Arkhiv patologii最新文献

{"title":"[Ultrastructural and morphometric features of follicular thyroid adenomas].","authors":"E R Asanova, E Yu Zyablitskaya, O V Ostapenko","doi":"10.17116/patol20268801118","DOIUrl":"10.17116/patol20268801118","url":null,"abstract":"<p><strong>Objective: </strong>Study of morphometric and ultrastructural features of follicular adenomas of the thyroid gland.</p><p><strong>Material and methods: </strong>The study was conducted on the surgical material of the thyroid glands of 11 patients with a preliminary cytological conclusion of \"Follicular neoplasia\" and a further histologically established diagnosis of \"Follicular adenoma\". Material - fragments obtained from morphologically verified nodes of follicular adenoma, fragments of tissue outside the nodular formation served as control samples. Light and transmission electron microscopy were used to study semi-thin and ultra-thin sections of the thyroid glands, respectively. Morphometric analysis and statistical processing were performed on semi-thin sections.</p><p><strong>Results: </strong>In follicular adenoma, the formation of intracellular microfollicles and narrowing of the lumen of the follicles with hypertrophy of the tumor cells: a reliable increase in the area of cells and their nuclei (<i>p</i>≤0.01), the numerical density of mitochondria (<i>p</i>≤0.001), a decrease in the diameter of the follicles (<i>p</i>≤0.001) were noted. The common ultrastructural features of the studied follicular adenomas are heterogeneous changes in the synthetic apparatus against the background of a sharp increase in the number of mitochondria. A possible mechanism of morphological rearrangements of tumor cells in follicular adenoma is compensatory adaptation at the level of cellular energy systems in response to dysfunction of the synthetic apparatus of thyrocytes. In the studied follicular adenomas with classical microfollicular morphology, signs of other, rarer histological patterns were found in a number of cells or in individual follicles, in particular, signet ring cell and clear cell patterns.</p><p><strong>Conclusion: </strong>The diversity of the detected morphological rearrangements reflects the stage-by-stage development of follicular adenomas. A number of ultrastructural features suggest that the rarer histological patterns described for follicular adenomas originate from the classical microfollicular pattern as a result of multidirectional transformation.</p>","PeriodicalId":8548,"journal":{"name":"Arkhiv patologii","volume":"88 1","pages":"18-25"},"PeriodicalIF":0.0,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146050021","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"[Slc7a5 protein expression in breast cancer samples, relationship with clinical and morphological parameters of the tumor and its regional metastasis].","authors":"V V Kometova, L M Mikhaleva, V V Rodionov, A A Kireev","doi":"10.17116/patol20268802114","DOIUrl":"10.17116/patol20268802114","url":null,"abstract":"<p><strong>Objective: </strong>To define the role of SLC7A5 expression in establishing an aggressive phenotype in primary breast cancer, specifically its correlation with major clinicopathological characteristics and the capacity for early lymphatic spread.</p><p><strong>Material and methods: </strong>The study included tumor samples from 358 breast cancer patients. SLC7A5 expression was assessed by immunohistochemistry and correlated with tumor parameters (size, histological type, grade (G), molecular subtype, ER, PR, HER2 status, Ki-67 index) and axillary lymph node status. Analysis was performed using the <i>χ</i>² test, Kruskal-Wallis test, and univariate logistic regression.</p><p><strong>Results: </strong>SLC7A5 expression was detected in 55.6% of cases (intense staining in 26.5%) and was associated with aggressive features: pT2-3 (<i>p</i>=0.033), G3 (<i>p</i>=0.001), Ki-67≥30% (<i>p</i><0.001), ER-negative (<i>p</i>=0.022), and PR-negative status (<i>p</i>=0.013). A subtype-specific pattern was observed: maximal frequency in HER2-positive non-luminal tumors (80%), minimal in luminal A (42.8%; <i>p</i><0.001). Expression in ≥10% of cells was more frequent in the lymph node metastasis group (51.8% vs. 31.8% in pN0; <i>p</i><0.001), and metastatic risk increased with expression intensity (<i>p</i><0.001). In age groups 18-44 and 60-74 years, as well as in ER-positive and G1 tumors, SLC7A5 positivity increased the odds of lymph node involvement by 2.26-6.5 times.</p><p><strong>Conclusion: </strong>SLC7A5 expression serves as an integral marker of breast cancer aggressiveness, associated with unfavorable immunophenotypes and independently predictive of lymphogenous metastasis. Its assessment may improve risk stratification and help identify candidates for LAT1 inhibitor-targeted therapy.