8 research outputs found
ΠΡΠΎΠ±Π΅Π½Π½ΠΎΡΡΠΈ Π»ΠΈΠΌΡΠΎΠ³Π΅Π½Π½ΠΎΠ³ΠΎ ΠΌΠ΅ΡΠ°ΡΡΠ°Π·ΠΈΡΠΎΠ²Π°Π½ΠΈΡ Π² Π·Π°Π²ΠΈΡΠΈΠΌΠΎΡΡΠΈ ΠΎΡ Π²Π½ΡΡΡΠΈΠΎΠΏΡΡ ΠΎΠ»Π΅Π²ΠΎΠΉ Π³Π΅ΡΠ΅ΡΠΎΠ³Π΅Π½Π½ΠΎΡΡΠΈ Π½Π΅ΠΌΠ΅Π»ΠΊΠΎΠΊΠ»Π΅ΡΠΎΡΠ½ΠΎΠ³ΠΎ ΡΠ°ΠΊΠ° Π»Π΅Π³ΠΊΠΈΡ Ρ ΠΏΠ°ΡΠΈΠ΅Π½ΡΠΎΠ² Ρ ΡΠ°Π·Π½ΡΠΌΠΈ ΠΌΠΎΡΡΠΎΠ»ΠΎΠ³ΠΈΡΠ΅ΡΠΊΠΈΠΌΠΈ ΠΈΠ·ΠΌΠ΅Π½Π΅Π½ΠΈΡΠΌΠΈ Π±ΡΠΎΠ½Ρ ΠΈΠ°Π»ΡΠ½ΠΎΠ³ΠΎ ΡΠΏΠΈΡΠ΅Π»ΠΈΡ
The aim of the study: to examine the relationship between the morphological diversity of non-small cell lung cancer and the frequency of lymph node metastasis in groups of patients with different epithelial conditions in the bronchi adjacent to the tumor. Material and methods. Surgical specimens from 90 patients with non-small cell lung cancer, who were treated in the Thoracoabdominal Department Of The Research Institute Of Oncology Of The Tomsk National Research Medical Center in the period from 2009 to 2017 were studied. The histological type of cancer was determined according to the who classification (2020). Lepidic, acinar, papillary, micropapillary, solid and solitary tumor cells were isolated in the parenchymal component of adenocarcinoma. In the parenchymal component of squamous cell carcinoma, 5 types of structures were distinguished: with keratinization, consisting of atypical cells of the prickly type without keratinization, consisting of atypical cells of the basaloid type, built of atypical cells with pronounced polymorphism, single tumor cells. Results. In patients with isolated basal cell hyperplasia, acinar (37 %), papillary (29 %) and solid (27 %) patterns were found less frequently in cases with metastatic regional lymph nodes compared to those without metastatic lymph nodes (63 %; p=0.05; 71 %; p=0.05; 73 %; p=0.01, respectively). In patients with isolated basal cell hyperplasia of the