17 research outputs found

    ASSESSMENT OF REFRACTORY GOLD-BEARING ORES BASED OF INTERPRETATION OF THERMAL ANALYSIS DATA

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    The article presents the results of a study on the possibility to assess refractory gold-bearing ores using thermal analysis data. It studies the flotation concentrates obtained during the enrichment of double refractory sulfide gold-bearing ores. This type of ore is complicated by the fine impregnation of gold in sulphide minerals and the presence of sorption-active scattered carbonaceous matter, which is in close association with sulphides. The results of thermogravimetric and mass spectrometric studies of refractory gold-bearing ores are presented. The obtained fragments for kerogen CHΒ (m/zΒ =Β 15), C2HΒ (m/zΒ =Β 29) and C3HΒ (m/zΒ =Β 43) indicate the presence of various types of carbonaceous matter in the studied samples. It is justified that the degree of sorption activity of carbonaceous matter depends on the presence of kerogen and bitumen in the ore. High sorption activity of scattered carbonaceous material significantly affects the processing technology of ores and concentrates, both flotation and pyro- and hydrometallurgical methods. Thermogravimetric and mass spectroscopic analyzes can be used to determine the degree of preg-robbing of refractory gold-bearing ores. The obtained results predetermine the direction of creating new methods and technologies in the field of decarburization of refractory gold-bearing ores in the integrated development of solid minerals in the mining regions of Russia

    ЦвСтовая Π΄Π΅ΡˆΠΈΡ„Ρ€ΠΎΠ²ΠΊΠ° Ρ‡Π΅Ρ€Π½ΠΎ-Π±Π΅Π»Ρ‹Ρ… Ρ€Π΅Π½Ρ‚Π³Π΅Π½ΠΎΠ³Ρ€Π°ΠΌΠΌ ΠΎΡ€Π³Π°Π½ΠΎΠ² Π³Ρ€ΡƒΠ΄Π½ΠΎΠΉ полости Π² Π½ΠΎΡ€ΠΌΠ΅

