Vol 19, No 1 (2014)

Objective: to study influence of regional chemo- and biotherapy on intraoperative blood loss. Materials and methods: An analysis of 122 cases of extensive liver resection accompanied with regional chemotherapy in colorectal metastases patients has been performed. 69 (57%) of them had bilobar lesions, 58 (48%) - had multiple metastases, 27 (22%) - had been resected for extrahepatic metastases. Results: bevacizumab inclusion in preoperative regional chemotherapy did not lead to increase of intraoperative blood loss. Conclusion: Median intraoperative blood loss was 1200 ml in both groups. Up to 6 courses of preoperative antitumor therapy, regardless of route of drug introduction did not increase blood loss. Intraoperative blood loss increases from standard to extended liver resection. Resection of contralateral lobe metastases did not lead to statistically significant increase in blood loss as compared with standard operation.

The results of 2 years survival after stereotactic radiation therapy for 117 patients with early-stages of non-small cell lung cancer (NSCLC) in patients with the age-related contraindications to surgery (with heavy cardiovascular diseases) were analyzed. We compare three treatment methods: 3D conformal radiotherapy in the free breathing - 39 patients (group 1); 3D dynamic conformal radiotherapy with active breath control - 42 patients (group 2), and high-hypofractionated stereotactic radiation therapy - 36 patients (3 group). Local control rate was highest in the group 3 - 85 %. Two year survival rate in groups 1, 2 and 3 reached 41%, 56% and 66 %, respectively. It was revealed that the results of high-dose hypofractionated radiation therapy for 2-year survival rates are comparable with surgery. Thus, the distant stereotactic conformal radiation therapy of NSCLC stages 1 and 2 with active breath control showed a higher efficiency without increasing the toxicity on the mediastinum, which has compromised heavy competing cardiovascular diseases. Also, the best long-term results of treatment were registered in a group of high-dose hypofractionated stereotactic radiotherapy.

Cancer, specific, nonspecific inflammatory and other pathological processes in lungs have similar lines in their visualization by multislice computed tomography methods. In order to improve the accuracy of the differential diagnosis of spherical formations in lungs by quantifying their internal structure with multislice computed tomography a newly developed method comprising sighting volume densitometry was used. 328 patients with primary cancer of a lung, pneumonia and infiltrative tuberculosis are surveyed. The set of densitometry parameters for differential diagnostics of diseases is defined. For paired division of diseases the nonlinear neuron was used. Sensitivity at division of the «primary cancer - infiltrative tuberculosis» made 91,1%, specificity - 88,6%, accuracy - 90,2%. Sensitivity at division of the «primary cancer - pneumonia» made 90,4%, specificity - 74,5%, accuracy - 84,2%. Sensitivity at division of the «infiltrative tuberculosis - pneumonia» made 79,5%, specificity - 80,8%, accuracy - 80,2%.

Представлены результаты исследования 150 пациенток с полипами наружного отверстия уретры в возрасте от 45 до 70 лет. Пациентки обследованы по предложенной схеме. После обследования на урогенитальную инфекцию методом культурального исследования и ПЦР пациентки поделены на две группы. 1-ю группу составили 90 женщин с полипами и выявленной урогенитальной инфекцией, во 2-ю группу вошли 60 пациенток с полипами уретры неинфекционной этиологии. Проведены исследование иммунной системы и патоморфологический анализ биоптатов полипа у пациенток обеих групп, что позволило выявить особенности течения данного заболевания.

The study of coagulation features and protein-synthetic function of blood in patients with cancer of pancreatoduodenal zone, complicated by mechanical jaundice and acute cholangitis was carried out. There are 106 patients included in this work, blood samples was taken at admission (day 1), 3-5 and 7-10 days after operation. Characteristic of hemocoagulation activity was studied by measuring the activity of coagulation factors V and VII. Protein-forming liver function was taken into account by measuring the activity of coagulation factors V and VII, as well as the main physiological anticoagulants - antithrombin III and protein C. The leading cause of blood coagulability reduction in examined patients was a disorder of the vitamin K - dependent factors synthesis (for example, factor VII) with the moderate changes of factor V, antithrombin III and protein C in the course of the disease.

Major research studies on the current predictors of gestational trophoblastic disease (GTD) were not conducted in Russia. The prognostic value of new prognostic factors such as the level of beta - hCG in spinal fluid in patients with disseminated tumor, the level of placental lactogen (PL) in patients with GTD have not been studied. Until now, there is no earlier criterion of tumor resistance to conventional chemotherapy (parameters beta - HCG, tumor size, etc.). As a result, clinicians often plan GTD treatment of patients according to clinical stage, apply non-standard chemotherapy regimens, which contributes to the development of tumor resistance and significantly worsens the prognosis of the disease. Thus, timely diagnosis and proper staging of GTD, it is important to optimize treatment planning. Proper treatment at an early stage can cure the vast majority of patients, using high-efficiency and low-toxicity standard first line chemotherapy regimens without harm to the reproductive health of women and reduce their quality of life. Comprehensive study of predictors of GTD will allow better planning of treatment, identify early factors tumor resistance to conventional chemotherapy and to develop evidence-based recommendations for optimizing the treatment of patients with GTD.