bronchial epithelium, in cases with the presence of lymph node metastasis in the parenchymal component of squamous cell carcinoma, structures 1 (with keratinization) (17 %), 2 (spiky pattern) (33 %) and 4 (polymorphic pattern) (29 %) were less frequently detected compared to those without metastases in regional lymph nodes (83 %; p=0.01; 67 %; p=0.02 and 71 %; p=0.01, respectively). In patients with a combination of basal cell hyperplasia and squamous metaplasia, a spiny pattern (65 %), a basaloid pattern (100 %), a polymorphic pattern (82 %) and single tumor cells (89 %) were more frequently detected in cases with metastatic lymph nodes than in cases without metastatic lymph nodes (35 %; Ρ=0.04; 0 %; Ρ=0.01; 18 %; Ρ=0.01; 11 %; Ρ=0.01, respectively). Conclusion. The data obtained clarify the available information on the significance of the morphological heterogeneity of the tumor for predicting the course of adenocarcinoma and squamous cell carcinoma of the lung.Π¦Π΅Π»Ρ ΠΈΡΡΠ»Π΅Π΄ΠΎΠ²Π°Π½ΠΈΡ β ΠΈΠ·ΡΡΠΈΡΡ ΡΠ²ΡΠ·ΠΈ ΠΌΠΎΡΡΠΎΠ»ΠΎΠ³ΠΈΡΠ΅ΡΠΊΠΎΠ³ΠΎ ΡΠ°Π·Π½ΠΎΠΎΠ±ΡΠ°Π·ΠΈΡ Π½Π΅ΠΌΠ΅Π»ΠΊΠΎΠΊΠ»Π΅ΡΠΎΡΠ½ΠΎΠ³ΠΎ ΡΠ°ΠΊΠ° Π»Π΅Π³ΠΊΠΎΠ³ΠΎ Ρ ΡΠ°ΡΡΠΎΡΠΎΠΉ Π»ΠΈΠΌΡΠΎΠ³Π΅Π½Π½ΠΎΠ³ΠΎ ΠΌΠ΅ΡΠ°ΡΡΠ°Π·ΠΈΡΠΎΠ²Π°Π½ΠΈΡ Π² Π³ΡΡΠΏΠΏΠ°Ρ
Π±ΠΎΠ»ΡΠ½ΡΡ
Ρ ΡΠ°Π·Π½ΡΠΌ ΡΠΎΡΡΠΎΡΠ½ΠΈΠ΅ΠΌ ΡΠΏΠΈΡΠ΅Π»ΠΈΡ Π² ΡΠΌΠ΅ΠΆΠ½ΡΡ
Ρ ΠΎΠΏΡΡ
ΠΎΠ»ΡΡ Π±ΡΠΎΠ½Ρ
Π°Ρ
. ΠΠ°ΡΠ΅ΡΠΈΠ°Π» ΠΈ ΠΌΠ΅ΡΠΎΠ΄Ρ. ΠΡΡΠ»Π΅Π΄ΠΎΠ²Π°Π»ΠΈ ΠΎΠΏΠ΅ΡΠ°ΡΠΈΠΎΠ½Π½ΡΠΉ ΠΌΠ°ΡΠ΅ΡΠΈΠ°Π» ΠΎΡ 90 Π±ΠΎΠ»ΡΠ½ΡΡ
Π½Π΅ΠΌΠ΅Π»ΠΊΠΎΠΊΠ»Π΅ΡΠΎΡΠ½ΡΠΌ ΡΠ°ΠΊΠΎΠΌ Π»Π΅Π³ΠΊΠΎΠ³ΠΎ, ΠΏΡΠΎΡ
ΠΎΠ΄ΠΈΠ²ΡΠΈΡ
Π»Π΅ΡΠ΅Π½ΠΈΠ΅ Π² ΡΠΎΡΠ°ΠΊΠΎΠ°Π±Π΄ΠΎΠΌΠΈΠ½Π°Π»ΡΠ½ΠΎΠΌ ΠΎΡΠ΄Π΅Π»Π΅Π½ΠΈΠΈ ΠΠΠ ΠΎΠ½ΠΊΠΎΠ»ΠΎΠ³ΠΈΠΈ Π’ΠΎΠΌΡΠΊΠΎΠ³ΠΎ ΠΠΠΠ¦ Π² ΠΏΠ΅ΡΠΈΠΎΠ΄ Ρ 2009 ΠΏΠΎ 2017 Π³. ΠΠΈΡΡΠΎΠ»ΠΎΠ³ΠΈΡΠ΅ΡΠΊΠΈΠΉ ΡΠΈΠΏ ΡΠ°ΠΊΠ° ΠΎΠΏΡΠ΅Π΄Π΅Π»ΡΠ»ΠΈ ΡΠΎΠ³Π»Π°ΡΠ½ΠΎ ΠΊΠ»Π°ΡΡΠΈΡΠΈΠΊΠ°ΡΠΈΠΈ WHo (2020). Π ΠΏΠ°ΡΠ΅Π½Ρ
