CC BY
8
ISSN2079-8334. Ceim медицини та бюлогп. 2018. № 4 (66)
Исследование проведено на большеберцовой и тазовой костях белых половозрелых крысах-самцах в начальном возрасте 3 месяца. Половая принадлежность выбрана в связи с тем, что в отличие от самок, у самцов не возникают циклические изменения в гормональном фоне. По данным однофакторного анализа, 60-дневное действие паров толуола на организм крыс достоверно влияло на показатели, характеризующие костеобразующую функцию проксимальных эпифизарных хрящей и надкостницы большеберцовой кости, а также фазовый состав биоминерала тазовых костей в период с 1 по 60 день наблюдения, при этом сила влияния действующего фактора для большинства показателей сохранялась на примерно одинаковом уровне до 15 дня периода наблюдения, а затем постепенно уменьшалась. Использование в качестве корректора тиотриазолина на фоне влияния паров толуола оказывало достоверное влияние по отношению к параметрам первой группы на показатели, характеризующие морфо-функциональное состояние костей в течение всего периода наблюдения, при этом на показатели, характеризующие фазовый состав биоминерала тазовых костей условия эксперимента оказывали достоверное влияние только с 15 по 60 день наблюдения.
Ключевые слова: кости, строение, толуол, тиотриазолин, факторный анализ.
Стаття надшшла 15.06.18 р.
tibia and pelvic bones of white mature rats-males in the early age of 3 months. Sex was chosen due to the fact that unlike females, males do not undergo cyclic changes of the hormonal background. According to univariate analysis, the 60-days action of toluene vapors on the rat body significantly influenced the indices of osteoplastic function of the proximal epiphyseal cartilage and the periosteum of the tibia, as well as phase composition of biomineral pelvic bones during the observation period of 1 to 60 days, the force of the acting factor's impact on most indices remained at approximately the same level until the 15th day of the observation period, and then gradually decreased. Using as a corrector of tiotriazolini on the toluene vapors impact background has provided a significant impact compared to the parameters of group 1 on the indices characterizing morphofunctional state of bones during the whole observation period, while the parameters characterizing the phase composition of pelvic bones biominerals, the experimental conditions had a significant effect only from 15th to 60th day of observation.
Key words: bones, structure, toluene, thiotriazoline, factor analysis.
Рецензент Шеттько B.I.
DOI 10.26724/2079-8334-2018-4-66-212-215 UDC 618.198-006.6-03
SOME SPECIFIC EPIDEMIOLOGICAL AND CLINICO-MORPHOLOGICAL FEATURES
OF MALE BREAST CANCER
E-mail: natavinnik0910@gmail.com
The paper presents current data on the features of male breast cancer (MBC) morbidity and mortality. The analysis of rates in Poltava region has been carried out. It has been revealed, that the level of MBC morbidity and mortality is similar to the national rates and conforms to the global tendencies. The need for significant improvement of diagnosis by active implementation of the advanced pathomorphological methods has been substantiated. The paper is also highlights the necessity for physicians of different specialization to be more aware about oncological diseases with rare localization, requiring more oncological alertness.
Keywords: breast cancer, men.
The paper is a fragment of the research project "Determination of the patterns of morphogenesis of organs, tissues and vascular-nervous structures in normal conditions, experiment and under the effect of exogenous factors. Mophoexperimantal substantiation of the effect of the novel suture material in its application in clinical practice", state registration No. 0113U0010024.
Male breast cancer (MBC) is a rare malignant tumor of the epithelial origin, developed from the cells of rudimentary mammary glands.
Breast cancer in women ranks first among the incidence of various neoplasia worldwide. The statistics reports male breast cancer to be uncommon pathology. In the structure of malignant tumors morbidity in men, male breast cancer is accounted on the average for 0,2% [4], with an incidence of 1:100 relative to breast cancer in women. The rate has not been changed for the last 30 years, accounting for less than 1% of all lethal cases due to malignant tumors among male population.
