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Background: Colorectal cancer is now an urgent problem in oncology. Recently, specialists have been interested in a comparative analysis of differences in the clinical course of malignant tumors in the proximal and distal colon. The sections differ not only in their embryogenesis and sources of blood supply, but also in the clinical course and population and epidemiological characteristics. The issue of distinctive immunological characteristics of tumors of the colon depending on the location remains open.Objective: A comparative analysis of local subpopulations of immunocompetent cells and an assessment of number of cells with the CD45+/- phenotype expressing toll-like receptors (TLRs) depending on the tumor location on the right or left sides of the colon.Material and methods: The study included 50 patients with verified colon cancer. The majority of patients were females – 26 (52%), aged 67 ± 0.4 years, and 50% of patients with stage II disease. Depending on the tumor location (the right or left sides of the colon), the patients were divided into 2 groups of 25 people each. All patients underwent standard surgery at the initial stage. The obtained material was used for subsequent studies: a cell suspension was obtained from a tumor tissue fragment, the perifocal zone (1–3 cm from the tumor) which was processed using an antibody panel (Becton Dickinson, USA) to identify the main subpopulations of leukocytes and lymphocytes. Expression of TLRs (2, 3, 4, 8, 9) on CD45+, CD45- cell populations was also determined using the BD FACSCanto flow cytometer (Becton Dickinson, USA). Statistical processing of the results was performed using the STATISTICA 13.3 package (StatSoft Inc., USA).Results: A comparative analysis of immunological parameters, depending on the tumor location on the right or left sides of the colon, showed:Tissues of the right-sided tumors had a higher T-lymphocytic infiltration, compared to the left-sided tumors, while the latter showed a higher B-lymphocytic infiltration (p = 0.025).Peritumoral zone tissues of left-sided tumors demonstrated a decrease of lymphocytes levels (p = 0.027), NKT – (p = 0.035), NK – (p = 0.041) and В lymphocytes (p = 0.038), and a significant increase in CD8+- (p = 0.02) and DP cells (p = 0.0018).Left-sided tumors showed a percentage decrease of CD45- cells expressing TLR4 and TLR8, compared to right-sided tumors, by 38% (p = 0.038) and 25% (p = 0.043).There was a decrease in the number of CD45+ cells expressing TLR2 and TLR4 in left-sided tumors by 54% (p = 0.035) and 33% (p = 0.04) respectively, than in right-sided tumors.The percent of CD45- cells expressing TLR4 in the perifocal tissues of left-sided tumors decreased by 61% (p = 0.031) in comparison to the corresponding tissues in right-sided tumors.The numbers of CD45+ cells expressing TLR2 and TLR4 were 81% (p = 0.02) and 87% (p = 0.018) lower respectively in the peritumoral tissues of left-sided tumors, compared to the corresponding tissues in right-sided tumors.Conclusion: The revealed characteristics of the local subpopulations of immunocompetent cells and the numbers of CD45+/- cells expressing TLRs depending on the tumor location on the right or left sides of the colon can serve as a prognosis of the disease clinical course and the choice of further treatment tactics.

Colorectal cancer (CRC) is a relevant issue of modern oncology and ranks the third place among most common malignancies. Every year, more than 1 million new cases of CRC are diagnosed worldwide, with approximately the same frequency of prevalence among the male and female population. Colon cancer (CC) amounts for more than half of all cases of CRC, and it's incidence and mortality remain rather high. Surgery remains the main method of CRC treatment, and determining the extent of surgery and lymph node dissection remains an urgent problem. For the first time in Japan, a classification of groups of lymph nodes (l.n.) was proposed depending on the level of lymph outflow and location in relation to the main vessels. According to the numbering of l.n. groups by the Japanese Society for Cancer of the Colon and Rectum (JSCCR), all lymph nodes are numbered with three digits. As a rule, lymphogenic metastasis occurs in one direction, bilateral spread is possible if the tumor is located at the same distance from two feeding vessels. With tumors of the right-sided localization, all groups of l.n. located along the branches of the superior mesenteric artery are removed, and with tumors of the left half of the colon, all l.n. located along the trunk of the inferior mesenteric artery are removed. The presence of affected l.n. is important for assessing the prognosis and further determining the need for adjuvant therapy. Some literature data demonstrate good results of surgical interventions performed in accordance with the concept of embryonic planes and complete mesocolonic excision. D3 lymph node dissection is not performed in daily practice in some European countries and North America, unlike a number of Eastern countries. However, the level of vessel ligation remains the subject of scientific discussion. The purpose of this review was to analyze the available literature on the problem of choosing the level of lymph node dissection in CC surgery.

Objective. To study level and structure of microbial colonization in cancer patients before admission to a surgery department using molecular methods. Materials and Methods. The presence of DNA of methicillin-resistant Staphylococcus aureus, methicillinresistant coagulase-negative staphylococci, Candida albicans/C. glabrata/C. krusei, Acinetobacter baumannii in the clinical specimens and the presence of antimicrobial resistance genes in cultures were detected by multiplex real-time PCR. A total of 741 clinical samples and 313 cultures were studied. Results. The high level of microbial colonization, including microorganisms with antibiotic resistance genes, was found in cancer patients. Methicillin-resistant staphylococci, A. baumannii and Candida spp. were detected in 56.6%, 20% and 24.8% of cancer patients, respectively. Of patients infected with A. baumannii, 35.9% had OXA-carbapenemase genes. A. baumannii producing blaOXA40 was the most common cause of infectious complications. Conclusions. Molecular methods can be used effectively not only for the diagnosis of infectious diseases, but also in microbiological monitoring programs.