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Objective: To comprehensively assess the functional molecular biological status of different tumor cell populations in glioblastoma samples., Material and Methods: The activity of Ki-67, Bcl-2, and BCL6 expression was determined in 20 tumor samples from patients with glioblastoma. After that, a spatial analysis of heterogeneity in the expression of these markers in different tumor cell populations was carried out using computer and software tools and calculating the percentage of cells (PC) expressing this marker (Ki-67 labeling index (LI)) and a modified histoscore in different cell clusters., Results: Analysis of heterogeneity in the distribution of Ki-67, Bcl-2, and BCL6 expression could identify five cell clusters differing in the expression level of the above-mentioned markers. The most active cluster was the perivascular one (the highest mean Ki-67 LI (22.23±1.4%) and histoscore (118.59±3.36%); BCL6 PC and histoscore (17.4±1.4 and 79.32±4.86%, respectively). The least proliferative activity was observed in the perinecrotic cluster (Ki-67 LI (6.83±0.5%) and histoscore (62.46±2.25%)), while the neighboring transient necrotic cluster displayed sufficiently active proliferative processes (Ki-67 LI (18.39±0.56%) and histoscore (112.65±2.76%)). In addition, the transient vascular cluster was noted for a low proliferative activity (Ki-67 LI (8.37±0.35%) and histoscore (75.48±2.04%)). Finally, the intermediate cluster was characterized by the mean values of all parameters (Ki-67 LI (10.68±0.39%) and histoscore (95.73±2.37%). It should be noted that the differences in the expression activity for markers in these clusters were statistically significant., Conclusion: The perivascular cluster carries the greatest potential for tumor progression and recurrence, which agrees with the data available in the literature: the perivascular zone is the most important niche for glioma stem cells that make a considerable contribution to the malignant potential of glioblastoma. Tumor pathogenesis and morphogenesis are a complex interweaving of interrelated factors, the realization of which within the framework of a multi-level heterochronic pathological process leads to the segregation of tumor cells and to the appearance of separate cell populations described in this paper.

Temporal and parahippocampal glial tumors at early morphological stages of their development may mimic the clinical and neuroimaging picture of limbic encephalitis. Delayed diagnosis of glioblastoma can have a negative impact on the prognosis of the disease, which is why there is a need to find approaches for its earlier detection. The aim of this paper is to analyze possible difficulties and errors in the differential diagnosis of autoimmune encephalitis (AE) and glioblastoma based on literature data and our own clinical observations. Features such as onset of the disease at a young age, subacute development of symptoms, response to immunosuppressive therapy and the MRI imaging of bilateral T2 hyperintense changes in the limbic areas are typical for AE, but do not exclude the diagnosis of a primary tumor of the central nervous system. Therefore, caution should be exercised regarding the likelihood of a primary brain tumor when patients of any age group present with symptoms characteristic of AE, especially if no specific for AE antibodies are detected. To shorten the time to diagnosis, a multidisciplinary approach, critical analysis of clinical data, a shortening of the examination interval and an increase in the frequency of imaging follow-up examinations are required.

The paper presents the results of neurospecific proteins S-100 and glial fibrillary acidic protein (GFAP) determination in blood serum samples of 145 neuro-oncology patients and 69 healthy people. The significant elevation of S-100 and GFAP was revealed in glioblastoma (G IV) patients compare to the patients with anaplastic astrocytoma (G III), benign meningioma (GI), celebral metastasis and healthy controls. The concentration of S-100 in blood serum of patients with anaplastic astrocytoma, benign meningioma, and celebral metastasis did not significantly differ among themselves, and in relation to the control group there was a significantly increase only in patients with cerebral metastasis. GFAP was characterized by high frequency of its detection in patients with glioblastoma (83%) compare to other groups of patients and healthy donors, in which it was practically undetectable. These data suggest the possibility of using GFAP as a marker of glioblastoma and S-100- as an additional biochemical criteria of cerebral lesions in oncology patients.

The paper describes a case of metastatic glioblastoma in a 64-year-old woman who died in the early postoperative period after tumor removal. Lung metastases were diagnosed at autopsy. The tumor invading the superior sagittal sinus, a large venous reservoir shunting blood to the superior vena cava, was a factor contributing to extracranial extraneural hematogenous dissemination of the tumor in this case.

Radiochemotherapy is leading the universal research effort in fighting lethality: it is improving relapse-free survival of patients with inoperable glioblastoma, the most pernicious brain tumor in adults. Its effectiveness was found to depend on expression of Mgmt gene of tumor DNA reparation following radiochemotherapy and adequate medication based on the molecular phenotype of tumor. Our study involved a 40-year old male with a low level of Mgmt gene expression as established by stereotactic biopsy. The patient received hypofractionated three-dimensional conformational proton therapy with the benefit of temozolomide (140 mg/24 hr). Subsequently, the dose was raised to 360 mg/24 hr, on days 1-5 of the cycle. Contrast-enhanced MRI examination established significant diminishing of the size of tumors on completion of cycles 7 and 8; patients felt better, memory and blood indices improved. As of the time this paper was written, relapse-free survival was 17.5 months, as compared with the literature data on inoperable glioblastoma--5.5 months.

