Morphological Verification Research Articles

Efficacy of endovascular superselective chemoembolization with HepaSphere 50–100 μm microspheres saturated with cytostatic in stopping nosebleeds in patients with nasopharyngeal cancer

The OBJECTIVE was to show the effectiveness of a new method for stopping nosebleeds in patients with nasopharyngeal cancer using endovascular superselective chemoembolization of the tumor arterial bed with HepaSphere 50–100 μm microspheres saturated with the cytostatic doxorubicin.METHODS AND MATERIALS. The results of treatment of 94 patients who against the background of progressive growth of nasopharyngeal cancer and ongoing combined treatment in oncology centers experienced nosebleeds are presented. In all these patients, according to the results of examinations in cancer centers, no convincing source of nosebleeds was identified. In the conditions of Polenov Neurosurgical Institute, 94 patients underwent endovascular superselective chemoembolization of the vasculature of nasopharyngeal cancer. The embolizate was a mixture of HepaSphere 50–100 μm microspheres saturated with the cytostatic doxorubicin (50 mg). All patients were included in the study in the absence of contraindications and after signing a voluntary informed consent approved by the ethics committee. The selection of patients was carried out according to the following criteria: thorough morphological verification of the neoplasm; locally advanced process of III and IV stages (T2-4 N0-2M0); no history of other cancers; absence of individual hematogenous metastases; absence of competitive pathology in the stage of decompensation; age was over 18 years old. All patients underwent induction-simultaneous chemoradiotherapy (CRT) with the use of radiation therapy in the usual dose fractionation regimen.RESULTS. The hemostatic effect was achieved in all 94 patients due to sequential superselective chemoembolization of the vasculature of the tumor itself with embolizate, which was a mixture of HepaSphere 50–100 μm microspheres saturated with the cytostatic doxorubicin (50mg). In the future, nosebleeds in these patients did not occur. The main sources of nosebleeds were the following branches of the external carotid artery: in 46.2 % of cases – the maxillary artery, in 37.6 % – the ascending pharyngeal artery, in 8.6 % – the occipital artery, in 5.4 % – the artery of the carotid node, in 2.2 % – other branches of the external and internal carotid arteries on one side or on both sides.CONCLUSION. The method of endovascular superselective chemoembolization with doxorubicin of the vasculature of nasopharyngeal cancer complicated by nosebleeds developed and introduced into medical practice was the initial stage of the combined treatment of these neoplasms. A good hemostatic effect was achieved in all 94 patients.

Overall survival of children with brain tumors after radiation therapy in Kazakhstan.

e22011 Background: Tumors of the central nervous system in children occupy the 2nd place in frequency in the structure of malignant neoplasms of childhood and the 1st place among solid tumors. They make up about 20% of all malignant neoplasms of childhood and are mainly represented by brain tumors. The purpose of the study was to analyze the survival rate depending on various factors during radiation therapy (RT) of brain tumors in children. Methods: Retrospective study included 277 patients who received RT from 2016 to 2020 at the Pediatric Oncology Center of the Kazakh Research Institute of Oncology and Radiology. The average follow-up time was 34.3 months. The median age was 9.5 years. RT was performed on a linear accelerator “TrueBeam”, in a single dose of 1.8 Gy, total 50.4-54.0 Gy, 5 fractions per week. Survival distributions was estimated by Kaplan and Meier curves and survival differences were evaluated using the log-rank test. IBM SPSS Statistics V23 was used for statistical analyses. Results: The overall survival (OS) rate of 277 patients was 70.8%, with an average life time of 55.6 months, 95% confidence interval (CI) (51.9 - 59.2). Children under 10 years of age showed a 12.5 % worse OS compare to children after 10 years of age. In patients with unconfirmed morphological verification, OS is 31.5% worse than in children with confirmed morphological verification. In children with grade I-II tumor differentiation, OS was 30.6% higher than in children with grade III-IV tumors. The method of RT (conformal RT, IMLT), gender of patients did not have a statistically significant effect on OS. Conclusions: Our study showed that OS rate depends on various factors, such as age, presence of morphology verification, and the degree of tumor differentiation. RT allows to achieve better survival in patients older than 10 years who received RT with a morphologically confirmed diagnosis of GI-II. RT is one of the main treatments for brain tumors in children.[Table: see text]

