257 research outputs found
MAS-MoM Hybrid Method with Wire\u27s Image using in Excitation Problems
An important class of problems is the interaction of an antenna with the cavity of a semi-open metallic structure. In a working environment, an antenna may change its performance due to interactions with its surroundings. This is especially true in automotive applications. Therefore, it is important to consider the interaction of an antenna with possible resonating parts, and to solve these complex electrodynamics problems together. The development of methods for modeling and studying electromagnetic compatibility (EMC) problems has practical value. The method of auxiliary sources (MAS) with the method of moments (MoM) is applied to solve the excitation problem where a wire, with voltage source excitation, is connected to an open metallic surface. For verification of the proposed algorithm, an experimental structure was built and measured. Computer modeling results and the experimental results are in good agreement. Some aspects and principles are described, which provide hybridization of MAS and MoM. Image of objects is effectively applied for the solution of the particular problem
The Method of Auxiliary Sources as an Efficient Numerical Technique for Large 3D Semi Open Structures
The method of auxiliary sources (MAS) has been demonstrated as suitable for solution of diffraction and inverse problems in complex 2D large objects. Based on MAS numerical study of 3D RCS, EMC/EMI and SAR problems, related to the EM field resonance enhancement inside vehicles and the interaction of the cellular telephone radiation with the user\u27\u27s head are given in other work. The objective of this paper is to present details of MAS application to the wide 3D electrodynamic problems. The area of its efficient application, some features and advantages to achieving efficient solutions, are discussed. The extension of the MAS for semi-open structures with partitions is also presented
Electromagnetic Analysis for Vehicle Antenna Development Using Method of Auxiliary Sources
In paper [l] the electromagnetic analysis of large semi-open structures like vehicles was presented formulated as scattering problem, illuminated by a wide range of incident EM fields. The effect of resonances within the semi-open structure on the RCS, near fields and pattem of reradiated fields had been shown. In this paper the interaction of the entire semi-open structure on the performance of an antenna is considered together with the investigation of near field distributions inside the cavity. The Method of Auxiliary Sources (MAS) [2] is utilized. For a simple geometry the results are compared to measurements
Circulating Concentrations of Vitamin B6 and Kidney Cancer Prognosis: A Prospective Case-Cohort Study
