Group Of Malignant Tumors Research Articles

Central nervous system embryonal tumors with EWSR1-PLAGL1 rearrangements reclassified as INI-1 deficient tumors at relapse

PurposeCentral nervous system (CNS) embryonal tumors are a diverse group of malignant tumors typically affecting pediatric patients that recently have been better defined, and this paper describes evolution of a unique type of embryonal tumor at relapse.MethodsTwo pediatric patients with CNS embryonal tumors with EWSR1-PLAGL1 rearrangements treated at Arkansas Children’s Hospital with histopathologic and molecular data are described.ResultsThese two patients at diagnosis were classified as CNS embryonal tumors with EWSR1-PLAGL1 rearrangements based on histologic appearance and molecular data. At relapse both patient’s disease was reclassified as atypical teratoid rhabdoid tumor (ATRT) based on loss of INI-1, presence of SMARCB1 alterations, and methylation profiling results.ConclusionCNS embryonal tumors with EWSR1-PLAGL1 rearrangements acquire or include a population of cells with SMARCB1 alterations that are the component that predominate at relapse, suggesting treatment aimed at this disease component at diagnosis should be considered.

Research Progress on the Prognostic Evaluation of MRD in Acute Myeloid Leukemia --Review

Acute myeloid leukemia (AML) is a highly heterogeneous group of malignant tumors in the blood system. Although many AML patients have achieved survive for a long time through chemotherapy and targeted therapy combined with/without HSCT, but some of them still be difficult to achieve remission or early relapse after remission. Therefore, refining risk stratification and achieving individualized treatment based on prognostic indicators is of great significance. As the research on prognostic indicators of AML deepens increasingly, the prognostic stratification has been continuously improved, from the MICM typing index to the comprehensive evaluation of biological disease characteristics such as MRD. This article reviews the development of prognostic indicators for AML and the research progress of MRD on AML prognosis evaluation to better identify patients with different risks and formulate and implement accurate diagnosis and treatment programs.

Functional Classification of Fusion Proteins in Sarcoma.

Sarcomas comprise a heterogeneous group of malignant tumors of mesenchymal origin. More than 80 entities are associated with different mesenchymal lineages. Sarcomas with fibroblastic, muscle, bone, vascular, adipocytic, and other characteristics are distinguished. Nearly half of all entities contain specific chromosomal translocations that give rise to fusion proteins. These are mostly pathognomonic, and their detection by various molecular techniques supports histopathologic classification. Moreover, the fusion proteins act as oncogenic drivers, and their blockade represents a promising therapeutic approach. This review summarizes the current knowledge on fusion proteins in sarcoma. We categorize the different fusion proteins into functional classes, including kinases, epigenetic regulators, and transcription factors, and describe their mechanisms of action. Interestingly, while fusion proteins acting as transcription factors are found in all mesenchymal lineages, the others have a more restricted pattern. Most kinase-driven sarcomas belong to the fibroblastic/myofibroblastic lineage. Fusion proteins with an epigenetic function are mainly associated with sarcomas of unclear differentiation, suggesting that epigenetic dysregulation leads to a major change in cell identity. Comparison of mechanisms of action reveals recurrent functional modes, including antagonism of Polycomb activity by fusion proteins with epigenetic activity and recruitment of histone acetyltransferases by fusion transcription factors of the myogenic lineage. Finally, based on their biology, we describe potential approaches to block the activity of fusion proteins for therapeutic intervention. Overall, our work highlights differences as well as similarities in the biology of fusion proteins from different sarcomas and provides the basis for a functional classification.

