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Особенности морфологического строения первичной опухоли при мультицентрическоммультифокусном росте рака молочной железы.

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????????? ??????????? ??????, 2011, ??? 26, ? 1, ?????? 1
???: 618.19&006.6&021.3&091&031.61
??????????? ???????????????? ???????? ????????? ???????
??? ??????????????????/?????????????? ????? ???? ????????
??????
?.?. ????????
??? ????????? ?? ????, ?????
??? ??? ????????? ??????????????? ??????????? ??????????? ??????????????????? ??????, ?????
E9mail: wtorushin@rambler.ru
FEATURES OF MORPHOLOGICAL STRUCTURE OF PRIMARY TUMORS
IN MULTICENTRIC/MULTIFOCAL GROWTH OF BREAST CANCER
S.V. Vtorushin
Institute of Oncology of the Siberian Branch of the Russian Academy of Medical Sciences, Tomsk
Siberian State Medical University, Tomsk
???????????? ???????????? ???????? ?? 511 ??????? 35?80 ??? (??????? ??????? ? 52,9�6 ???) ? ?????????&
?????? ?????????? ????? ???????? ?????? ?????? T 2?4 N0&2 M0. ? ??????????? ?? ???????? ????? ???????
??? ????????? ???? ????????? ?? 2 ??????. ? ?????? ?????? ????? 441 ??????? ? ??????????????? ????? (??).
?????? ?????? ????????? 106 ????????? ? ??????????????????/?????????????? ?????? ???????. ?????????&
?????? ???????????? ??????? ????????? ??????? ???????, ??????????? ? ????????? ????? ???? ???????? ????&
?? (???). ??? ????????????? ????? ???? ???????? ?????? ?????????? ?????? ??????????????? ???????????&
?? ???????????????? ??????????, ????? ??????? ??????????? ?&????????? ? ?????? ??????????? TGF&? ? ???&
????, ??????????? ???????????? ? ??????. ? ??????? ? ??????????????????/?????????????? ????? ????????
?????? ???????? ???????? ? ??????? ??????????????? ??????????? ?????? ??????????? ????.
92
?.?. ????????
??????????? ???????????????? ???????? ?????????...
???????? ?????: ??????????????????/?????????????? ??? ???????? ??????, ??????????????? ???????????
???????.
Surgical specimens from 511 patients in the age of 35?80 years (average age 52.9�6 years) with invasive ductal breast
cancer stages T2?4 N0&2M0 were studied. Depending on the version of the tumor all patients were divided into 2 groups.
The first group included 441 patient with unicentral cancer. The second group included 106 patients with multicentric/
multifocal tumor growth. Morphological examination of the tumor revealed differences associated with a variant of the
growth of breast cancer. In multiple growth of breast cancer tumor cells are characterized by a predominance of parenchymal
component, higher expression of E&cadherin and low expression of TGF&? in tumor, angiogenesis intense in the stroma.
In patients with multicentric/multifocal breast cancer differences in the inflammatory infiltrate of the stroma of the
tumor were revealed.
Key words: multicentric/multifocal breast cancer, morphological features of tumor.
????????
?? ??????????? ???? ??? ?????? ???????? ? ??????&
??? ? ???, ?????? ? ?????? ???????&??????????????&
?? ??????????, ??? ??????? ???????, ?????? ??????? ?
???????? ?????????????????? ????????, ??????? ?????&
?????????? ?????????????????, ??? ??????? ????????
????????? ??????????, ?????????? ????????? ?????&
???????? ???????? ?????????? ?????? [1, 9].
?????? ?? ??????, ???????? ? ???????? ? ??????&
??? ?? ???????????? ???, ???????? ????? ????????????&
??, ??? ??????????? ?????? ?????? ????????? ??????? ?
??????????????? ???????????? Her2/neu. ?? ?????? ??&
??????????? ???????? ????? ????????????? ??????? ??&
???????????????? ???????? ???????? ?????? ? ????&
????? ? ?????????, ?????????????????? ????????? ?