ΠΈΠΌΠ°ΡΠΎΠ·Π½ΠΎΠΌ ΠΊΠΎΠΌΠΏΠΎΠ½Π΅Π½ΡΠ΅ Π°Π΄Π΅Π½ΠΎΠΊΠ°ΡΡΠΈΠ½ΠΎΠΌΡ Π²ΡΠ΄Π΅Π»ΡΠ»ΠΈ ΡΡΡΡΠΊΡΡΡΡ ΡΠΈΠΏΠ° lepidic, Π°ΡΠΈΠ½Π°ΡΠ½ΡΠ΅, ΠΏΠ°ΠΏΠΈΠ»Π»ΡΡΠ½ΡΠ΅, ΠΌΠΈΠΊΡΠΎΠΏΠ°ΠΏΠΈΠ»Π»ΡΡΠ½ΡΠ΅, ΡΠΎΠ»ΠΈΠ΄Π½ΡΠ΅ ΠΈ ΠΎΠ΄ΠΈΠ½ΠΎΡΠ½ΡΠ΅ ΠΎΠΏΡΡ
ΠΎΠ»Π΅Π²ΡΠ΅ ΠΊΠ»Π΅ΡΠΊΠΈ. Π ΠΏΠ°ΡΠ΅Π½Ρ
ΠΈΠΌΠ°ΡΠΎΠ·Π½ΠΎΠΌ ΠΊΠΎΠΌΠΏΠΎΠ½Π΅Π½ΡΠ΅ ΠΏΠ»ΠΎΡΠΊΠΎΠΊΠ»Π΅ΡΠΎΡΠ½ΠΎΠΉ ΠΊΠ°ΡΡΠΈΠ½ΠΎΠΌΡ Π²ΡΠ΄Π΅Π»ΡΠ»ΠΈ 5 ΡΠΈΠΏΠΎΠ² ΡΡΡΡΠΊΡΡΡ: (1) Ρ ΠΎΡΠΎΠ³ΠΎΠ²Π΅Π½ΠΈΠ΅ΠΌ, (2) ΡΠΎΡΡΠΎΡΡΠΈΠΉ ΠΈΠ· Π°ΡΠΈΠΏΠΈΡΠ½ΡΡ
ΠΊΠ»Π΅ΡΠΎΠΊ ΡΠΈΠΏΠΎΠ²Π°ΡΠΎΠ³ΠΎ ΡΠΈΠΏΠ° Π±Π΅Π· ΠΎΡΠΎΠ³ΠΎΠ²Π΅Π½ΠΈΡ, (3) ΡΠΎΡΡΠΎΡΡΠΈΠΉ ΠΈΠ· Π°ΡΠΈΠΏΠΈΡΠ½ΡΡ
ΠΊΠ»Π΅ΡΠΎΠΊ Π±Π°Π·Π°Π»ΠΎΠΈΠ΄Π½ΠΎΠ³ΠΎ ΡΠΈΠΏΠ°, (4) ΠΏΠΎΡΡΡΠΎΠ΅Π½Π½ΡΠΉ ΠΈΠ· Π°ΡΠΈΠΏΠΈΡΠ½ΡΡ
ΠΊΠ»Π΅ΡΠΎΠΊ Ρ ΡΠ΅Π·ΠΊΠΎ Π²ΡΡΠ°ΠΆΠ΅Π½Π½ΡΠΌ ΠΏΠΎΠ»ΠΈΠΌΠΎΡΡΠΈΠ·ΠΌΠΎΠΌ, (5) ΠΎΠ΄ΠΈΠ½ΠΎΡΠ½ΡΠ΅ ΠΎΠΏΡΡ
ΠΎΠ»Π΅Π²ΡΠ΅ ΠΊΠ»Π΅ΡΠΊΠΈ. Π Π΅Π·ΡΠ»ΡΡΠ°ΡΡ. Π Π³ΡΡΠΏΠΏΠ΅ Π±ΠΎΠ»ΡΠ½ΡΡ
Ρ ΠΈΠ·ΠΎΠ»ΠΈΡΠΎΠ²Π°Π½Π½ΠΎΠΉ Π±Π°Π·Π°Π»ΡΠ½ΠΎΠΊΠ»Π΅ΡΠΎΡΠ½ΠΎΠΉ Π³ΠΈΠΏΠ΅ΡΠΏΠ»Π°Π·ΠΈΠ΅ΠΉ Π² ΡΠ»ΡΡΠ°ΡΡ
Ρ ΠΌΠ΅ΡΠ°ΡΡΠ°ΡΠΈΡΠ΅ΡΠΊΠΈΠΌ ΠΏΠΎΡΠ°ΠΆΠ΅Π½ΠΈΠ΅ΠΌ ΡΠ΅Π³ΠΈΠΎΠ½Π°ΡΠ½ΡΡ
Π»ΠΈΠΌΡΠΎΡΠ·Π»ΠΎΠ² ΡΠ΅ΠΆΠ΅ Π±ΡΠ» ΠΎΠ±Π½Π°ΡΡΠΆΠ΅Π½ Π°ΡΠΈΠ½Π°ΡΠ½ΡΠΉ (37 %), ΠΏΠ°ΠΏΠΈΠ»Π»ΡΡΠ½ΡΠΉ (29 %) ΠΈ ΡΠΎΠ»ΠΈΠ΄Π½ΡΠΉ (27 %) ΠΏΠ°ΡΡΠ΅ΡΠ½Ρ ΠΏΠΎ ΡΡΠ°Π²Π½Π΅Π½ΠΈΡ Ρ Π½Π°Π±Π»ΡΠ΄Π΅Π½ΠΈΡΠΌΠΈ, ΠΊΠΎΠ³Π΄Π° Π»ΠΈΠΌΡΠΎΠ³Π΅Π½Π½ΡΡ
ΠΌΠ΅ΡΠ°ΡΡΠ°Π·ΠΎΠ² Π½Π΅ Π±ΡΠ»ΠΎ (63 %; Ρ=0,05; 71 %; Ρ=0,05; 73 %; Ρ=0,01 ΡΠΎΠΎΡΠ²Π΅ΡΡΡΠ²Π΅Π½Π½ΠΎ). Π£ ΠΏΠ°ΡΠΈΠ΅Π½ΡΠΎΠ² Ρ ΠΈΠ·ΠΎΠ»ΠΈΡΠΎΠ²Π°Π½Π½ΠΎΠΉ Π±Π°Π·Π°Π»ΡΠ½ΠΎΠΊΠ»Π΅ΡΠΎΡΠ½ΠΎΠΉ Π³ΠΈΠΏΠ΅ΡΠΏΠ»Π°Π·ΠΈΠ΅ΠΉ Π±ΡΠΎΠ½Ρ
ΠΈΠ°Π»ΡΠ½ΠΎΠ³ΠΎ ΡΠΏΠΈΡΠ΅Π»ΠΈΡ Π² ΡΠ»ΡΡΠ°ΡΡ
Ρ Π½Π°Π»ΠΈΡΠΈΠ΅ΠΌ Π»ΠΈΠΌΡΠΎΠ³Π΅Π½Π½ΠΎΠ³ΠΎ ΠΌΠ΅ΡΠ°ΡΡΠ°Π·ΠΈΡΠΎΠ²Π°Π½ΠΈΡ Π² ΠΏΠ°ΡΠ΅Π½Ρ
ΠΈΠΌΠ°ΡΠΎΠ·Π½ΠΎΠΌ ΠΊΠΎΠΌΠΏΠΎΠ½Π΅Π½ΡΠ΅ ΠΏΠ»ΠΎΡΠΊΠΎΠΊΠ»Π΅ΡΠΎΡΠ½ΠΎΠΉ ΠΊΠ°ΡΡΠΈΠ½ΠΎΠΌΡ ΡΠ΅ΠΆΠ΅ Π²ΡΡΠ²Π»ΡΠ»ΠΈΡΡ ΡΡΡΡΠΊΡΡΡΡ 1-Π³ΠΎ (Ρ ΠΎΡΠΎΠ³ΠΎΠ²Π΅Π½ΠΈΠ΅ΠΌ) (17 %), 2-Π³ΠΎ (ΡΠΈΠΏΠΎΠ²Π°ΡΡΠΉ ΠΏΠ°ΡΡΠ΅ΡΠ½) (33 %) ΠΈ 4-Π³ΠΎ (ΠΏΠΎΠ»ΠΈΠΌΠΎΡΡΠ½ΡΠΉ ΠΏΠ°ΡΡΠ΅ΡΠ½) (29 %) ΡΠΈΠΏΠΎΠ² ΠΏΠΎ ΡΡΠ°Π²Π½Π΅Π½ΠΈΡ ΡΠΎ ΡΠ»ΡΡΠ°ΡΠΌΠΈ, ΠΊΠΎΠ³Π΄Π° ΠΌΠ΅ΡΠ°ΡΡΠ°Π·ΠΎΠ² Π² ΡΠ΅Π³ΠΈΠΎΠ½Π°ΡΠ½ΡΡ
