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Определение стадии опухолевого процесса является важнейшим этапом в лечении пациенток со злокачественными заболеваниями, напрямую коррелирует с прогнозом и выбором специализированного лечения, облегчая при этом обмен информацией между медицинскими специалистами. Система стадирования должна обладать тремя основными характеристиками: она должна быть действенной, надежной и практичной. Существующая система стадирования (классификации) рака эндометрия разработана в 2009 г., является высоковоспроизводимой и не требует чрезмерных диагностических исследований. При этом в классификации имеется множество «серых зон», которые препятствуют обоснованному подбору необходимого лечения у пациенток, оказавшихся в них. Наиболее ярким примером является необходимость проведения лимфодиссекции при I клинической стадии рака эндометрия, где при промежуточном риске решение о её проведении остается на усмотрение лечащего врача. Для решения данной проблемы, попытки индивидуализировать лечение и стратифицировать риск развития рецидива, в последние годы широкое распространение получила молекулярная классификация. А в 2023 г. Международная федерация акушеров-гинекологов предложила для использования новую систему стадирования рака эндометрия. Текущий обзор посвящен историческим аспектам эволюции представления о системной оценке рака эндометрия, и позволяет лучше оценить последние достижения в понимании биологии опухолей эндометрия.
Библиографические ссылки
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