Search

Background. Despite advances in surgical and therapy techniques, non-small cell lung cancer (NSCLC) is one of the most common cancers and the leading cause of cancer-related death. Therefore, it is increasingly important to search for markers that predict the risk of tumor progression. The study of the morphology of the epithelium of the bronchi of different calibers has great potential for solving this problem. The aim of the study was to comparatively evaluate the characteristics and frequency of occurrence of various combinations of morphological changes in the epithelium of the bronchi of large and small calibers in patients with lung squamous cell carcinoma and lung adenocarcinoma. Material and methods. lung samples were collected from 151 NSCLC patients (stage T1–4N0–3M0), who underwent surgery at the cancer Research institute, TNRMC. Various morphological changes in the bronchial epithelium were analyzed. Results. The study of the frequency of occurrence of various morphological changes in small-caliber bronchi showed that basal cell hyperplasia occurred in 90.8 % of cases. Diffuse isolated basal cell hyperplasia was observed in 33.8 % of cases. Focal basal cell hyperplasia was diagnosed in 38.4 % of cases. A combination of basal cell hyperplasia with squamous metaplasia was observed in 18.5 % of cases. The study of the frequency of occurrence in large-caliber bronchi demonstrated that basal cell hyperplasia was the most common morphological variant (93.4 %, including diffuse isolated basal cell hyperplasia in 33.8 % and focal basal cell hyperplasia in 38.4 %). The combination of basal cell hyperplasia and squamous metaplasia was found in 19.8 %. The combination of basal cell hyperplasia with squamous metaplasia and dysplasia was found in 1.3 % compared to the epithelium of small-caliber bronchi. Conclusion. The obtained results on the frequency of occurrence of morphological changes in large-caliber bronchi are of theoretical interest for further research to identify groups at high risk of progression of non-small cell lung cancer.

Surgery is the standard of care for non-small cell lung cancer (NSCLC). The overall survival rates especially in patients with locally advanced lung cancer are low. The resistance of cancer cells to chemotherapeutic drugs reduces the efficacy of treatment. Special attention is paid to the feasibility of assessing the tumor sensitivity to certain chemotherapy drugs. Currently, the most studied predictors are monoresistance and multidrug resistance genes, such as ABCC5, RRM1, ERCC1, BRCA1, TOP1, TOP2a, TUBB3 and TYMS.The aim of the study was to analyze the outcomes of combined modality treatment using radical surgery and personalized adjuvant chemotherapy for stage II–III NSCLC.Material and Methods. The study included 120 patients with stage II–III NSCLC, who underwent radical lung resection with mediastinal ipsilateral lymph node dissection. The patients were then divided into two groups. The main group consisted of 60 patients who received personalized platinum-based adjuvant chemotherapy based on the expression levels of the genes, such as ABCC5, RRM1, ERCC1, BRCA1, TOP1, TOP2a, TUBB3 and TYMS. The control group consisted of 60 patients who received postoperative chemotherapy empirically.Results. In the main group, disease progression occurred in 14 out of 60 patients, three-year disease-free survival (DFS) was 76.7 % (the median was not reached). In the control group, DFS was 53.3 % (28 out of 60 patients), the median was 31.0 (4–36 months); the differences were statistically significant: Logrank test χ2 =4.382 p=0.036. The overall three–year survival rate was 90.0 % in the main group (6/60 patients died) and 61.7 % in the control group (23/60 patients died), the differences were statistically signifcant: Logrank test χ2 =6.915, p=0.009.Conclusion. The personalized adjuvant chemotherapy resulted in the improved three-year relapse-free and overall survival rates in NSCLC patients.

