Tumors Of Reproductive System Research Articles

Per- and Polyfluoroalkyl Substances (PFAS) Affect Female Reproductive Health: Epidemiological Evidence and Underlying Mechanisms

PFAS (per- and polyfluoroalkyl substances) have been extensively used across numerous industries and consumer goods. Due to their high persistence and mobility, they are ubiquitous in the environment. Exposure to PFAS occurs in people via multiple pathways such as dermal contact, water supply, air inhalation, and dietary intake. Even if some PFAS are being phased out because of their persistent presence in the environment and harmful impacts on human health, mixes of replacement and legacy PFAS will continue to pollute the ecosystem. Numerous toxicological investigations have revealed harmful effects of PFAS exposure on female reproductive health, e.g., polycystic ovaries syndrome, premature ovarian failure, endometriosis, reproductive system tumors, pregnancy complications, and adverse pregnancy outcomes. Despite extensive epidemiological studies on the reproductive toxicity of PFAS, research findings remain inconsistent, and the underlying mechanisms are not well understood. In this review, we give an in-depth description of the sources and pathways of PFAS, and then review the reproductive toxicity of PFAS and its possible mechanisms.

B4GALT5 a sialylation-related genes associated with patient prognosis and immune microenvironment in ovarian cancer and pan-cancer

BackgroundOvarian cancer (OC) is the predominant primary tumor in the human reproductive system. Abnormal sialylation has a significant impact on tumor development, metastasis, immune evasion, angiogenesis, and treatment resistance. B4GALT5, a gene associated with sialylation, plays a crucial role in ovarian cancer, and may potentially affect clinicopathological characteristics and prognosis.MethodsWe conducted a comprehensive search across TIMER, GEPIA2, GeneMANIA, and Metascape to obtain transcription profiling data of ovarian cancer from The Cancer Genome Atlas (TCGA). The expression of B4GALT5 was test by immunohistochemistry. To investigate the impact of B4GALT5 on growth and programmed cell death in OC cells, we performed transwell assays and western blots.ResultsThe presence of B4GALT5 was strongly associated with an unfavorable outcome in OC. B4GALT5 significantly promoted the proliferation of OC cells. Upon analyzing gene ontology (GO) and Kyoto Encyclopedia of Genes and Genomes (KEGG), it was discovered that B4GALT5 played a crucial role in the extracellular matrix, particularly in collagen-containing structures, and exhibited correlations with ECM-receptor interactions, transcriptional dysregulation in cancer, as well as the interleukin-1 receptor signaling pathway. Furthermore, there is a clear link between B4GALT5 and the tumor immune microenvironment in OC. Moreover, B4GALT5 exhibits favorable expression levels across various types of cancers, including CHOL, KIRC, STAD and UCES.ConclusionIn conclusion, it is widely believed that B4GALT5 plays a pivotal role in the growth and progression of OC, with its heightened expression serving as an indicator of unfavorable outcomes. Moreover, B4GALT5 actively participates in shaping the cancer immune microenvironment within OC. This investigation has the potential to contribute significantly to a deeper understanding of the substantial involvement of B4GALT5 in human malignancies, particularly OCs.

Targeting tumor-associated macrophage-derived CD74 improves efficacy of neoadjuvant chemotherapy in combination with PD-1 blockade for cervical cancer

BackgroundCervical cancer has the second-highest mortality rate among malignant tumors of the female reproductive system. Immune checkpoint inhibitors such as programmed cell death protein 1 (PD-1) blockade are promising therapeutic...

NAP1L1 Promotes Endometrial Cancer Progression via EP300-Mediated DDX5 Promoter Acetylation.