Π»ΠΈΠΌΡΠΎΡΠ·Π»Π°Ρ
Π½Π΅ Π±ΡΠ»ΠΎ (83 %; Ρ=0,01; 67 %; Ρ=0,02 ΠΈ 71 %; Ρ=0,01 ΡΠΎΠΎΡΠ²Π΅ΡΡΡΠ²Π΅Π½Π½ΠΎ). Π Π³ΡΡΠΏΠΏΠ΅ Π±ΠΎΠ»ΡΠ½ΡΡ
Ρ ΡΠΎΡΠ΅ΡΠ°Π½ΠΈΠ΅ΠΌ Π±Π°Π·Π°Π»ΡΠ½ΠΎΠΊΠ»Π΅ΡΠΎΡΠ½ΠΎΠΉ Π³ΠΈΠΏΠ΅ΡΠΏΠ»Π°Π·ΠΈΠΈ ΠΈ ΠΏΠ»ΠΎΡΠΊΠΎΠΊΠ»Π΅ΡΠΎΡΠ½ΠΎΠΉ ΠΌΠ΅ΡΠ°ΠΏΠ»Π°Π·ΠΈΠΈ Π² ΡΠ»ΡΡΠ°ΡΡ
Ρ ΠΌΠ΅ΡΠ°ΡΡΠ°ΡΠΈΡΠ΅ΡΠΊΠΈΠΌ ΠΏΠΎΡΠ°ΠΆΠ΅Π½ΠΈΠ΅ΠΌ Π»ΠΈΠΌΡΠΎΡΠ·Π»ΠΎΠ² ΡΠ°ΡΠ΅ Π±ΡΠ»ΠΈ ΠΎΠ±Π½Π°ΡΡΠΆΠ΅Π½Ρ ΡΠΈΠΏΠΎΠ²Π°ΡΡΠΉ ΠΏΠ°ΡΡΠ΅ΡΠ½ (65 %), Π±Π°Π·Π°Π»ΠΎΠΈΠ΄Π½ΡΠΉ ΠΏΠ°ΡΡΠ΅ΡΠ½ (100 %), ΠΏΠΎΠ»ΠΈΠΌΠΎΡΡΠ½ΡΠΉ ΠΏΠ°ΡΡΠ΅ΡΠ½ (82 %) ΠΈ ΠΎΠ΄ΠΈΠ½ΠΎΡΠ½ΡΠ΅ ΠΎΠΏΡΡ
ΠΎΠ»Π΅Π²ΡΠ΅ ΠΊΠ»Π΅ΡΠΊΠΈ (89 %) ΠΏΠΎ ΡΡΠ°Π²Π½Π΅Π½ΠΈΡ Ρ Π½Π°Π±Π»ΡΠ΄Π΅Π½ΠΈΡΠΌΠΈ, ΠΊΠΎΠ³Π΄Π° Π»ΠΈΠΌΡΠΎΠ³Π΅Π½Π½ΡΡ
ΠΌΠ΅ΡΠ°ΡΡΠ°Π·ΠΎΠ² Π½Π΅ Π±ΡΠ»ΠΎ (35 %; Ρ=0,04; 0 %; Ρ=0,01; 18 %; Ρ=0,01; 11 %; Ρ=0,01 ΡΠΎΠΎΡΠ²Π΅ΡΡΡΠ²Π΅Π½Π½ΠΎ). ΠΠ°ΠΊΠ»ΡΡΠ΅Π½ΠΈΠ΅. ΠΠΎΠ»ΡΡΠ΅Π½Π½ΡΠ΅ Π΄Π°Π½Π½ΡΠ΅ ΡΡΠΎΡΠ½ΡΡΡ ΠΈΠΌΠ΅ΡΡΠΈΠ΅ΡΡ ΡΠ²Π΅Π΄Π΅Π½ΠΈΡ ΠΎ Π·Π½Π°ΡΠ΅Π½ΠΈΠΈ ΠΌΠΎΡΡΠΎΠ»ΠΎΠ³ΠΈΡΠ΅ΡΠΊΠΎΠΉ Π³Π΅ΡΠ΅ΡΠΎΠ³Π΅Π½Π½ΠΎΡΡΠΈ ΠΎΠΏΡΡ
ΠΎΠ»ΠΈ Π΄Π»Ρ ΠΏΡΠΎΠ³Π½ΠΎΠ·Π° ΡΠ΅ΡΠ΅Π½ΠΈΡ Π°Π΄Π΅Π½ΠΎΠΊΠ°ΡΡΠΈΠ½ΠΎΠΌΡ ΠΈ ΠΏΠ»ΠΎΡΠΊΠΎΠΊΠ»Π΅ΡΠΎΡΠ½ΠΎΠ³ΠΎ ΡΠ°ΠΊΠ° Π»Π΅Π³ΠΊΠΎΠ³ΠΎ
ΠΠ΅ΡΡΠΎΠ½Π°Π»ΠΈΠ·ΠΈΡΠΎΠ²Π°Π½Π½Π°Ρ Π°Π΄ΡΡΠ²Π°Π½ΡΠ½Π°Ρ Ρ ΠΈΠΌΠΈΠΎΡΠ΅ΡΠ°ΠΏΠΈΡ Π½Π΅ΠΌΠ΅Π»ΠΊΠΎΠΊΠ»Π΅ΡΠΎΡΠ½ΠΎΠ³ΠΎ ΡΠ°ΠΊΠ° Π»Π΅Π³ΠΊΠΎΠ³ΠΎ IIβIII ΡΡΠ°Π΄ΠΈΠΉ
Surgery is the standard of care for non-small cell lung cancer (NSCLC). The overall survival rates especially in patients with locally advanced lung cancer are low. The resistance of cancer cells to chemotherapeutic drugs reduces the efficacy of treatment. Special attention is paid to the feasibility of assessing the tumor sensitivity to certain chemotherapy drugs. Currently, the most studied predictors are monoresistance and multidrug resistance genes, such as ABCC5, RRM1, ERCC1, BRCA1, TOP1, TOP2a, TUBB3 and TYMS.The aim of the