Aim: improvement of early diagnostics of prostate cancer by developing a technique, which makes possible to predict its clinical significance in outpatient setting before initiation of invasive procedures. Material and Methods. Clinical data of 398 patients who underwent transrectal prostate biopsy in 2012-2014 in SSMU S. R. Mirotvortsev Clinical Hospital, was used to build an artificial neural network, while its output allowed to determine whether the tumour corresponds to Epstein criteria and which D'Amico risk group it belongs to. Internal validation was performed on 80 patients, who underwent prostate biopsy in September 2014 — December 2014. Sensitivity, specificity, positive and negative predictive value of artificial neural network were calculated. Results. Accuracy of predicting adenocarcinoma presence in biopsy specimen was 93,75%; accuracy of predicting whether the cancer meets active surveillance criteria was 90%. Accuracy of predicting T stage (T1c, T2a, T2b, T2c)was 57,1%. Prediction of D'Amico risk group was accurate in 70% of cases; for low-risk cancer accuracy was 81,2%. Conclusion. Artificial neural networks may be responsible for prostate cancer risk stratification and determination of its clinical significance prior to biopsy.
Shatylko T.V., Popkov V.M., Fomkin R.N. Integrative approach to pre-operative determination of clinically significant prostate cancer // Saratov Journal of Medical Scientific Research, Vol. 11, Issue 3, 2015, pp. 345-348

Prostate cancer is one of the most urgent problems of modern oncology. The article provides an overview of the methods of treatment of locally advanced prostate cancer, comparative characteristics, the advantages of both independent and combined methods. The results of multicenter studies have been stated.
Popkov V.M., Kim T.D., Ponukalin A.N. Diagnosis and combined treatment of patients with locally advanced prostate cancer // Saratov Journal of Medical Scientific Research, Vol. 11, Issue 3, 2015, pp. 317-322

The purpose of this study was to identify risk factors for recurrence of prostate adenocarcinoma after HIFU therapy. Material and methods: Material for the study was obtained from patients diagnosed with adenocarcinoma before and after HIFU treatment. Morphological study was conducted using a standard staining, and immunohistochemical markers: PCNA, Amacr, E-cadherin, Bel2, Andr, Estr, VEGF, P53, PCNA. Results: After treatment in 89% of patients with initial prostate volume greater than 50 cc the signs of recurrence of adenocarcinoma were showed. At low risk for D'Amico after treatment the expression of proliferation markers, VEGF, Amacr significantly decreased. With a high degree of risk — increased expression of Bel2. After treatment the expression of the following markers: PCNA, Amacr, VEGF significantly increased in the group of patients with the presence of invasion. Conclusion: Patients with initial prostate volume less than 50 cc, low risk to D'Amico, the lack of perineural and perivascular invasion have a low risk of recurrence after HIFU therapy; patients at high risk for D'Amico, the presence of perineural and perivascular invasion initial and prostate volume greater than 50 cc, low-grade cribriform form of adenocarcinoma have a high risk of recurrence of adenocarcinoma. Recurrence of adenocarcinoma develops independently of the period after HIFU therapy.
Popkov V.M., Maslyakova G.N., Voronin E.S., Fomkin R.N. Identification of risk factors of prostate adenocarcinoma recurrence after HIFU therapy using immunohistochemical markers // Saratov Journal of Medical Scientific Research, Vol. 10, Issue 4, 2014, pp. 654-658

The research goal is to optimize the management of patients with serum PSA level falling in the range of 4-10 ng/ ml by designing and educating of an artificial neural network, which may be used to predict prostate gland morphology basing on clinical, laboratory and imaging data. Material and methods. Data of 254 patients, who were admitted to the oncological Department of S. R. Mirotvortsev Clinical hospital for transrectal prostate biopsy, was collected to construct several artificial neural networks with different architecture. External validation was performed on 27 patients, who had prostate biopsy in January-February 2014. Results. One-layer network, consisting of 11 input, 9 hidden and 3 output neurons, was determined to be the most successful: in 92.6% cases it was correct in predicting prostate cancer or its absence. Input factors were evaluated according to their relative importance, from more important to less important: prostate volume, serum PSA, patient's age, prostate consistency, PSA velocity, prostate symmetry, previous negative biopsy, free serum PSA, intake of 5-alpha-reductase inhibitors. Conclusion. Artificial neural networks may be used to predict morphological findings in prostate biopsy. High PSA density and firm prostate consistency should cause suspicion of prostate cancer.
Popkov V.M., Shatylko T.V., Fomkin R.N. Prognosis of prostate gland morphology study using artificial neural network // Saratov Journal of Medical Scientific Research, Vol. 10, Issue 2, 2014, pp. 328-332

