Puncture biopsy of bifurcation lymph nodes in the diagnosis of lung cancer

Clinical, radiological and pathological data of a number of authors testify to the frequent defeat of the lymph nodes of the mediastinum with cancer metastases (MN Goryunova, 1951; Ya. G. Dillon, 1947; BK Osipov, 1959, etc.). Anatomical works of Ruvier (1932), DA Zhdanov (1947) and others testify to broad afferent connections of bifurcation lymph nodes in normal conditions with the organs of the chest cavity. These factors create the possibility of lymphogenous metastasis of cancer of the lung and esophagus in the mediastinal lymph nodes, in particular, in the bifurcation.

Approximation of the age distribution of cancer incidence using a mutational model

The approximation of the age distributions of cancer was carried out using a complex mutational model presented in our work [1]. Datasets from the American National Cancer Institute (SEER program) were used. We approximated the data of age distributions of lung, stomach, colon and breast cancer in women; cancer of the lung, stomach, colon and prostate in men. The average number of mutations (required for cancer formation) averaged over the four types of cancer is 5.25 mutations per cell in women and 5.5 mutations per cell in men. The average (over the four types of cancer) mutation rate is estimated as 0.0004 mutations per year per cell for women and 0.0008 mutations per year per cell for men. This article is a continuation of work [1].

MicroRNA-146a – the predictor of the development of metastases of choroidal melanoma

MicroRNAs (miRNA, miR) - regulate gene expression, take part in the regulation of cell life, proliferation and apoptosis. There are not enough publications on the study of microRNA in the plasma of patients with choroidal melanoma (CM) and the presented data are contradictory. An increase in the level of microRNA-146a in blood plasma was noted in patients with cancer of the lung, esophagus and breast. In the present study, we used microRNA-146a in the blood plasma of patients with CM. Purpose. To determine the possibility and reliability of detecting microRNA-146a in the blood plasma of patients with CM, taking into account the localization of the tumor and its size. Material and methods. The blood plasma of 84 patients was studied mean age 63.4±1.2 years. A control group of 28 people who did not have tumor or chronic autoimmune diseases mean age 63.25±1.43 years. The expression level of miRNA-146a was determined by quantitative PCR. Results. An increase in the level of microRNA-146a was shown, which correlates with the localization and thickness of the tumor. The results were confirmed by statistical analysis. Conclusion. MicroRNA-146a, which increases in plasma levels in patients with CM as its size increases, can be used as a biomarker of aggressive tumor course in terms of hematogenous metastasis. Key words: choroidal melanoma, microRNA-146a, biomarkers.

Prehabilitation during a pandemic: preoperative exercise to improve fitness in patients undergoing complex surgery for cancer of the lung or oesophagus, the PRE-HIIT trial: an updated study protocol

Background: Pre-operative fitness is an established predictor of postoperative outcome; accordingly, targeting pre-operative fitness through exercise prehabilitation has logical appeal. Exercise prehabilitation for patients with cancer of the lung or oesophagus is challenging to implement due to the short opportunity for intervention between diagnosis and surgery. In addition, there are now additional challenges to providing prehabilitation during the coronavirus disease 2019 (COVID-19) pandemic due to concerns about social distancing and minimising patient contact. The PRE-HIIT project will examine the influence of virtually delivered exercise prehabilitation on physiological outcomes and postoperative recovery. Methods: The PRE-HIIT randomised controlled trial (RCT) will compare a 2-week high intensity interval training programme to standard preoperative care in a cohort of patients with thoracic and oesophageal cancers. A protocol for this study has been published previously. As a result of the COVID-19 pandemic, changes to the study assessment battery and the mode of intervention delivery have been made. The PRE-HIIT programme will now be a home-based intervention. Both the exercise intervention and standard care will be delivered via telehealth. The recruitment target for the study remains 78 participants. There is no change to the primary outcome of the study; cardiorespiratory fitness. Secondary outcomes include measures of pulmonary and physical function, quality of life and post-operative morbidity. Outcomes will be measured at baseline and post-intervention. The impact of PRE-HIIT on well-being will be examined qualitatively with interviews post-intervention (T1). This revised protocol will also explore participant’s satisfaction with delivery of prehabilitation via telehealth. The healthcare costs associated with the PRE-HITT programme will also be examined. Discussion: The overall aim of this RCT is to examine the effect of tailored, individually prescribed high intensity interval training on pre-operative fitness and postoperative recovery for patients undergoing complex surgical resections. Trial registration: ClinicalTrials.Gov NCT03978325 07/06/2019

A clinical case of central cancer of the lung and infiltrative tuberculosis

The scientific challenge of combining the tuberculosis process and lung cancer has not been fully disclosed in modern literature. This primarily involves the low incidence of these two pathologies at the same time. This may contribute to difficulties in the qualitative and timely diagnosis of these diseases. Tuberculosis hides the radiological manifestations of a malignant tumor for a long time that contributing to its progression and the development of high mortality among patients. Lung cancer facilitates hemato- and lymphogenous spread of a specific pathogen. As an example, a clinical case of simultaneous occurrence of pulmonary tuberculosis and lung cancer which was observed in the patient admitted to the Department for patients with respiratory tuberculosis of Nizhny Novgorod regional clinical tuberculosis dispensary, was presented. We concluded that compliance with the algorithm of the mandatory diagnostic minimum when patients admitted to the general healthcare network, as well as compliance with the rules for population screening, especially among people over 45, will minimize the risks of delayed diagnosis in case of coexistence of respiratory tuberculosis and lung cancer.