Prospective cohort studies have found that prediagnostic circulating vitamin B6 is inversely associated with both risk of kidney cancer and kidney cancer prognosis. We investigated whether circulating concentrations of vitamin B6 at kidney cancer diagnosis are associated with risk of death using a case-cohort study of 630 renal cell carcinoma (RCC) patients. Blood was collected at the time of diagnosis, and vitamin B6 concentrations were quantified using LC-MS/MS. Hazard ratios (HR) and 95% confidence intervals (CI) were calculated using Cox regression models. After adjusting for stage, age, and sex, the hazard was 3 times lower among those in the highest compared to the lowest fourth of B6 concentration (HR4vs1 0.33, 95% CI [0.18, 0.60]). This inverse association was solely driven by death from RCC (HR4vs1 0.22, 95% CI [0.11, 0.46]), and not death from other causes (HR4vs1 0.89, 95% CI [0.35, 2.28], p-interaction = 0.008). These results suggest that circulating vitamin B6 could provide additional prognostic information for kidney cancer patients beyond that afforded by tumour stage
ΠΠ·Π°ΠΈΠΌΠΎΠ΄Π΅ΠΉΡΡΠ²ΠΈΠ΅ ΡΠ°ΠΊΡΠΎΡΠΎΠ² ΠΎΠΊΡΡΠΆΠ°ΡΡΠ΅ΠΉ ΡΡΠ΅Π΄Ρ ΠΈ Π³Π΅Π½Π΅ΡΠΈΡΠ΅ΡΠΊΠΎΠ³ΠΎ ΠΏΠΎΠ»ΠΈΠΌΠΎΡΡΠΈΠ·ΠΌΠ° Π² ΡΡΠΈΠΎΠ»ΠΎΠ³ΠΈΠΈ Π·Π»ΠΎΠΊΠ°ΡΠ΅ΡΡΠ²Π΅Π½Π½ΡΡ ΠΎΠΏΡΡ ΠΎΠ»Π΅ΠΉ
Πnvironmental and lifestyle factors play a dominant role in etiology of cancer. In addition, genetic factors significantly influence interindividualΒ variation in cancer incidence. The epidemiological studies in which effects of genetic polymorphism on the risk of cancer have beenΒ elucidated are somewhat disappointing. An important problem of these studies is their size. Moreover some of them do not have informationΒ on life-style and environmental exposures.Β The epidemiological method used to investigate the effect of genetic polymorphism on cancer risk is a retrospective case-control study.Β The chance of discovery of the specific Β«frequentΒ» allelic variant which is associated with small increase in the risk is higher in studies includingΒ large numbers of cases and controls.Β This paper reviews the epidemiologic studies conducted in Department of epidemiology (Institute of carcinogenesis, Russian N. N. BlokhinΒ Cancer Research Centre) in cooperation with countries of Central and Eastern Europe (Hungary, Poland, Romania, Slovakia) and coordinated byΒ the International Agency for Research on Cancer (IARC). We will cover the studies, in which an attempt has been made to investigate the interactionΒ between polymorphisms of phase 2 xenobiotic metabolism genes (GST), alcohol and aldehyde-metabolizing genes (ADH, ALDH), folate metabolismΒ genes (MTHFR, TYMS) and CHECK2 with environmental and life-style factors in etiology of cancers of the lung, kidney and upper aerodigestive tract.Β The analyses of these studies suggest that genetic polymorphism modifies the effect of environmental exposures (including occupational carcinogens)Β and life-style factors (including tobacco, alcohol and diet) on the risk of cancer. The risk of cancer associated with known carcinogenicΒ exposure may increase or decrease depending on the genotype. Interaction between exposure to carcinogenic factor and genotypeΒ is a major and significant determinant of cancer risk. Spontaneous tumors develop as a result of a combined effect of environmental factorsΒ and genetic polymorphism or endogenous and exogenous factors.ΠΠΎΠΌΠΈΠ½ΠΈΡΡΡΡΡΡ ΡΠΎΠ»Ρ Π² ΡΡΠΈΠΎΠ»ΠΎΠ³ΠΈΠΈ Π·Π»ΠΎΠΊΠ°ΡΠ΅ΡΡΠ²Π΅Π½Π½ΡΡ
