employee
National Research Tomsk Polytechnic University (Deputy Director)
employee
Tomsk, Russian Federation
employee
Tomsk, Russian Federation
Tomsk, Russian Federation
employee
Tomsk, Russian Federation
employee
Tomsk, Russian Federation
employee
Tomsk, Russian Federation
Obsuzhdayutsya problemy diagnostiki i lecheniya neyroendokrinnyh opuholey, predstavlyayuschih soboy geterogennuyu gruppu onkologicheskih zabolevaniy s raznoobraznymi klinicheskimi proyavleniyami i biologicheskimi osobennostyami, zavisyaschih kak ot lokalizacii i rasprostranennosti opuholevogo processa, tak i ot proyavleniy gormonal'noy sekrecii. Nesmotrya na to, chto neyroendokrinnye opuholi yavlyayutsya dostatochno redkimi, v nastoyaschee vremya otmechaetsya nepreryvnyy rost zabolevaemosti. Osoboe vnimanie v dannoy rabote udelyaetsya izucheniyu roli vysokoaffinnyh somatostatinovyh receptorov (sstr), rassmatrivaemyh v kachestve osnovnyh misheney v teranostike dannoy gruppy onkologicheskoy patologii. V svyazi s nevozmozhnost'yu ispol'zovaniya nativnogo somatostatina, v nastoyaschee vremya aktivno primenyayutsya ego neprirodnye sinteticheskie analogi. V otlichie ot nativnogo somatostatina, svyazyvayuschegosya so vsemi sstr (1–5) s vysokoy affinnost'yu i specifichnost'yu, analogi somatostatina vzaimodeystvuyut sstr2, sstr3 i sstr5. Diagnoz neyroendokrinnyh opuholey obychno stavitsya na osnovanii klinicheskoy simptomatiki, dannyh gistologicheskogo i immunogistohomicheskogo issledovaniy s ocenkoy gormonal'noy ekspressii. K sozhaleniyu, ispol'zovanie tradicionnyh diagnosticheskih metodov ne vsegda v polnoy mere pozvolyaet ocenit' rasprostranennost' opuholevogo processa, chto obuslovlivaet neobhodimost' sozdaniya novyh vizualiziruyuschih agentov. Primenenie metodov yadernoy mediciny, osobenno vypolnenie PET issledovaniy, v dannom sluchae demonstriruet vysokie pokazateli chuvstvitel'nosti i specifichnosti. Stremitel'noe razvitie personificirovannoy mediciny pozvolyaet ispol'zovat' effektivnye molekulyarnye misheni takzhe i dlya radionuklidnoy terapii onkologicheskih zabolevaniy. Otnositel'no nedavno etot princip byl primenen dlya neyroendokrinnyh opuholey s primeneniem pary 68Ga-DOTATATE/177Lu-DOTA-oktreotid, kotorye uspeshno ispol'zuyutsya vo mnogih yadernyh medicinskih centrah. Takim obrazom, v nastoyaschee vremya mechennye analogi somatostatina shiroko ispol'zuyutsya kak dlya radionuklidnoy diagnostiki neyroendokrinnyh opuholey, tak i dlya radionuklidnoy terapii ukazannyh novoobrazovaniy. Metody yadernoy mediciny obladayut vysokimi pokazatelyami chuvstvitel'nosti i specifichnosti, osobenno pri vypolnenii PET-issledovaniy. Mnogocentrovye issledovaniya v otnoshenii radionuklidnoy terapii neyroendokrinnyh opuholey prodemonstrirovali vysokie pokazateli ee effektivnosti i dokazali bezopasnost' ee primeneniya. V to zhe vremya v Rossiyskoy Federacii zaregistrirovan lish' odin preparat dlya vizualizacii neyroendokrinnyh opuholey – 111In-oktreotid, chto obuslavlivaet neobhodimost' vypolneniya issledovaniy po razrabotke novyh otechestvennyh diagnosticheskih i terapevticheskih radiofarmpreparatov.
neyroendokrinnye opuholi, somatostatinovye receptory, radiofarmpreparaty, teranostika
Нейроэндокринные опухоли (НЭО) представляют собой редкую и достаточно гетерогенную группу онкологических заболеваний с разнообразной клинико‑морфологической симптоматикой и биологическими особенностями. По эпидемиологическим данным, бόльшая часть НЭО представлена опухолями желудочно‑кишечного тракта и поджелудочной железы, что составляет 1–4 % всех злокачественных образований (ЗНО) пищеварительной системы и 60 % всех НЭО. Бронхопульмональные НЭО представлены 3 % всех ЗНО данной локализации и примерно 25 % всех НЭО. Несмотря на то, что НЭО считаются достаточно редкой онкологической патологией, в настоящее время отмечается непрерывный рост заболеваемости, в частности вследствие повышения качества диагностики на основе широкого внедрения в медицинские стандарты эндоскопических методов исследования.
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