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<article article-type="research-article" dtd-version="1.3" xmlns:mml="http://www.w3.org/1998/Math/MathML" xmlns:xlink="http://www.w3.org/1999/xlink" xmlns:xsi="http://www.w3.org/2001/XMLSchema-instance" xml:lang="ru"><front><journal-meta><journal-id journal-id-type="publisher-id">oncotomsk</journal-id><journal-title-group><journal-title xml:lang="ru">Сибирский онкологический журнал</journal-title><trans-title-group xml:lang="en"><trans-title>Siberian journal of oncology</trans-title></trans-title-group></journal-title-group><issn pub-type="ppub">1814-4861</issn><issn pub-type="epub">2312-3168</issn><publisher><publisher-name>Tomsk National Research Medical Сепtеr of the Russian Academy of Sciences</publisher-name></publisher></journal-meta><article-meta><article-id pub-id-type="doi">10.21294/1814-4861-2025-24-1-70-78</article-id><article-id custom-type="elpub" pub-id-type="custom">oncotomsk-3464</article-id><article-categories><subj-group subj-group-type="heading"><subject>Research Article</subject></subj-group><subj-group subj-group-type="section-heading" xml:lang="ru"><subject>ЛАБОРАТОРНЫЕ И ЭКСПЕРИМЕНТАЛЬНЫЕ ИССЛЕДОВАНИЯ</subject></subj-group><subj-group subj-group-type="section-heading" xml:lang="en"><subject>LABORATORY AND EXPERIMENTAL STUDIES</subject></subj-group></article-categories><title-group><article-title>Молекулярно-генетические предикторы прогрессирования трижды негативного рака молочной железы</article-title><trans-title-group xml:lang="en"><trans-title>Molecular genetic predictors of progression of triple negative breast cancer</trans-title></trans-title-group></title-group><contrib-group><contrib contrib-type="author" corresp="yes"><contrib-id contrib-id-type="orcid">https://orcid.org/0000-0001-7923-4317</contrib-id><name-alternatives><name name-style="eastern" xml:lang="ru"><surname>Панченко</surname><given-names>И. С.</given-names></name><name name-style="western" xml:lang="en"><surname>Panchenko</surname><given-names>I. S.</given-names></name></name-alternatives><bio xml:lang="ru"><p>Панченко Иван Сергеевич - ассистент кафедры онкологии и лучевой диагностики им. О.П. Модникова, медицинский факультет им. Т.З. Биктимирова, Институт медицины, экологии и физической культуры, ФГБОУ ВО «УлГУ»; хирург-онколог хирургического отделения опухолей молочной железы и кожи, ГУЗ «ОКОД».</p><p>432017, Ульяновск, ул. 12 сентября, 90; 432017, Ульяновск, ул. Льва Толстого, 42</p></bio><bio xml:lang="en"><p>Ivan S. Panchenko - MD, Assistant, O.P. Modnicov Department of Oncology and Radiation Diagnostics, T.Z. Bictimirov Medical Department, Institute of Medicine, Ecology and Physical Education, Ulyanovsk State University; Surgeon-Oncologist, Breast and Skin Surgical Oncology Department, Regional Clinical Oncology Dispensary.</p><p>90, 12 September St., Ulyanovsk, 432017; 42, Leo Tolstoy St., Ulyanovsk, 432017</p></bio><email xlink:type="simple">pan91ch@yandex.ru</email><xref ref-type="aff" rid="aff-1"/></contrib><contrib contrib-type="author" corresp="yes"><contrib-id contrib-id-type="orcid">https://orcid.org/0000-0003-0096-7126</contrib-id><name-alternatives><name name-style="eastern" xml:lang="ru"><surname>Родионов</surname><given-names>В. В.</given-names></name><name name-style="western" xml:lang="en"><surname>Rodionov</surname><given-names>V. V.</given-names></name></name-alternatives><bio xml:lang="ru"><p>Родионов Валерий Витальевич - доктор медицинский наук, заведующий отделением патологии молочной железы.</p><p>117997, Москва, ул. Академика Опарина, 4</p></bio><bio xml:lang="en"><p>Valery V. Rodionov - MD, DSc, Head of the Department of Breast Pathology, National Medical Research Center of Obstetrics, Gynecology and Perinatology named after Academician V.I. Kulakov of the Ministry of Health of Russia.</p><p>4, Academician Oparin St., Moscow, 117997</p></bio><xref ref-type="aff" rid="aff-2"/></contrib><contrib contrib-type="author" corresp="yes"><contrib-id contrib-id-type="orcid">https://orcid.org/0000-0001-9666-6875</contrib-id><name-alternatives><name name-style="eastern" xml:lang="ru"><surname>Кометова</surname><given-names>В. В.