorov'yu v sluchae yatrogennogo udaleniya molochnykh zhelez vsledstvie oshibochnoi gistologicheskoi verifikatsii onkologicheskoi patologii.

A case of commission forensic medical examination in the St. Petersburg Bureau of Forensic Science of a civil case due to an unfavorable treatment outcome is presented. Patient T., 45 years old; due to erroneous histological verification of oncological pathology, she had both breasts removed and received antitumor treatment. It has been shown that defects in histological diagnosis can lead to errors by clinicians and become the subject of lawsuits by patients accusing healthcare professionals of adverse treatment outcomes. It is emphasized that the current legislation lacks medical criteria and an algorithm for assessing the severity of injury to health in women with one or both breasts removed.

[Evaluation of the chemopreventive potential of polyprenols from the needles of Picea abies L. and Pinus sylvestris L. using the model of prostate carcinogenesis in male Wistar rats].

For decades, one of the most popular ideas in reducing the burden of cancer worldwide is the idea of cancer chemoprevention with low-toxic agents. There is an evidence that polyprenols (polyisoprenoid alcohols) are perspective agents for cancer chemoprevention. The aim of the study is to investigate anticancer activity of the polyprenol complex (the main polyprenols are prenol-14, prenol-15, prenol-16 and prenol-17) against prostate cancer (PCa) and its precursor (prostatic intraepithelial neoplasia, PIN). Material and methods. For induction of prostate carcinogenesis we used modified protocol of two-stage model. Mature male Wistar rats were administrated with single intravenous injection of N-methyl-N-nitrosourea and chronic intraperitoneal injections of four testosterone esters following surgical castration. Animals with an initial body weight of 328±39 g were randomized into 3 groups: experimental group (n=32) - animals received polyprenols complex 12.5 mg/kg per os diluted in vegetable oil 5 days a week; control group (n=38) - animals received vehicle (vegetable oil) 0.5 ml per os 5 days a week; intact group (n=12) - animals without intervention. Duration of the experiment was 56 weeks. At the end of the study and in euthanized animals in terminal state as well, the prostate and seminal vesicles were processed by histological technique and serial step sections of all lobes were assessed blindly by two independent pathologists. Incidence and multiplicity of precancerous lesion (PIN) and prostate tumors were calculated. Results. Compared with the control group, long-term consumption of polyprenols significantly reduced the overall incidence of PIN from 76.5 to 44.8% (р=0.0183; relative risk, RR=0.59; 95% CI 0.38-0.91), multiplicity of PIN per rat per group by 48.4% (р=0.0081), the incidence of PIN in 2 or 3 lobes of the prostate from 55.9 to 27.6% (р=0.0402), the incidence of PIN in the dorsolateral prostate from 70.6 to 41.4% (р=0.0240), the incidence of PIN in the ventral lobe from 47.1 to 20.7% (р=0.0362). The polyprenol complex exhibited a pronounced anticancer effect against induced prostate tumors. In the group of animals receiving the tested agent, there was a significant decrease in the total incidence of PCa from 64.7 to 34.5% (р=0.0234; RR=0.53; 95% CI 0.30-0.93), as well as the multiplicity of PCa per rat per group and per PIN carrier by 63.4% (р=0.0024) and by 30.6% (р=0.0240) respectively. In the polyprenols group we observed significant decrease in the incidence of prostate cancer in 2 or 3 lobes from 32.4 to 6.9% (р=0.0147) and the incidence of PCa in the dorsolateral prostate from 58.8 to 24.1% (р=0.0101). Oral administration of polyprenols provided a nonsignificant trend towards a decrease in the incidence of metastatic prostate cancer from 32.4 to 20.7% (р=0.3962). Conclusion. Chronic oral consumption of polyprenols from the needles of Picea abies L. and Pinus sylvestris L. (12.5 mg/kg per day) significantly suppresses the development of PIN and PCa induced by MNM and a mixture of testosterone esters in male Wistar rats. Despite the exploratory nature of the study, our results can serve the rationale for further investigation of polyprenols in prostate cancer chemoprevention trials.

[Assessment of PD-L1 expression using the neural network analysis algorithm in non-small cell lung carcinoma biopsy specimens]. / Otsenka v bioptatakh nemelkokletochnykh kartsinom legkogo ekspressii PD-L1 s primeneniem algoritma neirosetevogo analiza.

Neural network analysis of digital copies of histological micropreparations is one of the methods used to standardize quantitative continuous data. PD-L1 (22C3) biomarker expression in metastatic non-small cell lung carcinomas without mutations in the EGFR, ALK, and ROS1 genes serves as an indication for the use of pembrolizumab for the first-line therapy. OBJECTIVE: To quantify PD-L1 biomarker expression in non-small cell lung carcinomas using the neural network analysis of digital copies of histological micropreparations. MATERIAL AND METHODS: Immunohistochemical study of PD-L1 (22C3) expression was performed on 96 non-small cell lung carcinoma biopsy specimens. The digital copies of histological micropreparations were processed by the QuPath software neural network analysis module. RESULTS: The neural network analysis module segmented tumor, stroma, and artifacts in the micropreparations, showing a sufficient level of agreement with a visual assessment. Digital image analysis quantified stained tumor cells in the high PD-L1 expression group and showed 96% agreement rate versus visual assessment. However, the group of tumors without PD-L1 expression versus visual assessment showed a low (58%) agreement rate. CONCLUSION: The neural network analysis algorithm is applicable to the study of digital copies of histological micropreparations containing tumor, stroma, and artifacts. The algorithm allows for quantitative immunohistochemical assessment of PD-L1 expression in tumor cells. The algorithm can quantify the immunohistochemically detected expression of PD-L1 in tumor cells.

[Revised WHO classification of tumors of hematopoietic and lymphoid tissues, 2017 (4th edition):lymphoid tumors]. / Peresmotrennaia klassifikatsiia VOZ opukholei gemopoéticheskoi i limfoidnoi tkanei, 2017 (4-e izdanie): opukholi limfoidnoi tkani.

The paper is devoted to changes in the 4th edition of the WHO classification of lymphoid tumors in the 2017 revision, to the principles of the structure and features of the classification. It discusses changes in the identification of new clinical and morphological categories and in the abolition of some previously existing ones. New information about lymphoid tumors, their immunophenotypic and molecular characteristics of classification importance are briefly outlined. The absolute need for molecular genetic studies for the diagnosis of certain lymphoproliferative diseases is underlined. The characteristics of lymphoid pretumor states are given.