34P Immunocytochemical determination of EpCAM protein expression in ascitic fluid cells in the diagnosis of ovarian cancer using the SER1 test system

The most common first symptom of ovarian cancer (OC) is the accumulation of serous fluid in the abdominal cavity. Morphological verification is necessary to resolve the issue of the nature of the process and the purpose of treatment. Cytological examination (CE) of ascitic fluid is a subjective method based on the knowledge and experience of a morphologist. The use of a comprehensive assessment of the CE with subsequent immunocytochemical (ICH) revision is a trend of modern diagnostics, and the use of test systems for the diagnosis of ICH, focused on one patient, will increase the availability of this type of study in the primary polyclinic.

MRI imaging for planning stereotactic biopsies of the brain lesions

Aim of the study . To evaluate the influence of modern MRI imaging, CT- and MRI fusion in STB planning on effectiveness of morphological verification and risks of intraoperative complications. Materials and methods . The most common indications for brain tumor biopsy is definitive diagnosis of the intracranial lesion and differentiation of the neoplastic and non-neoplastic pathology. During 2019 170 patients (95 men and 75 femmes) 7–69 years old underwent stereotactic biopsy an Integra LifeSciences Corporation Cosman–Roberts–Wells® (CRW®) system. In 80 cases, we used CT and MRI fusion by NeuroSight program to select the target point, entry point and trajectory of the brain biopsy. In 90 cases we use only CT images for stereotactic brain biopsy planning. Results . Among 80 patients with use of combined CT-MRI fusion only one case was not histologically verified. In 90 patients with use of only CT-imaging for STB 3 cases were histologically not verified. There were no hemorrhagic complications among 80 patients in CT-MRI fusion group. In 3 cases intracranial hematomas were identified that required surgical treatment after STB with use of CT-imaging for STB panning. Conclusion . The use of modern MRI and PET-CT imaging for STB planning increases its informativity and reduces the probability of hemorrhagic complications. Stereotactic biopsies remain a safe and reliable method for obtaining histological material. The use of modern imaging methods in biopsy planning increases their accuracy and reduces possible complications.

The difficulties of applying the classification of TI-RADS in the ultrasound examination of the thyroid gland

The article presents the experience of using the TIRADS classification (2020) in multiparametric ultrasound examination of the thyroid gland of 60 patients with subsequent morphological verification by fine needle aspiration biopsy. The article support the problems and difficulties that may arise in the ultrasound diagnostics doctor during the stratification of nodules and possible ways to solve this problems.

Cervical mediastinoscopy in diagnosis and treatment of lung cancer

Lung cancer remains the leading cause of cancer mortality. It ranks first in the incidence of cancer in the world. According to the European Association of Oncologists, the annual incidence of lung cancer is increasing with every passing year and amounts to about 1.8 million new cases worldwide. Men have a higher prevalence of lung cancer (33.8 per 100,000) than their female counterparts (13.5 per 100,000). In most cases, it is diagnosed at an advanced stage (III — IV), which is characterised by mediastinal lymphadenopathy. Early detection of lung cancer allows seeking early treatment. Lung cancer screening is used to find a tumour and/or lung cancer metastasis, determine its location and size as well as its morphological verification.
 Objective — to define the most accurate invasive and non‑invasive methods of verification and diagnosis of mediastinal lymphadenopathy and improve diagnosis and treatment of lung cancer through the extensive use of cervical mediastinoscopy and creation of an algorithm for its optimal use.
 Materials and methods. The study included 146 patients. A wide range of clinical, laboratory, endoscopic (Endobronchial ultrasound transbronchial needle aspiration (EBUS‑TBNA), Cervical Mediastinoscopy (CM)), radiographical (Computed tomography (CT), Positron emission tomography (PET)), morphological, immunohistochemical and statistical methods were used. Statistical analysis was performed using Statistics for Windows Version 10.0 (Stat Soft Inc., USA).
 Results. The study involved 146 patients who underwent screening for mediastinal lymphadenopathy using mediastinoscopy. According to the laboratory findings, 98 patients had lung cancer. The rest of the cases were presented by other pathologies. Colorectal and stomach cancers were most commonly seen. In one case, the patient had a comorbidity, a combination of lung cancer and colorectal cancer.
 Conclusions. Mediastinoscopy is the most effective diagnostic method for mediastinal lymphadenopathy, especially in lung cancer.

