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2014 г. №6 Том 22

ОБЗОРЫ

Е.А. ШЛЯХТУHОВ

МИHИМАЛЬHАЯ ОСТАТОЧHАЯ БОЛЕЗHЬ ПРИ СОЛИДHЫХ ОПУХОЛЯХ – СОВРЕМЕHHОЕ СОСТОЯHИЕ ПРОБЛЕМЫ

УО «Витебский государственный медицинский университет»,
Республика Беларусь

В статье представлен обзор современной литературы по вопросам диагностики минимальной остаточной болезни (МОБ) при солидных опухолях. Отдаленные метастазы остаются главной причиной смерти пациентов со злокачественными новообразованиями. МОБ определяется как присутствие опухолевых клеток, которые не могут быть обнаружены на основе использования сегодняшних рутинных диагностических методов, применяющихся для определения стадии опухолевого процесса. Установлено, что у 20-45% онкологических пациентов с категорией М0 в периферической крови обнаруживаются циркулирующие опухолевые клетки (ЦОК), а у 25–60% пациентов диссеминированные опухолевые клетки (ДОК) обнаруживаются в костном мозге. В настоящее время ЦОК и ДОК предложено отнести к категории МОБ. Установлен порог количества ЦОК, который составляет 5 ЦОК в 7,5 мл крови. Наличие ≥5 опухолевых клеток в 7,5 мл периферической крови ассоциируется с плохим прогнозом. В настоящее время для поиска ЦОК применяется один коммерчески доступный прибор одобренный FDA – CellSearch (Veridex LLC) для мониторинга лечения пациенток, страдающих раком молочной железы, колоректальным раком и раком предстательной железы. Кроме того, используя различные модификации ПЦР-анализа, возможна идентификация опухоль-ассоциированных генов, таких как ген тирозиназы (TYR), ген сурвивина (BIRC5), ген рецептора эпидермального фактора роста (ErbB-2/HER2-Neu), а также генов «домашнего хозяйства» (GAPDH, 18S rRNA). Данные гены рассматриваются в настоящее время также, как маркеры МОБ.

Ключевые слова: минимальная остаточная болезнь, метастазирование, солидная опухоль, диагностика
с. 735-742 оригинального издания
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Адрес для корреспонденции:
210023, Республика Беларусь,
г. Витебск, пр. Фрунзе, д. 27,
УО «Витебский государственный
медицинский университет»,
кафедра онкологии с курсами ЛД, ЛТ, ФПК и ПК,
тел. раб.:+375 212 57-64-16,
e-mail: Evgenij-shlyakhtunov@yandex.ru,
Шляхтунов Евгений Александрович
Cведения об авторах:
Шляхтунов Е.А., к.м.н., доцент кафедры онкологии с курсами ЛД, ЛТ, ФПК и ПК УО «Витебский государственный медицинский университет».
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