Endometrial cancer (EC) is one of the predominant tumors of the female reproductive system. In this current study, we investigated the functions and related mechanisms of NAP1L1/DDX5 in EC. This retrospective study analyzed the medical records of EC patients, collected tissue samples for NAP1L1 and DDX5 staining, and conducted survival analysis using the Kaplan-Meier method. To evaluate the impact of NAP1L1 and/or DDX5 on cellular processes in EC cells, several techniques were employed. These included CCK-8 assay, wound healing assay, Transwell assay, as well as overexpression or knockdown of target gene expression. Additionally, ChIP, dual luciferase reporter gene, Co-IP assay were utilized to confirm the interaction between NAP1L1, EP300 and DDX5. Furthermore, qRT-PCR, western blot and Co-IP assay were performed to analyze the modulation of NAP1L1/DDX5 in Wnt/β-catenin. NAP1L1 and DDX5 expression were upregulated in EC tissues, and correlated with poor prognosis. NAP1L1/DDX5 promoted EC cell proliferation, migration and invasion. NAP1L1 promotes acetylation and transcription by recruiting EP300 to the DDX5 promoter. DDX5 could activate Wnt/β-catenin signal by binding to β-catenin. In animal models, knockdown of NAP1L1 inhibits EC tumor growth and lung metastasis. To sum up, our study demonstrated that NAP1L1 promoted the malignant phenotypes of EC cells via recruiting EP300 to promote DDX5 acetylation, thus activating the Wnt/β-catenin signaling pathway. Implications: Our research findings indicate that targeting the NAP1L1/EP300/DX5 axis might be a new potential treatment option for endometrial cancer.

Predominant localization and ways of metastatic dissemination to the brain of malignant tumors of the female reproductive system

Background. Metastases of the female reproductive system cancer to the brain are rare and reach about 5 % of all cases with metastatic lesions of the central nervous system. The most common metastases are ovarian cancer (0.49–6.1 %), endometrial cancer (0.4–1.2 %) and cervical cancer (0.3–0.9 %). The predominant localization and ways of spreading metastases to the brain in this category of tumors may differ from lung cancer, breast cancer, kidney cancer or melanoma.Aim. To analyze the localization of brain metastases of malignant tumors of the female reproductive system and the ways of dissemination of malignant cells from the primary focus to the central nervous system.Materials and methods. From 2013 to 2020, a total number of 448 patients with metastatic brain tumors from different cancers were operated on at the Department of Neuro‑Oncology of the Federal Center of Neurosurgery (Novosibirsk). Metastases of tumors of the female reproductive system were presented in 32 (7.1 %) cases. The average age was 55.1 (27–72) years. Ovarian cancer was the primary focus in 24 (5.3 %) cases, endometrial cancer – in 6 (1.3 %), cervical cancer – in 2 (0.4 %). Occipital lobe was the most often location for the metastases in the brain and occurred in 10 (31.3 %) patients. Subtentorial localization was on the second place and noted in 9 (28.1 %) cases. Of these, metastases to the cerebellum were registered in 8 cases and in 1 case the metastasis was located in the brain stem.Results. Gross total removal of metastasis was achieved in all 32 patients. Of 9 cases with subtentorial localization of metastasis, only 1 patient had lung metastases verified. Regression of neurological symptoms and improvement of the condition were noted in 16 patients after surgery. The Karnovsky performance score at the time of discharge was 85.2.Conclusion. The subtentorial location of metastases in malignant tumors of the female reproductive system occupies one of the leading places. This is because the dissemination of tumor cells from the pelvis can occur through a Batson vertebral venous system directly to the cerebellum or brain stem without the pulmonary blood circulation and lung dissemination. This should be taken into account for the early diagnosis of subtentorial metastatic brain tumors and referral of these patients for neurosurgical treatment.

N6-Methyladenosine modified circ-NAB1 modulates cell cycle and epithelial-mesenchymal transition via CDKN3 in endometrial cancer.

Endometrial cancer (EC) is a common malignant tumor in the female reproductive system. Circular RNAs (circRNAs) and N6-methyladenosine (m6A) modification are widely involved in cancer progression. Nevertheless, the cross-talk between circ-NAB1 and m6A as well as the biological functions of circ-NAB1 in EC remain unclear. Circ-NAB1 was observed to be upregulated in EC tissues and cells by RT-qPCR. MeRIP and RNA pull-down assays were utilized for detecting the m6A modification of circ-NAB1. The interaction between circ-NAB1 and RNAs was also detected. Colony formation, transwell, flow cytometry, and western blot were utilized for measuring EC cell behaviors. Mechanically, we proved the m6A demethylase alkylation repair homolog protein 5 (ALKBH5) can mediate circ-NAB1 expression through an m6A-YTHDF2-dependent manner. Circ-NAB1 overexpression can promote cell proliferation, migration, invasion, epithelial-mesenchymal transition (EMT) process, and cell cycle through functional assays. Circ-NAB1 knockdown exerts the opposite function on EC cells. Furthermore, we proved that circ-NAB1 can sponge miR-876-3p to upregulate the target gene cyclin-dependent kinase inhibitor 3 (CDKN3) in EC cells. CDKN3 overexpression can reverse the impacts of circ-NAB1 depletion on EC cell behaviors. Collectively, we proved that ALKBH5-mediated m6A modification of circ-NAB1 promoted EMT process and cell cycle in EC via targeting the miR-876-3p/CDKN3 axis.