Cryoablation of localized renal cancer on the MKS cryotherapy unit with liquid nitrogen as a cryogen: functional and oncological efficiency of the method

BACKGROUND: Ablation is a method of destroying a pathological focus using a controlled temperature or other effect. The most promising ablative treatment for localized kidney cancer today is cryoablation.
 AIM: To analyze functional and oncological results of cryoablation of localized kidney cancer using liquid nitrogen as cryogen.
 MATERIALS AND METHODS: Between 2017 and 2020, 56 patients with suspected localized kidney cancer were observed and treated at the N.N. Petrov National Medical Research Center of Oncology. With morphological verification, renal cell carcinoma was detected in 19 (65.5%) patients, chromophobe renal cell carcinoma in 3 (10.4%), oncocytoma in 3 (10.4%), in 4 (13.8%) cases the tumor was not detected in morphological material. All patients underwent cryoablation using the MKS cryotherapy unit with liquid nitrogen as a cryogen (ultrasound-guide cryotherapy was performed in 4 (7.1%) cases, CT-guide in 46 (82.1%), laparoscopically in 6 (10.7%) patients).
 RESULTS: Renal function in this study was assessed by creatinine level and glomerular filtration rate (GFR) before and after cryoablation. The creatinine level before cryoablation was 101 18 mol/l, after 113.8 18 mol/l (p = 0.21), GFR before cryoablation 63 13 ml/min, after 65 13 ml/min. These differences were not significant (p = 0.87). Local disease control was achieved in 100% of cases. The overall and specific survival rate were 100% (one patient died from synchronous primary multiple cancer at 4 years of observation), the survival rate to recurrence was 90.9 3.9%, and the event-free survival was 70.2 6.6%. During the follow-up period, 9 (16%) recurrences of the disease were diagnosed.
 CONCLUSIONS: Cryoablation makes it possible to maintain a large volume of renal parenchyma, thereby not reducing the functional ability of the kidney. In addition, the outcomes and survival rates are quite high, making it an alternative option for other nephron-saving operations.

Диагностические возможности ПЭТ/КТ с 18F-ПСМА у пациентов с подозрением на рак предстательной железы

Relevance. Prostate cancer (PC) is one of the most common malignant neoplasms in men. Every year, about 1.4 million new cases of prostate cancer are diagnosed in the world and 366,000 men die each year from this pathology. Despite the presence of a fairly wide range of diagnostic options in the early diagnosis of prostate cancer, primarily the determination of the level of prostate specific antigen (PSA) in the blood serum and multiparametric magnetic resonance imaging (mpMRI), there remains a group of patients with ambiguous values of the above indicators. The use of positron emission tomography combined with computed tomography (PET/CT) with a tumoritropic radiopharmaceutical drug (RFLP) 18F-PSMA improves the early diagnosis of prostate cancer, which is the key to success for successful treatment, duration and quality of life of the patient. Material and methods. The study included 30 patients with suspected prostate cancer, based on the PSA level in the ʽgray zoneʼ 2–10 ng/ml and Pi-RADS 3 according to the MRI data. All patients underwent PET/CT with 18F-PSMA, with further morphological verification of the process. Results. Out of 30 patients, 7 (23.33%) had positive PET/CT with 18F-PSMA. The diagnostic model obtained during the construction and subsequent analysis of the SUV level ROC-curve showed high values of sensitivity (86%), specificity (100%), diagnostic accuracy (86%) and positive predictive value (100%) of the method (area under ROC-curve (AUC) 0.93), with reference indicators of RFLP accumulation – standardized uptake value (SUV) 2.5. The negative predictive value was 27%. Conclusion. Our study confirmed the high diagnostic accuracy of PET/CT with 18F-PSMA in the differential diagnosis of a tumor process in the prostate gland, with a reference indicator SUV > 2.5. We recommend 18F-PSMA PET/CT in patients with suspected PCa who have ambiguous PSA (2-10 ng/mL) and mpMRI (Pi-RADS 3) findings.

