Accuracy diagnostic methods in medicine, it largely determines the outcome of the patient’s disease, the prognosis for his recovery and restoration of ability to work. Even the most experienced doctor will not be able to prescribe effective treatment without knowing the exact diagnosis of his patient. The most important role In oncology, the determination of the morphological type of tumor and the stage of the process plays a role. Unfortunately, incorrect diagnosis is not such a rare occurrence in domestic medicine. And while a false positive diagnosis usually does not pose a real threat to the patient’s life, a false negative diagnosis can turn into a disaster. A new direction in medicine – repeat histology – allows us to minimize the likelihood of erroneous diagnosis.

Relevance of the histological diagnostic method

The importance of histological examination in the diagnosis of malignant neoplasms cannot be overestimated. Despite the existence of modern instrumental methods (CT, MRI, PET), it is morphological study remains the gold standard for diagnosis malignant tumors. Only after identifying tumor cells under a microscope does an oncologist have the right to make a final diagnosis. An incorrect diagnosis can cost the patient his life, so all cancer patients are recommended to undergo a histology review procedure.

Services of our company for repeated histological examinations

In addition to reviewing glasses in the oncology center, we provide organizational services for the diagnosis of malignant neoplasms:

• polymerase chain reaction;
• molecular genetic diagnostics;
• cytological examination of scrapings from the cervix and cervical canal.

In what cases is repeat histology performed?

Why do we need to review histological slides? The main problem is the difficulty of interpreting histological studies. Even correct collection of material and preparation of a microscopic sample do not guarantee the accuracy of the diagnosis. A histologist who has little experience or has not previously encountered such a microscopic picture may make an incorrect diagnosis. Leading histologists at the private Israeli clinic Assuta have many years of experience and are recognized professionals in their field around the world. By using their histology slide review services, you can be confident that there will be no diagnostic errors.

Procedure for reviewing histological preparations

The service is provided in several stages.

1. First, you need to obtain histological sections and microscopic samples from the laboratory.
2. After this, you will need to bring the collected materials to the representative office of the Assuta clinic.
3. Then, over the course of several days, leading Israeli specialists review the discs and draw up a medical report.
4. You receive the histologist's verdict by email, which you provided during registration.

The main advantages of glass revision and biopsy in the private Israeli clinic “Assuta”

By reviewing your biopsy in a leading Israeli clinic, you receive a number of objective advantages.

• There is no need to travel to another country, and, accordingly, no additional costs for travel and accommodation: you only need to deliver histological samples to the clinic’s representative office.
• Highly qualified doctors narrow profile ensures the accuracy of the diagnosis.
• The coordinated work of all links in the patient-doctor chain ensures that results are obtained within 3–5 days after the provision of histological samples.

Services of the representative office of the Assuta Moscow clinic for correspondence diagnostics of biopsy material

The representative office of the Assuta clinic in Moscow offers a number of organizational services necessary for accurate diagnosis oncological diseases.

• Histological examination.
• Cytological analysis(cytopathology).
• Examination of cervical smears.
• Molecular diagnostics using PCR and FISH technologies.
• Genetic research.

Liquid biopsy

Liquid biopsy is a modern method for diagnosing malignant neoplasms, based on identifying the genetic material of tumor cells in the blood. By revising a biopsy using this technique, it becomes possible to diagnose diseases on the basis of high accuracy. early stage, determine the histological type of tumor, evaluate the effectiveness of therapy. The method is absolutely harmless to humans, simple to perform and accessible to most patients.

Indications

• Diagnosis of tumor diseases in the early stages.
• Detection of mutations in tumor cell genes.
• Determination of the molecular genetic subtype of the tumor.
• Selection drug therapy(sensitivity is determined cancer cells to different classes of anticancer drugs).
• Evaluation of the effectiveness of the treatment.
• Making a prognosis for the disease.

How is it carried out?

For analysis it is taken deoxygenated blood. The sample is sent to a laboratory where it is tested: the blood is passed through microchips coated with antibodies to cancer cells. Adsorbed on the chips, tumor cells and their fragments begin to glow under the influence of fluorescent dye. The isolated cells are transferred into a test tube and used for further genetic, cytological and immunohistochemical studies.

