29 research outputs found
Nonspecific aortoarteritis as a Cause of Aortic Dissection in a Middle Aged Man
Nonspecific aortoarteritis (Takayasu's disease) is a systemic inflammatory disease characterized by granulomatous lesions of the aorta and its large branches. The article describes the clinical manifestations, methods of diagnosis and treatment of this pathology. It also describes a clinical observation that illustrates the delayed diagnosis of the disease in a 47-year-old man, where Takayasu arteritis with lesions of the root, ascending aorta, both common carotid arteries, thoracic and abdominal aorta (type V according to the angiographic classification proposed by Moriwaki R.) manifested a syncopal state, just a few days before the development of a life β threatening complication-aortic dissection of type I according to the DeBakey classification. From a clinical point of view, it is important that Takayasu's disease does not always develop in young people, women, and Asian origin, and, unfortunately, it is often very late to diagnose, although the effectiveness of therapy, including surgical correction of this disease, is entirely determined by the timeliness of its diagnosis
Explainable AI for higher cognitive functions: How to provide explanations in the face of increasing complexity
Since the introduction of the term explainable artificial intelligence (XAI), many contrasting definitions and methods have been proposed. This lack of a common framework impedes not only further progress in the field but also the realization of existing regulations, such as the EUβs general data protection regulation on the βright to an explanationβ (Goodman & Flaxman, 2017). While some researchers use interpretation algorithms as post-hoc explanations (Samek et al., 2021; Ribeiro, 2016), others argue that we should use models which are interpretable in the first place (Rudin, 2019). Although the latter is important, developers are not always willing to sacrifice accuracy by choosing a less complex interpretable model. Here, we propose a working definition of what explaining an AI model means, focusing on robustness, representativeness, and comprehensibility as central properties, and on the importance of causal links (Miller, 2019). In addition, we suggest starting with simple models and gradually scaling up the level of complexity if necessary, whilst setting a case-specific threshold for its trade-off with accuracy and ensuring that we obtain explanations that meet the requirements of our working definition
Statin-induced rhabdomyolysis in a 60-year-old woman with decompensated type 2 diabetes: a case report
Rhabdomyolysis is a very rare and most severe form of statin-induced muscle adverse event characterized by muscle pain, muscle necrosis with myoglobinemia and/or myoglobinuria with a very high risk of acute kidney injury and death. The article presents a case report of developing rhabdomyolysis in a middleaged female patient with hypertension, decompensated type 2 diabetes and albuminuria. A 60-year-old woman was admitted to the hospital for emergency indications with complaints of severe muscle weakness that began in the neck, which spread over several days to the upper and lower extremities, with a symptoms progression up to paresis. According to the appointment of a primary care physician, three months before hospitalization, the patient was switched from therapy with European generic brand-name rosuvastatin 20 mg to the Russian generic unbranded atorvastatin in the same dose (20 mg), which is not comparable in lipid-lowering effect. In a laboratory study, an increase in creatine phosphokinase level by 348 times (50462 U/L) of upper normal limit in combination with severe hypokalemia 1Π±7 mmol/L in the absence of renal dysfunction was recorded. Cancellation of statin, metformin and empagliflozin, intensive infusion therapy and treating electrolyte imbalance made it possible to prevent the development of acute renal damage, life-threatening arrhythmias and completely stop muscle complaints within a few days. The patient was discharged from the hospital on the 23rd day with reference clinical and laboratory values, including creatine phosphokinase.This case emphasizes the importance of maintaining clinical suspicion regarding rhabdomyolysis in patients receiving statin therapy in the presence of risk factors (in this case, female sex, hyperglycemia, chronic kidney disease, concomitant therapy), as well as the relevance of timely diagnosis and treatment of this condition
Ablation Strategies for Different Types of Atrial Fibrillation in Europe: Results of the ESC-EORP EHRA Atrial Fibrillation Ablation Long-Term Registry
Aims: The ESC EORP EHRA Atrial Fibrillation (AF) Ablation Long-Term registry was designed to assess management and outcomes of AF catheter ablation procedures in Europe. To investigate the current ablation approaches and their outcomes for patients with paroxymal AF (PAF) and non-PAF in Europe.
Methods and results: Data from index ablations were collected in 27 European countries at 104 centres in a prospective fashion. Pre-procedural, procedural, and 1-year follow-up data were captured on a web-based electronic case record form. Data on the ablation procedure were available for 3446 patients. Of these, 2513 patients and 933 patients underwent pulmonary vein isolation (PVI) or PVI plus (PVIplus) additional ablation, respectively. The ablation strategy was limited to PVI in 81% and 56% of patients in the PAF and non-PAF group, respectively (P < 0.001). In the non-PAF group, left atrial linear ablation and ablation of complex fragmented atrial electrograms were more commonly performed. Arrhythmias recurrence after PVI was 29% and 39% in the PAF and non-PAF group, respectively (P < 0.001) and 42% after PVIplus in both groups. Atrial fibrillation related hospital admissions were more common in the PVIplus group (20% vs. 14%). A very low procedural complication rate was observed. No relevant differences were observed with regard to repeat ablation (PVI 9% and PVIplus 11%).