</given-names></name><name name-style="western" xml:lang="en"><surname>Kometova</surname><given-names>V. V.</given-names></name></name-alternatives><bio xml:lang="ru"><p>Кометова Влада Владимировна - кандидат медицинских наук, заведующая патологоанатомическим отделением.</p><p>117997, Москва, ул. Академика Опарина, 4</p></bio><bio xml:lang="en"><p>Vlada V. Kometova - MD, PhD, Head of the Pathology Department, National Medical Research Center of Obstetrics, Gynecology and Perinatology named after Academician V.I. Kulakov of the Ministry of Health of Russia.</p><p>4, Academician Oparin St., Moscow, 117997</p></bio><xref ref-type="aff" rid="aff-2"/></contrib><contrib contrib-type="author" corresp="yes"><contrib-id contrib-id-type="orcid">https://orcid.org/0000-0002-9006-2023</contrib-id><name-alternatives><name name-style="eastern" xml:lang="ru"><surname>Панченко</surname><given-names>С. В.</given-names></name><name name-style="western" xml:lang="en"><surname>Panchenko</surname><given-names>S. V.</given-names></name></name-alternatives><bio xml:lang="ru"><p>Панченко Сергей Викторович - кандидат медицинских наук, доцент кафедры онкологии и лучевой диагностики им. О.П. Модникова, медицинский факультет им. Т.З. Биктимирова, Институт медицины, экологии и физической культуры, ФГБОУ ВО «УлГУ»; онколог, ГУЗ «ОКОД».</p><p>432017, Ульяновск, ул. 12 сентября, 90; 432017, Ульяновск, ул. Льва Толстого, 42</p></bio><bio xml:lang="en"><p>Sergey V. Panchenko - MD, PhD, Associate Professor, O.P. Modnicov Department of Oncology and Radiation Diagnostics, T.Z. Bictimirov Medical Department, Institute of Medicine, Ecology and Physical Education, Ulyanovsk State University; Oncologist, Regional Clinical Oncology Dispensary.</p><p>90, 12 September St., Ulyanovsk, 432017; 42, Leo Tolstoy St., Ulyanovsk, 432017</p></bio><xref ref-type="aff" rid="aff-1"/></contrib><contrib contrib-type="author" corresp="yes"><contrib-id contrib-id-type="orcid">https://orcid.org/0000-0002-8782-4111</contrib-id><name-alternatives><name name-style="eastern" xml:lang="ru"><surname>Шарафутдинов</surname><given-names>М. Г.</given-names></name><name name-style="western" xml:lang="en"><surname>Sharafutdinov</surname><given-names>M. G.</given-names></name></name-alternatives><bio xml:lang="ru"><p>Шарафутдинов Марат Гакифович - кандидат медицинских наук, доцент, заведующий кафедрой онкологии и лучевой диагностики им. О.П. Модникова, медицинский факультет им. Т.З. Биктимирова, Институт медицины, экологии и физической культуры, ФГБОУ ВО «УлГУ»; онколог, ГУЗ «ОКОД».</p><p>432017, Ульяновск, ул. 12 сентября, 90; 432017, Ульяновск, ул. Льва Толстого, 42</p></bio><bio xml:lang="en"><p>Marat G. Sharafutdinov - MD, PhD,Associate Professor, Head of the O.P. Modnicov Department of Oncology and Radiation Diagnostics, T.Z. Bictimirov Medical Department, Institute of Medicine, Ecology and Physical Education, Ulyanovsk State University; Oncologist, Regional Clinical Oncology Dispensary.</p><p>90, 12 September St., Ulyanovsk, 432017; 42, Leo Tolstoy St., Ulyanovsk, 432017</p></bio><xref ref-type="aff" rid="aff-1"/></contrib><contrib contrib-type="author" corresp="yes"><name-alternatives><name name-style="eastern" xml:lang="ru"><surname>Лаврентьева</surname><given-names>И. А.</given-names></name><name name-style="western" xml:lang="en"><surname>Lavrentieva</surname><given-names>I. A.</given-names></name></name-alternatives><bio xml:lang="ru"><p>Лаврентьева Ирина Александровна - кандидат медицинских наук, доцент кафедры патологической анатомии.</p><p>170100, Тверь, ул. Советская, 4</p></bio><bio xml:lang="en"><p>Irina A. Lavrentyeva - MD, PhD, Associate Professor, Department of Anatomical Pathology, Tver State Medical University of the Ministry of Health of Russia.