Gynaecological malignancy is a major challenge in women’s health worldwide. Cervical cancer (CC) is a particularly common type affecting the female reproductive system through an uncontrolled cell propagation causing cervical tissue injury in women. The advent of new technologies empowers research into the discovery and development of novel markers for early diagnosis, as well as therapy evaluation and monitoring. Despite manifold attempts to unravel the molecular mechanisms of CC, its pathogenesis remains largely unclear. The study of putative CC predictors is key to the invention of effective alleviating treatments. Systems biology enabled with high-throughput methods currently provides routes to tackle this problem. Unlike a traditional approach, it generates a wealth of data on prognostic biomarkers and therapeutic targets in cervical cancer, fuelling the search for novel high-sensitive and specific molecular markers. This approach will help improve the early diagnosis and treatment efficacy at a lower relapse rate. This review presents the currently on-stage and emerging biomarkers in cellular and molecular research into cervical cancer detection and prognosis.

Cervical cancer comprises a major female health problem worldwide. Despite population screening programmes, broad vaccination, precision pathogenesis studies and emergent diagnostics and treatment strategies, its prevalence is rising by year. We increasingly report the spread of disease, particularly of metastatic cervical cancer. The such patients’ prognosis is far from favourable. We review the literature relevant to diagnostic and treatment options in metastatic cervical cancer. The options and survival rates described vary by the locality of metastatic lesions and routes of metastasis. Patients with haematogenous metastases have a worse prognosis than patients with lymphogenous ones. From a diagnostic point of view, 2-fluoro-2-deoxy-D-glucose-positron emission tomography (FDG PET) and PET-computed tomography remain efficacious for detecting distant metastases. Adjuvant chemotherapy and concurrent chemoradiotherapy are effective in lymphogenous metastases. Haematogenous lung metastases resection and/or chemotherapy are the tactics of choice to contain relapsed metastatic cervical cancer. Accordingly, chemoradiotherapy is the optimal choice in patients with stage IVB cervical cancer. Multimodal therapy has revealed better survival prognosis. Stereotactic radiosurgery or craniotomy is indicated in oligometastatic brain lesions, with treatment outcomes and survival rates improving for the techniques’ combination with whole-brain radiation therapy. However, in multiple metastasis to brain or extracranial metastasis, chemotherapy combined with palliative whole-brain radiation are left as the only option.

Aim. To assessment of risk factors for erosion of the vaginal mucosa after the use of mesh prostheses to correct genital prolapse. Materials and methods. The authors of this article evaluated modifiable and unmodifiable risk factors for erosion of the vaginal mucosa after the use of a mesh implant to correct pelvic prolapse. The analysis of the relationship between the indicators of obstetric-gynecological, somatic anamnesis in women with an implant-associated complication (erosion of the vaginal mucosa, n=25) and in women with successful surgical treatment of genital prolapse using a mesh prosthesis (n=58) was carried out. The STATISTICA 10.0 and EViews 12.0 software packages were used for statistical processing of the obtained results. Results. Statistical analysis revealed the relationship of vaginal erosion after the use of a mesh prosthesis in the surgical correction of genital prolapse with the presence of factors such as: premenopausal age at the time of surgery (p=0.002; odds ratio OR 4.7, relative risk RR 2.79), vaginal delivery over the age of 35 years (p=0.003; OR 6.35, RR 2.78), episiotomy in the anamnesis (p0.0001; OR 11.2, RR 6.19), perineal ruptures III degrees in anamnesis (p0.0001; OR 19.7, RR 6.57), hypertension (p=0.049; OR 2.79, RR 2.19), type 2 diabetes mellitus (p=0.007; OR 4.99, RR 1.82). Conclusion. The formation of a high-risk group for erosion of the vaginal mucosa will allow us to develop a set of preventive measures and improve the outcomes of surgical treatment of genital prolapse.

Background. Cervical cancer is among the commonest malignancies and a top fourth leading cause of cancer death in women worldwide. The five-year survival rate in locally advanced cervical cancer is 91.5%, and only 17.2% — in distant metastasis. Primary cervical cancer metastasis to brain is very rare. Report and analysis of quite rare clinical cases may shed light on this issue, helping formulate relevant therapeutic and diagnostic interventions.Materials and methods. The article describes a case of cervical cancer metastasis to brain. The patient received modern 3D conformal intensity-modulated (IMRT) and image-guided (IGRT) radiation therapies on an Elekta Synergy highenergy linear digital accelerator instrument.Results. Clinical effect has been achieved by end of treatment. Time since diagnosis of primary cervical cancer was 13 months, and 7 months — since diagnosis of brain metastasis.Discussion. The survival rate in brain metastasis is marginal-low and depends on the patient’s age, primary tumour state, presence of extracranial metastases, as well as volume, number and location of metastases in brain parenchyma. An integrated approach including surgery, radiation and chemotherapy is considered superior to improve survival and the quality of life.Conclusion. Despite sheer coverage of therapies available, the mean survival rate in intracranial metastasis remains subtle. Thereby, research and discovery of relapse and metastasis biomarkers of cervical cancer is relevant.

BACKGROUND: Chronic endometritis is a clinical and morphological syndrome in which, due to persistent endometrial damage to the endometrium by an infectious agent, multiple secondary morphofunctional changes occur that impair cyclic transformation and receptivity of the uterine mucosa. AIM: This study aimed to reveal morphological features of the endometrium in patients with atrophic chronic endometritis and impaired hemodynamics in the endometrium. MATERIALS AND METHODS: The study involved 86 female patients divided into two groups. Group 1 comprised 44 patients with chronic endometritis and impaired endometrial hemodynamics. Group 2 included 42 patients with chronic endometritis without impaired microcirculation in the endometrium. The patients underwent endometrial pipelle biopsy for histological and immunohistochemical examination to determine the expression of VEGF, TGF- and CD138 during the proliferative phase of the menstrual cycle. RESULTS: Histological examination revealed vascular sclerosis, plasma cells, inflammatory infiltrates, stromal fibrosis, granulomas, and hemorrhagic foci in patients with atrophic chronic endometritis and impaired hemodynamics. CONCLUSIONS: While examining the morphological picture of atrophic chronic endometritis with impaired hemodynamics, the formation of scar tissue was noted resulting in impaired blood circulation, which leads to focal hemorrhages in the uterine mucosa. According to immunohistochemical analysis, patients with impaired endometrial hemodynamics showed a statistically significant decrease in VEGF and an increase in TGF- expression, which indicates the severity of fibrosis.