Objective.To study the state of cellular immunity and local immunity in patients with gastric adenocarcinoma.

Materials and methods.From 2017 to 2018 45 primary patients with gastric adenocarcinoma (25 — with stages I–III, 20 — with stage IV) received surgical / combined treatment or chemotherapy at the Blokhin Scientific Research Center of Oncology, respectively. Peripheral blood and tumor tissue were collected before starting treatment. The percentage of the degree of infiltration of tumor tissue by lymphocytes (CD45 + CD14‑TILs) was assessed by flow cytometry: T‑cells (CD3 + CD19‑TILs), B‑cells (CD3‑CD19 + TILs), NK‑cells (CD3‑CD16 + CD56 + TILs), effector cells CD16 and CD8 and their cytotoxic potential (CD16 + Perforin + TILs, CD16CTPTILs), (CD8 + Perforin + TILs; CD8CTPTILs); subpopulations of regulatory T‑cells — NKT‑cells (CD3 + CD16 + CD56 + TILs), regulatory CD4‑cells (CD4 + CD25 + CD127‑TILs) and CD8 (CD8 + CD11b‑CD28‑TILs) and parameters of systemic immunity.

Intratumoral and stromal subpopulations of CD4 + TILs, CD8 + TILs, CD4 + / CD8 + TILs ratios were studied by immunohistochemistry. Also, the cellular composition of peripheral blood was investigated. The prognostic significance of immune cells, inflammation factors (neutrophil‑lymphocyte index, platelet‑lymphocyte index) and clinical characteristics (patient»s age (both by years and by groups: up to 45 years, 46–60 years, over 60 years), disease stage, differentiation (G), Lauren type and MSI status were evaluated for overall survival (OS) and progression‑free survival (PFS).

Results.The factor of a favorable prognosis for PFS in patients with local and locally advanced forms of gastric cancer was an increase in the number of CD3 + CD19‑TILs (HR0.865, 95 %CI 0.782–0.957, p = 0.005), and for poor prognosis — an increase in NK‑cells; HR1.382, 95 %CI 1.087–1.758, p = 0.008. There was a negative effect of the relative content of NK‑cells, an increase in the level of neutrophils in the peripheral blood on the OS of patients with metastatic GC (HR1.42, 95 %CI 1.06–1.89, p = 0.017 and HR1.64, 95 %CI 1.12–2.40, p = 0.011). At the same time, an increase in the age of patients, the level of neutrophils and platelets (HR1.106, 95 %CI 1.002–1.199, p = 0.015; HR1.714, 95 %CI 1.063–2.764, p = 0.027 and HR1.017, 95 %CI 1.006–1.029, p = 0.003) reduce PFS in patients with metastatic gastric cancer.

Conclusion.Indicators of local immunity, the cellular composition of peripheral blood, characterizing the systemic inflammatory response, as well as indicators of systemic immunity can serve as additional prognostic factors in gastric cancer.

Malnutrition is one of the most common disorders observed in patients who are being treated for various diseases. In cancer patients with a palliative profile, compared with patients without malignant neoplasms, anemia, lymphopenia, decreased glomerular filtration rate were significantly more often detected, and a tendency to lower albumin levels was revealed. There was a significant decrease in PNI, BMI, shoulder circumference, thickness of the skin‑fat fold of the scapula and shoulder, and a tendency to reduce lean body weight in patients with palliative malignancies. The logistic regression analysis revealed the relationship between the presence of a malignant tumor in palliative patients and the presence of trophic status disorders: PNI (β = –0.37, p = 0.021), weight (β = –0.41, p = 0.001), BMI (β = –0.36, p = 0.001), shoulder circumference (β =–0.65, p = 0.001), thickness of the scapular skin‑fat fold (β = –0.66, p = 0.001).

Breast augmentation with the use of silicone breast implants is a routine practice for breast surgeons. Breast implant capsule‑associated squamous cell carcinoma is a rare and aggressive malignant tumor accounting for less than 0,1 % of invasive breast cancer. Currently there is no single concept of a complex therapy for such tumors due to the low incidence rate. The article describes a case of a 49‑year‑old female patient after surgical treatment of left‑sided breast implant capsule‑associated squamous cell carcinoma diagnosed in 2019. After the disease progression the patient underwent removal of the chest wall tumor with resection of ribs 3–5, allo‑and autoplasty, and left axillary lymph node dissection (ALND). In most cases, breast implant capsule‑associated squamous cell carcinoma is treated surgically but the role of adjuvant chemotherapy, radiation therapy, and endocrine therapy is still ambiguous.

Breast cancer (BC) is a heterogeneous disease characterized by the presence or absence of membrane receptor overexpression on tumor cells that correlates with the disease prognosis. Understanding of the patterns and mechanisms of tumor progression gained through clinical experience of managing BC patients is important. The treatment strategy depends on the hormone receptor status of the tumor, the HER2 / neu expression, and the proliferative activity level. A clinical case of advanced luminal A breast cancer is reported, and the rationale for sequential treatment strategy is provided taking into account the clinical situation and clinical course of the disease. Adequate endocrine therapy for hormone-positive metastatic BC provides long-term tumor control like in this case, as well as a high quality of life over the entire course of sequential treatment with anticancer drugs.