oncotomskСибирский онкологический журналSiberian journal of oncology1814-48612312-3168Tomsk National Research Medical Сепtеr of the Russian Academy of Sciences10.21294/1814-4861-2024-23-4-172-185oncotomsk-3203Research ArticleОБЗОРЫREVIEWSАнгиогенез при раке эндометрия: клиническое и биологическое значениеAngiogenesis in endometrial cancer: clinical and biological significancehttps://orcid.org/0000-0002-8182-5084МайбородинИ. В.MaiborodinI. V.

Майбородин Игорь Валентинович, доктор медицинских наук, профессор, главный научный сотрудник лаборатории технологий управления здоровьем

630090, г. Новосибирск, пр. ак. Лаврентьева, 8

Igor V. Maiborodin, MD, Professor, Chief Researcher, Laboratory of Health Management Technologies

8, Akademika Lavrenteva St., Novosibirsk, 630090

https://orcid.org/0009-0001-8005-0723ГончаровМ. А.GoncharovM. A.

Гончаров Максим Александрович, аспирант лаборатории технологий управления здоровьем

630090, г. Новосибирск, пр. ак. Лаврентьева, 8

Maxim A. Goncharov, Postgraduate, Laboratory of Health Management Technologies

8, Akademika Lavrenteva St., Novosibirsk, 630090

https://orcid.org/0000-0002-3164-9377ШевелаА. И.ShevelaA. I.

Шевела Андрей Иванович, доктор медицинских наук, профессор, заведующий отделом «Центр новых медицинских технологий»

630090, г. Новосибирск, пр. ак. Лаврентьева, 8

Andrew I. Shevela, MD, Professor, Head of Department the Center of New Medical Technologies

8, Akademika Lavrenteva St., Novosibirsk, 630090

https://orcid.org/0000-0003-0687-0894КрасильниковС. Э.KrasilnikovS. E.

Красильников Сергей Эдуардович, доктор медицинских наук, профессор кафедры акушерства и гинекологии

630090, г. Новосибирск, ул. Пирогова, 2

Sergey E. Krasilnikov, MD, Professor, Department of Obstetrics and Gynecology

2, Pirogova St., Novosibirsk, 630090

https://orcid.org/0009-0008-1839-071XШумейкинаА. О.ShumeikinaA. O.

Шумейкина Анастасия Олеговна, аспирант кафедры акушерства и гинекологии

630090, г. Новосибирск, ул. Пирогова, 2

Anastasia O. Shumeikina, Postgraduate, Department of Obstetrics and Gynecology

2, Pirogova St., Novosibirsk, 630090

https://orcid.org/0000-0002-5169-6373МайбородинаВ. И.MaiborodinaV. I.

Майбородина Виталина Игоревна, доктор медицинских наук, ведущий научный сотрудник лаборатории технологий управления здоровьем

630090, г. Новосибирск, пр. ак. Лаврентьева, 8

Vitalina I. Maiborodina, MD, DSc, Leading Researcher, Laboratory of Health Management Technologies

8, Akademika Lavrenteva St., Novosibirsk, 630090

imai@mail.ruФГБУН «Институт химической биологии и фундаментальной медицины СО РАН»РоссияInstitute of Chemical Biology and Fundamental Medicine, Russian Academy of Sciences, Siberian BranchRussian FederationФГАОУ ВО «Новосибирский национальный исследовательский государственный университет»РоссияNational Research Novosibirsk State UniversityRussian Federation202410092024234172185Copyright © Майбородин И.В., Гончаров М.А., Шевела А.И., Красильников С.Э., Шумейкина А.О., Майбородина В.И., 20242024Майбородин И.В., Гончаров М.А., Шевела А.И., Красильников С.Э., Шумейкина А.О., Майбородина В.И.Maiborodin I.V., Goncharov M.A., Shevela A.I., Krasilnikov S.E., Shumeikina A.O., Maiborodina V.I.Данная работа распространяется под лицензией Creative Commons Attribution 4.0.This work is licensed under a Creative Commons Attribution 4.0 License.https://www.siboncoj.ru/jour/article/view/3203