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    Colour identification of normal black-and-white chest radiograms using the UAR-2 imaging device has provided additional abilities to study all the parts of pleura, lung tissue, stroma and lung vessels as well as to get the information on density, width and area of different mediastinal parts. A correlation between coloured imaging data and constitution, gender and age has been established.ΠŸΡ€ΠΈ Ρ†Π²Π΅Ρ‚ΠΎΠ²ΠΎΠΉ Π΄Π΅ΡˆΠΈΡ„Ρ€ΠΎΠ²ΠΊΠ΅ Ρ‡Π΅Ρ€Π½ΠΎ-Π±Π΅Π»Ρ‹Ρ… Ρ€Π΅Π½Ρ‚Π³Π΅Π½ΠΎΠ³Ρ€Π°ΠΌΠΌ ΠΎΡ€Π³Π°Π½ΠΎΠ² Π³Ρ€ΡƒΠ΄Π½ΠΎΠΉ полости Π² Π½ΠΎΡ€ΠΌΠ΅ Π½Π° Ρ‚Π΅Π»Π΅Π²ΠΈΠ·ΠΈΠΎΠ½Π½ΠΎΠΉ установкС УАР-2 ΠΏΠΎΠ»ΡƒΡ‡Π΅Π½Ρ‹ Π΄ΠΎΠΏΠΎΠ»Π½ΠΈΡ‚Π΅Π»ΡŒΠ½Ρ‹Π΅ возмоТности для изучСния всСх ΠΎΡ‚Π΄Π΅Π»ΠΎΠ² ΠΏΠ»Π΅Π²Ρ€Ρ‹, Π»Π΅Π³ΠΎΡ‡Π½ΠΎΠΉ Ρ‚ΠΊΠ°Π½ΠΈ, стромы ΠΈ сосудов Π»Π΅Π³ΠΊΠΈΡ…, Π° Ρ‚Π°ΠΊΠΆΠ΅ для получСния ΠΈΠ½Ρ„ΠΎΡ€ΠΌΠ°Ρ†ΠΈΠΈ ΠΎ плотности, ΡˆΠΈΡ€ΠΈΠ½Π΅ ΠΈ ΠΏΠ»ΠΎΡ‰Π°Π΄ΠΈ Ρ€Π°Π·Π»ΠΈΡ‡Π½Ρ‹Ρ… частСй срСдостСния. УстановлСна Π·Π°Π²ΠΈΡΠΈΠΌΠΎΡΡ‚ΡŒ Π΄Π°Π½Π½Ρ‹Ρ… Ρ†Π²Π΅Ρ‚ΠΎΠ²ΠΎΠ³ΠΎ изобраТСния ΠΎΡ‚ конституции, ΠΏΠΎΠ»Π° ΠΈ возраста

    ЛСгочная Ρ‚ΠΎΠΊΡΠΈΡ‡Π½ΠΎΡΡ‚ΡŒ, индуцированная Π±Π»Π΅ΠΎΠΌΠΈΡ†ΠΈΠ½ΠΎΠΌ, Ρƒ Π±ΠΎΠ»ΡŒΠ½Ρ‹Ρ… Π»ΠΈΠΌΡ„ΠΎΠΌΠΎΠΉ Π₯ΠΎΠ΄ΠΆΠΊΠΈΠ½Π°

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    Bleomycin used as part of many chemo-therapeutic programs for treating Hodgkin lymphoma is associated with pulmonary toxicity. Development of complications after mediastinal radiotherapy is also well-known. However, the synergistic effect of the combination of radiotherapy and bleomycin is considered in the literature much less frequently and mainly when using the total focal doses (SOD) of 36 – 40 Gy. Since 1998 the chemo-radiotherapeutic regimens applied to the treatment of Hodgkin lymphoma in the MRRC (Obninsk) has involved subradical TTD of 20 – 30 Gy. The goal of the study is to evaluate pulmonary toxicity in Hodgkin lymphoma patients treated with chemo-radiotherapy involving ABVD and mediastinal treatment