</p>","PeriodicalId":8548,"journal":{"name":"Arkhiv patologii","volume":"88 2","pages":"14-19"},"PeriodicalIF":0.0,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147697341","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"[Extrapulmonary lymphangioleiomyomatosis with retroperitoneal lymph node involvement].","authors":"A A Borzova, V A Smolyannikova, A V Filatov","doi":"10.17116/patol20268804160","DOIUrl":"10.17116/patol20268804160","url":null,"abstract":"<p><p>Lymphangioleiomyomatosis (LAM) is a rare disease of unknown etiology that occurs almost exclusively in women, primarily of reproductive age. This disease is characterized by smooth muscle cell proliferation, most commonly in the lungs. However, cases of extrapulmonary LAM have been reported, such as in the lymph nodes of mediastinum, abdominal cavity, and retroperitoneum. The clinical manifestations of pelvic lymph node LAM are subtle manifesting as symptoms of compression due to a large tumor mass but more often diagnosed incidentally in lymph node specimens removed during gynecologic oncology surgeries. This article provides literature data and our own observation of lymph node LAM in a patient with metastatic endometrial cancer.</p>","PeriodicalId":8548,"journal":{"name":"Arkhiv patologii","volume":"88 4","pages":"60-64"},"PeriodicalIF":0.0,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148629344","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"[Pathology of the digestive system organs in post-COVID syndrome according to autopsy data from 2021-2024].","authors":"E A Kogan, A D Romanovskya, O N Kichigina, N V Zharkov, A V Bukova, T A Demura, V T Ivashkin","doi":"10.17116/patol20268801152","DOIUrl":"10.17116/patol20268801152","url":null,"abstract":"<p><strong>Objective: </strong>Clinical and morphologic analysis of pathologic changes of digestive system organs in COVID-19 patients according to autopsy data of 2021-2024.</p><p><strong>Material and methods: </strong>A retrospective clinical and morphologic analysis of data from 69 autopsies of patients who underwent COVID-19 (confirmed by polymerase chain reaction test) and had symptoms of digestive system lesions, according to clinical data, was performed. The data of case histories, autopsies, pathologoanatomic diagnoses and causes of death of patients were studied. Microscopic studies of tissue samples of stomach, intestine, liver, pancreas were performed. Immunohistochemical study with antibodies CD3, CD45, CD68, spike- and nucleocapsid-protein SARS-CoV-2 was performed.</p><p><strong>Results: </strong>According to autopsy data, pathologic changes of the stomach that first developed and pre-existing more than 3 months after SARS-CoV-2 infection were detected in 49 (71.01%) of 69 cases. Among them, chronic superficial gastritis was the most common with 17 (34.99%) observations and acute stress-induced gastric erosions and ulcers with 13 (26.53%). Small and large intestinal lesions were seen in 15 (30.61%) cases, among which intestinal adenocarcinomas predominated with 6 (40.00%), colonic diverticula and chronic lymphocytic colitis with 3 (20.00%) cases each. Liver pathology, new-onset and pre-existing, was present in 100.00% cases: muscadic liver 45 (65.22%), massive liver necrosis (7.25%), hepatic steatosis and steatohepatitis (26.09%), brown atrophy (8.70%). Pancreatic lesions, new-onset and pre-existing, were detected in 57 (82.60%) cases. Among them, sclerosis and lipomatosis were more frequently registered in type 2 diabetes mellitus - 46 (80.70%) observations, pancreonecrosis - 11 (19.30%).</p><p><strong>Conclusions: </strong>Gastric, intestinal, liver, and pancreatic pathology in COVID-19 patients may be either first-onset or preexisting. The detected persistence of nucleocapsid and spike proteins of the virus in tissues may cause direct and autoimmune tissue damage, leading to the development of new and progressive chronic diseases of the digestive organs.</p>","PeriodicalId":8548,"journal":{"name":"Arkhiv patologii","volume":"88 1","pages":"52-59"},"PeriodicalIF":0.0,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146049977","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"[PDCD4 as tumor suppressor protein in gastric mucosa in early, advanced precancerous lesions and gastric adenocarcinoma].","authors":"A V Kononov, V A Rubtsov, E G Pomorgailo, S I Mozgovoi, A G Shimanskaya, M V Markelova","doi":"10.17116/patol2026880216","DOIUrl":"10.17116/patol2026880216","url":null,"abstract":"<p><p>The PDCD4 (programmed cell death protein 4) protein is a key target protein, in particular for the well-studied miR-21. By suppressing its synthesis, miR-21 exerts its influence on key cellular biological processes. Furthermore, miR-21 itself is one of the most relevant predictor markers for assessing the risk of developing gastric cancer.</p><p><strong>Objective: </strong>Evaluation of PDCD4 expression as a potential marker for gastric cancer prediction and in the differential diagnosis of gastric mucosal dysplasia.