Conclusion: In patients with PAF and non-PAF, the ablation strategies of PVI and PVIplus led to similar arrhythmia-free survival rates after 1 year. A considerable hospital readmission rate was noted.info:eu-repo/semantics/publishedVersio
Cytokine mRNA profiles of immunocompetent vaginal cells of women with chronic recurrent vulvovaginal candidiasis
The main idea of this study was to describe cytokine profiles of immunological vaginal cells of women with chronic recurrent vulvovaginal candidiasis (CWC). There were 76 women recruited into the study. Out of them CW C was verified among 34 women. A control group included 23 relatively healthy women without inflammatory diseases of reproductive system and 19 patients with βclassical" bacterial vaginosis (BV). Biocoenosis data and cytokines expressions profile were evaluated in vaginal swabs of women with CWC, BV and healthy women. It was demonstrated that CW C was associated with an elevation of cytokine levels (TNF-Ξ±, IL-Ξ², IL-6, IL-8, IFN-Ξ³, IL-10) and the decrease of IL-12Ξ±/p35 and IL-18.ΠΠ°Π½Π½Π°Ρ ΡΡΠ°ΡΡΡ ΠΏΠΎΡΠ²ΡΡΠ΅Π½Π° ΠΎΡΠΎΠ±Π΅Π½Π½ΠΎΡΡΡΠΌ ΠΈΠΌΠΌΡΠ½Π½ΠΎΠ³ΠΎ ΠΎΡΠ²Π΅ΡΠ° ΠΏΡΠΈ Ρ
ΡΠΎΠ½ΠΈΡΠ΅ΡΠΊΠΎΠΌ ΡΠ΅ΡΠΈΠ΄ΠΈΠ²ΠΈΡΡΡΡΠ΅ΠΌ Π²ΡΠ»ΡΠ²ΠΎΠ²Π°Π³ΠΈΠ½Π°Π»ΡΠ½ΠΎΠΌ ΠΊΠ°Π½Π΄ΠΈΠ΄ΠΎΠ·Π΅ (Π₯Π ΠΠ). ΠΠ· 76 ΠΎΠ±ΡΠ»Π΅Π΄ΠΎΠ²Π°Π½Π½ΡΡ
ΠΆΠ΅Π½ΡΠΈΠ½ ΡΠ΅ΠΏΡΠΎΠ΄ΡΠΊΡΠΈΠ²Π½ΠΎΠ³ΠΎ Π²ΠΎΠ·ΡΠ°ΡΡΠ°, Π₯Π ΠΠ Π²ΡΡΠ²Π»Π΅Π½ Ρ 34 ΠΏΠ°ΡΠΈΠ΅Π½ΡΠΎΠΊ. ΠΡΡΠΏΠΏΡ ΡΡΠ°Π²Π½Π΅Π½ΠΈΡ ΡΠΎΡΡΠ°Π²ΠΈΠ»ΠΈ 23 ΡΡΠ»ΠΎΠ²Π½ΠΎ-Π·Π΄ΠΎΡΠΎΠ²ΡΠ΅ ΠΆΠ΅Π½ΡΠΈΠ½Ρ ΠΈ 19 ΠΏΠ°ΡΠΈΠ΅Π½ΡΠΎΠΊ Ρ Π±Π°ΠΊΡΠ΅ΡΠΈΠ°Π»ΡΠ½ΡΠΌ Π²Π°Π³ΠΈΠ½ΠΎΠ·ΠΎΠΌ (ΠΠ). ΠΠΏΠΈΡΠ°Π½ΠΎ ΡΠΎΡΡΠΎΡΠ½ΠΈΠ΅ ΠΌΠΈΠΊΡΠΎΡΠ»ΠΎΡΡ ΠΈ ΠΏΡΠΎΠ²Π΅Π΄Π΅Π½ Π°Π½Π°Π»ΠΈΠ· ΠΏΡΠΎΡΠΈΠ»Ρ ΡΠΊΡΠΏΡΠ΅ΡΡΠΈΠΈ ΠΌΠ ΠΠ Π³Π΅Π½ΠΎΠ² ΡΠΈΡΠΎΠΊΠΈΠ½ΠΎΠ² ΠΏΡΠΈ Π₯Π ΠΠ, Π² Π½ΠΎΡΠΌΠ΅ ΠΈ ΠΏΡΠΈ ΠΠ. ΠΠΎΠΊΠ°Π·Π°Π½ΠΎ, ΡΡΠΎ Π₯Π ΠΠ ΡΠΎΠΏΡΠΎΠ²ΠΎΠΆΠ΄Π°Π΅ΡΡΡ ΠΏΠΎΠ²ΡΡΠ΅Π½ΠΈΠ΅ΠΌ ΡΡΠΎΠ²Π½Ρ ΡΠΊΡΠΏΡΠ΅ΡΡΠΈΠΈ ΠΌΠ ΠΠ ΠΏΡΠΎΠ²ΠΎΡΠΏΠ°Π»ΠΈΡΠ΅Π»ΡΠ½ΡΡ
ΡΠΈΡΠΎΠΊΠΈΠ½ΠΎΠ² (TNF-Ξ±, IL-1Ξ², IL-6, IL-8, IFN-Ξ₯), Π° ΡΠ°ΠΊΠΆΠ΅ IL-10 ΠΈ ΡΠ½ΠΈΠΆΠ΅Π½ΠΈΠ΅ΠΌ ΡΡΠΎΠ²Π½Ρ ΡΠΊΡΠΏΡΠ΅ΡΡΠΈΠΈ ΠΌΠ ΠΠ Π³Π΅Π½ΠΎΠ² IL-18 ΠΈ IL-12Ξ±/p35
Reproducibility of cytological diagnoses in evaluating liquid cervical smears and immunocytochemical co-expression of p16/Ki-67 using manual and automatic methods
Aim. To assess the reproducibility of cytological diagnoses in evaluating liquid cervical smears and immunocytochemical co-expression of p16/Ki-67 using manual and automatic methods.