ΠΎΠΏΡΡ
ΠΎΠ»Π΅ΠΉ ΠΈΠ³ΡΠ°ΡΡ ΡΠ°ΠΊΡΠΎΡΡ ΠΎΠΊΡΡΠΆΠ°ΡΡΠ΅ΠΉ ΡΡΠ΅Π΄Ρ ΠΈ ΠΎΠ±ΡΠ°Π·Π° ΠΆΠΈΠ·Π½ΠΈ ΡΠ΅Π»ΠΎΠ²Π΅ΠΊΠ°. Π ΡΠΎΒ ΠΆΠ΅ Π²ΡΠ΅ΠΌΡ ΠΈΠ½Π΄ΠΈΠ²ΠΈΠ΄ΡΠ°Π»ΡΠ½ΡΠΉ ΡΠΈΡΠΊ ΡΠ°Π·Π²ΠΈΡΠΈΡ ΡΠ°ΠΊΠ° ΠΎΠΏΡΠ΅Π΄Π΅Π»ΡΠ΅ΡΡΡ Π³Π΅Π½Π΅ΡΠΈΡΠ΅ΡΠΊΠΎΠΉ ΠΏΡΠ΅Π΄ΡΠ°ΡΠΏΠΎΠ»ΠΎΠΆΠ΅Π½Π½ΠΎΡΡΡΡ.Β ΠΠΎΠΏΡΠΎΡΡ Π²Π»ΠΈΡΠ½ΠΈΡ Π³Π΅Π½Π΅ΡΠΈΡΠ΅ΡΠΊΠΎΠ³ΠΎ ΠΏΠΎΠ»ΠΈΠΌΠΎΡΡΠΈΠ·ΠΌΠ° Π½Π° ΡΠΈΡΠΊ ΡΠ°Π·Π²ΠΈΡΠΈΡ ΠΎΠΏΡΡ
ΠΎΠ»Π΅ΠΉ ΠΏΠΎΡΠ²ΡΡΠ΅Π½ΠΎ ΠΌΠ½ΠΎΠΆΠ΅ΡΡΠ²ΠΎ ΡΠ°Π±ΠΎΡ. ΠΠ΄Π½Π°ΠΊΠΎ ΠΈΡ
ΡΠ΅Π·ΡΠ»ΡΡΠ°ΡΡΒ ΡΠ°Π·ΠΎΡΠ°ΡΠΎΠ²ΡΠ²Π°ΡΡ. ΠΠ»Π°Π²Π½ΠΎΠΉ ΠΏΡΠΎΠ±Π»Π΅ΠΌΠΎΠΉ ΡΡΠΈΡ
ΠΈΡΡΠ»Π΅Π΄ΠΎΠ²Π°Π½ΠΈΠΉ ΡΠ²Π»ΡΠ΅ΡΡΡ Π½Π΅Π±ΠΎΠ»ΡΡΠΎΠ΅ ΠΊΠΎΠ»ΠΈΡΠ΅ΡΡΠ²ΠΎ Π½Π°Π±Π»ΡΠ΄Π΅Π½ΠΈ. ΠΡΠΎΠΌΠ΅ ΡΠΎΠ³ΠΎ, Π²ΠΎ ΠΌΠ½ΠΎΠ³ΠΈΡ
ΡΠ°Π±ΠΎΡΠ°Ρ
Π½Π΅ ΡΡΠΈΡΡΠ²Π°Π»Π°ΡΡ ΠΈΠ½ΡΠΎΡΠΌΠ°ΡΠΈΡ ΠΎ ΡΠ°ΠΊΡΠΎΡΠ°Ρ
ΠΎΠΊΡΡΠΆΠ°ΡΡΠ΅ΠΉ ΡΡΠ΅Π΄Ρ ΠΈ ΠΎΠ±ΡΠ°Π·Π° ΠΆΠΈΠ·Π½ΠΈ ΠΏΡΠΎΠ±Π°Π½Π΄ΠΎΠ².Β ΠΠ΅ΡΠΎΠ΄ ΡΠ»ΡΡΠ°ΠΉβΠΊΠΎΠ½ΡΡΠΎΠ»Ρ β ΠΎΡΠ½ΠΎΠ²Π½ΠΎΠΉ ΡΠΏΠΈΠ΄Π΅ΠΌΠΈΠΎΠ»ΠΎΠ³ΠΈΡΠ΅ΡΠΊΠΈΠΉ ΠΌΠ΅ΡΠΎΠ΄ ΠΈΠ·ΡΡΠ΅Π½ΠΈΡ Π³Π΅Π½Π΅ΡΠΈΡΠ΅ΡΠΊΠΈΡ
Π²Π°ΡΠΈΠ°Π½ΡΠΎΠ², Π²Π»ΠΈΡΡΡΠΈΡ
Π½Π° ΡΠΈΡΠΊ ΡΠ°Π·Π²ΠΈΡΠΈΡΒ ΡΠ°ΠΊΠ°. ΠΠ»Ρ Π²ΡΡΠ²Π»Π΅Π½ΠΈΡ ΡΠ°ΡΡΠΎ Π²ΡΡΡΠ΅ΡΠ°ΡΡΠΈΡ
ΡΡ Π²Π°ΡΠΈΠ°Π½ΡΠΎΠ², Π²Π»ΠΈΡΠ½ΠΈΠ΅ ΠΊΠΎΡΠΎΡΡΡ
Π½Π° ΡΠΈΡΠΊ Π½Π΅Π²Π΅Π»ΠΈΠΊΠΎ, Π½Π΅ΠΎΠ±Ρ
ΠΎΠ΄ΠΈΠΌΡ Π±ΠΎΠ»ΡΡΠΈΠ΅ Π²ΡΠ±ΠΎΡΠΊΠΈ Π±ΠΎΠ»ΡΠ½ΡΡ
Β ΠΈ ΠΊΠΎΠ½ΡΡΠΎΠ»ΡΠ½ΠΎΠΉ Π³ΡΡΠΏΠΏΡ. Π ΡΠ²ΡΠ·ΠΈ Ρ ΡΡΠΈΠΌ ΠΌΠ½ΠΎΠ³ΠΎΡΠ΅Π½ΡΡΠΎΠ²ΠΎΠ΅ ΠΈΡΡΠ»Π΅Π΄ΠΎΠ²Π°Π½ΠΈΠ΅ β ΠΏΡΠΈΠ½ΡΡΡΠΉ ΠΌΠ΅ΡΠΎΠ΄ Π² ΠΎΠ±Π»Π°ΡΡΠΈ ΠΌΠΎΠ»Π΅ΠΊΡΠ»ΡΡΠ½ΠΎΠΉ ΡΠΏΠΈΠ΄Π΅ΠΌΠΈΠΎΠ»ΠΎΠ³ΠΈΠΈ.Β Π Π½Π°ΡΡΠΎΡΡΠ΅ΠΌ ΠΎΠ±Π·ΠΎΡΠ΅ ΠΏΡΠ΅Π΄ΡΡΠ°Π²Π»Π΅Π½Ρ ΡΠ΅Π·ΡΠ»ΡΡΠ°ΡΡ ΠΌΠ½ΠΎΠ³ΠΎΡΠ΅Π½ΡΡΠΎΠ²ΡΡ
ΠΌΠΎΠ»Π΅ΠΊΡΠ»ΡΡΠ½ΠΎ-ΡΠΏΠΈΠ΄Π΅ΠΌΠΈΠΎΠ»ΠΎΠ³ΠΈΡΠ΅ΡΠΊΠΈΡ
ΠΈΡΡΠ»Π΅Π΄ΠΎΠ²Π°Π½ΠΈΠΉ, ΠΏΡΠΎΠ²Π΅Π΄Π΅Π½Π½ΡΡ
Π² ΠΎΡΠ΄Π΅Π»Π΅Π½ΠΈΠΈ ΡΠΏΠΈΠ΄Π΅ΠΌΠΈΠΎΠ»ΠΎΠ³ΠΈΠΈ ΠΠΠ ΠΊΠ°Π½ΡΠ΅ΡΠΎΠ³Π΅Π½Π΅Π·Π° Π ΠΠΠ¦ ΠΈΠΌ. Π. Π. ΠΠ»ΠΎΡ
ΠΈΠ½Π° ΡΠΎΠ²ΠΌΠ΅ΡΡΠ½ΠΎ Ρ ΠΊΠΎΠ»Π»Π΅Π³Π°ΠΌΠΈ ΠΈΠ· ΡΡΡΠ°Π½ Π¦Π΅Π½ΡΡΠ°Π»ΡΠ½ΠΎΠΉ ΠΈ ΠΠΎΡΡΠΎΡΠ½ΠΎΠΉ ΠΠ²ΡΠΎΠΏΡΒ (ΠΠ΅Π½Π³ΡΠΈΡ, ΠΠΎΠ»ΡΡΠ°, Π ΡΠΌΡΠ½ΠΈΡ, Π‘Π»ΠΎΠ²Π°ΠΊΠΈΡ). ΠΡΡΠ»Π΅Π΄ΠΎΠ²Π°Π½ΠΈΠ΅ ΠΊΠΎΠΎΡΠ΄ΠΈΠ½ΠΈΡΠΎΠ²Π°Π»ΠΎ ΠΠ΅ΠΆΠ΄ΡΠ½Π°ΡΠΎΠ΄Π½ΠΎΠ΅ Π°Π³Π΅Π½ΡΡΡΠ²ΠΎ ΠΏΠΎ ΠΈΠ·ΡΡΠ΅Π½ΠΈΡ ΡΠ°ΠΊΠ° (ΠΠΈΠΎΠ½, Π€ΡΠ°Π½ΡΠΈΡ).Β Π Π°Π±ΠΎΡΡ, Π²ΠΊΠ»ΡΡΠ΅Π½Π½ΡΠ΅ Π² ΠΎΠ±Π·ΠΎΡ, ΠΏΠΎΡΠ²ΡΡΠ΅Π½Ρ ΠΈΠ·ΡΡΠ΅Π½ΠΈΡ ΡΠΎΠ»ΠΈ ΠΏΠΎΠ»ΠΈΠΌΠΎΡΡΠΈΠ·ΠΌΠ° Π³Π΅Π½ΠΎΠ² II ΡΠ°Π·Ρ ΠΌΠ΅ΡΠ°Π±ΠΎΠ»ΠΈΠ·ΠΌΠ° ΠΊΡΠ΅Π½ΠΎΠ±ΠΈΠΎΡΠΈΠΊΠΎΠ² (GSTM1 ΠΈ GSTT1),Β Π°Π»ΠΊΠΎΠ³ΠΎΠ»ΡΠ΄Π΅Π³ΠΈΠ΄ΡΠΎΠ³Π΅Π½Π°Π·Ρ (ADH1Π ΠΈ ADH1C) ΠΈ Π°Π»ΡΠ΄Π΅Π³ΠΈΠ΄Π΄Π΅Π³ΠΈΠ΄ΡΠΎΠ³Π΅Π½Π°Π·Ρ (ALDH2), ΠΌΠ΅ΡΠ°Π±ΠΎΠ»ΠΈΠ·ΠΌΠ° ΡΠΎΠ»Π΅ΠΉ ΡΠΎΠ»ΠΈΠ΅Π²ΠΎΠΉ ΠΊΠΈΡΠ»ΠΎΡΡ β ΠΌΠ΅ΡΠΈΠ»Π΅Π½ΡΠ΅ΡΡΠ°Π³ΠΈΠ΄ΡΠΎΡΠΎΠ»Π°ΡΡΠ΅Π΄ΡΠΊΡΠ°Π·Ρ (MTHFR) ΠΈ ΡΠΈΠΌΠΈΠ΄ΠΈΠ»Π°ΡΡΠΈΠ½ΡΠ΅ΡΠ°Π·Ρ (TYMS) ΠΈ Π³Π΅Π½Π° CHECK2 Π² ΡΡΠΈΠΎΠ»ΠΎΠ³ΠΈΠΈ ΡΠ°ΠΊΠ° Π»Π΅Π³ΠΊΠΎΠ³ΠΎ, Π²Π΅ΡΡ
Π½ΠΈΡ
Π΄ΡΡ
Π°ΡΠ΅Π»ΡΠ½ΡΡ
ΠΈ ΠΏΠΈΡΠ΅Π²Π°ΡΠΈΡΠ΅Π»ΡΠ½ΡΡ
ΠΎΡΠ³Π°Π½ΠΎΠ² ΠΈ ΠΏΠΎΡΠΊΠΈ.Β ΠΠ½Π°Π»ΠΈΠ· ΠΏΡΠΎΠ²Π΅Π΄Π΅Π½Π½ΡΡ
