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Злокачественные опухоли

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Проблема современных классификаций гепатоцеллюлярного рака. Аналитический

https://doi.org/10.18027/2224-5057-2017-2-68-75

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Аннотация

Гепатоцеллюлярный рак (ГЦР) в подавляющем большинстве случаев развивается на фоне хронических заболеваний печени, чаще – вирусных гепатитов В и С, и часто диагностируется на поздних стадиях [1, 3]. Несмотря на некоторые успехи современной онкологии (некоторые пациенты «доживают» даже до метастазов ГЦР в головной мозг [1]), прогноз при ГЦР остается плохим. В целом прогноз зависит не только от биологических характеристик самой опухоли, но и от фонового заболевания печени, часто – на стадии цирроза. В отличие от другой злокачественной опухоли печени – холангиоцеллюлярной карциномы, для ГЦР нет универсальных прогностических классификаций [2]. Так, международная классификация TNM, используемая для большинства солидных опухолей, не может применяться в качестве «референсной» для ГЦР [4]. Для определения прогноза c последующей тактикой ведения в западных и азиатских странах в последние годы разработаны различные шкалы оценки и классификации ГЦР. Для создания таких систем чаще используют регрессионную модель на основании прогностических переменных изучаемой популяции. На сегодняшний день не существует универсальной и признанной всеми прогностической шкалы или классификации ГЦР. Почти все эти классификации включают в себя такие признаки, как: функция печени, характеристики опухоли, клинические проявления, сопутствующие заболевания, наличие цирроза [3]. 

Об авторах

Д. Л. Ротин
ГБУЗ «Московский клинический научно-практический центр имени А.С. Логинова» (ГБУЗ МКНЦ ДЗМ), Москва
Россия
д.м.н., заведующий патологоанатомическим отделением


Е. А. Мороз
ФГБУ «Российский онкологический научный центр им. Н. Н. Блохина» (РОНЦ им. Н. Н. Блохина), Москва
Россия
к.м.н., с.н.с. отдела патологической анатомии


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Для цитирования:


Ротин Д.Л., Мороз Е.А. Проблема современных классификаций гепатоцеллюлярного рака. Аналитический. Злокачественные опухоли. 2017;(2):68-75. https://doi.org/10.18027/2224-5057-2017-2-68-75

For citation:


Rotin D.L., Moroz E.A. The problem of current classications of the hepatocellular carcinoma. Analytical review. Malignant tumours. 2017;(2):68-75. (In Russ.) https://doi.org/10.18027/2224-5057-2017-2-68-75

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