Materials and methods. Cytological smears prepared using the liquid cytology method on the Becton Dickinson device (SurePath technology) were studied. An immunocytochemical study was carried out using a Ventana BenchMark Ultra automatic immunostainer with a commercial CINtec kit (determination of p16/Ki-67 co-expression). In total, 100 cytological slides (50 pairs of Pap-smears and immunocytochemical slides) were studied. The diagnostic kit was reviewed by five cytologists independently, and the cytologic slides were evaluated using four categories according to the Bethesda system (2014) and according to the categories of normal/abnormal. The co-expression of p16/Ki-67 was assessed per the manufacturer's recommendations (Roche) using the manual method (light microscope) and the automatic Vision Cyto Pap ICC system. Statistical processing of the results was performed using the SPSS software package version 26.0.0.0 with the calculation of the reproducibility indices of Cohen's kappa and Fleiss' kappa.
Results. When assessing the reproducibility of four categories of cytological diagnoses according to the Bethesda system (2014), Cohen's kappa was 0.0480.265. The overall Fleiss' kappa between all cytologists was 0.103. When only two categories (normal/abnormal) were used, the reproducibility ranged from 0.058 to 0.377. When assessing the co-expression of p16 and Ki-67, Cohen's kappa reproducibility was from 0.196 to 0.574, while the overall Fleiss' kappa was 0.407. When comparing the evaluation results of each of the cytologists with the neural network, Cohen's kappa reproducibility ranged from 0.103 to 0.436.