??????? ???????? [1, 7]. ??????????????? ?????????
Her2/neu ??? ???? ???????? ?????? ??????????? ?????&
????????? ????????? ? ?????????? ?????????, ??????
????????????????? ? ???????????? ? ????? ???????????
???????? ??????? [4, 7, 10].
? ????????? ??????????? ?????? ????????? ??????&
????????? ?????? ? ??????????????? ?????????? ???&
????, ?????????? ????????, ????????, ?????????? ??&
??????? ???????????? ??????? ? ??????????? ???????&
???????? ??????. ?????? ??????????????? ???????? ???&
??? ?? ??? ?? ?????? ???????? ???????????.
?????? ? ???????????????? ?????????????? ?????&
????? ???????, ?????? ???????? ??????? ??????????
?????? ???????, ? ?????????, ???????? ???????????, ??&
?????????? ? ????????????? ??????? ??????????????
???????????? ? ??? [6, 12, 15].
????????, ??? ? ????? ??????? ???? ???????????????
????? ???? ?????????????, ??? ?????????? ?????????&
?????????/??????????????. ????????? ???????? ?????
???? ???????? ?????? ?? ???????? ?????? ??????????.
????????? ? ?????????? ?????? ? ??????? ???????????&
?? ??????? ???????? ??? ?????? ??????????? ? ?????&
????? ?? 3,76 ?? 58% ?????????? [3, 5, 11]. ?????? ????&
?? ???????????? ? ?????? ????????????? ????????????
?? ???????????? ???????????????? ???????? ?????????
???????, ? ???????????????, ?????????? ????? ?? ???&
?????????? ????????, ??? ??????????????? ??????????,
????????? ????????, ?????????? ???????? ????????????
???????, ???????? ???????? ? ????????? ? ??????????&
??? ?????? ???. ????? ????, ??????????? ?????? ? ??&
??????? ???????????? ?????????? ??????? ? ???????
?????????????? ???????????? ? ??? ? ??????? ? ????&
??????????????/?????????????? ?????? ????????????&
???.
???? ????????????: ???????? ??????????, ???????&
??? ???????? ????????????? ???????? ?????????? ???&
??? ? ????????? ???????????? ?????????? ? ?????????
??????? ??????????? ??????????? ??? ??? ?????????&
?????????/?????????????? ????????? ?????.
???????? ? ??????
???????? ???????????? ???????? ?? 511 ???????
??????????????? ??? ? ?????? T2?4 N0&2 M0, ???????&
????? ?? ??????? ? ????????? ????? ????????? ???
????????? ?? ???? ? 2000 ?? 2005 ??. ??????? ???????
??? ?? 35 ?? 80 ???, ??????? ??????? ???????? 52,9�6
???. ? ???????????????? ??????? 380 ??????? ?????&
?????? 2?4 ????? ?????????????? ???????????? ?? ???&
?? CMF ??? FAC; 131 ????????? ???????????????? ????&
??? ?? ???????????; 380 ??????? ????????????? ????&
??? ???? ????????? ? ?????? ??????????? ???????????.
? 131 ?????????? ????????? ????????????????? ???&
????? (??????????? ??? ???????????? ???????? ?????&
??? ?????? ? ??????????? ???????????????). ? ?????&
???????????? ??????? 495 ????????? ???????? ????&
??????? ???????. ? 172 ??????? ??????????? 2?6 ??????
???????????? ?? ??????????? ?????? CMF ??? FAC, 44
???????? ???????? ??????????????. ? 279 ??????? ???&
???????? ??????????? ???????, ? ??????? ???????? 220
?????????? ??????????? ??????? ???????. ????????????&
???? ???????????? ??????????? ???????????? ??????&
??. ??????????? ????? ????????? ?????????? ????? ? ???