Current aspects of the diagnosis and treatment of adenoid cystic carcinoma of the trachea and larynx: a literature review

This review discusses current aspects of the diagnosis and treatment of adenoid cystic carcinoma of the trachea and larynx. It describes different variants of surgical treatment, radiotherapy, combination therapy, endotracheal interventions using endoscopic techniques and physical methods, grafting, tracheal transplantation, complications, and oncological and functional treatment outcomes. We also analyze clinical aspects of adenoid cystic carcinoma of the larynx, most common tumor location, difficulties associated with morphological verification, and controversial issues related to surgery volume, considering that this disease is rare and clinical experience is often insufficient.

Prediction and verification of wafer surface morphology in ultrasonic vibration assisted wire saw (UAWS) slicing single crystal silicon based on mixed material removal mode

Monocrystalline silicon slicing is the first step in making chips, and the surface quality of silicon wafers directly affects the quality of later processing and accounts for a large proportion in the chip manufacturing cost. Ultrasonic vibration assisted wire saw (UAWS) is an effective sawing process for cutting hard and brittle materials such as monocrystalline Si, which can significantly improve the surface quality of silicon wafers. In order to further study the formation mechanism of the surface morphology of single crystal silicon sliced by UAWS, a new model for prediction of wafer surface morphology in UAWS slicing single crystal silicon based on mixed material removal mode is presented and verified by experiments in this paper. Firstly, the surface model of diamond wire saw tool is established by equal probability method. Then, the trajectory equation of arbitrary abrasive particles on the surface of wire saw is derived and analyzed. Thirdly, a new model for prediction of the wafer surface morphology based on mixed material removal mode is presented. Finally, the prediction model is verified by UAWS slicing experiment, and the effects of slicing parameters such as wire saw speed, feed speed, and workpiece rotate speed on the surface quality of silicon wafer were studied. It shows that the predicted wafer surface morphology and the experimental wafer surface morphology are similar in some characteristics, and the average error between the experimental and the theoretical values of the wafer surface roughness is 11.9%, which verifies the validity of the prediction model.

Reproductive disorders in women of reproductive age who have undergone urgent surgery on the reproductive organs

The objective: to analyze the long-term reproductive effects in women who after emergency gynecological surgery. Materials and methods. A retrospective analysis of the reproductive outcomes after urgent surgical operations (after 2 years) was performed in 300 gynecological patients aged 19 to 42 years. Results. A retrospective analysis showed that 69,3% of women who underwent emergency gynecological surgery had a history of gynecological diseases, but 30,7% of patients were not observed by a gynecologist. Before surgery, menstrual disorders were diagnosed in 42,0 % of patients, pathology of the lower genital tract – 19,7%, inflammatory diseases of the pelvic organs – 7,7 %. 8,2 % of women had gynecological operations before, 13,9 % – reproductive losses, and 11,1 % persons were examined and treated for infertility. The predominant method of surgical intervention in this cohort of patients was open laparotomy (59,7 %), laparoscopic intervention was performed in 40,3 % of cases. The most common indications for surgery were damage tubal pregnancy, ovarian apoplexy, complicated ovarian formation. Morphological verification of intraoperative findings showed that most often indications for operations were serous ovarian tumors (38,7 %), follicular tumors (22,4 %), complicated endometrioid and dermoid cysts (22,4 %), corpus luteum cysts with hemorrhage (9,2 %), paraovarian cysts (7,1 %). Rehabilitation postoperative therapy was performed for a limited number of patients (31,7 %), which could not but affect the state of reproductive health of women – an increase in the incidence of pain (42,0 %; p<0,05) and chronic pelvic pain (42,3%) in the absence of such before surgery, as well as infertility (from 11,1 % to 22,5 %; p<0,05). Conclusions. The lack of pathogenetically intra- and postoperative measures after urgent surgical interventions leads to increase the frequency of reproductive dysfunction, which requires the development and improvement of differentiated rehabilitation therapy and secondary prevention according to the nosology that caused urgent surgical operatrion.

