Risk factors for dyshormonal benign hyperplasia and breast cancer

Risk factors for the occurrence of benign diseases and breast cancer were studied in a comparative analysis of the survey data of 321 women who were operated on the mammary gland, had an established histological diagnosis and were registered in the oncology offices of the Kursk polyclinics (main group), and 150 women who did not have any clinical , no objective manifestations of breast pathology (comparison group). To study the frequency of dyshormonal hyperplasias of the mammary glands and risk factors in girls, an in-depth preventive examination of 390 schoolgirls aged 13-17 years was carried out.

Opportunities to improve the diagnosis chronic tndometritis

Goal of the research: optimization of the diagnosis of chronic endometritis. Methodology: perspective research. Institution: Department of obstetrics and gynecology of the Kursk medical University. Material of the research: 67 patients suffering benign diseases of endometrium and myometrium connected with it. 59 patients with the diseases of the uterus of the same пaтe without chronic endometritis. Methods of the research: clinico-laboratory, ultrasonography, hysteroscopic, histologic, cytologic, microbiologic examination of the endometrium, PSR, radioimmunological method to determine progesterone rate in the blood plasma. Results of the research: the endoscopice variants of chronic endometritis are extreted: hyperplastic and hypoplastic (and also its forms - focal and diffusive). They are necessary stages achieving reliable diagnosis of the inflammatory process of endometrium a differential method of probing of endometrium depending on a variant and damage rate of chronic endometritis is worked out. Conclusion: the complex method of the diagnosis chronic endometritis including hysteroscopy with visual biopsy and cytologic-histologic examination of endometrium increases the quality of diagnosis by 64,4% in comparison with the traditional curettement of the endometrium and considerably decreases the number of posttraumatic and inflammatory complications.

Detection of Marker Associated with CTC in Colorectal Cancer in Mononuclear Cells of Patients with Benign Inflammatory Intestinal Diseases

Colorectal carcinoma (CRC) belongs to the most common tumor entities in western countries. Circulating tumor cells (CTC) in blood of CRC patients are a powerful prognostic and predictive biomarker. However, whether CTC-associated markers can also be used for early CRC detection and discrimination from benign diseases is not known. This study investigated the presence of CTC-associated markers CK20, PLS3, LAD1, and DEFA5 in blood of patients with benign inflammatory intestinal disease (IID) and their correlation with malignancy. The detection rate of CK20 and DEFA5 significantly differed between diseased patients and healthy controls. LAD1 and PLS3 were detected in all samples with clear differences in gene expression. DEFA5 expression was higher in CRC and IID patients compared to healthy donors, while CK20 and PLS3 were lower in CRC compared to IID patients or healthy controls. Overall, all CTC-associated markers were detectable in blood of IID patients, but not correlating with inflammation severity. Finally, PLS3 emerged as a suitable marker for differentiation between malignant and non-malignant intestinal diseases or healthy controls, however its suitability for early CRC detection needs to be further validated.

МОДИФИЦИРОВАННАЯ МАЛОИНВАЗИВНАЯ МЕТОДИКА ЛАПАРОСКОПИЧЕСКИХ ОПЕРАЦИЙ ПО ПОВОДУ ДОБРОКАЧЕСТВЕННЫХ ЗАБОЛЕВАНИЙ ПРИДАТКОВ МАТКИ

The article substantiates the feasibility of developing minimally invasive operations on the adnexa and minimizing surgical trauma. The technique of the modified laparoscopic surgery method proposed by the authors for benign diseases of the adnexa is described in details. The results of treatment of 37 patients operated on by the presented method are considered. The selection criteria for patients for the application of this method of surgical treatment are determined. It is shown that the presented method corresponds to the current trend of minimizing surgical trauma, has a good cosmetic effect, helps to reduce postoperative pain, and is also economically feasible, because it does not require the use of additional endoscopic instruments.

First assessment of comparative efficacy of virtual bronchoscopy and radial endobronchial ultrasound for minimally invasive diagnosis of peripheral pulmonary lesions

Data regarding the efficacy of virtual bronchoscopy (VB) compared to radial endobronchial ultrasound (rEBUS) for minimally invasive diagnostics of peripheral pulmonary lesions (PPLs) are still controversial.Aim. To assess the comparative efficacy of VB versus VB plus rEBUS in patients with PPLs.Methods. The study enrolled 36 subjects with PPLs detected by chest high resolution computed tomography (HRCT). All patients had bronchoscopy with various biopsy methods (based on navigation) alone or in combination with each other, followed by cytological, histological (if the biopsy sample was available), and microbiological analysis of the specimens. The subjects were randomized into two groups depending on the navigation technique: VB + rEBUS group (I) and VB group (II). VB (Osirix) was done as a planning procedure before real bronchoscopy with rEBUS navigation (Olympus UM-S20-17S) in group I. In group II VB was the only navigation technique.Results. Overall diagnostic yield (d. y.) reached 60% and 56% for groups I and II, respectively. In group I, the d.y. reached 86% for malignancy and 42% for other benign diseases. In group II, the d.y. reached 100% for malignancy and 36% for other benign diseases. The navigation efficacy was higher in the presence of a draining bronchus sign according to chest HRCT, lesion size more than 20 mm, upper lobe peripheral lesion. In group I, detecting the lesion with the ultrasound radial mini probe was also a predictor of efficacy. In group II, abnormal intraluminal bronchial anatomy according to VB as a sign of central lung cancer was also a predictor of efficacy.Conclusion. Both rEBUS and VB are safe and effective navigation techniques that provide for highly effective minimally invasive diagnosis of PPLs. VB could be a sound alternative when rEBUS is unavailable.