study was to analyze the outcomes of combined modality treatment using radical surgery and personalized adjuvant chemotherapy for stage IIβIII NSCLC.Material and Methods. The study included 120 patients with stage IIβIII NSCLC, who underwent radical lung resection with mediastinal ipsilateral lymph node dissection. The patients were then divided into two groups. The main group consisted of 60 patients who received personalized platinum-based adjuvant chemotherapy based on the expression levels of the genes, such as ABCC5, RRM1, ERCC1, BRCA1, TOP1, TOP2a, TUBB3 and TYMS. The control group consisted of 60 patients who received postoperative chemotherapy empirically.Results. In the main group, disease progression occurred in 14 out of 60 patients, three-year disease-free survival (DFS) was 76.7 % (the median was not reached). In the control group, DFS was 53.3 % (28 out of 60 patients), the median was 31.0 (4β36 months); the differences were statistically significant: Logrank test Ο2 =4.382 p=0.036. The overall threeβyear survival rate was 90.0 % in the main group (6/60 patients died) and 61.7 % in the control group (23/60 patients died), the differences were statistically signifcant: Logrank test Ο2 =6.915, p=0.009.Conclusion. The personalized adjuvant chemotherapy resulted in the improved three-year relapse-free and overall survival rates in NSCLC patients.ΠΡΠ½ΠΎΠ²Π½ΡΠΌ ΠΌΠ΅ΡΠΎΠ΄ΠΎΠΌ Π»Π΅ΡΠ΅Π½ΠΈΡ Π½Π΅ΠΌΠ΅Π»ΠΊΠΎΠΊΠ»Π΅ΡΠΎΡΠ½ΠΎΠ³ΠΎ ΡΠ°ΠΊΠ° Π»Π΅Π³ΠΊΠΎΠ³ΠΎ (ΠΠΠ Π) ΡΠ²Π»ΡΠ΅ΡΡΡ Ρ
ΠΈΡΡΡΠ³ΠΈΡΠ΅ΡΠΊΠΈΠΉ, ΠΏΡΠΈ ΡΡΠΎΠΌ ΠΏΠΎΠΊΠ°Π·Π°ΡΠ΅Π»ΠΈ ΠΎΠ±ΡΠ΅ΠΉ Π²ΡΠΆΠΈΠ²Π°Π΅ΠΌΠΎΡΡΠΈ, ΠΎΡΠΎΠ±Π΅Π½Π½ΠΎ ΠΏΡΠΈ ΠΌΠ΅ΡΡΠ½ΠΎΡΠ°ΡΠΏΡΠΎΡΡΡΠ°Π½Π΅Π½Π½ΠΎΠΌ ΠΏΡΠΎΡΠ΅ΡΡΠ΅, Π½ΠΈΠ·ΠΊΠΈΠ΅. Π₯ΠΈΠΌΠΈΠΎΡΠ΅Π·ΠΈΡΡΠ΅Π½ΡΠ½ΠΎΡΡΡ ΠΎΠΏΡΡ