??????????? ????????????? ????. ??? ????????? ????&
??????????????? ????? ??? ??????????????? ?????????&
??? ????????? ????? ???????? ?????? ?? ??????? ????&
?????? (??? ??????????? ???????????) ? ????? ??????&
???? ??????? (??? ????????????????? ?????????). ??&
????? ?????? ????????????? ? 10&?????????? ????????&
??? ?????????. ???????? ????????????? ?? ????????&
??? ???????? ? ????????? ? ???????. ????? ????????
5?6 ??? ???????????? ?????????????? ? ???????. ??&
????? ???? ???????? ?????? ?????????????? ????????
??????????????? ????????????? ???????? ????????
?????? (???, ????, 2003).
? ??????????? ?? ???????? ????? ??????? ??? ????&
????? ???? ????????? ?? ??? ??????. ? ?????? ??????
????? 441 ??????? ? ??. ?????? ?????? ????????? 106
????????? ? ??????????????????/ ?????????????? ??&
???? ???????. ??? ???? ? 27 ????????? ?????? ??? ???&
93
????????? ??????????? ??????, 2011, ??? 26, ? 1, ?????? 1
?? ??? ??? ?????????????? ?? ?????????????? ????? ?
??????? ???????&???????????????? ??????? (??????&
???????????? ????, ?????????? ?????????? ? ???). ?
79 ??????????? ????????????? ???????? ????? ????&
????? ????? ???????????????? ???????????? ?????????
????? ???????? ?????? (?????????????????? ????, ??&
???????? ?????????????? ? ???).
??? ???????????? ???????????????? ??????????
?????????? ?????????? ????????? ???????? ???????&
???, ?????????????, ?????????????????, ????????
?????????, ?????? ??????. ??????????? ?????????? ?????&
??? ? ??????????????? ?????????? ? ?????? ??????.
??????? ????????????????? ????????? ?? ??????????&
?????? ????? P. Scarff, H. Bloom ? W. Richardson. ??? ????
????????? ?????????? ?????????? ? ?????????? ?????&
???, ????? ??????? ? ????????? ???????????.
?????????????? ???????????? ? ?????? ????????&
?? ??????????? ???? ????????? ??????????????????
??????? ?? 3&???????? ??????? (1 ???? ? ????? ????&
??????, 2 ????? ? ???????? ??????????, 3 ????? ? ?????
??????????).
???????????? ?????? ??????????????? ?? ???????&
???? ??????????? ???????????????? ? ????????????
??????????, ??? 1 ?????? ?????????? ?????? ???????&
????? ?????? (????????? ?70%), 2 ??????? ? ??????&
??? ???????????? ?????? (????????? <70%, ?? >10%),
3 ??????? ?????????? ?????? ? ????? ?????????? ????&
??? (????????? <10%).
???????? ????????? ?????????????? ?????????????
?????? ?????????? ??????????? ???? ? ??????? ???????&
??????? ???????????? ? ??? ????????? ?? ????????&
??? ?????? ????????????????????? ???????? ? ??????&
???????? ????????????&??????????? ??????. ??? ?????&
??????? ????????? ???????? ????? ?Dako? ? ???????&
??? ????????? (???? 1D5, RTU, ???????), ? ??????????
???????????? (???? PgR636, RTU, ???????), ? ???????&
????? c&erbB?2, ? Ki67 (???? MIB&1, RTU, ???????), ? CD
3 (???? UCHT1), CD8 (???? C8/144B), CD20 (???? L26),
????? ?Novocastra? ? ?53 (???? CM1), ? bcl2 (???? bcl2/
100/D5), ? ?&????????? (???? 36B5), ? TGF? (????
TGF?17), ? TGF?R1 (???? 8?11), ? CD4 (???? 1F6), ? CD
25 (???? 4C9), CD68 (???? 514H12), CD117 (???? T595), ?
CD 138 (???? 5F7), ????? ?Biogenex? ? CD45 LCA (????
