UJR 2016, vol XXIV, # 1
2016, vol. XXIV, pub. 1, page 4
E. N. SUKHINA, A. A. MIHANOVSKY, V S. SUKHIN, E. V NEMALTSOVA, U. V. KHARCHENKO
SI «Grigoriev Institute for Medical Radiology of National Academy of Medical Sciences of Ukraine», Kharkiv
ASSESSMENT OF POSSIBLE APPLICATION OF TUMOR-ASSOCIATED MARKER HE-4 For DIAGNOSIS Of OVARIAN Cancer
Introduction. Ovarian cancer is the fourth most common cause of death resulted from oncological diseases and is «responsible» for 5 % of cancer deaths among women.
The aim of the study was to estimate the possibility of using HE-4 tumor marker for early diagnosis of ovarian cancer.
Materials and Methods. The expression levels of HE-4 and CA-125 tumor markers have been studied in 63 patients with ovarian cancer and in 19 ones with benign ovarian neoplasms.
Results. In the patients diagnosed with ovarian cancer in 88.9 % there was an increase in the expression level of HE-4, in 96.8 % — an increase in the expression level of CA-125.
Conclusions. The HE-4 sensitivity is similar to the one of CA-125 tumor marker, however the specificity is 1.8 times higher as well as the frequency of false positive results is 5 times lower.
Keywords: ovarian cancer, tumor markers, oncomarkers, НЕ-4, СА-125.
2016, vol. XXIV, pub. 1, page 8
V. V. KARVASARSKAYA, N. A. MITRYAEVA, L. V. GREBENIK, N. V. BELOZOR, T. S. BAKAY, V. P. STARENKYI, V. G. SHEVTSOV
SI «Grigoriev Institute for Medical Radiology of National Academy of Medical Sciences of Ukraine», Kharkiv
PECUIARITIES OF VEGF CONTENT IN THE BLOOD SERUM OF PATIENTS WITH NSCLC OVER TYME OF CONFORMAL RADIOTHERAPY
Purpose. To define the peculiarities of VEGF expression in the blood serum in patients with NSCLC over time of conformal radiotherapy for treatment response assessment.
Materials and Methods. The study involved 30 patients with NSCLC aged from 40 to 79 years who underwent treatment at Grigoriev Institute for Medical Radiology of National Academy of Medical Science of Ukraine. The patients completed a course of remote radiation therapy by means of the linear accelerator Clinac 600C in terms of consecutive chemoradiotherapy. The control group included 20 apparently healthy people. The general clinical, morphological examination of all patients was carried out. The content of serum VEGF in the blood was estimated due to the method of enzyme multiplied immunoassay with the use of the standard «Vektor-Best» sets (Russia) before and after radiation therapy.
Results. The content of serum VEGF before treatment was increased in 90 % patients with NSCLC. The interrelation between serum VEGF expression and such clinical and morphological characteristics as disease stage, tumor grade and nodal involvement has been established. Significant difference between the content of VEGF and histological option of lung cancer, age and sex of patients has not been detected. The interrelation between concentration of angiogenic factor — VEGF and the objective response to conformal radiotherapy in patients with NSCLC has been proved.
Conclusions. Dynamic changes of VEGF indicators in the blood serum of patients with NSCLC in the course of radiation therapy associated with the analysis of the objective response (progression, regression or process stabilization) can be used as additional criteria of assessment of treatment efficiency. Hyperexpression of VEGF as a key factor of aggressive nature of the process is a predictive marker of radiation therapy efficiency of NSCLC. It is reasonable to use the ratio of VEGF before and after treatment (К = VEGF1/VEGF2) as an additional criterion for estimation of the further treatment approach for NSCLC patients with process stabilization after radiation therapy. In case of К < 1,5 the adjuvant polychemotherapy is recommended, if К > 1,5 the course of radiotherapy with further dynamic observation and CT in a month is recommended.
Keywords: radiotherapy, vascular endothelial growth factor (VEGF), angiogenesis, non-small-cell lung cancer (NSCLC).
2016, vol. XXIV, pub. 1, page 14
O. P. LUKASHOVA
SI «Grigoriev Institute for Medical Radiology of National Academy of Medical Sciences of Ukraine», Kharkiv
INFLUENCE OF FINELY FRACTIONAL X-RAY RADIATION IN THE TOTAL DOSE OF 10 GY AND ETOPOSIDE CHEMOTHERAPEUTIC AGENT ON ULTRASTRUCTURE OF HEREN CARCINOMA CELL
Purpose. Electron-microscopic study of structural and functional state of Heren carcinoma cell and processes of apoptosis development after administration of Etoposide and local X-ray radiation in the total dose of 10 Gy using 2 Gy single fractions.