ΠΈΡΡΠ»Π΅Π΄ΠΎΠ²Π°Π½ΠΈΠΉ ΠΏΠΎΠ·Π²ΠΎΠ»ΡΠ΅Ρ Π·Π°ΠΊΠ»ΡΡΠΈΡΡ, ΡΡΠΎ Π³Π΅Π½Π΅ΡΠΈΡΠ΅ΡΠΊΠΈΠΉ ΠΏΠΎΠ»ΠΈΠΌΠΎΡΡΠΈΠ·ΠΌ ΠΌΠΎΠ΄ΠΈΡΠΈΡΠΈΡΡΠ΅Ρ ΡΠΈΡΠΊ ΡΠ°Π·Π²ΠΈΡΠΈΡ ΡΠ°ΠΊΠ° Π² ΡΠ΅Π·ΡΠ»ΡΡΠ°ΡΠ΅Β ΡΠΊΡΠΏΠΎΠ·ΠΈΡΠΈΠΈ ΠΊ ΡΠΎΠΌΡ ΠΈΠ»ΠΈ ΠΈΠ½ΠΎΠΌΡ Π²Π½Π΅ΡΠ½Π΅ΠΌΡ ΡΠ°ΠΊΡΠΎΡΡ. ΠΠΎΠΊΠ°Π·Π°ΡΠ΅Π»Ρ P, ΠΊΠΎΡΠΎΡΡΠΉ Ρ
Π°ΡΠ°ΠΊΡΠ΅ΡΠΈΠ·ΡΠ΅Ρ Π²Π·Π°ΠΈΠΌΠΎΠ΄Π΅ΠΉΡΡΠ²ΠΈΠ΅ (ΠΈΠ½ΡΠ΅ΡΠ°ΠΊΡΠΈΡ) ΠΌΠ΅ΠΆΠ΄Ρ Π²Π»ΠΈΡΠ½ΠΈΠ΅ΠΌ ΡΠ°ΠΊΡΠΎΡΠ° ΠΎΠΊΡΡΠΆΠ°ΡΡΠ΅ΠΉ ΡΡΠ΅Π΄Ρ ΠΈ ΠΎΠΏΡΠ΅Π΄Π΅Π»Π΅Π½Π½ΡΠΌ Π³Π΅Π½ΠΎΡΠΈΠΏΠΎΠΌ ΠΈ ΡΠΈΡΠΊΠΎΠΌ ΡΠ°Π·Π²ΠΈΡΠΈΡ ΡΠ°ΠΊΠ°, ΡΠ°ΡΡΠΎ ΠΈΠΌΠ΅Π΅Ρ ΡΡΠ°ΡΠΈΡΡΠΈΡΠ΅ΡΠΊΠΈ Π΄ΠΎΡΡΠΎΠ²Π΅ΡΠ½ΠΎΠ΅ Π·Π½Π°ΡΠ΅Π½ΠΈΠ΅.Β Π’Π°ΠΊΠΈΠΌ ΠΎΠ±ΡΠ°Π·ΠΎΠΌ, Π±ΠΎΠ»ΡΡΠΈΠ½ΡΡΠ²ΠΎ ΡΠΏΠΎΠ½ΡΠ°Π½Π½ΡΡ
ΠΎΠΏΡΡ
ΠΎΠ»Π΅ΠΉ ΡΠ΅Π»ΠΎΠ²Π΅ΠΊΠ° ΡΠ°Π·Π²ΠΈΠ²Π°ΡΡΡΡ Π² ΡΠ΅Π·ΡΠ»ΡΡΠ°ΡΠ΅ Π²Π·Π°ΠΈΠΌΠΎΠ΄Π΅ΠΉΡΡΠ²ΠΈΡ Π³Π΅Π½Π΅ΡΠΈΡΠ΅ΡΠΊΠΎΠ³ΠΎ ΠΏΠΎΠ»ΠΈΠΌΠΎΡΡΠΈΠ·ΠΌΠ° ΠΈ Π²Π½Π΅ΡΠ½ΠΈΡ
ΡΠ°ΠΊΡΠΎΡΠΎΠ²
Π€ΠΠΠ’ΠΠ Π« Π ΠΠ‘ΠΠ ΠΠΠ§ΠΠ§ΠΠ-ΠΠΠΠ’ΠΠ§ΠΠΠΠ Π ΠΠΠ
Smoking, overweight, obesity, hypertension, occupational exposures to pesticides, specifically to trichloroethylene are considered causal risk factors for sporadic i.e. non-hereditary renal cell cancer (RCC). Some of these factors not only increase the risk of RCC but also affect the survival of patients. For example, in patients with RCC who continue smoking, the risk of dying from other causes is twice as high as in patient who quit smoking. The risk of second cancer is 5 times higher in patients who continue smoking 20 or more cigarettes per day than in non-smokers. The low penetrance polymorphism is an important factor in etiology of sporadic RCC, which contrary to high penetrance mutations is a common event. However, the risk associated with this type of inheritance is quite low. The majority of sporadic RCC have polygenic etiology. They develop as a result of combined effect of large number of low penetrance genetic susceptibility genes (genetic polymorphism). Environmental factors play a decisive role in causation of sporadic RCC. The interplay of exposures to environmental risk factors and genetic susceptibility of exposed individuals is believed to influence the risk of developing sporadic RCC. The studies in molecular epidemiology based on candidate gene approach have shown that polymorphisms of certain genes, for example glutathione-S-transferase family genes, are associated with RCC. The genome wide association studies identified about twenty loci with single nucleotide polymorphism (SNPs) affecting the risk of RCC. However the risk loci so far identified for RCC account for only about 10 % of the familial risk of RCC. The power of largest studies which include many thousands of observations allow to detect 80 % of the major common loci (with minor allele frequency β MAF>0.2) conferring risk β₯1.2. However, for detecting alleles with smaller effects and/or MAF<0.1, more studies with larger sample size are needed. By implication, variants with such profiles probably represent a much larger class of susceptibility loci for RCC and hence a large number of variants remain to be discovered. Future investigation of the genes targeted by the risk SNPs is likely to yield increased insight into biology of RCC and will lead to new approaches for prevention, early detection and treatment.