MammaPrint

Breast cancer ranks first in both the morbidity and mortality structure among all cancers in women. Even well-carried out surgical, radio- and chemotherapy treatment does not guarantee complete recovery. MammaPrint is a modern diagnostic test that is designed to determine the risk of breast cancer recurrence and metastases within 10 years after removal of the tumor. The test is based on genetic diagnosis. Based on the test results, the patient may be classified as high or low risk. The doctor, after analyzing the data, decides on the need for postoperative chemotherapy.

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Revision of histology, cytology slides

Study period 1 day

Why do we need to review histological (cytological) slides?

Oncological practice shows that delivered in one medical institution the diagnosis very often needs confirmation or refutation. And, although examination under a microscope is carried out by professional specialists, the possibility of error or oversight cannot be excluded. Therefore, such a study as the revision of histology slides is no longer a rarity.

When is it necessary to review existing histology results?

This procedure is carried out if:

A correct diagnosis must be made;

Specify the type or subtype of tumor;

Determine the prevalence of the oncological process;

Confirm previous results.

Repeated examination of slides in another laboratory significantly reduces
risk of error. The patient can pick up histology slides in one laboratory,
to transfer to another institution and verify the correctness of the results.
In many cases, this sequence of actions is even recommended.

What can prevent a pathologist from qualitatively reviewing histological slides?

Poor quality of sections in the previous laboratory makes it almost impossible to clarify the diagnosis or find out other important details pictures of the disease.

There are two ways out of this situation:

Order an additional biopsy through Oncostandard;

Take your paraffin blocks from the previous laboratory along with the histological slides.

Even the most precise methods studies often need to be re-checked. Through the Onkostandard company, it is possible to obtain an independent result based on the opinion of one or more highly qualified specialists of our partner clinics within 2-3 business days. At the same time, you do not have to come to the laboratory yourself: our courier service will pick up the drugs for review from you and deliver them back along with the test results after the procedure.

Glass review procedure

When writing a histological report, there is a risk of making a mistake, and in order to prevent this from happening in the laboratory where the study was originally carried out, it is necessary to review the slides in another laboratory. In practice everything is simple. The patient needs to pick up histological slides from his laboratory in which the initial analysis was performed and transfer these slides for review to another laboratory that is not related to the first one. Review of drugs will take two working days from the moment the drugs are delivered to the laboratory. Paraffin blocks must be sent along with histological slides. This is necessary in case the histological preparation could have been made incorrectly in the first laboratory, and additional new sections will need to be made. This will not increase the time it takes for the result to be ready, but will also take two to a maximum of three days. You can get your result by e-mail, immediately on the day it is ready. Blocks, slides and the original histological report will be delivered by express courier to your home at the address you specified.

Transfer of histological materials for revision

The procedure for transferring histological slides and paraffin blocks is very simple. First, you need to contact our company Onkostandart. Next, we will arrange for you free delivery of your histological slides to our laboratories, with which we have an agreement for the revision of histological slides. Delivery time takes up to three days. The delivery itself is carried out from any corner of Russia immediately to the laboratory of our clinics. We value your time and make sure that you are satisfied with the quality of the services provided.

. Worry about the uncontrollable side effects(such as constipation, nausea or mental confusion. Concern about addiction to pain medications. Non-adherence to prescribed pain medication regimen. Financial barriers. Health system issues: Low priority for cancer pain management. The most appropriate treatment may be too expensive for patients and their families Tight regulation of controlled substances Problems with affordability or access to treatment Opiates not available over the counter to patients Unavailable medications Flexibility is key to cancer pain management As patients vary in diagnosis, stage of disease, response to pain and personal preferences, then it is necessary to be guided by these particular features. More details in the following articles: ">Pain in cancer 6

