Hyriavenko N. Pathomophological characteristics of the primary cancer of fallopian tubes

The thesis is focused on the important problem - the optimization of morphological diagnostics of the primary cancer of the fallopian tubes by using the histological, immunohistochemical and statistical methods of research. In this thesis, for the first time, a considerable number of patients with tumors of fallopian tubes was studied (71 cases) within clinical and morphological parameters. The increase of oncologic alertness, improvement of diagnostics methods and implementation of immunohistochemical research methods has resulted in determination of specific phenotype of neoplasia. This provides important diagnostic and predictive information about the disease status and its biological properties. The frequency of diagnosis has been determined and the main clinical and morphological parameters (age, disease stages, T and N parameters, histogenesis and differentiation grades) of this neoplasia have been studied. For the first time, the main molecular and biological characteristics (hormonal status, proliferative potential, apoptosis markers, neoangiogenesis and inflammatory tumor microenvironment) of serous tumors of the fallopian tubes are studied in relation to clinical and morphological parameters. It was established that in most cases the primary cancer of the fallopian tubes is a hormonally dependent tumor that must be taken into account for treatment prescription. It was found that HER2 / neu overexpression is atypical for tumors of this localization. By using the complex of modern immunohistochemical methods, a correlation between the expression of prognostic and adverse receptors of cancer cells (Ki-67, p53, VEGF), the qualitative composition of inflammatory tumor microenvironment and neoplastic proliferation, which has negative impact on malignant process in the fallopian tube, were determined. Despite the tumors of the fallopian tubes are diagnosed at early stages of the neoplastic process, many patients require the adjuvant therapy. The algorithm for treatment of patients with the primary cancer of the fallopian tubes has been offered, taking into account the molecular profile of the tumor (antihormonal therapy for the disease with a positive hormonal status, the obligatory adjuvant chemotherapy at high rates of proliferation and positive expression of p53 protein, anti-VEGF therapy at high angiogenic potential of neoplasia). This will increase the effectiveness of the therapy and improve the results of overall and non-recurring survival of the patients.