Establishment of cluster of differentiation 20 immobilized cell membrane chromatography for the screening of active antitumor components in traditional Chinese medicine

Non-Hodgkin lymphoma (NHL) is a heterogeneous group of malignant tumors occurring in B or T lymphocytes, and no small molecule-positive drugs to treat NHL have been marketed. Cluster of differentiation 20 (CD20) is an important molecule regulating signaling for the life and differentiation of B lymphocytes and possesses the characteristics of a drug target for treating NHL. 2-Methoxyestradiol induces apoptosis in lymphoma Raji cells and CD20 protein is highly expressed by Raji lymphoma cells. Therefore, in this study, a CD20-SNAP-tag/CMC model was developed to validate the interaction of 2-methoxyestradiol with CD20. 2-Methoxyestradiol was used as a small molecule control compound, and the system was validated for good applicability. The cell membrane chromatography model was combined with high-performance liquid chromatography ion trap time-of-flight mass spectroscopy (HPLC-IT-TOF-MS) in a two-dimensional system to successfully identify, analyze, and characterize the potential active compounds of Schisandra chinensis (Turcz.) Baill. extract and Lysionotus pauciflorus Maxim. extract, including Schisandrin A, Schizandrol A, Schizandrol B, Schisantherin B, and Nevadensin, which can act on CD20 receptors. The five potential active compounds were analyzed by non-linear chromatography. The thermodynamic and kinetic parameters of their interaction with CD20 were also analyzed, and the mode of interaction was simulated by molecular docking. Their inhibitory effects on lymphoma cell growth were assessed using a Cell Counting Kit-8 (CCK-8). Nevadensin and Schizandrin A were able to induce apoptosis in Raji cells within a certain concentration range. In conclusion, the present experiments provide some bases for improving NHL treatment and developing small molecule lead compounds targeting CD20 with low toxicity and high specificity.

Primitive neuroectodermal tumors of the ovary: a multidecade review of the scientific literature.

Primitive neuroectodermal tumor (PNET) is a general term used in scientific literature for a heterogeneous group of small round-cell malignant tumors primarily arising from neural crest cells. These are extremely aggressive neoplasms which usually occur within soft tissue or bone of young adults. Ovarian tumors composed of primitive neuroectodermal elements are extremely rare, with only few case reports in scientific literature. Due to being so exceedingly rare, PNETs are frequently misdiagnosed and there are no standard therapeutic guidelines. Young patients seem to have better prognoses and individualized strategy is recommended. Limited data suggests that various gene deletions as well as amplifications may be crucial factors for tumorigenesis and the aggressive behavior of PNET. In this paper, we performed a brief review of all cases of primary ovarian PNETs published in the scientific literature to date, in regard to their clinical, histopathological, and therapeutic aspects, with the aim to provide a more comprehensive understanding of this exceedingly rare pathology.

Advancing rare cancer research by MALDI mass spectrometry imaging: Applications, challenges, and future perspectives in sarcoma.

MALDI mass spectrometry imaging (MALDI imaging) uniquely advances cancer research, by measuring spatial distribution of endogenous and exogenous molecules directly from tissue sections. These molecular maps provide valuable insights into basic and translational cancer research, including tumor biology, tumor microenvironment, biomarker identification, drug treatment, and patient stratification. Despite its advantages, MALDI imaging is underutilized in studying rare cancers. Sarcomas, a group of malignant mesenchymal tumors, pose unique challenges in medical research due to their complex heterogeneity and low incidence, resulting in understudied subtypes with suboptimal management and outcomes. In this review, we explore the applicability of MALDI imaging in sarcoma research, showcasing its value in understanding this highly heterogeneous and challenging rare cancer. We summarize all MALDI imaging studies in sarcoma to date, highlight their impact on key research fields, including molecular signatures, cancer heterogeneity, and drug studies. We address specific challenges encountered when employing MALDI imaging for sarcomas, and propose solutions, such as using formalin-fixed paraffin-embedded tissues, and multiplexed experiments, and considerations for multi-site studies and digital data sharing practices. Through this review, we aim to spark collaboration between MALDI imaging researchers and clinical colleagues, to deploy the unique capabilities of MALDI imaging in the context of sarcoma.