to cure or at least stabilize the development of cancer. Like other therapies, the choice to use radiation therapy to treat a specific cancer depends on a number of factors. These include, but are not limited to, the type of cancer, the patient's physical condition, the stage of the cancer, and the location of the tumor. Radiation therapy (or radiotherapy is important technology to shrink tumors. High energy waves are directed at the cancerous tumor. The waves cause damage to cells, disrupting cellular processes, preventing cell division, and ultimately leading to the death of malignant cells. The death of even part of the malignant cells leads to a reduction in the tumor. One significant disadvantage of radiation therapy is that the radiation is not specific (that is, it is not aimed exclusively at cancer cells for cancer cells and can also harm healthy cells. Responses of normal and cancer tissue to therapy The response of tumor and normal tissues to radiation depends on their nature growth before the start of therapy and during treatment. Radiation kills cells through interaction with DNA and other target molecules. Death does not occur instantly, but occurs when cells try to divide, but as a result of exposure to radiation, a failure in the division process occurs, which is called abortive mitosis. For this reason, radiation damage occurs more quickly in tissues containing cells that divide rapidly, and cancer cells are the ones that divide rapidly. Normal tissues compensate for the cells lost during radiation therapy by accelerating the division of remaining cells. In contrast, tumor cells begin to divide more slowly after radiation therapy, and the tumor may shrink in size. The extent of tumor shrinkage depends on the balance between cell production and cell death. Carcinoma is an example of a type of cancer that often has a high rate of division. These types of cancer tend to respond well to radiation therapy. Depending on the dose of radiation used and the individual tumor, the tumor may begin to grow again after stopping therapy, but often more slowly than before. To prevent tumor regrowth, radiation is often given in combination with surgical intervention and/or chemotherapy. Goals of Radiation Therapy Curative: For curative purposes, radiation exposure is usually increased. Reaction to radiation ranges from mild to severe. Symptom relief: This procedure is aimed at relieving cancer symptoms and prolonging survival, creating a more comfortable living environment. This type of treatment is not necessarily performed with the intention of curing the patient. Often this type of treatment is prescribed to prevent or eliminate pain caused by cancer that has metastasized to the bones. Radiation instead of surgery: Radiation instead of surgery is effective tool against a limited number cancer diseases. Treatment is most effective if the cancer is found early, while it is still small and non-metastatic. Radiation therapy may be used instead of surgery if the location of the cancer makes surgery difficult or impossible to perform without serious risk to the patient. Surgery is the preferred treatment for lesions that are located in an area where radiation therapy may be more harmful than surgery. The time required for the two procedures is also very different. Surgery can be performed quickly after diagnosis; Radiation therapy may take weeks to be fully effective. There are pros and cons to both procedures. Radiation therapy may be used to save organs and/or avoid surgery and its risks. Radiation destroys rapidly dividing cells in the tumor, while surgical procedures may miss some of the cancerous cells. However, large tumor masses often contain oxygen-poor cells in the center that do not divide as quickly as cells near the surface of the tumor. Because these cells do not divide rapidly, they are not as sensitive to radiation therapy. For this reason, large tumors cannot be destroyed using radiation alone. Radiation and surgery are often combined during treatment. Useful articles for a better understanding of radiation therapy: ">Radiation Therapy 5

Skin reactions with targeted therapy Skin problems Shortness of breath Neutropenia Disorders nervous system Nausea and vomiting Mucositis Menopause symptoms Infections Hypercalcemia Male sex hormone Headaches Hand-foot syndrome Hair loss (alopecia Lymphedema Ascites Pleurisy Edema Depression Cognitive problems Bleeding Loss of appetite Restlessness and anxiety Anemia Confusion. Delirium Difficulty swallowing. Dysphagia Dry mouth. Xerostomia Neu Ropathy O For specific side effects, read the following articles: "> Side effects36