Phototheranostics of Cervical Neoplasms with Chlorin e6 Photosensitizer.

Simple SummaryNeoplasms of the cervix are the most common types of oncological pathology. Photodynamic therapy with intravenous administration of the photosensitizer chlorin e6 shows high efficiency in the treatment of precancerous lesions of the cervix with complete eradication of the human papillomavirus. The treatment method can reduce deaths from cervical cancer and preserve fertility in patients. Spectral and video fluorescence diagnostics allows intraoperatively assessing the degree of photosensitizer accumulation and photobleaching and visualizing the boundaries of pathologically altered tissues.(1) Purpose: Improving the treatment effectiveness of intraepithelial neoplasia of the cervix associated with human papillomavirus infection, based on the application of the method of photodynamic therapy with simultaneous laser excitation of fluorescence to clarify the boundaries of cervical neoplasms. (2) Methods: Examination and treatment of 52 patients aged 22 to 53 years with morphologically and cytologically confirmed mild to severe intraepithelial cervix neoplasia, preinvasive, micro-invasive, and squamous cell cervix carcinoma. All patients were carriers of human papillomavirus infection. The patients underwent photodynamic therapy with simultaneous laser excitation of fluorescence. The combined use of video and spectral fluorescence diagnostics for cervical neoplasms made it possible to control the photodynamic therapy process at all stages of the procedure. Evaluation of the photodynamic therapy of intraepithelial cervical neoplasms was carried out with colposcopic examination, cytological conclusion, and morphological verification of the biopsy material after the photodynamic therapy course. The success of human papillomavirus therapy was assessed based on the results of the polymerase chain reaction. (3) Results. The possibility of simultaneous spectral fluorescence diagnostics and photodynamic therapy using a laser source with a wavelength of 660 nm has been established, making it possible to assess the fluorescence index in real-time and control the photobleaching of photosensitizers in the irradiated area. The treatment of all 52 patients was successful after the first photodynamic therapy procedure. According to the PCR test of the discharge from the cervical canal, the previously identified HPV types were not observed in 48 patients. Previously identified HPV types were absent after repeated PDT in four patients (CIN III (n = 2), CIS (n = 2)). In 80.8% of patients, regression of the lesion was noted. (4) Conclusions. The high efficiency of photodynamic therapy with intravenous photosensitizer administration of chlorin e6 has been demonstrated both in relation to eradication therapy of human papillomavirus and in relation to the treatment of intraepithelial lesions of the cervix.

Coaxial system with permanent infiltration anesthesia for ct-assisted transthoracic trepanobiopsy of lung tumors

To assess irradiation time, pain syndrome and safety of the proposed device and technique compared to conventional CT-assisted transthoracic biopsy. CT-guided transthoracic trepanobiopsy of thoracic tumors was carried out in 296 patients between January 2017 and January 2020. There were 189 (63.8%) men and 107 (36.2%) women. Mean age of patients was 64.1±9.6 years (range 35-83). All patients were randomized into 2 groups by 148 people: group 1 - morphological verification via conventional CT-guided transthoracic trepanobiopsy, group 2 - morphological verification using a coaxial system and a specially developed CT-guided transthoracic trepanobiopsy. Coaxial system with permanent anesthesia in CT-guided transthoracic manipulations reduces post-manipulation complications by 4-5%, get more qualitative morphological material (by 4%), reduces the time of procedure by 2 times and irradiation of patients by 27%, excludes irradiation of physicians and significantly reduces pain syndrome.

