Peer-rewieved medical journal. The aim of the edition is to promote scientific achievements of Russian medicine in Russia and abroad. The publication of reviews, lectures, essays by leading Russian and foreign experts in the field of fundamental and ...
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Regulatory role of growth factors during N-acetylcysteine administration in the model of radiation-induced pancreatic injury
Purpose of the study. To evaluate the roles of the growth factors IGF‑1, TGF-β, and VEGF-A in regulating delayed regenerative mechanisms induced by N-acetylcysteine (NAC) administered prior to local pancreatic irradiation with electrons at a total dose of 30 Gy. Materials and methods. An experimental study was conducted on 60 male Wistar rats, which were divided into four groups: Group 1 (control, n = 10): rats received an intraperitoneal injection of NaCl solution without local electron irradiation; Group 2 (n = 20): intraperitoneal administration of 0.9 % NaCl solution prior to local electron irradiation in a fractionated mode with a total focal dose (TFD) of 30 Gy; Group 3 (n = 20): intraperitoneal administration of N-AC at a dose of 120 mg/kg prior to local electron irradiation in a fractionated mode with a TFD of 30 Gy; Group 4 (n = 10): intraperitoneal administration of N-AC at a dose of 120 mg/kg without local electron irradiation. Thirty days after irradiation, blood levels of glucose, insulin, and amylase were measured. Histological analysis of pancreatic islet architecture, the degree of perivascular fibrosis (Masson’s trichrome staining), and the expression of IGF‑1, TGF-β, and VEGF-A were assessed by immunohistochemistry through counting positively stained cells. Results. Irradiation resulted in elevated blood glucose and amylase levels and decreased insulin levels. Signs of radiation-induced pancreatic injury were accompanied by reduced expression of IGF‑1 and VEGF-A in the islets by 39 % and 56 %, respectively, while the proportion of TGF-β-positive cells exceeded the control values by 3.4‑fold. Pre-irradiation administration of NAC partially preserved biochemical parameters within the normal range, suppressed TGF-β expression, and maintained the numbers of IGF‑1- and VEGF-A-positive endocrine cells at levels 2.5 and 3 times higher than those in the irradiation-only group, respectively. Conclusion. Pre-irradiation administration of NAC exerts a modulatory effect on the expression of growth factors IGF‑1, TGF-β, and VEGF-A in the late period following local electron irradiation of the pancreas, promoting restoration of the organ’s structural integrity and endocrine function. The obtained data suggest that N-AC is a promising agent for the prevention of delayed post-radiation complications, including fibrosis as well as metabolic and secretory insufficiency of the pancreatic islets.
Predictors of complete pathological response to neoadjuvant TCHP therapy in patients with early HER2-positive breast cancer: a single-center experience
Neoadjuvant chemotherapy with dual anti-HER2 blockade is the standard of care for early HER2-positive breast cancer (BC), leading to a complete pathological response (pCR) in a significant proportion of patients. However, the response to therapy is heterogeneous, and the identification of accessible clinicopathological predictors of pCR remains a key challenge for treatment personalization and efficacy prediction. Purpose of the study. To evaluate the efficacy of the TCHP (docetaxel, carboplatin, trastuzumab, pertuzumab) neoadjuvant regimen and to identify independent clinicopathological predictors of achieving pCR in patients with stage IIA–IIIA HER2-positive BC. Patients and methods. A single-center retrospective study was conducted at the P.A. Hertsen Moscow Oncology Research Institute. The analysis included data from 120 patients with stage IIA–IIIA HER2-positive BC who received neoadjuvant TCHP therapy between 2022 and 2025. The primary endpoint was the rate of pCR (ypT0/is ypN0). Univariate comparative analysis and multivariate binary logistic regression were used to identify predictors of response. ROC analysis was used to determine the optimal cutoff value for the predictor. Results. Complete pathological response was achieved in 70 out of 120 patients (58.3 %). In the multivariate analysis, estrogen receptor (ER) expression level was the only independent predictor of pCR. For each one-point increase in the Allred score for ER expression, the odds of achieving pCR decreased by 16.1 % (OR 0.839; 95 % CI 0.753–0.934; p = 0.001). ROC analysis identified an optimal cutoff value for ER expression of ≤ 6 points for predicting pCR (AUC = 0.665; p = 0.001). Conclusion. ER expression level is a key independent predictor of response to neoadjuvant TCHP therapy in patients with HER2-positive breast cancer. ER expression assessment can be used in clinical practice as an accessible biomarker for patient stratification and for identifying a group with a lower likelihood of achieving pCR who may require alternative or intensified therapeutic regimens.