cause cell death in various directions. Some of the drugs are natural compounds that have been identified in various plants, while other chemicals are created in the laboratory. Some various types chemotherapy drugs are briefly described below. Antimetabolites: Drugs that can affect the formation of key biomolecules inside the cell, including nucleotides, the building blocks of DNA. These chemotherapeutic agents ultimately interfere with the process of replication (production of a daughter DNA molecule and therefore cell division. Examples of antimetabolites include the following drugs: Fludarabine, 5-Fluorouracil, 6-Thioguanine, Ftorafur, Cytarabine. Genotoxic drugs: Drugs that can damage DNA. By causing this damage, these agents interfere with DNA replication and cell division. As an example of drugs: Busulfan, Carmustine, Epirubicin, Idarubicin. Spindle inhibitors (or mitosis inhibitors): These chemotherapy agents aim to prevent proper cell division by interacting with cytoskeletal components that allow one cell to divide into two parts. An example is the drug paclitaxel, which is obtained from the bark of the Pacific Yew and semi-synthetically from the English Yew ( Yew berry, Taxus baccata Both drugs are given as a series of intravenous injections Other chemotherapeutic agents: These agents inhibit (slow down cell division through mechanisms not covered in the three categories above. Normal cells are more resistant (resistant to drugs because they often stop dividing under conditions that are not favorable. However, not all normal dividing cells escape the effects of chemotherapy drugs, which is evidence of the toxicity of these drugs. Cell types that tend to divide rapidly, such as those in the bone marrow and in the lining of the intestines , as a rule, suffer the most. Death of normal cells is one of the common side effects of chemotherapy. More details about the nuances of chemotherapy in the following articles: ">Chemotherapy 6

