Saratov JOURNAL of Medical and Scientific Research

Maslyakova G.N.

Saratov State Medical University n.a. V.I. Razumovsky, Director of the Research Institute of the Fundamental and Clinical Uronephrology, Professor, Doctor of Medical Sciences

Clinical significance of cystatin С and TGF-01 in the assessment of renal function in the surgical treatment of renal cell carcinoma

Year: 2020, volume 16 Issue: №3 Pages: 786-792
Heading: Urology Article type: Original article
Authors: Tarasenko A.I., Rossolovsky A.N., Berezinets O.L., Durnov D.A., Chekhonatskaya M.L., Loiko V.S., Bobylev D.A., Maslyakova G.N.
Organization: First Moscow State Medical University n.a. I.M. Sechenov, Saratov State Medical University
Summary:

Objective: to evaluate the possibility of using cystatin С and TGF-p as prognostic markers of renal impairment and unfavorable oncological results of surgical treatment of renal cell carcinoma (RCC). Material and Methods. We examined 60 patients with RCC. Patients were divided into 3 groups: with RCC after nephrectomy (group 1); after laparo-scopic nephrectomy (group 2); after laparoscopic resection of the tumor (group 3). All patients before the operation on the 7th-10th day, after 1-3 years of postoperative follow-up, the concentrations of cystatin С and TGF-p in the blood serum were studied by solid-phase ELISA. Results. The majority of patients in the groups showed a significant decrease in glomerular filtration rate (GFR) compared to the control, and 3 years after nephrectomy, most patients had stage C3A chronic kidney disease (CKD). The Cystatin С content in all groups of patients with RCC had a statistically significant increase compared to the control (2664, 3103, and 2709 ng/ml in groups 1.2 and 3 versus 143 ng/ml, respectively) (p<0.05). Conclusion. In the majority of patients with RCC, postoperative initiation and progression of "surgical" CKD occurs, which persists 3 years after surgical treatment. Cystatin С can be considered as a predictor of high antitumor activity in patients with RCC, and requires monitoring in the long-term postoperative period.

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Morphological changes of the bladder wall of fetuses with antenatally detected syndrome "megacystis"

Year: 2020, volume 16 Issue: №3 Pages: 779-785
Heading: Urology Article type: Original article
Authors: Deryugina L.A., Napsheva A.M., Medvedeva A.V., Rozhkova D.V., Maslyakova G.N.
Organization: Saratov State Medical University
Summary:

Objective: To determine the morphological features of the structure of the wall of the urinary bladder of the fetus with antenatally identified syndrome "megacystis". Material and Methods: Morphological investigations of the bladder wall of 11 fetuses of 12-21 weeks of gestation with diagnosed "megacystis" syndrome, obtained as a result of the termination of pregnancies, were carried out. The study was carried out using survey method, histochemical and immunohisto-chemical staining methods. Results: In all cases, the structure of the bladder wall with diagnosed syndrome "megacystis" sharply differed from the norm. The changes affected all layers, but the most pronounced pathological processes developed in the muscle layer, which did not differentiate into layers, the process was accompanied by a violation of the course of muscle fibers. Detrusor hypotrophy was observed in fetuses up to 18 weeks of gestation, the thickness of which decreased on average by 1,8 times. In fetuses with a gestational age of 21 weeks, the hypertrophic variant of the detrusor prevailed with an increase in its thickness by 2,6 times. In all cases, there was a significant depletion of the muscle wall with blood vessels up to 6% of the norm and a decrease in the number of nerve fibers to 24%. Conclusion. The study allowed to distinguish two variants of changes in the bladder at the syndrome "megacystis": "hypertrophic variant", characterized by an increase in the thickness of the muscle layer, and "hypotrophic variant", characterized by a decrease in the thickness of the muscle layer, which fits into the diagnostic concept of "detrusor dysplasia".

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Prognostic significance of the assessment of the expression of immunohistochemical markers and the degree of pathomorphism before and after treatment of patients with prostate cancer at high risk of progression

Year: 2019, volume 15 Issue: №2 Pages: 318-324
Heading: Urology Article type: Original article
Authors: Voronina E.S. , Fomkin R.N. , Bucharskaya A.B. , Palatova T.V. , Popkov V.M., Maslyakova G.N.
Organization: Saratov State Medical University
Summary:

Purpose: to analyze the expression of immunohistochemical markers in patients with prostate adenocarcinoma at high risk of progression before and after combined and combined treatment of patients with prostate specific antigen (PSA) level of blood below discriminatory. Material and methods. Examined patients (n = 80) with a diagnosis of “High-risk progression prostate cancer,” with clinical stage T3a, total score for Gleason scale from 8 to 10, the level of total PSA more than 20 ng / ml. Patients of the 1st group (n = 42) only combined surgical treatment in the scope of TUR and HIFU ablation the prostate; The 2nd group of patients (n = 38) additionally applied androgen deprivation in adjuvant mode. Results. Blood PSA, determined in patients after various methods of treatment is not always an objective indicator of its effectiveness. Immunohistochemical studies of tumor tissue for proliferative activity tumor cells, the activation of apoptosis in them, as well as the assessment of specific tumor markers and tumor suppressor genes showed that a decrease in the expression of these markers in patients with PSA values ​​of blood lower than discriminatory observed in all patients independently on the type of treatment. However, after treatment in the 1st group of patients, despite the achievement PSA level of nadir, there is a decrease in the expression of an intercellular adhesion marker E-cadherin, which indicates an increased risk of tumor metastasis, as well as increased expression of markers of the apoptosis inhibitor Bcl-2 and androgens, which indicates about the possibility of progression of tumor growth. Conclusion For a more accurate assessment therapeutic pathomorphism in patients with prostate cancer at high risk of progression, which HIFU ablation monotherapy was carried out, along with the determination of blood PSA level, it is necessary during the control biopsy of the prostate immunohistochemical studies of tumor tissue to determine the prognosis and risk of relapse.

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Biomarkers of renal damage and immunohistochemical detection of oncogenesis in the surgical treatment of renal cell carcinoma

Year: 2018, volume 14 Issue: №3 Pages: 420-426
Heading: Urology Article type: Original article
Authors: Tarasenko A.l., Rossolovsky A.N., Berezinets O.L., Ponukalin A.N., Medvedeva A.M., Zakharova N.B., Popkov V.M., Maslyakova G.N.
Organization: Saratov State Medical University, I.M. Sechenov First Moscow State Medical University
Summary:

Objective: to assess the possibility of using markers of renal injury and carcinogenesis as additional criteria for the choice of the method of surgical treatment of RCC and to minimize the risk of development and progression of kidney injury. Material and Methods. 60 patients with morphologically confirmed RCC T1-3M0N0 operated on in the volume of open nephrectomy or laparoscopic nephrectomy or laparoscopic resection and the kidney were examined. Patients were divided into 3 groups: group 1: patients after nephrectomy performed for kidney cancer using traditional surgical technique, group 2: patients after laparoscopic nephrectomy and group 3: after laparoscopic resection of kidney tumor. Before surgical operation, on the 5-7 day and after 1 month, all patients were examined by concentrations of urinary excreted lipocalin 2 (NGAL), and serum concentrations of IL-18, MMP-9 and IGF-1. Renal function was estimated using the calculated GFR equation (CKD-EPI 2009) based on serum creatinine level. Immunohistochemical study of histological preparations of distant tumors on proliferation antibodies (Ki-67, PCNA), apoptosis (BAX, Bcl-2) was performed. Differences in clinical data and clinical variables were compared using Spearman rank correlations and t-test. Results. The studied indices of renal damage of IL-18, NGAL, MMP-9 and IGF-1 both in the early (5-7 days) and later (1 month) postoperative period showed a correlation between the surgical intervention method and the degree of tumor cell differentiation. Conclusion. The levels of biomolecular markers of renal damage (IL-18, NGAL, MMP-9 and IGF-1) correlate with the degree of differentiation in thetumoral cells and functional activity of the remaining renal parenchyma in the postoperative period, but also depend on the individual characteristics of the patient's body. A certain level of expression of MMP-9 and IL-18 with a small tumor size can be a guide to determine the indications for the choice of organ-preserving surgery in patients.

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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.

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Dynamics of laser speckle imaging of blood flow in the tissues at partial temporary pancreatic ischemia of hungry, fed and alcoholized rats

Year: 2016, volume 12 Issue: №2 Pages: 106-109
Heading: Macro- and Micromorphology Article type: Original article
Authors: Alexandrov D.A., Timoshina P.A., Tuchin V.V., Maslyakova G.N., Palatova T.V., Sedov D.S., Izmailov R.R.
Organization: Saratov State Medical University
Summary:

The aim of the study is to determine the influence of a partial temporary ischemia and reperfusion on the development of pancreatitis in laboratory rats. Material and Methods. The experiments were performed on 73 white rats. Occluded blood vessels and blood flow were recorded by digital biomicroscopy and laser speckle contrast imaging. Statistical data processing was carried out the program Statistica for Windows 6.0 using the Student's criterion. Results. Laser speckle imaging and digital microscopes provide the monitoring of blood flow in the vessels of the pancreas. After a five-minute partial ischemia reactive hyperemia occurs, changes are invertible. After a twenty-minute partial ischemic reactive hyperemia does not occur, without developing pancreatitis necrosis. Pancreas of alcoholized rats has been found out to be more sensitive to ischemia. Conclusion. The method of laser speckle imaging and intravital microscopy after digital five- and twenty-minute partial ischemia of the pancreas revealed phase opposite directed changes in its tissue perfusion and varying severity of postischemic pancreatitis.

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The actual conception of development and pathology of fetal testes

Year: 2015, volume 11 Issue: №4 Pages: 511-514
Heading: Macro- and Micromorphology Article type: Review
Authors: Maslyakova G.N., Palatova T.V., Serkova А.А.
Organization: Saratov State Medical University
Summary:

The actual problem recently determined is concerned with the reproductive disorders in men. Male infertility results from a variety of pathological processes in the body. It is known that most anomalies of organs of reproductive system develop in the period of prenatal ontogenesis. The review provides the data on embryogenesis of fetal testes and factors that can lead to disturbances in the formation of the testes and male infertility.