Methods. Due to standard methods of electron microscopy ultrastructure of tumor cells has been studied as well as mitosis and apoptosis indices in 6 and 24 hours after local X-ray radiation of Heren carcinoma in the total dose of 10 Gy (5fractions/2 Gy daily) and administration of Etoposide chemotherapeutic agent in the dose of 8 mg/kg 18 hours before the final radiation fraction have been estimated.
Findings. It has been established that Etoposide after administration leads to significant reduction of mitosis index in the tumor in 6 hours, appearance of small tumor cells for one day long, inconsiderable changes of apoptosis index. Presence of binuclear and polynuclear cells in the tumor along with pleiomorphic nuclei and micronuclei in the tumors cells is peculiar to radiation action. The cytoplasm is characterized by decreased amount of free ribosomes and polysomes; the number of profiles of granular endoplasmic reticula tends to increase. Significant reduction of mitosis index is observed when apoptosis index rises to the maximum during the sixth hour. In case of combined action of radiation and Etoposide, the ultrastructure of Heren carcinoma cells is similar to the one which is observed if one radiation is carried out together with presence of small tumor cells. Both periods are characterized by considerable reduction of mitosis index level and significant increase of apoptosis index. Conclusions. The main effect of Etoposide on Heren carcinoma cell consists in short-term antimitosis at the early stage after administration with the subsequent one in 24 hours that is accompanied by appearance of small tumor cells for 1 day long. Etoposide scarcely influences ultrastructure of most tumor cells and is considered to be a weak inducer of apoptosis in Heren tumor. Long-term finely fractional radiation results in significant ultrastructural changes in Heren carcinoma cells that suggest radiation injury of nuclei and inversion of tumor cells function from growth and division to protein-synthetic activity. Significant antimitosis in both periods of the study can result from these processes. Short-term increase of apoptosis index during the 6 hour is obviously caused by action of the final radiation fraction. In case of combined use of radiation and Etoposide, indicative changes of tumor cells ultrastructure are caused by radiation, presence of small tumor cells results from chemotherapeutic agent effect and reduction of mitotic activity and activation of apoptosis processes are induced by both factors. Different ways of development such as mediated p53 and ceramide apoptosis way can participate in mechanisms of induction of apoptosis in action of radiation and Etoposide.
Keywords: radiation, Etoposide, Heren carcinoma, ultrastructure, apoptosis.
2016, vol. XXIV, pub. 1, page 22
A. B. GRIAZOV, O. YA. GLAVATSKY, G. Y. KHMELNYTSKY
State institution A. P. Romodanov Institute of Neurosurgery of the NAMS of Ukraine, Kyiv
СOMPARATIVE STUDY OF RADIOSURGICAL TREATMENT WITH THE USE OF METRONIDAZOLE IN BRAIN METASTASES OF DIFFERENT NOSOLOGIES
Summary. In order estimate the effectiveness of stereotactic radiosurgery with the use of metronidazole, the data obtained due to magnetic resonance imaging of 30 patients with brain metastases resulting from non-small cells lung cancer, breast cancer, renal cell carcinoma and skin melanoma have been analyzed. Early response to the treatment was assessed in 7, 14, 21 and 28 days. Significant volume reductions of brain metastases (no less than 50.0 % out of the initial one) after radiosurgery the use of metronidazole was observed in 7 and 14 days (in 41,2 % и 60,0 % of patients respectively) that was accompanied by reduction of edema zone, mass effect signs according to the data of neuroimaging and neurological symptoms in clinical presentation of the disease. The best early response (in 7 and 14 days) was obtained in the group of patients with breast cancer and it reached 50,0 % and 80.0 % respectively. In 21 days after radiosurgery in patients with breast cancer metastases the outcomes were better as well; the response to treatment was obtained in 90,0 % of cases while the mean value for all nosologies was 80.0 %. In 28 days all 30 (100,0 %) patients showed metastases reduced no less than by 50 % out of the initial volume, by 74,5 % on the average. This index was the highest in patients with breast cancer and it reached 88,6 %. Thus, the most important criterion of effectiveness of radiosurgery with the use of metronidazole radiosensitizer in our observations was early response in the form of reduced volume of foci in metastatic tumors of the brain. Reduced edema zones and mass effect signs including neurological symptoms recession were important criteria as well.
Keywords: stereotactic radiosurgery, metronidazole, brain metastases.