The paper analyzes the capacities of computed tomography (CT) and magnetic resonance imaging (MRI) in the postoperative period to evaluate the efficiency of surgical removal of the most malignant type of gliomas of the cerebral hemispheres. A total of 45 patients with different histological forms of cerebral hemispheral gliomas were examined, 37 of them with glioblastomas. Comparison of the results obtained by CT and MRI within the first 24 hours indicated that the latter was of greater informative value in all cases. At the same time only the use of a strict methodological approach to postoperatively estimating the remaining portions of glioblastomas makes it possible to apply these two methods as objective criteria for evaluating the efficiency of removal of a glioblastoma and hence the efficiency of subsequent therapeutic protocols. Contrast-enhanced MRI may be regarded as the method of choice in the primary assessment of patients with suspected recurrent glioblastoma.

Introduction. glioblastomas multiforme (grade Iv gliomas) are common and the most aggressive primary tumors of the brain with very unfavorable prognosis. In all previously published papers on epileptiform activity in glioblastomas, not enough information on encephalogram results is presented.Aim. To study the features of epileptiform activity in patients with glioblastomas and development of a plan for further study of these patients.Materials and methods. An analysis of articles from Elsevier, Embase, Scopus, The Cochrane Library, global Health, Russian Science Citation Index (RSCI) databases, Scholar, google, web of Science, pubmed search engines and scientific electronic library CyberLeninka was performed. materials were selected considering journal indexing system and citations, scientific novelty of the studies, statistical significance of the results. publications repeating data from previous articles or describing animal experiments were excluded from analysis.Results. During the study, data on mechanisms of epileptiform activity pathogenesis, predisposing factors (tumor location in the temporal, frontal or parietal lobes, IDH-1 and / or IDH-2 gene mutations), treatment options in patients with glioblastomas were systemized. Additionally, and original plan of data accumulation for clinical studied taking into account limitations of the previous studies was developed to increase quality of results interpretation.Conclusion. Epileptiform symptoms in glioblastomas negatively affect patients’ quality of life and lifespan. Currently, researchers actively search for an effective method of treatment of epileptic seizures in patients with glioblastomas. The most effective is combination of temozolomide with valproate and levetiracetam due to good control of seizure frequency, low toxicity, and pharmacological synergy between the drugs.

Gliomas are the most common primary tumors of the central nervous system. Their aggressive form – glioblastomas is characterized by an unfavorable prognosis and a high frequency of relapses. It is believed that prior traumatic brain injury is one of the possible factors for the subsequent development of glial brain tumors. Several authors have proposed several criteria for establishing a possible causal relationship between traumatic brain injury and gliomas. However, the actual role of antecedent brain injury in the pathogenesis of this tumor type is still a matter of debate. It has been suggested that traumatic injuries cause an active and prolonged inflammatory process, while disrupting the permeability of the blood-brain barrier, which leads to exposure of the brain tissue to carcinogenic (toxic) substances, various growth factors or cells of the immune system circulating in the bloodstream, which ultimately can lead to malignant transformation of glial cells. One of the evidence for this hypothesis is supported by reports of meningiomas located adjacent to posttraumatic meninges and cerebral scars. In this paper, we will try to elucidate the potential relationship between traumatic brain injury and the formation of glial brain tumors.

The paper deals with morphological changes in glioblastoma multiforme following megavoltage radiotherapy (1.25 and 25 MeV). Both tumour cell death and glioblastoma multiforme tissue destruction resulted from 6,000-7,500 rads megavoltage irradiation. Depending upon the time following irradiation the histological study showed the prevalance of either acute aseptic inflammation, or coagulation necrosis, or degenerative changes leading to the formation of glial and connective tissue scars and dystrophic calcification. Glioblastoma multiforme, rich in cell elements with hyperchromatic nuclei and having a high mitotic activity, proved to be the most radiosensitive tumour. The highest radioresistance was noted in tumours with a tendency to haemorrhages and necroses.

Current paper presents the results of the system development for intracranial implantation aimed on therapy and prevention of brain gliomas relapse. The main property of the system, in prospective, will be to direct the growth of glioma cells localized in the region adjacent to the site of the removed tumor along the fi bers towards the proximal part of the fiber-optic scaffold (neuroport). Such approach will allow carrying out cells diagnostics by the photoluminescence signal and provide subsequent destruction of malignant cells by photodynamic action. Besides, this system could be used for monitoring the processes occurring in the probed area in order to control the possible relapses. The localization of cells along the fi ber structures covered with gelatin compound, which is the source of amino acids during cultivation, was shown during the glioma cells growth dynamics study. Moreover, four different designs of intracranial scaffold models, serving as ports for diagnostic and therapeutic laser radiation delivery, were developed and successfully tested in the framework of the research. The results obtained on the rats brain with induced tumors (glioma C6) after neuroport implantation demonstrate sufficiently intense fluorescence in the tumor bed after intravenous injection of the nonmetallic sulfonated phthalocyanine based photosensitizer, and a pronounced photodynamic effect leading to total destruction of the tumor. In this way, the results of this study open the prospects of creating the neuroport with an internal fi ber structure that focuses the glioma cells growth.

The paper analyzes treatments for glioblastoma. The role of resurgery, reradiotherapy, and antitumor drug therapy in the treatment of recurrent glioblastoma has been studied. Multicenter trials of the use of temozolamide and temozolomide in combination with bevacizumab have been reviewed. It has been shown that the use of bevacizumab to treat patients with glioblastoma makes it possible to increase survival and to improve quality of life.