Epidermal growth factor receptor blockers – known possibilities and new perspectives in oncology
The epidermal growth factor receptor (EGFR) is a critical signaling molecule that, upon activation, promotes neoplastic transformation and metastasis. The utilization of targeted drugs, specifically EGFR inhibitors, has emerged as a pivotal component in the management of diverse malignant neoplasms. Among them, low-molecular-weight heterocyclic compounds acting as blockers of the EGFR tyrosine kinase domain occupy a key position. Purpose of the study. Is to conduct analysis of modern literature data devoted to the development and study of the antitumor acttivity of small molecule EGFR inhibitors, with a focus on blockers of the receptor’s intracellular domain. Materials and methods. A comprehensive literature search was conducted in the PubMed and eLibrary databases. The following keywords were entered into the search engine: "EGFR inhibitors", "small molecular weight kinase inhibitors" (SMKIs), "antitumor effect", "pyrimidine derivatives", "molecular docking", and "molecular modeling". Original research articles, meta-analyses, randomized controlled trials, and systematic reviews published predominantly published within the last five years. Results. The review presents the main characteristics of small molecule EGFR inhibitors, their mechanisms of action, and classification. The present study explores the underlying causes of resistance to targeted drugs aimed at the internal domain of the receptor, as well as the available strategies for overcoming such drug resistance. The subsequent sections of this text will discuss the development of new EGFR blockers, strategies for increasing their selectivity and efficacy, including through bioinformatic approaches. Conclusion. Currently, a significant amount of data has been accumulated on the development and use of small molecule heterocyclic EGFR tyrosine kinase inhibitors in the treatment of cancer patients. The main reasons limiting their use in clinical practice are the emergence of resistance due to receptor mutations and toxicity. In this regard, the search for new candidate compounds with a putative antitumor mechanism of action and high affinity to the target remains relevant. Inhibitory activity against the internal domain of EGFR directly depends on the structure of the heterocycle underlying the drug, which must be taken into account when creating new molecules that block this receptor. An important role in this process is played by computer modeling, which allows for a significant reduction in material costs and time. The presented review can be useful for researchers developing domestic targeted drugs aimed at the internal domain of EGFR, as part of import substitution to ensure the technological sovereignty of the Russian Federation.
The role of sentinel lymph node biopsy in head and neck cancer
Secondary lesion of the lymph nodes of the neck is a significant factor in the prognosis and choice of surgical tactics in patients with malignant neoplasms of the head and neck organs. In early cases of the disease, in order to identify latent metastases, a sentinel lymph node (SLN) biopsy can be performed, according to the results of which it is possible to assume the probability of damage to the remaining groups of cervical lymph nodes and conclude that cervical lymph dissection is necessary. Purpose of the study. Discussion of the achievements of the scientific community regarding the role of sentinel lymph node biopsy in malignant tumors of the head and neck, and analysis of current detection methods. Materials and methods. The analysis of scientific sources of the Scientific Electronic Library databases is carried out "eLIBRARY.RU" and "National Center for Biotechnology Information" published in the period from 2010 to 2025, demonstrating the main indicators of the clinical informativeness (frequency of detection, diagnostic accuracy, sensitivity, specificity, predictive value of a negative result) of various methods of detecting sentinel lymph nodes in patients with malignant neoplasms of the head and neck. Results. Several methods are used to identify sentinel lymph nodes, including instrumental, contrast-visual, radioisotopic, fluorescent, and combined techniques, each having specific advantages and limitations. The most common in clinical practice is the radioisotope detection method, which makes it possible to detect the accumulation of a radiopharmaceutical drug both at the preoperative stage and intraoperatively. Conclusion. To overcome the limitations of individual lymphography methods, new indicators, including hybrid agents, are being actively developed, offering significant prospects for practical medicine and further scientific research.