Flap loss in head and neck reconstruction: Is there a singular cause for failure?

Despite the high success rates reported in head and neck reconstruction, free flap failures continue to persist. Understanding the factors associated with flap loss and improving overall success are paramount. This study aimed to comprehensively assess the factors influencing flap revision and free tissue transfer survival in head and neck reconstruction.The study included 70 patients with defects in the lower two-thirds of the head and neck region and underwent reconstruction using free flaps. Patient age, gender, smoking status, comorbidities and data on the location and aetiology of the defect, the specific type of flap employed, the recipient artery and vein chosen, instances of revision and the overall success of the flap were collected. The investigation aimed to establish correlations between these variables as well as flap success and revision rates. No statistically significant differences were observed in arterial and venous anastomosis revision rates, or flap survival, in relation to variables such as age, gender, flap type, smoking status, comorbidities, recipient artery or vein and the number of vein anastomoses. The malignant tumour group exhibited a lower requirement for arterial revision and a higher flap survival rate compared to the benign tumour group.This study underscores the comparable safety profiles of perforator-based and conventional flaps in head and neck reconstruction. Furthermore, it reveals that patient characteristics are not contraindications for free tissue transfer. Additionally, the quantity of the veins and choice of recipient vessels are flexible and do not significantly impact flap success. The higher rates of flap success in patients with malignant aetiology requires further investigation.

Activity of Potassium Channels in CD8+ T Lymphocytes: Diagnostic and Prognostic Biomarker in Ovarian Cancer?

CD8+ T cells play a role in the suppression of tumor growth and immunotherapy. Ion channels control the Ca2+-dependent function of CD8+ lymphocytes such as cytokine/granzyme production and tumor killing. Kv1.3 and KCa3.1 K+ channels stabilize the negative membrane potential of T cells to maintain Ca2+ influx through CRAC channels. We assessed the expression of Kv1.3, KCa3.1 and CRAC in CD8+ cells from ovarian cancer (OC) patients (n = 7). We found that the expression level of Kv1.3 was higher in patients with malignant tumors than in control or benign tumor groups while the KCa3.1 activity was lower in the malignant tumor group as compared to the others. We demonstrated that the Ca2+ response in malignant tumor patients is higher compared to control groups. We propose that altered Kv1.3 and KCa3.1 expression in CD8+ cells in OC could be a reporter and may serve as a biomarker in diagnostics and that increased Ca2+ response through CRAC may contribute to the impaired CD8+ function.

Progress in the treatment of soft tissue sarcoma in the 2023 annual meeting of the American Society of Clinical Oncology

Soft tissue sarcoma (STS) is a group of rare malignant tumors originating from mesenchymal tissue, with a high degree of malignancy and a wide range of pathological subtypes. The prognosis varies among different subtypes, and treatment increasingly relies on selecting appropriate treatment methods for different subtypes. Surgical treatment is still the main treatment method at present, and the development of immune and targeted therapy also brings new hope for the treatment of soft tissue sarcoma. Immune checkpoint inhibitors, oncolytic viruses and T cell therapy have shown well safety and efficacy in clinical trials. Targeted drugs such as trabectedin and lenvatinib have changed the treatment pattern of soft tissue sarcoma. Currently, chemotherapy based on doxorubicin and ifosfamide is still the first line treatment for patients with advanced soft tissue sarcoma who have distant metastasis. However, the adverse reactions of doxorubicin limit its application in elderly patients, and trofosfamide has shown good efficacy and safety as an alternative in clinical trials. The efficacy of postoperative radiotherapy has been confirmed, which can reduce the local recurrence rate after surgical resection of soft tissue sarcoma. In summary, multimodal comprehensive treatment has become the main strategy for the treatment of soft tissue sarcoma. The combination of different treatment methods can generate synergistic effects and help patients obtain more clinical benefits, such as the combination of doxorubicin and immune checkpoint inhibitors, and the combination of antiangiogenic drugs and chemotherapy drugs. At the 2023 annual meeting of the American Society of Clinical Oncology (ASCO), oncologists from all over the world reported many researches related to the treatment of soft tissue sarcoma. This article aims to review the new progress in the treatment of soft tissue sarcoma in the 2023 annual meeting of ASCO.

