medalphabetМедицинский алфавитMedical alphabet2078-56312949-2807ООО «Альфмед»10.33667/2078-5631-2023-36-35-41medalphabet-3481Research ArticleСтатьиПатогенетические особенности эндометриоидной аденокарциномы матки на современном этапеPathogenetic characteristics of endometrioid adenocarcinoma of uterus at present stagehttps://orcid.org/0000-0003-4037-7649МоисеенкоТ. И.MoiseenkoT. I.

Моисеенко Татьяна Ивановна - д. м. н., проф., г. н. с. отдела опухолей репродуктивной системы. AuthorID: 705829.

Ростов-на-Дону

Moiseenko Tatiana I. - DM Sci (habil.), professor, chief researcher at Dept of Tumors of Reproductive System1. AuthorID: 705829.

Rostov-on-Don

https://orcid.org/0000-0002-9228-7330ШаталоваС. В.ShatalovaS. V.

Шаталова Светлана Валерьевна - аспирант. AuthorID: 1092564.

Ростов-на-Дону

Shatalova Svetlana V. - graduate student1. AuthorID: 1092564.

Rostov-on-Don

svetlana_kornienko_94@mail.ruhttps://orcid.org/0000-0003-0521-8837НепомнящаяЕ. М.NepomnyashchayaE. M.

Непомнящая Евгения Марковна - д. м. н., проф., врач-патологоанатом патологоанатомического отделения. AuthorID: 519969.

Ростов-на-Дону

Nepomnyashchaya Evgeniya M. - DM Sci (habil.), professor, pathologist at Pathoanatomical Dept1. AuthorID: 519969.

Rostov-on-Don

https://orcid.org/0000-0002-2302-8271БандовкинаВ. А.BandovkinaV. A.

Бандовкина Валерия Ахтямовна - д. м. н., с. н. с. лаборатории изучения патогенеза злокачественных опухолей. AuthorID: 696989.

Ростов-на-Дону

Bandovkina Valeriya A. - DBio Sci (habil.), senior researcher at Laboratory of Study of Tumor Pathogenesis1. AuthorID: 696989.

Rostov-on-Don

https://orcid.org/0000-0003-4188-3746АдамянМ. Л.AdamyanM. L.

Адамян Мери Людвиковна - к. м. н., н. с. отдела опухолей репродуктивной системы. AuthorID: 710702.

Ростов-на-Дону

Adamyan Meri L. - PhD Med, researcher at Dept of Reproductive Tumors, National Medical Research Centre for Oncology1. AuthorID: 710702.

Rostov-on-Don

ФГБУ «Национальный медицинский исследовательский центр онкологии» Минздрава РоссииРоссияNational Medical Research Centre for OncologyRussian FederationФГБОУ ВО «Ростовский государственный медицинский университет» Минздрава РоссииРоссияRostov State Medical UniversityRussian Federation202317012024036Диагностика и терапия (4)3541Copyright © Моисеенко Т.И., Шаталова С.В., Непомнящая Е.М., Бандовкина В.А., Адамян М.Л., 20242024Моисеенко Т.И., Шаталова С.В., Непомнящая Е.М., Бандовкина В.А., Адамян М.Л.Moiseenko T.I., Shatalova S.V., Nepomnyashchaya E.M., Bandovkina V.A., Adamyan M.L.Данная работа распространяется под лицензией Creative Commons Attribution 4.0.This work is licensed under a Creative Commons Attribution 4.0 License.https://www.med-alphabet.com/jour/article/view/3481

Рак тела матки (РТМ) является одним из наиболее распространенных онкогинекологических заболеваний, демонстрирующих постоянную устойчивую тенденцию к возрастанию частоты во всем мире. Основной причиной роста РТМ, кроме старения женской популяции, считают эпидемию ожирения и связанную с ней гиперинсулинемию. Скрининг при РТМ не разработан. Однако карцинома эндометрия (КЭ) проявляет себя конкретной симптоматикой и клиникой, а методы диагностики доступны, чувствительны и очерчены определенным кругом коморбидных заболеваний. Именно эти факторы делают возможным диагностику КЭ в 80 % случаев на ранних стадиях заболевания. Методы лечения стандартизованы, в зависимости от стадии РТМ и морфологической структуры КЭ, возраста больной, и позволяют достичь 72–76 % общей 5-летней выживаемости. Казалось, что заболевание протекает с благополучным исходом и находится под контролем. Однако в конце прошлого столетия стали появляться публикации, касающиеся клинической и морфологической неоднородности КЭ, что позволило Я. В. Бохману предложить дихотомическое деление РТМ на клинико-патологические варианты. Подобное деление было принято во всем мире и заставило по-новому оценить прогностическое значение различных гистотипов аденокарциномы эндометрия в зависимости от фенотипа и гормоногенеза КЭ. Изначально к эстрогензависимой эндометриоидной аденокарциноме был отнесен и аденосквамозный рак (в современной классификации – эндометриоидная аденокарцинома с плоскоклеточной метаплазией), а плоскоклеточный рак эндометрия – к неблагоприятному типу с плохим прогнозом и без связи с гормональным влиянием. Интерес к плоскоклеточному компоненту в диморфной аденокарциноме эндометрия в течение последних десятилетий возникал неоднократно из-за непредсказуемости клинического течения. Последняя TCGA молекулярно-генетическая классификация РТМ не внесла ясность в возникшие вопросы, но породила новые, связанные с этиологией и канцерогенезом данного гистотипа КЭ и ее клинической интерпретации.

Endometrial cancer (EC) is one of the most common cancers with a constantly and steadily growing incidence worldwide. The main reason for EC development, in addition to the female population aging, involves the obesity epidemic and associated hyperinsulinemia. Screening for EC has not been developed. However, endometrial carcinoma (ECa) demonstrates a specific symptomatology and clinical picture, and diagnostic methods are available, sensitive and defined by a certain range of comorbid diseases. These factors allow early ECa diagnosis in 80 %. The methods of treatment are standardized, depending on the stage of RTM and the morphological structure of EC, the age of the patient and allow to achieve 72–76 % of the overall 5-year survival rate. The methods of treatment are standardized, depending on the EC stage, the morphological structure of ECa, and the patient’s age, and allow achieving the 5-year overall survival of 72–76 %. The disease promised a favorable outcome and seemed to be controlled. However, at the end of the last century, researchers started to report the clinical and morphological heterogeneity of ECa, which allowed Ya. V. Bohman to propose a dichotomous division of EC into clinical and pathological variants. Such a division was accepted all over the world and required re-evaluation of the prognostic value of various endometrial adenocarcinoma histotypes depending on the phenotype and hormonogenesis of ECa. Initially, adenosquamous cancer (or endometrioid adenocarcinoma with squamous metaplasia, in the modern classification) was also classified as estrogen-dependent endometrioid adenocarcinoma, and squamous cell endometrial cancer was classified as an unfavorable type with a poor prognosis and without hormonal influence. Interest in the squamous cell component in dimorphic endometrial adenocarcinoma has repeatedly arisen over the past decades due to its unpredictable clinical course. The newest TCGA molecular classification of EC did not clarify the issues, but gave rise to new ones related to the etiology and carcinogenesis of this ECa histotype and its clinical interpretation.

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The authors declare that there are no conflicts of interest present.