55 Диагностика и лечение опухолей мочеполовой системы. Рак мочевого пузыряВведение Доля злокачественных новообразований органов малого таза в структуре онкологической заболеваемо-сти составляет около 16 % всех локализаций. В тех случаях, когда в опухолевый процесс вовлечены од-новременно несколько органов малого таза: мочевые пути, женские гениталии и прямая кишка, -возника-ет необходимость в выполнении расширенных опера-ций вплоть до тотальной тазовой экзентерации (ТЭ). Местно-распространенные опухоли тазовых органов без отдаленных метастазов могут сопровождаться серьез ными клиническими проявлениями: болевым синдромом, задержкой мочи, уретерогидронефрозом (УГН), кишечной непроходимостью, кровотечением, что опасно для жизни пациентки и приводит к значи-тельному ухудшению качества жизни.В случае вовлечения в опухолевый процесс треу-гольника мочевого пузыря (МП), стенки влагалища, матки, сигмовидной и прямой кишок -ТЭ может по-тенциально спасти жизнь пациента. ТЭ выполняется при первичном или рецидивном раке шейки матки (РШМ), раке прямой кишки (РПК), тела матки, вуль-вы, раке мочевого пузыря (РМП) и тазовой саркомы [1][2][3]. Наиболее часто показаниями к ТЭ служат зло-качественные опухоли женской половой сферы, сиг-мовидной и прямой кишки, мочевой системы.РШМ составляет 15 % всех онкологических забо-леваний, в структуре онкологической смертности на-

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Background. The adrenal glands are one of the most common sites of metastases in malignant disease, particularly lung cancer. The frequency of adrenal metastasis in patients with breast cancer and lung cancer reaches 39 and 35 % respectively.Materials and methods. A total of 156 patients with adrenal tumors underwent surgical treatment in the Siberian State Medical University between December 1998 and July 2017. The study included 16 (10.2 %) patients (9 males and 7 females) with adrenal metastases. The mean age of study participants was 57.6 years (range: 44–73 years).Results. By the moment of surgery, the mean metastatic adrenal tumor size was 4.9 ± 3.0 cm (range: 1.0–10.2 cm). Thirteen out of 16 patients had adrenal metastases from renal cell carcinoma, one patient – from colon cancer, one patient – from lung cancer, and one patient – from breast cancer. Nine patients had left-sided adrenal metastases, whereas six patients had right-sided adrenal metastases. Synchronous adrenal metastasis was detected in two cases: one patient had adrenal metastasis at the side of the renal tumor; the other one had bilateral renal cell carcinoma with both adrenal glands affected.We identified three main variants of the disease course according to prevailing clinical manifestations of adrenal metastasis: no manifestations, pain syndrome, and arterial hypertension.Seven participants had no clinical manifestations; of them, 6 patients had renal cell carcinoma, whereas 1 patient had breast cancer. The mean time between surgical removal of the primary tumor and detection of adrenal metastases was 24.1 months; the mean tumor size was 4.5 cm.Pain syndrome was observed in 5 patients. In three of them, adrenal metastases derived from renal cell carcinoma, in one patient – from lung cancer, and in one patient – from colon cancer. The mean time between removal of the primary tumor and detection of adrenal metastases was 19.8 months; the mean tumor size was 5.4 cm.Arterial hypertension was diagnosed in four patients. The mean time between removal of the primary tumor and identification of adrenal metastases was 27.3 months; the mean tumor size was 4.1 cm. The five-year overall survival rate in operated patient was 47.8 %.Conclusion. Regular examinations of patients after surgical treatment of malignant tumors are needed to detect adrenal metastases; surgery can extend the patient’s life. can extend the patient’s life.

The article presents the results of surgical treatment of patients with pancreatic

Background. Currently, in the study of prostate cancer, much attention is given to specific molecular patterns reflecting the biological potential of the tumor. Of most interest is analysis of the proteins of chimeric genes in a tumor. Aim of study is analysis of peculiarities of ERG and PBOV1 proteins expression in tumor cells and correlation of them with the prognostic parameters of the disease in patients. Materials and Methods. The group of study consisted of 85 patients diagnosed with prostatic carcinoma (stage II-III of the disease, T1-3N1-2M0), after radical prostatectomy. No specific preoperative treatment was given. Histological examination was conducted using a standard method, and immunohistochemical one – with use of an automatic stainer. Morphological characteristics of the tumor, of distant regional lymph nodes and of seminal vesicles were evaluated. Correlation between the histological and expression parameters of tumor and occurrence of distant metastases was studied. Results. Correlation was found between parameters of expression of the studied proteins with such variant of tumor progression as hematogenic metastasis. A higher percentage of expression of ERG and PBOV1markers in cells of prostate carcinoma correlates with a lower degree of tumor differentiation and with a poor prognosis for the course of the disease. Conclusion. The results of the conducted research demonstrate significance of ERG and PBOV1 proteins as additional prognostic factors in patients with prostate carcinoma, and probably may be used for evaluation of prognosis of the disease in selection of the management tactics for the given category of patients.