Search

Teratoma is a tumor consisting of several types of tissues derived from one, two or three germ leaves, the presence of which is not peculiar to those organs and anatomical areas of the body in which the tumor develops. According to the WHO classification definition, immature teratomas are those containing embryonic tissues along with definitive, mature tissue structures. In histological WHO classification immature teratomas belong to germ cell ovarian tumors and are in­cluded into the group of teracomas. The prognosis is determined by the variant of the histological structure, the primary localization of the tumor, timely and adequate treatment.This article presents a clinical case of treatment of a young female patient with persistently recurrent pelvic teratoma.The presented observation demonstrates, on the one hand, the unpredictability of the course of the tumor process in embryonic tumors. On the other hand, there were demonstrated the possibilities of surgical treatment of another re­lapse of teratoma in a young patient with a massive tumor of the pelvic cavity in a situation where the hopes for a radical operation according to previous abdominal revisions seemed vague.

Purpose. Study of expression of protein nm23 inprimary and secondary foci of colorectal cancer (CRC) taking in consideration the clinical and morphological features of the disease and the possibility of predicting the risk of distant metastases. Material and methods. The study included postoperative material of 264 CRC patients with I–IV stages of cancer. Immunohistochemical staining performed by biotin-streptavidin immunoperoxidase method on the paraffin tissue sections of primary colon tumors and their metastases in lymph nodes and liver using antibodies against nm23 protein (H‑1 and H‑2) (“Dako”, Denmark). The results were evaluated by semiquantitative method based on the staining intensity and the number of antigen-positive cells and localization of immunoreactivity in cancer cells. Results. During the immunohistochemical study of primary tumors of the colon the increase of the accumulation of nm23 protein was observed in 53.4% (141/264) studied cases. In nmtastasis of CRC the main patterns of expression of a marker characteristic of the corresponding primary tumors was preserved. Survival curves, computed according to the method of Kaplan-Meyer showed that patients with nm23‑positive staining of tumors show a lower 5‑year overall survival than patients with negative immunoreactivity in the tumor. Indicators of disease-free survival in patients with CRC also deteriorated in nm23‑negative status of tumors compared to nm23‑positive status. Conclusion. The overexpression of nm 23 protein were freqently detected in metastasizing primary tumors of colon and their liver metastases and was associated with a high risk of developing distant metastases, and poor outcome of the disease and the deterioration of the postoperative overall and disease-free survival of CRC patients. A high expression level of this marker is a sign of unfavorable prognosis for CRC patients.

The role of extracellular matrix enzymes in the development of distant metastases of colorectal cancer was studied. The expression of types 2 and 9 matrix metalloproteinases was evaluated in primary colorectal adenocarcinomas (264 patients) and their metastases in the lymph nodes (127 patients) and liver (109 patients). Increased expression of matrix metalloproteinase-9 was associated with the probable progress of tumor process and with a low level of histological differentiation of the tumor (p=0.048), deeper invasion of the tumor in the intestinal wall (p=0.012), unfavorable outcome (p=0.037), high risk of metastases in the liver, and worse overall and uneventful survival of patients with colorectal cancer (p=0.001 and p=0.01, respectively). High expression of matrix metalloproteinase-2 was less significant for the invasive potential and prognosis of colorectal tumors. It is suggested that matrix metalloproteinase-9 is an important marker for analysis of the postoperative prognosis and risk of metastases in the liver in patients with colorectal cancer.

Expression of matrix metalloproteinases 2 and 9 was studied in primary tumors and their metastases in patients with colorectal cancer. The correlation of immunoreactivity with clinical morphological signs, prognosis of the disease, and development of metastases in the liver was analyzed. The level of expression and distribution of markers in patients with colorectal cancer with metastases in the liver differed from that in control patients without metastases. Enhanced expression of matrix metalloproteinases 2 and 9 was detected in colorectal cancer patients with distant metastases. Increased expression of matrix metalloproteinase 9 was associated significantly with low histological differentiation of the tumor, deeper tumor invasion, and was more often observed in tumors of colorectal cancer patients with unfavorable prognosis. Thus, matrix metalloproteinase 9 is a valuable marker for clinical observation and prognosis in patients with this location of the tumor process.

The role of expression of markers (beta-catenin, matrix metalloproteinase 9, collagen IV, and laminin) in primary colorectal adenocarcinomas and their metastases in the liver and lymph nodes of patients with colorectal cancer was studied. High level of matrix metalloproteinase 9 expression in zones of invasive growth of colorectal cancer was associated with high accumulation of beta-catenin in cancer cell nuclei in the peripheral zones of 30% studied tumors. The presence of nuclear beta-catenin and high content of matrix metalloproteinase 9 in the tumor were associated with abnormal accumulation of laminin in the cytoplasm and with the absence of basal membranes containing collagen IV. These changes were characteristic of colorectal cancer with high invasive metastatic potential. It was found that beta-catenin, matrix metalloproteinase 9, laminin, and collagen IV were important markers for prediction of the clinical course of colorectal cancer. The expression of proteins associated with risk of metastases in the liver was coordinated and most pronounced in zone of invasive front-line of tumors.

Immunohistochemical analysis of the expression of E-cadherin, beta-catenin, and CD-44v6 proteins was carried out for evaluating the metastatic potential of colorectal cancer cells. Specific features of expression, distribution, and interactions of adhesive molecules in primary tumors of the large intestine and their metastases in the liver and lymph nodes were studied. Reduction and complete absence of E-cadherin expression were much more often observed in patients with colorectal cancer with metastases in the liver than in patients without metastases. Cytoplasmic immunoreactivity and nuclear translocation of beta-catenin were increased in more than 80% cases with colorectal adenocarcinoma with metastases. These changes in the expression of E-cadherin and beta-catenin in tumor cells can be regarded as factors of unfavorable prognosis of colorectal cancer. No significant relationship between expression of CD-44v6 protein and metastatic potential of cancer cells was detected.