[Sex steroid hormone receptors in the cytosolic fraction of cancer and leukoplakia of the oral mucosa]. / Retseptory polovykh steroidnykh gormonov v tsitozol'noi fraktsii raka i leikoplakii slizistoi obolochki polosti rta.

The paper deals with the studies of sexual steroidal hormone receptors in the tumor cytosolic fraction in 37 patients with squamous cell carcinoma and in 18 patients from leukoplakia foci in the oral mucosa. One or two types of androgen and estrogen receptors were detected in the tumor cytosolic fraction in most female (75%) and male (62%) patients with squamous cell carcinoma. The detection rate and the mean values of androgen and estrogen receptors in squamous cell carcinoma of the oral mucosa were associated with sex, age, disease stage, type of growth and site of a tumor. Detection and levels of androgen and estrogen receptors in the leukoplakia foci of the oral mucosa depended on the age of patients. Cytoplasmic estrogen receptors (50%) and oral mucosal squamous cell cancer (34.4%) were much more encountered in the foci of leukoplakia and their mean levels tended to increase. The mechanism of action of sexual steroids on normal and tumor target cells, the role of androgens and estrogens in the pathogenesis of oral mucosal carcinoma and leukoplakia, and possible methods of endocrine therapy for these diseases are discussed.

[Metal-dependent collagenolytic activity in primary foci and metastatically involved lymph node in melanoma]. / Metallozavisimaia kollagenoliticheskaia aktivnost' v pervichnykh ochagakh i metastaticheski porazhennykh limfaticheskikh uzlakh melanom.

Collagenolytic activity was estimated in primary focuses of melanoma, in preparations of normal skin surrounding the tumor, in benign pigmentary neoplasms (nevus) as well as in normal and metastatic lymph nodes. Both metal-dependent and -independent collagenolytic activity was significantly increased in tumoral tissues as compared with that of healthy tissues. At the same time, the collagenolytic activity was considerably lower in benign pigmentary neoplasms than that of melanoma primary focuses. Importance of the collagenolytic enzymes in the processes of melanoma invasion and metastatic spreading is discussed.

[Lysosomal proteolytic enzymes in the processes of melanoma invasion and metastasis]. / Lizosomal'nye proteoliticheskie fermenty v protsessakh invazii i metastazirovaniia melanom.

Spectrofluorimetry was used to study the activity of lysosomal and membrane-binding endopeptidases such as cathepsins B (CB), D (CD) and L (CL) in 72 patients with skin malignant melanoma. Lysosomal endopeptidases were measured separately in the primary tumor, normal skin adjacent to tumor and intact and metastatic lymph nodes. The activity of lysosomal CB in the primary tumor was higher than in the adjacent normal skin. The peak activity of membrane-binding KB was established in metastatic lymph nodes. A significant increase in the activity of lysosomal KB was observed in involved regional lymph nodes as compared to intact ones. The activity of membrane-binding KB in metastatic lymph nodes was 6 times that in metastasis-free ones. A significant increase in the activity of lysosomal KD was established in primary melanoma nodes compared to adjacent normal skin as well as in metastatic lymph nodes compared to intact ones. Preoperative chemo- and radiation therapy was followed by a decrease in lysosomal KB and KL activity in metastatic lymph nodes which, however, did not reach the level established for intact lymph nodes. The pathogenetic role of proteolytic endopeptidases in invasion and dissemination of malignant melanoma is discussed as well as the value of their level measurement for assessing metastatic potential of tumor and prognosis of disease on the basis of tumor site, degree of invasion regional lymph node status.

[Substantiation of the expediency of performing extensive lymph node dissection in surgical treatment of esophageal cancer]. / Obosnovanie tselesoobraznosti vypolneniia rasshirennoi limfo- dissektsii pri khirurgicheskom lechenii raka pishchevoda.

The performance of extensive lymph node dissection+ in esophageal carcinoma is substantiated. From their own data the authors conclude that squamous cell carcinoma of the esophagus possesses high lymphatic metastatic activity and point to the statistically significant increase of the incidence of involvement of the superior perigastric lymph nodes in localization of the tumor in its infrathoracic part. At the same time, the frequency of affection of the mediastinal lymph collector does not depend on the localization of the tumor. The authors emphasize that extensive subsequent lymph node dissection+ of the mediastinum and upper part of the abdominal cavity should be an obligatory stage of an operative intervention in esophageal carcinoma.

