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Aim      To analyze fatal outcomes of myocardial infarction (MI) in patients after COVID-19.Material and methods  Data of pathoanatomical protocols and case histories of 612 patients managed in clinics of the Siberian State Medical University from 01.01.2020 through 31.12.2021 were studied. 68 (11%) of these patients were transferred to the clinics from respiratory hospitals for rehabilitation after the novel coronavirus infection. The main condition for hospitalization was a negative polymerase chain reaction (PCR) test for SARS-CoV-2 virus RNA. 544 (89%) of patients had no history of COVID-19. The incidence of MI was 14% (7/68) in patients after COVID-19 and 10% (74/544) in patients who have not had it. In pathoanatomical protocols and case histories of 81 patients diagnosed with MI, macroscopic and histological changes in the heart, pericardial cavity, coronary arteries, and laboratory results were evaluated. Statistical analysis was performed with a STATISTICA version 10.0 software package.Results The patients after COVID-19 had a lower percentage stenosis, more frequent coronary artery thrombosis, and a positive D-dimer. According to our data, MI emerged 10.0 (2.0; 21.0) days after admission to the hospital, had a larger area, always was transmural, and rapidly resulted in death; the time of necrotic changes in all cases did not exceed 24 h. Upon admission to the hospital, the PCR test for SARS-CoV-2 virus RNA was negative, and acute inflammatory changes were stopped at the previous stage of hospitalization.Conclusion      The risk of coronary thrombosis in patients after COVID-19 remains after the relief of acute inflammatory response and elimination of the infectious agent, thereby creating a risk of MI, that often leads to a fatal outcome.

A case of organ-preserving treatment of prostate stromal tumor with an uncertain malignancy potential is presented in the article. The patient underwent laparoscopic resection of the prostate neoplasm. Mesenchymal prostate tumors are rare. Their diagnosis is difficult due to the lack of experience of both pathologists and urologists. Mesenchymal neoplasms include prostate stromal tumors of uncertain malignant potential. Due to the rare occurrence of these tumors and the difficulties of its diagnosis, there is no recommended treatment algorithm. Taking into account the anatomical location of the tumor, the patient underwent enucleoresection without removing the entire prostate. The control examination, including pelvic MRI, was carried out after 3 months. There were no signs of disease progression. The presented clinical case of prostate preservation during resection of a prostate stromal tumor of uncertain malignancy potential demonstrates a possibility of organ-preserving procedures in such a rare disease. However, due to a small number of publications and a short follow-up period, these tumors require further study and evaluation of long-term results.

Triple negative breast cancer (BC) is a heterogeneous group of carcinomas that substantially differ in clinical, morphological, and molecular genetic characteristics, tumor response to chemotherapy, and prognosis. These features define triple negative BC today as a special clinical problem that has not yet been completely solved. The review is devoted to the description and systematization of the currently available literature data concerning molecular and genetic features and differences in a fairly significant group of breast carcinomas with a severe, aggressive course and an extremely poor prognosis. The review presents the existing molecular genetic classification of triple negative BC based on the results of studies conducted by M.D. Burstein (2015) and B.D. Lehmann (2016), which determines the presence of 4 tumor-specific subtypes: basal-like type (type 1 and type 2), mesenchymal, and luminal androgen receptor types. The paper reflects the main stages of transformation of the proposed classification over the past decade and an attempt has been make to describe the molecular characteristics of each subtype of these carcinomas.

Crosstalk between the estrogen receptors and the receptor tyrosine kinases, including vascular endothelial growth factor receptor type II (VEGFR2), is a key mechanism in breast cancer resistance to antiestrogen therapy with tamoxifen. A high level of VEGFR2 expression in a tumor serves as a marker of tamoxifen resistance. The tamoxifen efficacy prognostic value of functional polymorphisms in the VEGFR2/KDR gene has not been established. Using qRT-PCR, we detected the rs2071559 and the rs2305948 variants and the levels of KDR gene expression in 122 breast tumor tissue samples from cohorts of patients with progression (distant metastases or relapse) and patients with no progression during tamoxifen therapy. The expression levels of VEGFR2 protein were analyzed by immunohistochemistry. The frequency of heterozygous and mutant genotypes of the rs2305948 SNP was significantly higher in patients without progression than in the cohort with progression. KDR rs2305948 was associated with high survival rates in breast cancer patients. A correlation between the mRNA of the ESR1 and KDR genes in patients without progression was detected. The results indicate the prognostic value of rs2305948 and its potential contribution to the tumor phenotype sensitive to tamoxifen.

The paper considers the data available in the modern literature on studies of potential molecular predictors for renal cell carcinoma (RCC). Investigations of cell death markers, namely; Bcl-2 as an inhibitor of apoptosis, are of interest. Its high expression correlates with a more favorable prognosis. Inactivation of Berclin 1 that is an authophagy indicator in intact tissues gives rise to t high risk for tumorigenesis. At the same time, high Beclin 1 expression in the tissue of the tumor itself results in the lower efficiency of performed chemotherapy. Excess annexin A2 in the tumor promotes the growth and invasion of cancer cells. Patients with tumor over-expression of SAM68 protein involved in cell proliferation have a lower overall survival rate. The lifespan of patients without distinct metastases survive significantly longer in the overexpression of epithelial cell adhesion molecule (EpCAM). High PD-L1 protein expression on the cell membrane is considered to be a potential marker of effective immunotherapy for RCC.