with TTD of 20 – 30 Gy.Methods. A series of 142 Hodgkin lymphoma patients received ABVD and mediastinal radiotherapy at the TTD 20 – 30 Gy. Conventional film and digital chest X-rays, linear and digital tomograms taken at different stages of treatment and follow up were analysed.Results. Changes in lungs in the form of a pathologic pulmonary pattern (interstitial pneumonitis) were seen in 39 (27.5%) of 142 patients. In 10 (25.6%) of 39 patients focal or confluent pneumonitis infiltration were found, that was 7% of the whole study group. Clinical evidence of bleomycin-induced pneumonitis was found in 6 (15.4%) of 39 patients. With follow-up terms up to 60 months fibrotic changes in lungs were absent. The occurrence of radiation pneumonitis was 17.6%, radiation fibrosis – 35.9%. Fibrotic changes were mainly grade 1 (94.1%). In HL patients with bleomycin-induced pneumonitis the occurrence of radiation pneumonitis was 43.6% (17 of 39 patients), radiation fibrosis – 58.9% (23 of 39 patients) while the corresponding figures for patients who did not have bleomycin-induced pneumonitis were 8.7% (9 of 103 patients) and 27.2% (28 of 103 patients), respectively (p < 0.001).Conclusion. A statistically significant increase in occurrence of radiation pneumonitis and radiation fibrosis was defined in HL patients who suffered bleomycin-induced pneumonitis.Π‘Π»Π΅ΠΎΠΌΠΈΡ†ΠΈΠ½, входящий Π² Π±ΠΎΠ»ΡŒΡˆΠΈΠ½ΡΡ‚Π²ΠΎ схСм Ρ…ΠΈΠΌΠΈΠΎΡ‚Π΅Ρ€Π°ΠΏΠΈΠΈ (Π₯Π’) Π±ΠΎΠ»ΡŒΠ½Ρ‹Ρ… Π»ΠΈΠΌΡ„ΠΎΠΌΠΎΠΉ Π₯ΠΎΠ΄ΠΆΠΊΠΈΠ½Π° (Π›Π₯), ΠΎΠ±Π»Π°Π΄Π°Π΅Ρ‚ Π»Π΅Π³ΠΎΡ‡Π½ΠΎΠΉ Ρ‚ΠΎΠΊΡΠΈΡ‡Π½ΠΎΡΡ‚ΡŒΡŽ. Π’Π°ΠΊΠΆΠ΅ извСстны ослоТнСния облучСния области срСдостСния. БинСргичСский эффСкт сочСтания Π»ΡƒΡ‡Π΅Π²ΠΎΠΉ Ρ‚Π΅Ρ€Π°ΠΏΠΈΠΈ ΠΈ Π±Π»Π΅ΠΎΠΌΠΈΡ†ΠΈΠ½Π° рассматриваСтся Π² Π»ΠΈΡ‚Π΅Ρ€Π°Ρ‚ΡƒΡ€Π΅ Π·Π½Π°Ρ‡ΠΈΡ‚Π΅Π»ΡŒΠ½ΠΎ Ρ€Π΅ΠΆΠ΅ ΠΈ прСимущСствСнно ΠΏΡ€ΠΈ использовании суммарных ΠΎΡ‡Π°Π³ΠΎΠ²Ρ‹Ρ… Π΄ΠΎΠ· (Π‘ΠžΠ”) ΠΎΠ± лучСния 36– 40 Π“Ρ€. Π‘ 1998 Π³. ΠΏΡ€ΠΈ Ρ…ΠΈΠΌΠΈΠΎΠ»ΡƒΡ‡Π΅Π²ΠΎΠΉ Ρ‚Π΅Ρ€Π°ΠΏΠΈΠΈ (Π₯Π›Π’) Π±ΠΎΠ»ΡŒΠ½Ρ‹Ρ… Π›Π₯ ΠΈΡΠΏΠΎΠ»ΡŒΠ·ΡƒΡŽΡ‚ΡΡ ΡΡƒΠ±Ρ€Π°Π΄ΠΈΠΊΠ°Π»ΡŒΠ½Ρ‹Π΅ Π‘ΠžΠ” облучСния 20–30 Π“Ρ€.