[Morphological prognostic criteria in skin melanoma]. / Morfologicheskie kriterii prognoza pri melanome kozhi.

The value of morphologic features to be used prognosing dissemination and survival in skin malignant melanoma is discussed. Single-factor statistical analysis showed tumor thickness, extent of invasion or local spreading, clinico-morphologic pattern, lymphoid-plasmocytic infiltration, mitotic activity and cell composition to be the most reliable in predicting survival and dissemination in clinical stage I malignant melanoma of the skin. These parameters should be evaluated at microscopic evaluation of the tumor. Two-, five- and ten-year prognosis was obtained by multifactorial analysis yielding credibilities of 86.2, 78.5 and 71% for survival and 61.5, 68.7 and 74.3% for lethality, respectively.

[The morphological criteria and prognosis of regional metastases and treatment outcomes in tongue cancer]. / Morfologicheskie kriterii i prognozirovanie regionarnykh metastazov i iskhodov lecheniia raka iazyka.

Differentiation degree of squamous-cell carcinoma of the mobile part of the tongue was studied in 139 patients. This sign was found to correlate with the incidence of regional metastases and survival rate. The degree of the tumor invasion in lingual muscles was found to be related to survival rate.

[The morphology of the preinvasive phase of different forms of skin melanomas]. / Morfologiia predynvazivnoi fazy razlichnykh form melanom kozhi.

Morphological criteria of the melanoma preinvasive stage on the basis of which the forms of melanoma (superficially spreading, acral-lentiginous, lentigo melanoma, nodular) are determined are presented. Out of 250 cases, in 8% melanoma is classified as lentigo, in 38.8% as superficially spreading, in 53.2%--as nodular. The distinguishing of various melanoma forms in justified as this is of value for determining the prognosis of life in patients with skin melanoma.

[Melanomas of the anorectal region]. / Melanomy anorektal'noi oblasti.

Melanoma of the anorectal region is a rare disease which makes up 1.8% of all rectal malignancies and 1.4% of all cases of melanoma. Surgery is the only radical procedure for the treatment of anorectal melanoma. Abdomino-perineal extirpation of the rectum proved most radical. Overall five-year survival rate was 17.0 +/- 5.3%.

[Morphologic diagnosis of Merkel cell cancer of the skin]. / Morfologicheskaia diagnostika raka kozhi iz kletok Merkelia.

Four cases of this carcinoma have been examined by cytologic and histologic methods and electron microscopy. The tumor may be diagnosed by light optics, and electron microscopy is highly effective here too. Examinations of the tumor and metastases puncture biopsy specimens permit the detection of undifferentiated small-cell carcinoma before the treatment.

[Merkel cell cancer]. / Rak iz kletok Merkelia.

The authors analyze 3 cases of Merkel-cell carcinoma, examined by light and electron microscopy with the use of the immunomorphologic method. The diagnosis of this type of carcinoma is based largely on microscopic examination of the tumor. The principal morphologic sign is the presence of relatively monomorphous cells characterized by a definite growth pattern; trabeculae, strands, separated by connective tissue laminae. Electron microscopy ranks second in informative value; it detects the endocrine granules, provided the number of the examined samples is sufficient. Immunomorphologic detection of cytokeratins confirms only the epithelial nature of the tumor.

[Results of examination of a population from a region with a high incidence of esophageal cancer: precancerous lesions of the esophageal mucosa]. / Rezul'taty obsledovaniia naseleniia v regione s vysokoi zabolevaemost'iu rakom poshchevoda: predrakovye porazheniia slizistoi obolochki pishchevoda.

Esophagoscopic evidence of chronic esophagitis of varying degree was found in 60% of the total number of 1348 examined males living in a region with high incidence of esophageal cancer. The high incidence of chronic esophagitis corroborates the hypothesis that this disease is a precursor of esophageal cancer.

[Melanocytic schwannoma]. / Melanotsitarnaia shvannoma.

One observation of melanocytic schwannoma in a woman aged 53 is described. The tumour localized in the subcutaneous fat of the crus and looked like an encapsulated node. Electron-microscopic study indicated the signs of schwannoma and the presence of premelanosomes in the tumour cells. Polymorphism of the cells and the increase in mitotic figures was suggesting of a malignant character of the tumour. The differential diagnosis with melanoma should be based on clinical, light-optical and ultrastructural data.

[Morphologic features and biological properties of melanomas in children]. / Izuchenie morfologicheskikh osobennostei i biologicheskikh svoistv melanomy u detei.

