Saratov JOURNAL of Medical and Scientific Research

Zakharova N.B.

Saratov State Medical University, Head of Central Scientific Research Laboratory, Professor, Doctor of Medical Science

The prospects for application of biomarker "vascular endothelial growth factor" in predicting the treatment outcomes of bladder cancer

Year: 2018, volume 14 Issue: №2 Pages: 268-272
Heading: Urology Article type: Original article
Authors: Zakharova N.B., Ponukalin A.N., Skriptsova S.A.
Organization: Saratov State Medical University
Summary:

Purpose: assessment of the diagnostic value of Vascular Endothelial Growth Factor (VEGF) in predicting the outcome treatment of patients with muscle-invasive bladder cancer. Material and Methods. The study involved 264 people: 204 patients with RMP; 60 people aged 21 to 60 years were the comparison group. Patients with RMP are divided into stages of the disease. With non-muscle-invasive ВС (NIRMP) under TA-1NxMo there were 75 patients. Out of 129 patients with muscle-invasive ВС (MIRE) within the body (pT2aN0M0-T2bN0M0) was diagnosed in 69 of people. In 60 patients, the tumor sprouted paravesical tissue and surrounding organs (rt3a-bn0m0-41; pT36N1M0-11; pT4N1M0-5; T4N1M1-3); 19 patients had metastases to the iliac lymph nodes are installed only after the operation. Metastases were found in three patients out of 19 in addition to the lymphonoduses in the lungs. Tumors had the following gradations: G1-97; G2-37; G3-58. All patients NMIN (n=75) completed a TUR of the bladder wall with the tumor. MERE patients underwent radical cystectomy (n=117), open resection of the bladder (n=12), palliative surgery (n=3). The period of follow-up after surgical treatment was 3.5±0.5years. Quantitative determination of VEGF in blood serum was performed by solid-phase ELISA. Results. Despite the fact that the increase in VEGF level of blood serum in groups of patients with NIMRE and MIRE has significant differences both before and in the postoperative period, it is associated with the aggressiveness of tumor growth, development of metastases and recurrences of the disease. Conclusion. The increase in the content of VEGF serum suitable for use as an indicator: the risk of relapse within the first year after TUR in patients NMIN; development of relapses and metastases in pre and postoperative periods in MERE patients.

AttachmentSize
2018_2_268-272.pdf242.72 KB

Dynamics of angiogenesis and inflammation biomarkers in patients with urolithic disease with obstructive uropathy

Year: 2017, volume 13 Issue: №3 Pages:
Heading: Urology Article type: Original article
Authors: Popkov V.M., Zakharova N.B., Ponukalin A.N., Polozov A.B., Khotko D.N., Khotko A.l., Spirin P.V.
Organization: Scientific Research Institute of Traumatology Orthopedics and Neurosurgery of Saratov State Medical University n.a. V.I. Razumovsky
Summary:

Purpose: to establish the nature of changes in markers of angiogenesis and inflammation in the blood serum and urine in patients with obstruction of the ureteropelvic segment or upper third of the ureter by ureteral stones in different terms of the kidney drainage. Material and Methods. 53 patients with urolithiasis have been examined. The main group consisted of 33 patients with concrements of the upper third of the ureter or renal pelvis-ureteral segment with pres- ent obstructive uropathy. The comparison group consisted of 20 patients with calculi of the kidney without symptoms of obstruction. In the main group patients underwent drainage of the kidney by percutaneous-nephrostomy puncture. Results. Patients of the main group revealed a significant increase in the levels of markers of angiogenesis and inflammation before the kidney drainage. The level of MCP-1 correlated with the level of serum creatinine. In the process of drainage the levels of these markers were decreased as a result of increased GFR. Determination of the concentration of urinary VEGF, IL-8 and MCP-1 in patients may have clinical value in personalized management of patients with obstructive uropathy to determine the optimal terms of the second stage of the surgical intervention. Conclusion. Determination of markers of inflammation and angiogenesis in the urine of patients in conjunction with assessment of renal function by creatinine level is important for determining the term of kidney drainage.

AttachmentSize
2017_03_527-532.pdf378.73 KB

Comparative analysis of biochemical, immunological status in patients with different stages of diabetic retinopathy.