PD7/26/16&2B1, RTU, ???????), ????? ?Diagnostic
Biosystem? ? ?&???????? (??????????????). ??????????&
??? ??????? ???? ??????? ?????????????? ???????????
??????????? ??????? ?? ???????? ??????.
?????????? ?53, Ki67, bcl2, TGF?, TGF?R, ?&???????&
??, ?&???????? ????????? ? ?????????? ?????????? ??&
?????????? ?????????? ?????? ? ?????? ???????? ?????&
??? ???????????????? ?????????? ????????? ???????.
?????????? bcl2, TG?F, TGF?R, ?D45 LCA, ?D3, ?D4, ?D8,
?D68, ?D117, ?D138, ?D20, ?D25 ? ??????? ???????????&
???? ??????????? ????????? ????????????????? (0 ???&
??? ? ??????????; 1 ???? ? 1?5 ??????; 2 ????? ? 6?20
??????; 3 ????? ? ????? 20 ??????) ?????? ??????? ????&
???? ???????? ???????????????? ?????????? ??????? (??
????? ??? ?? 1?2 ???????? ?????? ?????????) ? ? ????&
?? ??????????????? ? ????????? ?? ???????????????
????????.
94
?????? ????????? ???????????? ? ?????? ???????
????????? ?? ????????? ?????????? ???????????????
???????? CD31. ????????? ??????????? ? ???????
??????&?????????? ?? ?????????? ??????? ?? 1 ??2.
?????????????? ????????? ?????? ??????????? ? ??&
????? ?????? ???????? STATISTICA 6.0. ??? ??????? ??&
???????? ?????? ???? ????????? ?????? ?????????&
??? ??????????, ????????????? ?????? (??????? ?????&
??? ?, ??????????? ?????????? ?). ??? ??????? ?????&
???????? ???????? ??????????? ?????????????????
???????? ??&???????, ????????????? ?????????????&???&
?????????? ?????? ?? ???????? (??????????? ?????&
??? ?????????? r), F ? ???????? ??????, p ? ???????
?????????????? ??????????.
??????????
?????????? ?????????? ??? ???????? ?????? ????&
???? ????? ?????? ??????????????? ?????? ???? ?????&
??? ?????? ? ?????????? ??????? 80% [14]. ? ????? ? ????
?????? ??????? ???????????? ???????? ????????????&
???? ???????? ?????? ??????????????? ????? ??? ???
?????? ????????? ????? ???????????????. ?????? ????&
?? ???????????????? ?????????, ??? ??????? ?????????&
?????? ????????????????? ?? ???????? ?????&???? ???&
????? ? ??????????? ?? ???????? ????? ??? (?2=4,1;
p=0,3). ?????? ??????? ?????????? ???????? ? ??????&
??? ???????, ??????? ???????? ????? ?? ????????? ???
?????? ??????? ????????????????? ???, ??????????
???? ?????????????? ? ?????????? ??????? ? ?????&
???????? ?????????? ????? (?2=6,5; p=0,002). ???????&
??? ?????? ???? ???????? ? ????????? ???????????&
?????? ????????. ????????, ??? ??? ??????? ???? ????&
?????? ??? ??????????????????/?????????????? ???&
?? ??????????????? ? ??????? ? ??????????? ???????&
?????? ?????? (?2=9,5; p=0,008).
?????&???? ???????? ???????? ?? ??????? ????????&
????? ???????? ???????? ? ????????? ?????????????
????? ?????????? ?????? ??? ?????? ????????? ?????
??? ???????? ?? ????.
??? ???????? ?????? ??????????? ????? ???????????
????? ???????? ? ??????????????? ?????????? ?????&
?? ? ?????????? ????? ???. ??????????, ??? ??? ??&
??? ???????? ??????????????????? ????, ? ????????? ?
??????????????? ???, ?????????? ???? ???? ????????&
???? ??????? ????????????? ???????????????? ???&
??????? ? ??????????? ?? ??????????? ?????? ? ?????
