Results of ELISA investigation of the pretreatment sPD-1 and sPD-L1 content in blood serum of 133 bone neoplasms patients aged 6-70 years and 57 practically healthy control persons aged 12-70 years are described. In 14 patients the neoplasms were of a benign character, in 16 - borderline giant-cell bone tumor was diagnosed, and in 103 - malignant bone lesions including 39 osteosarcomas and 42 chondrosarcomas were revealed. The sPD-1 receptor concentrations in blood serum did not differ between control healthy persons and primary bone tumor patients, while serum sPD-L1 level in bone tumor patients was statistically significantly increased (p<0.0000001). By means of ROC curve construction a cut-off sPD-L1 level of 16.5 pg/ml was found that imposed 75,9% sensitivity and 75,4% specificity in relation to healthy control. However, the frequency of sPD-L1 levels exceeding 16.5 pg/ml was approximately similar in benign, borderline and malignant bone tumor patients. Analysis of the pattern of sPD-1 and sPD-L1 circulation in the peripheral blood of patients with the most prevalent malignant bone tumors - osteosarcoma and chondrosarcoma - demonstrated that in both sarcoma types sPD-L1 level was significantly higher than in control, but in patients with chondrogenic tumors the soluble ligand sPD-L1 dominates in the circulation, while in those with osteogenic tumors - sPD-1 receptor prevails. In particular, sPD-1 level is statistically significantly higher in patients with typical osteosarcoma than in those with typical chondrosarcoma (p=0.002437), and sPD-L1/sPD-1 concentration ratio in chondrosarcoma is highly significantly more than 2-fold higher than in osteosarcoma (0.81 and 0.35 respectively; p=0.000284). The sensitivity of sPD-L1 ≥16.5 pg/ml test in typical osteosarcoma patients’ group comprised only 70.2%, and in those with typical chondrosarcoma - 84.6%. Serum sPD-1 and sPD-L1 concentrations in osteosarcoma and chondrosarcoma patients were not associated with the indices of tumor advancement, its histological grade, localization in the osseous system, and type of affected bone. Thus, it can be concluded that the ratio between circulating soluble forms of the receptor and the ligand of PD-1/PD-L signaling pathway differs between patients with chondrogenic and those with osteogenic tumors, sPD-L1 being diagnostically valuable mostly for chondrogenic bone neoplasms.
Представлено редкое наблюдение успешного комплексного лечения больного с злокачественной гемангиоперицитомой малого таза. На первом этапе проведена неоадъювантная химиотерапия с последующей радикальной операцией в объ-еме цилиндрической брюшно-промежностной экстирпации прямой кишки. Продемонстрированы клиническая картина и особенности данного редкого заболевания, а также этапы хирургического вмешательства.
Ключевые слова: неэпителиальная опухоль, гемангиоперицитома, цилиндрическая брюшно-промежностная экстирпация прямой кишки.The paper describes a rare case of successful combination treatment in a patient with malignant small pelvic hemangiopericytoma. The diagnosis was verified by immunohistochemical examination. Neoadjuvant chemotherapy, followed by radical operation as cylindrical abdominoperineal extirpation of the rectum, was performed at Stage 1. This communication demonstrates the clinical picture and specific features of this rare disease and the stages of a surgical intervention.
Objectives. To analyze the efficacy of contemporary decompressive-and-stabilizing techniques, including percutaneous vertebroplasty, in patients with a spine and spinal cord myelomatosis (SSCM). Material and Methods. Seventy-two patients with SSCM were evaluated with respect to the results of treatment. Sixty-two patients underwent surgical interventions followed by radiotherapy and chemotherapy: open interventions were performed in 53 (85.5 %) patients and percutaneous vertebroplasty (PVP) – in 9 (14.5 %). Ten patients underwent only a specific therapy for SSCM. Pain regression, neurologic state and quality of life were evaluated after surgery. Results. Radiotherapy and chemotherapy are the methods of choice for SSCM. However in some cases with increasing neurologic deficit, intractable pains and instability of an involved spine segment a surgical intervention is necessary and capable to prevent catastrophic complications. Best results, regarding neurologic impairments and quality of life, were achieved in a group of patients in whom decompressiveand- stabilizing procedures were performed. Conclusion. PVP is a minimally invasive procedure ensuring quick regression of a pain syndrome and prevention of pathologic fractures in patients with myelomatosis of the spine.
scite is a Brooklyn-based organization that helps researchers better discover and understand research articles through Smart Citations–citations that display the context of the citation and describe whether the article provides supporting or contrasting evidence. scite is used by students and researchers from around the world and is funded in part by the National Science Foundation and the National Institute on Drug Abuse of the National Institutes of Health.