Conclusion. The reproducibility of cytological diagnoses according to the Bethesda system (2014) and two categories (normal/abnormal) based on the Pap smear study was low. Such results are primarily due to a large number of abnormal smears in the study. The immunocytochemical method has diagnosis reproducibility three times higher, indicating the need to measure the co-expression of p16 and Ki-67 to increase the sensitivity and specificity of the cytological method. Similar reproducibility when comparing the manual and automatic evaluation of the "double label" suggests that the neural network algorithm can currently help in decision support rather than replace the cytologist at the diagnostic stage
ΠΠΈΠΏΠ΅ΡΡΡΠΈΠ³Π»ΠΈΡΠ΅ΡΠΈΠ΄Π΅ΠΌΠΈΡ - ΠΌΡΠ»ΡΡΠΈΠ΄ΠΈΡΡΠΈΠΏΠ»ΠΈΠ½Π°ΡΠ½Π°Ρ ΠΏΡΠΎΠ±Π»Π΅ΠΌΠ° ΡΠΎΠ²ΡΠ΅ΠΌΠ΅Π½Π½ΠΎΠΉ ΠΌΠ΅Π΄ΠΈΡΠΈΠ½Ρ
Acute pancreatitis is one of the most common gastrointestinal causes for hospitalization after acute appendicitis. Despite recent advances in the treatment methods, mortality from acute pancreatitis and its complications remains high. Hypertriglyceridemia is an underestimated cause of acute pancreatitis, accounting for 10% among other etiological factors. Timely diagnosis of hypertriglyceridemia, a personalized approach, and the selection of adequate lipid-lowering therapy allow reducing the risk of developing and/or preventing recurrent acute pancreatitis. The article presents the clinical case of a patient with recurrent pancreatitis and hypertriglyceridemia. Despite high levels of triglycerides and annual hospitalizations for recurrent pancreatitis, the patient has not received optimal treatment for a long time. Therefore, lipid-modifying therapy has not been prescribed and none dietary recommendations have been suggested, including the exclusion of alcoholic beverages. Structural changes in the pancreas (the formation of pseudocysts) and the progression of pancreatogenic diabetes have developed.ΠΡΡΡΡΠΉ ΠΏΠ°Π½ΠΊΡΠ΅Π°ΡΠΈΡ (ΠΠ) - ΠΎΠ΄Π½Π° ΠΈΠ· ΠΎΡΠ½ΠΎΠ²Π½ΡΡ