Identification of necroptosis-related gene signatures for predicting the prognosis of ovarian cancer

Ovarian cancer (OC) is one of the most prevalent and fatal malignant tumors of the female reproductive system. Our research aimed to develop a prognostic model to assist inclinical treatment decision-making.Utilizing data from The Cancer Genome Atlas (TCGA) and copy number variation (CNV) data from the University of California Santa Cruz (UCSC) database, we conducted analyses of differentially expressed genes (DEGs), gene function, and tumor microenvironment (TME) scores in various clusters of OC samples.Next, we classified participants into low-risk and high-risk groups based on the median risk score, thereby dividing both the training group and the entire group accordingly. Overall survival (OS) was significantly reduced in the high-risk group, and two independent prognostic factors were identified: age and risk score. Additionally, three genes—C-X-C Motif Chemokine Ligand 10 (CXCL10), RELB, and Caspase-3 (CASP3)—emerged as potential candidates for an independent prognostic signature with acceptable prognostic value. In Gene Ontology (GO) and Kyoto Encyclopedia of Genes and Genomes (KEGG) enrichment analyses, pathways related to immune responses and inflammatory cell chemotaxis were identified. Cellular experiments further validated the reliability and precision of our findings. In conclusion, necroptosis-related genes play critical roles in tumor immunity, and our model introduces a novel strategy for predicting the prognosis of OC patients.

Abstract PO1-28-05: Preventive Microsurgery in Breast Cancer Treatment

Abstract Relevance: Breast cancer (breast cancer) ranks first among all oncological diseases in women in the world. In 2020, 2.3 million people worldwide were diagnosed with breast cancer. The most common complication after radical breast surgery is violation of lymph outflow in the form of lymphatic edema (lymphedema) of the limb. The probability of developing lymphedema according to scientific literature is from 12 to 60%. Treatment of this complication is carried out conservatively and surgically. According to a review of international experience, a preventive microsurgical technique for restoring lymph outflow from the upper limb – the application of lymphovenous anastomoses (LVA) has a positive result for the prevention of lymphedema, similar to a sentinel lymph node biopsy and can be considered as an addition to standard axillary lymph dissection (ALD). Objective: To evaluate the effectiveness of preventive microsurgical application of LVA after ALD in breast cancer. Methods: From August 2022 to June 2023, 44 operations were performed with preventive microsurgical application of lymphovenous anastomoses on the basis of the Department of Tumors of the Female Reproductive System of the Central Clinical Hospital “RZD-Medicine”, Moscow. In 39 patients, surgery was performed during the primary treatment: disease stage cT1-4N1-3M0. Organ-preserving resection with lymph node dissection (9),mastectomy with lymph node dissection (30). In 14 patients, a biopsy of the sentinel lymph node was performed at the first stage; according to the result of a lesion of 2 or more, ALD and LVA were performed. In 5 patients, ALD was performed for local recurrence of the disease in the axillary region. All patients underwent immediate microsurgical restoration of lymphatic outflow from the upper limb during one operation in the axillary region after the stage of lymph node dissection. A fluorescent dye was used for reverse mapping of lymphatic pathways from the upper limb. Isotopes + fluorescent dye were used to determine the sentinel lymph node. Lymphatic venous anastomoses were applied end-to-end, end-to-side, side-to-side and by the Optocus technique. Results: The median follow-up was 5.5 months. The duration of the operation increased by an average of 70 minutes: at the same time, the ALD time increased by an average of 14 minutes for gentle skeletization of the veins for the subsequent application of LVA. In 4 patients, the integrity of the recipient vein was damaged during lymph node dissection and restored microsurgically. No surgical complications were observed. The average duration of lymphorrhea in the postoperative period was 2.3 days (without LVA 13.9 days). Conclusions: The preventive microsurgical technique for restoring lymph drainage from the upper limb has a number of technical limitations, requires special training and microsurgical equipment. Nevertheless, the technique is safe, feasible and effective in the early postoperative period. The application of LVA led to a significant decrease in lymphorrhea in the postoperative period, a reduction in hospital stay, but an increase in the duration of the operation. Longer follow-up is required to assess the overall effect of LVA on the incidence of lymphedema. Citation Format: Vladimir Vorotnikov, Alexander Soynov, Alexander Soynov, Regina Pakhomova, Alexandra Gugnina, Sardor Abdugafforov, Sofia Kim, Tornike Mchedlidze. Preventive Microsurgery in Breast Cancer Treatment [abstract]. In: Proceedings of the 2023 San Antonio Breast Cancer Symposium; 2023 Dec 5-9; San Antonio, TX. Philadelphia (PA): AACR; Cancer Res 2024;84(9 Suppl):Abstract nr PO1-28-05.