????? ???????? ? ??????? ?? ???????????????? ???????&
?? ?????. ?????? ??????????? ????????? ???????? ????&
?? ??? ??? ???????, ? ??????? ????????????? ?????? ???
???????? (?2 =13,8; p=0,03).
????????? ?????????? ????????????????? ???????
????? ????????? ???????????? ??????? ?? ?????????&
?????? ?????????????? ???????, ?????? ????????? ????&
???????? ?????????? ? ???????????? ?????????? ? ???&
??????? ???? ??????????? ? ?????? ????? ???????. ???,
???? ????????, ??? ? ?????????, ?? ?????????? ???????&
??????? ???????????? ? ??????? ???????????????&
???/?????????????? ???, ?????? ??????? ???? ??????&
?? ??????, ??? ? ????????????????, ??? ??????? ????
?.?. ????????
??????????? ???????????????? ???????? ?????????...
??????? 1
??????????? ??????? ??????????????? ?? ????????????
??????? ??????? ??? ?????? ????????? ????? ???
???????????
?????? ?????9
??
??+??+
??+???
??????
?????+
?????? ??????????? ????, ?? (M�)
??????? ????? ???? ???????? ??????
1
2
??
???
3
???
2,8�5
3,1�5
3,3�8 p1?2=0,23
3,0�1
F=1,59; p=0,19
2,7�3
2,8�4
3,9�8 p2?3=0,38
2,7�3
F=0,49; p=0,83
2,8�9
1,9�47
4,26�5 p1?3=0,025
2,3�1
F=3,0; p=0,035
??????????????? ?????????? ?????????? ?????? ???
???? ???????? ??????, ????????? ??????????????? ??&
????????, ?????????? ???????? ???????? ????????, ??&
???????? ???????? ? ???????????? ???????. ? ????? ? ???,
??? ?????????? ????????????????? ??????? ????? ???&
?????? ???????????? ??????? ?? ??? ????????, ??????
?????? ?????????? ??? ?????? ????????? ????? ??? ??
????????? ?????? ? ???????? ???????, ?? ??????????
??????????????? ??????? (????. 2).
??? ????? ?? ??????, ?????????????? ? ???????, ???&
?????? ???????? ????? ??? ?? ?????????? ?? ??????&
????? ??????????????? ?????????? ? ????????. ??????
??? ????????????? ?????????? ????? ???????? ?????
?????????? ?????????? ???????? ??????? ????????????
??????? ?&????????? ? ?????? ?????????? ??????? ?????
TGF&? ? ?????????? ? ????? ??????? ?????????? ?????&
????? ? ????.
????????? ?????? ?? ????????????? ?????????? ??&
??????? ? ?????? ????? ???????, ???? ????????????&
???? ????? ????? ??????? ?????????? ? ???????? ???&
??????? ??????????? ??????????? ????. ?????????, ???
?????? ??? ??????????????????/?????????????? ???&
?? ??????? ???????? ?????????? ????? ????????? ???&
???? ? ??????????? ???????? ?????????????????? ???&
????? ?53 (r=?0,57; ?=0,026), ???? ?? ??????????? ???
??????????????? ????? ??????????????? (r=?0,04;
?=0,76).
?????????? ??????????????? ?????????? ? ???????&
??? ??????? ???????? bcl&2 ? ????????? ??????? ?? ????
??????? ? ????????? ??????????? ????. ?????????, ??&
???????? ????????? ??????????? ? ???????????? ????&
???, ????? ????????? ?? ???????????????? ? ????????
??????? ??? ??? ??????????????? ???, ??? ? ??? ????&
??????????? ?????. ?????????? ?????????? ?????????&
?? ???????? ????????? ??????? TGF&? ? ????????? ? ????
?? ???? ????????? ? ???????? ??????????????? ?? ???
????? ?? ????????? ?????.