</p><p><strong>Material and methods: </strong>Comparative immunohistochemical analysis of PDCD4 protein was performed in biopsy specimens of the antral gastric mucosa with signs of chronic gastritis and gastric mucosal dysplasia, as well as in surgical specimens from stomachs resected for adenocarcinoma.</p><p><strong>Results: </strong>In gastric mucosa with signs of chronic gastritis, high immunohistochemical expression of PDCD4 was maintained, regardless of the severity of inflammation, atrophy, and type of metaplasia. PDCD4 protein expression in the dysplasia group was significantly lower compared to gastric mucosal biopsy samples with signs of chronic gastritis (<i>p</i>=0.00001) and did not differ from that in adenocarcinoma tissues (<i>p</i>=0.43). A simple logistic regression model demonstrated a significant negative association between PDCD4 protein expression and dysplasia in the gastric mucosa (OR=0.27, CI=[0.16-0.46]).</p><p><strong>Conclusion: </strong>Low PDCD4 protein expression in dysplasia in the gastric mucosa and high levels regardless of the presence and severity of atrophy and inflammation may indicate its high potential for use in the differential diagnosis of indefinite for dysplasia and true dysplasia of the gastric mucosa.</p>","PeriodicalId":8548,"journal":{"name":"Arkhiv patologii","volume":"88 2","pages":"6-13"},"PeriodicalIF":0.0,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147697311","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"[HER2 status assessment in carcinomas of various localizations. A multicenter morphological study in the Russian Federation].","authors":"L E Zavalishina, S V Vtorushin, G A Raskin, O A Kuznetsova, D A Nosov, V V Karaseva, G A Frank","doi":"10.17116/patol2026880317","DOIUrl":"10.17116/patol2026880317","url":null,"abstract":"<p><p>HER2 is a clinically significant predictive and prognostic marker in a number of epithelial malignant neoplasms. With the introduction of HER2-targeted therapeutic approaches, including antibody-drug conjugates, the need for standardized assessment of HER2 status in tumors of various localizations has become increasingly important.</p><p><strong>Objective: </strong>To assess the prevalence of HER2-positive tumors (IHC 3+) in epithelial malignant neoplasms of various localizations in the Russian population using a unified diagnostic approach.</p><p><strong>Material and methods: </strong>This multicenter study included 1.511 tumor tissue samples from patients with epithelial malignant neoplasms of various localizations, obtained from reference pathology centers of the Russian Federation. HER2 status was determined by immunohistochemistry using anti-HER2 antibody (clone 4B5, Ventana) and standardized interpretation criteria developed for gastric cancer and gastroesophageal junction cancer. In cases of equivocal HER2 status (IHC 2+), <i>in situ</i> hybridization was recommended.</p><p><strong>Results: </strong>HER2-positive tumors (IHC 3+) were identified in the majority of the analyzed localizations, with prevalence varying widely depending on tumor type. The highest frequency of HER2 positivity was observed in urothelial carcinoma of the urinary bladder, as well as in gastric and gastroesophageal junction cancers. No HER2-positive cases were detected in lung adenocarcinoma or pancreatic cancer.</p><p><strong>Conclusion: </strong>The study results confirm the reproducibility of HER2 status assessment using a unified diagnostic approach in a multicenter setting. The application of standardized HER2 interpretation criteria ensures data comparability and provides a methodological basis for further clinicopathological studies and for the implementation of HER2-targeted therapeutic strategies in clinical practice.</p>","PeriodicalId":8548,"journal":{"name":"Arkhiv patologii","volume":"88 3","pages":"7-14"},"PeriodicalIF":0.0,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148275804","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"[An improved algorithm for genetic diagnostics of aggressive B-cell lymphomas in pediatric oncohematology: the experience of the Dmitry Rogachev National Medical Research Center of Pediatric Hematology, Oncology and Immunology].","authors":"A S Sharlai, E V Volchkov, D S Abramov, I V Sidorov, M A Baranova, N V Myakova, D M Konovalov","doi":"10.17116/patol2026880115","DOIUrl":"10.17116/patol2026880115","url":null,"abstract":"<p><strong>Objective: </strong>To improve the stratification algorithm for aggressive B-cell lymphomas in children based on the analysis of genetic changes in the genes <i>TP53, MYC, BCL2, BCL6</i> and the long arm of chromosome 11 (11q).</p><p><strong>Material and methods: </strong>A comprehensive cytogenetic and molecular genetic analysis of tumor samples was carried out using NGS and FISH methods. Rearrangements of the <i>MYC</i> locus and the presence of translocations with different chromosomal partners were investigated, as well as the analysis of mutations and deletions of the <i>TP53</i> gene. The presence of <i>MYC, BCL2, BCL6</i> rearrangements and 11q aberrations was investigated as part of the algorithm.