ΠΎΠ»ΠΈ ΠΎΠΏΡΠ΅Π΄Π΅Π»ΡΠ΅Ρ Π½ΠΈΠ·ΠΊΡΡ ΡΡΡΠ΅ΠΊΡΠΈΠ²Π½ΠΎΡΡΡ ΠΏΡΠΎΠ²ΠΎΠ΄ΠΈΠΌΠΎΠ³ΠΎ Π°Π΄ΡΡΠ²Π°Π½ΡΠ½ΠΎΠ³ΠΎ Π»Π΅ΠΊΠ°ΡΡΡΠ²Π΅Π½Π½ΠΎΠ³ΠΎ Π»Π΅ΡΠ΅Π½ΠΈΡ. ΠΡΠΎΠ±ΠΎΠ΅ Π²Π½ΠΈΠΌΠ°Π½ΠΈΠ΅ ΠΈΡΡΠ»Π΅Π΄ΠΎΠ²Π°ΡΠ΅Π»Π΅ΠΉ ΠΏΡΠΈΠ²Π»Π΅ΠΊΠ°Π΅Ρ Π²ΠΎΠ·ΠΌΠΎΠΆΠ½ΠΎΡΡΡ ΠΎΡΠ΅Π½ΠΊΠΈ ΡΡΠ²ΡΡΠ²ΠΈΡΠ΅Π»ΡΠ½ΠΎΡΡΠΈ ΠΎΠΏΡΡ
ΠΎΠ»ΠΈ ΠΊ ΠΎΠΏΡΠ΅Π΄Π΅Π»Π΅Π½Π½ΡΠΌ Ρ
ΠΈΠΌΠΈΠΎΠΏΡΠ΅ΠΏΠ°ΡΠ°ΡΠ°ΠΌ. ΠΠ°ΠΈΠ±ΠΎΠ»Π΅Π΅ ΠΈΠ·ΡΡΠ΅Π½Π½ΡΠΌΠΈ ΠΏΡΠ΅Π΄ΠΈΠΊΡΠΎΡΠ°ΠΌΠΈ Π² Π½Π°ΡΡΠΎΡΡΠ΅Π΅ Π²ΡΠ΅ΠΌΡ ΡΠ²Π»ΡΡΡΡΡ ΡΠ°ΠΊΠΈΠ΅ Π³Π΅Π½Ρ ΠΌΠΎΠ½ΠΎΡΠ΅Π·ΠΈΡΡΠ΅Π½ΡΠ½ΠΎΡΡΠΈ ΠΈ ΠΌΠ½ΠΎΠΆΠ΅ΡΡΠ²Π΅Π½Π½ΠΎΠΉ Π»Π΅ΠΊΠ°ΡΡΡΠ²Π΅Π½Π½ΠΎΠΉ ΡΡΡΠΎΠΉΡΠΈΠ²ΠΎΡΡΠΈ, ΠΊΠ°ΠΊ ΠΠΠ‘Π‘5, RRM1, ERCC1, BRCA1, TOP1, TOP2Ξ±, TUBB3 ΠΈ TYMS. Π¦Π΅Π»Ρ ΠΈΡΡΠ»Π΅Π΄ΠΎΠ²Π°Π½ΠΈΡ β ΠΈΠ·ΡΡΠΈΡΡ ΡΠ΅Π·ΡΠ»ΡΡΠ°ΡΡ ΠΊΠΎΠΌΠ±ΠΈΠ½ΠΈΡΠΎΠ²Π°Π½Π½ΠΎΠ³ΠΎ Π»Π΅ΡΠ΅Π½ΠΈΡ Π½Π΅ΠΌΠ΅Π»ΠΊΠΎΠΊΠ»Π΅ΡΠΎΡΠ½ΠΎΠ³ΠΎ ΡΠ°ΠΊΠ° Π»Π΅Π³ΠΊΠΎΠ³ΠΎ IIβIII ΡΡΠ°Π΄ΠΈΠΈ Ρ ΠΈΡΠΏΠΎΠ»ΡΠ·ΠΎΠ²Π°Π½ΠΈΠ΅ΠΌ ΡΠ°Π΄ΠΈΠΊΠ°Π»ΡΠ½ΠΎΠ³ΠΎ Ρ
ΠΈΡΡΡΠ³ΠΈΡΠ΅ΡΠΊΠΎΠ³ΠΎ Π²ΠΌΠ΅ΡΠ°ΡΠ΅Π»ΡΡΡΠ²Π° ΠΈ ΠΏΠ΅ΡΡΠΎΠ½Π°Π»ΠΈΠ·ΠΈΡΠΎΠ²Π°Π½Π½ΠΎΠΉ Π°Π΄ΡΡΠ²Π°Π½ΡΠ½ΠΎΠΉ Ρ
ΠΈΠΌΠΈΠΎΡΠ΅ΡΠ°ΠΏΠΈΠΈ.ΠΠ°ΡΠ΅ΡΠΈΠ°Π» ΠΈ ΠΌΠ΅ΡΠΎΠ΄Ρ. Π ΠΈΡΡΠ»Π΅Π΄ΠΎΠ²Π°Π½ΠΈΠ΅ Π²ΠΊΠ»ΡΡΠ΅Π½Ρ 120 Π±ΠΎΠ»ΡΠ½ΡΡ
Ρ Π½Π΅ΠΌΠ΅Π»ΠΊΠΎΠΊΠ»Π΅ΡΠΎΡΠ½ΡΠΌ ΡΠ°ΠΊΠΎΠΌ Π»Π΅Π³ΠΊΠΎΠ³ΠΎ IIβIII ΡΡΠ°Π΄ΠΈΠΈ, ΠΊΠΎΡΠΎΡΡΠΌ Π½Π° ΠΏΠ΅ΡΠ²ΠΎΠΌ ΡΡΠ°ΠΏΠ΅ ΠΊΠΎΠΌΠ±ΠΈΠ½ΠΈΡΠΎΠ²Π°Π½Π½ΠΎΠ³ΠΎ Π»Π΅ΡΠ΅Π½ΠΈΡ ΠΏΡΠΎΠ²ΠΎΠ΄ΠΈΠ»ΠΎΡΡ Ρ
ΠΈΡΡΡΠ³ΠΈΡΠ΅ΡΠΊΠΎΠ΅ Π»Π΅ΡΠ΅Π½ΠΈΠ΅, Π²ΠΊΠ»ΡΡΠ°ΡΡΠ΅Π΅ ΡΠ°Π΄ΠΈΠΊΠ°Π»ΡΠ½ΡΡ ΡΠ΅Π·Π΅ΠΊΡΠΈΡ Π»Π΅Π³ΠΊΠΎΠ³ΠΎ Π² ΠΎΠ±ΡΠ΅ΠΌΠ΅ Π»ΠΎΠ±-, Π±ΠΈΠ»ΠΎΠ±- ΠΈΠ»ΠΈ ΠΏΡΠ»ΡΠΌΠΎΠ½ΡΠΊΡΠΎΠΌΠΈΠΈ Ρ ΠΌΠ΅Π΄ΠΈΠ°ΡΡΠΈΠ½Π°Π»ΡΠ½ΠΎΠΉ ΠΈΠΏΡΠΈΠ»Π°ΡΠ΅ΡΠ°Π»ΡΠ½ΠΎΠΉ Π»ΠΈΠΌΡΠΎΠ΄ΠΈΡΡΠ΅ΠΊΡΠΈΠ΅ΠΉ. ΠΠ°Π»Π΅Π΅ Π±ΠΎΠ»ΡΠ½ΡΠ΅ Π±ΡΠ»ΠΈ ΡΠ°ΡΠΏΡΠ΅Π΄Π΅Π»Π΅Π½Ρ Π½Π° Π΄Π²Π΅ Π³ΡΡΠΏΠΏΡ. ΠΡΠ½ΠΎΠ²Π½ΡΡ Π³ΡΡΠΏΠΏΡ ΡΠΎΡΡΠ°Π²ΠΈΠ»ΠΈ 60 ΠΏΠ°ΡΠΈΠ΅Π½ΡΠΎΠ², ΠΊΠΎΡΠΎΡΡΠΌ ΠΏΠΎΡΠ»Π΅ ΠΎΠΏΠ΅ΡΠ°ΡΠΈΠΈ ΠΏΡΠΎΠ²Π΅Π΄Π΅Π½Ρ ΠΊΡΡΡΡ ΠΏΠ΅ΡΡΠΎΠ½Π°Π»ΠΈΠ·ΠΈΡΠΎΠ²Π°Π½Π½ΠΎΠΉ Π°Π΄ΡΡΠ²Π°Π½ΡΠ½ΠΎΠΉ Ρ
ΠΈΠΌΠΈΠΎΡΠ΅ΡΠ°ΠΏΠΈΠΈ, Π½Π°Π·Π½Π°ΡΠ΅Π½Π½ΠΎΠΉ Π½Π° ΠΎΡΠ½ΠΎΠ²Π°Π½ΠΈΠΈ ΡΡΠΎΠ²Π½Π΅ΠΉ ΡΠΊΡΠΏΡΠ΅ΡΡΠΈΠΈ Π³Π΅Π½ΠΎΠ² ΠΠΠ‘Π‘5, RRM1, ERCC1, BRCA1, TOP1, TOP2Ξ±, TUBB3 ΠΈ TYMS Π² Π²ΠΈΠ΄Π΅ ΠΏΠ»Π°ΡΠΈΠ½ΠΎΡΠΎΠ΄Π΅ΡΠΆΠ°ΡΠΈΡ
