Purpose of the study. To evaluate the prognostic significance of biological factors VEGF-A, sVEGF-R1, VEGF-D, FGF, EGF, EGFR, IGF-1, IGF-2, IGFBP-1, IGFBP-2, somatotropin-releasing factor (GHRH) in kidney tissues (tumour tissue, tissue of the perifocal zone and conditionally intact tissue) in local and generalized clear cell renal cancer using ROC analysis.

Materials and methods. Two groups of patients were included in the study. Group 1 comprised 50 patients with local kidney cancer (T1–3N0M0), while group 2 comprised 50 patients with metastatic kidney cancer (T1–4N0M1). 10% cytosolic fractions of the kidney tumour tissue were examined. The content of growth factors — somatotropinreleasing factor (GHRH), somatotropin-releasing factor (GHRH) — was determined by the ELISA assay using standard test systems. An assessment of prognostically unfavourable factors that significantly affect the generalization of the tumour process was carried out using binary logistic regression and ROC analysis.

Results. The performed ROC analysis revealed diagnostically significant progression biomarkers and their critical values for clear cell renal cancer (for conditionally intact tissue, these values were: VEGF-A ≤ 9107.9 pg/g of tissue; VEGF-R1 ≤ 122.8 ng/g of tissue; FGF ≤ 364.7 pg/g of tissue; IGF-2 ≤ 148 ng/g of tissue; for perifocal tissue, VEGF-A ≤ 5839.6 pg/g of tissue; for tumour tissue, VEGF-A > 9622.5 pg/g of tissue, FGF ≤ 435.1 pg/g of tissue, somatotropin-releasing factor (GHRH) ≤ 158.6 ng/g of tissue). The obtained data contribute to optimization of the disease prognosis.

Conclusion. It is established that the most prognostically significant markers of clear cell renal cancer progression include VEGF-A, FGF, somatotropin-releasing factor (GHRH), which can serve as an additional criterion for the differential diagnosis of progression and monitoring of clear cell renal cancer.   

Purpose of the study. To evaluate the role of chronic chlamydial infection in the genesis of proliferative processes in the female genital area.

Materials and methods. The study involved 267 women aged from 27 to 43 years. Depending on the severity of the pathological process in the genital tract and the presence of the Chlamydia trachomatis infection, 6 groups were distinguished: 1st — 30 somatically healthy women without pathologies of the female reproductive system; 2nd and 3rd — those with inflammatory processes in the reproductive organs of non-chlamydial (36) and chlamydial nature (38); 4th and 5th — those with proliferative processes in the pelvic organs of non-chlamydial (50) and chlamydial nature (58); 6th — patients with cervical cancer (55). The PCR and ELISA (Chem Well, USA) methods were used to identify the presence of Chlamydia trachomatis. The concentration of estradiol (E) and progesterone (P) (ELISA) in the blood, as well as their ratio (E/P), was determined. The as-obtained data were compared with the results of cytomorphological and ultrasound studies.

Results. Proliferative processes in the genital tract are accompanied by a change in the level of female sex hormones, in particular, by a sharp decrease in progesterone in the luteal phase of the cycle against the background of absolute or relative hyperestrogenism. These changes are more pronounced in women with chronic chlamydial infection. A connection between the presence of the infectious agent in question and the severity of hyperplastic processes in the female genital tract is established. A comparison of the obtained morphological data with the blood progesterone content in women without Chlamydia trachomatis showed that an increase in the severity of disorders correlates with a decrease in the level of female hormones. In women infected with Chlamydia trachomatis, the severity of hyperplastic processes shifts to the right, i. e. towards normal progesterone values. Therefore, even at maximal progesterone concentrations close to the reference values, a greater severity of pathological changes is observed.

Conclusion. The obtained results demonstrate the undeniable role of chronic chlamydial infection in initiating a hormonal imbalance towards absolute or relative hyperestrogenia with a severe progesterone deficiency. A causal relationship of the Chlamydia trachomatis infectious agent with the severity of hyperplastic processes in the pelvic organs is established. It is concluded that the detection of chlamydial infection should be considered as an essential element in the screening and prevention of hyperplastic processes.

This article reviews modern ideas about the pathogenesis of chronic pain in cancer patients and describes main approaches to its relief. Special attention is focused on factors important for the development of a patient-specific approach to the pathophysiology and management of chronic pain syndrome. These factors include genetics, gender, age, early anamnesis, patients’ immunological and endocrine status, as well as those shedding light on the pathogenetic aspects of chronic pain thus facilitating the choice of an optimal therapeutic approach. The review identifies limitations of pharmacotherapy as the major method of chronic pain management and justifies the need for alternative approaches. The latter include monitoring of the circadian rhythms of pain and various nonspecific effects, such as physical factors, psychological methods or reflex therapy. The experience and possibilities of non–pharmacological methods in the complex pathogenetic therapy of chronic pain are analysed, along with preventive measures permitting the development of chronic pain to be avoided. The pathological disorganizing and stressful role of chronic pain is considered with regard to the theory of functional systems. The pathogenetic significance of chronic pain in carcinogenesis and cancer progression is illustrated by examples from scientific literature. The authors emphasize the necessity of effective pain prevention, including invasive methods, in order to ensure an acceptable quality of life for cancer patients at any stage of the malignant process.

