?????? ??? ?????? ??????? ?????? ???? ???? ???????, ?????? ?????? ?????? ???? ???????? ???? ????? ???? ?????? ????? ??. ???????? ????????, ?? ??????? ??????? ??????????? - ????? - ???? ????? ?????? ?????? ?????????? ????? ????????? ????????? ??????? ??????? ?????? ??. ????????? ??? ??????? ?????? ????????? ???? ????? ? ??????? ?????? ?????????? ????? ???????? ???? ?????? ????????? ?????? ????????? ???? ?????? ??, ?? ?????? ???????? ?????? ????????? ???? ??? ???????? ??? ??? ??. ? ?????? ??????????? ???????? ??????? ???? ?? ????? ?????? ???????? ???????????? ??? ??????? ???? ???? ????? ???? ??? ??: ?????? ??????, ???????? ??????, ???????? ???????? ??? ???????? ????????.

?

?????? ??: ??????????????? ???????: ???? ??????? ?????? ?????? ??????

?.? ?????????????? ????????? ?????????? ?????

???????? ?????????, ???? (????????????????) ?? ????? ????? ???? "????? ???" ????? ??????? ??? ??. ??? ????? ???????, ???????? ??????? ????? ????????? ?????, ???? ????????? ??????????? ??? ???????? ????? ??????? ????? ??????? ???? ??????????? ????? ??. ?? ??, 2018 ??? ???? ???????? ?????? ?????? ???? ?????? ???????? ?? ????????? ??????? ? ???????? ?????????? ????? ??? - ?????? ???? ????? ??? ?????? ??? ?? ????? ?????? ???? ?????? ???????? ??? ????? ?????? ?????? ???????? ??????????? ???? ?????? ??? ??, ???? ??????? ????? ?? ???? ??? ??? ??. ? ??? ????? "??? ???? ???????? ?????????? ??? ??" ???? ?????????????? ?????? ???? ???, ????? ????????? ????????? ????? ???? ?? ???? ???????????? ?? ???? ??.

?

?.? ??????? ????? ????????????

????????? ?????? ?????, ????? ?????????? ??????? ??? ????? ???? ????? ????? ????? ?? ????? ????????? ?????? ??? ??, ???? ???????????????? ?????? ????? ????? ?????????? ??? ?? ??. ???? ???????, ????? ????????????? ??? ?? ???? ?????-6-??????? (M6P) ??? ??, ?? ????????? ??????? ???????? ???? ????? ????????? ?????? ??? ??. ?????? ???????? ???????? ??????? ?????? ??????? ??? ?????????? ???? ?????? ????? ??? ??: ??????? ???????????? ???????? ?????????? ???? ??????????? ???? ???? ?????, ?? ?????????? ?? ????? ??????????? ?????? ??. ? ??????????? ????? ?? ????????? ????? ???? ????????? ???? ????? ??, ????? ???? ?????? ?????? ???????? ????? ???? ?????????? ???????? ???????? ????? ??? ??.

?

?????? ??: ????????? ????????: ?????? ???? ??????? ??????? ?????

?.? ????????? ?????????: ?????? ?????? "???? ?????" ?????? ?????? ???? ?????

???? ???? (?? ??? ?? ????????? ????? ?????????? ?? ????? ???? ???????????? ?? ???? ???? ??) ?? ??????? ??? ????? ??????? ?????? ??????? ???? ???? ?? ???? ????? ????? ????? ??. ?? ??????? ???? ??????? ???????? ????????? ?????? ??????? ?? ????? ?????? ??????? ????????? ???, ?? ??????????? ?????? ?????????? ??? ?? ??? M6P ????? ?? ??? ??????? ???? ????????? ???? ??? ??. ? "??????-?????????" ????? ??????? ????????????? (GLUT) ?? ????? ?? ???? ??? ??, ????? ????????????? ??????????? ??????????? ??????? ???? ?? ??????? ??? ??, ???? ??????? ???????????? ??? ?????????????????? ???? ??????? ????? ?????????? ???? ??? ??, ?? ???? ?????? ??????? ????? ???? ???? ??? ?? (????? 1).

?

?.? ????????????: ?????? ??????? ??????????? ????????????

2023 ??? ????? ??????????? ?????? ??? ????????????? ???????? ????? ?? ????????? ??? ????? ?????? ?? ?? ????? ??????? ????????? ?????? ????????? ????? ?????? ??????? ?????????? ????????? ?????? ??? ??. ??????? ??????? ?? ?? ????? ???? ?????? ?????? ???????????? ?????? ???????, ???????? MYC ?? ??????? ???????? ????????? ?????? ??? ??? ??, ??? ???? ???????????????? ????????? ????????? ???? ??????? ??. ? ?????????? ?????????????? ??? ???? ?????? ?????? ??? ????? ????????????? ???? ???? ??, ?? ??????? ?????????? ?????? ????? ???? ?????????? ???? ???? ???? ??.

?

?.? ???????????? ?????: PD-L1 ?? "????????? ?????" ?? ??? ?????

?????? ?? ??? ???????? ? ?? ?? ?? ? ???? ??????? ?? ????? ?????? ?????? ?????? ?????????? ?????? ????? ??? ??. ??? ???????????????? ???????? ??????, ???????? ?????? ??? ?? ????? ???? N-????????????? ????????? ??? ????? PD-L1 ????????? ????? ???????? ??? ????????? ????????????? ?????? ??. PD-L1 ???????, ?? ?????? ???????? "?????????? ????" ?????? ??, ?? ?????????? ??? ?????? ??????? ?????? ??? ??, ?????? T ???? ?? ?????? ????? ??? ??? ??. ???????? ???? ????????, ????? ??? ?????-PD-1 ??????????? ???????? ?????? ???????? ?? 78% ???? ?????, ?? ????? ?????? ???? ??? ????? ?? (????? 2).