Year: 2017, volume 13 Issue: №2 Pages: 412-416
Heading: Ophtalmology Article type: Original article
Authors: Kozorezova O.V., Kamenskikh T.G., Kolbenev I.О., Zakharova N.B., Kozletsov A.P., Stepanova T.V.
Organization: Saratov State Medical University
Summary:

Objective: comparative analysis of biochemical, immunological status in patients with different stages of diabetic retinopathy. Material and methods. The study group included 137 patients with diabetic retinopathy. A control group consisted of 30 patients with myopia average. Results. The increase of indicators such as glycated hemoglobin, glucose, cholesterol, LDL cholesterol, IL-8, IL-6, TNF-alpha in patients with diabetic retinopathy compared to normal values. The content of IFN -y in both groups significantly below the normal level. Conclusion. The final peroxidation products, reactive oxygen species generate new antigens and trigger an immune response that is expressed in the form of increased concentration of IL-6 (acute phase of immune inflammation), and then TNF-alpha and IL-8; these cytokines activate angiogenic growth factors TGF 131 and VEGF. Increasing the concentration of angiogenic factors triggers neovascularization and proliferation.

AttachmentSize
2017_02-1_412-416.pdf261.7 KB

Efficiency analysis of laser magnetic stimulation of an eye drainage system in the treatment of patients with different stages of primary open angle glaucoma based on developments of functional indicators and biochemistry factors

Year: 2017, volume 13 Issue: №2 Pages: 406-411
Heading: Ophtalmology Article type: Original article
Authors: Filatova V.S., Kamenskikh T.G., Zaharova N.B.
Organization: Saratov State Medical University
Summary:

The purpose of study is to develop efficiency analysis of laser magnetic stimulation of an eye drainage system in the treatment of patients with primary open angle glaucoma (POAG). Material and Methods. The study included 197 patients with established diagnosis of POAG. The first group included 104 patients treated with drug treatment and laser magnetic stimulation of the drainage system of the eye using the «AMO-ATOS-ICL». The second group included 93 patients who received only drug therapy. Patient underwent visometry, oftalmobiomicroscopy, threshold perimetry electrophysiological study, the study of intraocular blood flow, level of VEGF and MCP-1. Results. A comparative analysis showed that the use of laser magnetic stimulation eye's drainage system in the treatment of patients with different stages of POAG to an activation of intraocular blood flow, but it was more significant in patients of the main group who were diagnosed with I and II stages of POAG. The decrease in intraocular blood flow resulted in ischemia while the level of VEGF increased. Conclusion. Analysis of clinical, electrophysiological and hemodynamic parameters in treatment of patients with POAG before and after laser magnetic stimulation improved of the state of the visual system in comparison with those in control group.

Keywords: MCP-1, VEGF
AttachmentSize
2017_02-1_406-411.pdf1.01 MB

Experience of antiangiogenic and corticosteroid therapy of a diabetic macular edema

Year: 2017, volume 13 Issue: №2 Pages: 383-388
Heading: Ophtalmology Article type: Original article
Authors: Kamenskikh T.G., Batishcheva Yu.S., Kolbenev I.O., Tsipyashchyk A.F., Andreychenko O.A., Gileva E.M., Vasil'yeva T.V., Zakharova N.B.
Organization: Saratov State Medical University
Summary:

Diabetic macular edema (DME) is a leading cause of blindness in patients with diabetes. The purpose of the research is to evaluate the effectiveness of treatment of patients with DMOs resistant to the administration of ranibi-zumab, using the intrauritreal implant "Ozurdex". Material and Methods. 66 patients (98 eyes) are examined. All of the patients were divided, into three groups, depending on a stage of a diabetic retinopathy. The patients underwent a complex of examinations: along with traditional methods, optical coherence tomography, fluorescence angiography of the fundus, multifocal electroretinography, determination of the content of VEGF-Aand cytokines in serum were used. Results. According to ОСТ of a retina and a visometry there are differences in efficiency of treatment depending on a condition balance of cytokine. Conclusion. The use of the intrauretic implant "Ozurdex" was more effective in patients with DMO in the stage of p re-pro I iterative diabetic retinopathy and in patients resistant to anti-VEGF therapy.

AttachmentSize
2017_02-1_383-388.pdf2.1 MB

Clinical and immunological parallels in the diagnosis of primary open-angle glaucoma.