ЦСлью исслСдования явилась ΠΎΡ†Π΅Π½ΠΊΠ° Π»Π΅Π³ΠΎΡ‡Π½ΠΎΠΉ токсичности Ρƒ Π±ΠΎΠ»ΡŒΠ½Ρ‹Ρ… Π›Π₯ ΠΏΡ€ΠΈ Π₯Π›Π’ – сочСтании Π₯Π’ Π² Ρ€Π΅ΠΆΠΈΠΌΠ΅ ABVD ΠΈ облучСния срСдостСния Π² Π‘ΠžΠ” 20–30 Π“Ρ€.ΠœΠ°Ρ‚Π΅Ρ€ΠΈΠ°Π»Ρ‹ ΠΈ ΠΌΠ΅Ρ‚ΠΎΠ΄Ρ‹. ΠžΠ±ΡΠ»Π΅Π΄ΠΎΠ²Π°Π½Ρ‹ Π±ΠΎΠ»ΡŒΠ½Ρ‹Π΅ Π›Π₯ (n = 142), ΠΏΠΎΠ»ΡƒΡ‡ΠΈΠ²ΡˆΠΈΠ΅ Π₯Π’ ABVD ΠΈ ΠΎΠ±Π»ΡƒΡ‡Π΅Π½ΠΈΠ΅ срСдостСния Π² Π‘ΠžΠ” 20–30 Π“Ρ€. ΠŸΡ€ΠΎΠ°Π½Π°Π»ΠΈΠ·ΠΈΡ€ΠΎΠ²Π°Π½Ρ‹ классичСскиС ΠΈ Ρ†ΠΈΡ„Ρ€ΠΎΠ²Ρ‹Π΅ ΠΎΠ±Π·ΠΎΡ€Π½Ρ‹Π΅ Ρ€Π΅Π½Ρ‚Π³Π΅Π½ΠΎΠ³Ρ€Π°ΠΌΠΌΡ‹, Π»ΠΈΠ½Π΅ΠΉΠ½Ρ‹Π΅ ΠΈ Ρ†ΠΈΡ„Ρ€ΠΎΠ²Ρ‹Π΅ ΠΊΠΎΠΌΠΏΡŒΡŽΡ‚Π΅Ρ€Π½Ρ‹Π΅ Ρ‚ΠΎΠΌΠΎΠ³Ρ€Π°ΠΌΠΌΡ‹ ΠΎΡ€Π³Π°Π½ΠΎΠ² Π³Ρ€ΡƒΠ΄Π½ΠΎΠΉ ΠΊΠ»Π΅Ρ‚ΠΊΠΈ, Π²Ρ‹ΠΏΠΎΠ»Π½Π΅Π½Π½Ρ‹Π΅ Π½Π° Ρ€Π°Π·Π»ΠΈΡ‡Π½Ρ‹Ρ… этапах лСчСния ΠΈ процСсса наблюдСния.Π Π΅Π·ΡƒΠ»ΡŒΡ‚Π°Ρ‚Ρ‹. ИзмСнСния Π² Π»Π΅Π³ΠΊΠΈΡ… ΠΎΠ±Π½Π°Ρ€ΡƒΠΆΠ΅Π½Ρ‹ Ρƒ 39 (27,5 %) ΠΈΠ· 142 Π±ΠΎΠ»ΡŒΠ½Ρ‹Ρ… Π² Π²ΠΈΠ΄Π΅ патологичСского Π»Π΅Π³ΠΎΡ‡Π½ΠΎΠ³ΠΎ рисунка (ΠΈΠ½Ρ‚Π΅Ρ€ΡΡ‚ΠΈΡ†ΠΈΠ°Π»ΡŒΠ½Ρ‹ΠΉ ΠΏΡƒΠ»ΡŒΠΌΠΎΠ½ΠΈΡ‚). Π’ 10 (25,6 %) случаях ΠΎΠΏΡ€Π΅Π΄Π΅Π»ΡΠ»Π°ΡΡŒ ΠΈΠ½Ρ„ΠΈΠ»ΡŒΡ‚Ρ€Π°Ρ†ΠΈΡ ΠΎΡ‡Π°Π³ΠΎΠ²ΠΎΠ³ΠΎ ΠΈΠ»ΠΈ сливного Ρ‚ΠΈΠΏΠΎΠ² (ΠΎΡ‡Π°Π³ΠΎΠ²Ρ‹ΠΉ, сливной ΠΏΡƒΠ»ΡŒΠΌΠΎΠ½ΠΈΡ‚), (7 % ΠΏΠ°Ρ†ΠΈΠ΅Π½Ρ‚ΠΎΠ² всСй Π³Ρ€ΡƒΠΏΠΏΡ‹). ΠšΠ»ΠΈΠ½ΠΈΡ‡Π΅ΡΠΊΠΈΠ΅ проявлСния Π±Π»Π΅ΠΎΠΌΠΈΡ†ΠΈΠ½ΠΎΠ²ΠΎΠ³ΠΎ ΠΏΡƒΠ»ΡŒΠΌΠΎΠ½ΠΈΡ‚Π° (Π‘ΠŸ) ΠΎΡ‚ΠΌΠ΅Ρ‡Π΅Π½Ρ‹ Ρƒ 6 (15,4 %) Π±ΠΎΠ»ΡŒΠ½Ρ‹Ρ…. ΠŸΡ€ΠΈ сроках наблюдСния Π΄ΠΎ 60 мСс. Ρ„ΠΈΠ±Ρ€ΠΎΠ·Π½Ρ‹Π΅ измСнСния Π² Π»Π΅Π³ΠΊΠΈΡ… Π²Π½Π΅ ΠΏΠΎΠ»Π΅ΠΉ облучСния отсутствовали. Частота Π»ΡƒΡ‡Π΅Π²ΠΎΠ³ΠΎ ΠΏΡƒΠ»ΡŒΠΌΠΎΠ½ΠΈΡ‚Π° (Π›ΠŸ) составила 17,6 %, Π»ΡƒΡ‡Π΅Π²ΠΎΠ³ΠΎ Ρ„ΠΈΠ±Ρ€ΠΎΠ·Π° – 35,9 %. ΠžΡ‚ΠΌΠ΅Ρ‡Π΅Π½Ρ‹ Ρ‚Π°ΠΊΠΆΠ΅ Ρ„ΠΈΠ±Ρ€ΠΎΠ·Π½Ρ‹Π΅ измСнСния прСимущСствСнно I стСпСни (94,1 %). Π£ Π±ΠΎΠ»ΡŒΠ½Ρ‹Ρ… Π›Π₯, ΠΏΠ΅Ρ€Π΅Π½Π΅ΡΡˆΠΈΡ… Π‘ΠŸ, частота Π›ΠŸ составила 17 (43,6 %) ΠΈΠ· 39 ΠΏΠ°Ρ†ΠΈΠ΅Π½Ρ‚ΠΎΠ², Π»ΡƒΡ‡Π΅Π²ΠΎΠ³ΠΎ Ρ„ΠΈΠ±Ρ€ΠΎΠ·Π° – 23 (58,9 %), Ρƒ Π»ΠΈΡ†, Π½Π΅ ΠΏΠ΅Ρ€Π΅Π½Π΅ΡΡˆΠΈΡ… Π‘ΠŸ, – 9 (8,7 %) ΠΈ 28 (27,2 %) ΠΈΠ· 103 Π±ΠΎΠ»ΡŒΠ½Ρ‹Ρ… соотвСтствСнно) (p < 0,001).