Evgeniy P. Kulikov

Leiomyosarcoma (LMS) is a rare, aggressive soft-tissue sarcoma arising from smooth muscle cells. It has a high metastatic potential and limited therapeutic options. Despite advances in oncology, the molecular landscape of LMS remains incompletely understood, particularly regarding the genetic and epigenetic alterations that affect key signaling pathways. This review summarizes the current knowledge of mechanisms driving LMS pathogenesis, including somatic mutations in genes such as TP53 and RB1, chromosomal instability, dysfunction of DNA damage response and repair, aberrant DNA methylation, histone modifications, and non-coding RNAs. Emerging treatment strategies include inhibitors of PI3K/AKT/mTOR and CDK4/6 signaling, epigenetic drugs, immunotherapy, and combinations of these approaches. However, the coexistence of multiple genetic abnormalities complicates diagnosis, prognosis, and therapeutic selection. Companion diagnostic tools that test candidate therapies ex vivo or in vitro may help exclude potentially ineffective targeted treatments.

The implementation of the federal project “Fight against oncological diseases”, (2019—2024 year), has become one of the priorities in the field of healthcare organization, both at the Federal and regional levels. Significant financial investments aimed at additional equipping of medical organizations providing primary, specialized, high-tech care to cancer patients and the proper level of modern drug treatment were accompanied by extensive organizational and methodological work. The criterion for the effectiveness of the regional cancer service in the designated time period was the target (indicator) indicators, the achievement of which testified to the correct way to reform the entire system of care for patients with malignant neoplasms. In the Ryazan region, as in many other regions of Russia, the implementation of this project has led not only to the modernization of the existing material and technical base, but also to the formation of a three-tier cancer service system, the commissioning of a new treatment building of an oncological dispensary, and the emergence of a patient routing system within the region. The consequence of these changes was the growth of key statistical indicators and achievement of their target values by the end of 2024. Mortality from malignant neoplasms decreased from 219.5 to 196.5 cases per 100 thousand population. The share of malignant neoplasms detected at stages I—II increased from 56.7% to 63%. The share of patients with malignant neoplasms registered for 5 years and more out of the total number of patients with malignant neoplasms under dispensary supervision increased from 54.9% to 59.5%. One-year mortality of patients with malignant neoplasms decreased from 22.4% to 17.8%.

Введение. Рак желудка остается одним из наиболее распространенных онкологических заболеваний, однако его этиология и механизмы развития до конца не изучены. В последние годы особое внимание уделяется роли генетических факторов, таких как генетические полиморфизмы, в предрасположенности к данному заболеванию. Исследование направлено на определение связи вариантов генов (CHEK2, MMP1, MTHFR, TNF, XPC, APE1) с вероятностью развития рака желудка. Материалы и методы. Проспективно проанализированы 180 образцов крови: 111 пациентов с раком желудка (основная группа) и 69 здоровых добровольцев (контрольная группа). Группы были сопоставимы по возрасту и полу. Полиморфизмы генов определялись методом ПЦР с электрофоретической детекцией. Статистический анализ проводился с использованием программы StatTech v. 4.8.0. Результаты. Установлено, что генотип Lys/Lys гена XPC (Lys939Gln) ассоциирован с повышенным риском развития рака желудка (OR = 7,3; 95 % ДИ: 2,1–25,4; p < 0,001). Для гена CHEK2 (Ile157Thr) выявлены достоверные различия между группами (p = 0,03), однако количественная оценка эффекта требует дальнейшего изучения. Полиморфизмы генов MTHFR, MMP1, TNF и APE1 не показали значимого влияния на риск заболевания. Выводы. Варианты генов XPC и CHEK2 играют значительную роль в развитии рака желудка, что подчеркивает важность генетических факторов в патогенезе заболевания. Полученные результаты открывают перспективы для дальнейших исследований в области персонализированной медицины и ранней диагностики.

