| چکیده انگلیسی مقاله |
Individually customized grafts have become standard for reconstructing extensive chest wall defects resulting from surgical interventions for sternal malignant neoplasms. However, the outcomes of these graft implantations can be further improved by administering patient-derived cells, which have minimal oncological risks. In 2021, a 52-year-old woman with chondrosarcoma (pT2N0M0G2, stage IIB) was admitted to the Department of Thoracic Surgery. The patient presented with a large tumor in the body of the sternum, measuring 81 × 94 × 91 mm, according to the computed tomography (CT) scan. To address this, an individualized endoprosthesis was modeled and created using the original 'pincer-dock' construction based on CT-scan screens. The mononuclear cell fraction (MNCs) was obtained from the patient's peripheral blood one week before surgery using a Haemonetics cell separation device and cryopreserved until the day of the procedure. The resulting 30 mL MNC suspension contained 12 mln cells per 1 mL. We performed flow cytometry analysis using a FACS Aria III flow cytometer to confirm the presence of mesenchymal stromal cells in the MNCs. We also performed immunostaining for S-100, a common tumor marker for benign and malignant diseases, and D2-40, a marker for the lymphatic endothelium that reacts with Kaposi's sarcoma and a subset of angiosarcomas. None of the cells were positive for either marker. Approximately 3 ml of the MNC suspension was injected into each rib edge and 30 ml into the operating field immediately after resection. The titanium endoprosthesis was placed in the sternal defect, and the body of the endoprosthesis was securely covered with a laparoscopically mobilized omental flap. After a one-year follow-up, the patient showed no signs of recurrence or post-surgical complications. These outstanding functional and cosmetic results highlight the potential for the broader clinical utilization of minimally manipulated cells in personalized medicine in oncology. These results could pave the way for wider clinical application of peripheral blood-derived minimally manipulated cells in personalized medicine as an adjuvant for titanium endoprosthesis reconstruction of osteochondral defects in patients with sarcoma. |
| نویسندگان مقاله |
| Ilya Klabukov
1)P.A.Hertzen Moscow Oncology Research Institute, National Medical Research Radiological Center of the Ministry of Health of the Russian Federation, Moscow, Russia 2) A.Tsyb Medical Radiological Research Center, National Medical Research Radiological Center of the Ministry of Health of the Russian Federation, Obninsk, Russia
| Vladimir Usachev
A.Tsyb Medical Radiological Research Center, National Medical Research Radiological Center of the Ministry of Health of the Russian Federation, Obninsk, Russia
| Ilya Klabukov
1)Department of Urology and Operative Nephrology, Peoples’ Friendship University of Russia (RUDN University), Moscow, Russia 2)National Medical Research Radiological Center of the Ministry of Health of the Russian Federation, Obninsk, Russia 3)Obninsk Institute for Nuclear Power Engineering, National Research Nuclear University MEPhI, Obninsk, Russia
| Grigoriy Afonin
A.Tsyb Medical Radiological Research Center, National Medical Research Radiological Center of the Ministry of Health of the Russian Federation, Obninsk, Russia
| Oleg Aleksandrov
P.A.Hertzen Moscow Oncology Research Institute, National Medical Research Radiological Center of the Ministry of Health of the Russian Federation, Moscow, Russia
| Anna Usacheva
A.Tsyb Medical Radiological Research Center, National Medical Research Radiological Center of the Ministry of Health of the Russian Federation, Obninsk, Russia
| Stanislav Shklyaev
A.Tsyb Medical Radiological Research Center, National Medical Research Radiological Center of the Ministry of Health of the Russian Federation, Obninsk, Russia
| Lyudmila Grivtsova
A.Tsyb Medical Radiological Research Center, National Medical Research Radiological Center of the Ministry of Health of the Russian Federation, Obninsk, Russia
| Dmitry Kabanov
P.A.Hertzen Moscow Oncology Research Institute, National Medical Research Radiological Center of the Ministry of Health of the Russian Federation, Moscow, Russia
| Natalia Rubtsova
P.A.Hertzen Moscow Oncology Research Institute, National Medical Research Radiological Center of the Ministry of Health of the Russian Federation, Moscow, Russia
| Peter Shegay
National Medical Research Radiological Center of the Ministry of Health of the Russian Federation, Obninsk, Russia
| Sergei Ivanov
A.Tsyb Medical Radiological Research Center, National Medical Research Radiological Center of the Ministry of Health of the Russian Federation, Obninsk, Russia
| Andrey Kaprin
1)P.A.Hertzen Moscow Oncology Research Institute, National Medical Research Radiological Center of the Ministry of Health of the Russian Federation, Moscow, Russia 2)Department of Urology and Operative Nephrology, Peoples’ Friendship University of Russia (RUDN University), Moscow, Russia 3)National Medical Research Radiological Center of the Ministry of Health of the Russian Federation, Obninsk, Russia
| Denis Baranovskii
1)P.A.Hertzen Moscow Oncology Research Institute, National Medical Research Radiological Center of the Ministry of Health of the Russian Federation, Moscow, Russia 2)A.Tsyb Medical Radiological Research Center, National Medical Research Radiological Center of the Ministry of Health of the Russian Federation, Obninsk, Russia 3)Department of Urology and Operative Nephrology, Peoples’ Friendship University of Russia (RUDN University), Moscow, Russia
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