THE IMPORTANCE OF ELECTRON MICROSCOPIC SYSTEMATIC CLASSIFICATION WE OFFER IN CERVICAL CANCER

Based on the electron microscopic diversity in tumour cells in cervical cancer, we systematized the results obtained in our study, considering the difference in the various cells of bioptates taken from the same patient.

The scientific novelty of the work is the development of an ultrastructural microscopic classification of neoplastic cells in cervical cancer by summarizing electron microscopic signs. The said classification allows us to explain the electron microscopic theoretical basis of differential diagnosis based on the organ-tissue and cytospecific ultrastructural signs (groups and types of tumour cells) of tumour tissue, on the one hand. On the other hand, it helps to specify the degree of ultrastructural differentiation of neoplasms, comparison between cells, types of tumour cell and options of tumours.

The main purpose of the use of electron microscope in practical medicine is related to the histogenetic diagnosis of tumours. From this point of view, the systematic classification we offer allows us to systematize electron microscopic signs of tumour cells and tumour cell groups, on the one hand, and, on the other hand, it allows us to detect the degree of ultrastructural differentiation of new derivatives (tumour cells, tumour cell groups, ratio of tumour options).

Thus, the systematic classification we provided as a result of our study allows us to explain the theoretical basis of the general principles of tumour cells. This system explains the specialization of ultrastructural organ-tissue-cell during specific electron microscopic differentiation of tumour cells. We can also get information, at electron microscopic level, on the morphogenetic potential of cambial cells, which are the source for creation of tumour cells as a result of such a systematic analysis.

Thus, in the irregular and numerous ultrastructural options of tumour cells in the tumour mass, precise regularities can be obtained, and we can say something about their cell composition based on these regularities. Based on the stated and obtained certain results, it is possible to substantiate the great importance of electron microscopy in practical activity and theoretic studies, diagnostics, differential diagnostics of tumours, differentiation, histogenesis, biological features of neoplastic cells.

OBJECTIVE

The research aims to optimize the prognostic criteria of the disease based on a comprehensive clinical, instrumental, morpho-functional, and statistic analysis of cervical cancer, as well as electron microscopic indicators.

MATERIAL AND METHODS

The study covered 330 patients with in cervical background diseases, precancerous diseases and cancer from 2007 to 2017.

Main group: 220 patients with cervical cancer;

Control group: 110 patients - erosions, cervical polyps, CIN 1-3

Electron microscopic studies were carried out and based on these studies, cytological (Pap-Smear and Bethesda) and histological and electron microscopic study of the ultrasound classification of Cervical Neoplasia was carried out. Electron microscopic studies were conducted on 93 cancer patients in an electron microscopic laboratory at the Department of Histology of AMU.

RESULTS

Differentiated tumour cells rich (60%) with ultrastructural organo-tissue and organoids with cytospecific signs are predominant in cervical squamous cell corned cancer (option 1) [6, 62, 117].

The amount of organoids in cervical squamous cell non-corned cancer is at medium level (50%), the activity of 2 groups of non-differentiated tumour cells, ultrastructural cataplasias noticed in one or more types of cell indicate a worse prognosis (option 2) [6, 62, 117].

In non-differentiated cervical cancer, only non-differentiated tumour cells with less ultrastructural organoids (30%) were noticed (option 3) [6, 62, 117].

The same number of differentiated and non-differentiated tumor cells is detected in cervical adenocarcinomas (variant IV). The said elements are related to heterogeneous cells and contribute to progress, development of tumours, and metastasis [6, 62, 117].

Based on the ultrastructural classification we applied in cervical neoplasms, different types, species of tumour cells, and comparative tumour options in the groups to which they belong were identified [2, 3, 117].

Based on calculation of prognostic score, it was detected that those over the age of 45 years (informativeness - 0,821) had more abortions in their anamnesis (1,640) had HPV positive (1,145), high stage (2,529), low degree of differentiation (1,422), lymph nodes (4,773) and gave distant metastases (4,823), and patients with less organelles (2,404) were found to be more likely to have recurrence during electron microscopic examination [3].