• and not small cell carcinoma lung These types are diagnosed based on how the cells look under a microscope. Based on the established type, treatment options are selected. To understand the prognosis of the disease and survival rate, I present statistics from open US sources for 2014 on both types of lung cancer together: New cases of the disease (prognosis: 224210 Number of projected deaths: 159260 Let us consider in detail both types, specifics and treatment options.">Lung cancer 4
• in the United States in 2014: New cases: 232,670 Deaths: 40,000 Breast cancer is the most common non-skin cancer among women in the United States (open sources, an estimated 62,570 cases of pre-invasive disease (in situ, 232,670 new cases of invasive disease, and 40,000 deaths, meaning less than one in six women diagnosed with breast cancer will die from the disease, compared with an estimated 72,330 American women will die of lung cancer in 2014. Breast cancer in men (yes, yes, there is such a thing) accounts for 1% of all breast cancer cases and deaths from this disease. Widespread screening has increased the incidence of breast cancer and changed the characteristics of detected cancer. Why has it increased? Yes, because the use modern methods has enabled detection of the incidence of low-risk cancers, precancerous lesions and ductal carcinoma in situ (DCIS). Population-based studies in the US and UK show an increase in DCIS and incidence invasive cancer breast since 1970, this is due to the widespread use of postmenopausal hormone therapy and mammography. In the last decade, postmenopausal women have refrained from using hormones and the incidence of breast cancer has decreased, but not to the level that can be achieved with the widespread use of mammography. Risk and protective factors Increasing age is the most important factor risk for breast cancer. Other risk factors for breast cancer include the following: Family medical history o Underlying genetic susceptibility Sex mutations in the BRCA1 and BRCA2 genes, and other breast cancer susceptibility genes Alcohol consumption Breast tissue density (mammographic) Estrogen (endogenous: o Menstrual history (onset of menstruation / late menopause o No history of childbirth o Elderly age at the birth of the first child History of hormonal therapy: o Combination of estrogen and progestin (HRT Oral contraception Obesity Lack of exercise Personal history of breast cancer Personal history of proliferative forms of benign breast diseases Radiation exposure to the breast Of all women with breast cancer, from 5% to 10 % may have germline mutations in the BRCA1 and BRCA2 genes, and studies have found that specific BRCA1 and BRCA2 mutations are more common among women Jewish origin. Men who carry a BRCA2 mutation also have an increased risk of developing breast cancer. Mutations in both the BRCA1 and BRCA2 genes also create an increased risk of developing ovarian cancer or other primary cancers. Once BRCA1 or BRCA2 mutations have been identified, it is advisable for other family members to undergo genetic counseling and testing. Protective factors and measures to reduce the risk of developing breast cancer include: Using estrogen (especially after a hysterectomy Establishing an exercise habit Early pregnancy Breast-feeding Selective estrogen receptor modulators (SERMs) Aromatase inhibitors or inactivators Reducing the risks of mastectomy Reducing the risk of oophorectomy or oophorectomy Screening Clinical trials have found that screening asymptomatic women with mammography, with or without clinical breast examination, reduces mortality from breast cancer. Diagnosis If If breast cancer is suspected, the patient usually must go through the following steps: Confirmation of the diagnosis Assessing the stage of the disease Selection of therapy The following tests and procedures are used to diagnose breast cancer: Mammography Ultrasound Breast magnetic resonance imaging (MRI, if clinically present) indications Biopsy Contralateral breast cancer Pathologically, breast cancer can be multicentric and bilateral. Bilateral disease is slightly more common in patients with invading focal carcinoma. Over 10 years after diagnosis, the risk of primary breast cancer in the contralateral breast is within 3% to 10%, although endocrine therapy may reduce this risk. Development of second breast cancer is associated with an increased risk of distant recurrence. If the BRCA1/BRCA2 gene mutation was diagnosed before the age of 40, the risk of cancer of the second breast in the next 25 years reaches almost 50%. Patients diagnosed with breast cancer should undergo bilateral mammography at the time of diagnosis to rule out synchronous disease. The role of MRI in screening for contralateral breast cancer and monitoring women treated with breast conservation therapy continues to evolve. Because the increased level detection of possible disease on mammography has been demonstrated, selective use of MRI for additional screening is occurring more frequently, despite the lack of randomized controlled data. Because only 25% of MRI-positive findings represent malignancy, pathological confirmation is recommended before treatment. Whether this increased rate of disease detection will lead to improved treatment outcomes is unknown. Prognostic Factors Breast cancer is usually treated with various combinations of surgery, radiation therapy, chemotherapy and hormonal therapy. Conclusions and selection of therapy may be influenced by the following clinical and pathological features (based on conventional histology and immunohistochemistry: Menopausal status of the patient. Stage of the disease. Degree primary tumor. Tumor status according to the status of estrogen receptor (ER and progesterone receptor (PR). Histological types. Breast cancer is classified into various histological types, some of which have prognostic significance. For example, favorable histological types include colloid, medullary and tubular cancer. Use of molecular Breast cancer profiling includes the following: ER and PR status testing HER2/Neu