?????? ? ??????????????? ???????????????? ?????&
??, ??????????? ?? ????????? ????????, ??? ??????
????????? ??????????? ????? ??? ??????????????? ????&
??????? ?????????. ?? ??????????? ?????? ?????????&
??? ??????????????? (?2=12,6; p=0,013). ?????? ?? ??&
???????? ???????????, ????? ????????, ??? ??? ?????&
???????? ????? ??? ? ????? ??????? ??????????? ??&
????????????? ????????? ? ??????? ???? ???????????
??????, ????? ?? ??????? ??????????.
??????????? ?????? ??????? ???????? ?????? ????&
??????, ?????????? ?? ?????? ?? ????????????? ???&
????????????? ? ???????????????? ???????????, ?? ? ??&
????????? ? ????????????? ??????? ???????????. ? ???&
?? ? ???? ???? ?????? ?????????? ??????? ?????? ???&
???? ??? ????????? ????????? ????? ???. ????????
??????? ?????????? ????????? ? ??????????? ?? ????&
???? ????? ??? ?? ??????????. ?????? ? ??????? ? ???&
?????????? ?????????? ????? ??????????????? ??????&
?? ????????? ? ??????? ??????? ??????? ???????? ? ??&
???????? ??????????? ?????????? ?????????? ? ??????&
?????? ? ????????? ? ??????????????? ??? (???????&
??????? 54 ? 44%; p=0,06). ???????? ???????? ????????
???? ???????? ??? ???????? ????????? ?????????????
?????????? ??????? ???????? ? ???????. ?????????, ???
? ??????? ???????????????????/??????????????? ????
???? ????????????, ???????????????, ???????????? ??&
???????? ?????????? ??????????, ????? ??? ??????????
????????????? ?????????? ?????????? (??), ??????? ???&
???????????? ???? [8] ??? ????? ????????????? ???????
? ????????? ???????????? ????????????????, ???? ??&
????? ??? ??????????????? ??? (?2=10,8; p=0,004).
??? ?????? ????????? ????? ??? ??? ????????
?????? ??????? ??????????? ???? ? ??????????? ?? ??????? 2
???????????? ???????. ????????, ??? ?????? ? ???&
???? ??????????????????? ????, ??????????? ??? ?????????? ??????????? ??????????????? ??????????, ????????,
??????????????? ????????????, ??????? ??????????? ???????????? ???????, TGF? ? TGF?!R ? ???????????????
????? ?????????? ???????????. ?????????, ??? ??? ?????????? ??????????? ???? ? ??????? ??? ?????? ?????????
?????? ???? ????? ??????? ?????????? ?????? ????? ???
??????????????? ?????????? ??? ?????????? ????&
??????????,%
??????? ????? ???? ???????? ??????
?????????
?????? ?? ? ?????????? ???????????? (??) ? ????&
(M�)
????? ?? ????????, ????? ??????? ????? ???????&
??????????????? ??????????????????/
??????????????
??? ??????????? ?????? (F=3,0; p=0,035), ?????&
?? 1. ????? ????, ?????????? ????????, ??? ?????? Ki67
7,3�,1
6,2�7
F=0,18; p=0,67
63,6�,2
59,1�,2
F=0,1; p=0,74
?????????????????? ???????? (??&??&) ??? ?????& p53
64,8�,5
63,3�,4
F=0,01; p=0,9
?? ?????? ??? ??? ? ????????? ? ????????????& bcl92
?9???????
62,6�,5
70,1�,5
F=0,4; p=0,52
??? ??? (p1?3=0,025).
?9????????
36,5�,7
60,3�,1
F=5,1; p=0,028
?????? ? ??????????? ???????? ? ???????? ??& TGF9?
67,0�,1
21,3�7
F=10,7; p=0,002
??????????????????? ????????, ?????????? ???????? ? TGF9?