?

?????? ????: ???????????? ???????? ????: ?????? ????? ??????? ?????

?.? ???????????? ???????? ??????????

???? ??????? ?? ??????? ????? ??????????, ?????? ??????-?????????? ?????? ?????? ?????? ??????? ??. ?? ??????? ???? 20% ????? ?????? ?????? ???????????? ?????? ????? ??????? ????????? ????? ??? ????? ?????? ?? ?????? ???????? ????? 40% ???? ??????? ??? ???, ??? ????? ??? ????????? ???? ???? ??????? ???? ??? ???? ??? ? ???. ??? ??????? ????, ?????? ???????????? ???? ????????? ????? ??????? ????? ??????, ??????? ????? ??????? ??????? 2.3 ??? ?????? ???, ?? ????? ??????????-????????? ????? ????? ??. ???????? ?????????? MD ??????? ?????? ?????? ???? ???????? ??????? ???????? ?????????? ?? ?? ????? ??????-??????? ???? ?????? ??? ??????????????? ???? ???????????? ?????? ??????? ???? ???? ???? ??????? ??.

?

?.? ???? ?????????? ??????????? ??????

?????????? ???????????? ???? ???? ????, ???? ???????? ????? ???????? ????? ??? ??. 2022 ??? ??? ?????? ??? I ???????? ?????? (NCT05220739) ? ????????? ????? ?????? ?????? ????????? ??? ??????? ????????? ????????? ????? ????? ????. ????????? ???? ??????? ?? ?? ????? 5 ????? ??? ????? ????????? ???? ????????? ??? ??, ??? ?????? ?????????? ???? ?????? DNA (ctDNA) ??????? ????????? ????? ??? ??. ?? ??, ?????? ??? 10 ????? ???? ?????, ?????? ???? 15% ??????? ???? ?????? ????? ?????, ?? ?????? ????????? ????????? ?????? ???????? ????? ??.

?

?.? ??????????????? ??????? ??????

?????? ???? ???????? ???? ????? ????? ???? ????, ?????? ?????? ???????? (????? 5 ????????? ????????? ?????? ??????) ???? ??????? ???? ???? ?????? ???? ???????? ???? ??? ??, ???? ??????? ????????????? ?????? ????????? ??? ????? ??. ??????, ???????? ???? ????????? ??????????? ???? ????? ?????????? 20 ??? ????? ??? ??? ??, ?????? ????? ??????? ????????? ??????? ???? ????? ????????? $50 ?? ???? ????? ??. ??????, ????-??????? ??????????????? ????????? ????-?????? ????????? ????????????? 80% ???? ????? ??? ??, ?? ???????? ?????????? ????? ??? ??? ??.

?

?????? ??? ????? ??? ?????: ????????? ??????????? ???? ??????

?.? ????????? ??????????? "?????? ?????" ???

? ??????? ????? ?? ?? ????? ? ?????? ???? ???. ????? ??????? ????????? (PMI) ??? ???????? ?????? ?????? ?????? ???? ?????-6-????????? ?????????-6-?????????? ????????? ??? ??? ??, ?? ???????????? ???????? ????? ??. ? "????????? ??????" ???? ???? 7% ?????????? ?????? ????????? ??? ??? ???, ?? ????????? ?????????? ???????? ?????????? ???????? ????? ??.

?

?.? ?????? ≠ ?????: ?????? ?????????? ???

???? ??????? ???????? GRAS (??????? ???? ???????? ????? ???????) ?????? ????? ????? ???? ?????? ??????? ??? ??, ?????? ?????? ??? ?? ???? ????? ?????? ???????? ??? ?? ????????? ?????? ???? ??. ????????? ?????????? ????? ?????? ?? ?? ??? ???? ????????? ?????? ???????? ??????? ??????? ?? ??? ??, ????? ?????? ?????? ??????? ?????????? (??? ?? ??????????) ?? ??????? ?? ??? ??? ??? ??. ? ???? ????? ?? ?? ???????? ????????? ?????????? ????????? ??? ???????????????? ??????????????? ??????? ????? ????.

?

?.? ????????? ?????? ??? ????????? ?????????? ??????? ???

"?????? ?????? ????" ?? ??????? ???????? ????, ?????? ???????? ????? ?????? ?????????? ?????????? ?????? ??????????????? ????? ??. ???????? ????????? FDA ? ????? ?????????? ??????? ???? ???? ??????? ?????? ????? ???? ????? ??, ????? ??? ???????? ????? ?? ?? "???? ??????? ????? ???????? ???? ???? ???." ?????????? ????? ?????? ?????????? ??????? ??? ???????????? ????????? ???? ???? ?????? ????????????? ??????? ???? ???? ??? ????? ??.

?

????????: ???? ?????????? ???? ?????

??????? ?????? ?????? ?????? ????? ??????? ???? ??? ???? ??????? ??????? ????? ???, ????? ??????????? ????????? ?? ????? ?? ??. ????????? ???????????????? ???? ???????????? ??????? ?????????? ???????????? ????, ?????????? ????? ??????? ???? ?????????????? ???????? ????, ? "???? ???????" ?????? ???????? ???????????? ????? ??? ??? ??. ???? ??? ??? ?? ?????? ?????? ??, ?? ????? ??? ???? ?? ?? ????? ?? ?????? ???????-?????? ?????? ????? ???? ?????? ?????? ???????? ??? ????? ????? ??? ??? ??. ??? ?????? ??????? ???: "?????? ??????? ????? ???? ????? ??? ??, ?????? ???????? ??????? ??? ???? ?????? ??."

?