Relation between cell-to-cell adhesion and angiogenesis and clinico-morphological prognostic factors in patients with gastric cancer.

AIM: To study the relation between the expression of the molecules of cell-to-cell adhesion (E-cadherin, alpha- and beta-catenins) and vascular endothelial growth factor (VEGF) and traditional clinico-morphological characteristics of tumors to evaluate their prognostic value in the patients with gastric cancer. METHODS: To analyze the expression of E-cadherin, alpha- and beta-catenins, and VEGF the paraffin embedded tumor samples were studied by immunohistochemical analysis with the use of respective monoclonal antibodies. RESULTS: The presence of E-cadherin in tumors correlated with the absence of metastases in regional lymph nodes and was observed, as a rule, in the patients at the early stages of the disease. The presence of beta-catenin expression has been detected in gastric tumors of the patients without distant metastases, while the level of VEGF expression correlated with the degree of gastric wall injury. It has been demonstrated that the expression of E-cadherin and alpha-catenin is associated with favourable disease course and is a characteristic pattern for early stages of gastric cancer of intestinal type. However, VEGF expression is typical for the late stages of gastric cancer of diffuse type and is associated with poor prognosis. CONCLUSION: At the base of combined clinical, histological and immunohistochemical analysis of gastric tumors it has been shown that E-cadherin, alpha-catenin and VEGF could be used as informative markers of the disease course.

Histological validation of diagnoses of thyroid cancer among adults in the registries of Belarus and the Ukraine.

In order to evaluate the diagnostic reliability of the thyroid cancers listed in adult registries from the Ukraine and Belarus, a histological review was organised of 327 randomly selected thyroid carcinoma cases diagnosed between 1980 and 1999. A final diagnosis was reached at a 5-day consensus conference by six pathologists who met around a multiheaded microscope. The study concluded with a comparison between the final diagnosis and the initial diagnosis. The pathologists agreed with the initial diagnosis of malignancy in 286 cases (88%). A final diagnosis of papillary, follicular or medullary thyroid carcinoma was reached in 86, 4, and 6% of the cases respectively. In 2.8% of the cases reviewed, diagnostic discrepancies persisted. The percentage of agreement between the final diagnosis and the initial diagnosis was 93%, with a weighted kappa-statistic of 0.61 (confidence interval 95% (CI(95%)): [0.45-0.77]). In all, 89% of the 286 confirmed cancer cases were in agreement for the type of cancer, with a kappa-statistic of 0.56 (CI(95%): [0.43-0.69]). The level of agreement differed according to cancer categories, with concordance rates of 94, 40 and 33% for papillary, follicular and medullary thyroid carcinomas respectively. The low prevalence of follicular thyroid carcinomas in the adult population studied calls for further exploration. The discrepancies and classification difficulties encountered were analysed.

[Prospects in the treatments of stomach neoplasms]. / Perspektivy lecheniia raka zheludka.

Highlighted in the paper are basic treatment modalities for carcinoma of the stomach at the present stage of development of abdominal oncology, including original developments of the Ukrainean Research Institute of Oncology and Radiobiology of the Ministry of Health of Ukraine as the head institution of the country. The main index of references reflect potentialities of and prospects for treatment of gastric carcinoma over the last ten years.

[The use of neoadjuvant selective intra-arterial polychemotherapy and its modifier verapamil in the combined treatment of colorectal cancer]. / Primenenie neoad'iuvantnoi selektivnoi vnutriarterial'noi polikhimioterapii i ee modifikatora verapamila v kombinirovannom lechenii kolorektal'nogo raka.

After combined treatment of 74 patients for colorectal cancer using preoperative neoadjuvant intraarterial selective polychemotherapy (IAPCT) three-year survival index have constituted (77.0 +/- 5.2)%, the cancer recurrence have occurred in (10.8 +/- 2.8)%, distant metastases were revealed in (17.5 +/- 4.2)%. Using verapamil as a IAPCT modifier in 54 patient three-year survival have increased by 11.8%, the frequency of distant metastases occurrence have reduced by 10.1%.

[Immediate and early results of combined treatment of colonic cancer using neoadjuvant selective intra-arterial polychemotherapy]. / Neposredstvennye i blizhaishie rezul'taty kombinirovannogo lecheniia raka obodochnoi kishki s primeneniem neoad"iuvantnoi selektivnoi vnutriarterial'noipolikhimioterapii.

The combined treatment of 53 patients with colonic cancer, using neoadjuvant intraarterial polychemotherapy (IAPCT), was conducted. The trustworthy lowering of the catheterized artery thrombosis occurrence rate, the tumor recurrence-by 7%, distant metastases-by 13.9%, two-year survival increase-by 15.5% was promoted by verapamil application as a IAPCT modifier.