Peritoneal carcinomatosis is associated with poor prognosis in gastric cancer patients. Stage IV gastric cancer (GC) is diagnosed in 39.8 % of patients; local metastases without evidence of distant metastases occur only in 18–20 % of stage IV gastric cancer patients.The purpose of the study was to estimate the efficacy of personalized chemotherapy in the combined modality treatment of patients with stage IV GC with peritoneal carcinomatosis.Material and Methods. Cytoreductive surgery was performed in 70 patients with GC with peritoneal dissemination. The control group patients (n=35) received postoperative chemotherapy with the FOLFOX regimen. The study group patients (n=35) received personalized systemic and intraperitoneal chemotherapy based on the expression of chemosensitivity and resistance genes.Results. The median survival time (18.7 months) in the study group patients was higher than that in the control group and in studies described in the world literature (CRS + HIPEC). Personalized chemotherapy improved median progressionfree survival (PFS) by 4.6 months (29.1 %) and median overall survival (OS) by 6 months (32 %) compared to FOLFOX regimen chemotherapy. In the study group, the 1-, 2and 3-year survival rates were observed in 35 (100 %), 9 (27 %) and 1 (3 %) patients, respectively.Conclusion. Personalized chemotherapy in the combined modality treatment can improve long-term treatment outcomes (longer median PFS and OS) in GC patients with peritoneal dissemination.

The aim of the study: to examine the relationship between the morphological diversity of non-small cell lung cancer and the frequency of lymph node metastasis in groups of patients with different epithelial conditions in the bronchi adjacent to the tumor. Material and methods. Surgical specimens from 90 patients with non-small cell lung cancer, who were treated in the Thoracoabdominal Department Of The Research Institute Of Oncology Of The Tomsk National Research Medical Center in the period from 2009 to 2017 were studied. The histological type of cancer was determined according to the who classification (2020). Lepidic, acinar, papillary, micropapillary, solid and solitary tumor cells were isolated in the parenchymal component of adenocarcinoma. In the parenchymal component of squamous cell carcinoma, 5 types of structures were distinguished: with keratinization, consisting of atypical cells of the prickly type without keratinization, consisting of atypical cells of the basaloid type, built of atypical cells with pronounced polymorphism, single tumor cells. Results. In patients with isolated basal cell hyperplasia, acinar (37 %), papillary (29 %) and solid (27 %) patterns were found less frequently in cases with metastatic regional lymph nodes compared to those without metastatic lymph nodes (63 %; p=0.05; 71 %; p=0.05; 73 %; p=0.01, respectively). In patients with isolated basal cell hyperplasia of the bronchial epithelium, in cases with the presence of lymph node metastasis in the parenchymal component of squamous cell carcinoma, structures 1 (with keratinization) (17 %), 2 (spiky pattern) (33 %) and 4 (polymorphic pattern) (29 %) were less frequently detected compared to those without metastases in regional lymph nodes (83 %; p=0.01; 67 %; p=0.02 and 71 %; p=0.01, respectively). In patients with a combination of basal cell hyperplasia and squamous metaplasia, a spiny pattern (65 %), a basaloid pattern (100 %), a polymorphic pattern (82 %) and single tumor cells (89 %) were more frequently detected in cases with metastatic lymph nodes than in cases without metastatic lymph nodes (35 %; р=0.04; 0 %; р=0.01; 18 %; р=0.01; 11 %; р=0.01, respectively). Conclusion. The data obtained clarify the available information on the significance of the morphological heterogeneity of the tumor for predicting the course of adenocarcinoma and squamous cell carcinoma of the lung.