receptor status testing Based on these results, breast cancer is classified as: Hormone receptor positive HER2 positive Triple negative (ER, PR and HER2 / Neu negative Although some rare inherited mutations, such as BRCA1 and BRCA2, predispose carriers to breast cancer, the prognostic data for BRCA1/BRCA2 mutation carriers is inconsistent; these women are simply at greater risk of developing cancer in the second breast. But it is not a fact that this can happen. Hormone replacement therapy After careful consideration, patients with severe symptoms may be treated with hormone replacement therapy. Follow-up Frequency of follow-up and advisability of screening after completion primary treatment Stage I, stage II, or stage III breast cancer remains controversial. Data from randomized trials suggest that periodic follow-up with bone scans, liver ultrasound, radiography chest and blood tests for liver function do not improve survival or quality of life at all compared with routine medical examinations. Even when these tests allow early detection of relapse of the disease, this does not affect the survival of patients. Based on these data, limited screening and annual mammography may be an acceptable continuation for asymptomatic patients who have been treated for stage I to III breast cancer. More detailed information in the articles: "> Mammary cancer5
• , ureters, and proximal urethra are lined by a specialized mucosa called transitional epithelium (also called urothelium. Most cancers that form in the bladder, renal pelvis, ureters, and proximal urethra are transitional cell carcinomas (also called urothelial carcinomas, derived from transitional epithelium Transitional cell bladder cancer can be low-grade or full-grade: Low-grade bladder cancer often recurs in the bladder after treatment, but rarely invades the bladder. muscle walls bladder or spreads to other parts of the body. Patients rarely die from low-grade bladder cancer. Full-blown bladder cancer usually recurs in the bladder and also has a strong tendency to invade the muscular walls of the bladder and spread to other parts of the body. High-grade bladder cancer is considered more aggressive than low-grade bladder cancer and is much more likely to cause death. Almost all deaths from bladder cancer are due to high-grade cancer. Bladder cancer is also divided into muscle-invasive and non-muscle-invasive disease, based on invasion of the muscle lining (also referred to as the detrusor muscle, which is located deep in the muscle wall of the bladder. Muscle-invasive disease is much more likely to spread to other parts of the body and is typically treated by either removing the bladder or treating the bladder with radiation and chemotherapy.As noted above, high-grade cancers are much more likely to be muscle-invasive cancers than low-grade cancers.Thus, Muscle-invasive cancer is generally considered to be more aggressive than non-muscle-invasive cancer.Non-muscle-invasive disease can often be treated by removing the tumor using a transurethral approach and sometimes chemotherapy or other procedures in which medicine inserted into the bladder through a catheter to help fight cancer. Cancer can arise in the bladder in the setting of chronic inflammation, such as a bladder infection caused by the parasite haematobium Schistosoma, or as a result of squamous metaplasia; The incidence of squamous cell carcinoma of the bladder is higher in the setting of chronic inflammation than otherwise. In addition to transitional carcinoma and squamous cell carcinoma, adenocarcinoma, small cell carcinoma, and sarcoma can form in the bladder. In the United States, transitional cell carcinomas account for the vast majority (more than 90% of bladder cancers. However, a significant number of transitional cell carcinomas have areas of squamous cell or other differentiation. Carcinogenesis and Risk Factors There is compelling evidence of the influence of carcinogens on the occurrence and development of bladder cancer. The most common risk factor for developing bladder cancer is cigarette smoking. It is estimated that up to half of all bladder cancer cases are caused by smoking and that smoking increases the risk of developing bladder cancer at two to four times the baseline risk. Smokers with less functional polymorphisms N-acetyltransferase-2 (known as a slow acetylator) has a higher risk of developing bladder cancer compared to other smokers, apparently due to a decreased ability to detoxify carcinogens. Certain occupational hazards have also been linked to bladder cancer, and higher rates of bladder cancer have been reported due to textile dyes and rubber in the tire industry; among artists; leather processing industry workers; from shoemakers; and aluminum, iron and steel workers. Specific chemicals associated with bladder carcinogenesis include beta-naphthylamine, 4-aminobiphenyl, and benzidine. Although these chemicals are now generally banned in Western countries, many other chemicals that are still used today are also suspected of causing bladder cancer. Exposure to the chemotherapy agent cyclophosphamide has also been associated with an increased risk of bladder cancer. Chronic infections urinary tract infections and infections caused by the parasite S. haematobium are also associated with an increased risk of developing bladder cancer, and often squamous cell carcinoma. Chronic inflammation, is believed to play a key role in the process of carcinogenesis in these conditions. Clinical signs Bladder cancer usually presents with simple or microscopic hematuria. Less commonly, patients may complain of frequent urination, nocturia, and dysuria, symptoms that are more common in patients with carcinoma. Patients with urothelial cancer of the upper urinary tract may experience pain due to obstruction by the tumor. It is important to note that urothelial carcinoma is often multifocal, necessitating examination of the entire urothelium if a tumor is detected. In patients with bladder cancer, imaging of the upper urinary tract is essential for diagnosis and follow-up. This