Цель исследования – обобщение имеющихся данных об особенностях васкуляризации эндометриоидной аденокарциномы (ЭАК). Материал и методы. Поиск соответствующих источников был произведен в базе данных «PubMed» по ключевым словам «endometrium + cancer + angiogenesis» и «endometrium + cancer + angiogenesis + lymph». Из выбранных источников в данный обзор включено 78 публикаций. Результаты. Ангиогенез представляет собой важный и необходимый этап в появлении, прогрессировании и метастазировании ЭАК, изучение васкуляризации опухоли открывает возможности для улучшения диагностики и персонализированного подхода к лечению. Сосудистая плотность коррелирует с продвинутой стадией ЭАК, высокой злокачественностью, инвазией миометрия, поражением шейки матки, придатков, прорастанием сосудов, метастазами в лимфатические узлы (ЛУ), присутствием раковых клеток в перитонеальной жидкости, низкой общей выживаемостью и выживаемостью без прогрессирования опухоли. При этом есть публикации, отрицающие связь васкуляризации с гистотипом и степенью дифференцировки опухоли, лимфоваскулярной инвазией, метастазами в ЛУ, глубиной прорастания миометрия и даже доказывающие, что плотность микрососудов не является независимым прогностическим фактором. Таким образом, нет единого мнения, о чем свидетельствует низкая или высокая васкуляризация ЭАК. В последнее время создано множество препаратов, влияющих как непосредственно на процессы ангиогенеза, так и на индукторы и факторы, контролирующие рост сосудов. К сожалению, эти средства обладают достаточно высокой токсичностью, и к ним быстро развивается резистентность. Заключение. Несмотря на многочисленность публикаций результатов исследований, посвященных изучению формирования кровеносных сосудов, и единичные данные о лимфоангиогенезе при ЭАК, в литературе отсутствуют результаты изучения изменений васкуляризации ЛУ при гинекологическом раке, тогда как проангиогенные и антиангиогенные факторы диссеминируются по всему организму и должны проявить свое действие в отдаленных органах и тканях. По изменениям васкуляризации ЛУ, видимо, станут возможными предсказание активности ангиогенеза в первичном опухолевом узле и оценка как прогноза течения основного процесса, так и эффективности лечения. Кроме того, значительная выраженность сосудистой сети в увеличенном и биоптированном ЛУ может являться симптомом развития злокачественной опухоли в регионе лимфооттока даже при отсутствии метастазов.

Objective: to summarize the available data on the features of vascularization of endometrioid adenocarcinoma (EAC). Material and Methods. The search for relevant sources was performed in the “PubMed” database using the keywords “endometrium + cancer + angiogenesis”, “endometrium + cancer + angiogenesis + lymph”. Of the selected sources, 78 were included in this review. Results. Angiogenesis is an important and necessary stage in the pathogenesis of the appearance, progression and metastasis of EAC and, thus, the study of tumor vascularization provides an opportunity to improve diagnosis and personalized approach to treatment. Vascular density correlates with advanced stage of EAC, high grade of malignancy, myometrial invasion, cervical and adnexal lesions, vascular invasion, metastases to lymph nodes (LN), the presence of cancer cells in the peritoneal fluid, low overall survival and survival without tumor progression. There are publications that deny the connection of vascularization with the histological type of tumor, its grade, lymphovascular invasion, lymph node metastases, the depth of myometrial invasion, and these publications even prove that microvessel density is not an independent prognostic factor. So, there is still no consensus and final opinion, as evidenced by low or high vascularization of EAC. Recently, there are many drugs that affect both the processes of angiogenesis directly and the inducers and factors that control vascular growth. Unfortunately, all such drugs have a fairly high toxicity, and resistance to them very quickly develops. Conclusion. Despite numerous results of studies devoted to the study of the formation of blood vessels and isolated data on lymphangiogenesis in EAC, there is no data in the literature on studying changes in the vascularization of LN in gynecological cancer. However, proangiogenic and antiangiogenic factors are disseminated throughout the body and must exert their effects in distant organs and tissues. Based on changes in the vascularization of LN, it will apparently become possible to predict the activity of angiogenesis in the primary tumor, assess the prognosis of the disease, and the effectiveness of the treatment. In addition, significant expression of the vascular network in an enlarged lymph node biopsied for diagnosis may be a symptom of the development of a malignant tumor in the lymph collection region, even in the absence of metastases.

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