ΠΏΡΠΈΡΠΈΠ½ Π³ΠΎΡΠΏΠΈΡΠ°Π»ΠΈΠ·Π°ΡΠΈΠΉ ΠΏΠΎ ΠΏΠΎΠ²ΠΎΠ΄Ρ Π·Π°Π±ΠΎΠ»Π΅Π²Π°Π½ΠΈΠΉ ΠΆΠ΅Π»ΡΠ΄ΠΎΡΠ½ΠΎ-ΠΊΠΈΡΠ΅ΡΠ½ΠΎΠ³ΠΎ ΡΡΠ°ΠΊΡΠ°, ΡΡΡΡΠΏΠ°ΡΡΠ°Ρ Π»ΠΈΡΡ ΠΎΡΡΡΠΎΠΌΡ Π°ΠΏΠΏΠ΅Π½Π΄ΠΈΡΠΈΡΡ. ΠΠ΅ΡΠΌΠΎΡΡΡ Π½Π° ΡΠΎΠ²Π΅ΡΡΠ΅Π½ΡΡΠ²ΠΎΠ²Π°Π½ΠΈΠ΅ ΠΌΠ΅ΡΠΎΠ΄ΠΎΠ² Π»Π΅ΡΠ΅Π½ΠΈΡ, Π»Π΅ΡΠ°Π»ΡΠ½ΠΎΡΡΡ ΠΎΡ ΠΠ ΠΈ ΡΠ²ΡΠ·Π°Π½Π½ΡΡ
Ρ Π½ΠΈΠΌ ΠΎΡΠ»ΠΎΠΆΠ½Π΅Π½ΠΈΠΉ Π΄ΠΎ ΡΠΈΡ
ΠΏΠΎΡ ΠΎΡΡΠ°Π΅ΡΡΡ Π½Π° Π²ΡΡΠΎΠΊΠΎΠΌ ΡΡΠΎΠ²Π½Π΅. ΠΠΈΠΏΠ΅ΡΡΡΠΈΠ³Π»ΠΈΡΠ΅ΡΠΈΠ΄Π΅ΠΌΠΈΡ (Π³ΠΈΠΏΠ΅ΡΠ’Π) ΡΠ²Π»ΡΠ΅ΡΡΡ Π½Π΅Π΄ΠΎΠΎΡΠ΅Π½Π΅Π½Π½ΠΎΠΉ ΠΏΡΠΈΡΠΈΠ½ΠΎΠΉ ΠΠ ΠΈ ΡΠΎΡΡΠ°Π²Π»ΡΠ΅Ρ ΠΎΠΊΠΎΠ»ΠΎ 10% ΡΡΠ΅Π΄ΠΈ Π΄ΡΡΠ³ΠΈΡ
ΡΡΠΈΠΎΠ»ΠΎΠ³ΠΈΡΠ΅ΡΠΊΠΈΡ
ΡΠ°ΠΊΡΠΎΡΠΎΠ². Π‘Π²ΠΎΠ΅Π²ΡΠ΅ΠΌΠ΅Π½Π½Π°Ρ Π΄ΠΈΠ°Π³Π½ΠΎΡΡΠΈΠΊΠ° Π³ΠΈΠΏΠ΅ΡΠ’Π, ΠΈΠ½Π΄ΠΈΠ²ΠΈΠ΄ΡΠ°Π»ΡΠ½ΡΠΉ ΠΏΠΎΠ΄Ρ
ΠΎΠ΄ ΠΈ ΠΏΠΎΠ΄Π±ΠΎΡ Π°Π΄Π΅ΠΊΠ²Π°ΡΠ½ΠΎΠΉ Π»ΠΈΠΏΠΈΠ΄Ρ-Π½ΠΈΠΆΠ°ΡΡΠ΅ΠΉ ΡΠ΅ΡΠ°ΠΏΠΈΠΈ ΠΏΠΎΠ·Π²ΠΎΠ»ΡΡΡ ΡΠ½ΠΈΠ·ΠΈΡΡ ΡΠΈΡΠΊΠΈ ΡΠ°Π·Π²ΠΈΡΠΈΡ ΠΠ ΠΈ/ΠΈΠ»ΠΈ ΠΏΡΠ΅Π΄ΠΎΡΠ²ΡΠ°ΡΠΈΡΡ ΡΠ΅ΡΠΈΠ΄ΠΈΠ²Ρ. Π ΡΡΠ°ΡΡΠ΅ ΠΏΡΠΈΠ²ΠΎΠ΄ΠΈΡΡΡ ΠΊΠ»ΠΈΠ½ΠΈΡΠ΅ΡΠΊΠΎΠ΅ Π½Π°Π±Π»ΡΠ΄Π΅Π½ΠΈΠ΅ Π·Π° ΠΏΠ°ΡΠΈΠ΅Π½ΡΠΎΠΌ Ρ ΡΠ΅ΡΠΈΠ΄ΠΈΠ²ΠΈΡΡΡΡΠΈΠΌ ΡΠ΅ΡΠ΅Π½ΠΈΠ΅ΠΌ ΠΏΠ°Π½ΠΊΡΠ΅Π°ΡΠΈΡΠ° Π½Π° ΡΠΎΠ½Π΅ Π³ΠΈΠΏΠ΅ΡΠ’Π. ΠΠ΅ΡΠΌΠΎΡΡΡ Π½Π° Π²ΡΡΠΎΠΊΠΈΠ΅ ΡΡΠΎΠ²Π½ΠΈ ΡΡΠΈΠ³Π»ΠΈΡΠ΅ΡΠΈΠ΄ΠΎΠ² ΠΈ Π΅ΠΆΠ΅Π³ΠΎΠ΄Π½ΡΠ΅ Π³ΠΎΡΠΏΠΈΡΠ°Π»ΠΈΠ·Π°ΡΠΈΠΈ ΠΏΠΎ ΠΏΠΎΠ²ΠΎΠ΄Ρ ΠΏΠΎΠ²ΡΠΎΡΠ½ΡΡ
ΡΠΏΠΈΠ·ΠΎΠ΄ΠΎΠ² ΠΏΠ°Π½ΠΊΡΠ΅Π°ΡΠΈΡΠ°, Π΄Π»ΠΈΡΠ΅Π»ΡΠ½ΠΎΠ΅ Π²ΡΠ΅ΠΌΡ Π΄ΠΎΠ»ΠΆΠ½ΠΎΠ³ΠΎ Π²Π½ΠΈΠΌΠ°Π½ΠΈΡ ΠΎΡΠ½ΠΎΠ²Π½ΠΎΠΌΡ ΡΡΠΈΠΎΠ»ΠΎΠ³ΠΈΡΠ΅ΡΠΊΠΎΠΌΡ ΡΠ°ΠΊΡΠΎΡΡ Π½Π΅ ΡΠ΄Π΅Π»ΡΠ»ΠΎΡΡ. Π‘Π»Π΅Π΄ΠΎΠ²Π°ΡΠ΅Π»ΡΠ½ΠΎ, Π½Π΅ Π½Π°Π·Π½Π°ΡΠ°Π»Π°ΡΡ Π»ΠΈΠΏΠΈΠ΄ΠΌΠΎ-Π΄ΠΈΡΠΈΡΠΈΡΡΡΡΠ°Ρ ΡΠ΅ΡΠ°ΠΏΠΈΡ ΠΈ Π½Π΅ ΡΠΎΠ±Π»ΡΠ΄Π°Π»ΠΈΡΡ Π΄ΠΈΠ΅ΡΠΈΡΠ΅ΡΠΊΠΈΠ΅ ΡΠ΅ΠΊΠΎΠΌΠ΅Π½Π΄Π°ΡΠΈΠΈ, Π² ΡΠΎΠΌ ΡΠΈΡΠ»Π΅ ΠΈΡΠΊΠ»ΡΡΠ΅Π½ΠΈΠ΅ ΡΠΏΠΎΡΡΠ΅Π±Π»Π΅Π½ΠΈΡ Π°Π»ΠΊΠΎΠ³ΠΎΠ»ΡΠ½ΡΡ
Π½Π°ΠΏΠΈΡΠΊΠΎΠ², ΡΡΠΎ ΠΏΡΠΈΠ²Π΅Π»ΠΎ ΠΊ ΡΡΡΡΠΊΡΡΡΠ½ΡΠΌ ΠΈΠ·ΠΌΠ΅Π½Π΅Π½ΠΈΡΠΌ Π² ΠΏΠΎΠ΄ΠΆΠ΅Π»ΡΠ΄ΠΎΡΠ½ΠΎΠΉ ΠΆΠ΅Π»Π΅Π·Π΅ (ΠΏΡΠ΅Π²Π΄ΠΎΠΊΠΈΡΡΠ΅) ΠΈ ΠΏΡΠΎΠ³ΡΠ΅ΡΡΠΈΡΠΎΠ²Π°Π½ΠΈΡ ΡΠ°Ρ
Π°ΡΠ½ΠΎΠ³ΠΎ Π΄ΠΈΠ°Π±Π΅ΡΠ° Π·Π° ΡΡΠ΅Ρ ΠΏΠ°Π½ΠΊΡΠ΅Π°ΡΠΎΠ³Π΅Π½Π½ΠΎΠ³ΠΎ ΠΊΠΎΠΌΠΏΠΎΠ½Π΅Π½ΡΠ°
ΠΠ½Π΄ΠΎΠΌΠ΅ΡΡΠΈΠΎΠ·-Π°ΡΡΠΎΡΠΈΠΈΡΠΎΠ²Π°Π½Π½ΡΠ΅ ΠΎΠΏΡΡ ΠΎΠ»ΠΈ ΡΠΈΡΠ½ΠΈΠΊΠ°: ΠΌΠΎΡΡΠΎΠ»ΠΎΠ³ΠΈΡΠ΅ΡΠΊΠΈΠ΅ ΠΈ ΠΈΠΌΠΌΡΠ½ΠΎΠ³ΠΈΡΡΠΎΡ ΠΈΠΌΠΈΡΠ΅ΡΠΊΠΈΠ΅ ΠΎΡΠΎΠ±Π΅Π½Π½ΠΎΡΡΠΈ
