e21067 Background: The purpose of the study was to analyze the expression of angiogenesis-controlling markers (CD31, VEGF) in tissues of melanocytic skin lesions. Methods: The study included 20 patients with benign pigmented lesions and 15 patients with superficial spreading and nodular melanoma. Immunohistochemical study was performed on sections of paraffin blocks for standard morphological studies using murine monoclonal CD31 and VEGF antibodies. UltraVision Quanto Detection System HRP DAB was used for visualization. Angiogenesis in tumors was assessed by intratumoral microvessel density (iMVD) index. Microvessels were stained with anti-CD31 antibody. The number of vessels was determined in each area of sight using objective lens with 40x magnification and AxioVs40 v-4.8.1.0 program. The tumor was considered VEGF-positive if more than 25% of tumor cells showed positive staining, and percentages of these tumor cells were calculated in each case (in %). Results: Quantitative evaluation of iMVD showed that the median number of microvessels in an area of sight in melanoma and nevi was 10.0±0.9 and 4.1±0.4, respectively, results of CD31 expression were statistically significant (р˂0.05). The numbers of CD31-stained vessels in melanoma ranged from 4 to 18 in one area of sight. 14 nevus cases (70%) showed 4 and less vessels, and only giant-cell nevi (6-30%) demonstrated up to 15 vessels in one area of sight. VEGF expression was found in the cytoplasm of melanoma cells in 100% of cases (15), in nevi – in 65% (13). The expression was not found in nevi cells in 35% (7). The number of VEGF-positive cells varied greatly in both melanomas and in nevi – from less than 5% to 50%. The maximal VEGF expression was observed in melanomas – 32.5±2.9%, while in nevi 23.8±2.1% (р˂0.05). Conclusions: The immunohistochemical study demonstrated a high angiogenic potential of melanoma that can be used as an additional criterion for tumor progression and malignant transformation of melanocytic skin neoplasms and thus contribute to the development of novel approaches to the diagnosis of the disease.

Purpose of the study. To assess the potential of sonography in the diagnosis of pelvic tumors in children. Patients and methods. We retrospectively analyzed results of ultrasound examination of the small pelvis, abdominal cavity and retroperitoneal space in 110 children with pelvic cancer referred for examination and treatment to National Medical Research Centre for Oncology of the Ministry of Health of Russia, distinguishing the most significant ultrasound parameters regardless of the tumor histological structure. 69.1% of patients were diagnosed with germ cell tumors, including 72.4% with gonadal and 27.6% with extragonadal tumors, 85.8% with sacrococcygeal tumors, 9.5% -uterine and 4.7% -vaginal tumors. Rhabdomyosarcoma was detected in 25.4%, neuroblastoma in 4.5% and a primitive neuroectodermal tumor in 1%. Standard ultrasound examination was performed using scanners Philips IU22 (USA) and Logic 400 MD (GE, USA) with convex transducers (3.5-5.5 MHz) in grayscale, color Doppler and power Doppler modes.Results. The first stage of diagnostics showed that malignant pelvic tumors were characterized with an irregular shape registered in 97 (88.2%; p<0.0001), uneven, fuzzy contours -94 (85.5%; p<0.0001), heterogeneous echostructure -102 (92.7%; p<0.0001), in 70 people (63.6%; р=0.001) due to cystic inclusions, calcified inclusions were found in 37 (33.6%; p>0.05); tumor echodensity was reduced in 75 children (68.2%; р=0.001). Dopplerography in most patients -100 (90.9%) -registered a hyperintense intratumoral blood flow, mainly of an arterial type, with maximum arterial velocities (MAV) ranging from 12.5 to 45 cm/s, average MAV = 30±2.7 cm/s. The specificity of the method was 86.3% (p=0.001), sensitivity 85.2% (p=0.011), accuracy 87.5% (p=0.014). Ultrasound monitoring was performed during treatment after each polychemotherapy cycle; we assessed changes in the size of tumors, their structure and neovascularization, allowing evaluation of the antitumor treatment effectiveness. Conclusion. A complex sonography is an important method in the primary diagnostics of pelvic tumors in children, as well as a priority method in antitumor treatment monitoring, which allows detection of the tumor extent and helps to avoid multiple radiation exposure of the growing child's body.

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Purpose of the study. Improving the results of surgical treatment of melanoma of the skin of the extremities by using skin-fascial flaps on perforating vessels.Patients and methods. In 42 patients with limb skin melanoma T1–3N0M0, the closure of a skin defect was performed by islet flaps on perforating vessels. Perforating vessels of the donor zone were detected with an assessment of the blood supply of the flaps in the pre- and postoperative period using ultrasound and marking of perforants with adjustment of the preliminary marking of the flaps.Results. Permanent perforating vessels with a diameter of more than 1 mm were used. After excision of the tumor, on the opposite sides of the wound defect, taking into account the location of the perforating vessels, flaps were taken, with further mobilization by excision of the fiber and muscle fascia, they were separated from the underlying tissues while maintaining the integrity of the supply vessels. The circulatory state of the selected flaps was determined by skin color and capillary response to digital pressure. The flaps were displaced to the center, covered the area of the defect and sutured with single sutures, the edges of the donor wound were mobilized, sutured with single sutures until light tension appeared and sutured into the remaining wound defect. In the postoperative period, the determination of the parameters of the blood flow of perforating vessels showed the absence of hemodynamically significant violations of the blood flow during the movement of the flap. Transient ischemia of one of the oncoming flaps after surgery developed in 11.9%, marginal necrosis of the distal flap — in 7.1% of cases. A normotrophic scar was formed, with a width of not more than 0.3 cm, which aesthetically satisfied 92.8% of patients. Assessment of two-year relapse-free survival showed a complete absence of local relapses.Conclusion. The flaps vascularized by perforating vessels have high viability, are identical in color and texture to the skin of the recipient area, and the close proximity to the receiving area contributes to minimal deformation of the donor area, which increases the radicality of the operation, reduces the incidence of postoperative complications and improves аesthetic and functional results.

e22083 Background: The ability of malignant tumors to invasion and metastasis is associated with increased activity of the plasmin/plasminogen family proteases. The purpose of the study was to analyze changes in the plasmin/plasminogen system in tumors and adjacent tissues in patients with cutaneous melanoma in dependence on their gender. Methods: The study included 13 men and 22 women with cutaneous melanoma pT1-2N0M0. Levels of plasmin (PAP), content and activity of uPA, content and activity of tPA, content and activity of PAI were determined by ELISA in homogenates of melanoma (M), perifocal (P) and resection line (RL) tissues after surgical treatment. All patients gave a voluntary informed consent for the study. Skin tissues obtained from 20 non-cancer patients after plastic surgery served as the control. Results: The maximal PAP content in women was found in M – 16.5 times higher than in control, in RL – twice higher; PAP in all tissues of men was on average 7 times higher than in control. The content and activity of uPA and tPA in M were elevated in patients of both genders: in women by more than 3 times, in men by 4.9 and 3.7 times for uPA, respectively, and on average by 1.4 times for tPA. Increased content and activity of PAI-I were observed only in M of women by 74.6 and 2.3 times respectively, while PAI-I levels in men were similar to control values, and its activity was 2.9 times higher. Content and activity of PAI in P and RL tissues of men did not exceed the norm despite an increased activity of uPA and tPA, while in women they were elevated on average by 4 and 1.8 times, respectively. Conclusions: A local increase in the content and activity of the PAI-I plasminogen activator inhibitor in P and RL tissues only in women is a distinctive gender characteristics that can inhibit the spread of melanoma.