</p><p>4, Sovetskaya St., Tver, 170100</p></bio><xref ref-type="aff" rid="aff-3"/></contrib></contrib-group><aff-alternatives id="aff-1"><aff xml:lang="ru"><institution>ГУЗ «Областной клинический онкологический диспансер»; Институт медицины, экологии и физической культуры, ФГБОУ ВО «Ульяновский государственный университет»</institution><country>Россия</country></aff><aff xml:lang="en"><institution>Regional Clinical Oncology Dispensary; Institute of Medicine, Ecology and Physical Education, Ulyanovsk State University</institution><country>Russian Federation</country></aff></aff-alternatives><aff-alternatives id="aff-2"><aff xml:lang="ru"><institution>ФГБУ «Национальный Медицинский исследовательский центр акушерства, гинекологии и перинатологии им. акад. В.И. Кулакова» Минздрава России</institution><country>Россия</country></aff><aff xml:lang="en"><institution>National Medical Research Center of Obstetrics, Gynecology and Perinatology named after Academician V.I. Kulakov of the Ministry of Health of Russia</institution><country>Russian Federation</country></aff></aff-alternatives><aff-alternatives id="aff-3"><aff xml:lang="ru"><institution>ФГБОУ ВО «Тверской государственный медицинский университет» Минздрава России</institution><country>Россия</country></aff><aff xml:lang="en"><institution>Tver State Medical University of the Ministry of Health of Russia</institution><country>Russian Federation</country></aff></aff-alternatives><pub-date pub-type="collection"><year>2025</year></pub-date><pub-date pub-type="epub"><day>18</day><month>03</month><year>2025</year></pub-date><volume>24</volume><issue>1</issue><fpage>70</fpage><lpage>78</lpage><permissions><copyright-statement>Copyright &amp;#x00A9; Панченко И.С., Родионов В.В., Кометова В.В., Панченко С.В., Шарафутдинов М.Г., Лаврентьева И.А., 2025</copyright-statement><copyright-year>2025</copyright-year><copyright-holder xml:lang="ru">Панченко И.С., Родионов В.В., Кометова В.В., Панченко С.В., Шарафутдинов М.Г., Лаврентьева И.А.</copyright-holder><copyright-holder xml:lang="en">Panchenko I.S., Rodionov V.V., Kometova V.V., Panchenko S.V., Sharafutdinov M.G., Lavrentieva I.A.</copyright-holder><license xml:lang="ru" license-type="creative-commons-attribution" xlink:href="https://creativecommons.org/licenses/by/4.0/" xlink:type="simple"><license-p>Данная работа распространяется под лицензией Creative Commons Attribution 4.0.</license-p></license><license xml:lang="en" license-type="creative-commons-attribution" xlink:href="https://creativecommons.org/licenses/by/4.0/" xlink:type="simple"><license-p>This work is licensed under a Creative Commons Attribution 4.0 License.</license-p></license></permissions><self-uri xlink:href="https://www.siboncoj.ru/jour/article/view/3464">https://www.siboncoj.ru/jour/article/view/3464</self-uri><abstract><p>Введение. Трижды негативный рак молочной железы (ТНРМЖ) – группа злокачественных опухолей молочной железы с неблагоприятным прогнозом и различными молекулярно-генетическими характеристиками. При данном заболевании гены определяют принадлежность пациенток к кластерам, отличающимся прогнозом. Работы, в которых гены рассматривались бы как факторы риска прогрессирования, немногочисленны. Цель исследования – определить гены ТНРМЖ, которые ассоциируются с высоким риском прогрессирования, и оценить их прогностическую значимость. Материал и методы. В исследование включено 246 пациенток с ТНРМЖ. В качестве панели генов использовались 45 генов. Методика молекулярно-генетического исследования заключалась в предварительном выделении РНК с последующей амплификацией кДНК в режиме реального времени методом ПЦР. Средние значения уровня экспрессии генов рассчитывали как меры центральной тенденции числового значения с 95 % доверительным интервалом. Значимость влияния генов на риск прогрессирования (локорегионарный рецидив или отдаленное метастазирование) оценивали с помощью формирования линейной дискриминантной функции и построения ROC-кривой. Оценку взаимосвязи генов с клинико-морфологическими параметрами проводили с помощью корреляционного анализа (критерий χ2 Пирсона и ρ Спирмена). После определения пороговых значений уровня экспрессии генов и последующего ранжирования пациенток на группы с высоким и низким уровнями экспрессии генов проводили анализ выживаемости сформированных групп (кривые Каплана–Майера). При сравнении кривых выживаемости использовался логранговый критерий. Все расчеты были выполнены на персональном компьютере с использованием прикладных