The purpose of the study is to investigate the mechanisms of MMP-7, -13, TIMP-2 and RhoA genes expression in blood cells after ionizing radiation exposure. Material and methods.\Ne had examined blood samples from 27 healthy donors, 32 prostate cancer patients before and after radiotherapy, and 32 Chernobyl liquidators by qRT-PCR method. Result. Our results suggests that the expression of MMP-7, MMP-13 genes in prostate cancer patients with grade 2 (T2N0M0). Probably, these changes were associated with the tumor process development, but no with radiation therapy. RhoA level in blood of liquidators was decreased.
Mikhailov V.F., Zasukhina G.D., Shishkina A.A., Shulenina L.V. ММР and RHOA gene expression in persoms exposed to ionizing radiation // Saratov Journal of Medical Scientific Research, Vol. 9, Issue 4, 2013, pp. 780-783

The aim of the article is to study the potential importance of specific location of biopsy of prostate cancer. Material and methods. Histological material from 700 patients has been examinated. 580 specimen of radical prostatectomy were examined. TRUS-guided 12-cores biopsy has been performed in all patients. Histological, computer morphomet-ric, immunohistochemal methods (PIN4-coctail, AR) were used. Results. It has been established that undergrading of carcinoma in needle biopsy occurred in 26% of patients. Overgrading of carcinoma in needle biopsy may also occur, but it was only found in 3% of cases. Undergrading results have been explained by low amount of tumor elements taken from tiny areas of carcinoma, multicentric growth and heterogenous structure of tumor. Conclusions. An important task is to identify the minimal or limited adenocarcinoma in biopsies, as tumor of >1cc volume is often found in prostatectomy specimen.
Fedorina Т.A., Poletaeva S.V. Prostate cancer diagnostics with biopsy material // Saratov Journal of Medical Scientific Research, Vol. 9, Issue 4, 2013, pp. 632-636

Research objective: Creation of mathematical prognosis of model of local relapsing tumors in patients with prostate cancer after treatment by high-intensive focused ultrasound (HIFU). Objects and Research Methods: Results of treatment are estimated at 102 patients with morphologically localized prostate cancer proved at biopsy. For the purpose to analyze interrelation of prognostic factors and postoperative morphological research of prostate control biopsies after HIFU ablation with frequent development of relapses comparative statistical research of received data has been conducted. For construction of mathematical models of relapse prognosis after HIFU of prostates two methods of mul-tifactorial analysis of the data have been used: the discriminant analysis and logistical regress. Results: While planning treatment of patients after HIFU ablation of prostates it has been necessary to estimate morphological risk factors of local relapse of a neoplasm such as preoperative level of serum PSA, the sum of Gleason, severity of disease, presence of lymphovascular and perineural invasion. The offered formulas are worth while using in revealing of probability of development of relapses. The comparative analysis of mathematical models has showed that accuracy of prognosis of results of HIFU of prostates is high enough.
Popkov V.M., Fomkin R.N., Blumberg B.I. Возможности прогнозирования рецидива рака простаты после HIFU-аблации с помощью математического моделирования // Saratov Journal of Medical Scientific Research, Vol. 9, Issue 2, 2013, pp. 314-320

