Chronic constipation is one of the most urgent problems in modern coloproctology and is observed in 14–16% of the population of developed countries. The causes of chronic constipation vary widely from functional to organic. The latter include various variants of dolichocolon, which occur in 16% of cases.The aim of the study was is to give a morphological and quantitative characteristic of subcompensated dolichocolon based on the morphogenesis of changes, compared with histologically normal colon.Material and methods. Colon tissue samples from 15 people were used, which were divided into two groups. The first, control group consisted of 5 sectional cases of a morphologically normal colon wall. The second group was represented by the surgical material of 10 patients with subcompensated dolichocolon. Observation groups were representative by sex and age.Results. In patients with subcompensated dolichocolon, compared with the control group, the thickness of the mucosa in the colon wall is statistically significantly (p=0.034) reduced by 1.06 times, which indicates atrophy; the thickness of the submucosal layer increases by 1.55 times due to edema with foci of sclerosis (p=0.0001); the thickness of the muscle layer increases by 1.16 times (p=0,0003), because of working hypertrophy and compensatory hyperplasia of smooth muscle cells; at the same time, the number of nerve cells in Auerbach's plexuses decreases by 1.59 times (p=0,0001), which will lead to atrophy of the muscle layer and decrease its evacuator-motor function; the average area of lymphoid follicles increases by 1.35 times (p=0,003) and the percentage of secondary follicles decreases 8 times (p=0,0001), which is a consequence of congestion of intestinal contents and activation of the intestinal lymphoid apparatus.Conclusion. Morphological signs of atrophy and sclerosis changes of the cellular elements of the colon neuromuscular apparatus begin to form at the subcompensated stage of dolichocolon, which requires new objective clinical and morphological indications for surgical treatment of patients in order to prevent the development of decompensation of the patients’ general condition and severe complications.

Introduction. Breast cancer is in the first place in the structure of morbidity among all malignant neoplasms in women. The prognosis of the disease depends on the tumor degree, including the presence of epithelial-mesenchymal transformation (EMT), the degree of invasion, the proliferative index, the preservation or absence of estrogen, progesterone, and epidermal growth factor receptors.Aim: To study the immunohistochemical and morphological characteristics of the epithelial-mesenchymal transformation of breast cancer.Material and Methods. Immunohistochemical study with antibodies to AE1/AE3, HMW, CK18, Snail, HER2/neu, E-cadherin, Vimentin, α-SMA, CD34, Ki-67 and p63 was performed in 60 patients of different age with breast cancer. Native preparations were stained with picrofuchsin according to van Gieson Alcian blue. Inflammatory infiltrate cells were examined for antibodies CD45, CD3, CD4, CD8, CD20, CD68.Results. In ductal carcinoma, positive expression for estrogen and progesterone was found in 82.7% and 86.3%, respectively, the proliferation index ranged before 66,6%, and p-53 was positive in 97%. In lobular cancer, positive expression to estrogen and progesterone was observed in 83.4% and 66.6%, respectively, the index of proliferative activity at the level of 50%, and p-53 was positive in 66.6%. Positive moderate expression of HER-2/neu was determined in 47% of ductal and 50% of lobular cancers. Estrogen plays an important role in the development of invasive breast cancer, leads to tumor progression and contributes to EMT. EMT, in turn, leads to the expression of E-cadherin associated with a worse survival prognosis. EMT indirectly leads to the intensification of angiogenesis, and the presence of a large number of newly formed vessels increases the risk of metastasis. Histochemical methods were used to determine the growth of fibrous tissue around invasively growing cancer complexes. Cells located perifocally looked like fibrobla ts, immunohistochemically moderately expressed Vimentin and weakly expressed pancytokeratin, which proved the tumor nature of the cells and the acquisition of mesenchymal features by them. The inflammatory infiltrate along the periphery of the tumor growth consisted mainly of T- and B-lymphocytes, and around the cancer complexes - of B-lymphocytes and macrophages.Conclusion.  The  study  of  the  immunohistochemical  tumor  phenotype  will  make  it  possible  to  prescribe  adequate polychemotherapy and determine the prognosis of the course of the disease.