[Cancer from an ulcer or ulcerative stomach cancer? (a review of the literature and the authors' own observations)]. / Rak iz iazvy ili iz''iazvlennyi rak zheludka? (obzor literatury i sobstvennye nabliudeniia).

On the basis of surveys of literature and the author's own experience of work, ulcerous lesions of the stomach should be regarded at present as a facultative (precancerous) condition rather than obligate precancer. A great many of biopsy specimens need to be taken from the patient's stomach across the lifespan and subjected to morphologic study on a repeated basis before an adequate answer can be given to a question of a possibility of developing cancer from chronic ulcer of the stomach.

[Screening for malignant neoplasms by using the new method of marker diagnosis, the Oncotest]. / Skrining zlokachestvennykh novoobrazovanii s ispol'zovaniem novogo metoda markernoi diagnostiki "Onkotesta".

The proposed method for tumor screening ("Oncotest") is based on detecting substances (calcium-histone complexes) in the human blood which are markers of malignant neoplasia. Using "Oncotest" in a series of 5411 cases, we identified malignant tumors of various histogenesis (cancer, sarcoma) arising in different sites in 69 cases. "Oncotest" is especially important for early (pre-clinical) detection of malignant neoplasms during preventive population screenings.

[Aggressive fibromatosis of the small pelvis]. / Agressivnyi fibromatoz polosti malogo taza.

Experience in the treatment of 25 patients with aggressive fibromatosis of the true pelvis is discussed. To establish a precise diagnosis obligatory and special methods of examination were applied. Secondary changes in the adjacent organs and structures were found in 24 patients. Radical operations were conducted on 19 (76%) patients, in 13 of them the interventions were combined. The mean duration of the operations was 5.3 hours. Complications developed in 17 out of 19 patients. Hemorrhage was the most frequent (in 12 out of 19 patients) and menacing complication. The blood loss was 3036.8 ml on the average. Recurrences were registered in 8 out of 19 (42.1%) patients.

[The clinico-morphological aspects and treatment characteristics of patients with Lennert's lymphoma]. / Kliniko-morfologicheskie aspekty i osobennosti lecheniia bol'nykh limfomoi Lennerta.

Lennert's lymphoma is a malignant lymphoproliferative disease first described by K. Lennert in 1966. Morphological manifestation of the disease is the presence of Hodgkin-, Berezovsky-Sternberg cells which are arranged at the background of lymphoid series cells, neutrophils, epithelioid cellular elements in the histological preparation. The clinical presentations of the disease include rapid progression, the presence of general toxic symptoms. Optimal treatment option of these conditions includes, in the authors' judgement, 1-3 courses of polychemotherapy at the start of the treatment, remote gamma-therapy to the area of the lesion foci, with subsequent use of several courses (not fewer than three) of polychemotherapy.

[Effectiveness of transthoracic puncture in the diagnosis and treatment of neoplasms of chest organs]. / Effektivnost' transtorakal'noi punktsii v diagnostike i lechenii novoobrazovanii organov grudnoi kletki.

A complex examination of 1400 patients with pathologies of the lungs and mediastinum was carried out using roentgenologic, endoscopic, bioptic and cytologic methods. Diagnosis was confirmed morphologically in 93.7% of cases. More specific information was obtained by express cytologic examination in 97.9% of cases of malignant growth and in 64.4% with benign tumors. On the basis of the test results, preoperative intratumor chemotherapy technique suggested by the authors may be recommended for clinical use.

[Preoperative selective intra-arterial chemotherapy in gastric cancer]. / Predoperatsionnaia izbiratel'naia vnutriarterial'naia khimioterapiia raka zheludka.

Preoperative intraarterial chemotherapy was administered to 69 patients with gastric cancer. In 34 patients the tumor was localized in the antral portion, in 27 in the body of the stomach involving the proximal portion, and in 8 total involvement of the stomach was revealed. Left gastric artery was catheterized in 42 patients, right gastric-omental artery in 27. An original method of "loop" catheterization of celiac artery branches was used permitting a selective probing of gastric arteries proper. For prolonged intraarterial chemotherapy of gastric cancer adriablastin or farmorubicin were used in single dose 30 mg/M2, 5-fluorouracil in dose 500 mg/M2; the cytostatics were infused in 2-3 sessions. Immediate results of intraarterial chemotherapy were assessed by angiography and other instrumental methods of investigation, as well as intraoperatively and by morphometric analysis. In 62.4% of patients significant or total destruction of the tumor was attained, the volumic share of a viable tumor component being 0 to 2.1%. Altogether 95% of patients survived the follow-up of 2 to 30 months.