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The assessment of molecular markers of cell interaction and lipid peroxidation in rats with alloxan diabetes and trans- planted liver cancer after intravenous injection of gold nanorods

Year: 2015, volume 11 Issue: №2 Pages: 107-112
Heading: Biochemistry Article type: Original article
Authors: Bucharskaya А.В., Dikht N.I., Afanasyeva G.A., Terentyuk G.S., Zakharova N.B., Maslyakova G.N., Khlebtsov B.N., Khlebtsov N.G.
Organization: Institute of Biochemistry and Physiology of Plants and Microorganisms of Russian Academy of Sciences, Saratov State Medical University
Summary:

Цель: оценить воздействие однократного внутривенного введения покрытых полиэтиленгликолем золотых наностержней на молекулярные маркеры межклеточного взаимодействия и показатели перекисного окисления в сыворотке крови четырех групп крыс: интактных, с аллоксановым диабетом, с перевитым раком печени; с перевитым раком печени на фоне аллоксанового диабета. Материалы и методы. Активность перекисного окисления липидов оценивалась по показателям гидроперекисей липидов, малонового диальдегида и молекул средней массы с использованием общепринятых спектрофотометрических методов, исследования молекулярных маркеров — фактора некроза опухоли TNF-a, инсулиноподобного фактора роста IGF-1, васкулоэн-дотелиального фактора роста VEGF-C проводились в сыворотке крови методом иммуноферментного анализа. Результаты. Выявлено, что при однократном внутривенном введении золотых наностержней не происходит значительного изменения количества маркеров межклеточного взаимодействия и показателей перекисного окисления липидов. в периферической крови. Заключение. Полученные результаты позволяют рекомендовать использование покрытых полиэтиленгликолем золотых наностержней в экспериментальной онкологии.

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Identification of risk factors of prostate adenocarcinoma recurrence after HIFU therapy using immunohistochemical markers

Year: 2014, volume 10 Issue: №4 Pages: 654-658
Heading: Urology Article type: Original article
Authors: Popkov V.M., Maslyakova G.N., Voronin E.S., Fomkin R.N.
Organization: Saratov State Medical University
Summary:

The purpose of this study was to identify risk factors for recurrence of prostate adenocarcinoma after HIFU therapy. Material and methods: Material for the study was obtained from patients diagnosed with adenocarcinoma before and after HIFU treatment. Morphological study was conducted using a standard staining, and immunohistochemical markers: PCNA, Amacr, E-cadherin, Bel2, Andr, Estr, VEGF, P53, PCNA. Results: After treatment in 89% of patients with initial prostate volume greater than 50 cc the signs of recurrence of adenocarcinoma were showed. At low risk for D'Amico after treatment the expression of proliferation markers, VEGF, Amacr significantly decreased. With a high degree of risk — increased expression of Bel2. After treatment the expression of the following markers: PCNA, Amacr, VEGF significantly increased in the group of patients with the presence of invasion. Conclusion: Patients with initial prostate volume less than 50 cc, low risk to D'Amico, the lack of perineural and perivascular invasion have a low risk of recurrence after HIFU therapy; patients at high risk for D'Amico, the presence of perineural and perivascular invasion initial and prostate volume greater than 50 cc, low-grade cribriform form of adenocarcinoma have a high risk of recurrence of adenocarcinoma. Recurrence of adenocarcinoma develops independently of the period after HIFU therapy.

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Experience of terahertz therapy in benign prostatic hyperplasia combined with chronic abacterial prostatitis

Year: 2014, volume 10 Issue: №4 Pages: 649-654
Heading: Urology Article type: Original article
Authors: Popkov V.M., Kirichuk V.F., Loyko V.S., Maslyakova G.N., Blyumberg B.l.
Organization: Saratov State Medical University
Summary:

Objective: to improve the treatment results of patients with benign prostatic hyperplasia (stage l-ll) accompanied with chronic abacterial prostatitis (category III A) by the use of terahertz therapy at frequencies of molecular spectrum of emission and absorption of nitric oxide 150,176-150,664 GHz. Material and methods. Atotal number of 75 patients met the inclusion criteria and were available for analysis. They were divided into three groups: 1st core group — 25 patients with BPH (stage l-ll) accompanied with chronic abacterial prostatitis (category III), which received standard medical therapy in combination with THZ-therapy; second group — 25 patients with BPH (stage l-ll) accompanied with CAP, which received standard medical therapy; third control group — 25 healthy men. Results. The combination of THZ — therapy with standard medical treatment allowed us to achieve marked improvements in the IPSS and QoL system, rapid anesthetic effect, more significant volume reduction of the prostate tissue in the 1st core group. Also THZ-therapy in 1st core group revealed a statistically significant increase of the maximum speed of blood vessels in the prostate tissue, improved a prostate secretion and rheological properties of blood. Conclusion. THZ-therapy as a complementary treatment has a beneficial effect on the clinical course of BPH (stage l-ll) accompanied with CAP (category III).

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