Biomedical subjects
Publications and source records attributed to N I Nikitina.
A cytological classification of dysplasia, intraepithelial and invasive cancer of the cervix uteri is suggested. Cytologic criteria for differential diagnosis are discussed. Cytologic diagnosis of precancer and cancer made on the basis of the said classification was verified in 63.5 and 97.3%, respectively.
Cytologic examination of scrapings from the uterine cervix was carried out in 498 patients in whom moderate or severe dysplasia of the squamous epithelium or suspicion for cancer were established in the course of gynecologic screening. The said pathology was diagnosed in 0.63% of screeneses. Cytologic follow-up of 57 cases of severe dysplasia established that, in patients over 40 years of age, it tended to progress to Ca in situ. This tendency was registered within 6-36 months and continued after a second biopsy. Severe dysplasia did not recur in the 20-40 year-old group. The extent of cervical biopsy (excision or conization) in severe dysplasia should be considered versus patients' age.
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An experience of organizing of activity of a centralized cytological laboratory is presented in the paper. It is based on an analysis of activity of leading cytological laboratories of the RSFSR. Certain issues of training of cytologists, laboratory assistants and technical staff on the basis of leading institutions of the country as well as problems of setting up control over reliability of cytological conclusions are discussed.
Preoperative diagnosis of thyroid pathology was improved following a cytological examination of punctates from nodulated formations of the thyroid in patients living in goiter-endemic regions. Diagnosis of thyroid cancer was confirmed preoperatively in 78% of cases, which, in turn, warranted application of adequate surgical procedures.
The results of 1,215 emergency surgical cytological assays conducted in 619 cases of cancer and some other malignant tumors are presented. Specimens were obtained by puncture of primary tumor, swollen lymph nodes, indurations and infiltrations, by attrition of primary tumor, serous surfaces and surgical incisions, from serous cavity fluids and imprints of bioptical material. The results of emergency cytological diagnosis of cancer and other malignant tumors were confirmed in 95% of cases.
Preliminary results are reported on the coordinating studies, conducted by the five oncological institutions of the Russia Federation on elaborating cytological criteria of the cervical epithelium malignant transformation. The material under investigation was the smears taken at mass prophylactic examinations. A group of women (512) with high cancer risk pathology has been distinguished--/various degree of dysplasia, preinvasive cancer, cancer in stage Ia/. A special card of cytological signs (including 40 criteria) was worked out for a computer analysis to select the major signs of malignancy which might contribute to establishing the most precise morphological diagnosis.
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The results of the complex clinico-morphological study of the effect of 17-a-hydroxyprogesterone-caproate are reported in 71 patients aged from 37 to 75. Stage I was noted in 17 patients, stage II--in 51, stage III--in 3. A total dosage was 5,0; 10,0; 20,0 and 30,0 for the course of treatment. Following the hormonal therapy all these patients were subjected to surgery. To study the hormonal pathomorphism specimens from the uterine cavity were assayed histologically and cytologically prior to and during the hormonal therapy, the removed specimen was examined after the operation. The clinico-morphological studies indicated that 17 GPC shows the antitumor effect in endometrial cancer, so the complete tumor regression seems to be possible. The antitumor effect is mostly pronounced at initial stages of the disease and with high-differentiated tumors. The data obtained may be used to solve the problem on the purposeful application of 17 GPC either in the complex of therapeutic measures or as a separate method of treatment.
Based on the material of the complex examination of 167 cervical cancer patients in stage Ia, the clinico-cytological features were studied comparatively. Extensive colposcopy and cytological assays of surface curetting specimens from the cervical canal and cervix mucosa were employed. In cervical cancer, stage Ia, cytological assay in 71.4% of cases is a reliable criterion in diagnosing the malignancy. In 51.7% of patients cytograms are similar to those of intraepithelial cancer, in 40.7%--smears correspond to the classical description of squamous cell cancer. The stromal reaction should be regarded as an indicator of a limited malignancy and as a manifestation of protective forces of the organism.
The authors report the data on the disease clinical course being dependent on the peculiarities of tumor differentiation. The work is based on the findings of treatment and dynamic follow-up of 156 patients with osteogenic sarcoma of extremity bones. Distant gammatherapy, as the principal method of treatment, was employed in all patients. A cytological test was used to determine the morphological character of the tumor. It was shown that clinico-cytological correlations sometimes help to reveal significant differences in development of the disease. In groups of patients with signs of primary tumor anaplasia male individuals showing acute pains, prompt tumor growth and marked general intoxication phenomena were predominating. In radiotherapy of this group of patients a positive response, which may allow a continuous dynamic observation, is more rarely gained.
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Uterine aspiration specimens from 172 females were examined cytologically (cancer in 89, non-cancer process -- in 71, in 12 cases aspiration specimens were obtained in a reproductive period in proliferative and secretory phases of the menstrual cycle). It was shown that in a group of histologically verified observations in 45.8% a gynecologist failed to recognize the true endometrial affection. Some cytological criteria elaborated are suggested (dominant, adjuvant and temporary), which combination helped to precisely diagnose cancer cytologically in 93.2%, while various forms of hyperplasia -- in 89.9%.
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The fluorometric and histochemical methods of the catecholamines contents determination and electronic microscopy of the ultrastructure were used in the examination of myocardium biopsy preparations. The heart operations were followed with the decrease of catecholamines contents in the myocardium and disorder of the mitochondria ultrastructure. The l-DOPA injection resulted in the increase of the myocardium contractile ability before the operation, but did not prevent from its decrease in the postoperative period. The postoperative l-DOPA administration combined with digitalis, according to the described scheme, contributed to the preservation of the myocardium contractile ability at the optimal level.
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