To date, genome instability is considered to be a common feature not only of tumor cells, but also of non-malignant cells of cancer patients, including peripheral blood lymphocytes (PBLs). The issue of the association between genome instability in tumor cells and PBLs, as well as of its relationship with tumor progression remains poorly understood. Aim: To evaluate the level DNA damage in tumor cells and PBLs of endometrial cancer (EC) patients with regard to clinical and morphological characteristics of the patients. Materials and Methods: DNA damage was assessed in 106 PBLs samples and 42 samples of tumor cell suspension from EC patients by comet assay. PBLs from 30 healthy women were used as control. The level of DNA damage was expressed as the percentage of DNA in the comet tails (% tail DNA). Results: It was revealed that the amount of DNA damage in PBLs of EC patients was 2.2 times higher in comparison with that of healthy donors (8.3 ± 0.7 and 3.7 ± 0.4% tail DNA, respectively) (p < 0.05). In this study, no association between the levels of DNA damage in endometrial tumor cells and PBLs was observed (r = 0.11; p > 0.05). The amounts of DNA damage both in tumor cells and PBLs were not related to the degree of tumor differentiation as well as the depth of myometrial invasion, but depended on the body mass index (BMI) of EC patients: high level of lesions was observed in patients with elevated BMI values. Furthermore, the level of DNA damage in tumor cells was associated to familial aggregation of cancer and was significantly higher in endometrial cells from patients with family history of cancer vs that from EC patients with sporadic tumors (32.3 ± 2.9 and 22.8 ± 1.8% tail DNA, respectively) (p < 0.05). It was also found that for women who had high level of DNA damage in PBLs, the risk of EC was greater (odds ratio value of 3.5) compared to those with low level of such lesions. Conclusion: Genome instability that appears as an increased level of DNA damage in tumor cells and PBLs of EC patients is associated with BMI and family history of cancer and can reflect a predisposition to cancer.
Summary. Background: It is known that more than half of the genes encoding human proteins are regulated by various microRNAs (miRNAs, miR), the expression of which may be associated with various pathological conditions. At the same time, the question of assessing the relationship between the expression of particular miRNAs and the aggressive molecular subtype of endometrial cancer remains open. Aim of the study was to determine the relationship between the expression of miR-34a, miR-125b, miR-142 and miR-101 in endometrioid carcinomas of the endometrium (ECE) and the features of the disease course. Materials and Methods: The samples of surgical material of 51 patients with ECE (mean age 59.8 ± 7.1 years), I–III stage were investigated using morphological, immunohistochemical methods, real time polymerase chain reaction (PCR), cytofluorometry. Results: In endometrial tumors with high proliferation index (> Me), the expression of miR-34a, miR-142 and miR-125b significantly decreased (1.8, 2.7 and 1.5 times, respectively) compared with those in ECE with low proliferation index (< Me). The expression of all studied miRNAs was lower in G3 tumors and those that deeply invaded the myometrium compared to G2 carcinomas and tumors with an invasion of < 1/2 myometrium and significantly decreased in tumors of patients with low stage III compared with stage I–II. The high (> Me) microvessel density in ECE was associated with a significant decrease of miR-125b and miR-101 expression, and the presence of signs of epithelial-mesenchymal transition — with a decreased expression of miR-34a and miR-101. Conclusions: The study revealed a significant heterogeneity of expression of miR-34a, miR-125b, miR-142 and miR-101 in ECE, which is associated with changes in morphofunctional characteristics of endometrial carcinoma.
The objective: to improve an effectiveness of therapy and quality of life of patients with infiltrative cervical cancer using radical hysterectomy accomplished with nerve-sparing methodology. Patients and Methods: Ninety patients with histologically verified infiltrative cervical cancer were cured with radical hysterectomy (RHE) in the Department of Oncogynecology of National Cancer Institute (Kyiv, Ukraine) in 2012-2016. The age of the patients was from 26 to 65 years (an average age of 42.61±1.06). The patients were distributed in 2 groups: group I treated with nerve-sparing radical hysterectomy (NSRHE), 45 patients, the main group; group II treated with radical hysterectomy (RHE III), the control group, 45 patients. The prognostic indexes in the groups were similar. Results. NSRHE that included the dissection of cardinal ligament, separation of dorsal and anterior layers of uterovesical ligament allowed separate uterine branch of inferior hypogastric plexus, preserve an innervation of urinary bladder and prevent the malfunction of its contractile function at postoperative period. Conclusion. The data of the urodynamic study using cystomanometry performed at pre- and early operative periods have shown that surgical treatment of patients with infiltrative cervical cancer with preservation of the major elements of pelvic autonomic plexuses allows significantly decrease the rate of postoperative urogenical malfunctions. Key words: nerve-sparing radical hysterectomy, cervical cancer, cystomanometry.
Summary. The aim of this study was to determine the rates of recurrences of stage I endometrial cancer (EC) and features of their localization depending on the clinical and pathological characteristics of the tumor and methods of patients’ treatment. Patients and Methods: The study included 968 patients with stage I endometrioid EC, who underwent surgical treatment in the Department of Oncogynecology of the National Cancer Institute in 2015–2019. Surveillance of patients lasted from January 2015 to December 2020, with a minimum follow-up period of 1 year from the date of surgery. Adjuvant radiation or chemotherapy was performed depending on the clinical and pathological characteristics of the EC case. Results: During the follow-up period, recurrences were observed in 7.0% of cases and were most often found in stage IC of low differentiation grade. It was found that during surgical treatment without adjuvant therapy relapses occurred in 12–36 months after the start of treatment, with adjuvant radiation therapy — in 6–18 months, and with adjuvant chemotherapy — in 32–60 months. Recurrences most often occurred in patients with EC who underwent surgical treatment in combination with chemotherapy (p < 0.05). The lowest number of recurrences was recorded among patients who underwent surgery as an only treatment. The best 5-year survival rate was observed in the group of patients with surgical treatment (93%), and the worst — in the patients treated with combination of surgery and chemotherapy (57%). In patients without recurrences, the survival rate after treatment was 97%, while in patients diagnosed with relapses, the survival rate was 65%. Conclusion: Despite the predominantly favorable course of EC stage I, some patients develop relapses. The rate and localization of recurrences depend on the histological structure of the tumor and treatment regimens of the EC patients.
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