Креативная хирургия и онкология (Aug 2018)
CELLULAR IMMUNE REACTION IN A GREAT OMENTUM WITH METASTASES IN PATIENTS WITH OVARIAN CANCER
Abstract
Introduction. Ovarian cancer is characterized by complex diagnostics and flow forecasting, which makes it important to search for prognostic criteria. However, the prognostic significance of some factors has not yet been studied.The purpose of the study: to identify the features of immune response in the localization of metastases in the large omentum in ovarian cancer.Tasks: to reveal the pathomorphological features of the cellular immune response to metastases in the large omentum in patients with ovarian cancer II–III stages; to conduct histomorphometry of elements of the immune system in the area of metastases.Material and methods. The study was carried out on the biomaterial of the large omentum of 94 women with ovarian cancer II–III stage. The measurements were carried out on paraffin sections stained with hematoxylin and eosin and included evaluation of the following parameters: the number of lymphocytes in the field of view at the border and away from the tumor, the continuity of the lymphocyte shaft at the border with the tumor, the number of neutrophils on the border with the tumor, the presence of plasmocytes on the border with tumor. The preparations were studied and photographed under a microscope with a microscope-microvision mVizo-103 and a microscope Micromed 3.The results. Observed 94 patients with stage II–III ovarian cancer. Over the three-year follow-up period, the disease-free survival rate was 79.8%. A total of 64 patients with stage III disease were observed. A recurrence-free survival rate among patients with stage III ovarian cancer was 74.32%. Without relapse during the follow-up period, those patients were found whose lymphocytes formed a continuous shaft at the border with the tumor, their number in the field of view ×200 was 400 or more, the plasmocytes were present in the composition of the shaft, and the neutrophils were absent or few.The conclusion. A detailed histological study to quantify and qualitatively determine the severity of lymphoid elements of the large omentum allowed an indirect assessment of the state of the immune system and the probability of an unfavorable outcome in patients with ovarian neoplasia.
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