Introduction. To date, one of the reasons for the ineffectiveness of chemotherapy in various malignant neoplasms, including lung cancer, is the formation of the multidrug resistance (MDR) phenotype in tumor cells, which is caused by the expression of ABC transporter genes.Aim. The aim of this work was to assess the expression of ABC-transporter genes during chemotherapy and to analyze the relationship with the effectiveness of chemotherapy and prognosis of the disease.Materials and methods. We used biopsy and surgical material from 91 patients with stage IIB–IIIA non-small cell lung cancer (NSCLC). The treatment regimen included: 2 courses of neoadjuvant chemotherapy (NAC), surgery and 3 courses of adjuvant chemotherapy (ACT) with platinum doublets. RNA was isolated from the samples, followed by quantitative PCR to assess the expression of genes ABCB1, ABCC1, ABCC2, ABCC5, ABCG1, ABCG2.Results and discussion. It was shown that the level of expression of the studied genes was not associated with the effect of NAC in patients with lung cancer, except for the ABCC5 gene, which showed a relationship at the level of a pronounced trend (p = 0.07). It was also shown that in the group of patients with an objective response to chemotherapy, the frequency of decreased expression of the ABCC1 (p = 0.01) and ABCC5 (p = 0.004) genes was statistically significantly higher than in the group of patients with stabilization. Further, using the Kaplan – Meier method, it was found that a decrease in expression is associated with high rates of metastatic-free survival (MFS). The highest rates of 5-year MFS (more than 85 %) are observed in patients with a decrease in the expression of the ABCB1 and ABCG2 genes, log-rank test p = 0.0007 and p = 0.002, respectively.Conclusion. Thus, it has been shown that changes in the expression of ABC transporter genes are associated with the effectiveness of chemotherapy and the prognosis of the disease. The data obtained can be used as a basis for the detection of potential drug targets.

Background. Neuroendocrine tumors (NETs) of the small bowel are rare and slow-growing tumors arising from intraepithelial endocrine cells that synthesize serotonin. Diagnosis of these tumors poses a signifcant challenge because they are often not diagnosed until an advanced stage, since the tumor may be asymptomatic or accompanied by non-specifc gastrointestinal complaints. Approximately 40 % of patients develop carcinoid syndrome due to hormonal activity of NETs. Surgery is the mainstay treatment of locoregional small bowel NETs. The fve-year survival rate of patients is about 85 %, with a median rate of 9.3 years.Case description. The female patient complained of facial redness and, to a lesser extent, redness of the skin of the trunk, accompanied by a feeling of heat, severe headache, lacrimation, and general feeling of weakness. The patient unsuccessfully received symptomatic treatment prescribed by various specialists (gynecologist, therapist, psychiatrist, endocrinologist, etc.) for 14 years. Based on the comprehensive examination, NET of the small bowel was diagnosed. The patient underwent radical surgery (pT2N1M0, stage IIIB, G2), but taking into account the unfavorable prognostic factors (metastases in the mesenteric lymph node, presence of carcinoid syndrome, elevated biochemical markers, Ki67 level = 6 %, presence of somatostatin receptors of 2 and 5 types in 60 % of tumor cells), the patient was further treated with somatostatin analogues.Conclusion. When small bowel NETs are suspected, especially with the evidence of carcinoid syndrome, every effort should be made to confrm the diagnosis using a combination of anatomical and functional tumor imaging with biochemical markers.

Gastric cancer (gc) is one of the most common cancers worldwide. The majority of newly diagnosed gastric cancer cases present with distant metastases. Peritoneal carcinomatosis (pc) is the most unfavorable type of progression of primary gc, which occurs in 14–43 % of patients. The purpose of the study was to highlight modern approaches to the treatment of gc with pc. Material and methods. We analyzed 136 publications available from pubmed, medline, cochrane library, and elibrary databases. The final analysis included 46 studies that met the specified parameters. Results. The modern approaches to the treatment of gc with peritoneal carcinomatosis were reviewed, namely: cytoreductive surgery (crs), combination of cytoreductive surgery and hyperthermic intraperitoneal chemotherapy (crs/hipec); neoadjuvant intraperitoneal/systemic chemotherapy (nips) and pressurized intraperitoneal aerosol chemotherapy (pipac). The results of large randomized trials and meta-analyses were analyzed. Benefits and limitations of these trials were assessed. Conclusion. The peritoneal cancer index (pci) and the level of cytoreduction are two key prognostic factors for increasing the median overall survival. By reducing tumor volume through cytoreductive surgery, it is possible to allow tumor cells to re-enter the proliferative phase of the cell cycle and make them more sensitive to antitumor agents. The hematoperitoneal barrier is the main reason that prevents the effective delivery of drugs from the systemic bloodstream to the abdominal cavity, which is why the effect of systemic chemotherapy on peritoneal metastases is extremely limited. Intraperitoneal chemotherapy offers a more effective and intensive regional therapy, creating a so-called «depot» of a chemotherapy drug, thereby prolonging the effect of the administered drugs. Cytoreductive surgery combined with hyperthermic intraperitoneal chemotherapy (crs + hipec) using the combination of surgical resection, cytotoxic chemotherapy, hyperthermic ablation of the tumor and hydrodynamic flushing, is a promising approach in the treatment of gc with peritoneal carcinomatosis.