Year: 2017, volume 13 Issue: №2 Pages: 378-383
Heading: Ophtalmology Article type: Original article
Authors: Kamenskikh I.D., Kamenskikh T.G., Kolbenev I.O., Zakharova N.B., Kozletsov A.P., Tuchin V.V.
Organization: Saratov State Medical University, Saratov state university, Yuri Gagarin State Technical University of Saratov
Summary:

The purpose of study is an assessment of the informative value of various diagnostic parameters in monitoring and prognosis of the state of the visual organ in patients with primary open-angle glaucoma. Material and methods. 216 patients (216 eyes) were examined. 126 patients (126 eyes) with the diagnosis of primary open-angle glaucoma I, II or III stage were included in the main group (I), and 90 patients (90 eyes) without ophthalmologic pathology were included in the control group (II). All patients underwent complex examination. Laser confocal scanning tomography for the analysis of the optic disc morphology was performed using a Heidelberg Retina Tomograph II from Heidelberg Engineering (Germany). Evaluation of the field of view was carried out using the computer static perimeter Oculus twinfield-2 (Germany). Electrophysiological studies (apparatus Roland Consult, Germany) included: the study of visual cortical potentials on the outbreak, the pattern-electroretinogram, photopic negative response. Neurotrophic brain factor, ciliary neurotrophic growth factor and protein NF-200, S-100 protein, monocyte chemoattractant, vascular endothelial growth factor were determined in the serum. Results. An increase in the concentration of the S-100 protein with progression of POAG testifies to the existence of parallels between apoptosis of retinal ganglion cells and systemic neurodegenera-tion affecting the central nervous system as a whole. The importance of electrophysiological research methods, which give information about the third neuron of the visual pathway, has been confirmed. Pattern-electroretinogram, photopic negative response most reflect abnormalities in the work of ganglion cells of the retina, including before the appearance of structural changes in the optic disc and the retina. Conclusion. The interrelation of dynamics of functional, morphological and immunological criteria of progression of POAG is revealed, which allows to predict the further course of the pathological process. Since the study involved patients with IOP target values, it is important not only to maintain IOP on target values, but also to carry out neuroprotection.

AttachmentSize
2017_02-1_378-383.pdf1.76 MB

Diagnostic value of bio-markers in the prognosis of postoperative relapses and metastases in patients with breast cancer

Year: 2017, volume 13 Issue: №2 Pages: 239-244
Heading: Oncology Article type: Original article
Authors: Cheburkayeva M.Yu., Zakharova N.B., Fedorov V.E., Teryoshkina N.E., Gergenreter Yu.S.
Organization: Regional Oncology center №2, Saratov State Medical University
Summary:

Purpose: to improve the diagnosis of relapse and metastasis of breast cancer in the postoperative period. Material and methods. 123 women were examined. Of these, 30 practically healthy women made up a control group, 20 women had benign breast diseases, 73 had breast cancer. The patients with ВС before the surgical intervention were divided into groups according to the stage of the disease. The 1st group consisted of 30 practically healthy women. In the second group — 20 women with fibroadenomas of the breast. In the third group — 33 women with l-ll stages of breast cancer without regional metastases. The 4th group consisted of 22 women with stage II breast cancer with regional metastases, in the 5th group — 18 patients with stage III breast cancer. After surgery, 68 patients were re-examined and divided into 2 analytical groups. The 6th group included women without clinical manifestations of relapses and metastases in the postoperative period — 44 (64.7%). Group 7 consisted of 24 (35.3%) women who had metastasis and local recurrences of the disease in the postoperative period. To determine the content of fetal proteins (Ca-15-3, Ca-125, REA), IL-8 and VEGF, commercial sets of reagents for solid-phase enzyme-linked immunosorbent assays were used. Results. Analysis of the data obtained showed that the most significant increase in serum and plasma VEGF levels occurred in breast cancer patients with clinical signs of metastasis and recurrence of the disease. Of fetal proteins, a significant increase in blood content showed Ca15-3 and CEA. Conclusion. We can assume that in patients with breast cancer only in the postoperative period, the rise in VEGF was associated with the growth of tumor tissue and the development of invasion and metastasis.