Publications report that the average morbidity among male population is on the average ten years later compared to females, occurred most often in the 6-7th decades of life; however, the occurrence of the pathology has been reported at the age of 9 [7] to 90 and more years [1]. At the same time the rapid rise of morbidity of female breast cancer is growing with age mainly to 50 years old and then slows down [6].
However, notwithstanding the relative rarity of this pathology, the problem of male breast cancer is of great importance, since more than a half of patients were first admitted to medical facilities already with locally advanced and metastatic breast cancer [5]. The clinical features of MBC, compared to female breast cancer, are more specific for late stages of the disease. The diagnosis of MBC at the time of first presentation is missed in approximately of 20% of cases. Notably, a prominent local advancement of the process is established in 46.8% of cases at the time of presentation [2]. V.P. Letiahin at al. [3] emphasizes
© S.N. Sovhyria, N.I. Vynnyk, 2018
ISSN2079-8334. Ceim MeduHunu ma 6ionozn. 2018. № 4 (66)
that the anatomical features of MBC and the proximity of the mammary gland facilitate detection of even small initial alterations by common superficial palpation. However, the authors also report about only 34% of men with breast cancer, visit a doctor during the first month after manifestation of the disease. Other patients, who noted the changes in the mammary gland, do not seek for medical assistance for months and sometimes years. In addition, it has been highlighted that 61.4% of 125 treated patients were presented with stage III/IV disease.
Thus, notwithstanding the simplicity of the MBC diagnosis, the advancement of the pathology is crucial for timely diagnosis of the disease [8]. Apparently, this fact has prompted many researchers to determine the most significant prognostic factors for MBC development to elaborate the effective multimodality therapy of the disease.
Fig. 1. Distribution of patients with breast cancer in Poltava region by age from the period 2010 to 2017.
The purpose of the study was to determine the major epidemiological and clinical-morphological features of the MBC, based on the analysis of publications on the breast cancer morbidity and mortality in Poltava region.
Materials and methods. To achieve the purpose of the research the analysis of the male breast cancer morbidity and mortality based on the data of the cancer-register of Poltava Regional Clinical Oncological Dispensary and repository of the biopsy material of Poltava Regional Bureau of Autopsy has been carried out from the period 2010 to 2017.
Fig. 2. Invasive carcinoma G1. Microspecimen *100. H&E stain. Fig. 3. Invasive carcinoma G2. Microspecimen *200. H&E stain.
Results of the study and their discussion. It has been established that during the studied period 34 first-revealed cases of MBC were recorded in Poltava region. 4.5±2.5 cases of breast cancer is registered in this geographic region annually with the peak incidence in 2010 (7 cases) and the lowest incidence in 2011 (2 patients). Thus, average of 0.7 cases in 100000 population are revealed annually in this region that is totally confirms to the similar national rates.
The average age of patients was 71 years, with the youngest aged 33 years and the oldest aged 95. It has been found that the prevailing majority of patients were of the senior (40%) and senile (43.5%) age (fig.1).
The MBC mortality rate accounted on the average of 0,4 in 100 thousand of population that confirms the similar national rates. Histological study showed mainly invasive forms of breast cancer
ISSN 2079-8334. Ceim Meduwuu ma dioROziu 2018. № 4 (66)
(97.06% of cases) that are significantly higher the rates presented by other investigators [5,6]. At this stage of invasion the primary site of tumor failed to be detected in most cases.
Determination of the stage of breast cancer differentiation showed that poorly differentiated tumors that correspond to Grade 3 of anaplasia (G3) accounted for 0,1%; moderately differentiated forms with Grade 2 of anaplasia (G2) were rare (35,2%) and the rest 14,7% was determined as Grade I of anaplasia (G1).
Grade I (G1) infiltrating carcinomas were presented mainly by adenocarcinomas and characterized by multiple tubular or solid-glandular structures, located among fibrous tissue. Hyperchromicity and multiformity of the nuclei was poorly expressed with few mitoses (fig. 2).
Grade II (G2) infiltrating carcinomas were presented by scarce alveolar structures, located among fibrous tissue. Cells of various size and shape and nuclei with different degree of hyperchromicity, as well as pathological mitoses were revealed (fig.3).