INTRODUCTION: Over the past decade, the number of patients with bladder cancer (BC) has been growing worldwide. In Europe and North America, BC is the fourth most common cause of cancer in men and the second most common malignant tumor of the genitourinary system. In Russia, BC ranks 7th among cancers in men and 17th in women. It is important to note that these patients, with the mean age ≥70 years, often have a severe concomitant pathology. The predominant histological form of BC is transitional cell carcinoma accounting for 90% of cases. AIM: Based on the literature data analysis, to determine the prospects of intra-arterial embolization and chemoembolization of tumor-supplying vessels for the treatment of bladder cancer. The information search was conducted in eLibrary, PubMed, Scopus, Google Patent, Google Scholar, ResearchGate databases from May to June 2024 without restrictions on the type and time of publication. The following keywords were used: muscle-invasive bladder cancer, hematuria, bladder malignancy, interventional oncology, embolization, and vesical artery chemoembolization. The primary treatment for BC is surgical intervention, however, recently, of special attention have been interventional methods of local treatment. Chemoembolization is an innovative approach combining local therapy and embolization of the tumor-supplying vessels. This allows for the delivery of high concentrations of chemotherapeutic drugs directly to the tumor, minimizing systemic side effects. This is especially relevant when radical tumor resection is not possible, or as a variant of emergency intervention to stop bleeding. CONCLUSION: Having reviewed the works, it can be concluded that intra-arterial embolization holds promise for the treatment of such a threatening BC complication as hematuria. In addition, the interventional tactics has shown encouraging results in the treatment of locally advanced BC, as well as the potential for palliative treatment of tumors of this location. However, due to the paucity of data, this approach requires further clinical investigation.

INTRODUCTION: The anatomy of the celiac trunk and superior mesenteric artery, due to their clinical significance, has been studied quite well both in abdominal surgery and oncology. At the same time, there is much less information about peculiarities of the structure and catheterization of the inferior mesenteric artery (IMA) in angiographic operations, which was the reason for studying this issue. AIM: To study the architecture of the IMA and the peculiarities of its catheterization based on X-ray contrast angiography data. MATERIALS AND METHODS: The study included 20 patients (13 men, 7 women; mean age (56.0 ± 7.0) years) with colorectal cancer and colorectal cancer metastases to regional lymph nodes, who underwent intra-arterial neoadjuvant/adjuvant therapy. X-ray endovascular intervention was performed using a Siemens Artis Zee device. In 10 patients, angiography was performed through the femoral access, in 10 patients — through a puncture of the brachial artery. The identified features of the structure of the IMA, were structured using a modified classification of H. Yada. RESULTS: Type I of the IMA structure according to H. Yada was detected in 70%; type II — in 15%; type III — in 10%; type IV — in 5%. Basic morphometric parameters of the IMA were: diameter — (2.90 ± 0.67) mm, length to the level of separation of the first branch — (29.8 ± 15.9) mm, separation angle — (32.0 ± 7.4)°. The revealed structural features of the inferior mesenteric artery make access through the upper limb using an MPA catheter preferable. CONCLUSION: Four variants of the structure of the IMA circulation according to H. Yada’s classification were confirmed, and its main morphometric parameters were established based on our clinical material. Access through the upper limb using an MPA catheter with the primary visualization of the IMA at the level of the fifth lumbar vertebra with subsequent pulling up and orientating the catheter tip toward the anterior wall of the left semicircle of the aorta is optimal for catheterization of the IMA and its branches.

The authors present a rare variant of celiac axis anatomy including acute angle of departure, ultra-short length and «parallel» course of the main branches. When analyzing the literature on this problem, they found no similar reports. This clinical example once again emphasizes significant variability of celiac axis anatomy and the need for a thorough examination of patients using all possible diagnostic methods, especially before surgery.

Glucocorticoids are widely used in the therapy of inflammatory and autoimmune disease as well as cancer. They realize the therapeutic effects via cytotoxic action on the immune cells; however, glucocorticoids are characterized by multiple severe side effects including metabolic and atrophic complications as well as glucocorticoid resistance development. With the progression in the field of steroid research and their mechanism of action, several steroid and non-steroid GC analogues with decreased adverse effects were developed for potential treatment on cancer, inflammatory and autoimmune diseases. Therefore, the important criteria of the evaluation of the efficacy of such molecules is the proof-of-concept studies in vivo on the proper models of the main disease as well as potential GC-related side effects. Here we summarized the current experience of the research groups worldwide in modeling of GC undesirable effects. The presented review will be useful for the translational research of GC and their analogues in vivo.