Background. In 2016, the World Health Organization published an updated version of the Histological Classification for ovarian tumors presenting a new category of endometriosis-associated tumors. The predictors of malignant transformation of endometriosis have not been clearly defined so far.Purpose. The search for histological and immunohistochemical markers of endometriosis-associated malignancy.Materials and methods. 28 female patients with endometrioid ovarian cancer and 11 patients with clear cell ovarian carcinoma were enrolled. Histological and immunohistochemical studies were carried out using conventional techniques. Immunohistochemistry was applied to determine the hormone receptor status: expression of steroid hormone receptors, BAF250a (ARID1A), PTEN, P-catenin, MSH6, PMS2, Ρ-53, WT-1, proliferative index (Ki-67). Microsatellite instability (MSI) testing was conducted according to the standard protocol.Results. In all cases of ovarian cancer, histological examination showed one of the endometriosis features. Atypical endometriosis was found in 39 % (11 / 28) of endometrioid tumors and in 9% (1/ 11) of clear cell carcinomas. Endometrioid ovarian cancer was found to be ER (74Β±7,8%) β and PR (67Β±5,4%) β positive; Ki-67 index was 68,2Β±3,7 %; loss of BAF250a (ARID1A) expression was observed in 14% (4/ 28), loss of PTEN expression in 29 % (8 / 28), nuclear expression of P-catenin in 32% (9/28) of cases. Loss of MMR expression was detected in 7% (2/28) of cases. MSI was found in one case only, which was also associated with loss of expression of BAF250a (ARID1A) and MSH6. Clear cell carcinoma of the ovary showed histological criteria for endometriosis; however, there were no changes immunohistochemical markers expression that were typical for endometriosis-associated malignancies. It could be due to a small number of patients in the group so further