A
Fig. 4. A. Invasive carcinoma G3. Microspecimen *200. H&E stain. B. Invasive carcinoma G3. Microspecimen *400. H&E stain.
B
Grade III (G3) infiltrating carcinomas were characterized by scirrhous structures, in some cases in the form of massive cellular sheets (fig. 4). A pronounced polymorphism of the cells and nuclei was detected. Nuclei were either large, clear with numerous nucleoli, or prominently hyperchromatic. Multiple pathological mitoses are typical (fig. 5). Prominent lymphoplasmacytic infiltration and vascular invasion was also revealed.
1. Breast cancer is the disease of predominantly senior (40%) and senile (43,5%) male population with the average age of 64±31 years, in contrast to females, where the average age is 40-50 years.
2. In Poltava region MBC morbidity and mortality rates are similar to the national rates.
3. The ratio of invasive to noninvasive forms of breast cancer accounted for 97.06% to 2.94%, respectively, indicating about very low level of the diagnostics at the stage of noninvasive forms. This index in Poltava region is much higher the index reported in publications, thus, there is a need in enhancement and improvement of methods of MBC diagnosis.
4. 50,1% of all cases of invasive carcinoma is characterized by the stage 3 anaplasia that has dramatically negative prognostic value and worsens the efficacy of treatment. Active implementation of immunohistochemical, biochemical and moleculogenetic markers is the prospective approach to pathomorphological diagnosis.
Consequently, the presented late diagnosis of breast cancer can be explained, from the one hand, by the patents' unawareness, and, from the other hand, inadequate oncological alertness of family physicians, as well as low level of diagnostics.
1. Bykova AV, Vorotnikov YK, Vishnevskaya YaV, Denchyk DA, Lyubchenko LN. Problema raka molochnoy zhelezy u muzhchin. Sibirskiy onkologicheskiy zhurnal. 2011; 4 (46): 64-8. [in Russian]
2. Gotko YS, Sochka AV. Rak grudnoyi zalozy u cholovikiv: vplyv kategoriyi T na prognoz zakhvoryuvannya. Onkolohiya. 2007; 9(1): 29-32. [in Ukrainian]
3. Letyagin VP. Opukholi molochnykh zhelez u muzhchin. Mammologiya. 2006; 2: 13-20. [in Russian]
4. Nikolayev KS. Kliniko-morfologicheskiye osobennosti raka molochnoy zhelezy u muzhchin. Voprosy onkologii. 2013; 3: 35862. [in Russian]
5. Nikolayev KS, Semiglazov VF, Semiglazov VV. Rak molochnoy zhelezy u muzhchin (obzor literatury). Sovremennaya onkologiya. 2014; 4 (16): 31 - 7. [in Russian]
ISSN2079-8334. Ceim медицини та бюлогп. 2018. № 4 (66)
6. Semiglazov VF. Breast cancer in men. Pharmateka. 2010; 6: 40-5.
7. Tyshchenko EV, Pak DD, Rasskazova EA. Breast cancer in men. Oncology: Journal named P.A. Herzen. 2014.; 1: 19-23.
8. Anderson WF, Chu KC, Chang S, Sherman ME. Comparison of agespecific incidence rate patterns for different histopathologic types of breast carcinoma. Cancer Epidemiol. Biomarkers Prev. 2004 Jul;13(7): 1128-35.
ДЕЯК1 ЕП1ДЕМЮЛОПЧШ ТА КЛ1ШКО-МОРФОЛОГ1ЧШ ОСОБЛИВОСТ1 РАКУ ГРУДНО1 ЗАЛОЗИ У ЧОЛОВ1К1В Совгиря С.М., Винник Н.1., Филенко Б.М., Сербш С.1., Агашков С.О. У статп наведет сучаст дат щодо сосбливостей захворюванност та смертност вщ раку трудно! залози у чоловiкiв. Проведено аналiз даних показникiв в Полтавськiй область Виявлено, що в Полтавсьюй област рiвень захворюванностi та смертностi вщ РГЗ у чоловiкiв не вiдрiзняeться вiд загальноукра!нських показникiв i вщповщають свiтовим тенденцiям. Обгрунована необхiднiсть значного покращення дiагностичного пошуку шляхом активного впровадження сучасних патоморфолопчних методiв. Також дана стаття мае за мету закцентувати увагу лiкарiв рiзного профшю до онкологiчних захворювань з рщюсною локалiзащею, що потребують бшьшо! онконастороженость
Ключовi слова: рак грудно! залози, чоловш.