To date, the role of human papillomavirus (HpV) in the development of lung cancer is still under investigation. The available published data do not provide evidence of the involvement of HpV in lung cancer pathogenesis. In Russia, there are no reports regarding the studies of viral contribution to lung carcinogenesis.The aim of the present study was to examine the presence of high-risk HpV infection in patients with non-small cell lung cancer (NSCLC).Material and Methods. The study included 30 patients with histologically verified stage IIBIIIA NSCLC. Normal and tumor lung tissue samples as well as whole blood samples from each patient were used. dNA was isolated from tissue samples using the QIAamp dNA mini Kit (Qiagen, Germany). Amplisens® reagent kits (Moscow, Russia) were used for dNA isolation and genotyping.Results. The presence of HpV dNA was detected in 3 (10.0 %) patients. HpV dNA was not detected in 27 (90.0 %) patients. HpV-16 genotype was observed in 2 HpV-positive patients, and HpV-33 was observed in 1 patient. A clinically insignificant viral load was found in almost all HpV-positive samples. The assessment of the virus integration in HpV16-positive lung cancer patients revealed mixed and integrated forms of the virus in the tumor tissue of these patients. The 5-year metastasis-free survival rate in all HpV-positive patients was 100 %.Conclusion. Our data showed HpV dNA prevalence rate of 10 % among NSCLC patients in the Russian population. The presence/absence of a viral component for lung cancer patients is a clinically significant parameter.

Aim. To study the ventilation function of the lungs in patients with varying degrees of severity of chronic obstructive pulmonary disease (COPD) and in patients with COPD combined with lung cancer (LC), as well as to establish the features of its disorders using spirography and body plethysmography.Materials and methods. A clinical and functional study of 57 individuals was carried out with 10 healthy patients (control group), 30 patients with COPD and 17 patients in whom LC was combined with COPD using the Masterlab Pro diagnostic complex (Erich Jaeger, Germany).Results. In patients with early COPD, a decrease in MEF75 (a ventilation parameter characterizing small airway patency) is the most informative. With the progression of bronchial obstruction, both restrictive and obstructive disorders, characterized by a decrease in FEV1, VC, a change in the structure of the total lung capacity in the form of an increase in the RV/TLC ratio such as an increase in the RV/TLC ratio and an increase in bronchial resistance were recorded. In patients with LC and mild COPD, pulmonary volumes, capacities, flow-volume loop and bronchial resistance parameters did not differ from patients with COPD with a similar bronchial obstruction. In patients with LC and more severe COPD, in contrast to patients suffering from a similar severity of COPD, a decrease in the patency of large, medium and small diameter bronchi (PEF, MEF25, MEF50, MEF75) was detected, which indicated development of generalized bronchial obstruction.Conclusion. Modern diagnostics of pulmonary ventilation disorders in patients with LC and COPD should be aimed at identifying the disease, and drug therapy should target maximum leveling of reversible components of bronchial obstruction in order to increase the functional reserve of the respiratory system and reduce the risk of postoperative complications caused by COPD.