программ Microsoft Excel 2010, «Статистика 19.0» (StatSoft Inc., USA), MedCalc (версия 20). Различия между двумя сравниваемыми группами считали статистически значимыми при р≤0,05. Результаты. Методом дискриминантного анализа было отобрано два гена, которые ассоциировались с локорегионарным рецидивом: PGR (p=0,007) и AR (p=0,001), и один ген, который ассоциировался с отдаленными метастазами, – FOXA1 (p=0,001). Были установлены статистически значимые (р&lt;0,05) связи между экспрессией анализируемых генов со степенью злокачественности (Grade) и уровнем пролиферативной активности опухоли (Ki67). Низкие значения уровня экспрессии PGR (≤-6,4), AR (≤-4,7), FOXA1(≤-4,4) ассоциировались с увеличением общей выживаемости. Заключение. У пациенток с ТНРМЖ PGR и AR являются предикторами локорегионарного рецидива, FOXA1 – отдаленного метастазирования. Экспрессия PGR, AR, FOXA1 статистически значимо коррелировала со степенью злокачественности и Ki67. Низкие значения экспрессии генов ассоциировались с благоприятным прогнозом.</p></abstract><trans-abstract xml:lang="en"><p>Introduction. Triple-negative breast cancer (TNBC) is a group of malignant breast tumors with poor prognosis and varying molecular genetic characteristics. In TNBC, genes determine whether patients belong to clusters that differ in prognosis. There are not enough studies that consider genes as risk factors for progression. The aim of this study was to identify genes of TNBC which are associated with high risk progression, and evaluate their prognostic significance. Material and methods. This study included 246 patients with TNBC. Forty-five genes performing various functions were used as a panel of genes. The molecular genetic research technique consisted of preliminary RNA isolation followed by real-time cDNA amplification using PCR. Mean gene expression levels were calculated as measures of central tendency of the numerical value with 95 CI. The significance of the influence of genes on the risk of progression (locoregional recurrence or distant metastasis) was assessed using the formation of the linear discriminant function and construction of ROC curve. The relationship between genes and clinical and morphological parameters was assessed using correlation analysis (Pearson’s χ2 Spearman’s ρ test). After determining the threshold values of gene expression levels and subsequent ranking of patients into groups with high and low levels, an analysis of the survival of the formed groups was carried out (Kaplan-Meier curves). When comparing survival curves, the long-rank test was used. Results. Two genes: PGR (p=0.007) and AR (p=0.001), which were associated with locoregional relapse, and 1 gene: FOXA1, which was associated with distant metastasis (p=0.001), were selected using discriminant analysis. Statistically significant (p&lt;0.05) correlations between the gene expressions and the tumor grade and the level of proliferative activity (Ki67) were found. Low expression levels of PGR (≤-6.4), AR (≤-4.7), FOXA1 (≤-4.4) were associated with improved overall survival. Conclusion. In patients with TNBC, PGR and AR are markers of locoregional relapse, and FOXA1 is a marker of distant metastasis. The expression of PGR, AR, FOXA1 was significantly correlated with the grade of the tumor and Ki67. Low gene expressions were associated with favorable prognosis.</p></trans-abstract><kwd-group xml:lang="ru"><kwd>трижды негативный рак молочной железы</kwd><kwd>ТНРМЖ</kwd><kwd>PGR</kwd><kwd>AR</kwd><kwd>FOXA1</kwd><kwd>локорегионарный рецидив</kwd><kwd>отдаленное метастазирование</kwd></kwd-group><kwd-group xml:lang="en"><kwd>triple negative breast cancer</kwd><kwd>TNBC</kwd><kwd>PGR</kwd><kwd>AR</kwd><kwd>FOXA1</kwd><kwd>locoregional relapse</kwd><kwd>distant metastasis</kwd></kwd-group></article-meta></front><back><ref-list><title>References</title><ref id="cit1"><label>1</label><citation-alternatives><mixed-citation xml:lang="ru">Kennecke H., Yerushalmi R., Woods R., Cheang M.С.U., Voduc D., Speers C.H., Nielsen T.O., Gelmon K. Metastatic behavior of breast cancer subtypes. J. 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