Geriatric Importance of Histopathological Parameters Evaluated in Thyroidectomy Specimens: A Single Center Retrospective Analysis.

Nowadays, the aging human population exerts a notable influence on the treatment of thyroid diseases. The most appropriate approach for the treatment of benign and malignant thyroid diseases in older adults has not yet been determined. The aim of our study is to evaluate the effect of thyroidectomies in geriatric patients considering age, sex and histopathological parameters and to determine the importance of thyroidectomy as a treatment option in the geriatric population. A total of 910 cases from all age groups were included, for which thyroidectomies were examined and reported. In accordance with the College of American Pathologists Cancer Protocol for thyroid reporting, considering geriatric patients, the rate of Thyroid Follicular Nodular Disease was significantly higher among the tumor types in the benign tumor group (p = 0.033), while Anaplastic Thyroid Carcinoma rate was higher in the malignant tumor group. The diagnosis rate of malignant tumors was higher in males, reflecting a more advanced pT stage (p < 0.001), larger tumor size (p < 0.001) and increased lymph node involvement rate (p = 0.039). Given that increasing age is associated with a heightened incidence of thyroid disease, the safety of surgery for geriatric patients is an important issue. Thyroidectomy should be considered in the treatment of these patients, especially in males, as the rate of malignant diagnosis and worse histopathological parameters are seen with increasing age.

Epidemiology of Cancer.

Cancers are a large and heterogeneous group of malignant tumors that collectively accounted for approximately 600 000 US deaths in 2020; only heart disease claimed more lives. A large amount of knowledge has accumulated regarding the epidemiology of most cancer types, including their causes. The cancer types most frequently diagnosed among adults in most high-income countries are lung, colorectal, female breast, cutaneous melanoma, and prostate. In general cancer incidence and mortality is very low in children and adolescents, rising exponentially with increasing age during adulthood. There is marked international variation in the incidence of most cancers. The most important causes of cancer are tobacco use (primarily cigarette use), excess alcohol consumption, obesity, lack of physical activity, diets low in fruits and vegetables, infectious agents, and sun exposure. Early detection can reduce the chances that a person will die of cancers of the female breast, uterine cervix, colon and rectum, lung, and prostate. Although the most common cancers in the United States continue to have a substantial impact on public health, they are caused in whole or part by factors over which people and governments have control through choices they make. Among these are tobacco and alcohol use, obesity, diets low in fruits and vegetables and lack of physical activity, and sun exposure. Thus, a very large proportion of cancer's impact could be ameliorated if more people avoided these exposures.

Mesenchymal Chondrosarcoma of the Mandible, a Big Dilemma: Report of a Rare Case in Mesenchymal Chondrosarcoma of the Mandible—Report of a Case With Discussion of Diagnostic and Therapeutic Dilemmas

Chondrosarcomas are a group of malignant neoplasms with cartilaginous matrix production mostly found in flat and peripheral long bones. Mesenchymal chondrosarcoma is one of the most unusual and rare histological variants of chondrosarcoma, with a distinct histopathological appearance and biologically aggressive behavior. The amount of cartilage in mesenchymal chondrosarcoma may be so abundant that it is easily found in random sections or so scarce that numerous sections are required to discover it. In such cases, it is tough to make an accurate diagnosis, which leads to a big dilemma for pathologists and surgeons regarding diagnosis and treatment. Here, we report a mandibular mesenchymal chondrosarcoma in a 38‐year‐old male with a diagnosis of malignant small round cell tumor in incisional biopsy without any bone or chondroid formation. After ruling out lymphoma, a complete lesion excision was done. Diagnosis of mesenchymal chondrosarcoma was confirmed with small foci of chondroid material and strong positivity of tumoral cells for CD99 and S100. We highlight the fact that incisional biopsy frequently fails to provide sufficient tissue to establish the diagnosis of mesenchymal chondrosarcoma. Adequate tissue with multiple sections, detailed histopathological examination, and adjunctive IHC study are the keys to a definitive diagnosis.

