Tumour classification systems provide the foundation for tumour diagnosis and patient therapy and a critical basis for epidemiological and clinical studies. This updated classification was developed with the aim to adhere to the principles of reproducibility, clinical significance, and simplicity in order to minimize the number of unclassifiable lesions.

Major changes in the revised classification as compared to the previous one (WHO 1981) include the addition of two pre-invasive lesions to squamous dysplasia and carcinoma in situ; atypical adenomatous hyperplasia and diffuse idiopathic pulmonary neuroendocrine cell hyperplasia. Another change is the subclassification of adeno-carcinoma: the definition of bronchioalveolar carcinoma has been restricted to noninvasive tumours. There has been substantial evolution of concepts in neuroendocrine lung tumour classification. Large cell neuroendocrine carcinoma (LCNEC) is now recognized as a histologically high grade non small cell carcinoma showing histopathoiogical features of neuroendocrine differentiation as well as immunohisto-chemical neuroendocrine markers. The large cell carcinoma class has been enriched with several variants, including the LCNEC and the basaloid carcinoma, both with a dismal prognosis. Finally, a new class was defined called carcinoma with pleomorphic, sarcomatoid, or sarcomatous elements, which brings together a number of proliferations characterized by a spectrum of epithelial to mesenchymal differentiation.

Immunohistochemistry and electron microscopy are invaluable techniques for diagnosis and subclassification, but our intention was to render the classification simple and practical to every surgical laboratory, so that most lung tumours could be classified by light microscopis criteria.

2,268 patients were operated for lung carcinoma in the period from 1990 to 2000. One hundred patients (3.5 %) were operated repeatedly. Hospital mortality was 9 %. Atypical and segment resections caused local relapses in 20 %. The intervention volume did not effect the perspective life expectancy. Longer period between primary and subsequent interventions was associated with better long-term prognosis. Patients with metachronous tumors had better prognosis when compared with patients having local relapses of a tumor. Synchronous and solitary primary tumors had poor prognosis, thus, they should be considered as early-metastasizing tumors.

The study was aimed to develop a method of videothoracoscopic collagen pleurodesis in malignant pleurisy and to evaluate its efficacy.

The article presents results of treatment of 24 patients with recurrent malignant pleurisy underwent videothoracoscopic collagen pleurodesis. Twenty patients were diagnosed non-small cell lung carcinoma and 4 ones were with breast cancer. The operative intervention included videothoracoscopic revision of the pleural cavity under the endotracheal anesthesia, pleura biopsy, evacuation of fluid, pulverization of powdered collagen (1 g), and drainage of the pleural cavity. Videothoracoscopy allowed macroscopic detection of pleural carcinomatosis in 100 % of the patients. Target histological examination of the biopsy samples determined a histological type of tumor in all the patients. All the cases showed a positive therapeutic clinical and radiological effect which was complete solution of the pleural effusion. Eighteen of 24 patients (75 %) did not have delayed relapses of the pleural effusion, need of thoracocentesis and evacuation of the fluid. We evaluated immediate and delayed results, survival and quality of life of the patients.

Conclusion. Videothoracoscopic collagen pleurodesis is a simple and quite effective method of palliative treatment of patients with malignant pleurisy improving their quality of life.

The aim of the study was to examine morphologic and molecular genetic features of lung cancer in patients engaged in radiation industry or living at radionuclide-polluted territories of Russia.

We performed morphologic and immunohistochemical investigations of lung cancer samples from patients engaged in radiation industry (16 cases) and patients living in radionuclide-polluted areas of Tula (8 cases) and Semipalatinsk (17 cases) regions. The immunuhistochemical analysis of lung cancer biomolecular markers (p53, bcl-2, c-myc, and ki67) and the transmission electronic microscopy with energy-dispersed analysis of dust chemical elements were performed.

We showed that lung cancer in patients exposed to low-dose radiation has some peculiarities. Fibrosis was a frequent background for peripheral lung cancer occurrence. Perivascular or peribronchial fibrosis with dust deposition was usual in these cases. Cesium presented in the dust deposits in patients from Tula region. Increased small cell lung cancer rate with low proliferative activity was typical in patients worked at the radiation industry.

Results of complex radiological examination of 102 patients with chronic lymphocytic leukemia are presented. Traditional (X-ray examination, electroroentgenotomography, computed tomography) and original (zone roentgenodensitometry using computed densitometer "Densigraph-2" of own construction, zone inspiratory and expiratory CT densitometry and planimetry, quantitative evaluation of emphysematous lung tissue using CT) methods were applied in all the patients. Results of radiological and functional evaluation of regional lung ventilation in the patients are analyzed. Diagnostic algorithms are shown allowing not only effective detection the thoracic complications in chronic lymphocytic leukemia patients but also determination their risk factors.

Total lipid peroxidation level (TLP), antioxidative activity level (AOA) and antioxidant enzyme activity (super-oxyde dismutase, catalase) were studied in malignant and benign lung neoplasm samples. We examined 65 patients with malignant tumors and 30 ones with benign tumors. The antioxidant enzyme activity was reduced, the TLP level was increased and the AOA was inhibited in malignant tumors. Intensity of these disorders depended on histological type of the tumor and grade of malignancy: they were most severe in adenocarcinoma and mildest in bronchioloalveolar carcinoma.