research is needed.Conclusion. Atypical endometriosis may be a morphological precursor of endometrioid and clear cell carcinoma of the ovary. Comprehensive assessment of a marker panel consisting of BAF250a (ARID1A), P-catenin, PTEN, p53, Ki-67 index, PMS2 and MSH6 will allow improving the diagnosis of atypical endometriosis and endometriosis-associated ovarian cancer.ΠΠΊΡΡΠ°Π»ΡΠ½ΠΎΡΡΡ. Π 2016 ΠΡΠ΅ΠΌΠΈΡΠ½Π°Ρ ΠΡΠ³Π°Π½ΠΈΠ·Π°ΡΠΈΡ ΠΠ΄ΡΠ°Π²ΠΎΠΎΡ
ΡΠ°Π½Π΅Π½ΠΈΡ ΠΎΠ±Π½ΠΎΠ²ΠΈΠ»Π° ΠΊΠ»Π°ΡΡΠΈΡΠΈΠΊΠ°ΡΠΈΡ ΠΎΠΏΡΡ
ΠΎΠ»Π΅ΠΉ ΡΠΈΡΠ½ΠΈΠΊΠ° ΠΈ ΠΏΡΠ΅Π΄ΡΡΠ°Π²ΠΈΠ»Π° Π½ΠΎΠ²ΡΡ Π³ΡΡΠΏΠΏΡ ΡΠ½Π΄ΠΎΠΌΠ΅ΡΡΠΈΠΎΠ·-Π°ΡΡΠΎΡΠΈΠΈΡΠΎΠ²Π°Π½Π½ΡΡ
ΠΎΠΏΡΡ
ΠΎΠ»Π΅ΠΉ. ΠΡΠΎΠ±Π»Π΅ΠΌΠ° ΠΏΠΎΠΈΡΠΊΠ° ΠΏΡΠ΅Π΄ΠΈΠΊΡΠΎΡΠΎΠ² Π·Π»ΠΎΠΊΠ°ΡΠ΅ΡΡΠ²Π΅Π½Π½ΠΎΠΉ ΡΡΠ°Π½ΡΡΠΎΡΠΌΠ°ΡΠΈΠΈ ΡΠ½Π΄ΠΎΠΌΠ΅ΡΡΠΈΠΎΠ·Π° Π΄ΠΎ ΡΠΈΡ
ΠΏΠΎΡ Π½Π΅ ΡΠ΅ΡΠ΅Π½Π°.Π¦Π΅Π»Ρ ΠΈΡΡΠ»Π΅Π΄ΠΎΠ²Π°Π½ΠΈΡ. ΠΠΎΠΈΡΠΊ Π³ΠΈΡΡΠΎΠ»ΠΎΠ³ΠΈΡΠ΅ΡΠΊΠΈΡ
ΠΈ ΠΈΠΌΠΌΡΠ½ΠΎΠ³ΠΈΡΡΠΎΡ
ΠΈΠΌΠΈΡΠ΅ΡΠΊΠΈΡ
ΠΌΠ°ΡΠΊΠ΅ΡΠΎΠ² ΠΌΠ°Π»ΠΈΠ³Π½ΠΈΠ·Π°ΡΠΈΠΈ ΡΠ½Π΄ΠΎΠΌΠ΅ΡΡΠΈΠΎΠ·Π°.ΠΠ°ΡΠ΅ΡΠΈΠ°Π» ΠΈ ΠΌΠ΅ΡΠΎΠ΄Ρ. Π ΠΈΡΡΠ»Π΅Π΄ΠΎΠ²Π°Π½ΠΈΠ΅ Π±ΡΠ»ΠΈ Π²ΠΊΠ»ΡΡΠ΅Π½Ρ 28 ΠΆΠ΅Π½ΡΠΈΠ½ Ρ Π΄ΠΈΠ°Π³Π½ΠΎΠ·ΠΎΠΌ ΡΠ½Π΄ΠΎΠΌΠ΅ΡΡΠΈΠΎΠ΄Π½ΡΠΉ ΡΠ°ΠΊ ΡΠΈΡΠ½ΠΈΠΊΠ° ΠΈ 11 Π±ΠΎΠ»ΡΠ½ΡΡ
ΡΠ²Π΅ΡΠ»ΠΎΠΊΠ»Π΅ΡΠΎΡΠ½ΡΠΌ ΡΠ°ΠΊΠΎΠΌ ΡΠΈΡΠ½ΠΈΠΊΠ°. ΠΠΈΡΡΠΎΠ»ΠΎΠ³ΠΈΡΠ΅ΡΠΊΠΎΠ΅ ΠΈ ΠΈΠΌΠΌΡΠ½ΠΎΠ³ΠΈΡΡΠΎΡ
ΠΈΠΌΠΈΡΠ΅ΡΠΊΠΎΠ΅ ΠΈΡΡΠ»Π΅Π΄ΠΎΠ²Π°Π½ΠΈΡ ΠΏΡΠΎΠ²ΠΎΠ΄ΠΈΠ»ΠΈΡΡ ΠΏΠΎ ΡΡΠ°Π½Π΄Π°ΡΡΠ½ΠΎΠΉ ΠΌΠ΅ΡΠΎΠ΄ΠΈΠΊΠ΅. ΠΠΌΠΌΡΠ½ΠΎΠ³ΠΈΡΡΠΎΡ
ΠΈΠΌΠΈΡΠ΅ΡΠΊΠΈΠΌ ΠΌΠ΅ΡΠΎΠ΄ΠΎΠΌ ΠΎΠΏΡΠ΅Π΄Π΅Π»ΡΠ»ΡΡ ΡΠ΅ΡΠ΅ΠΏΡΠΎΡΠ½ΡΠΉ ΡΡΠ°ΡΡΡ ΠΎΠΏΡΡ
ΠΎΠ»ΠΈ: ΡΠΊΡΠΏΡΠ΅ΡΡΠΈΡ ΡΠ΅ΡΠ΅ΠΏΡΠΎΡΠΎΠ² ΡΡΠ΅ΡΠΎΠΈΠ΄Π½ΡΡ
Π³ΠΎΡΠΌΠΎΠ½ΠΎΠ², ΡΠΊΡΠΏΡΠ΅ΡΡΠΈΡ BAF250a (ARID1A), PTEN, Ρ-ΠΊΠ°ΡΠ΅Π½ΠΈΠ½, MSH6, PMS2, Ρ-53, WT-1, ΠΈΠ½Π΄Π΅ΠΊΡ ΠΏΡΠΎΠ»ΠΈΡΠ΅ΡΠ°ΡΠΈΠΈ (Ki-67). ΠΠΎΠ»Π΅ΠΊΡΠ»ΡΡΠ½ΠΎ-Π³Π΅Π½Π΅ΡΠΈΡΠ΅ΡΠΊΠΈΠΉ Π°Π½Π°Π»ΠΈΠ· MSI ΠΏΡΠΎΠ²ΠΎΠ΄ΠΈΠ»ΡΡ ΠΏΠΎ ΡΡΠ°Π½Π΄Π°ΡΡΠ½ΠΎΠΌΡ ΠΏΡΠΎΡΠΎΠΊΠΎΠ»Ρ.Π Π΅Π·ΡΠ»ΡΡΠ°ΡΡ. ΠΡΠΈ ΠΌΠΎΡΡΠΎΠ»ΠΎΠ³ΠΈΡΠ΅ΡΠΊΠΎΠΌ ΠΈΡΡΠ»Π΅Π΄ΠΎΠ²Π°Π½ΠΈΠΈ Π²ΠΎ Π²ΡΠ΅Ρ
ΡΠ»ΡΡΠ°ΡΡ