Стаття надiйшла 2.10.18 р.
НЕКОТОРЫЕ ЭПИДЕМИОЛОГИЧЕСКИЕ
И КЛИНИКО-МОРФОЛОГИЧЕСКИЕ ОСОБЕННОСТИ РАКА ГРУДНОЙ ЖЕЛЕЗЫ У МУЖЧИН Совгиря С.М., Винник Н.И., Филенко Б.М., Сербин С.И., Агашков Е.А. В статье приведены современные данные об особенностях заболеваемости и смертности от рака грудной железы у мужчин. Проведен анализ данных показателей в Полтавской области. Выявлено, что в Полтавской области уровень заболеваемости и смертности от РГЖ у мужчин не отличается от общеукраинских показателей и соответствуют мировым тенденциям. Обоснована необходимость значительного улучшения диагностического поиска путем активного внедрения современных патоморфологических методов. Также данная статья имеет целью акцентировать внимание врачей разного профиля к онкологическим заболеваниям с редкой локализацией, требующих большей онконастороженности.
Ключевые слова: рак грудной железы, мужчины.
Рецензент Протна О.М.
DOI 10.26724/2079-8334-2018-4-66-215-218 УДК 611.018.1:616.64-089.87:599.323.7
СТРУКТУРНА ОРГАШЗАЦШ ШТЕРСТИЩАЛЬНИХ ЕНДОКРИНОЦИТ1В
ТА СУСТЕНТОЦИТ1В ПРИ ЕКСПЕРИМЕНТАЛЬНШ Х1М1ЧН1Й КАСТРАЦП НА РАНН1Х СТРОКАХ СПОСТЕРЕЖЕННЯ У ЩУР1В
E-mail: svi.umsa@gmail.com
Проведет детальн електронномкроскотчт дослщження штерстищальних ендокриноци™ та сустентоци™ сiм'яникiв статевозрiлих щурiв-самцiцiв лiнii «Вютар». Описанi особливостi структурно! оргатзацш цих клiтин за умов xiMi4Ho! кастрацii гозерiлiном пiсля 1 мюяця спостереження.
Ключов! слова: ам'яники, штерстищальт ендокриноцити, сустентоцити, xiiviinHa кастращя
The study is a fragment of the research project "Experimental morphological study of of cryopreserved placenta transplants action and other exogenous factors on the morphofunctional status in a number of internal organs ", state registration No. 0113U006185.
Актуальною проблемою сьогодення e вивчення морфофункцюнального стану структурних компоненпв им'яниюв за умов зменьшення фертильносп чолов1чого оргашзму при дн внутршшх та зовшшних чинниюв, яю впливают на перебн сперматогенезу [2,6,7]. Ультрамшроскошчш дослщження им'яниюв допомагають розкрити кооперативы впливи кттин Сертол1 та Лейдна при д1! р1зних шюдливих чинниюв, що призводять до порушень фертильност [3,5]. Не до кшця залишаються вивченими особливост ультраструктурно! оргашзацн сперматогенного ештелда та штерстицшно! тканини имяниюв з його кттинним складом у р1зн1 фази сперматогенезу при х1м1чн1й кастрацш [1]. Тому, з теоретично! i практично! точки зору, актуальним e проведення дослщжень вшх структурних компонентiв сiм'яникiв та його стану в рiзнi фази сперматогенезу.
Метою дослщження було встановлення особливостей електронно-мшроскошчно! органiзацii iнтерстицiальних ендокриноцитiв та сустентоципв щурiв при експериментальнiй хiмiчнiй кастрацii.
© С.В. Стецук, А.М. Гольцев, 2018