We observed 155 patients aged 18 to 70 had been admitted to a hospital for lung cavities. Complex radiological and endoscopic examination revealed peripheral lung carcinomas with cavitation in 25 patients, lung abscess in 105, lung tuberculosis in 13, lung aspergillosis in 4, echinococcus in 2, lung cysts in 3, and emphysematous bullae in 3 patients. So, lung cavities detected during radiological examination require bronchoscopy with various kinds of biopsy to verify a diagnosis. This increases the diagnosis accuracy from 45.9 to 78.8 %. Combination of radiological methods with bronchoscopy and thoracoscopic biopsy helps to reach the diagnosis in 97.6 %.Therapeutic bronchoscopy with intrabronchial lymphotropic antimicrobial and immune therapy and laser irradiation is effective in 96.2 % of patients with lung abscess.

We examined 82 lung cancer patients admitted to the S.P.Botkin hospital for pneumonia. As a result of complex examination including radiological methods, bronchoscopy and biopsy central lung cancer was diagnosed in 68 patients, bronchioloalveolar carcinomas were revealed in 8 ones, and peripheral carcinomas with the lung tissue destruction were found in 6 patients. Principal radiological signs of the central lung carcinoma were a tumour in the lung root and ventilation disorders of a lung part. Main endoscopic features of the central lung carcinoma were tumour impression, invasion, or peribronchial growth. Bronchioloalveolar carcinomas were characterized radiologically with infiltrates and endoscopically with great volume of liquid foamy secretion. The radiological features of peripheral carcinomas with the lung tissue destruction were nodular outline of a tumour, sometimes with spiculations, and irregular inner interface.

The article discusses various aspects of radiotherapy of lung cancer depending on location and size of the primary tumour, its histological type, metastases into regional lymph nodes and other organs, and clinical features in a patient. The radiotherapy of lung cancer have developed to a certain degree and is effective in most patients. Doctors and health care workers should consider that not enough compliance with a radiologist can diminish the effect of the therapy.

We studied effects of Eurespal (fenspirid) on clinical course and inflammation in COPD patients. The trial included 2 stages: 3-week therapy of exacerbation and 3-month outpatient treatment in stable condition. The drug was given twice a day, 160 mg dally. We assessed scoring of main clinical signs, lung function parameters, bronchoscopic findings, laboratory markers of inflammation, antioxidant status, and quality of life, performed cytological and cytochemical investigation of induced sputum (IS). During the exacerbation Eurespal had early and distinct cough-inhibiting and mucolytic effects, reduced bronchial obstruction, bronchial inflammation severity, decreased C-reactive protein level, IS cytosis, and neutrophil percentage (p < 0.01), increased IS concentration of lyzosomal and cationic proteins (p < 0.01) and serum level of total antioxidants (in 46.2 % of the patients compared with 26.3 % under the typical therapy). Three-month treatment with Eurespal in COPD patients resulted in further positive shifts in clinical and laboratory inflammation markers, IS cytological and cytochemical parameters. The results show Eurespal to increase the efficiency of the COPD treatment and could be included in the complex therapy of COPD. It has high antiinflammatory activity, inhibits bronchial obstruction progressing and improves quality of life of COPD patients.

The study was aimed to Investigate severe asthma therapy in Russia. It involved 515 patients from 7 Russian cities according to the criteria of severe asthma. Individual registration cards were filled in considering dem ographic data, principal clinical features, drug therapy. It has been found that both inpatient and outpatient therapy of severe asthm a in Russia does not correspond to the standards recommended. The results confirmed high efficiency of inhaled corticosteroids when combined with long-acting β2-agonists. This therapy was found to be more effective then other regarding to symptoms, lung function param eters, rate of admission to a hospital and duration of hospital staying. Patients treated with this drug combination were satisfied by the treatment more often.

Open non-comparative 3-month study of efficacy of combined therapy with beclomethasone (Beclason ECO Easy Breathe) and formoterol (Foradil) was performed in children 6 to 11 years old with moderate bronchial asthma. The study involved 35 patients (the average age was 8.64 ± 0.65 yrs), 69 % were boys. The length of the disease was 2 to 10 yrs (6.01 ± 0.83 yrs). All the patients were given Beclason ECO Easy Breathe 200 meg and Foradil 9 meg twice a day. We evaluated inhalation technique, clinical and functional dynamics, possibilities of achieving the full asthma control, need in short-acting β₁-agonists, tolerability and safety of the therapy. No one patient experienced technique problems when using Beclason ECO Easy Breathe. By the 8-th week of the treatment asthma symptoms disappeared in all the patients, breathing rate and lung auscultation became normal. Significant improvement in lung function was noted by the 12-th week of the therapy. The FEV₁ growth under the bronchodilating test diminished indicating more bronchial stability. Peak expiratory flow rate increased even in children with initial normal parameters. The need in short-acting β₂-agonists reduced from 1,9 ± 0,4 to 0,6 ± 0,2 doses daily. The treatment was well tolerated.

Thus, the combination of Beclason ECO Easy Breathe and Foradil in moderate asthma children results in achieving the full asthma control, clinical stability, elimination of the asthma signs, improvement in lung function.