Primary lymphoma of the female genital tract masquerading as gynecological malignancy

BackgroundPrimary lymphoma of the female genital tract (PLFGT) is a rare malignant tumor in the female reproductive system, with a low incidence and few clinical reports. The aim of this study is to report our institutional experience with this rare malignancy and emphasize the need for increasing the awareness about PLFGT presenting with gynecologic symptoms.MethodsThe medical records of patients diagnosed with PLFGT from March 2014 to November 2022 in the First Affiliated Hospital of Wannan Medical College were reviewed. Histological classification and staging were based on the World Health Organization and Ann Arbor systems, respectively.ResultsThere were 13 patients with diagnosis of PLFGT and the median length of follow-up was 31 months (0-102 months). The main clinical symptoms included postmenopausal vaginal bleeding, pelvic mass and abdominal pain. Serum LDH increased in 10 patients and serum CA125 elevated in 2 patients. The tumor of ovarian or uterine presented as solid masses in CT or MRI, and ascites was rare. The histological subtypes were diffuse large B-cell (n = 12) and follicular (n = 1) lymphoma. Tumors were located in ovary (n = 8), uterus (n = 3), and cervix (n = 2). According to the Ann Arbor staging system, 6 cases were classified as stage II and 7 cases were classified as stage IV, respectively. A total of 10 patients underwent surgery. Combination chemotherapy was used in 10 patients. Eight patients had tumor-free survival, 1 patient had recurrent disease, 3 patients died and 1 patient lost to follow-up. The median survival time was 32 months (1-102 months).ConclusionPLFGT usually presents as gynecological symptoms and solid masses in pelvis. Surgery or biopsy was the way to obtain the pathologic diagnosis, and combination chemotherapy is the efficient method for PLFGT. Making an accurate preoperative diagnosis is of paramount importance to avoid radical gynecologic surgery.

The Use of Erythropoietin in Cancer Treatment and Its Correlation with Ovarian Cancer

Erythropoietin is produced by the kidneys, which can stimulate the production of red blood cells, and has a better therapeutic and prognostic role in cancer anemia. Ovarian cancer, which originates from ovarian tissue, is one of the malignant tumors of the female reproductive system, with high lethality and not easy to detect. It has been proved that EPO in correlates with the growth of tumor cells, and its receptor EPOR and recombinant human EPO (rhEPO) are expressed in cancer cells. EPO can treat EPO tumors by restoring endothelial erythrocytes and promoting angiogenesis, while rhEPO mainly has a better ameliorative effect on cancer anemia induced by radiotherapy. However, it remains controversial and contradictory whether EPO has a concomitant promoting effect on tumor cells while relieving ischemia. In this article, we will introduce the sources of EPO and EPOR in vivo, analyze the pathways that promote erythropoiesis, and analyze their effects on tumor cells. It will also confirm the correlation between the two by analyzing the EPO content in ovarian cells. The intervention effect of rhEPO analogs on cancer is also briefly described. Since aberrant activation of the JAK/STAT signaling pathway may exist in ovarian cancer patients, in-depth study of such targets may become a new research direction for the treatment of ovarian cancer.

Caregiver experiences of caring for family members with urostomy: a qualitative study.