Endobronchial Ultrasound-Guided Transbronchial Needle Aspiration (EBUS-TBNA): Technical Updates and Pathological Yield

Since the endobronchial ultrasound bronchoscope was introduced to clinical practice, endobronchial ultrasound-guided transbronchial needle aspiration (EBUS-TBNA) has become the procedure of choice to sample hilar and mediastinal adenopathy. Multiple studies have been conducted in the last two decades to look at the different technical aspects of the procedure and their effects on the final cytopathological yield. In addition, newer modes of ultrasound scanning and newer tools with the potential to optimize the selection and sampling of the target lymph node have been introduced. These have the potential to reduce the number of passes, reduce the procedure time, and increase the diagnostic yield, especially in rare tumors and benign diseases. Herein, we review the latest updates related to the technical aspects of EBUS-TBNA and their effects on the final cytopathological yield in malignant and benign diseases.

THE USE OF ANTEGRADE ENDOBILIARY INTERVENTIONS IN BENIGN DISEASES OF THE BILIARY TRACT COMPLICATED BY MECHANICAL JAUNDICE

Introduction. One of the most common manifestations of diseases of the biliary tract are strictures or stenoses. They can have malignant, inflammatory and traumatic etiology, as well as be accompanied by mechanical jaundice syndrome. Aim. To study the results of the use of antegrade endobiliary interventions in benign diseases of the biliary tract complicated by mechanical jaundice. Materials and methods. An analysis of surgical treatment of 34 patients with benign diseases of the biliary tract complicated by mechanical jaundice (MJ) in the SI “V.T. Zatsev IGUS NAMSU». Choledocholithiasis was the cause of MF in 21 (61.8 %) cases, stricture of the LV in 6 (17.6 %) and stricture of the biliodigestive anastomosis (BDA) in 7 (20.6 %) patients. BDA strictures developed after the following operations: biliobiliostomy — 1 (14.3 %), hepaticojejunostomy — 3 (42.9 %), choledochoduodenoanastomosis — 2 (28.5 %) and hepaticoduodenostomy — 1 (14.3 %) %). Research results. External percutaneous transhepatic cholangiodrainage was performed in 7 (46.7 %) patients, external-internal percutaneous transhepatic cholangiodrainage was performed in 6 (40 %), percutaneous transhepatic cholecystostomy was performed in 2 (13.4 %) patients. With slightly dilated intrahepatic ducts (<5 mm) cholangiodrainage was established in 3 (20 %) patients. Of these, in 3 (20.0 %) cases, a separate percutaneous transhepatic cholangiodrainage of the right and left lobular ducts of the liver was performed. Performing percutaneous transhepatic cholangiography and percutaneous transhepatic cholangiodrainage allows to determine the level and nature of biliary block in a minimally invasive way, to perform biliary decompression and prevention of complications after an unsuccessful attempt at endoscopic treatment. Conclusions. By using antegrade endobiliary interventions, we were able to reduce the risk of biliary decompression complications compared with patients who had unsuccessful attempts at endoscopic treatment from 15 (78.9 %) to 1 (6.67 %), and to reduce the number of complications after reconstructive rehabilitation. operations from 10 (52.6 %) to 1 (6.67 %) and the mortality rate from 2 (10.5 %) to 1 (6.67 %).

P-BN33 Should a three-port technique be the gold standard for laparoscopic cholecystectomy?

Background The four-port technique is currently considered the gold standard technique for laparoscopic cholecystectomy. A three-port technique has been described but there is no consensus over the safety profile and efficacy of this technique compared to the four-port technique. Methods A comprehensive systematic review and meta-analysis comparing the three-port technique to the standard four-port technique in laparoscopic cholecystectomy for benign diseases of the gallbladder was performed. Two authors independently conducted an electronic database search of CENTRAL, MEDLINE, EMBASE, CINAHL, WHO ICTRP and ClinicalTrials.gov. For each outcome, we calculated the risk ratio (RR), mean difference (MD) or standardised mean difference (SMD) with 95% confidence intervals. Results Eighteen trials were included which randomised 2085 participants. Length of hospital stay and postoperative analgesia requirement favoured the three-port group [(MD -0.29, 95% CI -0.43 – -0.16, p &lt; 0.0001) and (SMD -0.68, 95% CI -1.03 – -0.33, p = 0.0001) respectively]. There were no differences in length of procedure and success rate between the two groups [(MD 0.90, 95% CI -3.78 – 5.58, p = 0.71) and (RR 0.99, 95% CI 0.97 – 1.01, p = 0.17) respectively]. There were no differences in the rate of any measured adverse events. There were no mortalities in either group. The GRADE quality of evidence was low. Conclusions The three-port technique for laparoscopic cholecystectomy can be chosen by experienced surgeons who perform it regularly. However, the decision to use three ports should not be at the expense of safe dissection.

Simple Serum Pancreatic Ductal Adenocarcinoma (PDAC) Protein Biomarkers—Is There Anything in Sight?

A poor PDAC prognosis is due to a lack of effective treatment and late diagnosis. The early detection of PDAC could significantly decrease mortality and save lives. Idealbiomarkers for PDAC should be cost-effective, detectable in easily accessible biological material, and present in sufficient concentration in the earliest possible phase of the disease. This review addresses newly selected, simple protein biomarkers—new ones such as thrombospondin-2, insulin-linked binding protein 2, lysophosphatidic acid, and autotaxin and conventional ones such as Ca19-9, inflammatory factors, and coagulation factors. Their possible use in the early detection of PDAC, differentiation from benign diseases, prognosis, and treatment response prediction is discussed. We also address the usefulness of possible combinations of biomarkers in diagnostic panels.