can be achieved using urethroscopy, retrograde pyelogram in cystoscopy, intravenous pyelogram, or computed tomography (CT urogram). In addition, patients with transitional cell carcinoma of the upper urinary tract have a high risk of developing bladder cancer; these patients require periodic cystoscopy and observation of the contralateral upper urinary tract.Diagnosis When bladder cancer is suspected, the most useful diagnostic test is cystoscopy.Radiological examination, such as CT scan or Ultrasounds are not sensitive enough to be useful for detecting bladder cancer. Cystoscopy can be performed in urological clinic. If cancer is detected during cystoscopy, the patient is typically scheduled for a bimanual examination under anesthesia and a repeat cystoscopy in the operating room so that transurethral tumor resection and/or biopsy can be performed. Survival Patients who die from bladder cancer almost always have metastases from the bladder to other organs. Bladder cancer with low level malignancy rarely grows into the muscle wall of the bladder and rarely metastasizes, so patients with low-grade malignancy (stage I bladder cancer) very rarely die from cancer. However, they may experience multiple recurrences that must be resected. Almost all deaths are from Bladder cancers occur among patients with disease with high level malignancy, which has a much greater potential to invade deep into the muscular walls of the bladder and spread to other organs. Approximately 70% to 80% of patients with newly diagnosed bladder cancer have superficial bladder tumors (ie, stage Ta, TIS, or T1. The prognosis of these patients depends largely on the grade of the tumor. Patients with Tumors high degree malignancies have a significant risk of dying from cancer, even if it is not muscle-invasive cancer. Those patients with high-grade tumors who are diagnosed with superficial, non-muscle-invasive bladder cancer in most cases have a high chance of cure, and even in the presence of muscle-invasive disease, sometimes the patient can be cured. Studies have shown that in some patients with distant metastases, oncologists achieved long-term complete responses after treatment with a combination chemotherapy regimen, although most of these patients have metastases limited to their lymph nodes. Secondary cancer Bladder Cancer tends to recur, even if it is non-invasive at the time of diagnosis. Therefore, standard practice is to monitor urinary tract after a diagnosis of bladder cancer. However, no studies have yet been conducted to evaluate whether surveillance affects progression rates, survival, or quality of life; although there is clinical trials to determine the optimal observation schedule. Urothelial carcinoma is thought to reflect a so-called field defect, in which the cancer arises due to genetic mutations that are widely present in the patient's bladder or throughout the urothelium. Thus, people who have had a resected bladder tumor often subsequently have ongoing tumors in the bladder, often in other locations than the primary tumor. Similarly, but less frequently, they may develop tumors in the upper urinary tract(i.e., in the renal pelvis or ureter. An alternative explanation for these patterns of recurrence is that cancer cells that are destroyed when the tumor is excised may reimplant elsewhere in the urothelium. Support for this second theory is that tumors are more likely to recur lower than in the opposite direction from the initial cancer. Upper urinary tract cancer is more likely to recur in the bladder than bladder cancer is to recur in the upper urinary tract. The rest is in the following articles: "> Bladder cancer4
• , as well as an increased risk of metastatic disease. The degree of differentiation (determining the stage of tumor development has important influence on the natural history of this disease and on the choice of treatment. An increase in the incidence of endometrial cancer has been found to be associated with long-term, unopposed estrogen exposure (increased levels). In contrast, combination therapy (estrogen + progesterone) prevents the increased risk of endometrial cancer associated with unopposed estrogen exposure specifically. Receiving a diagnosis is not the most good timing. However, you should know - endometrial cancer is a curable disease. Monitor the symptoms and everything will be fine! In some patients, a previous history of complex hyperplasia with atypia may play an “activator” role for endometrial cancer. An increase in the incidence of endometrial cancer has also been found in connection with the treatment of breast cancer with tamoxifen. According to researchers, this is due to the estrogenic effect of tamoxifen on the endometrium. Because of this increase, patients prescribed tamoxifen therapy should mandatory undergo regular pelvic examinations and should be attentive to any abnormal uterine bleeding. Histopathology The distribution pattern of malignant endometrial cancer cells depends in part on the degree of cellular differentiation. Well differentiated tumors, as a rule, limit their spread to the surface of the uterine mucosa; myometrial expansion occurs less frequently. In patients with poorly differentiated tumors, invasion of the myometrium is much more common. Invasion of the myometrium is often a precursor to lesions lymph nodes and distant metastases, and often depends on the degree of differentiation. Metastasis occurs in the usual way. Spread to the pelvic and para-aortic nodes is common. When distant metastases occur, it most often occurs in: Lungs. Inguinal and supraclavicular nodes. Liver. Bones. Brain. Vagina. Prognostic factors Another factor that is associated with ectopic and nodal spread of the tumor is the participation of the capillary-lymphatic space in histological examination. The three prognostic groupings of clinical stage I were made possible by careful operative staging. Patients with stage 1 tumors involving only the endometrium and no evidence of intraperitoneal disease (i.e., adnexal extension) are at low risk (">Endometrial Cancer 4