In China, bladder tumors rank first for morbidity and mortality among urological and reproductive system tumors. Total radical cystectomy plus urinary flow conversion is the gold standard for the treatment of muscle-layer invasive bladder cancer. With an increasing number of radical cystectomies each year, the number of patients living with urostomy is growing. After discharge, primary care of urostomy patients is given at home, and high demands are placed on home caregivers due to issues of privacy and the complexity of replacing the urostomy device. This research explored the challenges faced by the family caregivers of urostomy patients. We used descriptive qualitative research methods to conduct interviews with twenty-five family caregivers of patients with urostomy. Survey subjects were from five general hospitals. All interviews were recorded, transcribed, and analyzed using thematic analysis. Three critical challenges were identified-confusion, family crisis, and struggle psychology. Within these three themes, six sub-themes wereconstructed by coders. They were knowledge and skill deficiency, strong insecurities and uncertainties, role conflict, economic burden, emotional overwhelmed and calm acceptance. Family caregivers play a critical role in patient care, and especially in urostomy care. Caregiving is associated with significant challenges that hinder the family caregiver's ability to effectively care for the patient, further diminishing the caregiver's quality of life. Therefore, healthcare professionals should consider the challenges faced by family caregivers and take measures to obviate them through education, preparation, and support.

KIF26B and CREB3L1 Derived from Immunoscore Could Inhibit the Progression of Ovarian Cancer.

Ovarian cancer (OV) is characteristic of high incidence rate and fatality rate in the malignant tumors of female reproductive system. Researches on pathogenesis and therapeutic targets for OV need to be continued. This study mainly analyzed the immune-related pathogenesis and discovered the key immunotherapy targets for OV. WGCNA was used for excavating hub gene modules and hub genes related to the immunity of OV. Enrichment analysis was aimed to analyze the related pathways of hub gene modules. Biological experiments were used for exploring the effect of hub genes on SKOV3 cells. We identified two hub gene modules related to the immunoscore of OV and found that these genes in the modules were related to the extracellular matrix and viral infections. At the same time, we also discovered six hub genes related to the immunity of OV. Among them, KIF26B and CREB3L1 can affect the proliferation, migration, and invasion of SKOV3 cells by the Wnt/β-catenin pathway. The local infection or inflammation of ovarian may affect the immunity of OV. KIF26B and CREB3L1 are expected to be potential targets for the immunotherapy of OV.

Multitask prediction models for serous ovarian cancer by preoperative CT image assessments based on radiomics.

High-grade serous ovarian cancer (HGSOC) has the highest mortality rate among female reproductive system tumors. Accurate preoperative assessment is crucial for treatment planning. This study aims to develop multitask prediction models for HGSOC using radiomics analysis based on preoperative CT images. This study enrolled 112 patients diagnosed with HGSOC. Laboratory findings, including serum levels of CA125, HE-4, and NLR, were collected. Radiomic features were extracted from manually delineated ROI on CT images by two radiologists. Classification models were developed using selected optimal feature sets to predict R0 resection, lymph node invasion, and distant metastasis status. Model evaluation was conducted by quantifying receiver operating curves (ROC), calculating the area under the curve (AUC), De Long's test. The radiomics models applied to CT images demonstrated superior performance in the testing set compared to the clinical models. The area under the curve (AUC) values for the combined model in predicting R0 resection were 0.913 and 0.881 in the training and testing datasets, respectively. De Long's test indicated significant differences between the combined and clinical models in the testing set (p = 0.003). For predicting lymph node invasion, the AUCs of the combined model were 0.868 and 0.800 in the training and testing datasets, respectively. The results also revealed significant differences between the combined and clinical models in the testing set (p = 0.002). The combined model for predicting distant metastasis achieved AUCs of 0.872 and 0.796 in the training and test datasets, respectively. The combined model displayed excellent agreement between observed and predicted results in predicting R0 resection, while the radiomics model demonstrated better calibration than both the clinical model and combined model in predicting lymph node invasion and distant metastasis. The decision curve analysis (DCA) for predicting R0 resection favored the combined model over both the clinical and radiomics models, whereas for predicting lymph node invasion and distant metastasis, DCA favored the radiomics model over both the clinical model and combined model. The identified radiomics signature holds potential value in preoperatively evaluating the R0, lymph node invasion and distant metastasis in patients with HGSC. The radiomics nomogram demonstrated the incremental value of clinical predictors for surgical outcome and metastasis estimation.

