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Background. More than 80 % of cases ovarian cancer are detected at stage III–IV. One of the most important predictive factors is the cytoreductive surgery without residual tumor. Aim. To determine the selection criteria for cytoreductive surgery in the advanced ovarian cancer patients. Materials and methods. The study included 190 primary IIB–IV stage ovarian cancer patients who underwent surgical treatment in the oncogynecological department of the N. N. Petrov NMRC on Oncology in the period from August 2017 to August 2020. All patients underwent pelvic magnetic resonance imaging, chest and abdominal computed tomography, and diagnostic laparoscopy. Assessment of the peritoneal carcinomatosis index (PCI) was performed according to P. Sugarbaker. The outcome of cytoreductive surgery was determined by the size of the residual tumor: complete – without a macroscopically detectable tumor, optimal – residual tumor ≤1 cm, suboptimal – residual tumor ≥1 cm. Results. The complete or optimal cytoreduction achieved in 72.6 % of cases (48.9 % (93 / 190) and 23.7 % (45 / 190), respectively), suboptimal in 22 % (42 / 190) of cases, 5 % (10 / 190) only a diagnostic laparoscopy due to the initial underestimation of the tumor dissemination. In the entire sample PCI value ranged from 0 to 35 points, the median was 4 points (2; 11). In the group of optimal cytoreductions PCI ranged from 0 to 19 points, median – 3 points (2; 6), in the group of suboptimal from 5 to 35 points, median – 19.5 points (15; 23) (p < 0.0001, Mann–Whitney test). No optimal cytoreduction was performed in PCI >20 points. The optimal cut-off PCI point was 9.5 points (sensitivity 92.1 %, specificity 86.2 %, overall accuracy 87.4 %), if PCI ≤ 9 points – the operation will be hypothetically optimal, if PCI ≥ 10 then hypothetically suboptimal. The main cause of non-optimal interventions (n = 52) were: diffuse carcinomatosis of the small bowel and its mesentery – 73 % (38 / 52), carcinomatosis of the hepatoduodenal zone – 9 % (5 / 52) and a total of 16 % (9 / 52) were other non-resectable tumors (paraaortal, intrathoracic lymph nodes, invasion of the pancreas or pleura, lung metastases). Radiation diagnostic and intraoperative revision were comparable in 60.5 % (115 / 190) of cases. The sensitivity of radiological diagnostic methods in detecting of the small intestine lesions was 23.7 %, the specificity was 90 %, while for laparoscopic diagnostics, the sensitivity in detecting of the small intestine lesions was 93.3 %, and the specificity was 100 %. In assessing of carcinomatosis of the hepatoduodenal zone, the advantage belongs to radiation diagnostic methods: the sensitivity of computed tomography was 66.7 %, the specificity was 97 %, while the sensitivity of diagnostic laparoscopy was 0 %. Conclusions. Determination of a high score in assessing the index of peritoneal carcinomatosis, detection of damage to the hepatoduodenal zone, diagnosed mainly by radiation imaging methods, detection of diffuse lesions of the small intestine, determined mainly by laparoscopic diagnosis reduces the frequency of suboptimal cytoreductive operations from 67 % to 13 %.

Human mesenchimal stem cells (MSC) growth dynamics, immunophenotype change, genetic stability on early (3—4) and late (10—12) passages at in vitro culturing was studied. Results of bone marrow stromal fibroblasts culturing (n=25) from allogeneic transplant recipients with hematological disorders are presented. It has been shown, that in MSC population cultivated in vitro linear homogeneity of cells is observed on 3—4 passage, and remains on 10—12 passage. Clonal heterogeneities of MSC population and selective advantage of certain clones during culturing was revealed as aneuploidy analysis results of cultivated cells. The MSC culturing protocol used in our work allows receiving well characterized MSC number sufficient for clinical application as early as 3—4 passage. While using in the therapeutic purposes MSC later terms of expansion it is necessary to have close control of cells immunophenotype and genetic stability, which will allow avoiding in the future the undesirable long-term consequences of MSC cultures clinical use. The obtained data are discussed and compared with literature data.

Mesenchymal stem cells (MSC) have been widely used in different areas of medicine because of their immunosupressive properties and influence on regeneration of the damaged tissues. The improvement of MSC expansion standard protocols allowing receiving necessary MSC amount with the ability of self-renewal and multilineage differentiation potential for clinical application is required. The present article summarizes the current experience concerning uses of various culture mediums and supplements for the ex vivo MSC expansion. The author's experience of ex vivo MSC expansion using both standard medium DMEM with the supplementation of fetal bovine serum (FBS) and serum-free medium MesenCult MSC Basal Medium (Human) (StemCell technologies Inc.) with addition Mesenchymal Stem Cell Stimulatory Supplements (Human) is presented. The influence of medium type on MSC growth and immunophenotype is analyzed.

Cord blood cell composition is a short-lasting delivery stress consequence and is similar on adult G-CSF-mobilized peripheral blood.G-CSF realizes biological effect by number of secondary messengers, many of which are also natural effectors of stress. In this research comparative characteristics of cell composition, including lymphocytes subpopulations, CD34+ and CD133+ cells, hematopoietic progenitor cells colony-forming activity and mobilizing cytokines concentration (IL-8, MMP-2, MMP-9), between term newborns cord blood and G-CSF-mobilized peripheral blood is shown.Mobilized cytokines concentration ratio in combination with CD34+ cells count in cord blood and mobilized peripheral blood suggests that delivery stress possibly is not single cause of cord blood features.