2016, vol. XXIV, pub. 1, page 27
I. SAFONOVА
Kharkiv Medical Academy of Postgraduate Education
ANTENATAL SONOGRAPHIC MONITORING AND PREDICTION OF PERINATAL OUTCOMES IN THE EARLY AND LATE VERSIONS OF FETAL GROWTH RETARDATION
Objective. To explore the value of Doppler monitoring and ultrasound (US) fetometry in the diagnosis of early and late forms of intrauterine growth retardation (IGR) and small for gestational age (SGA) fetus, as well as in perinatal outcome predicting.
Materials and Methods. There were studied the Doppler monitoring results and clinical perinatal catamnesis in 204 fetuses, which had calculated weight at the antenatal stage below the 10th percentile for gestational age, and 100 fetuses with the calculated weight above the 10th percentile. The study included only singleton pregnancies. To calculate the estimated fetal weight the Hadlock’s formula was used. Doppler monitoring included study of umbilical artery, uterine artery and fetal middle cerebral artery flow. Postnatal results were classified as follows: adverse general postnatal outcome (GPO) meant perinatal or infant death; adverse clinical postnatal outcome (CPO) meant severe neonatal morbidity.
Results. Adverse GPO at antenatal US biometry below the 10th percentile occurred 11.7 times more often than at normal gestational fetometry (p = 0.02). Postnatal results in fetuses with fetometry below the 10th percentile after 34 GW had a wide variability — from extremely unfavorable GPO and cPO up to constitutionally low weight at full clinical wellbeing. fetuses with fetometry below the 10th percentile before 34th GW occurred 2.2 times more frequently than after 34 weeks: 141 (69.2 %) and 63 (30.8 %) cases respectively. No statistically significant differences occurred in comparing the frequency of adverse GPO and the frequency of true IGR at fetometry below the 10th percentile before 34 GW and after 34 GW (p < 0.05). In the studied cohort the calculation of the estimated fetal weight percentile allowed to diagnose the true early IGR with an accuracy of 71 % and the true late IGR with an accuracy of 45 %. True late IGR was confirmed in only 24/63 (38.1 %) fetuses with fetometry below the 10th percentile after 34 GW. The best quality of the diagnosis true of early IGR (area under the ROc-curve 0.9902) was observed with the application of integrated US monitoring, and the worst one (the area under the ROc-curve 0.4012) — with a percentile fetometry assessment after 34 GW.
Keywords: pregnancy, fetus, ultrasound, fetal growth retardation, perinatal outcome.
2016, vol. XXIV, pub. 1, page 34
A. N. BELIY1 2, V A. VINNIKOV1, N. V KRASNOSELSKIY1 2, N. A. MITRYAEVA1
1 SI «Grigoriev Institute for Medical Radiology of National Academy of Medical Sciences of Ukraine», Kharkiv
2 Kharkiv National Medical University
PROSPECTS OF APPLICATION OF MOLECULAR BIOLOGICAL MARKERSin patients with locally advanced breast cancer
The review contains current opinions on prognostic and predictive marker analysis of the disease, possible progression of the locally advanced breast cancer. Clinical-morphological, serum, immunohistochemical and genetic markers are discussed. The analysis of literature on the importance of tumor stroma, macrophages, condition of regional lymph nodes in predicting of overall and relapse-free survival is performed. Parallels between the significance of certain markers and possible ways of metastasis are given.
Keywords: locally advanced breast cancer, molecular biological markers, immunohistochemistry, metastasis.
2016, vol. XXIV, pub. 1, page 43
YU. G. TKACHENKO
SI «Grigoriev Institute for Medical Radiology of National Academy of Medical Sciences of Ukraine», Kharkiv
RADIATION-INDUCED CANCER OF THE PAROTID GLAND IN A TEENAGER PATIENT WITH THYROID CANCER
Improving of treatment effectiveness and early diagnosis of malignant tumors has led to a significant increase of terms of survivance of these patients.
It is proved that the risk of cancer is higher in individuals who have already been treated for a malignant tumor. The peak of development of second cancers occurs for a period of 5-20 years from the end of initial treatment. The paper presents a clinical case of development of radiation-induced cancer of the parotid gland after 20 years of complex treatment of patients with thyroid cancer in early life. The treatment schedule included combined radiation treatment: gamma-ray teletherapy and radioactive iodine therapy.
Thus, from the point of view of radiobiology we can not forget about the damaging effect of ionizing radiation on the child's body.
Keywords: radiation-induced cancer, the child's body, radiation therapy.
2016, vol. XXIV, pub. 1, page 62
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