ΠΠΎΠΊΠ°Π·Π°Π½Π½ΡΠΌΠΈ ΡΠ°ΠΊΡΠΎΡΠ°ΠΌΠΈ ΡΠΈΡΠΊΠ° ΡΠΏΠΎΠ½ΡΠ°Π½Π½ΠΎΠ³ΠΎ, Ρ.Π΅. Π½Π΅ Π½Π°ΡΠ»Π΅Π΄ΡΡΠ²Π΅Π½Π½ΠΎΠ³ΠΎ, ΠΏΠΎΡΠ΅ΡΠ½ΠΎ-ΠΊΠ»Π΅ΡΠΎΡΠ½ΠΎΠ³ΠΎ ΡΠ°ΠΊΠ° (ΠΠΠ ) ΡΠ²Π»ΡΡΡΡΡ ΠΊΡΡΠ΅Π½ΠΈΠ΅, ΠΈΠ·Π±ΡΡΠΎΡΠ½ΡΠΉ Π²Π΅Ρ, ΠΎΠΆΠΈΡΠ΅Π½ΠΈΠ΅, Π³ΠΈΠΏΠ΅ΡΡΠΎΠ½ΠΈΡ, Π½Π΅ΠΊΠΎΡΠΎΡΡΠ΅ ΠΏΡΠΎΡΠ΅ΡΡΠΈΠΎΠ½Π°Π»ΡΠ½ΡΠ΅ ΡΠ°ΠΊΡΠΎΡΡ, ΡΠΊΡΠΏΠΎΠ·ΠΈΡΠΈΡ ΠΊ ΠΏΠ΅ΡΡΠΈΡΠΈΠ΄Π°ΠΌ ΠΈ ΡΡΠΈΡ
Π»ΠΎΡΡΡΠΈΠ»Π΅Π½Ρ. Π€Π°ΠΊΡΠΎΡΡ ΠΎΠ±ΡΠ°Π·Π° ΠΆΠΈΠ·Π½ΠΈ, Π½Π°ΠΏΡΠΈΠΌΠ΅Ρ ΠΊΡΡΠ΅Π½ΠΈΠ΅, Π½Π΅ ΡΠΎΠ»ΡΠΊΠΎ ΠΏΠΎΠ²ΡΡΠ°ΡΡ ΡΠΈΡΠΊ ΡΠ°Π·Π²ΠΈΡΠΈΡ ΠΠΠ , Π½ΠΎ ΠΈ Π²Π»ΠΈΡΡΡ Π½Π° Π²ΡΠΆΠΈΠ²Π°Π΅ΠΌΠΎΡΡΡ Π±ΠΎΠ»ΡΠ½ΡΡ
Ρ ΡΡΠΈΠΌ Π·Π°Π±ΠΎΠ»Π΅Π²Π°Π½ΠΈΠ΅ΠΌ. Π’Π°ΠΊ, Π½Π°ΠΏΡΠΈΠΌΠ΅Ρ, ΡΠΈΡΠΊ ΡΠΌΠ΅ΡΡΠΈ ΠΎΡ Π½Π΅ΠΎΠ½ΠΊΠΎΠ»ΠΎΠ³ΠΈΡΠ΅ΡΠΊΠΈΡ
ΠΏΡΠΈΡΠΈΠ½ Ρ ΠΏΡΠΎΠ΄ΠΎΠ»ΠΆΠ°ΡΡΠΈΡ
ΠΊΡΡΠΈΡΡ Π±ΠΎΠ»ΡΠ½ΡΡ
ΠΠΠ Π² Π΄Π²Π° ΡΠ°Π·Π° Π²ΡΡΠ΅ ΠΏΠΎ ΡΡΠ°Π²Π½Π΅Π½ΠΈΡ Ρ Π½ΠΈΠΊΠΎΠ³Π΄Π° Π½Π΅ ΠΊΡΡΠΈΠ²ΡΠΈΠΌΠΈ Π±ΠΎΠ»ΡΠ½ΡΠΌΠΈ, a ΡΠΈΡΠΊ ΡΠ°Π·Π²ΠΈΡΠΈΡ Π²ΡΠΎΡΠΎΠΉ ΠΎΠΏΡΡ
ΠΎΠ»ΠΈ Ρ ΠΏΡΠΎΠ΄ΠΎΠ»ΠΆΠ°Π²ΡΠΈΡ
ΠΊΡΡΠΈΡΡ Π±ΠΎΠ»ΡΠ½ΡΡ
ΠΠΠ Π±ΠΎΠ»Π΅Π΅ 20 ΡΠΈΠ³Π°ΡΠ΅Ρ Π² Π΄Π΅Π½Ρ Π² 5 ΡΠ°Π· Π²ΡΡΠ΅, ΡΠ΅ΠΌ Ρ Π½Π΅ΠΊΡΡΡΡΠΈΡ
ΠΏΠ°ΡΠΈΠ΅Π½ΡΠΎΠ². Π ΡΡΠΈΠΎΠ»ΠΎΠ³ΠΈΠΈ ΡΠΏΠΎΠ½ΡΠ°Π½Π½ΠΎΠ³ΠΎ ΠΠΠ Π²Π°ΠΆΠ½ΡΡ ΡΠΎΠ»Ρ ΠΈΠ³ΡΠ°Π΅Ρ Π½ΠΈΠ·ΠΊΠΎΠΏΠ΅Π½Π΅ΡΡΠ°Π½ΡΠ½ΡΠΉ Π³Π΅Π½Π΅ΡΠΈΡΠ΅ΡΠΊΠΈΠΉ ΠΏΠΎΠ»ΠΈΠΌΠΎΡΡΠΈΠ·ΠΌ, ΠΊΠΎΡΠΎΡΡΠΉ Π² ΠΎΡΠ»ΠΈΡΠΈΠ΅ ΠΎΡ Π²ΡΡΠΎΠΊΠΎΠΏΠ΅Π½Π΅ΡΡΠ°Π½ΡΠ½ΡΡ
ΠΌΡΡΠ°ΡΠΈΠΉ Π²ΡΡΡΠ΅ΡΠ°Π΅ΡΡΡ Π΄ΠΎΠ²ΠΎΠ»ΡΠ½ΠΎ ΡΠ°ΡΡΠΎ. ΠΠ΄Π½Π°ΠΊΠΎ ΡΠΈΡΠΊ ΡΠ°Π·Π²ΠΈΡΠΈΡ ΡΠ°ΠΊΠ°, Π°ΡΡΠΎΡΠΈΠΈΡΠΎΠ²Π°Π½Π½ΡΠΉ Ρ ΡΡΠΈΠΌ ΡΠΈΠΏΠΎΠΌ Π½Π°ΡΠ»Π΅Π΄ΡΡΠ²Π΅Π½Π½ΠΎΡΡΠΈ, Π½Π΅Π²ΡΡΠΎΠΊ. Π’Π΅ΠΌ Π½Π΅ ΠΌΠ΅Π½Π΅Π΅ Π±ΠΎΠ»ΡΡΠΈΠ½ΡΡΠ²ΠΎ ΠΎΠΏΡΡ
ΠΎΠ»Π΅ΠΉ ΡΠ΅Π»ΠΎΠ²Π΅ΠΊΠ° ΡΠ°Π·Π²ΠΈΠ²Π°ΡΡΡΡ Π² ΡΠ΅Π·ΡΠ»ΡΡΠ°ΡΠ΅ ΠΊΠΎΠΌΠ±ΠΈΠ½ΠΈΡΠΎΠ²Π°Π½Π½ΠΎΠ³ΠΎ ΡΡΡΠ΅ΠΊΡΠ° Π±ΠΎΠ»ΡΡΠΎΠ³ΠΎ ΡΠΈΡΠ»Π° Π³Π΅Π½ΠΎΠ² Ρ Π½ΠΈΠ·ΠΊΠΎΠΉ ΠΏΠ΅Π½Π΅ΡΡΠ°ΡΠΈΠ΅ΠΉ, Ρ.Π΅. ΠΈΠΌΠ΅ΡΡ ΠΏΠΎΠ»ΠΈΠ³Π΅Π½Π½ΡΡ ΡΡΠΈΠΎΠ»ΠΎΠ³ΠΈΡ. Π ΡΡΠΈΠΎΠ»ΠΎΠ³ΠΈΠΈ ΡΡΠΈΡ
ΠΎΠΏΡΡ
ΠΎΠ»Π΅ΠΉ Π²Π°ΠΆΠ½ΡΡ ΡΠΎΠ»Ρ ΠΈΠ³ΡΠ°ΡΡ ΡΠΊΠ·ΠΎΠ³Π΅Π½Π½ΡΠ΅ ΡΠ°ΠΊΡΠΎΡΡ: ΠΈΠΌΠ΅Π΅Ρ ΠΌΠ΅ΡΡΠΎ Π²Π·Π°ΠΈΠΌΠΎΠ΄Π΅ΠΉΡΡΠ²ΠΈΠ΅ Π½Π°ΡΠ»Π΅Π΄ΡΡΠ²Π΅Π½Π½ΠΎΡΡΠΈ ΠΈ ΡΠ°ΠΊΡΠΎΡΠΎΠ² ΠΎΠ±ΡΠ°Π·Π° ΠΆΠΈΠ·Π½ΠΈ ΠΈ ΠΎΠΊΡΡΠΆΠ°ΡΡΠ΅ΠΉ ΡΡΠ΅Π΄Ρ. ΠΠΎΠ»Π΅ΠΊΡΠ»ΡΡΠ½ΠΎ-ΡΠΏΠΈΠ΄Π΅ΠΌΠΈΠΎΠ»ΠΎΠ³ΠΈΡΠ΅ΡΠΊΠΈΠ΅ ΠΈΡΡΠ»Π΅Π΄ΠΎΠ²Π°Π½ΠΈΡ, ΠΎΡΠ½ΠΎΠ²Π°Π½Π½ΡΠ΅ Π½Π° ΠΏΡΠ΅Π΄Π²Π°ΡΠΈΡΠ΅Π»ΡΠ½ΠΎΠΉ Π³ΠΈΠΏΠΎΡΠ΅Π·Π΅, ΠΏΠΎΠΊΠ°Π·Π°Π»ΠΈ, ΡΡΠΎ ΠΏΠΎΠ»ΠΈΠΌΠΎΡΡΠΈΠ·ΠΌ Π½Π΅ΠΊΠΎΡΠΎΡΡΡ
Π³Π΅Π½ΠΎΠ², Π½Π°ΠΏΡΠΈΠΌΠ΅Ρ ΡΠ΅ΠΌΠ΅ΠΉΡΡΠ²Π° Π³Π»ΡΡΠ°ΡΠΈΠΎΠ½-S-ΡΡΠ°Π½ΡΡΠ΅ΡΠ°Π·, Π²Π»ΠΈΡΠ΅Ρ Π½Π° ΡΠΈΡΠΊ ΠΠΠ . Π ΡΠ΅Π·ΡΠ»ΡΡΠ°ΡΠ΅ ΠΏΠΎΠ»Π½ΠΎΠ³Π΅Π½ΠΎΠΌΠ½ΡΡ
ΠΈΡΡΠ»Π΅Π΄ΠΎΠ²Π°Π½ΠΈΠΉ ΠΈΠ΄Π΅Π½ΡΠΈΡΠΈΡΠΈΡΠΎΠ²Π°Π½Ρ ΠΎΠΊΠΎΠ»ΠΎ 20 ΠΎΠ΄Π½ΠΎΠ½ΡΠΊΠ»Π΅ΠΎΡΠΈΠ΄Π½ΡΡ
ΠΏΠΎΠ»ΠΈΠΌΠΎΡΡΠΈΠ·ΠΌΠΎΠ² (ΠΠΠ) Π²ΡΡΠΎΠΊΠΎΠ³ΠΎ ΡΠΈΡΠΊΠ°, ΠΊΠΎΡΠΎΡΡΠ΅, Π²ΠΏΡΠΎΡΠ΅ΠΌ, ΠΎΠ±ΡΡΡΠ½ΡΡΡ Π»ΠΈΡΡ 10 % ΡΠΈΡΠΊΠ° ΡΠ΅ΠΌΠ΅ΠΉΠ½ΡΡ
ΡΠ»ΡΡΠ°Π΅Π² ΠΠΠ . Π Π°Π·ΠΌΠ΅Ρ ΡΠ°ΠΌΡΡ
ΠΊΡΡΠΏΠ½ΡΡ
ΠΈΡΡΠ»Π΅Π΄ΠΎΠ²Π°Π½ΠΈΠΉ, ΠΊΠΎΡΠΎΡΡΠ΅ Π²ΠΊΠ»ΡΡΠ°ΡΡ ΠΌΠ½ΠΎΠ³ΠΈΠ΅ ΡΡΡΡΡΠΈ Π½Π°Π±Π»ΡΠ΄Π΅Π½ΠΈΠΉ, ΠΏΠΎΠ·Π²ΠΎΠ»ΡΠ΅Ρ Π²ΡΡΠ²ΠΈΡΡ Π»ΠΈΡΡ 80 % ΠΎΡ ΠΎΡΠ½ΠΎΠ²Π½ΡΡ
, ΡΠ°ΡΡΠΎ Π²ΡΡΡΠ΅ΡΠ°ΡΡΠΈΡ
ΡΡ Π°Π»Π»Π΅Π»ΡΠ½ΡΡ
Π²Π°ΡΠΈΠ°Π½ΡΠΎΠ² (Ρ ΡΠ°ΡΡΠΎΡΠΎΠΉ ΠΌΠΈΠ½ΠΎΡΠ½ΡΡ