Objective: to generalize the world experience of lung cancer screening using modern diagnostic methods. Material and Methods. Literature search was performed in Medline, Cochrane Library, Elibrary, PubMed systems, including publications describing the current capabilities of laboratory, instrumental and molecular genetic methods for early diagnosis of lung cancer, 58 of which were used to write this review. Results. The review highlighted the results of international randomized trials of lung cancer screening using sputum Cytology and low-dose computed tomography. Special attention was paid to the description of modern molecular and genetic biomarkers of lung cancer, such as epigenetic markers, microRNAs, the use of proteomics technology, metabolomics, microbiome research, and biomarkers from liquid biopsy. The analysis of the world literature confirming the prospects of methods of non-invasive diagnostics of tumor processes based on the analysis of exhaled air was carried out. Conclusion. The use of modern screening methods will significantly improve the effectiveness of early diagnosis and, as a result, cancer treatment. Starting treatment at an early stage can significantly increase the patient’s chances of recovery and faster social and labor adaptation. As a non – invasive method of cancer diagnosis, an electronic nose can act as a set of gas sensors and a certain method of information processing. An electronic nose based on relatively cheap gas sensors has comparable accuracy, ease of data collection, mobility, and other advantages compared to the above mentioned devices.

Thymolipoma is a rare benign pathological tumor of the anterior mediastinum and accounts for about 2–9 % of thymus tumors. Tumor is usually represented as soft tissue consisting of adipose and thymic tissues. Because of the asymptomatic presentation, patients are often diagnosed with a large tumor. Gigantism of the tumor due to long-term and progressive compression of adjacent organs and anatomical structures of this region can lead to dysfunction, and in some cases, to a complete block of their activity, which is fraught with a fatal outcome. Preoperative diagnosis is always a difficult task due to the lower sensitivity of CT scans and biopsies. The main method of treatment is radical surgical excision. The article presents a clinical case of a 51-year-old patient with a giant tumor of the left hemithorax with a long-term asymptomatic presentation, who was diagnosed with thymolipoma after surgical excision and final histopathological examination.

Surgery results of II-III stage lung cancer remain unsatisfactory and the chemotherapy does not improve the survival. The main obstacle is the use of the standard clinical parameters for the treatment strategy and not sufficiently effective selection of regimens for the chemotherapy. Monoresistance genes defining the tumor cells sensitivity to the chemotherapeutic drugs play a significant role in development of the lung tumor resistance. The review examines the mechanisms of transport, activation and targets of the chemotherapeutic drugs, identifies the key markers for predicting their effectiveness and possible use in the clinical practice. Monoresistance genes, such as ABCC5, RRM1, ERCC1, TOP1, TOP2a, TUBB3 and TYMS are characteristic of lung cancer. Clinical trials demonstrating the efficiency of their use as predictive markers for the lung cancer chemotherapy are described. A prospective study with a personalized adjuvant chemotherapy for lung cancer patients will be performed.

Relevance. Follicular dendritic cell sarcoma (FDcs) is an extremely rare tumor originating from dendritic cells of lymphoid follicles. It most commonly arises from lymph nodes, but may originate from a variety of extranodal sites. Case description. We present the rare case of a 42 year-old-man with extranodal FDcs of the lung. the patient underwent right extended pneumonectomy with resection of the pericardium and mediastinal lymph node dissection. We analyzed clinical, morphological and immunohistochemical characteristics and assessed Vimentin, cD23, cD35, cD68, cD21, cD1a, Ki67 expressions in the tumor cells. Immunohistochemical study showed that the tumor cells were positive for Vimentin, cD23, and cD35. the cD68 expression was observed in most tumor cells, and the cD 21 expression was less abundant in tumor cells. the proliferative activity of Ki67 was about 30 % of the tumor cells. there was no cD1a expression. thus, the diagnosis of FDcs of the lung with the involvement of 2 broncho-pulmonary lymph nodes was made. Conclusion. considering the following evidence: extremely rare malignant neoplasm involving the lung; slow-growing indolent disease; difficulty in preoperative diagnosis; extended surgery with resection of the main bronchus and vessels through the pericardial cavity; unfavorable risk factors (tumor is more than 6 cm, involvement of bronchopulmonary lymph nodes), adjuvant chemoradiotherapy was recommended.

