Introduction. Cystic neoplasms of the pancreas (PC) represent a group of heterogeneous neoplasms that differ in the principles of clinical management and require morphological verification. A promising method of differential diagnosis involves Raman spectroscopy providing information about the substance composition based on the spectral lines obtained by irradiating the substance with a laser.

Materials and methods. A prospective single-center study was performed in patients with morphologically verified cystic neoplasms of the pancreas. The analysis included 13 observations: 4 pseudocysts and 9 mucinous cysts. The cyst composition was analyzed using a portable OPTEC-785LRam spectrometer with an excitation wavelength of 785 nm. Statistical analysis was performed after digital preprocessing using the principal component analysis (PCA) supplemented by nonparametric tests.

Results. The first two principal components (PC1 and PC2) explained 37.77 and 15.98% of the variability, respectively. The division of the sample into mucinous cysts and pseudocysts was performed according to PC1. After comparison by the Mann–Whitney test and assessment of the effect size, wave numbers with the most characteristic peaks for mucinous cysts (1102, 1228, and 1422 cm- ¹) and pseudocysts (644, 610, and 966 cm- ¹) were identified. These wave numbers correspond to vibrations of amide and lipid bonds. The Leave-one-out analysis confirmed the stability of key features.

Discussion. This study represents the first application of Raman spectroscopy in the determination of the cyst composition for the differential diagnosis of pancreatic mucinous cysts. Despite high values of sensitivity and specificity, the obtained data should be considered preliminary: external validation is required due to the small sample size.

Conclusion. The performed Raman spectroscopic analysis of native cystic fluid revealed spectral differences between mucinous cysts and pseudocysts, which can reflect differences in protein-lipid composition and inflammatory changes. The method eliminates complex sample preparation and can potentially be used as an additional tool for the differential diagnosis of pancreatic cystic neoplasms.

Introduction. The optimal timing of elective surgery after acute inflammatory complications of colonic diverticular disease (DD) has not been established. The commonly recommended interval of 6–12 weeks is based predominantly on expert opinion and does not account for the severity of the complication or persistence of inflammatory activity. Aim: To improve the outcomes of elective surgical treatment in patients having undergone conservative or minimally invasive management of acute inflammatory complications of colonic diverticular disease by optimizing the timing of surgery.

Materials and methods. This single-center retro-prospective study included 118 patients who underwent elective surgery between 2010 and 2023 and 41 patients enrolled prospectively between 2024 and 2025. The patients were divided into three subgroups: recurrent diverticulitis (Hinchey 0), pericolic inflammatory mass (Hinchey Ia), and pericolic abscess (Hinchey Ib–IIb). Surgical complications, conversion to open surgery, and histopathological signs of acute inflammation were considered adverse events. Based on the retrospective analysis, clinically justified time intervals for surgery were identified and subsequently applied in the prospective group.

Results. In patients with Hinchey 0 disease, surgery was performed no earlier than 54 days (8 weeks) after admission for the most recent complication; in patients with Hinchey Ia disease, after 58–74 days (8–10 weeks); and in those with Hinchey Ib–IIb disease, after 88–106 days (13–15 weeks). In the prospective group, C-reactive protein levels did not exceed 6 mg/L, and no conversions, intraoperative complications, or postoperative complications were recorded. In the retrospective group, surgical complications occurred in 13/118 (11.0 %) patients, including severe Clavien–Dindo grade IIIb–V complications in 8/118 (6.8 %). The length of hospital stay was Me(Q1;Q2) 9 (7; 10) versus 9 (8; 11) days, respectively (p = 0.003). Histopathological signs of acute inflammation were identified in 21/118 (17.7 %) patients in the retrospective group and were absent in all 41 patients in the prospective group (p = 0.002).

