At least for the past 25 years, mammography screening has been the official policy of the healthcare systems of European countries, North America and Australia. Seven huge randomized trials have shown a reduction of mortality from breast cancer (BC) by 20-35% in women 50-61 years old, accepted the invitation to mammography screening. At the same time, some epidemiologists and other researchers in biostatistics doubt the success of mammographic screening, considering "suboptimal" randomization in some of these studies. Nordic Cochrane Centre also does not recommend this strategy to reduce mortality from breast cancer. There is no doubt that the progress of adjuvant systemic therapy (chemo-, endocrine and targeted therapy) has reduced mortality from breast cancer. Therefore, the contribution of screening and systemic therapy in reducing mortality from breast cancer has evolved in favor of therapy. Nevertheless, mammography screening still should be recommended, especially for women 50-69 years old. This strategy is confirmed by the recomendations of the European Union, ESMO (2014), and ASCO (2014).

The impact of changes in orientation of the metabolism of carbohydrates and minerals in the cell malignancy has been demonstrated in several studies. The aim of this study was to analyze the molecular mechanisms and relationship of carbohydrate and mineral homeostasis with the processes of carcinogenesis. Parameters of carbohydrate and mineral metabolism of blood were defined in 73 patients with malignant tumors of epithelial tissues and 31 healthy subjects. In the presence of malignant tumors of epithelial tissues there was a statistically significant increase in the levels of glucose and glycated hemoglobin in the early stages of the disease and the absence of them at stage IV of the disease. There were no statistically significant differences in the levels of C-peptide and immunoreactive insulin in blood samples of cancer patients, although they tended to increase compared with the control group. Analysis of the composition of macroelements at the early stages of carcinogenesis revealed a statistically significant reduction of sodium level in plasma which wasn’t observed at the terminal stage of the disease. The concentrations of potassium and chlorine tend to increase in cancer patients, but the differences between these parameters were not statistically significant. Concentrations of calcium and magnesium significantly increased in the presence of malignant tumors. Analysis of microelements in the blood plasma showed a decrease in the concentration of cuprum and lithium (in 2.5-5 times) and the growth of strontium concentrations. Lithium has multiple effects on the life of cells, affecting a number of elements of messengers, as well as being the link between the carbohydrate metabolism and cell malignancy. Disorders of mineral homeostasis are important element in the disintegration of the metabolic processes in carcinogenesis

One of the most currently studied markers in oncology are receptors for fibroblast growth factor and their ligands. In this review we focus on the molecular processes that occur during the activation of receptors for fibroblast growth factor. And also consider the frequency of disorders of the expression of components of the signaling pathway of this receptor in various types of malignant diseases.

According to most investigators, stomach is the most common site of gastrointestinal lymphomas, but endoscopic semiotics and diagnostics of these lesions is not sufficiently developed.

Aim: to develop criteria for the diagnosis of endoscopic non-Hodgkin lymphomas (NHL) of the stomach.

Materials and methods: We studied endoscopic view of gastric lymphoma in 250 patients, in 160 (64%) patients lesions were regarded as the primary, and in 90 (36%) – as secondary. In our study all patients underwent standard videoendoscopic examination of the stomach, which included examination with magnification of 115 times, together with an analysis of microvascular picture with narrow spectrum analysis of mucosal and submucosal layers of the stomach wall, followed with chromogastroscopy using 0.4% solution of indigo carmine and endoscopic ultrasound. The diagnosis of lymphoma was verified by morphological and immunohistochemical methods.

Results: According to our observations duration of the period of the presence of gastroenterological diseases until diagnosing of a tumor in the group of patients with primary lymphoma of the stomach is very variable: during the first 3 months diagnosis was established in 30.6% (n=49) of patients, during 6 months – in 18.1% (n=29) of patients, during period from 6 to 12 months in 15.6% (n=25) of patients and it should be noted that nearly a third of patients (27.5%, n=44) diagnosis of primary gastric lymphoma was established after one year. Macroscopic forms of gastric tumor was presented by the following variants: exophytic – in 22 patients (8.8%), infiltrative – in 54 (21.6%), ulcerative – in 37 (14.8%), infiltrative-ulcerous – in 71 (28.4% ), gastritis-like - in 36 (14.4%) and mixed - in 30 (12.0%)..