</p><p><strong>Results: </strong>It has been shown that the classical translocation, t(8;14)(q24;q32) <i>MYC::IGH</i>, is detected in 77% of cases with typical Burkitt lymphoma histology. This translocation was not present in 23% of the samples. In a group of cases with classic histology of Burkitt lymphoma, where the t(8;14)(q24;q32) translocation was absent, rare genetic variations were identified - 11q gain/loss, and atypical FISH patterns indicative of complex genetic changes. <i>TP53</i> mutations were detected in 26-30% of cases, localized mainly in the DNA-binding domain. A wide range of genetic changes has been identified, including monoallelic <i>TP53</i> deletions and atypical FISH patterns that require attention and additional research.</p><p><strong>Conclusion: </strong>An improved diagnostic algorithm based on the combined use of FISH and NGS methods makes it possible to increase the accuracy of identification of genetic subtypes of aggressive B-cell lymphomas in children. This helps to categorize the diagnosis based on the molecular and genetic characteristics of the tumor, paving the way for improved prognosis and treatment effectiveness.</p>","PeriodicalId":8548,"journal":{"name":"Arkhiv patologii","volume":"88 1","pages":"5-10"},"PeriodicalIF":0.0,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146050217","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"[Alterations in the transcriptional profile of genes in tumors as a prerequisite for personalization of treatment in breast cancer patients].","authors":"V V Kometova, O V Burmenskaya, D Yu Trofimov, M V Rodionova, V V Rodionov, L A Ashrafyan, L M Mikhaleva","doi":"10.17116/patol20268801135","DOIUrl":"10.17116/patol20268801135","url":null,"abstract":"<p><strong>Objective: </strong>To evaluate changes in gene expression activity during preoperative testing for tumor hormone sensitivity to aromatase inhibitors and tamoxifen in postmenopausal women with ESR+/HER2- breast cancer.</p><p><strong>Material and methods: </strong>The study included 174 breast cancer patients. Pathological examination of FFPE core biopsy specimens, performed before the hormone response test, and surgical specimens were examined, as well as immunohistochemistry (Ki67, ER, PR, HER2/neu) and molecular genetic testing of an expression panel of 45 target genes using quantitative real-time PCR.</p><p><strong>Results: </strong>The use of aromatase inhibitors in the preoperative hormone response test is accompanied by statistically significant changes in the mRNA expression of 37 genes in breast tumors, of which a decrease in the expression level was found for 35 genes (<i>ESR1, PGR, AR, ERBB2, FGFR4, MKI67, MYBL2, CCNB1, AURKA, BIRC5, CCND1, CCNE1, CDKN2A, KIF14, PPP2R2A, PTTG1, TMEM45B, TPX2, ANLN, MMP11, CTSL2, EMSY, PAK1, BCL2, BAG1, PTEN, TYMS, EXO1, UBE2T, NAT1, SCGB2A2, GATA3, FOXA1, ZNF703, CD274/PD-L1</i>), an increase - for two genes (<i>SFRP1, KRT5</i>). While the use of tamoxifen statistically significantly correlates with a decrease in the level of mRNA expression of 35 genes: <i>ESR1, PGR, AR, EGFR, ERBB2, FGFR4, MKI67, MYBL2, CCNB1, AURKA, BIRC5, CCND1, CCNE1, CDKN2A, KIF14, PPP2R2A, PTTG1, TMEM45A, TMEM45B, TPX2, ANLN, MMP11, EMSY, PAK1, BCL2, BAG1, PTEN, TYMS, EXO1, UBE2T, NAT1, GATA3, FOXA1, ZNF703, CD274/PD-L1</i>, and an increase in only one gene - <i>MYC</i>.</p><p><strong>Conclusion: </strong>Comparative mRNA expression analysis confirms that a short preoperative course of aromatase inhibitors induces a more potent and uniform molecular response, characterized by profound suppression of proliferation and complete inhibition of estrogen-dependent signaling. Tamoxifen therapy is also effective but results in less pronounced suppression of key targets and, crucially, may be accompanied by early activation of the <i>MYC</i> oncogene, a potential marker for resistance development.</p>","PeriodicalId":8548,"journal":{"name":"Arkhiv patologii","volume":"88 1","pages":"35-43"},"PeriodicalIF":0.0,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146050246","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"[Inter-pathologist reproducibility in classifying extraovarian implants in borderline serous ovarian tumor and low-grade serous carcinoma].","authors":"A S Badlaeva, A V Asaturova, A V Tregubova, A B Chamorovskaya, N A Arzhanukhina, V D Borzunov, P L Sheshko, V V Litvinova, V V Sukhoparova","doi":"10.17116/patol20268801111","DOIUrl":"10.17116/patol20268801111","url":null,"abstract":"<p><p>One of the key differences between ovarian borderline serous tumors and low-grade serous carcinoma is the pattern of extraovarian tumor spread. Therefore, accurate diagnostics of the peritoneal implant's histotype plays a crucial role in treatment and disease prognosis. Despite established histological criteria for differential diagnosis, the classification of implant type remains subjective, and the interobserver reproducibility among pathologists is still understudied.