Study of the intensity of free radical oxidation in mitochondria of endometrioid adenocarcinoma cells depending on the degree of tumor differentiation
Purpose of the study. To investigate redox-balance parameters in mitochondria of endometrioid adenocarcinoma (EA) cells in oncogynecological patients, as well as in mitochondria of Guerin carcinoma cells with intramural tumor localization in rats. Materials and methods. The clinical part of the study included patients who underwent surgical treatment for EA (n = 42) and uterine fibroids (n = 14). Among patients with EA, 16 had well-differentiated tumors (G1), 12 had moderately differentiated tumors (G2), and 14 had poorly differentiated tumors (G3). The mean age of patients with EA was 60.8 ± 2.9 years, and with fibroids – 49.4 ± 2.5 years. None of the patients received neoadjuvant therapy. The experimental part of the study included biological material obtained from non-linear white female laboratory rats (n = 15) weighing 250 ± 25 g. Intramural growth of Guerin carcinoma was reproduced in these animals. In mitochondria isolated from EA, fibroid, and intact uterine tissues, concentrations of the following parameters were determined using standard ELISA methods: mitochondrial superoxide dismutase (SOD‑2), DNA and RNA oxidative modification products, malondialdehyde (MDA), diene conjugates (DC), and total protein (biuret method). Statistical analysis was performed using Statistica 10.0. Results. In women, mitochondria of EA cells in G1 tumors demonstrated a markedly elevated content of MDA and DC – 2.3‑fold and 2.9‑fold higher, respectively, compared with values in mitochondria of intact uterine tissue. In G2 tumors, MDA levels were 3.2‑fold higher and DC levels 2.7‑fold higher than in intact mitochondria. In G3 tumors, the degree of DNA damage increased 1.6‑fold (p < 0.05), while MDA, DC, and SOD‑2 concentrations increased 2.4‑fold, 3.0‑fold, and 3.4‑fold, respectively, compared with intact values. In female rats, mitochondria isolated from tumor tissues with intramural Guerin carcinoma growth displayed changes similar in direction to the clinical results: DNA damage increased 1.6‑fold (p < 0.05), MDA 1.6‑fold (p < 0.05), DC 1.5‑fold (p < 0.05), and SOD‑2 2.4‑fold. Conclusion. The oxidative stress and mitochondrial dysfunction identified in malignant cells of women indicate a differentiationdependent pathogenetic feature. Additionally, an identical direction of redox-balance alterations was demonstrated in the experimental subcellular model, supporting the translational relevance of the findings.
On the 70th Birthday of Elena Yu. Zlatnik
High-frequency ultrasound imaging of subcutaneous lymphatic and venular vessels in the planning of lymphatic drainage surgeries
Upper limb lymphedema following axillary lymph node dissection for breast cancer is one of the most common postoperative complications, significantly reducing patients’ quality of life. This clinical case demonstrates the effectiveness of lymphovenular anastomosis (LVA) as a method that allows for the correction of pathological processes associated with obstructive lymphedema at the early and intermediate stages of the disease. The importance of preoperative assessment and mapping of lymphatic and venous vessels using ultrasound technologies is emphasized, as it enables optimization of surgical tactics, improves the procedure’s efficiency, and reduces operative time. The article discusses the pathophysiological features of lymphedema, including vascular sclerosis and decreased lymphatic drainage capacity, as well as the advantages of modern instrumental diagnostic methods in planning LVA. Attention is drawn to the necessity of an individualized approach to each patient, based on thorough preoperative evaluation of the vascular network, as well as the importance of ultrasound monitoring in the postoperative period for controlling the condition of lymphedema. Thus, the decisive role of a comprehensive strategy – including preliminary diagnostics and meticulous surgical planning – ensures the most effective clinical outcomes in the treatment of upper limb lymphedema using the LVA method.