Another direction of our study was to identify the characteristics of the macroscopic manifestations depending on the morphological variant of gastric lymphoma. According to presented data gastritis-like variant dominated in patients with MALT-lymphoma (in 34.3%), infiltrative-ulcerous variant dominated in patients with diffuse large B-cell lymphoma of MALT type, as in patients with diffuse large B-cell lymphoma - in 45.0% and 41.1% respectively. Infiltrative variant was most frequent in patients with follicular lymphoma (31.8%), and ulcerative variant was dominated in patients with Burkitt's lymphoma (60.0%).

Conclusion: the most informative diagnostic criteria for endoscopic gastric NHL were established.

Relevance: Hilar cholangiocarcinoma is the most common malignant tumor of the bile ducts.

Aim: analysis of the first experience of radical and conditionally radical operations performed in MCSC during one year.

Materials and methods: Extended hepatectomies combined with resection of bile ducts and first segment performed in 18 patients with Klatskin tumor. Right hemihepatectomy performed in 8 patients, resection with caudal lobectomy – in 8 patients. The preoperative percutaneous right-sided selective portal embolisation using Celonova microspheres was performed in 5 patients. One patient with type II tumor according to Bismuth-Corlette classification underwent hemihepatectomy with a left caudal lobectomy and resection of the extrahepatic bile ducts using laparoscopic approach and DaVinci robotic system.

Results: The average volume of intraoperative blood loss was 705±616 ml (range 200 to 2000 ml). Postoperative III and IV grade complications according to Clavien-Dindo classification occurred in 13 patients (72%). Two patients (11%) died postoperatively. The cause of death in both observations was severe sepsis. Patients with R1 and R2-resections undergo adjuvant chemotherapy with no objective signs of progression. Patients with R0-resection are under observation with no signs of progression.

Conclusion: Late diagnosis, a high risk of postoperative complications requires a multidisciplinary approach at each stage of the treatment of Klatskin tumor.

Uveal melanoma is a tumor that has neuroectodermal origin and develops from melanocytes of uveal tract (choroid, ciliary body, iris). This disease is a rare variant of melanoma, accounting for about 3.5% of all reported cases of melanoma. In the treatment of metastatic melanoma has already achieved considerable success, tyrosine kinase inhibitors BRAF and MEK (vemurafenib, dabrafenib, trametinib, etc.) and monoclonal antibodies to block CTLA-4, PD-1 and PD-L1 (ipilimumab, lambrolizumab , nivolumab, etc.) are created and registered, and uveal melanoma scientists actively search for new targets for antitumor therapy.

Within the framework of multicenter double-blind randomized clinical trial studied pharmacokinetics and safety of BCD-022 (trastuzumab, "Biocad" company, Russia), compared with the drug Herceptin (trastuzumab, F. Hoffmann-La Roche Ltd., Switzerland). Evaluation of the effectiveness was not the aim of the interim analysis, the results of which are shown. BCD-022 and Herceptin were used in combination with paclitaxel in patients with metastatic breast cancer with HER2 overexpressing (HER2 (+), mBC).

Methods. The analysis included 46 patients with HER2 (+) metastatic breast cancer (mBC) at the age of 29 to 71 years (22 - in the group of studied drug BCD-022 and 24 - in the Herceptin group). All patients received one course of therapy of BCD-022 or Herceptin 8 mg/kg intravenously and paclitaxel 175 mg/m2 intravenously on day 1 of a three-week course of treatment and continue to receive treatment with the same scheme with the use of trastuzumab 6 mg/kg (mandatory in the study is to conduct 6 courses of therapy). Randomization was carried out in groups in a ratio of 1: 1. The primary endpoint of pharmacokinetics evaluation was the area under the curve "concentration-time» (AUC0-504) of trastuzumab after a single application, the secondary - Cmax, T1 / 2 and Tmax. Safety was assessed based on the incidence of adverse events after the first course of therapy.

Results. Haematological toxicity, myalgia and arthralgia were the most frequent adverse events. Most reported adverse events had mild to moderate grade according to CTCA 4.03 and were caused  by effect of myelosuppressive chemotherapy. There were no statistically significant differences in adverse events frequency between the groups. There were 6 serious adverse events: 2 - in the BCD-022 group and 4 - in the Herceptin group. All pharmacokinetic parameters, including the primary endpoint (AUC 0-504) and secondary endpoints (Cmax, T1 / 2 and Tmax), of studied drug BCD-022 and Herceptin had no statistically significant difference.

Conclusion. BCD-022 (trastuzumab, "Biocad" company, Russia) regarding to its safety profile and pharmacokinetic properties is fully consistent with the original drug trastuzumab Herceptin (F. Hoffmann-La Roche Ltd., Switzerland) and can be recommended for further clinical study.