23,7�,1
37,8�,6
F=2,7; p=0,1
95
????????? ??????????? ??????, 2011, ??? 26, ? 1, ?????? 1
??? ???? ???????? ???????? ? ???????????? ???????&
??? ????????? (?????????? CD31) ? ??????? ? ??????? ?
?????? ?????????? ????? ???????. ???, ??? ??????????&
????????/?????????????? ????? ??????????????? ????&
??? ?????????? ????????? ??????? ??? ????, ??? ???
??????????????? ????? (?????????????? 110�,1 ?
81,3�,9; F=6,6, p=0,01).
??? ????? ?????? ????????????, ???????????????
??????????? ????????? ??????? ? ?????????? ?????&
?????? ???????? ??????? ? ???, ???????? ???????????&
??? ????????????. ??? ?????? ????????? ????? ???
???? ??????????? ???????????? ? ???????????? ??????
?????????????? ????????????. ????????, ??? ???????&
????? CD45 LCA+ ???????? ?? ????? ???????????? ??&
????? ??? ??????????????? ? ????????????? ?????&
????? ????? (?2=0,7; p=0,67). ?????? ??? ????????? ??&
??????????? ??????? ??????????????? ??????????? ???
????????? ??? ???????? ????????. ?????????, ??? ???
??????????????????/?????????????? ????? ?????????&
??? ? ?????? ??????? ????? ?? ???????????????? ???&
??????? ?D20+ ?&??????????? ??????? ????, ??? ???
??????????????? ??? (?2=16,5; p=0,0008). ???, ??? ???&
???????????? ???????? ????? ??????? ?????????? ??&
?????????? CD20+?&??????????? ???????? ? 40,4%
??????????, ? ?? ????? ??? ? ???????? ??????? ? ???&
?????????? ?????? ? ???? ? 6,7%.
????? ????????, ??? ?? ? ????? ?????? ??? ??????&
????????? ??? ? ?????????????? ??????????? ?? ????
???????? ??????????? ?????? ?????? (CD117+), ???????
??? ??????????????? ????? ?????????????? ? 51% ???&
????? (?2=12,2; p=0,006). ?? ?????? ????????? ?????&
?????????, ??????????? ? ??????????? ?????? ?????? ???
??? ????????????? ? ????????????? ????????? ????&
??????? [13].
????? ???????? ??????? ? ???????????? ???????&
????? ?????? ??????? ????? ?? ???????????????? ???&
??????? ?????????????? ?&??????????. ??????????,
??? ??? ??????????????????/?????????????? ?????
??????? ???? ??????????? ?????? ? ?????????? ??????&
??????? ?D8+ ???????????, ??? ??? ???????????????
??? (? 2=9,2; p=0,025). ??????? ? ?????? ??????? CD4+
?????????? ??? ??????????????? ????? ??????????? ?
59,6%, ? ?? ????? ??? ??? ????????????? ????? ? ??????
? 26,7% (p=0,016).
?????&???? ??????? ? ???????????? ?????? ?????&
?? CD68+ ??????????? (?2=4,2; p=0,2), ?????????????&
?? ???????? (CD138? ?2=5,1; p=0,15), ? ????? ? ???????&
??? ???????? ??????????? ????????? ? ????????????&2
(CD25) ??? ?????? ????????? ????? ??? ?? ????.
??????????
??????????? ???????????? ????????? ??????????
??? ???????????? ??????? ? ??????????????? ?????&
??? ?????????? ????? ??? ??????????????????/??????&
???????? ????? ???? ???????? ??????. ??????? ???
?????? ???????? ????? ??????????????? ??????? ???&
???????????? ????????????? ???????????????? ?????&
?????, ?????? ???????? ??????????????? ????? ???????
??????????? ??????? ???????????? ??????? (?&???????&
96
??) ? ?????? ??????????? ????????? ??????? (TGF&?).
????????? ????????? ?????????? ????? ???????? ???&
?????? ????? ?????????????? ???????? ???????????.