Discussion. A differentiated approach to the timing of surgery—based on the severity of the preceding complication, clinical and laboratory remission, and the resolution of inflammation—resulted in no conversions, complications, or morphological signs of acute inflammation in the prospective group. However, the statistical optimality of the intervals used could not be confirmed due to the small number of events.

Conclusion. The proposed approach appears clinically applicable and requires validation in a prospective multicenter study.

Introduction. Diffuse adult-type gliomas are characterized by significant molecular heterogeneity, highlighting the need for reliable biomarkers for diagnosis, disease characterization, and therapeutic stratification. The aim of this study is to evaluate the role of ERBB3, REST, DDR1, ACSS2, and DHODH proteins as potential biomarkers using integrated transcriptomics and protein imaging data.

Materials and methods. Transcriptome validation was performed using RNA-seq data from The Cancer Genome Atlas (TCGA), including samples of IDH-wild-type Grade 4 glioblastoma (n = 153), IDH-mutant Grade 2 (n = 249) and Grade 3 (n = 263) diffuse astrocytoma, and normal brain tissue (n = 270). Protein expression, tissue distribution, and subcellular localization were assessed using immunohistochemistry (IHC) and immunofluorescence (IFA) images from the Human Protein Atlas (HPA) database.

Results. The ERBB3 and REST genes showed the highest expression in glioblastoma, with progressively decreased levels in lower-grade gliomas and normal brain tissue. DDR1 gene expression was significantly elevated in all glioma groups compared to normal brain tissue, with less pronounced differences between tumor grades. ACSS2 gene expression was elevated in glioma tissue, while DHODH showed particularly high expression in highgrade Grade 3–4 gliomas. IHC analysis demonstrated increased protein expression and a predominantly cytoplasmic/membrane localization in tumor tissue. ELISA analysis revealed distinct subcellular patterns: ERBB3 and DDR1 proteins were predominantly membrane-associated, REST was primarily nuclear, while ACSS2 and DHODH proteins showed predominantly cytoplasmic localization.

Discussion. ERBB3, REST, DDR1, ACSS2, and DHODH proteins represent promising candidates for biomarkers of adult-type gliomas. Their differential expression and distinct subcellular localization suggest involvement in complementary mechanisms of tumor progression. Integrated HPA imaging and TCGA transcriptome analysis provides a useful framework for biomarker prioritization and subsequent experimental and clinical validation.

Conclusion. These results confirm the potential of the molecular markers investigated for the study and characterization of adult-type diffuse gliomas.

Introduction. Glioblastoma is characterized by marked molecular heterogeneity and aggressive biologic behavior, which requires reliable molecular biomarkers for prognostic stratification. The aim of this study is to identify potential prognostic biomarkers for glioblastoma through integrated bioinformatic and proteomic analysis.

Materials and methods. Transcriptomic and clinical data were obtained from the Gene Expression Database (GEO), The Cancer Genome Atlas (TCGA), the Chinese Glioma Genome Atlas (CGGA), and the Human Tissue Gene Expression Database (GTEx). Protein expression data were assessed using the Human Protein Atlas (HPA). Differentially expressed genes (DEGs) were identified in GSE147352. Next, protein-protein interaction (PPI) network analysis was performed using STRING and Cytoscape/cytoHubba. Key genes, or hub genes, were selected based on the Degree method. Their expression patterns were subsequently confirmed using independent datasets and HPA immunohistochemistry (IHC). Kaplan-Meier survival analysis, LASSO regression, and Cox proportional hazards regression were used to assess prognostic significance and construct a multigene risk model.