Intraoperative lymphography with indocyanine green experience in liver resection planning in patients with biliary cancer
Purpose of the study was to evaluate the feasibility of intraoperative lymphography with indocyanine green in cholangiocarcinoma and gallbladder cancer. Patients and methods. The study included 26 patients with biliary cancer, who underwent intraoperative fluorescent lymphography with indocyanine green (ICG lymphography) during the period from April 2023 to January 2025 while planning lymph node (LN) dissection and liver resection. The lymph drainage from the liver and bile ducts was studied at 1, 3, 5, 10, 15, 30 ± 45 minutes from the ICG introduction with the determination of the first three stained LNs – sentinel lymph nodes (SLNs) – followed by subsequent LN dissection with the removal of regional LNs, as well as all stained LNs outside the areas of regional metastases. When technically possible, the planned volume of liver surgery and biliary tract resection was performed. Results. In two cases (7.7 %) no SLN was detected, in this group there were no metastases in the LNs. In the remaining cases (92.3 %, n = 24), accumulation of ICG in one or more LNs was noted. LN invasion was noted in 12 patients. In this group, when using the first two stained LNs as SLNs, the sensitivity was 91.7 % (n = 11/12). Studying SLN 3 did not affect the sensitivity, but allowed identifying affected LNs outside the areas of regional metastases in two cases (7,7 %). Conclusion. ICG lymphography is a promising method for determination of the SLNs and lymphatic drainage pathways in biliary cancer. It is advisable to evaluate the effect of LN dissection performed using fluorescence lymphography on long-term outcomes in patients with resectable biliary cancer.
Antitumor efficacy of combined NOS/PDK inhibitor T1084 and gamma radiation in an experimental model
One of the approaches to overcoming the problem of tumor radioresistance, which significantly limits the effectiveness of radiotherapy, is the combination of different treatment strategies, including the use of anti-angiogenic agents. However, the drawbacks of existing anti-angiogenic drugs (toxicity, high cost) indicate the need to develop new, safer, and more effective agents of this class. Purpose of the study. To investigate the efficacy of an experimental combined antitumor therapy that integrates radiation exposure with subchronic parenteral administration of compound T1084, which exhibits anti-angiogenic and hypoxia-targeted cytotoxic activity. Materials and methods. The study examined the bifunctional compound T1084 (1‑isobutanoyl‑2‑isopropylisothiourea dichloroacetate), which has dual inhibitory activity against nitric oxide synthases (NOS) and pyruvate dehydrogenase kinase (PDK). The compound was developed and synthesized at the A. Tsyb Medical Radiological Research Center (Patent RU2699558). Antitumor efficacy was evaluated in a transplanted solid Ehrlich carcinoma (SEC) model in 149 F1(CBA×C57Bl/6j) mice across two independent experiments performed according to a unified protocol. The animals were divided into four groups: control (tumor-bearing animals), local irradiation of the tumor (10 Gy single dose or 20 Gy fractionated), monotherapy with T1084 (70.7 mg/kg, daily intraperitoneal administration), and combined therapy (T1084 plus gamma irradiation). Irradiation was performed using the Rokus-M gamma unit (⁶⁰Co, 1 Gy/min), and dosimetry was carried out according to the standards of the International Atomic Energy Agency (IAEA). Tumor development was assessed morphometrically. Results. It was demonstrated that subchronic application of T1084 at a safe dose of 70.7 mg/kg (1/4 LD₁₆) significantly enhanced the antitumor efficacy of different radiotherapy regimens without impairing treatment tolerability or inducing toxic effects. In two independent SEC experiments, the combination therapy produced a consistent and statistically significant antitumor effect (TI = 45–50 %), exceeding the efficacy of radiotherapy alone and of T1084 monotherapy. Conclusion. The experimental data obtained support the rationale for using the NOS/PDK inhibitor T1084 in combination with radiotherapy for the treatment of radioresistant solid tumors characterized by high angiogenic activity.