Π°Π»Π»Π΅Π»Π΅ΠΉ >0,2), ΠΊΠΎΡΠΎΡΡΠ΅ ΠΏΠΎΠ²ΡΡΠ°ΡΡ ΡΠΈΡΠΊ ΠΠΠ Π² 1,2 ΠΈ Π±ΠΎΠ»Π΅Π΅ ΡΠ°Π·. Π ΡΠΎ ΠΆΠ΅ Π²ΡΠ΅ΠΌΡ Π΄Π»Ρ Π²ΡΡΠ²Π»Π΅Π½ΠΈΡ ΠΏΠΎΠ»ΠΈΠΌΠΎΡΡΠ½ΡΡ
Π²Π°ΡΠΈΠ°Π½ΡΠΎΠ² Ρ ΠΌΠ΅Π½ΡΡΠΈΠΌ ΡΡΡΠ΅ΠΊΡΠΎΠΌ Π½Π° ΡΠΈΡΠΊ ΠΠΠ , Ρ ΡΠ°ΡΡΠΎΡΠΎΠΉ ΠΌΠΈΠ½ΠΎΡΠ½ΡΡ
Π°Π»Π»Π΅Π»Π΅ΠΉ <0,1, ΡΠ°Π·ΠΌΠ΅Ρ Π²ΡΠ±ΠΎΡΠΊΠΈ Π΄ΠΎΠ»ΠΆΠ΅Π½ Π±ΡΡΡ Π·Π½Π°ΡΠΈΡΠ΅Π»ΡΠ½ΠΎ Π±ΠΎΠ»ΡΡΠ΅. Π‘ΠΊΠΎΡΠ΅Π΅ Π²ΡΠ΅Π³ΠΎ, ΡΡΠΎΡ ΡΠΈΠΏ Π²Π°ΡΠΈΠ°Π½ΡΠΎΠ² ΡΠΎΠ΄Π΅ΡΠΆΠΈΡ Π±ΠΎΠ»ΡΡΠ΅ ΠΠΠ ΠΏΠΎΠ²ΡΡΠ΅Π½Π½ΠΎΠΉ ΠΏΡΠ΅Π΄ΡΠ°ΡΠΏΠΎΠ»ΠΎΠΆΠ΅Π½Π½ΠΎΡΡΠΈ ΠΊ ΡΠ°Π·Π²ΠΈΡΠΈΡ ΠΠΠ ΠΈ ΠΈΡ
ΠΏΡΠ΅Π΄ΡΡΠΎΠΈΡ ΠΎΡΠΊΡΡΡΡ. ΠΡΠ΄ΡΡΠΈΠ΅ ΠΈΡΡΠ»Π΅Π΄ΠΎΠ²Π°Π½ΠΈΡ, Π½Π°ΠΏΡΠ°Π²Π»Π΅Π½Π½ΡΠ΅ Π½Π° ΠΈΠ΄Π΅Π½ΡΠΈΡΠΈΠΊΠ°ΡΠΈΡ ΠΎΠ΄Π½ΠΎΠ½ΡΠΊΠ»Π΅ΠΎΡΠΈΠ΄Π½ΡΡ
ΠΏΠΎΠ»ΠΈΠΌΠΎΡΡΠΈΠ·ΠΌΠΎΠ² Π²ΡΡΠΎΠΊΠΎΠ³ΠΎ ΡΠΈΡΠΊΠ°, ΠΏΡΠΈΠ²Π΅Π΄ΡΡ ΠΊ Π»ΡΡΡΠ΅ΠΌΡ ΠΏΠΎΠ½ΠΈΠΌΠ°Π½ΠΈΡ Π±ΠΈΠΎΠ»ΠΎΠ³ΠΈΠΈ ΠΠΠ ΠΈ Π±ΡΠ΄ΡΡ ΡΠΏΠΎΡΠΎΠ±ΡΡΠ²ΠΎΠ²Π°ΡΡ ΡΠ°Π·ΡΠ°Π±ΠΎΡΠΊΠ΅ Π½ΠΎΠ²ΡΡ
Π½Π°ΠΏΡΠ°Π²Π»Π΅Π½ΠΈΠΉ ΠΏΡΠΎΡΠΈΠ»Π°ΠΊΡΠΈΠΊΠΈ, ΡΠ°Π½Π½Π΅ΠΉ Π΄ΠΈΠ°Π³Π½ΠΎΡΡΠΈΠΊΠΈ ΠΈ Π»Π΅ΡΠ΅Π½ΠΈΡ ΡΡΠΎΠ³ΠΎ Π·Π°Π±ΠΎΠ»Π΅Π²Π°Π½ΠΈΡ
Loss of chromosome Y leads to down regulation of KDM5D and KDM6C epigenetic modifiers in clear cell renal cell carcinoma
Recent genomic studies of sporadic clear cell renal cell carcinoma (ccRCC) have uncovered novel driver genes and pathways. Given the unequal incidence rates among men and women (male:female incidence ratio approaches 2:1), we compared the genome-wide distribution of the chromosomal abnormalities in both sexes. We observed a higher frequency for the somatic recurrent chromosomal copy number variations (CNVs) of autosomes in male subjects, whereas somatic loss of chromosome X was detected exclusively in female patients (17.1%). Furthermore, somatic loss of chromosome Y (LOY) was detected in about 40% of male subjects, while mosaic LOY was detected in DNA isolated from peripheral blood in 9.6% of them, and was the only recurrent CNV in constitutional DNA samples. LOY in constitutional DNA, but not in tumor DNA was associated with older age. Amongst Y-linked genes that were downregulated due to LOY, KDM5D and KDM6C epigenetic modifiers have functionally-similar X-linked homologs whose deficiency is involved in ccRCC progression. Our findings establish somatic LOY as a highly recurrent genetic defect in ccRCC that leads to downregulation of hitherto unsuspected epigenetic factors, and suggest that different mechanisms may underlie the somatic and mosaic LOY observed in tumors and peripheral blood, respectively
ΠΡΠΊΠ°Π· ΠΎΡ ΠΊΡΡΠ΅Π½ΠΈΡ ΠΏΠΎΡΠ»Π΅ ΠΏΠΎΡΡΠ°Π½ΠΎΠ²ΠΊΠΈ Π΄ΠΈΠ°Π³Π½ΠΎΠ·Π° ΡΠ°ΠΊΠ° Π»Π΅Π³ΠΊΠΎΠ³ΠΎ ΡΠ»ΡΡΡΠ°Π΅Ρ ΠΏΡΠΎΠ³Π½ΠΎΠ· Π·Π°Π±ΠΎΠ»Π΅Π²Π°Π½ΠΈΡ
