Etiopatogeneticheskie Podkhody K Lecheniyu Raka Shchitovidnoy Zhelezy

Rak shchitovidnoy zhelezy - naibolee chasto vstrechayushchayasya zlokachestvennaya opukhol' endokrinnykh organov, lidiruyushchaya po chislu smertel'nykh iskhodov sredi zlokachestvennykh endokrinnykh opukholey. V etiologii i patogeneze raka shchitovidnoy zhelezy vazhnuyu rol' igraet radiatsionnyy i nasledstvennyy faktory. Anomal'no vysokaya zabolevaemost' RShchZh na zagryaznennykh vsledstvie chernobyl'skoy avarii territoriyakh sredi naseleniya, obluchennykh v detskoy i podrostkovom vozraste, sokhranyaetsya po sey den'. Proveden sravnitel'nyy analiz klinicheskogo techeniya radiatsionno-indutsirovannogo i sporadicheskogo, nasledstvennogo i sporadicheskogo raka shchitovidnoy shchitovidnoy zhelezy. Izuchen vliyanie nasledstvennykh i somaticheskikh mutatsiy izvestnykh onkogenov (RET i BRAF), a takzhe spektra epigeneticheskikh narusheniy pri razlichnykh tipakh kartsinom shchitovidnoy zhelezy. Na mnogochislennom klinicheskom materiale vypolnen mnogofaktornyy analiz vliyaniya prognosticheskikh faktorov na bezretsidivnuyu vyzhivaemost' bol'nykh vsemi izvestnymi gistologicheskimi tipami raka shchitovidnoy zhelezy. V tselyakh snizheniya riska nevrologicheskikh oslozhneniy khirurgicheskogo lecheniya primenyalsya metod intraoperatsionnogo neyromonitoringa. Optimizirovany algoritmy diagnostiki i lecheniya.