Quality of life of patients with cervical and uterine cancer after radical treatment and rehabilitation options using hyaluronic acid-based volume-forming agents
Purpose of the study. To assess the quality of life of patients with cervical cancer (CC) and endometrial cancer (EC) after radical specialized treatment, and to evaluate the effectiveness of hyaluronic acid-based volumizing agents in correcting vulvovaginal atrophic changes. Patients and methods. The study included data from 201 patients with morphologically verified cervical cancer (CC) stages I–III and endometrial cancer (EC) stages I–II (FIGO, 2018), who underwent examination and restorative treatment at the A. Tsyb Medical Radiological Research Centre. The mean age of the patients was 56.6 ± 10.0 years. All patients were postmenopausal, with menopause being treatment-induced in 40.8 % of cases; the mean duration of postmenopause was 9.5 ± 7.1 years. Patients were stratified into clinical groups according to the method of radical treatment: surgical – 67 (33.3 %), combined (surgery + radiotherapy) – 75 (37.3 %), and radiotherapy/chemoradiotherapy – 59 (29.4 %). Restorative therapy consisted of intravaginal and perineal administration of volumizing agents based on stabilized hyaluronic acid using the authors’ proprietary technique. Before and after the restorative therapy, vaginal transudate pH, the Vaginal Health Index (VHI), and sexual function (PISQ-12) were evaluated. Results. Before restorative treatment, all patients demonstrated severe vulvovaginal atrophy, which was more pronounced in groups receiving radiotherapy alone or as adjuvant therapy. Vaginal pH levels were 6.59 ± 0.6 and 6.43 ± 0.8, respectively, compared with 6.05 ± 0.9 in the surgical group (p = 0.001 and p = 0.01, respectively). VHI values were 7.7 ± 2.5 and 9.2 ± 3.7 compared with 11.1 ± 3.7 (p = 0.00001 and p = 0.02, respectively). One month after restorative treatment, there was a statistically significant decrease in vaginal pH and an increase in VHI scores in all groups (p < 0.00001 for all comparisons): to 5.2 ± 0.8 and 17.3 ± 2.9 in the 1st group; to 5.5 ± 0.6 and 16.75 ± 3.0 in the 2nd group; and to 5.4 ± 0.7 and 16.7 ± 2.6 in the 3rd group, with no significant differences between the groups (p > 0.05). The therapeutic effect persisted for 12 months. All positive changes observed during therapy contributed to normalization of sexual function. After 1 month, the PISQ-12 score decreased from 15.9 ± 6.7 to 12.0 ± 5.0 in the 1st group (p < 0.00001) and from 14.7 ± 6.0 to 12.0 ± 4.7 in the 3rd group (p < 0.00001). In the combined treatment group, a significant improvement was observed at later follow-up: from 15.8 ± 4.9 to 9.5 ± 3.5 (p < 0.00001). Conclusion. All gynecologic oncology patients experience vaginal mucosa atrophy after radical specialized treatment, which is more pronounce after combined radiation/chemoradiation therapy. This justifies starting for preventive measures immediately after completion of radiotherapy programs. Non-hormonal corrective therapy using hyaluronic acid-based volume-forming agents is an effective method for restoring vaginal mucosal properties, regardless of the specialized treatment method used.
Focal spleen sarcoidosis: clinical and diagnostic characteristics
Purpose of the study. Analysis of literature data on cases of spleen sarcoidosis focal manifestations. Materials and methods. A search was conducted for publications in the PubMed database using the keywords "splenic sarcoidosis", "isolated splenic sarcoidosis" and "primary splenic sarcoidosis" for the period from 1944 to 2024. Articles describing clinical observations of spleen sarcoidosis were selected, where it was possible to reliably determine the presence of focal manifestations of spleen sarcoidosis with a descriptive diagnostic picture, morphological verification, as well as additional information about lesions of other organs. Results. The analysis of these articles revealed 128 cases of spleen sarcoidosis, of which isolated focal spleen sarcoidosis was detected in 41 (32.0 %) cases. Combined sarcoidosis (in which the lesion of the spleen was combined with one or two other localizations or was part of a multiple lesion of the entire organism) accounted for 68.0 % of cases. Sarcoidosis developed synchronously or after surgical treatment of cancer in 22 (17.2 %) cases: synchronously – 12 (54.5 %) cases; in the postoperative period – 10 (45.5 %). An analysis of the identified observations is carried out. The main clinical and radiation characteristics of focal sarcoidosis of the spleen, as well as the most common other localizations in our analysis, are highlighted. Conclusion. Spleen lesions can occur in various clinical situations, ranging from asymptomatic patients to critically ill patients. However, focal formations of the spleen are quite rare, which makes it difficult to collect data from large groups of homogeneous morphological forms for analysis and development of criteria for differential diagnosis, therefore, the presence of a focus in the spleen often causes difficulties for specialists to make a diagnosis. The review identifies the incidence rates of focal spleen sarcoidosis and highlights its main clinical and radiation characteristics. Knowledge of these signs makes it possible to differentiate the disease, especially with an isolated lesion.