Results. A total of 4,506 DEGs were identified in GSE147352, of which 200 genes with high and low expression were selected for PPI analysis. Ten key genes were identified (SNAP25, FN1, H3C12, SYN1, CAMK2A, SYP, SYT1, CD44, CCL2, and SLC17A7). FN1, H3C12, CD44, and CCL2 were consistently upregulated in glioblastoma, while SNAP25, SYN1, CAMK2A, SYP, SYT1, and SLC17A7 were downregulated in independent datasets. HPA data confirmed the differences at the protein level. Increased expression of FN1, H3C12, CD44, and CCL2 was associated with worse overall survival (OS), while increased expression of six downregulated genes was associated with better OS. This prognostic model, based on FN1, H3C12, CD44, and CCL2, significantly stratified patients into high- and low-risk groups (log-rank test p = 0.0361; hazard ratio = 1.52, 95 % confidence interval (CI): 1.05–2.20). The model demonstrated a C-index of 0.675 (95 % CI: 0.607–0.744; p < 0.001).

Discussion. Integrated transcriptomic and proteomic analysis identified the FN1, H3C12, CD44, and CCL2 genes as promising prognostic biomarkers for glioblastoma. Their combined expression profile may provide a useful basis for molecular risk stratification and individualized prognostic assessment.

Conclusion. The obtained results confirm the potential of the identified molecular markers for assessing prognosis and risk stratification in glioblastoma.

Introduction. Lymphatic surgery involves a wide range of potential adverse effects. The most common of these is lymphorrhea with a probability of up to 87.5%. Unsatisfactory treatment results are mainly caused by an incorrect assessment of the risk of complications, as well as errors in the selection of treatment tactics. Aim. To consider the possibilities of predicting the severity of lymphorrhea using a multivariate analysis.

Materials and methods. A total of 198 medical records of patients with cutaneous melanoma and breast cancer was analyzed. The results of the performed multivariate analysis were used to construct the mathematical model predicting the probability of unfavorable lymphorrhea-associated outcomes in the postoperative period. Patients were divided into two groups: 61 patients with an uneventful postoperative period and moderate lymphorrhea rates and 137 patients with clinically significant lymphorrhea. A total lymphorrhea volume and duration of less than 1000 mL and 14 days, respectively, are considered to be normal values.

Results and discussion. The performed regression analysis revealed the following main factors affecting lymphorrhea during the preoperative period: volume of intervention, hypertension, anemia, coagulopathy, diabetes mellitus, body mass index, total blood protein, and aspartate aminotransferase levels. The factors of the postoperative period additionally include surgery duration, number of leukocytes in the blood on the first day after the intervention, and volume of drainage discharge. The first part of regression equations is solved to predict the volume and duration of lymphorrhea at the preoperative stage. The third equation of the model estimates the probability of developing pathological lymphorrhea. The predictive power of the model is 84.1% with a sensitivity of 95%. The use of all predictive model elements creates favorable conditions to establish indications for preventive and therapeutic measures reducing the probability of developing profuse lymphorrhea, which has a positive effect on the safety profile of surgery.

Conclusion. Predictive models can be used in intervention planning to substantiate the probability of complications in the postoperative period, which can serve as the basis for carrying out measures preventing lymphorrhea.

Introduction. Tumor necrosis factor receptor-associated protein 1 (TRAP1) is a mitochondrial molecular chaperone involved in maintaining mitochondrial homeostasis, cellular metabolism, and the regulation of oxidative stress and apoptosis. However, its biological significance in gliomas remains poorly understood. The aim of this study was to evaluate TRAP1 expression at the mRNA and protein levels in normal brain tissue and gliomas of varying grades using bioinformatics databases and to assess its relationship with tumor grade and IDH mutation status.

Materials and methods. We analyzed publicly available data from the Human Protein Atlas (HPA), The Cancer Genome Atlas (TCGA), and the Genotype-Tissue Expression Project (GTEx). TRAP1 transcript expression was assessed in various brain regions and cell populations. Protein expression was assessed using HPA immunohistochemistry (IHC) data. Glioma samples were stratified according to tumor grade and IDH mutation status. Subcellular localization of TRAP1 was assessed using immunofluorescence data from the U-251 glioblastoma cell line. Statistical differences in transcript expression were assessed using the Kruskal—Wallis test.