The immune system plays an important role in the development and treatment of many cancer types. This fact determined the emergence of numerous immunotherapeutic approaches, including that of adoptive cell therapy (ACT). In this article, we set out to describe the basic methods of adoptive cell cancer therapy, their application and development prospects. The first part of the article deals with the significance of immunotherapeutic methods for cancer treatment and describes the current state of the problem. The main part of the article provides information on the mechanisms of adoptive T cell (unmodified and genetically modified) transfer, the creation of dendritic cell vaccines and cytokine-induced killers (CIK). In addition, a review of recent achievements in the introduction of the aforementioned methods into the clinical practice is carried out. The conclusion is made that adoptive cell therapy can be considered as one of the most promising methods of cancer immunotherapy, which should be optimized for more effective use in the treatment of cancer.

Prostate cancer (Pca) is the most common urogenital tumour in men. The most common histological form of prostate cancer is acinar adenocarcinoma. Rare morphological types of prostate cancer present an urgent clinical problem due to their aggressive course and the lack of rigorous standards for the management of such patients. Squamous and combined adenosquamous (ASC) prostate cancers are extremely rare histological forms of Pca, occurring in 0.5–1% of cases. The age of patients with these conditions varies from 52 to 79 years. Squamous cell and ASC cancers are among the most aggressive morphological types of prostate cancer. By the time of the diagnosis, most patients develop distant metastases, which are frequently localized in the lymph nodes and bones. In tumours of such a morphological structure, bone metastases are of osteolytic nature. The prognosis is unfavourable due to the rapid metastasis and development of the malignant process. The survival rate of patients averages 16 months after combined treatment. Only 20% of the patients with distant metastases at the time of diagnosis live longer than 6 months. In most cases, squamous cell Pca manifests itself through local symptoms, such as dysuria, bone pain and hematuria. The vast majority of patients have a normal level of prostate-specific antigen (PSA) in serum. Since ASC Pca is a fairly rare form of prostate cancer, no treatment standards have thus far been developed. Hormone therapy, chemotherapy and radiation therapy are believed to either be ineffective or show low efficacy in the treatment of ASC Pca. In cases where ASC Pca is localized, surgical treatment in the amount of radical prostatectomy, cystoprostatectomy or simultaneous surgical interventions with rectal resection can significantly extend the life of such patients. The article presents the clinical case of managing a patient with ASC Pca.

Renal cell carcinoma (RCC) accounts for 3.9 % of all cancers. In 2018, 24,291 and 63,990 new cases of RCC were recorded in Russia and the US, respectively. The most common approach to early stage RCC treatment consists in either radical or partial nephrectomy. This article presents a clinical case of the successful treatment of a localized renal cell carcinoma T3аN0M0 in a 65-year-old man. 8 weeks after the performed kidney resection, the biochemical blood parameters and glomerular filtration rate did not significantly differ from the initial values (p > 0.05). A control CT examination of the abdominal cavity and the retroperitoneal space (after 12 weeks) detected no enlarged regional, paraaortic and paracanal lymph nodes. Partial nephrectomy is considered to be an alternative surgical treatment of localized RCC forms due to its potential for maximal organ preservation. Partial nephrectomy should be a method of choice in cases where it is technically and strategically feasible, since this type of surgical intervention provides for a better preservation of renal function under a lower risk of postoperative complications.

The aim of this work was to assess the significance of investigating clinical and laboratory parameters for diagnosing acute monocytic leukemia in children on the basis of a clinical case. The article demonstrates specific features of differentiating AML M5a from other forms of acute myeloid leukemia. According to the results of hematological, morphological and cytofluorimetric studies of blood and bone marrow samples, the diagnosis of acute myeloid leukemia was established. The morphological and phenotypic characteristics of blast cells hampered the diagnosis of an AML form. However, a comprehensive analysis of the expressed CD antigens allowed acute monocytic leukemia to be identified, which diagnosis was subsequently confirmed by a cytochemical study. Thus, the clinical diagnosis was established over a short period of time. This was of importance given the rising severity of the patient’s condition requiring immediate treatment, the initial hyperleukocytosis and the development of life-threatening complications associated with leukostasis in the lungs and the central nervous system. In the presented case, the clinical manifestations of the underlying disease and the results of flow cytofluorimetry were determining factors in initiating timely specific therapy.