Possibilities of vaccine therapy for the treatment of glioblastoma
Glioblastoma is the most common and most aggressive primary brain tumor with a median survival of less than two years. Great hopes in the complex treatment of glioblastomas are placed on the use of immunotherapy, including vaccine therapy. Purpose of the study. To reflect the features of the use of vaccine therapy for brain tumors based on the analysis of modern scientific publications and present the results obtained in Russia and abroad. Materials and methods. The literature search was conducted in the Medline, E-library, PubMed systems. Results. The review presents data on unsatisfactory results of standard treatment of glioblastomas, characterizes their biological differences that determine weak sensitivity to most types of antitumor therapy and difficulties arising during vaccination; describes the properties of dendritic cells and their significance for the development of one of the main types of vaccines. The results of non-randomized and few randomized studies on the clinical use of vaccine therapy in Russia and abroad, mainly dendritic cell vaccines (DCVs) in patients with glioblastomas are highlighted. The prospects of personalized vaccination are emphasized; the effect of DCVs on some components of the immune system is described, as well as the dual role of exosomes in the development of a malignant process, resistance to treatment and the possibility of their use in creating vaccines. Information on clinical experience with the use of peptide vaccines and vaccines based on matrix RNA is presented. Conclusion. Despite certain difficulties in the use of vaccine therapy in patients with glioblastomas, encouraging results have been obtained in Russia and abroad. It is emphasized that antitumor vaccines have undoubted potential for the treatment of glioblastomas and are becoming promising methods of immunotherapy that can bring clinical benefit to patients with these most aggressive and difficult to treat malignant tumors.
Therapeutic approaches to pulmonary metastases in colorectal cancer
Pulmonary metastases of colorectal cancer (CRC) represent a significant clinical problem that requires a multidisciplinary approach in determining treatment tactics. To date, there are no prognostic scales and algorithms that make it possible to stratify patients with metastatic lung damage and give preference to surgical treatment, systemic or radiotherapy. Purpose of the study. To systematize data on treatment methods for pulmonary metastases of CRC and to evaluate the influence of prognostic factors on survival rates in this cohort of patients. Materials and methods. The analysis of publications for 2000–2025 in the PubMed and Google Scholar databases was carried out using the keywords: "colorectal cancer", "pulmonary metastases", "thoracoscopic surgery", "stereotactic radiation therapy", "circulating tumor DNA". Studies that do not correspond to the topic, duplicate data, and work on metastatic lung damage in other nosologies are excluded. Results. The results of treatment in the group of patients with pulmonary metastases of CRC are significantly influenced by many characteristics of the tumor. These include the number of metastatic foci, the presence or absence of affected mediastinal lymph nodes, and the level of cancer-­ embryonic antigen (CEA). A prognostically unfavorable factor is a history of metastatic liver damage and KRAS/BRAF mutations. The localization of the primary tumor among patients with oligometastatic CRC is also significant: the left-sided localization of the primary tumor is characterized by better overall survival rates than with the right-­sided lesion. Conclusion. Surgical resection for pulmonary metastases is the standard of treatment in the group of patients with oligometastatic CRC. Therapeutic tactics for each individual case should be determined by a multidisciplinary team, considering the biological and genetic characteristics of the tumor. In the presence of negative prognosis factors, adjuvant systemic therapy can improve long-term treatment outcomes. Modern treatment approaches for pulmonary metastases are based on data from retrospective studies, which highlights the need for prospective randomized trials and the importance of developing standardized algorithms.