Abstract: The presented clinical and epidemiological study is the worldΒ»s first large prospective study of the effect of smoking cessation after lung cancer (LC) diagnosis on the prognosis. Followβup of 517 patients with NSCLC for 7 years in average showed that continued smoking after diagnosis is a serious negative prognostic factor. At the same time smoking cessation improves OS and PFS by 22,6 months and specific cancer mortality by 22,8 months; reduces the risk of allβcause mortality by 33β%, the risk of progression by 30β% and the risk of specific cancer mortality by 25β%. Almost 60β% of patients in our study continued smoking after diagnosis. Consequently, they had avoidable excess mortality which eventually reduced their life by 2 years.The positive effect of smoking cessation after diagnosis found in our study significantly exceeds the Β«meaningful benefitΒ» (improvement in median overall survival by 2,5β6 months) for antineoplastic agents proposed by the American Society of Clinical Oncology (ASCO). Moreover, the study suggests that the benefits of smoking cessation after LC diagnosis are at least equal or superior to the significant results obtained in clinical studies of the effectiveness of innovative treatments.We hope that the results of our study will contribute to the inclusion of smoking cessation in clinical guidelines for the treatment of NSCLC and other cancers. The treatment program for cancer patients should include evidenceβbased methods of smoking cessation presented in the form of Β«Clinical Guidelines for Smoking Cessation for Cancer PatientsΒ».Treating smoking in cancer patients is costβeffective for the health care system, especially when compared to other treatβments. Conversely, continuing smoking after diagnosis significantly increases treatment costs.The introduction of recommendations on smoking cessation and treatment of nicotine addiction into the practice will improve the overall mortality rate by 30β35β% in more than 60,000 patients annually diagnosed with lung cancer in Russia. The clinical value of this method is obvious, since it has been proven to be highly efficient in improving the life expectancy of patients, and, ultimately, in reducing cancer mortality in Russia.ΠΠ½Π½ΠΎΡΠ°ΡΠΈΡ: ΠΡΠ΅Π΄ΡΡΠ°Π²Π»Π΅Π½Π½ΠΎΠ΅ ΠΊΠ»ΠΈΠ½ΠΈΠΊΠΎ-ΡΠΏΠΈΠ΄Π΅ΠΌΠΈΠΎΠ»ΠΎΠ³ΠΈΡΠ΅ΡΠΊΠΎΠ΅ ΠΈΡΡΠ»Π΅Π΄ΠΎΠ²Π°Π½ΠΈΠ΅ β ΠΏΠ΅ΡΠ²ΠΎΠ΅ Π² ΠΌΠΈΡΠ΅ ΠΊΡΡΠΏΠ½ΠΎΠ΅ ΠΏΡΠΎΡΠΏΠ΅ΠΊΡΠΈΠ²Π½ΠΎΠ΅ ΠΈΡΡΠ»Π΅Π΄ΠΎΠ²Π°Π½ΠΈΠ΅, Π² ΠΊΠΎΡΠΎΡΠΎΠΌ ΠΈΠ·ΡΡΠ°Π»ΡΡ ΡΡΡΠ΅ΠΊΡ ΠΎΡΠΊΠ°Π·Π° ΠΎΡ ΠΊΡΡΠ΅Π½ΠΈΡ ΠΏΠΎΡΠ»Π΅ ΠΏΠΎΡΡΠ°Π½ΠΎΠ²ΠΊΠΈ Π΄ΠΈΠ°Π³Π½ΠΎΠ·Π° ΡΠ°ΠΊΠ° Π»Π΅Π³ΠΊΠΎΠ³ΠΎ (Π Π) Π½Π° ΠΏΡΠΎΠ³Π½ΠΎΠ·.ΠΡΠΎΡΠ»Π΅ΠΆΠΈΠ²Π°Π½ΠΈΠ΅ 517 ΠΏΠ°ΡΠΈΠ΅Π½ΡΠΎΠ² Ρ ΠΠΠΠ Π Π² ΡΠ΅ΡΠ΅Π½ΠΈΠ΅ 7 Π»Π΅Ρ Π² ΡΡΠ΅Π΄Π½Π΅ΠΌ ΠΏΠΎΠΊΠ°Π·Π°Π»ΠΎ, ΡΡΠΎ ΠΏΡΠΎΠ΄ΠΎΠ»ΠΆΠ΅Π½ΠΈΠ΅ ΠΊΡΡΠ΅Π½ΠΈΡ ΠΏΠΎΡΠ»Π΅ ΠΏΠΎΡΡΠ°Π½ΠΎΠ²ΠΊΠΈ Π΄ΠΈΠ°Π³Π½ΠΎΠ·Π° β ΠΎΡΠ΅Π½Ρ ΡΠ΅ΡΡΠ΅Π·Π½ΡΠΉ Π½Π΅Π³Π°ΡΠΈΠ²Π½ΡΠΉ ΠΏΡΠΎΠ³Π½ΠΎΡΡΠΈΡΠ΅ΡΠΊΠΈΠΉ ΡΠ°ΠΊΡΠΎΡ. Π ΡΠΎ ΠΆΠ΅ Π²ΡΠ΅ΠΌΡ ΠΎΡΠΊΠ°Π· ΠΎΡ ΠΊΡΡΠ΅Π½ΠΈΡ ΡΠ»ΡΡΡΠ°Π΅Ρ ΠΎΠ±ΡΡΡ Π²ΡΠΆΠΈΠ²Π°Π΅ΠΌΠΎΡΡΡ (ΠΠ) ΠΈ Π²ΡΠΆΠΈΠ²Π°Π΅ΠΌΠΎΡΡΡ Π±Π΅Π· ΠΏΡΠΎΠ³ΡΠ΅ΡΡΠΈΡΠΎΠ²Π°Π½ΠΈΡ (ΠΠΠ) Π½Π° 22,6 ΠΌΠ΅ΡΡΡΠ΅Π² ΠΈ ΡΠ½ΠΈΠΆΠ°Π΅Ρ ΡΠΏΠ΅ΡΠΈΡΠΈΡΠ΅ΡΠΊΡΡ ΠΎΠ½ΠΊΠΎΠ»ΠΎΠ³ΠΈΡΠ΅ΡΠΊΡΡ ΡΠΌΠ΅ΡΡΠ½ΠΎΡΡΡ Π½Π° 22,8 ΠΌΠ΅ΡΡΡΠ΅Π²; ΡΠ°ΠΊΠΆΠ΅ ΠΎΡΠΌΠ΅ΡΠ΅Π½ΠΎ ΡΠ½ΠΈΠΆΠ΅Π½ΠΈΠ΅ ΡΠΈΡΠΊΠ° ΡΠΌΠ΅ΡΡΠ½ΠΎΡΡΠΈ ΠΎΡ Π²ΡΠ΅Ρ
ΠΏΡΠΈΡΠΈΠ½ Π½Π° 33%, ΡΠΈΡΠΊΠ° ΠΏΡΠΎΠ³ΡΠ΅ΡΡΠΈΡΠΎΠ²Π°Π½ΠΈΡ β Π½Π° 30% ΠΈ ΡΠΈΡΠΊΠ° ΡΠΏΠ΅ΡΠΈΡΠΈΡΠ΅ΡΠΊΠΎΠΉ ΠΎΠ½ΠΊΠΎΠ»ΠΎΠ³ΠΈΡΠ΅ΡΠΊΠΎΠΉ ΡΠΌΠ΅ΡΡΠ½ΠΎΡΡΠΈ β Π½Π° 25%. Π Π½Π°ΡΠ΅ΠΉ ΠΊΠΎΠ³ΠΎΡΡΠ΅ ΠΏΠΎΡΡΠΈ 60% Π±ΠΎΠ»ΡΠ½ΡΡ