Comparative Analysis of FSE T2 Weighted, Chemical Shift and Dynamic Contrast-Enhanced MR Imaging in the Characterization of Adrenal Masses Based on Qualitative and Quantitative Parameters.

The purpose of our study was to investigate the role of different magnetic resonance imaging (MRI) parameters in the characterization of adrenal masses. A total of 150 patients who presented with 186 adrenal tumors were retrospectively evaluated in this study. Final patient cohort consisted of 17 pheochromocytomas, 3 adrenocortical carcinomas, 24 metastases, 31 lipid-poor adenomas and 111 lipid-rich adenomas. We carried out a visual assessment on FSE (Fast spin echo)T2 weighted images and also calculated T2 signal intensity ratio of all adrenal masses and also performed a qualitative assessment on chemical shift imaging (CSI) together with quantitative calculation using Adrenal to spleen signal intensity (si) ratio and Adrenal si index formulas. On dynamic contrast-enhanced sequences, visual assessment based on enhancement patterns on late-arterial phase images was performed and also mean signal intensity measurements were carried out. All examinations were interpreted by two abdominal radiologists in consensus who were blinded to the clinical and pathological findings. Statistical analysis was performed. On FSE T2 weighted imaging, isointense to liver and slightly hyperintense than liver was found higher in benign cases, however, in malignant cases moderately and strikingly hyperintense than liver was higher than in benign cases (p=0.001, p<0.01). There was a statistically significant difference between the T2 signal intensity ratio values of adrenal tumor groups (p=0.001, p<0.01). In lipid-rich and lipid-poor adenoma groups, T2 signal intensity ratio values was significantly lower than in pheochromocytoma and metastasis cases. In malignant group, T2 signal intensity ratio values were found statistically significantly higher than in the benign group (p=0.001, p<0.01). There was a statistically significant difference between CSI visual assessment of adrenal tumor groups (p=0.001, p<0.01). Although moderate and significant signal intensity loss was usually detected in lipid-rich adenoma group, never detected in other tumor groups. There was also a statistically significant difference between benign and malignant adrenal tumor groups (p=0.001, p<0.01). In the malignant group, Adrenal to spleen si ratio values were found significantly higher whereas, Adrenal si index values were significantly lower compared to benign tumors (p=0.001, p<0.01). Based on malignancy, there was a statistically significant difference between adrenal tumor groups (p=0.001, p<0.01). Although capillary blush and homogenous type enhancement were more common in benign cases than in malignant ones, peripheral-patchy and strikingly capillary blush type enhancement was more frequent in malignant tumors. Based on malignancy, mean arterial signal intensity values of malignant tumors were statistically higher than benign tumors (p=0.001; p<0.01). Dynamic contrast-enhanced MRI protocol including CSI aids in the characterization of indeterminate adrenal masses. Herein, the combined use of qualitative and quantitative parameters enables more tumors to be recognized that otherwise would be indeterminate.

Comparative analysis of matrix metalloproteinases by zymography in patients with colorectal carcinoma.