Identification, screening and experimental approbation of the biological activity of Vaccinium praestans Lamb. fruit extract
Early manifestation of age‑associated diseases is linked to pathological free radical formation and the development of chronic oxidative stress. Vaccinium praestans Lamb (redberry, klopovka) is of practical interest for the prevention of such diseases as a potential source of natural antioxidants. Purpose of the study. To identify phenolic compounds in V. praestans fruits, screen their potential biological activity, and experimentally determine the antioxidant activity of V. praestans fruit liquid extract in vitro and in vivo. Materials and methods. The composition of phenolic compounds in the liquid extract of V. praestans fruits was analyzed using high‑performance liquid chromato‑mass‑spectrometry (HPLC–MS/MS). Total soluble phenolic compounds were quantified using the Folin–Ciocalteu method. Preliminary screening of biological activity of the identified phenolic compounds was performed using the PASS online computational prediction tool. Antioxidant activity of the extract was evaluated using the ABTS and FRAP assays. The effect of the extract on the antioxidant defense system of rats was assessed by modeling oxidative stress induced by carbon tetrachloride administration. Results. Ten phenolic compounds were identified in the liquid extract of V. praestans fruits, including quercetin glycosides, catechin, cyanidin glycosides, hydroxycinnamic acids, and their derivatives. The total phenolic content in the liquid extract of V. praestans fruits was 9.1 ± 0.12 mg‑GAE/mL. Preliminary biological activity screening indicated that the identified phenolic compounds may exhibit antioxidant, anticancer, antihypoxic, and cytoprotective activities. Antiradical activity of the liquid extract was confirmed using ABTS and FRAP assays. In the rat oxidative stress model, administration of the V. praestans liquid extract reduced malondialdehyde (MDA) levels by 20.57 % and increased total antiradical activity (TAA) 1.72‑fold compared with the control group (p < 0.05). Conclusion. The study expands current knowledge on the chemical composition and pharmacological activity spectrum of V. praestans fruits.
For the 70th Anniversary Elena M. Frantsiyants
Computed tomography in terms of transposition of the great arteries
Transposition of the great arteries (TGA) is one of the most complex congenital heart defects, which requires surgical intervention in the first days after the birth of a child. The article describes a unique clinical case of a patient with TGA who underwent two- stage surgical correction in childhood with long-term complications 30 years after surgery. In the presented clinical case, computed tomography (CT) with contrast and ECG synchronization demonstrated advantages over echocardiography (EchoCG), becoming the determining method for choosing a further treatment strategy. The importance of CT diagnostics was due to the following advantages: three-­dimensional visualization of conduit degeneration (calcification, 72 % stenosis), accurate assessment of right ventricular remodeling, diagnosis of subclinical thrombosis of the distal branches of the pulmonary artery, quantitative analysis of right ventricular function, visualization of collateral circulation, detection of ascites and signs of liver fibrosis. The analysis of the presented clinical observation demonstrates the possibilities of X-ray imaging methods and emphasizes the need to monitor patients after TGA correction.
Possibilities of using Dopplerography in squamous intraepithelial neoplasia of the cervix
Improvements in screening programs have significantly increased the number of newly diagnosed cases of cervical cancer at the in situ stage. However, the methods used are not always sufficiently sensitive and specific. Determination of blood flow indices in the uterine arteries and cervical arteries during transvaginal ultrasound examination (TVUS) with Dopplerography can be considered as an additional screening method. Purpose of the study. To assess the relationship between the blood flow indices of the uterine and cervical arteries with different degrees of squamous cell intraepithelial neoplasia of the cervix TVUS with Dopplerography. Patients and methods. The study included 60 patients. The 1st study group included 20 patients with high grade squamous intraepithelial lesion (HSIL) infected with HPV of high carcinogenic risk (mainly types 16 and 18). The 2nd group included 20 patients with low grade squamous intraepithelial lesion (LSIL) and HPV of low carcinogenic risk. The control group included 20 healthy female patients. All patients underwent a comprehensive transabdominal and TVUS was performed in real time on Ressona 7, Mindray (Germany) ultrasound machines. Resistance index (RI) of the uterine arteries and cervical vessels were measured by Doppler ultrasound and calculated automatically for each identified artery. Statistical analysis was performed using Microsoft Excel 365 and SPSS 20.0 software packages. Differences were considered statistically significant at p < 0.05. Results. According to the results of the analysis of variance the RI of the cervical arteries in the 1st study group (0.37 (0.25–0.57)) was significantly lower (p < 0.001). In the 2nd study group (0.63 (0.59–0.67)), there was a tendency to decrease (p = 0.09) compared with the control group (0.70 (0.61–0.73)). The analysis of the parameters within the two study groups revealed a significant (p < 0.001) decrease in cervical artery pressure in group 1 (0.37 (0.25–0.57)) compared with group 2 (0.63 (0.59–0.67)). No correlation was noted in the correlation analysis of the RI of the cervical arteries and uterine arteries in Study Group I and II. Conclusion. The use of TVUS with Dopplerography in combination with other screening methods can be used as an additional method to improve the results of early diagnosis and treatment of precancerous diseases of the cervix.