????? ????? ??? ??????????????????/??????????????
????? ???????? ???????????? ???????????????? ?????&
????? ? ???????, ??? ????? ???? ??????????? ????? ???&
??? ?????????????? ??????????? ?????? ? ???????????
???????????? ? ?????? ???????????????. ????? ???????
??????????? ???? ??? ????????????? ???????? ?????
??? ? ??????????? ???????? ????? ????????? ? ??????&
??? ? ???????????????. ? ??????? ??????????????????
???????? ???????? ???????? ? ???????????? ???????
??????????????? ??????????? ?????? ??????????? ????,
????????????? ????????? ???????????? ??????????
??????????????????? ????????, ?????????? ??? ? ??&
????????? ???????? ???????, ??? ? ? ?&??????????
???????????? ?????????.
??????????
1. ????? ?.?., ?????????? ?.?., ?????????? ?.?. ? ??. ???????
???????? ??? ???? ???????? ?????? // ??????????? ??&
???????. ? 2005. ? ?. 7, ? 1. ? ?. 4?9.
2. ??????? ?.?., ??????? ?.?., ?????????? ?.?. ???????? ??&
???????????? ???? ???????? ?????? ? ?? ???????????
???????? ??? ???????? [??????????? ??????] // VII ??????&
???? ?????????????? ???????????. ? ?., 2003. ? URL : http:
//www.rosoncoweb.ru/library/7th_conf.
3. ???????? ?.?. ????????&????????????? ??? ????????
?????? // ?????????? ?????????????? ??????. ?1999. ?
? 2. ? ?. 9?11.
4. ???????? ?.?., ?????????? ?.?. ???????? ??????? ??? ???&
???? ???????? ??? ???? ???????? ?????? // ?????????&
??? ?????????. ? 2002. ? ?. 3, ? 1. ? ?. 38?44.
5. ??????? ?.?. ?????????????????? ??? ???????? ??????:
??????????? ???????, ?????????? ???????, ??????? // ???&
???????. ? 2006. ? ? 2. ? ?. 32?36.
6. ??????? ?.?., ?????? ?.?. ????????????? ? ????????? ????
???????????? ? ???? ???????? ?????? // ????? ??????&
???. ? 2008. ? ?. 70, ? 1. ? ?. 62?65.
7. ??????????? ?.?., ????????? ?.?., ??????? ?.?. ? ??. ???&
???????? ???????? ?????????? ??????????, ????????????
? ????????? HER2/NEU ? ??????? ???? ???????? ?????? //
?????????. ? 2002. ? ?. 4, ? 1. ? ?. 33?36.
8. ?????? 2300111 ?????????? ?????????, ???51 G 1 N 33/
74, G 1 N 33/50 ?????? ??????????????? ??????? ??????&
????? ????? ???????? ?????? / ???????? ?.?., ????????&
??? ?.?., ??????? ?.?. ? ??. ? ?2005118627/15 ; ?????.
15.06.05 ; ?????. 27.05.07, ???. ? 15. ? 9 ?.
9. ??????????? ?.?., ??????? ?.?. ???????? ?????????????&
???????? ??????? ??? ??????????? ????????? ??????? ?
???????? ?????????? ??????????? // ????? ?????????. ?
2000. ? ???. 5. ? ?. 26?30.
10. ?????? ?.?., ???????? ?.?. ??????? ERBB2/HER2: ?? ????&
???????? ? ??????????? ????????? // ??????? ??????&
???. ? 2002. ? ?. 48, ? 2. ? ?. 137?144.
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?.?. ????????
??????????? ???????????????? ???????? ?????????...
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????????? 21.12.2010
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???? ?????? ? ?????????, ??????????????? ? ????????&
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??? ???????????? ??????? ???????? ?????????.
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?????: ?? 200 ???.
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???????? ?????????? ???????????? ???????
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E?mail: smj@cardio.tsu.ru
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