Оценка изменений показателей онкологической службы при раке гортаноглотки в Казахстане

According to the forecasts of the International Agency for Research on Cancer in 2040, about 127 thousand new cases of laryngopharyngeal cancer (LFC) are predicted and it is expected that about 60 thousand people will die from this pathology.Objective. Evaluation of some indicators of the oncological service for laryngopharyngeal cancer in Kazakhstan for 2017-2021.Methods. The material of the study was the data of the Ministry of Health of the Republic of Kazakhstan – annual Form No. 7 and 35 concerning LFC (ICD 10 – C12, C13, C14) for 2017-2021 – incidence, mortality, early diagnosis, neglect, morphological verification. A retrospective study using descriptive and analytical methods of biomedical statistics was used as the main method.Results. For the period 2017-2021, 802 new cases of LFC and 477 deaths from this pathology were registered for the first time in the republic. The average annual crude incidence rate of LFC was 0.87±0.02 0/0000 (95% CI=0.82-0.91) and decreased in dynamics from 0.90±0.07 0/0000 (2017) to 0.86±0.07 0/0000 in 2021, the difference was not statistically significant (p>0.05). In dynamics, mortality rates from LFC tended to increase from 0.48±0.05 0/0000 (2017) to 0.53±0.05 0/0000 in 2021 (p>0.05), and the average annual crude mortality rate from LFC was 0.52±0.02 0/0000 (95% CI=0.47-0.56). Indicators of early diagnosis (the proportion of patients with stage I-II) decreased from 27.2% (2017) to 22.7% in 2021, the proportion of patients with stage III (from 60.5% to 62.6%) and stage IV (from 12.3% to 14.7%) increased over the years studied. The indicators of morphological verification at LFC were quite high and improved from 96.9% to 98.2% over the years studied.Conclusion. As a result of the analysis of the indicators of the oncological service at LFC, a decrease in incidence rates, an increase in neglect and mortality rates have been established, which health managers should undoubtedly pay attention to and take into account when organizing targeted anti-cancer measures.Keywords: laryngopharyngeal cancer, incidence, mortality, early diagnosis, neglect, morphological verification.

Comparison of the efficacy of transbronchial cryobiopsy with transbronchial forceps biopsy in the diagnosis of diffuse parenchymal lung diseases

Introduction. Pathologies included in the diffuse paren-chymal lung disease group are numerous, differential di-agnosis between them is difficult and requires morpho-logical verification. There are minimally invasive methods of morphological verification, such as transbronchial forceps lung biopsy, which is less traumatic compared to surgical biopsy, but is accompanied by a smaller vol-ume of biological material, which often contains artifacts due to damaging with forceps. In 2008, for the first time, a method of transbronchial lung cryobiopsy was pro-posed for morphological verification of lung diseases. The effectiveness of cryobiopsy for diagnosing diffuse parenchymal lung diseases differs according to different sources, however, based on the data of meta-analyses, it can be said that the effectiveness of cryobiopsy is ap-proaching the “gold standard” of surgical lung biopsy. In Russia, however, the use of cryotechniques is limited to single clinical centers, which may be due to the lack of a sufficient number of publications in the domestic lit-erature. The aim of the study was to evaluate the effi-cacy of transbronchial cryobiopsy versus transbronchial forceps biopsy in patients with diffuse parenchymal lung disease. Materials and methods. Inclusion criteria: pres-ence of diffuse parenchymal lung disease of unknown etiology, need for invasive diagnostics. Exclusion criteria: FEV1 less than 40%. Transbronchial forceps lung biop-sy and transbronchial lung cryobiopsy were performed simultaneously. Results. Of 21 patients included in the study, the process was verified in 17 (80.95%). Lung sar-coidosis was detected in 12 (57.14%) cases, pulmonary tuberculosis — in 3 (14.28%), pulmonary mycobacterio-sis — in 2 (9.52%). The diagnosis was verified according to cryobiopsy in 15 patients (71.42%), according to for-ceps lung biopsy in 10 (47.61%). Conclusion. Transbron-chial cryobiopsy of the lung shows better efficacy in com-parison with transbronchial forceps biopsy. Cryobiopsy can be combined with transbronchial forceps biopsy if there is a pathology in the apex of the lungs and/or if it is impossible to place the cryoprobe in the “safe” zone. Further research is needed to confirm the findings on a larger clinical material.