ΡΠ°ΠΊΠ° ΡΠΈΡΠ½ΠΈΠΊΠ° ΠΏΡΠΈΡΡΡΡΡΠ²ΠΎΠ²Π°Π» ΠΎΠ΄ΠΈΠ½ ΠΈΠ· ΠΏΡΠΈΠ·Π½Π°ΠΊΠΎΠ² ΡΠ½Π΄ΠΎΠΌΠ΅ΡΡΠΈΠΎΠ·Π°. ΠΡΠΈΠΏΠΈΡΠ΅ΡΠΊΠΈΠΉ ΡΠ½Π΄ΠΎΠΌΠ΅ΡΡΠΈΠΎΠ· ΠΎΠ±Π½Π°ΡΡΠΆΠ΅Π½ Π² 39% (11/28) ΡΠ½Π΄ΠΎΠΌΠ΅ΡΡΠΈΠΎΠ΄Π½ΡΡ
ΠΈ Π² 9% (1/11) ΡΠ²Π΅ΡΠ»ΠΎΠΊΠ»Π΅ΡΠΎΡΠ½ΡΡ
ΠΎΠΏΡΡ
ΠΎΠ»ΡΡ
. ΠΠ½Π΄ΠΎΠΌΠ΅ΡΡΠΈΠΎΠ΄Π½ΡΠΉ ΡΠ°ΠΊ ΡΠΈΡΠ½ΠΈΠΊΠ° Π΄Π΅ΠΌΠΎΠ½ΡΡΡΠΈΡΠΎΠ²Π°Π» ΠΏΠΎΠ·ΠΈΡΠΈΠ²Π½ΡΡ ΡΠ΅Π°ΠΊΡΠΈΡ ΠΊ ΡΠ΅ΡΠ΅ΠΏΡΠΎΡΠ°ΠΌ ΡΡΠ΅ΡΠΎΠΈΠ΄Π½ΡΡ
Π³ΠΎΡΠΌΠΎΠ½ΠΎΠ² β ER (74Β±7,8%) ΠΈ PR (67Β±5,4%), ΠΈΠ½Π΄Π΅ΠΊΡ Ki-67 ΡΠΎΡΡΠ°Π²ΠΈΠ» 68,2Β±3,7%, ΠΏΠΎΡΠ΅ΡΡ ΡΠΊΡΠΏΡΠ΅ΡΡΠΈΠΈ BAF250Π° (ARID1A) Π²ΡΡΠ²Π»Π΅Π½Π° Π² 14% (4/28), ΠΏΠΎΡΠ΅ΡΡ PTEN 29% (8/28), ΡΠ΄Π΅ΡΠ½Π°Ρ ΡΠΊΡΠΏΡΠ΅ΡΡΠΈΡ Ρ-ΠΊΠ°ΡΠ΅Π½ΠΈΠ½Π° Π² 32% (9/28) ΡΠ»ΡΡΠ°Π΅Π². ΠΠΎΡΠ΅ΡΡ ΡΠΊΡΠΏΡΠ΅ΡΡΠΈΠΈ Π±Π΅Π»ΠΊΠΎΠ² MMR Π²ΡΡΠ²Π»Π΅Π½Π° Π² 7% (2/28) ΡΠ»ΡΡΠ°Π΅Π². MSI ΠΎΠ±Π½Π°ΡΡΠΆΠ΅Π½Π° ΡΠΎΠ»ΡΠΊΠΎ Π² 1 ΡΠ»ΡΡΠ°Π΅, Π² ΠΊΠΎΡΠΎΡΠΎΠΌ Π½Π°Π±Π»ΡΠ΄Π°Π»Π°ΡΡ ΠΏΠΎΡΠ΅ΡΡ ΡΠΊΡΠΏΡΠ΅ΡΡΠΈΠΈ BAF250Π° (ARID1A) ΠΈ MSH6. Π ΡΠ²Π΅ΡΠ»ΠΎΠΊΠ»Π΅ΡΠΎΡΠ½ΠΎΠΌ ΡΠ°ΠΊΠ΅ ΡΠΈΡΠ½ΠΈΠΊΠ° ΠΎΠΏΡΠ΅Π΄Π΅Π»ΡΠ»ΠΈΡΡ Π³ΠΈΡΡΠΎΠ»ΠΎΠ³ΠΈΡΠ΅ΡΠΊΠΈΠ΅ ΠΊΡΠΈΡΠ΅ΡΠΈΠΈ ΡΠ½Π΄ΠΎΠΌΠ΅ΡΡΠΈΠΎΠ·Π°, ΠΎΠ΄Π½Π°ΠΊΠΎ ΠΈΠ·ΠΌΠ΅Π½Π΅Π½ΠΈΡ ΡΠΊΡΠΏΡΠ΅ΡΡΠΈΠΈ ΠΈΠΌΠΌΡΠ½ΠΎΠ³ΠΈΡΡΠΎΡ
ΠΈΠΌΠΈΡΠ΅ΡΠΊΠΈΡ
ΠΌΠ°ΡΠΊΠ΅ΡΠΎΠ², Ρ
Π°ΡΠ°ΠΊΡΠ΅ΡΠ½ΡΠ΅ Π΄Π»Ρ ΡΠ½Π΄ΠΎΠΌΠ΅ΡΡΠΈΠΎΠ·-Π°ΡΡΠΎΡΠΈΠΈΡΠΎΠ²Π°Π½Π½ΡΡ
ΠΎΠΏΡΡ
ΠΎΠ»Π΅ΠΉ, Π½Π΅ Π±ΡΠ»ΠΈ ΠΎΠ±Π½Π°ΡΡΠΆΠ΅Π½Ρ. ΠΠΎΠΆΠ½ΠΎ ΠΏΡΠ΅Π΄ΠΏΠΎΠ»ΠΎΠΆΠΈΡΡ, ΡΡΠΎ ΡΡΠΎ ΡΠ²ΡΠ·Π°Π½ΠΎ Ρ ΠΌΠ°Π»ΠΎΡΠΈΡΠ»Π΅Π½Π½ΠΎΡΡΡΡ Π³ΡΡΠΏΠΏΡ, ΠΏΠΎΡΡΠΎΠΌΡ ΡΡΠ΅Π±ΡΡΡΡΡ Π΄Π°Π»ΡΠ½Π΅ΠΉΡΠΈΠ΅ ΠΈΡΡΠ»Π΅Π΄ΠΎΠ²Π°Π½ΠΈΡ.ΠΠ°ΠΊΠ»ΡΡΠ΅Π½ΠΈΠ΅. ΠΡΠΈΠΏΠΈΡΠ΅ΡΠΊΠΈΠΉ ΡΠ½Π΄ΠΎΠΌΠ΅ΡΡΠΈΠΎΠ· ΠΌΠΎΠΆΠ΅Ρ ΡΠ²Π»ΡΡΡΡΡ ΠΌΠΎΡΡΠΎΠ»ΠΎΠ³ΠΈΡΠ΅ΡΠΊΠΈΠΌ ΠΏΡΠ΅Π΄ΡΠ΅ΡΡΠ²Π΅Π½Π½ΠΈΠΊΠΎΠΌ ΡΠ½Π΄ΠΎΠΌΠ΅ΡΡΠΈΠΎΠ΄Π½ΠΎΠ³ΠΎ ΠΈ ΡΠ²Π΅ΡΠ»ΠΎΠΊΠ»Π΅ΡΠΎΡΠ½ΠΎΠ³ΠΎ ΡΠ°ΠΊΠ° ΡΠΈΡΠ½ΠΈΠΊΠ°. ΠΠΎΠΌΠΏΠ»Π΅ΠΊΡΠ½Π°Ρ ΠΎΡΠ΅Π½ΠΊΠ° ΡΠΊΡΠΏΡΠ΅ΡΡΠΈΠΈ ΠΏΠ°Π½Π΅Π»ΠΈ ΠΌΠ°ΡΠΊΠ΅ΡΠΎΠ² BAF250a (ARID1A), Ρ-ΠΊΠ°ΡΠ΅Π½ΠΈΠ½Π°, PTEN, p53, ΠΈΠ½Π΄Π΅ΠΊΡΠ° Ki-67, PMS2 ΠΈ MSH6 ΠΏΠΎΠ·Π²ΠΎΠ»ΠΈΡ ΡΠ»ΡΡΡΠΈΡΡ Π΄ΠΈΠ°Π³Π½ΠΎΡΡΠΈΡΠ΅ΡΠΊΠΈΠΉ ΠΏΠΎΠΈΡΠΊ Π°ΡΠΈΠΏΠΈΡΠ΅ΡΠΊΠΎΠ³ΠΎ ΡΠ½Π΄ΠΎΠΌΠ΅ΡΡΠΈΠΎΠ·Π° ΠΈ ΡΠ½Π΄ΠΎΠΌΠ΅ΡΡΠΈΠΎΠ·-Π°ΡΡΠΎΡΠΈΠΈΡΠΎΠ²Π°Π½Π½ΡΡ
ΠΎΠΏΡΡ
ΠΎΠ»Π΅ΠΉ ΡΠΈΡΠ½ΠΈΠΊΠ°