</p><p><strong>Objective: </strong>To assess the level of reproducibility in implant type classification among pathologists for ovarian borderline serous tumors and low-grade serous carcinoma.</p><p><strong>Material and methods: </strong>A series of 33 slides from resected omentum and peritoneum specimens obtained from 23 patients with ovarian borderline serous tumors and low-grade serous carcinoma were independently evaluated by three gynecologic pathologists and three oncopathologists with varying experience in gynecologic pathology to determine implant type. A consensus diagnosis was established by majority agreement among gynecologic pathologists.</p><p><strong>Results: </strong>The consensus diagnosis classified 42.4% of cases as low-grade serous carcinoma metastases and 57.6% as non-invasive implants of borderline serous tumors. The Fleiss' kappa was 0.61, indicating substantial reproducibility among all pathologists, but Cohen's kappa varied significantly (0.348-0.817). Reproducibility was perfect between gynecologic pathologists and between them and the consensus diagnosis. However, reproducibility among general pathologists was only moderate, while their agreement with the consensus diagnosis ranged from minimal to substantial.</p><p><strong>Conclusion: </strong>This study confirms significant diagnostic challenges in distinguishing non-invasive implants of borderline serous tumors from low-grade serous carcinoma metastases among pathologists, highlighting the need for developing and implementing standardized diagnostic algorithms.</p>","PeriodicalId":8548,"journal":{"name":"Arkhiv patologii","volume":"88 1","pages":"11-17"},"PeriodicalIF":0.0,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146050213","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"[Comparative analysis of two methods for assessing the proportion of residual tumor in non-small cell lung cancer after neoadjuvant therapy].","authors":"A D Petrova, N A Kozlov, D V Rogozhin","doi":"10.17116/patol20268803115","DOIUrl":"https://doi.org/10.17116/patol20268803115","url":null,"abstract":"<p><p>The tumor response to neoadjuvant therapy (NAT) in non-small cell lung cancer (NSCLC) defines further treatment tactics and has prognostic value. According to IASLC Guidelines, the amount of viable tumor is expressed as the total percentage of invasive carcinoma obtained by averaging the results for all the fragments studied. In this case, the variability of the tumor bed size in these fragments is not taken into account, which in some cases may lead to overestimation or underestimation of the final results. As an alternative method, it was proposed to calculate the weighted arithmetic mean of the proportion of residual cancer, taking into account the area of the tumor bed in each slide.</p><p><strong>Objective: </strong>Comparative analysis of the accuracy of two methods for assessing the proportion of residual tumor in the NSCLC resection specimens after NAT.</p><p><strong>Material and methods: </strong>The lung resection specimens from 91 patients with NSCLC who had been treated with neoadjuvant therapy were included in this study. Pathological assessment of the percentage of residual tumor in each case was performed by two pathologists on digital images using two scoring methods - the estimation of average percentage and weighted arithmetic mean for residual tumor.</p><p><strong>Results: </strong>The discrepancy between the values obtained using the two techniques in each case ranged from 0% to 32%. A discrepancy of less than 5% in the proportion of viable carcinoma was observed in 77 (85%) patients. More than 10% difference in values was observed in 3 (3%) patients, which was associated with significant variability in the size of the tumor bed area in different slides of one case. Conversion of the morphological regression category after recalculating was observed in 3 (3%) patients.</p><p><strong>Conclusion: </strong>It is more effective to use the calculation of the arithmetic mean value of the residual tumor proportion in routine practice. However, in case of significant variability in the size of the tumor bed area and the proportion of residual carcinoma in each fragment, as well as with the value of the proportion of residual carcinoma close to the threshold value of the MPR (10%) it is recommended to take into account the size of the tumor bed in each slide.</p>","PeriodicalId":8548,"journal":{"name":"Arkhiv patologii","volume":"88 3","pages":"15-19"},"PeriodicalIF":0.0,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148275575","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}