A complex morphologic study was made of primary skin melanoma, its metastases to the lymph nodes in a boy of 8, as well as of the tumour inoculate from the lymph node of the child on nude mice BALB/c in passages 1-6, 9, 10 and 44. The mitotic regimen of the material was studied. The data obtained show that childhood and adult melanoma is characterized by the same clinical-morphologic features. The electron microscopic study provided additional information for the confirmation of the histogenesis and identification of the melanoma type. To study individual sensitivity to antitumour drugs, it might be more reasonable to use first passages of the tumour, as the ultrastructural cell differentiation in them is maximally similar to the original one.

Survey of a population with a high incidence of oral and oesophageal cancer.

The results of a survey of a population with a high incidence of oral and oesophageal cancer are presented. The population under study appears to have several epidemiologic characteristics, some of which may be associated with a high incidence of oral and oesophageal cancer. A remarkably high proportion (41%) of the men surveyed were nass users and this habit, like the use of other types of tobacco mixtures, has been related to oral cancer. Oral leukoplakia and chronic oesophagitis (conditions thought to be precursors of oral and oesophageal cancer) have been diagnosed in 11% and 60%, respectively, of the persons examined. Analysis of the relationship between nass use, cigarette smoking, oral leukoplakia and oesophagitis revealed that the prevalence of oral leukoplakia is highest among cigarette smokers who use nass. It appears that nass use does not affect the frequency of occurrence of chronic oesophagitis. However, a slight elevation of the prevalence odds ratio was observed for current smokers and drinkers. Biochemical analysis of the blood of a random sample of the surveyed population revealed low levels of riboflavin, vitamin A and carotenoids--vitamins that most probably have a protective effect against the development of cancer. The mutagenicity test has shown that nass contains a chemical or chemicals that exert a genotoxic effect. Chemical analysis revealed the presence in nass of tobacco-specific N-nitroso compounds.

[Prognostic significance of the morphological traits of skin melanoma of the head and neck]. / Prognosticheskoe znachenie morfologicheskikh priznakov melanomy kozhi golovy i shei.

Histologic slides of a primary tumour from 146 patients with the skin melanoma of the head or neck treated only surgically were studied. The significance of different histologic criteria in prognosis of life and metastasis was evaluated by means of unifactorial statistical analysis. The thickness of a tumour, its invasiveness and histologic type are the most informative morphological criteria. The unifactorial analysis allows foreseeing the appearance of metastasis and lethal outcome in 20 to 46% of cases. Multifactorial analysis permits predicting the appearance of metastasis within 3 years in 76,8% of cases and in 85,3% of cases within 5 years.

[Differential diagnosis of basalioma and metatypical skin cancer]. / K differentsial'noi diagnostike bazaliomy i metatipicheskogo raka kozhi.

The WHO histological classification of skin tumors (Geneva, 1980) has first distinguished a new nosologic variety of skin carcinoma, metatypic carcinoma (MTC) being intermediate between basalioma and squamous cell carcinoma. Separation of MTC from the group of basaliomas is important prognostically because this tumor is capable of metastasizing, whereas MTC diagnosis is difficult because it simulates basalioma clinically and morphologically. The study of the mitotic regimen in 13 cases of MTC and 20 cases of basalioma showed this method to be adequate for differential diagnosis of these tumors. The values of the mitotic regimen in MTC always differed from similar values in basalioma: the mitotic activity, the specific content of dividing cells at the stage of metaphase, and the rate of pathologic mitoses increased considerably, there appeared multipolar and monocentric mitoses, bridges, three-phase metaphases.

[Ultrastructure of human skin melanomas]. / Ul'trastruktura melanom kozhi cheloveka.

Sixty invasive melanomas of human skin including 30 nodular, 28 extending superficially and 2 lentigo-melanomas were studied. The results indicate that electron microscopy may be efficiently used for differential diagnosis of melanomas and poorly differentiated tumors of other histogenesis. Some ultrastructural differences between lentigo-melanoma, melanoma extending superficially and nodular melanomas were found.

[Melanoma developing from a cellular blue nevus]. / Melanoma, voznikshaia na fone kletochnogo golubogo nevusa.

A rare observation of melanoma developing in the presence of the cellular blue nevus of the ear lobe with a comparatively favourable course is presented. Melanoma metastases appeared in the right parotid salivary gland and lymph nodes 25 years after removal of the primary tumor and 7 years of survival after parotidectomy and fascial dissection of the cervical adipose tissue.