For a long time, the standards of first-line drug therapy for patients with advanced non-small-cell lung cancer (NSCLC), excluding cases of mutations of EGFR, ALK and ROS1, were platinum-containing regimens. However, the chemotherapeutic regimes used in the therapy of the first line therapy of NSCLC have insignificant efficiency, and therefore the total survival rate of patients remains low: the response rate varies from 12 to 37%, the median survival rate without progression is from 4 to 7 months, the median of total survival – from 8 to 13 months.The use of a new class of immunooncologic drugs called immune checkpoint inhibitors has expanded the treatment options for NSCLC patients. One of the most effective immunooncologic drugs is pembrolizumab, which showed a clear advantage in increasing the overall survival rate in comparison with chemotherapy – median was 30.0 months vs. 14.2 months. (RR 0,63; 95% CI: 0,47–0,86; р = 0,002).The article presents the clinical observation of a patient with the diagnosis of «adenocarcinoma of the upper part of the right lung of the IIIA stage» with the progression developed in two years after the combined treatment. The patient received 29 courses of pembrolizumab immunotherapy in the first line of therapy with partial response achievement.The presented clinical observation confirms the efficacy of pembrolizumab in the first line of NSCLC treatment. Due to the immunotherapy with pembrolizumab there is no progression of the disease during more than 22 months with satisfactory quality of life and absence of pronounced toxicity of treatment.

Despite advances in the treatment of non-small cell lung cancer (NSC LC), prognosis of advanced lung cancer is extremely poor. The search for additional treatment options to prevent local recurrence and distant metastases is of great importance. Monoresistance genes, such as ABCC5, BRCA1, RRM1, ERCC1, TOP1, TOP2a, TUBB3, and TYMS play a significant role in tumor sensitivity to chemotherapy for NSC LC. The expression levels of these genes in tumor tissue should be assessed for personalization of adjuvant chemotherapy in patients with NSC LC.Case description. We present a clinical case of a 65-year-old patient diagnosed with non-small cell lung cancer who underwent extended combined surgery followed by 4 courses of personalized adjuvant chemotherapy. The expression levels of monoresistance genes (ABCC5, RRM1, ERCC1, TOP1, TOP2a, TUBB3, BRCA 1 and TYMS) determined by reverse-transcriptase quantitative real-time PCR (RTqPCR) were used as predictive markers of response to adjuvant chemotherapy regimen.Conclusion. Our case report demonstrated the feasibility of performing organ-preserving surgery followed by personalized adjuvant chemotherapy based on the expression levels of monoresistance genes as predictive markers of benefit from adjuvant chemotherapy.

The objective response rate to neoadjuvant chemotherapy (NAC) in patients with non-small cell lung cancer (NSCLC) is approximately 16 %. Therefore, the search for new predictive factors and markers that could precisely predict the NAC response and be relevant to the choice of the adequate treatment policy is of utmost importance. the purpose of the study was to analyze the relationship between the expression levels of chemosensitivity genes and NAC response in patients with non-small cell lung cancer. material and methods. The study included 30 patients with stage IIAIIIB NSCLC. Total RNA was isolated from normal and tumor lung tissue samples prior to NAC. The expression level of chemosensitivity genes, such as BRCA1, RRM1, ERCC1, TOP1, TOP2a, TUBB3, TYMS, and GSTP1 was evaluated by real-time reverse transcriptase quantitative PCR (RT-qPCR). results. A significant difference in the expression levels of the studied genes between patients with different NAC response was found. The objective response to therapy was observed in 67 % (10/15) of patients having no ERCC1 expression compared to those with ERCC1 expression (p