Zymography is an electrophoretic method in which proteins are separated in a polyacrylamide gel in the presence of sodium dodecyl sulfate (SDS-PAGE). This method is used for the detection of enzymatic activity and molecular characterization of proteins. In contrast to the standard SDS-PAGE method, a substrate is incorporated into the gel during zymography, which is subsequently cleaved by target proteases. Many studies have focused on the development and progression of inflammatory diseases affecting the gastrointestinal tract, emphasizing the role of the largest group of proteases, matrix metalloproteinases (MMPs). The most used classification of this group of enzymes (by researchers in MMP biology) is based in part on the historical evaluation of the substrate specificity of MMPs and in part on the cellular localization of MMPs. MMPs are thus classified into the groups of collagenases, gelatinases, stromelysins, matrilysins, membrane-type MMPs (MT-MMPs), and others. An important group of MMPs are gelatinases which are involved in the breakdown of collagen type IV and gelatin of extracellular matrix and participate in the regulation of various physiological or pathological processes such as morphogenesis, angiogenesis, tissue repair, cirrhosis, arthritis, and metastasis. The present study's objective was to determine the amount of active MMP-9 and MMP-2 forms in tissue samples using zymography. The patient group was according to histology findings divided into the benign tumor (control) group (8 patients), and the malignant tumor group (24 patients). The respondents in the malignant tumor group were further divided according to the standard TNM classification. The results of this study confirmed that MMP-2, unlike MMP-9, can be used as a prognostic biomarker of CRC, because only the expression of active MMP-2 confirmed statistically significant differences between individual stages of CRC. Moreover, MMP-2 seems to play a more important role in higher stages of CRC. Substantial disparities in the determination of active MMPs between the observed groups support the assumption for the integration of zymography into clinical diagnostics of CRC together with molecular and other studies.

GASTRIC CANCER: EPIDEMIOLOGY AND PROSPECTS FOR THE DEVELOPMENT AND IMPLEMENTATION OF INNOVATIVE TECHNOLOGIES FOR EARLY DETECTION AND TREATMENT

Relevance: Gastric cancer is a heterogeneous group of malignant epithelial tumors arising from the cells of the gastric mucosa, one of the most common forms of malignant neoplasms in many countries of the world. But, despite repeated attempts, there are no convincing approaches to early large-scale (screening) detection technology for this form of cancer. This causes a high rate of late detection of advanced forms of gastric cancer in most countries of the world, a high one-year mortality rate of patients, and a low five-year survival rate. Currently, full screening for gastric cancer is carried out only in Japan, Korea, and China – countries with high incidence rates.&#x0D; The study aimed to assess the epidemiologically disadvantaged regions of Kazakhstan for cancer to select optimal early detection techniques to improve the treatment results.&#x0D; Methods:For the analysis, we used available epidemiological indicators on GC from the specialized literature, data obtained from annual reporting forms No. 7, approved by the Ministry of Health of the Republic of Kazakhstan, in the country code (ICD 10 – C16), publications with statistical and analytical materials on Kazakhstan. Morbidity and mortality rates were calculated based on data from the Bureau of National Statistics of the Agency for Strategic Planning and Reforms of the Republic of Kazakhstan website on the average annual population by region of Kazakhstan.&#x0D; Results: A long-term decrease in the incidence and mortality from gastric cancer in Kazakhstan since 2021 has been replaced by a stable increase in the incidence of gastric cancer against the backdrop of a high frequency of advanced forms, relatively high mortality, and low fiveyear survival of patients. At the same time, there is experience in the world of certain approaches to screening the population for early detection of gastric cancer.&#x0D; Conclusion: The high morbidity of gastric cancer in most regions of the country in recent years requires the search and development of optimal forms of screening for its early detection; this will reduce mortality from gastric cancer and increase the five-year survival rate of patients.