Колоректальный рак занимает ведущие позиции в структуре заболеваемости и смертности среди онкологических заболеваний. Наличие метастатического поражения сильно ухудшает прогноз течения и исхода колоректального рака, являясь непосредственной причиной смерти у большинства пациентов. В обзоре литературы проанализированы имеющиеся в научных публикациях сведения о влиянии на процесс метастазирования колоректального рака таких клинико-морфологических факторов как пол и возраст пациента, макроскопический и гистологический тип опухоли, степень ее дифференцировки и локализация, степень инвазии, наличие изолированных клеток опухоли и опухолевого почкования, перитуморального фиброза и лимфоцитарной инфильтрации, состояние латерального края резекции, использование нео-и адъювантной химиотерапии, наличие осложнений. Результаты показали их значимость для прогнозирования метастатического потенциала опухоли, однако оценка, основанная на статистических показателях, позволяет определить лишь тенденцию развития процесса, интерпретируемую не всегда однозначно, не давая возможности комплексно учесть все факторы и их влияние на прогноз для конкретного пациента. Выход из ситуации видится в создании максимально многофакторной математической модели с использованием байесовского метода, позволяющего на основе «обучающего массива» количественно определить влияние каждого как квантитативного, так и квалитативного клинико-морфологического показателя, его информативность и их суммарную прогностическую значимость для оценки метастатического потенциала колоректального рака в конкретном клиническом наблюдении. Ключевые слова: колоректальный рак, метастазирование, прогноз, математическое моделирование.

Introduction. Chronic constipation is one of the most actual problems in modern coloproctology and found in 14–16% of developed countries population. The causes of chronic constipation vary widely from functional to organic. The latter include dolichocolon, different variants of which occur in 16% cases.Aim: To give a morphological and quantitative characteristic of the decompensated stage of dolichocolon based on the morphogenesis of changes in comparison with the histologically normal colon.Material and Methods. Colon tissue samples from 16 people were used and divided into two groups. The first, control group, included 8 sectional cases of a morphologically normal colon wall. The second, the study group, was represented by surgical material from 8 patients with dolichocolon decompensated stage. Observation groups were comparable by sex and age.Results. In average, in patients with the decompensated dolichocolon stage, in comparison with the control group, statistically significantly (p ˂ 0.05), the thickness of the mucous and muscular membranes decreases by 1.07 and 2.26 times, respectively. The thickness of the submucosa increases by 1.17 times. However, the maximum and minimum values of this parameter change only by 1.35 times, while in the control group – by 7.21 times, as a consequence of the development of insufficiency of the evacuation-motor function of the colon which indicates the maximum smoothness of the colon wall, and is a consequence of its functional insufficiency. The specific proportion of neuro plexuses in the muscular membrane is 1.45 times higher than in the control group. However, the number of nerve cells decreases by 2.98 times, as a result of the development of insufficiency in the evacuation-motor function of the colon. The average area of lymphatic follicles decreases by 1.49 times, and secondary follicles disappear altogether, meaning the depletion of the compensatory-adaptive reactions of the lymphoid apparatus.Conclusion. Morphological and morphometric signs of irreversible changes, such as dystrophy, atrophy and sclerosis of all structural elements of the thick wall in the stage of decompensated dolichocolon, suggest surgical treatment, as well as prevention of the development of decompensation of the general condition of patients.

Introduction. Chronic constipation is one of the most actual problems in modern coloproctology and found in 14-16% of developed countries population. The causes of chronic constipation vary widely from functional to organic. The latter include dolichocolon, different variants of which occur in 16% cases.Aim. To give a morphological and quantitative characteristic of the decompensated stage of dolichocolon based on the morphogenesis of changes in comparison with the histologically normal colon.Material and Methods. Colon tissue samples from 16 people were used and divided into two groups. The first, control group, included 8 sectional cases of a morphologically normal colon wall. The second, the study group, was represented by surgical material from 8 patients with dolichocolon decompensated stage. Observation groups were comparable by sex and age.Results. In average, in patients with the decompensated dolichocolon stage, in comparison with the control group, statistically significantly (p ˂ 0.05), the thickness of the mucous and muscular membranes decreases by 1.07 and 2.26 times, respectively. The thickness of the submucosa increases by 1.17 times. However, the maximum and minimum values of this parameter change only by 1.35 times, while in the control group – by 7.21 times, as a consequence of the development of insufficiency of the evacuation-motor function of the colon which indicates the maximum smoothness of the colon wall, and is a consequence of its functional insufficiency. The specific proportion of neuro plexuses in the muscular membrane is 1.45 times higher than in the control group. However, the number of nerve cells decreases by 2.98 times, as a result of the development of insufficiency in the evacuation-motor function of the colon. The average area of lymphatic follicles decreases by 1.49 times, and secondary follicles disappear altogether, meaning the depletion of the compensatory-adaptive reactions of the lymphoid apparatus.Conclusion. Morphological and morphometric signs of irreversible changes, such as dystrophy, atrophy and sclerosis of all structural elements of the thick wall in the stage of decompensated dolichocolon, suggest surgical treatment, as well as prevention of the development of decompensation of the general condition of patients.