Трансректальная полифокальная биопсия под контролем ультразвуковой навигации в диагностике рака предстательной железы

Background: prostate cancer (PCa) is a topic of special interest in the modern urologic oncology. PCa is associated with high rates of morbidity and mortality among the male population in Russia and worldwide. The current diagnostic algorithm for PCa detection includes a digital rectal examination to check the prostate, and a PSA test to measure levels of prostate specific antigen (PSA) in the blood, and a prostate biopsy followed by morphological verification. Aim: to analyze the results of transrectal ultrasound guided polyfocal biopsies of the prostate, performed from 2021 to 2022 in patients who underwent diagnosis and treatment at the Clinical Hospital "RZD-Meditsina" of the city of Krasnoyarsk. Patients and Methods: in all cases the evaluation of patients included the measurement of a total PSA (PSAtotal) concentration, standard examination, and the preparation for biopsy. The ultrasound guided prostate biopsy was performed in the hospital setting. After the procedure, all patients were followed up to control and prevent possible complications. Histological examination of the biomaterial included the verification of malignant neoplasms or benign lesions in the prostate tissue, Gleason score, and other morphological characteristics. Results: findings of 220 transrectal ultrasound guided prostate biopsies were analyzed. The median age of patients was 64 (44–89) years. Benign prostatic hyperplasia (BPH) was diagnosed in 112 (51%) patients, prostate cancer — in 108 (49%) patients. PSA level varied from 0.48 to 37.9 ng/ml in the BPH patients, and from 4.48 to 100.0 ng/ml in the PCa group. The median prostate volume was 74.61 (10.26–134.80) cm3 in the PCa group, and 153.45 (116.22–185.50) cm3 in the patients with BPH. Most of PCa patients had Gleason score ≤7 representing moderately differentiated tumors. Post-biopsy complications were observed in 141 (64.09%) patients and included hematuria, short-term rectal bleeding, chronic prostatitis exacerbation. All complications were cured successfully treated using conservative therapy. Conclusion: PCa can be diagnosed even in patients with low PSATotal levels or the normal prostate volume . Moderately differentiated tumors (Gleason score ≤7) predominated in the population of patients. These data are consistent with the effective early detection of PCa. Patients should be closely monitored in the early post-operative period after a diagnostic prostate biopsy to prevent potential complications. KEYWORDS: prostate cancer, biopsy, prostate, transrectal puncture biopsy, ultrasound navigation. FOR CITATION: Berezhnoy A.G., Dunaevskaya S.S., Auzina S.I. Ultrasound guided transrectal polyfocal biopsy in prostate cancer diagnosis. Russian Medical Inquiry. 2022;6(6):309–313 (in Russ.). DOI: 10.32364/2587-6821-2022-6-6-309-313.