THE RESULTS OF THE JAPANESE GASTRIC CANCER ASSOCIATION MORPHOLOGICAL CLASSIFICATION ADAPTATION FOR THE KAZAKH POPULATION

Relevance: Gastric cancer is a heterogeneous group of malignant epithelial tumors arising from the cells of the gastric mucosa, one of the most common forms of malignant neoplasms in many countries of the world. But, despite repeated attempts, there are no convincing approaches to early large-scale (screening) detection technology for this form of cancer. This causes a high rate of late detection of advanced forms of gastric cancer in most countries of the world, a high one-year mortality rate of patients, and a low five-year survival rate. Currently, full screening for gastric cancer is carried out only in Japan, Korea, and China – countries with high incidence rates.&#x0D; The study aimed to was a retrospective analysis of literary data on the epidemiology of gastric cancer in the world, individual countries, but, above all, our own materials, summarized by specialists of the Joint Stock Company “Kazakh Research Institute of Oncology and Radiology” (JSC “KazNIIOiR”) on the situation with cancer stomach in Kazakhstan; analysis of information on the types and results of screenings for the early detection of gastric cancer in the world.&#x0D; Methods:For the analysis, we used available epidemiological indicators on GC from the specialized literature, data obtained from annual reporting forms No. 7, approved by the Ministry of Health of the Republic of Kazakhstan, in the country code (ICD 10 – C16), publications with statistical and analytical materials on Kazakhstan. Morbidity and mortality rates were calculated based on data from the Bureau of National Statistics of the Agency for Strategic Planning and Reforms of the Republic of Kazakhstan website on the average annual population by region of Kazakhstan.&#x0D; Results: A long-term decrease in the incidence and mortality from gastric cancer in Kazakhstan since 2021 has been replaced by a stable increase in the incidence of gastric cancer against the backdrop of a high frequency of advanced forms, relatively high mortality, and low fiveyear survival of patients. At the same time, there is experience in the world of certain approaches to screening the population for early detection of gastric cancer.&#x0D; Conclusion: The high morbidity of gastric cancer in most regions of the country in recent years requires the search and development of optimal forms of screening for its early detection; this will reduce mortality from gastric cancer and increase the five-year survival rate of patients.

GASTRIC CANCER: EPIDEMIOLOGY AND PROSPECTS FOR THE DEVELOPMENT&#x0D; AND IMPLEMENTATION OF INNOVATIVE TECHNOLOGIES FOR EARLY DETECTION&#x0D; AND TREATMENT

Relevance: Gastric cancer is a heterogeneous group of malignant epithelial tumors arising from the cells of the gastric mucosa, one of the&#x0D; most common forms of malignant neoplasms in many countries of the world. But, despite repeated attempts, there are no convincing approaches&#x0D; to early large-scale (screening) detection technology for this form of cancer. This causes a high rate of late detection of advanced forms of gastric cancer in most countries of the world, a high one-year mortality rate of patients, and a low five-year survival rate. Currently, full screening&#x0D; for gastric cancer is carried out only in Japan, Korea, and China - countries with high incidence rates.&#x0D; The study aimed was a retrospective analysis of literary data on the epidemiology of gastric cancer in the world, individual countries, but,&#x0D; above all, our own materials, summarized by specialists of the Joint Stock Company “Kazakh Research Institute of Oncology and Radiology”&#x0D; (JSC “KazNIIOiR”) on the situation with cancer stomach in Kazakhstan; analysis of information on the types and results of screenings for the&#x0D; early detection of gastric cancer in the world.&#x0D; Methods: For the analysis, we used available epidemiological indicators on GC from the specialized literature, data obtained from annual&#x0D; reporting forms No. 7, approved by the Ministry of Health of the Republic of Kazakhstan, in the country code (ICD 10 - C16), publications with&#x0D; statistical and analytical materials on Kazakhstan. Morbidity and mortality rates were calculated based on data from the Bureau of National&#x0D; Statistics of the Agency for Strategic Planning and Reforms of the Republic of Kazakhstan website on the average annual population by region&#x0D; of Kazakhstan.&#x0D; Results: A long-term decrease in the incidence and mortality from gastric cancer in Kazakhstan since 2021 has been replaced by a stable&#x0D; increase in the incidence of gastric cancer against the backdrop of a high frequency of advanced forms, relatively high mortality, and low fiveyear survival of patients. At the same time, there is experience in the world of certain approaches to screening the population for early detection&#x0D; of gastric cancer.&#x0D; Conclusion: The high morbidity of gastric cancer in most regions of the country in recent years requires the search and development of&#x0D; optimal f