Mueller matrix polarization interferometry of optically anisotropic architectonics of biological tissue object fields: the fundamental and applied aspects

The presented results concern the diagnostic application of vector-parameter polarization mapping and polarization-interference phase scanning applied to layered azimuths and ellipticity polarization maps obtained with the help of digital holographic reproduction for phase-inhomogeneous tissue layers in the female reproductive system. The differential diagnosis of the pathological changes in optically anisotropic polycrystalline tissue components, specifically “benign (fibroids) and precancerous (endometriosis),” was investigated. All studies within the representative groups of the histological samples were conducted using circularly polarized laser radiation, ensuring azimuthal invariance and polarization measurement reliability. Integral and layered maps and polarization azimuths and ellipticity random variable distribution histograms were obtained from the microscopic images of histological sections from the female reproductive system tumors. Systematized tables present statistical moments which characterize azimuths and ellipticity polarization maps for fibroids and endometriosis tissues. It is shown that the statistical parameters (diagnostic markers) are the most sensitive to benign and precancerous changes in the female reproductive system tissues. The results of information analysis, including the accuracy determination of the diagnostic vector-parameter polarization and polarization-interference methods for detecting and differentiating the samples of fibroids and precancerous endometriosis tissues in the female reproductive system, are presented.

ROS-responsive polyprodrug micelles carrying suicide genes in combination with chemotherapy and gene therapy for prostate cancer treatment.

Prostate cancer is the most common malignant tumor in the male reproductive system, and its incidence increases with age. Chemotherapy is one of the main strategies for treating prostate cancer, but it often comes with unavoidable side effects. Nanocarriers can improve drug utilization and targeting, and cationic carriers can also carry nucleic acids for gene therapy. In this study, we prepared a cationic micelle constructed from a polyprodrug that can deliver both chemotherapeutic drugs and nucleic acids simultaneously. The typical chemotherapeutic drug hydroxycamptothecin (HCPT) was linked by reactive oxygen species (ROS)-responsive coupling agents and forms amphiphilic block polymers with low molecular weight polyethyleneimine (PEI). The resulting cationic micelles can be triggered by high levels of ROS in tumor cells and collapse to release HCPT and suicide genes to kill tumor cells. At the same time, it reduces the killing of normal cells. In prostate cancer cells, it has been confirmed that the co-delivery carriers combined with chemotherapy and a suicide gene prodrug system have shown an ideal therapeutic effect on prostate cancer.

The role of circRNAs in regulation of drug resistance in ovarian cancer.

Ovarian cancer is one of the female reproductive system tumors. Chemotherapy is used for advanced ovarian cancer patients; however, drug resistance is a pivotal cause of chemotherapeutic failure. Hence, it is critical to explore the molecular mechanisms of drug resistance of ovarian cancer cells and to ameliorate chemoresistance. Noncoding RNAs (ncRNAs) have been identified to critically participate in drug sensitivity in a variety of human cancers, including ovarian cancer. Among ncRNAs, circRNAs sponge miRNAs and prevent miRNAs from regulation of their target mRNAs. CircRNAs can interact with DNA or proteins to modulate gene expression. In this review, we briefly describe the biological functions of circRNAs in the development and progression of ovarian cancer. Moreover, we discuss the underneath regulatory molecular mechanisms of circRNAs on governing drug resistance in ovarian cancer. Furthermore, we mention the novel strategies to overcome drug resistance via targeting circRNAs in ovarian cancer. Due to that circRNAs play a key role in modulation of drug resistance in ovarian cancer, targeting circRNAs could be a novel approach for attenuation of chemoresistance in ovarian cancer.

Research on Endometrial Cancer: Risk factors, Classification and Treatment

Endometrial cancer (EC) is one of the most common tumors of the female reproductive system. Its pathogenesis is complex, and the incidence tends to be younger, which seriously endangers women's health. Research has found that the calssification of EC is of great significance in clinical applications, including traditional types I (estrogen-dependent) and II (non-estrogen-dependent), as well as four molecular subtypes (POLE ultramutated, microsatellite instability hypermutated, copy number low, and copy number high). The risk factors affecting EC include genetic factors, obesity, menstrual irregularities, etc. In addition, significant progress has been made in the treatment of EC, with new breakthroughs in surgery, radiotherapy, chemotherapy, endocrine therapy, targeted therapy, etc. This article discusses risk factors, traditional classification, molecular classification and treatments of EC, in order to provide reference for clinical research on EC.

Progress in the treatment and pregnancy of precancerous lesions and borderline tumors of reproductive system in pregnant women.