Introduction. The lack of low-cost and available methods for the diagnosis of lymph node metastasis from gastric cancer and the standards of surgery for proximal gastric cancer is a hot topic for research. the aim of research is to study the effectiveness of the method of pigment lymphography and to develop criteria for determining the extent of surgery in the treatment of locally advanced proximal gastric cancer. Material And Methods. The study included 68 patients with locally advanced proximal gastric cancer. All patients were divided into 2 groups according to the extent of surgery: proximal subtotal gastric resection and gastrectomy. For intraoperative detection of lymph node metastases, the method of peroral pigmented lymphography was used.Results. The sensitivity, specificity and accuracy of pigment lymphography in detecting lymph node metastases were 99.0 %, 89.8 % and 93.4 %, respectively. The developed algorithm for the choice of the extent of surgery for proximal gastric cancer demonstrated advantage of proximal subtotal resection over gastrectomy in terms of overall survival (66.4 ± 13.2 % versus 48.7 ± 16.9 %, p=0.021). Conclusion. Peroral pigmented lymphography was shown to be an effective method in detecting lymph node metastases from gastric cancer. Proximal subtotal gastrectomy in patients with locally advanced gastric cancer improved long-term treatment outcomes.

Аim.The incidence of cardioesophageal cancer has been steadily increasing over the past few decades, posing significant diagnostic challenges.Materials and metods. X-ray examination remains the primary imaging modality for the initial diagnosis of gastric tumors. However, the modern imaging techniques, such as ultrasound (US) and spiral computed tomography (SCT) are needed to assess the extent of tumor invasion into the gastric wall and adjacent organs as well as lymph node involvement and metastatic spread.Conclusion.The role of US and SCT in diagnostic imaging of cardioesophageal cancer was studied and the examination algorithm using US and SCT with conventional X-rays was offered.

We present a clinical case of non-small cell lung cancer treated with personalized adjuvant chemotherapy. The expression levels of drug resistance genes, such as ABCC5, RRM1, ERCC1, TOP1, TOP2a, TUBB3 and TYMS in tumor tissue from non-small cell lung cancer were used as predictive markers. This case shows the usefulness of determination of the expression of drug resistance genes before and after preoperative chemotherapy, and it is important in terms of determining the individual sensitivity of the tumor to chemotherapy drugs, thus allowing the treatment plan for the individual patient to be tailored.

We studied the expression of multidrug resistance genes (MDR) and monoresistance genes in normal bronchial tissue and tumor tissue of the non-small cell lung cancer (NSCLC) after neoadjuvant chemotherapy (NACT) (vinorelbine-carboplatine). The study included 30 patients with NSCLC (Т2–4N0–3M0)). Normal bronchial tissue, normal lung tissue and tumor tissue collected during surgery following neoadjuvant chemotherapy (NACT) served as a material of the study. The expression levels of MDR genes (ABCB1, ABCB2, ABCC1, ABCC2, ABCС5, ABCG1, ABCG2, GSTP and MVP, and monoresistance genes (BRCA1, ERCC1, RRM1, TOP1, TOP2A, TUBB3 and TYMS) were estimated by quantitative reverse transcriptase PCR (RT-qPCR). The expression levels of some MDR genes and monoresistance genes (АВСВ1, АВСВ2, ABCG1, ERCC1, GSTP1 and MVP) were significantly higher in the bronchi than in tumor tissue. The expression of ABCG1, ABCG2 and ERCC1 genes was higher in patients with T1-2 cancer than in patients with T3-4 cancer. Patients with adenocarcinoma had higher expression of BRCA1, MVP and ABCB1 genes than patients with squamous cell lung cancer. A tendency towards reduction in the expression level of MDR-genes and monoresistance genes was observed in patients with partial tumor regression compared to that observed in patients with stable disease. These findings were consistent with the previous data on reduction in the MDR-gene expression after chemotherapy with a good response in breast cancer patients.