Π—Π°ΠΊΠ»ΡŽΡ‡Π΅Π½ΠΈΠ΅. УстановлСно достовСрно Π·Π½Π°Ρ‡ΠΈΠΌΠΎΠ΅ ΠΏΠΎΠ²Ρ‹ΡˆΠ΅Π½ΠΈΠ΅ частоты Π›ΠŸ ΠΈ Π»ΡƒΡ‡Π΅Π²ΠΎΠ³ΠΎ Ρ„ΠΈΠ±Ρ€ΠΎΠ·Π° Ρƒ Π±ΠΎΠ»ΡŒΠ½Ρ‹Ρ… Π›Π₯, ΠΏΠ΅Ρ€Π΅Π½Π΅ΡΡˆΠΈΡ… Π‘ΠŸ

    ДиагностичСская Π·Π½Π°Ρ‡ΠΈΠΌΠΎΡΡ‚ΡŒ ICG-картирования стороТСвых Π»ΠΈΠΌΡ„ΠΎΡƒΠ·Π»ΠΎΠ² Ρƒ Π±ΠΎΠ»ΡŒΠ½Ρ‹Ρ… Ρ€Π°ΠΊΠΎΠΌ эндомСтрия I стадии

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    Background. Lymphatic spread is the main route of metastasis in early stage endometrial cancer. Considering its significance, three risk factors of lymph node metastasis were identified. At a high risk of lymph node metastasis in patients with stage I endometrial cancer, pelvic and lumbar lymph node dissection is recommended. In low-risk patients, lymph node dissection is not performed. Lymph node dissection in medium-risk patients is considered as a staging procedure. However, in patients with aggravating factors that prevent extended hysterectomy, lymph node biopsy with ICG mapping and subsequent microstaging may be an alternative to lymph node dissection. Purpose of the study: to analyze the effectiveness of surgical approaches for staging endometrial cancer at different risk factors for lymphatic metastasis.Material and Methods. The treatment outcomes were retrospectively analyzed in 565 patients with stage I endometrial cancer treated at the gynecological oncology department of Botkin City Clinical Hospital and at the gynecological oncology department of Kaluga Regional Clinical Oncology Center from 2021 to 2023. All women were divided into three groups according to the risk factors of lymph node metastasis. Patients underwent