[The tumor pathomorphosis and status of the regional lymph nodes after the preoperative polychemotherapy of patients with vulvar cancer]. / Patomorfoz opukholi i sostoianie regionarnykh limfaticheskikh uzlov posle predoperatsionnoi polikhimioterapii bol'nykh rakom vul'vy.

Effect of endolymphatic lymphotropic polychemotherapy on tumor and regional lymphatic nodi was studied in postoperative material of 30 patients with vulval carcinoma. Significant antiblastomatous effect was obtained, tumor impairment index ranging from 68.9 to 79.2%.

[Effectiveness of transthoracic puncture in the diagnosis and treatment of lung cancer]. / Effectivnost transtorakalnoi punktsii v diagnostike i lechenii raka lëgkogo.

The complex examination of 1400 patients with pathologic masses of the lungs and mediastinal organs with the use of roentgenologic, endoscopic, puncture bioptic and cytologic methods was carried out. Morphologic verification of diagnosis was performed in 93.7% of the patients. In express cytologic study, histogenesis of neoplasms of the thoracic cavity organs was specified in 97.9% of cases of a malignant tumour, and in 64.4% of those of a benign one.

[Chemoembolization of blood vessels in the complex treatment of children with nephroblastoma]. / Khimioémbolizatsiia sosudov v komplekse lecheniia detei s nefroblastomoi.

The results of roentgeno-endovascular intervention in nephroblastoma in 31 child are presented. For chemoembolization, suspension of lipiodol and adriamycin was used, for control of the effectiveness of the intervention--the radiopharmaceutical preparation pyrophosphate. After embolization, the decrease in tumor size was noted. This made easier the performance of nephrectomy, the volume of blood loss reduced. Pathomorphism of neuroblastoma induced by chemoembolization was studied. No complications were noted.

[The diagnosis of histiocytic lymphomas]. / O diagnostike gistiotsitarnykh limfom.

The histogenesis, classification, terminology of histiocytic lymphomas is analyzed. The possibilities are shown of their diagnosis evaluating lectin histochemistry data which is of major importance for the prognosis of the clinical course of the disease.

[Preoperative superselective intra-arterial polychemotherapy in the treatment of stomach cancer]. / Predoperatsionnaia superselektivnaia vnutriarterial'naia polikhimioterapiia v lechenii raka zheludka.

Results of treatment of gastric cancer with using preoperative superselective intraarterial polychemotherapy are described. The method was used in 57 patients with gastric cancer of the III-IV degrees and was followed by radical surgical treatment. The use of chemotherapy and operation resulted in complete destruction of the tumor in 63.8% of cases, partial regression in 19.2%. An inconsiderable effect was obtained in 17.0%. One-year survival was noted in 100% of the patients.

[Endolymphatic polychemotherapy with local UHF hyperthermia in the surgical treatment of rectal neoplasms]. / Endolimfaticheskaia polikhimioterapiia s lokal'noi SVCh-gipertermiei pri khirurgi-cheskom lechenii bol'nykh rakom priamoi kishki.

To reduce the risk of intraoperative metastases and increasing ablastic principles in radical surgical treatment of patients with cancer of the rectum the authors developed a scheme of preoperative treatment including endolymphatic polychemotherapy and UHF-hyperthermia. 5-fluorouracil and platidiam were used in the treatment of 30 patients with different histological types of adenocarcinomas of the rectum (grade III-IV). After treatment the viable epithelial component in the tumour was 26.5% as compared with 44.8% in the control. The effect of treatment was favourable both objectively and subjectively. The treatment was well tolerated.

[A method for the combined treatment of cancer of the esophagus and cardia by using intensive preoperative gamma teletherapy and intracavity hyperthermia]. / Metodika kombinirovannogo lecheniia raka pishchevoda i kardii s primeneniem intensivnoi predoperatsionnoi telegammaterapii i vnutripolostnoi gipertermii.

Local intracavitary hyperthermia and simultaneous intensive-concentrated irradiation were used in 23 patients with esophageal cancer and 64 cases of cardioesophageal malignancy prior to surgery. The procedure for thermometry is described. Hyperthermia was carried out after the second and fifth (out of six) radiation fractions, thermotolerability being taken into account. Complete and partial response rate was 72.7% in the study group compared to 56.5% in controls. The volume fraction of viable parenchyma dropped to 2.1 +/- 0.2% (16.6 +/- 1.5% in controls) whereas the injury index according to Lavnikova rose to 95.0% (58.7% in controls).