ΠΏΠΎΡΠ»Π΅ ΠΏΠΎΡΡΠ°Π½ΠΎΠ²ΠΊΠΈ Π΄ΠΈΠ°Π³Π½ΠΎΠ·Π° ΠΏΡΠΎΠ΄ΠΎΠ»ΠΆΠ°Π»ΠΈ ΠΊΡΡΠΈΡΡ. Π‘ΡΠ΅Π΄ΠΈ Π½ΠΈΡ
ΠΈΠΌΠ΅Π»Π° ΠΌΠ΅ΡΡΠΎ ΠΏΡΠ΅Π΄ΠΎΡΠ²ΡΠ°ΡΠΈΠΌΠ°Ρ ΠΈΠ·Π±ΡΡΠΎΡΠ½Π°Ρ ΡΠΌΠ΅ΡΡΠ½ΠΎΡΡΡ, ΠΊΠΎΡΠΎΡΠ°Ρ Π² ΡΠ΅Π·ΡΠ»ΡΡΠ°ΡΠ΅ ΡΠΎΠΊΡΠ°ΡΠΈΠ»Π° ΠΈΠΌ ΠΆΠΈΠ·Π½Ρ Π½Π° 2 Π³ΠΎΠ΄Π°.ΠΠΎΠ»ΡΡΠ΅Π½Π½ΡΠΉ Π² Π½Π°ΡΠ΅ΠΉ ΡΠ°Π±ΠΎΡΠ΅ ΠΏΠΎΠ»ΠΎΠΆΠΈΡΠ΅Π»ΡΠ½ΡΠΉ ΡΡΡΠ΅ΠΊΡ ΠΎΡΠΊΠ°Π·Π° ΠΎΡ ΠΊΡΡΠ΅Π½ΠΈΡ ΠΏΠΎΡΠ»Π΅ ΠΏΠΎΡΡΠ°Π½ΠΎΠ²ΠΊΠΈ Π΄ΠΈΠ°Π³Π½ΠΎΠ·Π° Π·Π½Π°ΡΠΈΡΠ΅Π»ΡΠ½ΠΎ ΠΏΡΠ΅Π²ΠΎΡΡ
ΠΎΠ΄ΠΈΡ Β«Π·Π½Π°ΡΠΈΠΌΡΡ ΠΏΠΎΠ»ΡΠ·ΡΒ» (meaningful benefit) β Π΄ΠΎΡΡΠΈΠΆΠ΅Π½ΠΈΠ΅ ΠΌΠ΅Π΄ΠΈΠ°Π½Ρ ΡΠ»ΡΡΡΠ΅Π½ΠΈΡ ΠΎΠ±ΡΠ΅ΠΉ Π²ΡΠΆΠΈΠ²Π°Π΅ΠΌΠΎΡΡΠΈ Π² ΠΏΡΠ΅Π΄Π΅Π»Π°Ρ
2,5β6 ΠΌΠ΅ΡΡΡΠ΅Π² Π΄Π»Ρ ΠΏΡΠΎΡΠΈΠ²ΠΎΠΎΠΏΡΡ
ΠΎΠ»Π΅Π²ΡΡ
ΠΏΡΠ΅ΠΏΠ°ΡΠ°ΡΠΎΠ², ΠΏΡΠ΅Π΄Π»ΠΎΠΆΠ΅Π½Π½ΡΡ ΠΠΌΠ΅ΡΠΈΠΊΠ°Π½ΡΠΊΠΈΠΌ ΠΎΠ±ΡΠ΅ΡΡΠ²ΠΎΠΌ ΠΊΠ»ΠΈΠ½ΠΈΡΠ΅ΡΠΊΠΈΡ
ΠΎΠ½ΠΊΠΎΠ»ΠΎΠ³ΠΎΠ² (ASCO). ΠΠΎΠ»Π΅Π΅ ΡΠΎΠ³ΠΎ, ΠΈΠ· ΠΈΡΡΠ»Π΅Π΄ΠΎΠ²Π°Π½ΠΈΡ ΡΠ»Π΅Π΄ΡΠ΅Ρ, ΡΡΠΎ ΠΏΠΎΠ»ΡΠ·Π° ΠΎΡΠΊΠ°Π·Π° ΠΎΡ ΠΊΡΡΠ΅Π½ΠΈΡ ΠΏΠΎΡΠ»Π΅ ΠΏΠΎΡΡΠ°Π½ΠΎΠ²ΠΊΠΈ Π΄ΠΈΠ°Π³Π½ΠΎΠ·Π° Π Π, ΠΊΠ°ΠΊ ΠΌΠΈΠ½ΠΈΠΌΡΠΌ, ΡΠ°Π²Π½ΠΎΠ·Π½Π°ΡΠ½Π°, ΠΈΠ»ΠΈ ΠΏΡΠ΅Π²ΠΎΡΡ
ΠΎΠ΄ΠΈΡ Π·Π½Π°ΡΠΈΠΌΡΠ΅ ΡΠ΅Π·ΡΠ»ΡΡΠ°ΡΡ, ΠΏΠΎΠ»ΡΡΠ΅Π½Π½ΡΠ΅ Π² ΠΊΠ»ΠΈΠ½ΠΈΡΠ΅ΡΠΊΠΈΡ
ΠΈΡΡΠ»Π΅Π΄ΠΎΠ²Π°Π½ΠΈΡΡ
ΡΡΡΠ΅ΠΊΡΠΈΠ²Π½ΠΎΡΡΠΈ ΠΈΠ½Π½ΠΎΠ²Π°ΡΠΈΠΎΠ½Π½ΡΡ
ΠΌΠ΅ΡΠΎΠ΄ΠΎΠ² Π»Π΅ΡΠ΅Π½ΠΈΡ Π Π.ΠΡ Π½Π°Π΄Π΅Π΅ΠΌΡΡ, ΡΡΠΎ ΡΠ΅Π·ΡΠ»ΡΡΠ°ΡΡ Π½Π°ΡΠ΅Π³ΠΎ ΠΈΡΡΠ»Π΅Π΄ΠΎΠ²Π°Π½ΠΈΡ Π±ΡΠ΄ΡΡ ΡΠΏΠΎΡΠΎΠ±ΡΡΠ²ΠΎΠ²Π°ΡΡ Π²ΠΊΠ»ΡΡΠ΅Π½ΠΈΡ ΠΎΡΠΊΠ°Π·Π° ΠΎΡ ΠΊΡΡΠ΅Π½ΠΈΡ Π² ΠΊΠ»ΠΈΠ½ΠΈΡΠ΅ΡΠΊΠΈΠ΅ ΡΠ΅ΠΊΠΎΠΌΠ΅Π½Π΄Π°ΡΠΈΠΈ ΠΏΠΎ Π»Π΅ΡΠ΅Π½ΠΈΡ ΠΠΠ Π ΠΈ Π΄ΡΡΠ³ΠΈΡ
ΠΎΠ½ΠΊΠΎΠ»ΠΎΠ³ΠΈΡΠ΅ΡΠΊΠΈΡ
Π·Π°Π±ΠΎΠ»Π΅Π²Π°Π½ΠΈΠΉ. ΠΡΠΎΠ³ΡΠ°ΠΌΠΌΠ° Π»Π΅ΡΠ΅Π½ΠΈΡ ΠΎΠ½ΠΊΠΎΠ»ΠΎΠ³ΠΈΡΠ΅ΡΠΊΠΈΡ
Π±ΠΎΠ»ΡΠ½ΡΡ
Π΄ΠΎΠ»ΠΆΠ½Π° Π²ΠΊΠ»ΡΡΠ°ΡΡ Π½Π°ΡΡΠ½ΠΎ ΠΎΠ±ΠΎΡΠ½ΠΎΠ²Π°Π½Π½ΡΠ΅ ΠΌΠ΅ΡΠΎΠ΄Ρ ΠΎΡΠΊΠ°Π·Π° ΠΎΡ ΠΊΡΡΠ΅Π½ΠΈΡ, ΠΏΡΠ΅Π΄ΡΡΠ°Π²Π»Π΅Π½Π½ΡΠ΅ Π² Π²ΠΈΠ΄Π΅ Β«ΠΠ»ΠΈΠ½ΠΈΡΠ΅ΡΠΊΠΈΡ
ΡΠ΅ΠΊΠΎΠΌΠ΅Π½Π΄Π°ΡΠΈΠΉ ΠΏΠΎ ΠΎΡΠΊΠ°Π·Ρ ΠΎΡ ΠΊΡΡΠ΅Π½ΠΈΡ Π΄Π»Ρ ΠΎΠ½ΠΊΠΎΠ»ΠΎΠ³ΠΈΡΠ΅ΡΠΊΠΈΡ
Π±ΠΎΠ»ΡΠ½ΡΡ
Β».ΠΠ΅ΡΠ΅Π½ΠΈΠ΅ ΡΠ°Π±Π°ΠΊΠΎΠΊΡΡΠ΅Π½ΠΈΡ Ρ ΠΏΠ°ΡΠΈΠ΅Π½ΡΠΎΠ² Ρ ΠΎΠ½ΠΊΠΎΠ»ΠΎΠ³ΠΈΡΠ΅ΡΠΊΠΈΠΌ Π΄ΠΈΠ°Π³Π½ΠΎΠ·ΠΎΠΌ ΡΠΊΠΎΠ½ΠΎΠΌΠΈΡΠ΅ΡΠΊΠΈ Π²ΡΠ³ΠΎΠ΄Π½ΠΎ Π΄Π»Ρ ΡΠΈΡΡΠ΅ΠΌΡ Π·Π΄ΡΠ°Π²ΠΎΠΎΡ
ΡΠ°Π½Π΅Π½ΠΈΡ, ΠΎΡΠΎΠ±Π΅Π½Π½ΠΎ ΠΏΠΎ ΡΡΠ°Π²Π½Π΅Π½ΠΈΡ Ρ Π΄ΡΡΠ³ΠΈΠΌΠΈ ΠΌΠ΅ΡΠΎΠ΄Π°ΠΌΠΈ Π»Π΅ΡΠ΅Π½ΠΈΡ. Π, Π½Π°ΠΎΠ±ΠΎΡΠΎΡ, ΠΏΡΠΎΠ΄ΠΎΠ»ΠΆΠ΅Π½ΠΈΠ΅ ΠΊΡΡΠ΅Π½ΠΈΡ ΠΏΠΎΡΠ»Π΅ Π΄ΠΈΠ°Π³Π½ΠΎΠ·Π° Π·Π½Π°ΡΠΈΡΠ΅Π»ΡΠ½ΠΎ ΡΠ²Π΅Π»ΠΈΡΠΈΠ²Π°Π΅Ρ ΡΡΠ°ΡΡ Π½Π° Π»Π΅ΡΠ΅Π½ΠΈΠ΅.ΠΠ½Π΅Π΄ΡΠ΅Π½ΠΈΠ΅ Π² ΠΏΡΠ°ΠΊΡΠΈΠΊΡ Π»Π΅ΡΠ΅Π½ΠΈΡ Π±ΠΎΠ»ΡΠ½ΡΡ
Ρ Π΄ΠΈΠ°Π³Π½ΠΎΠ·ΠΎΠΌ Π Π ΡΠ΅ΠΊΠΎΠΌΠ΅Π½Π΄Π°ΡΠΈΠΉ ΠΏΠΎ ΠΎΡΠΊΠ°Π·Ρ ΠΎΡ ΠΊΡΡΠ΅Π½ΠΈΡ ΠΈ Π»Π΅ΡΠ΅Π½ΠΈΡ Π½ΠΈΠΊΠΎΡΠΈΠ½ΠΎΠ²ΠΎΠΉ Π·Π°Π²ΠΈΡΠΈΠΌΠΎΡΡΠΈ Π½Π° 30β35% ΡΠ»ΡΡΡΠΈΡ ΠΏΠΎΠΊΠ°Π·Π°ΡΠ΅Π»Ρ ΠΎΠ±ΡΠ΅ΠΉ ΡΠΌΠ΅ΡΡΠ½ΠΎΡΡΠΈ Ρ Π±ΠΎΠ»Π΅Π΅ 60 000 Π±ΠΎΠ»ΡΠ½ΡΡ
Π Π, Π΄ΠΈΠ°Π³Π½ΠΎΡΡΠΈΡΡΠ΅ΠΌΡΡ
Π΅ΠΆΠ΅Π³ΠΎΠ΄Π½ΠΎ Π² Π ΠΎΡΡΠΈΠΈ. ΠΡΠ΅Π²ΠΈΠ΄Π½Π° ΠΊΠ»ΠΈΠ½ΠΈΡΠ΅ΡΠΊΠ°Ρ ΡΠ΅Π½Π½ΠΎΡΡΡ ΡΡΠΎΠ³ΠΎ ΠΌΠ΅ΡΠΎΠ΄Π°, Ρ Π΄ΠΎΠΊΠ°Π·Π°Π½Π½ΠΎΠΉ Π²ΡΡΠΎΠΊΠΎΠΉ ΡΡΡΠ΅ΠΊΡΠΈΠ²Π½ΠΎΡΡΡΡ Π² ΡΠ»ΡΡΡΠ΅Π½ΠΈΠΈ ΠΏΡΠΎΠ΄ΠΎΠ»ΠΆΠΈΡΠ΅Π»ΡΠ½ΠΎΡΡΠΈ ΠΆΠΈΠ·Π½ΠΈ Π±ΠΎΠ»ΡΠ½ΡΡ
, Π° Π² ΠΊΠΎΠ½Π΅ΡΠ½ΠΎΠΌ ΠΈΡΠΎΠ³Π΅ β ΡΠ½ΠΈΠΆΠ΅Π½ΠΈΠΈ ΡΠΌΠ΅ΡΡΠ½ΠΎΡΡΠΈ ΠΎΡ ΡΠ°ΠΊΠ° Π² Π ΠΎΡΡΠΈΠΈ
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