Π΄ΡΠ±Π»Π΅ΡΠΎΠ². ΠΠΎΠ½ΡΡΠΎΠ»ΡΠ½ΡΡ Π³ΡΡΠΏΠΏΡ ΡΠΎΡΡΠ°Π²ΠΈΠ»ΠΈ 60 ΠΏΠ°ΡΠΈΠ΅Π½ΡΠΎΠ², ΠΊΠΎΡΠΎΡΡΠΌ ΠΏΠΎΡΠ»Π΅ΠΎΠΏΠ΅ΡΠ°ΡΠΈΠΎΠ½Π½Π°Ρ Ρ
ΠΈΠΌΠΈΠΎΡΠ΅ΡΠ°ΠΏΠΈΡ Π½Π°Π·Π½Π°ΡΠ°Π»Π°ΡΡ ΡΠΌΠΏΠΈΡΠΈΡΠ΅ΡΠΊΠΈ.Π Π΅Π·ΡΠ»ΡΡΠ°ΡΡ. Π ΠΎΡΠ½ΠΎΠ²Π½ΠΎΠΉ Π³ΡΡΠΏΠΏΠ΅ ΠΏΡΠΎΠ³ΡΠ΅ΡΡΠΈΡΠΎΠ²Π°Π½ΠΈΠ΅ Π·Π°Π±ΠΎΠ»Π΅Π²Π°Π½ΠΈΡ Π·Π°ΡΠΈΠΊΡΠΈΡΠΎΠ²Π°Π½ΠΎ Ρ 14 ΠΈΠ· 60 ΠΏΠ°ΡΠΈΠ΅Π½ΡΠΎΠ², ΡΡΠ΅Ρ
Π»Π΅ΡΠ½ΡΡ Π±Π΅Π·ΡΠ΅ΡΠΈΠ΄ΠΈΠ²Π½Π°Ρ Π²ΡΠΆΠΈΠ²Π°Π΅ΠΌΠΎΡΡΡ (ΠΠ Π) β 76,7 % (ΠΌΠ΅Π΄ΠΈΠ°Π½Π° Π½Π΅ Π΄ΠΎΡΡΠΈΠ³Π½ΡΡΠ°). Π Π³ΡΡΠΏΠΏΠ΅ ΠΊΠΎΠ½ΡΡΠΎΠ»Ρ ΠΠ Π ΡΠΎΡΡΠ°Π²ΠΈΠ»Π° 53,3 % (28 ΠΈΠ· 60 ΠΏΠ°ΡΠΈΠ΅Π½ΡΠΎΠ²), ΠΌΠ΅Π΄ΠΈΠ°Π½Π° ΡΠΎΡΡΠ°Π²ΠΈΠ»Π° 31,0 ΠΌΠ΅Ρ (ΠΎΡ 4 Π΄ΠΎ 36 ΠΌΠ΅Ρ); ΡΠ°Π·Π»ΠΈΡΠΈΡ ΡΡΠ°ΡΠΈΡΡΠΈΡΠ΅ΡΠΊΠΈ Π·Π½Π°ΡΠΈΠΌΡ: Logrank test Ο2 =4,382 Ρ=0,036. ΠΠ±ΡΠ°Ρ 3-Π»Π΅ΡΠ½ΡΡ Π²ΡΠΆΠΈΠ²Π°Π΅ΠΌΠΎΡΡΡ Π² ΠΎΡΠ½ΠΎΠ²Π½ΠΎΠΉ Π³ΡΡΠΏΠΏΠ΅ ΡΠΎΡΡΠ°Π²ΠΈΠ»Π° 90,0 % (ΡΠΌΠ΅ΡΠ»ΠΎ 6/60 ΠΏΠ°ΡΠΈΠ΅Π½ΡΠΎΠ²), Π² Π³ΡΡΠΏΠΏΠ΅ ΠΊΠΎΠ½ΡΡΠΎΠ»Ρ β 61,7 % (ΡΠΌΠ΅ΡΠ»ΠΎ 23/60 ΠΏΠ°ΡΠΈΠ΅Π½ΡΠΎΠ²), ΡΠ°Π·Π»ΠΈΡΠΈΡ ΡΡΠ°ΡΠΈΡΡΠΈΡΠ΅ΡΠΊΠΈ Π·Π½Π°ΡΠΈΠΌΡ: Logrank test Ο2 =6,915, Ρ=0,009.ΠΠ°ΠΊΠ»ΡΡΠ΅Π½ΠΈΠ΅. Π Π°Π·ΡΠ°Π±ΠΎΡΠ°Π½Π½Π°Ρ ΠΏΡΠΎΠ³ΡΠ°ΠΌΠΌΠ° ΠΊΠΎΠΌΠ±ΠΈΠ½ΠΈΡΠΎΠ²Π°Π½Π½ΠΎΠ³ΠΎ Π»Π΅ΡΠ΅Π½ΠΈΡ ΠΠΠ Π Ρ ΠΏΠ΅ΡΡΠΎΠ½Π°Π»ΠΈΠ·ΠΈΡΠΎΠ²Π°Π½Π½ΡΠΌ Π½Π°Π·Π½Π°ΡΠ΅Π½ΠΈΠ΅ΠΌ ΠΏΠΎΡΠ»Π΅ΠΎΠΏΠ΅ΡΠ°ΡΠΈΠΎΠ½Π½ΠΎΠΉ Ρ
ΠΈΠΌΠΈΠΎΡΠ΅ΡΠ°ΠΏΠΈΠΈ ΠΏΠΎΠ·Π²ΠΎΠ»ΡΠ΅Ρ Π΄ΠΎΠ±ΠΈΡΡΡΡ ΡΠ»ΡΡΡΠ΅Π½ΠΈΡ ΠΏΠΎΠΊΠ°Π·Π°ΡΠ΅Π»Π΅ΠΉ 3-Π»Π΅ΡΠ½Π΅ΠΉ Π±Π΅Π·ΡΠ΅ΡΠΈΠ΄ΠΈΠ²Π½ΠΎΠΉ ΠΈ ΠΎΠ±ΡΠ΅ΠΉ Π²ΡΠΆΠΈΠ²Π°Π΅ΠΌΠΎΡΡΠΈ
THE INFLAMMATORY STATUS AND LYMPH NODE METASTASES IN NON-SMALL CELL LUNG CANCER
Introduction. The development of inflammation is characterized by changes in blood hematology parameters and indices. Various inflammatory parameters are used to assess the inflammatory status (IS) during cancer treatment. Recent studies have revealed a relationship between