Research objective: To study the role of prognostic factors in the estimation of risk development of recurrent prostate cancer after treatment by high-intensive focused ultrasound (HIUF). Objects and Research Methods: The research has included 102 patients with morphologically revealed localized prostate cancer by biopsy. They have been on treatment in Clinic of Urology of the Saratov Clinical Hospital n.a. S. R. Mirotvortsev. 102 sessions of initial operative treatment of prostate cancer by the method of HIFU have been performed. The general group of patients (n=102) has been subdivided by the method of casual distribution into two samples: group of patients with absent recurrent tumor and group of patients with the revealed recurrent tumor, by morphological research of biopsy material of residual prostate tissue after HIFU. The computer program has been used to study the signs of outcome of patients with prostate cancer. Results: Risk of development of recurrent prostate cancer has grown with the PSA level raise and its density. The index of positive biopsy columns <0,2 has shown the recurrence of prostate cancer in 17% cases while occurrence of prostate cancer in 59% cases has been determined by the index of 0,5 and higher. The tendency to obvious growth of number of relapses has been revealed by the sum of Glison raise with present perineural invasion. Cases of recurrent prostate cancer have been predominant in patients with lymphovascular invasions. In conclusion it has been worked out that the main signs of recurrent prostate cancer development may include: PSA, PSA density, the sum of Glison, lymphovascular invasion, invasion.
Popkov V.M., Fomkin R.N., Blyumberg B.I. Prognostic factors in the estimation of HIFU treatment efficiency in patients with localized prostate cancer // Saratov Journal of Medical Scientific Research, Vol. 9, Issue 1, 2013, pp. 116-121

Research objective: to estimate efficiency of treatment of prostate cancer using high-intensive focused ultrasound on the basis of laboratory analysis of postoperative level prostate-specific antigen (PSA). Objects of research. Objects of research consisted of 110 patients treated in urological clinic of Hospital n.a. S. R. Mirotvortsev (Saratov State Medical University) during the period February, 2009 — March, 2012. Patients took 110 sessions of primary operative treatment of prostate cancer by HIFU therapy method. Technique and research methods. Concentration of PSA in blood changed in all patients every 1,5 month within 6 months after operation, irrespective of its kind (including after repeated HIFU), further — after every 3 month till one year, and later on after 6 months. We were guided by references of the International Consensus, which considers PSA level more than 0,5 ng/ml in blood after 3 months of treatment to be unsatisfactory result. We also headed for PSA level before treatment and oncological risk degree. Results. Median nadir formed 0,5 ng/ml PSA by 3 months after treatment. Patients demonstrated different indicators of PSA dynamics depending on oncological risk, stage and hormonal therapy management. Patients with low oncological risk had initially lower PSA concentration, further PSA concentration reached nadir level faster. At patients with widespread forms of prostate cancer accurate dependence of PSA concentration according to prevalence of process was traced. Time of PSA nadir amount did not differ and was marked as 12-14 weeks on average. At patients received hormonal therapy, lower value of PSA nadir was marked. The conclusion. Monitoring of PSA concentration (PSA nadir by 3 months, dynamics of PSA concentration change) is of great importance in early revealing of relapse after prostate HIFU therapy. High level of PSA nadir and PSA growth according to time period are important prognostic factors.
Popkov V.M., Fomkin R.N., Blyumberg B.I. Postoperative monitoring of prostate-specific antigen (PSA) after treatment with high-intensive focused ultrasound (HIFU // Saratov Journal of Medical Scientific Research, Vol. 8, Issue 4, 2012, pp. 1001-1007

Increasing interest devoted to technology of high intensity focused ultrasound (high-intensity focused ultrasound, HIFU), basically, is explained by a wide spectrum of potential fields of application at minimum invasiveness of the given method. In oncourology HIFU is applied in prostate and kidney cancer. In case of tumors of renal parenchyma the given technique is being clinically tested, while HIFU is currently used in the practice of European oncourologists in treatment of prostate cancer. The majority of the references describing the results of HIFU application in prostate cancer is based on data of a number of clinical observations. It has been proved that HIFU is a possible method of treatment of highly — and moderate-differentiated tumors, and local relapses after remote radial therapy.
Popkov V.M., Fomkin R.N., Blyumberg B.I. High intensity focused ultrasound (HIFU) as the alternative method of treatment of oncourological diseases // Saratov Journal of Medical Scientific Research, Vol. 8, Issue 4, 2012, pp. 989-995