hysterectomy, hysterectomy combined with pelvic or pelvic and lumbar lymphadenectomy, as well as hysterectomy with ICG mapping and sentinel lymph node biopsy.Results. A total of 334 endometrial cancer patients underwent surgery at Botkin City Clinical Hospital. In the medium-risk group patients (n=94), who underwent hysterectomy with pelvic (n=36) and pelvic + lumbar lymphadenectomy (n=31), lymph node metastases were detected in 4 (11.1 %) and 6 (19.4 %) patients, respectively. In the high-risk group (n=50) with similar surgeries, metastatic lymph nodes were identified in 2 (10.5 %, n=19) and 6 (26.1 %, n=23) patients, respectively. At Kaluga Regional Oncology Center, 231 patients underwent hysterectomy with sentinel lymph node biopsy. The low-risk group, the medium-risk group, and the high-risk group showed lymph node metastases in 7 (5.47 %), 6 (10.2 %), and 6 (13.6 %) patients, respectively.Conclusion. In stage I endometrial cancer patients with a low risk of lymph node metastasis, hysterectomy with sentinel lymph node biopsy is recommended. For medium-and high-risk groups, hysterectomy with systemic lymphadenectomy is recommended. If it is not possible to remove the pelvic and lumbar lymph nodes, their biopsy with ICG mapping and microstaging can be recommended. A combination of systemic lymphadenectomy with sentinel lymph node biopsy is a promising technique that could hypothetically demonstrate better results in terms of disease staging.Π’Π²Π΅Π΄Π΅Π½ΠΈΠ΅. Π›ΠΈΠΌΡ„ΠΎΠ³Π΅Π½Π½Ρ‹ΠΉ ΠΏΡƒΡ‚ΡŒ мСтастазирования являСтся прСимущСствСнным ΠΏΡ€ΠΈ Π½Π°Ρ‡Π°Π»ΡŒΠ½Ρ‹Ρ… стадиях Ρ€Π°ΠΊΠ° эндомСтрия. Учитывая Π΅Π³ΠΎ Π·Π½Π°Ρ‡ΠΈΠΌΠΎΡΡ‚ΡŒ, Π²Ρ‹Π΄Π΅Π»Π΅Π½Ρ‹ Ρ‚Ρ€ΠΈ стСпСни риска Π»ΠΈΠΌΡ„ΠΎΠ³Π΅Π½Π½ΠΎΠ³ΠΎ мСтастазирования. ΠŸΡ€ΠΈ высокой стСпСни риска ΠΏΠ°Ρ†ΠΈΠ΅Π½Ρ‚ΠΊΠ°ΠΌ с I стадиСй заболСвания рСкомСндуСтся лимфадСнэктомия Ρ‚Π°Π·ΠΎΠ²Ρ‹Ρ… ΠΈ поясничных Π»ΠΈΠΌΡ„ΠΎΡƒΠ·Π»ΠΎΠ², ΠΏΡ€ΠΈ Π½ΠΈΠ·ΠΊΠΎΠΉ – ΡƒΠ΄Π°Π»Π΅Π½ΠΈΠ΅ лимфатичСских ΡƒΠ·Π»ΠΎΠ² Π½Π΅ проводят. Π›ΠΈΠΌΡ„Π°Π΄Π΅Π½ΡΠΊΡ‚ΠΎΠΌΠΈΡŽ Π»ΠΈΠΌΡ„ΠΎΡƒΠ·Π»ΠΎΠ² ΠΏΡ€ΠΈ ΠΏΡ€ΠΎΠΌΠ΅ΠΆΡƒΡ‚ΠΎΡ‡Π½ΠΎΠΉ стСпСни риска мСтастазирования ΠΏΠΎΠ·ΠΈΡ†ΠΈΠΎΠ½ΠΈΡ€ΡƒΡŽΡ‚ ΠΊΠ°ΠΊ ΡΡ‚Π°Π΄ΠΈΡ€ΡƒΡŽΡ‰ΡƒΡŽ ΠΏΡ€ΠΎΡ†Π΅Π΄ΡƒΡ€Ρƒ. Однако ΠΏΡ€ΠΈ Π½Π°Π»ΠΈΡ‡ΠΈΠΈ ΠΎΡ‚ΡΠ³ΠΎΡ‰Π°ΡŽΡ‰ΠΈΡ… Ρ„Π°ΠΊΡ‚ΠΎΡ€ΠΎΠ², ΠΏΡ€Π΅ΠΏΡΡ‚ΡΡ‚Π²ΡƒΡŽΡ‰ΠΈΡ… ΠΏΡ€ΠΎΠ²Π΅Π΄Π΅Π½ΠΈΡŽ Ρ€Π°ΡΡˆΠΈΡ€Π΅Π½Π½ΠΎΠΉ гистСрэктомии, Π°Π»ΡŒΡ‚Π΅Ρ€Π½Π°Ρ‚ΠΈΠ²Π½Ρ‹ΠΌ ΠΌΠ΅Ρ‚ΠΎΠ΄ΠΎΠΌ ΠΌΠΎΠΆΠ΅Ρ‚ Π±Ρ‹Ρ‚ΡŒ биопсия стороТСвых Π»ΠΈΠΌΡ„ΠΎΡƒΠ·Π»ΠΎΠ² с ICG-ΠΊΠ°Ρ€Ρ‚ΠΈΡ€ΠΎΠ²Π°Π½ΠΈΠ΅ΠΌ ΠΈ ΠΏΠΎΡΠ»Π΅Π΄ΡƒΡŽΡ‰ΠΈΠΌ микростадированиСм.ЦСль исслСдования – ΠΏΡ€ΠΎΠ°Π½Π°Π»ΠΈΠ·ΠΈΡ€ΠΎΠ²Π°Ρ‚ΡŒ ΡΡ„Ρ„Π΅ΠΊΡ‚ΠΈΠ²Π½ΠΎΡΡ‚ΡŒ хирургичСских ΠΏΠΎΠ΄Ρ…ΠΎΠ΄ΠΎΠ² для стадирования Ρ€Π°ΠΊΠ° эндомСтрия ΠΏΡ€ΠΈ Ρ€Π°Π·Π»ΠΈΡ‡Π½Ρ‹Ρ… стСпСнях риска Π»ΠΈΠΌΡ„ΠΎΠ³Π΅Π½Π½ΠΎΠ³ΠΎ мСтастазирования.ΠœΠ°Ρ‚Π΅Ρ€ΠΈΠ°Π» ΠΈ ΠΌΠ΅Ρ‚ΠΎΠ΄Ρ‹. РСтроспСктивно ΠΏΡ€ΠΎΠ°Π½Π°Π»ΠΈΠ·ΠΈΡ€ΠΎΠ²Π°Π½Ρ‹ Ρ€Π΅Π·ΡƒΠ»ΡŒΡ‚Π°Ρ‚Ρ‹ лСчСния 565 Π±ΠΎΠ»ΡŒΠ½Ρ‹Ρ… Ρ€Π°ΠΊΠΎΠΌ эндомСтрия I стадии Π² онкогинСкологичСском ΠΎΡ‚Π΄Π΅Π»Π΅Π½ΠΈΠΈ Городской клиничСской Π±ΠΎΠ»ΡŒΠ½ΠΈΡ†Ρ‹ ΠΈΠΌ. Π‘.П. Π‘ΠΎΡ‚ΠΊΠΈΠ½Π° ΠΈ онкогинСкологичСском ΠΎΡ‚Π΄Π΅Π»Π΅Π½ΠΈΠΈ ΠšΠ°Π»ΡƒΠΆΡΠΊΠΎΠ³ΠΎ областного клиничСского онкологичСского диспансСра с 2021 ΠΏΠΎ 2023 Π³. ВсС ΠΆΠ΅Π½Ρ‰ΠΈΠ½Ρ‹ Π±Ρ‹Π»ΠΈ Ρ€Π°Π·Π΄Π΅Π»Π΅Π½Ρ‹ Π½Π° Ρ‚Ρ€ΠΈ Π³Ρ€ΡƒΠΏΠΏΡ‹ Π² зависимости ΠΎΡ‚ стСпСни риска Π»ΠΈΠΌΡ„ΠΎΠ³Π΅Π½Π½ΠΎΠ³ΠΎ мСтастазирования. ΠŸΠ°Ρ†ΠΈΠ΅Π½Ρ‚ΠΊΠ°ΠΌ Π²Ρ‹ΠΏΠΎΠ»Π½Π΅Π½Ρ‹ гистСрэктомия, гистСрэктомия Π² сочСтании с Ρ‚Π°Π·ΠΎΠ²ΠΎΠΉ ΠΈΠ»ΠΈ с Ρ‚Π°Π·ΠΎΠ²ΠΎΠΉ ΠΈ поясничной лимфадСнэктомиСй, Π° Ρ‚Π°ΠΊΠΆΠ΅ гистСрэктомия с ICG-ΠΊΠ°Ρ€Ρ‚ΠΈΡ€ΠΎΠ²Π°Π½ΠΈΠ΅ΠΌ ΠΈ биопсиСй стороТСвых Π»ΠΈΠΌΡ„ΠΎΡƒΠ·Π»ΠΎΠ². Π Π΅Π·ΡƒΠ»ΡŒΡ‚Π°Ρ‚Ρ‹. Π’ онкогинСкологичСском ΠΎΡ‚Π΄Π΅Π»Π΅Π½ΠΈΠΈ Городской клиничСской Π±ΠΎΠ»ΡŒΠ½ΠΈΡ†Ρ‹ ΠΈΠΌ. Π‘.