The comparative analysis of immediate and long-term clinical outcomes in 68 patients with stage III non-small cell lung cancer was carried out. The study group comprised 36 patients who received 2 cycles of neoadjuvant vinorelbin/carboplatin-containing chemotherapy with subsequent assessment of objective response. If complete and partial responses were achieved and in cases with stable disease, patients underwent radical surgery followed by 3 cycles of the same regimen of adjuvant chemotherapy. The control group consisted of 32 patients who underwent surgery alone. The results obtained showed efficacy of the combined modality treatment due to significant decrease in the rate of local recurrences, distant metastases and increase in the rate of overall survival as compared to the group with surgery alone.

Comparative analysis of the relationship between the character of dysregeneratory changes occurring in the bronchial epithelium adjacent to the tumor and the development of recurrence of squamous cell and grandular carcinomas of the lung was carried out. The study showed no any relationship between such parameters as tumor size, presence of lymphogenic metastasis, tumor stage and tumor recurrences. The incidence of recurrence in non-small cell lung cancer indirectly related to the character of dysregeneratory changes in the respiratory epithelium of the bronchial mucosa outside the tumor. High incidence rates of squamous cell carcinoma and adenocarcinoma of the lung were observed in cases with combination of basal cell hyperplasia and squamous metaplasia (BCH+SM+).

A case of successful surgical treatment for peripheral lung cancer with concurrent coronary artery bypass for ischemic heart disease has been presented.

A rare clinical case of squamous cell lung cancer with metastases to the skin of the gluteal region after combined modality treatment has been presented. This case is of interest due to atypical localization of metastases, histological tumor type and disease prognosis.

The life quality of patients with lung cancer after the intraoperative irradiation with a dose 15 Gy during the surgery (loband pneumonoectomies) for the period of two years has been studied. The form developed by the European Organization for Research and Treatment of Cancer EORTC QLQ-C 30 and the QLQ-LC 13 module were used. It is shown that the life quality of patients with lung cancer after combined therapy is determined mainly by the volume of surgery made, rather than by the adjuvant therapy conducted. Of great importance for patients was the period needed for the adaptation of the organism to new living conditions. In general, no significant differences in the main life quality indices were revealed among patients of both groups. Based on the results obtained, one can say that the addition of surgery with intraoperative radiotherapy with a total focal dose 15 Gy does not lead to the considerable worsening of life quality of patients and can be recommended for clinical application.

Purpose: Currently, more researchers are attracted by the possibility of assessing the sensitivity of a lung tumor to certain chemotherapy drugs and their personalized choice based on an assessment of this sensitivity. The purpose of this study was to explore the prognostic significance of the level of 8 chemosensitivity genes' expression in patients with non-small cell lung cancer (NSCLC)., Methods: The study included 59 patients with NSCLC IIB-IIIA stage. RNA was isolated from the surgical material of the tumor and normal lung tissue. The expression level of 8 chemosensitivity genes BRCA1, RRM1, ERCC1, TOP1, TOP2a, TUBB3, TYMS, GSTP1 was evaluated using RT-PCR., Results: Cases with higher metastasis-free survival rates showed a significantly low level of expression of the ERCC1, BRCA1, GSTP1 genes (p=0.0004, p=0.01, p=0.01). In addition, analysis of the overall survival revealed that the highest rates were achieved in patients with overexpression of the ERCC1 gene. The overall survival in these patients was 86%, versus 55% in the other group and the differences were statistically significant (p=0.002). No statistically significant differences were found for the remaining genes., Conclusion: Thus, a comprehensive assessment of the chemosensitivity genes expression is important not only from the point of view of understanding the heterogeneity and complexity in the field of molecular biology of NSCLC, but also for a more accurate prognosis and course of the disease.