Characteristics and Role of Apparent Diffusion Coefficient (ADC) Value in Musculoskeletal Soft Tissue Tumor

Introduction: Musculoskeletal soft tissue tumors (STTs) consist of a group of malignant and benign tumors that present challenges in diagnosis and therapy. Adding diffusion-weighted imaging and apparent diffusion coefficient (DWI/ADC) ​​provides tissue characteristics that are different from those obtained by conventional MR techniques. Quantitative examination of the diffusion of water molecules in tissue is expressed as ADC value, which is expected to be more helpful in differentiating malignant and benign soft tissue masses. This study was carried out to determine the characteristics and role of ADC values ​​in musculoskeletal STTs. Methods: This research was conducted retrospectively. Analysis was performed using MRI results of patients with musculoskeletal STTs who met the inclusion and exclusion criteria. Three regions of interest (ROI) were assessed in the tumor area with the strongest contrast enhancement for DWI mapping, ADC, and ROI ADC value placement. An Independent T-test test was performed to determine the mean difference of ADC in each tumor category. Receiver Operating Characteristics (ROC) were generated to find the optimal cut-off value. Then, a diagnostic test was carried out to determine the sensitivity, specificity, PPV, and NPV of the ADC value. Results: There were 41 research subjects with musculoskeletal STTs with male predominance, in which 75.61% of cases were malignant. DWI/ADC showed that 78.05% of patients with musculoskeletal soft tissue tumors had restricted diffusion areas. In this study, the ADC cutoff value to differentiate benign and malignant musculoskeletal STT is 0,84 x 10-3mm2/s with 77.4% sensitivity and 90% specificity, 96% positive predictive value and 56.3% negative predictive value. Conclusion: In differentiating malignant and benign musculoskeletal STTs, the ADC value provides fair sensitivity, very good specificity, good positive predictive value, and low negative predictive value.

Cancer of unknown primary—state of the art

SummaryThe Cancer of Unknown Primary (CUP) syndrome does not represent a single clinical entity but comprises a diverse group of malignant tumors. CUP is defined as a histologically confirmed metastatic malignant disease for which the primary tumor cannot be identified after completing initial diagnostics. Although its incidence has decreased, managing CUP patients remains a significant clinical challenge, particularly for those in the poor prognosis group, where the overall survival is merely 3 months. In this context, accurate diagnostics and prompt treatment initiation are crucial. While platinum-based chemotherapy still plays a central role in CUP therapy, the future holds promise with the advent of next-generation targeted therapies and immunotherapies guided by the results of advanced sequencing tools. These advancements offer hope for improving the bleak outcomes faced by these patients.

Overview of brain cancer, its symptoms, diagnosis and treatment

Brain cancer, also known as intracranial neoplasms, represents a group of malignant tumors that originate within the brain or its surrounding tissues. This article provides overview of brain cancer, focusing on its epidemiology, etiology, pathogenesis, clinical presentation, diagnostic approaches, and treatment modalities. The epidemiological data highlights the incidence, prevalence, and risk factors associated with brain cancer, emphasizing the importance of early detection and monitoring. Brain tumors are intracranial tumours that occupy skull space. Brain tumors are a relatively rare but lethal malignancy that presents difficulties in determining risk factors in the community. Because of their protected location in the brain, these tumors are intrinsically difficult to cure, with surgery, radiation, and chemotherapy therapies possibly resulting in long-term morbidity for patients and inadequate tumor cure. Because the space inside the skull is limited, brain tumors are dangerous because their growth raises intracranial pressure and can induce edema, restricted blood flow, and displacement, with subsequent degeneration, of healthy tissue that regulates important processes. In fact, brain tumors are the second largest cause of cancer fatalities in children and young people. Methods of prevention are being developed.