Results. TRAP1 mRNA was widely expressed in normal brain regions and in multiple neuronal, glial, vascular, and immune cell populations. Protein expressions were detected in neurons, astrocytes, microglia, and neuropil. TRAP1 mRNA expression differed significantly between gliomas and control tissues (Kruskal-Wallis test, H = 560, p = 4.52×10- ²¹). IDH-mutated tumors demonstrated significantly higher TRAP1 mRNA expression than IDH-wildtype tumors in astrocytoma grades 2–3 and glioblastoma. IHC analysis revealed an increase in tumor-associated TRAP1 immunoreactivity with increasing glioma grade, with the highest expression observed in glioblastoma. TRAP1 protein is predominantly localized in the mitochondria of U-251 cells.

Discussion. These results indicate that TRAP1 mRNA expression is associated with glioma grade and IDH molecular status. Its mitochondrial localization and increased expression in higher-grade tumors support a potential role in metabolic adaptation and tumor progression.

Conclusion. TRAP1 may represent a promising diagnostic and prognostic biomarker for gliomas.

Introduction. Multidrug resistance represents a major obstacle to tuberculosis control. Treatment of multidrug-resistant tuberculosis is lengthy, complex, and often ineffective. Surgical methods, such as thoracoplasty, can improve treatment effectiveness compared with conservative treatment. One contemporary minimally invasive approach to collapse surgery is endobronchial valve insertion, which can be performed as an independent procedure or in combination with other surgical interventions. Wider and more timely use of collapse surgery in patients with destructive tuberculosis and multiple or extensive drug resistance may shorten treatment duration and improve clinical outcomes.

Materials and methods. A retrospective study was conducted at the Republican Clinical Center for Phthisiology and Pulmonology (Republic of Bashkortostan, Russia). Primary medical records, an archive of radiographic images (including CT scans), and sputum culture results obtained from the BAKLAB system based on data from the Republican Medical Information and Analytical System (RMIAS) were analyzed for 80 patients with destructive tuberculosis caused by drug-resistant pathogens. Statistical analysis was performed using the Microsoft Office software package. Differences were considered statistically significant at p < 0.05.

Results and discussion. In the present study, three criteria were used to assess the effectiveness of complex treatment for destructive forms of tuberculosis. These include time to sputum culture conversion, cavity closure, and positive radiological dynamics (R-dynamics). Analysis of sputum culture conversion time in patients with destructive drug-resistant tuberculosis yielded the following results: χ² = 12.056, p = 0.061 (at the border of statistical significance). Analysis of R-dynamics yielded χ² = 7.86, p = 0.228. Statistical significance was not achieved, presumably due to the small sample size of 20 patients per group. In contrast, the difference in cavity closure rates was statistically significant: χ² = 20.04, p = 0.0027. Combined treatment was associated with a higher cavity closure rate than conservative treatment.

Conclusion. The results of the study demonstrate that collapse surgery combined with chemotherapy regimens may result in faster recovery compared to treatment with a standard chemotherapy regimen alone.

Microfluidic technologies, which enable precise manipulation of cells and biological fluids at the microscale, represent a promising platform for reproductive medicine and urologic oncology. This review examines the operating principles, engineering features, and clinical potential of microfluidic systems for seminal fluid analysis, sperm selection, and liquid biopsy in prostate cancer. The reviewed domestic and international literature addresses microfluidic sperm selection, sperm DNA fragmentation, rheotaxis, inertial microfluidics, circulating tumor cells, and molecular biomarkers in seminal fluid. Microfluidic devices can facilitate gentle processing of spermatozoa, enrichment of samples with progressively motile cells, and isolation of tumor cells, extracellular vesicles, and cell-free DNA. Particular attention is paid to the potential for standardized processing of viscous and heterogeneous samples prior to molecular analysis and cytological evaluation in specialized laboratories. A particularly promising area is the development of integrated platforms suitable for clinical validation and subsequent incorporation into diagnostic pathways for patients with prostate diseases.