Progress in the treatment and pregnancy of precancerous lesions and borderline tumors of reproductive system in pregnant women.

Application of multicolor flow cytometry in liquid biopsy of breast cancer

As a result of the clinical study NCT04817501 “Phenotypic characterization of circulating tumor cells (CTCs) in tumors of the female reproductive system”, we developed a method for preoperative prediction of a recurrence risk in patients with stage T1 endometrial cancer (Patent No. 2762493 of 21.12.2021).The article presents a clinical case of the use of multicolor flow cytometry in liquid biopsy of breast cancer (BC). CTCs were detected in the blood of a patient with T2N0M0 BC, stage IIA before the initiation of treatment. Using multicolor flow cytometry, various CTC phenotypes were studied and the Her2/neu and ki-67 markers were determined. These markers were also studied in the biopsy and surgical material of the BC tissue using immunohistochemistry. As a result of the study, it was shown that the molecular profile of CTCs in the blood taken before fine needle aspiration biopsy coincided with that of cancer cells in the BC tissue. In addition, the calculated risk of tumor progression before biopsy predicted recurrence of cancer in this patient 20 months before its occurrence. The obtained results show the practical utility of multicolor flow cytometry in liquid biopsy of cancers. The ability to evaluate CTCs by various molecular parameters can be useful for diagnosing, predicting, monitoring, and determining treatment strategies for cancer patients.

Algorithm for the provision of comprehensive psychotherapeutic support to women experiencing neuropsychiatric symptoms during rehabilitation following the treatment of malignant neoplasms of the reproductive system

Background. Radical treatment of malignant neoplasms (MNs) of female reproductive system often has serious consequences. Chronic pain syndrome, distress, anxiety and depression, decreased self-esteem, sexual dysfunction and social maladjustment reduce quality of life (QoL) and require psychotherapeutic support.Objective: to create an algorithm for the provision of comprehensive psychotherapeutic support during rehabilitation following the treatment of reproductive system MNs and to evaluate its effect on QoL indicators in women with neuropsychiatric disorders.Material and methods. The algorithm for the provision of comprehensive psychotherapeutic support included clinical interview, cognitive behavioral therapy, visualization, audio therapy, art therapy, group and individual psychotherapy, family psychotherapy, image therapy. The QoL indicators were determined by questionnaires using the Functional Assessment of Cancer Therapy – General (FACT-G) with nosology-specific extensions (subscales of physical well-being, social/family well-being, emotional wellbeing and functional well-being), Hospital Anxiety and Depression Scale (HADS), Kupperman–Uvarova Modified Menopausal Index (MMI). The follow-up period was 1 year after radical surgical treatment of reproductive system MNs in different localizations. The main group received the algorithm for the provision of comprehensive psychotherapeutic support as part of active medical rehabilitation, the comparison group received basic rehabilitation.Results. The study included 47 women with vulvar cancer (VC): active rehabilitation group (VC-1) – 24 patients and basic rehabilitation group (VC-2) – 23 patients; 61 women with endometrial cancer (EC): active rehabilitation group (EC-1) – 29 patients and basic rehabilitation group (EC-2) – 32 patients; 103 women with cervical cancer (CC): active rehabilitation group (CC-1) – 51 patients and basic rehabilitation group (CC-2) – 52 patients; 62 women with stages I–II ovarian cancer (OC) and low malignant potential tumor (LMPT): active rehabilitation group (LMPT-1) – 29 patients and basic rehabilitation group (LMPT-2) – 33 patients. Differences in physical, social/family and functional well-being (FACT-G) were significant from the 6th month and in emotional well-being – by the end of follow-up. Neurovegetative and psycho-emotional disorders, as assessed by Kupperman–Uvarova MMI, showed significant positive dynamics in women who received the algorithm for the provision of comprehensive psychotherapeutic support, in contrast to the comparison group, where these indicators remained without significant dynamics or worsened by the end of the follow-up period. The HADS scores during psychotherapeutic support decreased to normal values at the 6–12th months of follow-up, while those who received the basic rehabilitation continued to have subclinical anxiety and depression.Conclusion. The developed algorithm for psychotherapeutic support as part of active medical rehabilitation of women who underwent radical treatment for reproductive system MNs (VC, EC, CC, OC, and LMPT) has demonstrated its effectiveness, justifuing its implementation in clinical practice.