Комплексная коррекция массы тела как ключевой фактор повышения эффективности терапии рака эндометрия с сохранением фертильности

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Аннотация

Рак эндометрия является распространённым онкологическим заболеванием, тесно связанным с ожирением и нарушениями углеводного и липидного обмена. Современные подходы к консервативной терапии рака эндометрия у молодых женщин направлены на сохранение репродуктивной функции и включают применение высоких доз прогестинов, которые могут приводить к дополнительному увеличению веса. Взаимосвязь ожирения и эффективности лечения рака эндометрия является многофакторной и включает гормональные изменения, хроническое воспаление, метаболические нарушения и изменения иммунной микросреды опухоли. Комплексный подход к коррекции веса, включающий диетические вмешательства (кетогенная диета, периодическое голодание, ограничение калорийности), регулярную физическую активность и поведенческую терапию, показал существенное улучшение показателей ремиссии опухоли и наступления беременности. В обзоре представлены ключевые механизмы влияния ожирения на развитие и прогрессирование рака эндометрия, обсуждаются современные стратегии коррекции массы тела, а также обозначены направления будущих исследований, включающие изучение роли метаболитов, кишечного микробиома, нейронных механизмов регуляции аппетита и внедрение персонализированных подходов с использованием искусственного интеллекта и носимых устройств. Комплексная коррекция веса становится приоритетным направлением для повышения эффективности терапии и улучшения исходов у пациенток с раком эндометрия, стремящихся сохранить репродуктивную функцию.

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Анна Капреловна Крюкова

Ростовский государственный медицинский университет

Автор, ответственный за переписку.
Email: glable@bk.ru
ORCID iD: 0009-0007-7809-7892
Россия, Ростов-на-Дону

Ксения Юрьевна Косых

Ростовский государственный медицинский университет

Email: kosyhksenia2003@mail.ru
ORCID iD: 0009-0005-3744-5446
Россия, Ростов-на-Дону

Арина Петровна Романченко

Воронежский государственный медицинский университет им. Н.Н. Бурденко

Email: frau.roman4enko2010@yandex.ru
ORCID iD: 0009-0009-3367-7820
Россия, Воронеж

Яна Вадимовна Беляева

Башкирский государственный медицинский университет

Email: yana.belyaeva123@mail.ru
ORCID iD: 0009-0001-1872-4440
Россия, Уфа

Светлана Александровна Будзинская

Санкт-Петербургский государственный педиатрический медицинский университет

Email: Svetoch5224@gmail.com
ORCID iD: 0009-0000-2291-7467
Россия, Санкт-Петербург

Валерия Сергеевна Алексеева

Башкирский государственный медицинский университет

Email: valeks.2025@mail.ru
ORCID iD: 0009-0008-5774-5771
Россия, Уфа

София Алексеевна Лозовая

Городская клиническая больница № 20

Email: lozisss@yandex.ru
ORCID iD: 0009-0009-9881-1592
Россия, Ростов-на-Дону

Айрат Ильфатович Ишбердин

Башкирский государственный медицинский университет

Email: airatok17@gmail.com
ORCID iD: 0009-0003-0201-1854
Россия, Уфа

Анастасия Андреевна Ишбердина

Башкирский государственный медицинский университет

Email: Abatrunova@gmail.com
ORCID iD: 0009-0000-3963-4922
Россия, Уфа

Никита Андреевич Крысин

Башкирский государственный медицинский университет

Email: buran007@list.ru
ORCID iD: 0009-0003-3428-702X
Россия, Уфа

Валерия Андреевна Тудиярова

Башкирский государственный медицинский университет

Email: victoriatt1337@gmail.com
ORCID iD: 0009-0002-6796-2469
Россия, Уфа

Рамиля Рубиновна Ядигарова

Самарский государственный медицинский университет

Email: ramilaadigarova@mail.ru
ORCID iD: 0009-0007-8999-0862
Россия, Самара

Нурия Данисовна Зайнуллина

Башкирский государственный медицинский университет

Email: zaynullina.nuriya@gmail.com
ORCID iD: 0009-0001-2831-8454
Россия, Уфа

Екатерина Сергеевна Дерун

Кубанский государственный медицинский университет

Email: derun.katya@mail.ru
ORCID iD: 0009-0008-9163-9390
Россия, Краснодар

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СМИ зарегистрировано Федеральной службой по надзору в сфере связи, информационных технологий и массовых коммуникаций (Роскомнадзор).
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