Interventional oncology is a rapidly evolving field of cancer treatment. Minimally invasive techniques, such as transarterial embolization with chemotherapeutic and radioactive agents, are common treatments and are found in many guidelines for the treatment of primary and metastatic liver lesions. It is known that the growth and development of a malignant neoplasm is primarily determined by angiogenesis. Rapid growth is ensured where the formation is directly related to the arterial bed. Therefore, when the drug is injected into the target vessel and providing tissue ischemia, it is possible to achieve a high degree of tumor pathomorphosis. This technique has an advantage for patients who, in some cases, cannot be treated surgically, and also increases the effectiveness of the chemotherapeutic effect. With the advent of necessary equipment in hospitals and the accumulation of experience in the use of minimally invasive interventions, it became possible to implement a new method of treating tumors of various localizations. In this review, we consider the results of domestic and foreign authors on the topic of intra-arterial chemoembolization before surgical treatment in patients with rectal cancer. It is noted that the analysis of the literature revealed a small number of works devoted to the chosen topic, despite the relevance of this problem for modern oncology.

Aim of the investigation. To evaluate associations of polymorphic variants of TNF (G308A), XPC (Lys939Gln), MTHFR (Ala222Val) genes with some biological features of gastric cancer. Materials and Methods. We evaluated polymorphic gene variants in 74 patients with verified gastric cancer or gastriesophageal junction cancer (Siewert III). Genotyping was performed by DNA isolation from venous blood leukocytes of the subjects followed by PCR with electrophoretic detection of the result. The association of polymorphic variants of genes with such biological features of the tumor as localization of the process, morphological type, degree of differentiation, type of tumor growth, presence or absence of lymphovascular or perineural invasion was evaluated. Results. Lys/Gln genotype of XPC gene (Lys939Gln) are 3.3 times more likely to develop gastric body cancer (p=0.04). Genotype GG of TNF gene (G308A) 5.3 times increases the development of gastric adenocarcinoma in comparison with other histological types (p=0.018), genotype GA of the same gene 5.2 times more often develop tumor with high-grade differentiation degree (p=0.032). Val/Val genotype of the MTHFR gene (Ala222Val) are significantly less likely to develop lymphatic/vascular invasion compared to carriers of the other genotype (p=0,029). Conclusion. The obtained data suggest that the genetic status of the patient itself may affect the biological characteristics of gastric cancer, which in turn may lead to a change in the patient’s treatment tactics.

The aim of the study was to evaluate the expression profile and search for markers of progression in tumor tissue in colorectal cancer. Materials and Methods - Tumor tissue samples obtained from videocolonoscopy in patients with verified colorectal cancer served as the material for the study. A total of 37 specimens were involved in the study. Of these, there were 14 samples with a “favorable” prognosis and 23 with an “unfavorable” prognosis. The quality and quantity of ribonucleic acid in the eluted solution were evaluated using an IMPLEN nanospectrophotometer (Germany). A SurePrint G3 HumanGeneExpv3 ArrayKit microarray kit (Agilent, USA) was used to assess gene expression. Microarrays were scanned on an InnoScan 1100 AL (USA) with subsequent image processing using Mapix Software (USA). For the procedure of searching for differentially expressed genes, we used the Moderated t-statistics method, which is implemented in the limma package. Results - Based on the scatter plot, the most divergent genes in samples with and without progression were selected. The following markers were selected: Marker9 (GZMB), Marker5 (CXCL11), Marker3 (SYNE4), Marker20 (MIR4432HG), Marker19 (ZDHHC11), Marker11 (COL17A1), Marker13 (ZDHHC11B), Marker17 (AGR3). Low-expressing genes mainly affected DNA replication and cell cycle pathways, whereas high-expressing genes affected metabolic pathways. Conclusions - We found an association of long-term outcomes with the expression of the gene combination ZDHHC11, MIR4432HG, and GZMB. Further study of this gene combination and increased sampling will allow the construction of a test system for predicting the course and response to treatment of patients with colorectal cancer.