Ростовский научно-исследовательский онкологический институт, г. Ростов-на-Дону, Россия Реферат Цель. Изучить возможность использования оценки факторов локального клеточного иммунитета для прогно-зирования эффективности лечения сарком мягких тканей. Методы. В исследование вошли 38 пациентов с саркомой мягких тканей: 22 с первичными опухолями и 16 с ре-цидивными, находившихся на хирургическом лечении в 2014-2016 гг. У всех пациентов с целью оценки пока-зателей локального иммунитета исследовали полученные интраоперационно ткани опухоли, перитуморальной зоны и условно здоровые ткани, соответствующие линиям резекции (всего 114 образцов). Образцы тканей гомо-генизировали, субпопуляции лимфоцитов определяли на проточном цитометре. Результаты. Исследованы характеристики лимфоцитарного микроокружения сарком мягких тканей в связи с клиническим эффектом комплексного лечения больных. При первичных саркомах развитию у больных бес-событийной выживаемости более 12 мес после операции соответствовало более высокое содержание NK-кле-ток в ткани опухоли и более высокое соотношение уровней NKT-лимфоцитов в перитуморальной зоне и опу-холи, а также более низкий уровень Tregs, чем у больных с бессобытийной выживаемостью менее 12 мес. При рецидивных саркомах короткая бессобытийная выживаемость была связана с высокими показателями уровня DN-клеток в опухоли и соотношения доли CD3 + -лимфоцитов в перитуморальной зоне и опухоли. Все указан-ные различия статистически значимы (р <0,05). Вывод. Клинический эффект комплексного лечения сарком мягких тканей связан с исходным состоянием им-мунологического микроокружения опухоли; ряд показателей локального клеточного иммунитета можно рас-сматривать в качестве прогностических факторов, различных для первичных и рецидивных сарком. Ключевые слова: саркома мягких тканей, прогностические факторы, бессобытийная выживаемость, локаль-ный иммунитет, субпопуляции лимфоцитов. Possibility of predicting the efficiency of soft tissue sarcoma treatment on the basis of features of their immunological microenvironment E.Yu. Zlatnik, I.A. Novikova, E.M. Nepomnyashchaya, O.N. Selyutina, T.V. Ausheva, T.A. Aliev, L.N. Vashchenko, E.P. Ul'yanova, N.M. Mashchenko Rostov Research Institute of Oncology, Rostov-on-Don, RussiaAim. To study the possibility of using the evaluation of local cellular immunity factors for predicting the efficiency of soft tissue sarcoma treatment. Methods. The study included 38 patients with soft tissue sarcoma: 22 with primary and 16 with recurrent tumors, admitted for surgical treatment in 2014-2016. In all patients, the intraoperative tumor tissue samples, peritumoral zone and relatively intact tissue samples corresponding to the resection lines (a total of 114 samples) were studied to assess the local immunity indices. The tissue samples were homogenized, lymphocyte subsets were detected with a flow cytometer. Results. Characteristics of immunological lymphocytic microenvironment of soft tissue sarcomas were studied in connection with the clinical effect of complex treatment of patient...
The aim of this work was to assess the significance of investigating clinical and laboratory parameters for diagnosing acute monocytic leukemia in children on the basis of a clinical case. The article demonstrates specific features of differentiating AML M5a from other forms of acute myeloid leukemia. According to the results of hematological, morphological and cytofluorimetric studies of blood and bone marrow samples, the diagnosis of acute myeloid leukemia was established. The morphological and phenotypic characteristics of blast cells hampered the diagnosis of an AML form. However, a comprehensive analysis of the expressed CD antigens allowed acute monocytic leukemia to be identified, which diagnosis was subsequently confirmed by a cytochemical study. Thus, the clinical diagnosis was established over a short period of time. This was of importance given the rising severity of the patient’s condition requiring immediate treatment, the initial hyperleukocytosis and the development of life-threatening complications associated with leukostasis in the lungs and the central nervous system. In the presented case, the clinical manifestations of the underlying disease and the results of flow cytofluorimetry were determining factors in initiating timely specific therapy.
приводим описание сложного пути диагностики острого мегакариобластного лейкоза, отягощенного множественной сопутствующей патологией, у ребенка с синдромом Дауна. В данном случае ключевую роль в постановке диагноза сыграла комплексная оценка клинических данных, результатов автоматического общеклинического анализа крови с детальной интерпретацией всего спектра параметров, а также морфологических и иммунофенотипических исследований костного мозга с применением расширенной панели моноклональных антител.
e23513 Background: The purpose of the study was to reveal the levels of biochemical parameters for assessing the intensity of bone metabolism in patients with primary and metastatic bone tumors. Methods: The study included 29 patients aged 55.9±12.17 years with primary (group 1, n = 12) and metastatic (group 2, n = 17) bone tumors. Group 2 included patients with breast cancer (2a, n = 10) and renal cancer (2b, n = 7) with a history of pathological fractures. Serum levels of the bone turnover marker osteocalcin, TSH, the resorption marker β-Cross Laps (C-terminal telopeptide) (Cobas e411, Japan) and calcium (Vitros 5600, USA) were measured before and after (day 14) organ-preserving treatment. The data were compared with that in non-cancer patients of similar age (n = 15) and evaluated in the Statistika 10.0 program. Results: Osteocalcin levels in group 1 prior to surgery was 1.74 times (p < 0.05) higher than in controls (13.56±1.35 ng/mL) and decreased by 35% (p < 0.05) compared to the initial values. In group 2, changes in osteocalcin levels were multidirectional: group 2a – 24% (p < 0.05) higher than in controls both before and after surgery; group 2b – similar to control values before surgery and decreased by 19% (p < 0.05) after it. Levels of β-Cross Laps in all patients before surgery were within the control range (0.49±0.02 ng/mL). After surgery, the levels in groups 1 and 2a did not change, while group 2b showed an increase in β-Cross Laps by 1.5 times (p < 0.05) and a decrease in calcium by 20% (p < 0.05) from the initial levels (2.33±0.09 mmol/L), which, along with a decrease in osteocalcin, could be the result of specific kidney damage. TSH in groups 1 and 2b was similar to controls, but initial TSH levels in group 2a were increased by 86% (p < 0.05) and did not change after surgery, as well as osteocalcin levels, which in the absence of changes in β-Cross Laps suggested a more favorable prognosis after organ-preserving treatment. Conclusions: Bone tissue remodeling processes are determined by the nature of the initial tumor. Measuring osteocalcin and β-Cross Laps in patients with specific bone lesions may be useful in assessing the risk of fractures.
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