AttachmentSize
2017_02_239-244.pdf516.97 KB

Biomolecular assessment of renal function in various types of surgical treatment of renal cell carcinoma

Year: 2017, volume 13 Issue: №1 Pages: 73-77
Heading: Traumatology and Orthopedics Article type: Original article
Authors: Popkov V.M., Tarasenko A.l., Maslyakova G.N., Rossolovsky A.N., Zakharova N.B., Berezinets O.L., Lomakin D.V.
Organization: First Moscow State Medical University n.a. I.M. Sechenov, Saratov State Medical University
Summary:

Objective: to assess the possibility of using the markers of acute kidney injury to predict the preoperative risk for the subsequent decline in glomerular filtration rate in different types of surgical treatment of renal cell carcinoma (RCC). Material and methods. 60 patients with histologically confirmed RCC T1-3M0N0 operated in the clinic of urology of Saratov State Medical University n.a. V. I. Razumovsky in the volume of nephrectomy or partial nephrectomy. Before surgery all patients underwent standard examination intended for patients with kidney tumors: ultrasound, MRI, excretory urography and dynamic renoscintigraphy, the perioperative values of serum creatinine and glomerular filtration rate were determined. Using the method of immuno-enzymatic analysis the concentrations of excreted with the urine NGAL and IL-18 in serum samples at the preoperative stage, after 5 days and after 1 month of postoperative follow-up were investigated. Differences in clinical data and clinical variables were compared by using Spearman rank correlations and t-test. Results. The determined parameters of acute kidney injury markers IL-18 and NGAL in the early postoperative period were increased in patients after open nephrectomy. Moreover, the correlation analysis according to the Spearman method revealed a strong significant correlation between the preoperative levels of IL-18 and GFR after surgery (r=1; p<0.05). Conclusion. Laparoscopic resection of RCC is the method of choice for surgical treatment of RCC. As a predictor of adverse prognosis, the level of IL-18 in serum may be used. Its increase correlates with a decline in renal function in the postoperative period, and according to some reports, IL-18 also is an independent predictor of adverse prognosis in patients with a localized RCC.

AttachmentSize
2017_01_073-077.pdf628.86 KB

Academic N. N. Sirotinin and his scientific contribution to the development of national medicine (to the 120th birth anniversary)

Year: 2016, volume 12 Issue: №4 Pages: 627-632
Heading: Scientific schools and memorable dates Article type: Short message
Authors: Yatskevitch S.N., Zavyalov A.l., Morrison V.V., Zakharova N.B.
Organization: Saratov State Medical University
Summary:

The article presents biographical data of academic N.N. Sirotinin. It describes his scientific and practical contribution to the development of medicine in Russia and to the training of academic staff for the national medical school.

AttachmentSize
2016_04_627-632.pdf487.51 KB

The diagnostic importance of biomarkers of angio-genesis and inflammation at patients with prostate diseases

Year: 2016, volume 12 Issue: №4 Pages: 593-598
Heading: Urology Article type: Original article
Authors: Popkov V.M., Zakharova N.B., Ponukalin A.N., Tonkoschkur A.N.
Organization: Saratov State Medical University
Summary:

Purpose: to establish the nature of change of the maintenance of PSA and markers of angiogenesis and inflammation in blood serum at patients with prostate diseases. Material and Methods. 72 patients with the level of the general PSA more than 4 ju/ml were examined. The first group of patients with benign prostatic hyperplasia with histology conclusion and with benign prostatic hyperplasia and prostatic intraepithelial neoplasia of low degree included 29 patients, the second group consisted of 9 patients with prostatic intraepithelial neoplasia of high degree, the third group included 5 patients with the localized prostate cancer, the fourth group consisted of 25 patients with locally advanced prostate cancer, and the fifth group with 6 metastatic prostate cancer patients. Results. At patients with prostate diseases the rise of VEGF level in blood serum occurs with increase of the maintenance of PSA and develops at the precancer stage (the prostatic intraepithelial neoplasia of high degree) and against high concentration of biomarkers of inflammation. Determination of VEGF concentration in blood serum at patients with "a gray zone" of PSA may have clinical value at the personified maintaining of patients with prostate cancer at the stage of pre-biopsy diagnostics. Conclusion. The simultaneous increase of the VEGF content in blood serum and the general PSA at prostate cancer patients is one of characteristics of a progression of tumoral growth.

AttachmentSize
2016_04_593-598.pdf475.7 KB