tumor progression and the presence of chronic inflammation. Consequently, there have been many attempts to predict the risk of tumor recurrence and distant metastases, as well as patientβs survival assessing the various inflammatory markers. The relationship between IS parameters and lymph node metastasis remains poorly understood in non-small cell lung cancer (NSCLC).Material and Methods. The prospective study included 35 patients with NSCLC (T1β4N0β2M0). Seventeen patients received 2β3 cycles of neoadjuvant chemotherapy (NAC). A leukocyte formula was determined in the peripheral blood and inflammatory indices, such as neutrophils to lymphocytes ratio (NLR), platelets to lymphocytes ratio (PLR), lymphocytes to monocytes ratio (LMR) and systemic immuno-inflammatory index (SII) were calculated. In addition, the concentrations of fibrinogen, C-reactive protein (CRP) and cortisol were evaluated.Results. NAC alone did not significantly change the parameters of patientsβ IS. Lymph node metastases were associated with changes in parameters indicating the enhanced IS. In the group of patients who did not receive NAC, lymph node metastasis was associated with fibrinogen blood levels (cut-off value 5.35 g/L), PLR index value (cut-off value 7.18) and cortisol blood concentration (cut-off value 414 nmol/mL). The confidence level was Ο2 =10.118; Ρ=0.018. In the group of patients who received NAC, lymph node metastasis was associated with the leukocyte count (cut-off value 7.1Γ109 /L), PLR index value (cut-off value is 7.18) and CRP blood concentration (cut-off value is 8.5 mg/L). The confidence level was Ο2 =8.193; Ρ=0.042.Conclusion. Risk of lymph node metastasis in NSCLC is associated with IS. Parameters of IS can be used to predict the risk of lymph node metastases