Mytsyk Y. Application of the imaging and molecular biomarkers in diagnostics, evaluation of the treatment efficiency and in prognostication of the survival in patients with the renal cell carcinoma.

The thesis is dedicated to improvement of diagnosis and treatment of patients with the renal cell carcinoma by means of application of the novel imaging and molecular biomarkers in differentiation, post-operative period monitoring, assessment of the effectiveness of the selective embolization of the renal arteries and systemic therapy, local relapse detection and prognostication of the survival. Based on results of the dispersion and classification analysis its was proved, that in the differential diagnosis of renal cell carcinoma and benign tumors of the kidneys, as well as in the diagnosis of its local relapse, the highest sensitivity and specificity are observed with the application of the apparent diffusion coefficient of the MRI. The use of the apparent diffusion coefficient of the MRI allowed accurately predict an early tissue response in setting of systemic therapy of the advanced renal cell carcinoma. It was found that the resistance index of Doppler USG reliably reflects the dynamics of renovascular resistance in patients with renal cell carcinoma before and after selective embolization of the renal arteries, and is a biomarker for its efficacy. It has been shown that the expression of microRNA-15a can be used as a sensitive molecular biomarker for diagnosis and screening of the advanced renal cell carcinoma. Based on the survival analysis, the value of the expression of microRNA-15a as a prognostic biomarker of the disease was demonstrated. With the aid of radiogenetic analysis, a polynomial model was developed to predict the survival of patients with the renal cell carcinoma.