Carried out to make a correct diagnosis, clarify the type or subspecies cancerous tumor and the prevalence of the tumor process. This is the basis for prescribing treatment protocols and prognosis for the patient’s future life. However, the capabilities and quality of histology directly depend on its competent implementation - from correct, careful and professional preparation to the qualifications of the pathologist studying the specimen. Also, the risks of poor-quality histology are significantly reduced by the peer review procedure. histological slides, which is carried out at UNIM on a case-by-case basis.

Glass review procedure

In order to reduce the risk of errors in the histological report, there is a practice of reviewing slides in another laboratory. The patient takes histological slides from the laboratory that performed the first analysis and transfers them for examination to another laboratory. When contacting UNIM, it takes two business days from the moment the drugs are delivered to the laboratory. However, it must be remembered that if the slides are poorly prepared (for example, there is no tumor on the section), additional sections may be required, so it is advisable to provide original paraffin blocks along with the histological slides. In this case, the final results when carrying out additional research will be ready in 2-3 business days. The patient or attending physician will be able to receive the results on the day the report is ready by email, and the original report, glasses and blocks will be delivered later by express mail.

Transfer of histological materials for revision

Previously, in order to conduct a review or repeat histology, the patient or his relatives had to personally come to the city in which these studies are carried out. In most cases, this involves additional costs and complications during an already difficult time. The UNIM company delivers from Russian regions to Moscow: glass/blocks/biopsy in formaldehyde free of charge. Delivery is organized on a door-to-door basis. This means that the company’s courier picks up the drugs at an address convenient for the sender and delivers them directly to the pathology laboratories of our partners, specializing specifically in these types of tumors. Delivery of histological preparations is carried out within 1-3 days from any region of Russia.

Additional studies after histology

Choosing the most modern laboratory with highly qualified specialists ensures not only high quality the research itself, but also provides the opportunity, if necessary, to conduct additional tests(IHC, FISH) for the fastest and most accurate diagnosis, as well as get advice the best specialists according to the profile of your disease from anywhere in the world using the system.

Any tumor consists of altered cells. Initially, it is very important to understand which cancer cells and their varieties make up a particular tumor. All further treatment of the patient depends on this. For example, the concept " lung cancer "includes more than twenty types of cancer, depending on the type of cells that form the tumor.

If you or your loved ones need medical assistance, contact us. The site’s specialists will recommend a clinic where you can get effective treatment:

Histological preparations and glasses. What it is?

Histological preparations are very thin sections of tumor tissue. During the manufacturing process, each section is painted with special dyes and placed on the so-called slide. This section is then covered with a special coverslip and examined under a microscope. This is how specialists find out exactly what cells the tumor consists of. Only after this can effective and reasonable treatment be prescribed.

That's what it is " histological slides" After the initial diagnosis has been made, it is very important to always have these glasses with you - at home, and not in the hospital where the diagnosis was first made. Using these glasses you can always clarify the diagnosis in Federal Oncology Clinics and abroad.

Revision of histological slides in Russia and abroad

It is important to understand that the primary histological diagnosis may not be entirely correct. There are many reasons for this. Insufficient experience of a specialist, bad dyes, low-quality glass... In general, in Russia good specialists are not even allowed to retire. Having vast experience behind them, such professionals can very accurately determine this or that type of tumor. But the main research tool is microscope. By the way, most cancer diagnoses are made, as they say, “under a microscope,” which is why such studies are so important.

We are ready to review glass remotely in leading centers and best laboratories in Moscow. More detailed information can be obtained by watching the video or calling.

In the West, special programs are used. Something like checking fingerprints for compatibility. The tissue section is run through a common international database and identical tumor variants are obtained. There is also such a concept as “ paraffin blocks" They are made and stored together with the glasses. And they represent some kind of blanks for cutting. If for one reason or another the glasses do not give unambiguous answers, you can always get new preparations from ready-made blocks.

So let's summarize.

For successful diagnosis and treatment of oncology you will need:

1. Discharge from the hospital where the cancer diagnosis was first made;
2. Histological glasses and blocks;
3. Referral for consultation to the federal oncology center.

Take care of yourself!

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