Features of uveal melanoma clinical course
Purpose of the study. Analysis of the clinical characteristics of patients with uveal melanoma to determine the features of the disease course. Patients and methods. The study included 223 patients with a diagnosis of uveal melanoma who were examined at the NMRC for Oncology, the Russian Federation Ministry of Health, in the period from 2019 to 2024. All patients underwent a standard ophthalmological examination, and computed tomography of the orbits, chest, and abdominal organs was performed. Using the methods of standard descriptive statistics, patient data were analyzed in order to identify the ratio of the following: gender, age, location of the neoplasm and its size, the degree of spread of the primary tumor, metastasis and clinical symptoms. Results. In the study group, the number of male patients was 92 people (41.2 %) and female patients – 131 people (58.8 %). The average age of all patients was 61.3 ± 0.9 years. The incidence among female patients is higher than among male patients, especially at the age of 60 to 74 years. The most common localization of uveal melanoma is the choroid, which accounted for 85.6 % (191 patients). Tumors with degree of spread of T2 and T3 were predominant – 70 (31.4 %) and 76 (34.1 %) people, respectively. Medium and large tumors were diagnosed in a larger number of patients – 30.9 % and 40.4 %, respectively. Among all patients, distant metastases were detected in 11.6 %. The main site of metastasis is the liver (61 %). To a lesser extent, metastatic lesions were found in the lungs and bones (9–13 %), as well as the kidneys, adrenal glands, pancreas and brain (3–7 %). A wide range of symptoms and consequences of the spread of the primary tumor was revealed. Conclusion. The variety of clinical symptoms in uveal melanoma depends on the location and extent of the tumor. Understanding the features of the development of the disease and its manifestations contributes to timely diagnosis and effective treatment.
Antitumor activity of tropolone JO-122(2) in subcutaneous CDX models of cancer
Purpose of the study. The present study investigates the antitumour effect of tropolone 2-(1,1‑dimethyl‑1H-benzo[e]indolin‑2‑yl)-5,6,7‑trichloro‑1,3‑tropolone (JO‑122(2)) in monotherapy and in combination with fluorouracil in subcutaneous CDX models of gastric cancer. Materials and methods. The experimental work was conducted on female BALB/c Nude mice (n = 32), with ages ranging from 6 to 8 weeks. The CDX models were created by subcutaneous administration of a tumor culture of human gastric adenocarcinoma (AGS) in a dose of 5 × 106 cells per mouse. After the tumors reaching a volume of 70–100 mm³, the animals were divided into four groups of eight individuals each, with the objective of ensuring minimal variation in the mean tumor node volume between groups. The efficacy of the therapeutic intervention was evaluated by measuring the inhibition of tumor growth (TGI %). The statistical data processing was performed using the Microsoft Excel 2013 and STATISTICA 12 software packages. The Mann–Whitney U test was utilized to evaluate the disparities between the experimental and control groups. Differences were considered statistically significant at p < 0.05. Results. Consequently, subcutaneous CDX models of gastric adenocarcinoma were obtained. The study demonstrated that the administration of JO‑122(2) as a monotherapy did not result in a statistically significant impact on the growth of tumor nodes. The most significant antitumor activity was observed in the group administered combination therapy (JO‑122(2) + 5‑fluorouracil). The mean value of tumor node volumes at the conclusion of the experiment (on day 29 after the commencement of treatment) in this group was 513.98 ± 56.50 mm³, whereas in the control group it was 915.08 ± 49.93 mm³. A comparison of tumor growth rates between the groups receiving 5‑fluorouracil monotherapy and combination therapy revealed statistically significant differences as early as the 22nd day of the experiment. Furthermore, the highest TPO value was observed in the group administered the combination of drugs, at 43.83 %. Conclusion. The results demonstrated a more effective antitumor effect on gastric adenocarcinoma models when tropolone was used in combination with a cytostatic. This finding suggests the potential for further investigation into the properties of this compound and the possibility of extending its study.