The present paper reviews the literature data on the current state of peritoneal carcinomatosis treatment. The international oncological associations of NSSN, ESMO, and AJCCA recommend chemotherapy to treat peritoneal carcinomatosis as a distant metastasis of malignant tumors. In recent years, the issues of combined modality treatment using various methods of locoregional impact have been widely discussed. The introduction of a new treatment strategy of “conversion surgery” based on cytoreductive operations has become a promising direction in the treatment of patients with peritoneal carcinomatosis. The effectiveness of systemic chemotherapy administered both as preoperative induction chemotherapy and in combination with surgical treatment methods, intraperitoneal hyperthermic chemotherapy, pressurized intraperitoneal aerosol chemotherapy, and peritonectomy is analyzed. The small sample of patients included in the study, as well as conflicting data on the effectiveness of these methods significantly complicate the reliability assessment of obtained results and necessitate the conduct of large-scale prospective randomized controlled trials with the scientific analysis of obtained results.

Hemodynamically significant left main coronary artery disease (LMCAD) not only affects the patient’s quality of life but also increases the risk of myocardial infarction and sudden cardiac death. Coronary artery bypass grafting previously considered the gold standard for surgical correction of LMCAD has recently given way to percutaneous coronary intervention. The present review systematizes the latest data on the possibilities of endovascular treatment in LMCAD patients, including the key studies demonstrating the safety of this approach and those substantiating the intraoperative application of intravascular imaging. The advantages of various stenting techniques and stent platforms are outlined. In addition, the review discusses challenges and potential areas for further research, which could improve the longterm outcomes of minimally invasive endovascular approaches in treating LMCAD patients.

Four currently known main molecular subtypes of endometrial cancer include tumors with POLE and p53 protein mutations, with a defective mismatch repair system, as well as without a specific molecular profile. The molecular classification of malignant tumors can be used to predict the course of the disease and determine the need for adjuvant treatment. Patients with POLE mutations often require no adjuvant treatment and have a favorable prognosis for overall and disease-free survival, while patients with p53 protein mutations require aggressive adjuvant treatment due to high rates of disease progression. Women with p53 protein mutations benefit most from adding chemotherapy to adjuvant treatment. Tumors with microsatellite instability and without a specific molecular subtype have an intermediate prognosis: the need for adjuvant treatment is determined by the extent of the disease. Moreover, the addition of immune therapy for metastatic cancer in patients with microsatellite instability brings benefits to survival rates. Knowing the molecular subtype of endometrial cancer can make treatment more personalized and improve targeting of radiation, immune, and drug therapy after surgery.

Introduction. Intraoperative bleeding control remains a key challenge in laparoscopic liver surgery. The standard time-limited Pringle maneuver causes total organ ischemia. An alternative involves the targeted occlusion of blood inflow and outflow to the liver part being removed, which is anatomically justified by the segmental structure of the organ.

Materials and methods. A patient was 67 years old with metastatic liver disease (segments VI and VII) due to previously treated rectal cancer. Laparoscopic S6–7 bisegmentectomy was performed using an original method of extraparenchymal selective hepatic vascular exclusion. Blood loss was less than 150 ml. The patient was discharged on day 6 after the complication-free postoperative period.

Results and discussion. The proposed method is based on the segmental structure of the liver (Couinaud, 1957) and knowledge of variant anatomy (Michels, Hiatt, Nakamura). In contrast to the Pringle maneuver and extra-Glissonian approach, ischemia is limited to the affected part, which excludes total ischemic damage and reduces the operating time. The obtained results are in line with the best world data. The method is protected by a Russian patent application.

Conclusion. Extraparenchymal selective hepatic vascular exclusion during laparoscopic liver resections represents a safe and effective method for minimizing blood loss and ischemic damage to the parenchyma. The method can be recommended for use in specialized centers.