П. Π‘ΠΎΡ‚ΠΊΠΈΠ½Π° Π±Ρ‹Π»ΠΎ ΠΏΡ€ΠΎΠΎΠΏΠ΅Ρ€ΠΈΡ€ΠΎΠ²Π°Π½ΠΎ 334 ΠΆΠ΅Π½Ρ‰ΠΈΠ½Ρ‹. Π£ ΠΏΠ°Ρ†ΠΈΠ΅Π½Ρ‚ΠΎΠΊ с ΠΏΡ€ΠΎΠΌΠ΅ΠΆΡƒΡ‚ΠΎΡ‡Π½ΠΎΠΉ ΡΡ‚Π΅ΠΏΠ΅Π½ΡŒΡŽ риска (n=94) послС гистСрэктомии с Ρ‚Π°Π·ΠΎΠ²ΠΎΠΉ ΠΈ с Ρ‚Π°Π·ΠΎΠ²ΠΎΠΉ (n=36) ΠΈ поясничной лимфадСнэктомиСй (n=31) выявлСно 4 (11,1 %) ΠΈ 6 (19,4 %) случаСв ΠΏΠΎΡ€Π°ΠΆΠ΅Π½Π½Ρ‹Ρ… Π»ΠΈΠΌΡ„ΠΎΡƒΠ·Π»ΠΎΠ² соотвСтствСнно. Π’ Π³Ρ€ΡƒΠΏΠΏΠ΅ высокого риска (n=50) послС Π°Π½Π°Π»ΠΎΠ³ΠΈΡ‡Π½Ρ‹Ρ… ΠΎΠΏΠ΅Ρ€Π°Ρ†ΠΈΠΉ патологичСскиС Π»ΠΈΠΌΡ„ΠΎΡƒΠ·Π»Ρ‹ ΠΎΠ±Π½Π°Ρ€ΡƒΠΆΠ΅Π½Ρ‹ Ρƒ 2 (10,5 %, n=19) ΠΈ 6 (26,1 %, n=23) ΠΏΠ°Ρ†ΠΈΠ΅Π½Ρ‚ΠΎΠΊ. Π’ ΠšΠ°Π»ΡƒΠΆΡΠΊΠΎΠΌ областном диспансСрС ΠΏΡ€ΠΎΠΎΠΏΠ΅Ρ€ΠΈΡ€ΠΎΠ²Π°Π½Π° 231 ΠΏΠ°Ρ†ΠΈΠ΅Π½Ρ‚ΠΊΠ°; всСм Π²Ρ‹ΠΏΠΎΠ»Π½Π΅Π½Π° гистСрэктомия с биопсиСй стороТСвых Π»ΠΈΠΌΡ„ΠΎΡƒΠ·Π»ΠΎΠ². ΠŸΡ€ΠΈ Π½ΠΈΠ·ΠΊΠΎΠΉ стСпСни риска выявлСно 7 (5,47 %) случаСв пораТСния ΡƒΠ·Π»ΠΎΠ², ΠΏΡ€ΠΈ ΠΏΡ€ΠΎΠΌΠ΅ΠΆΡƒΡ‚ΠΎΡ‡Π½ΠΎΠΉ – 6 (10,2 %), ΠΏΡ€ΠΈ высокой стСпСни риска мСтастазирования – 6 (13,6 %) случаСв злокачСствСнных ΠΊΠ»Π΅Ρ‚ΠΎΠΊ Π² Π»ΠΈΠΌΡ„ΠΎΡƒΠ·Π»Π°Ρ….Π—Π°ΠΊΠ»ΡŽΡ‡Π΅Π½ΠΈΠ΅. Π£ Π±ΠΎΠ»ΡŒΠ½Ρ‹Ρ… Ρ€Π°ΠΊΠΎΠΌ эндомСтрия I стадии с Π½ΠΈΠ·ΠΊΠΎΠΉ ΡΡ‚Π΅ΠΏΠ΅Π½ΡŒΡŽ риска Π»ΠΈΠΌΡ„ΠΎΠ³Π΅Π½Π½ΠΎΠ³ΠΎ мСтастазирования цСлСсообразно Π²Ρ‹ΠΏΠΎΠ»Π½ΡΡ‚ΡŒ Π³ΠΈΡΡ‚Π΅Ρ€ΡΠΊΡ‚ΠΎΠΌΠΈΡŽ с биопсиСй стороТСвых Π»ΠΈΠΌΡ„ΠΎΡƒΠ·Π»ΠΎΠ². ΠŸΡ€ΠΈ ΠΏΡ€ΠΎΠΌΠ΅ΠΆΡƒΡ‚ΠΎΡ‡Π½ΠΎΠΉ ΠΈ высокой стСпСни риска рСкомСндуСтся гистСрэктомия с систСмной лимфадСнэктомиСй. ΠŸΡ€ΠΈ отсутствии возмоТности удалСния Ρ‚Π°Π·ΠΎΠ²Ρ‹Ρ… ΠΈ поясничных лимфатичСских ΡƒΠ·Π»ΠΎΠ² ΠΌΠΎΠΆΠ½ΠΎ Ρ€Π΅ΠΊΠΎΠΌΠ΅Π½Π΄ΠΎΠ²Π°Ρ‚ΡŒ ΠΈΡ… биопсию с ICG-ΠΊΠ°Ρ€Ρ‚ΠΈΡ€ΠΎΠ²Π°Π½ΠΈΠ΅ΠΌ ΠΈ микростадированиСм. ΠŸΠ΅Ρ€ΡΠΏΠ΅ΠΊΡ‚ΠΈΠ²Π½Ρ‹ΠΌ Π½Π°ΠΏΡ€Π°Π²Π»Π΅Π½ΠΈΠ΅ΠΌ ΠΌΠΎΠΆΠ΅Ρ‚ ΡΠ²ΠΈΡ‚ΡŒΡΡ сочСтаниС систСмной лимфадСнэктомии с биопсиСй стороТСвых Π»ΠΈΠΌΡ„ΠΎΡƒΠ·Π»ΠΎΠ², ΠΊΠΎΡ‚ΠΎΡ€Ρ‹Π΅ гипотСтичСски ΠΌΠΎΠ³ΡƒΡ‚ ΠΏΡ€ΠΎΠ΄Π΅ΠΌΠΎΠ½ΡΡ‚Ρ€ΠΈΡ€ΠΎΠ²Π°Ρ‚ΡŒ Π»ΡƒΡ‡ΡˆΠΈΠ΅ Ρ€Π΅Π·ΡƒΠ»ΡŒΡ‚Π°Ρ‚Ρ‹ с ΠΏΠΎΠ·ΠΈΡ†ΠΈΠΈ стадирования заболСвания
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