Increment of the incidence of glioblastoma following decrease in the incidence of brain tumors in 2000-2020: a population-based registry study

Prevalence and dynamics of certain morphological variants of neuroglial brain malignancies (ICD-10 C71) are unknown in the Russian Federation. To assess the incidence of neuroglial brain malignancies in 2000-2020 considering individual records of morphologically verified cases in the cancer registry of the Arkhangelsk region. We analyzed overall and age-adjusted incidence of neuroglial brain malignancies in 2000-2020 considering morphological subtypes of tumor. Incidence of morphologically verified glioblastoma was assessed in detail taking into account gender, age and place of residence. Segmented regression analysis was used to assess the dynamics and significance of linear trends. In total, there were 1699 brain malignancies for the period from 2000 to 2020. Morphological verification was obtained in 1289 (76%) patients including 467 (27%), 92 (5%) and 307 (18%) ones with glioblastoma, anaplastic G3 glioma and G2 glioma, respectively. Percentage of glioblastoma and anaplastic gliomas increased from 23.4% and 3.9% in 2000 to 55.3% and 9.2% in 2020, respectively. Age-adjusted incidence for the entire C71 group decreased from 5.2 to 3.2 cases per 100,000 after 2015 (annual decline 7.1%). However, incidence of glioblastoma monotonously increased from 1.0 to 2.1 per 100,000 (annual increment 6.2%). Incidence was similar in men and women. Age-adjusted incidence was 50-70% higher among rural population. Significant increase (>2 times) in the incidence of glioblastoma was found over the past twenty years. Probably, it is associated with improved diagnosis and registration of this disease. In-depth analysis of morbidity and survival of patients with rare neuroglial tumors is required.

Хронический эндометрит: актуальные проблемы диагностики

The review deals with the relevant problems of chronic endometritis diagnostics, which is the cause of infertility, unsuccessful attempts of in-vitro fertilisation and miscarriage. The frequency of this pathology varies within 2.8-56.8% in women with infertility and 9.3-67.6% in patients with recurrent miscarriages and amounts to 57.8% in missed pregnancies in medical history. The analysis of modern publications predominantly from E-library and PubMed databases for the period 2012-2021 was carried out. The key points of etiopathogenesis, diagnostic methods, their possibilities and limitations were analysed. The issues of the “gold standard” and new biomarkers for morphological verification of chronic endometritis were considered. An analysis of the literature has shown that, despite complex diagnostic approaches, many aspects of the pathogenesis of this pathology are not completely clear, and pathoanatomical diagnostic standards do not fully meet modern requirements.

Esophageal squamous cell carcinoma localized in pharyngeal-esophageal diverticulum

Squamous cell carcinoma in Zenker's diverticulum was first described in 1933. No large studies have yet been conducted due to rarity of this disease. There are a lot of unresolved issues regarding diagnosis and treatment of this pathology. In the literature, there are only few reports on cancer of Zenker diverticulum. It is only known that clinical symptoms are not specific, and diagnosis of carcinoma is traditionally correlated with age and male sex. Despite esophageal localization of primary tumor, its development can take up to 10 years. The authors report squamous cell carcinoma in Zenker diverticulum, discuss the main difficulties of morphological verification of this disease and choice of surgical approach.

Onco-epidemiological features of head and neck tumors within the competence of the otorhinolaryngological service across the regions of the Republic of Belarus

Objective. To analyze the onco-epidemiological features of head and neck tumors within the competence of the otorhinolaryngological service across the regions of the Republic of Belarus.Materials and methods. The material for the study was data on 21,533 cases of malignant neoplasms of the head and neck (including laryngeal tumors) registered in the Belarusian Cancer Registry from 2009 to 2018.Results. Significant changes have occurred in the structure of the incidence of head and neck malignant neoplasms over the past decade. The leading positions are occupied by such tumors of visual localization as cancer of the oropharynx (14.9 %), the floor of the oral cavity (12.4 %), tonsils (11.4 %) and tongue (excluding the root of the tongue) (11.4 %), which are available for diagnosis during routine clinical examination.Conclusion. The analysis of newly diagnosed cases of malignant neoplasms depending on the localization has showed that regardless of the availability of otorhinolaryngologists and staffing levels, patients with primary manifestations of the tumor process are not timely referred to the health experts for morphological verification, which requires further organizational decisions on patient referral at different levels of health care and defining the role and scope of responsibility of subject-matter primary care specialists.