1 if 3MICT BCTYN.. 3 CNUCOK OCHOBHMX CKOPOUEH.... nt Bi 6 BATASIBHA OHKOSIOLIA.... es osssseienensnensenenunssen i 7 Posain 1 ETIOSIOFIA TA ENIQEMIONOFIA SNOAKICHX HOBOYTBOPEHb (kangnaar meanvnnx HayK, aoueHT 0.C, Soros, P.B. Moora) Z Tloxasnnxn saxeopiosaHocri Ta CMepTHOCTI, ik BHOHANEHHA Ta SHaHOHHA 7 Erionoris Ta natoreHes anonkicHoro pocty 9 Posnin 2 OPFAHISALIIA OHKONOFI4HO! ONOMOrM. OCHOBM NPOOISIAKTUKM S/IOSKICHUX HOBOYTBOPEHb (xanannar mequanix HayK A.B. FaitcenKo, KaHanaar menvrinx Hayk LM. MOTYSIOK, kavaunar MenMIHNX HayK 3.1. BenoperKo) 7 Posain3 MATONOTIA NYXMMHHOTO POCTY. MATOFEHES K/IHINHUX CUHAPOMIB (aorrop Meawsnnx Hayk JIM. Saxapyeea, K.O. Mekyp) si 2 Beryn 8 onkoMopsonorito tS Teopin npupoavoticropii pany. Hoxrinisrt a kninisninh nepionH poasuTey Paky. 35 (OcHoBHi kniniwni cbeHomenn anosKicnitx HoBoyTBOpeNt (A.A. BypnaKa) 2 36 Tepannno-Hoxunui nyxninihl ypaxenis (O.T. Exres). sai copay eT Tapaneornactuuii camponn (10.1. Sarisencea) 39 Pospin4 METOMM AIATHOCTMKN 3/10SKICHNX HOBOYTBOPEHb (ranannar meausnix Haye JLB. [pnexosa, Kamar MenMHiX HayK, AO\eHT O.C, 30708) 48 Tloxsrrra npo crannaptu plarHocrakn Ta rikyBaHHA .... eee 49 Meroponorivii ra topawuni acnextu onKonOri¥Horo AlarHO3y .. . 50 Inctpym@¥iranbiia alarHocTuKa 8 OMKONOT. - Mopeonorisna nlarMocraca nya (xanswaT MeN Hay P.M, Saxapueea, KO. MeKyp) 69 Bioxiiuni-ra imyHonorivni mevoaN gocriaxeHHa (A.A. BypmaKa) ermattaiOT Posazin5 © NPMHUMN JIKYBAHHA NALIEHTIB. 31 3/IOAKICHUMM HOBOYTBOPEHHSAMM.. 1 8B Xipyprine nikysana (€.C. Kosavy)... 83 Tipomenena repanin (€.C. KosauyX) . si 87 Menuwamesroana tepanig (Kananaar uezuennx waye 0.€. NodaH08a) etd MpotnGonbosa repanin (A.A. BYNAKA)..ocseseeeinrctntentree : ence 105, Posain6 PEABINITALIS| XBOPIX OHKONOFINHOFO NPOOINIO. MEQUKO-COLASIBHA EKCNEPTM3A APAUESOAUIORT (kanannar menusnix HayK 0.1. CAaOpsyK) ti ssiseeescis 405) 4 okkonoria oS aeCIMCOK OCHOBHUX CKOPOUEHB Agr - anTigiyperannit ropmow AKT — agpeHoxoprnkorponHnti ropMon AnAT — anavinaninoToancepasa ACAT —acnapraraminotpanchepasa Aon — anvcpa-qeronporein 8003 — Beecairia opranizauia oxoponn saopoa'a rm —ramma-rayraminrpancnentapasa 7 —ropmonorepania AA83-cnnapom — cimnpoM auceminosaHoro sHyTpiwAeocyAMHHoro sropTantiA KpOBI aK — nesoxcupnGonyknelnosa kucnora EQ — exepreriuna nonnneporpadia ekr — enextpoKapziorpawa 3H —snonkioie nosoyreopeHHa lea —innynecha cnextpansra nonnneporpadia KaK — konopose nonnnepiscexe KaprysaHia «T —Kown'torepha romorpadia ann — moaceKiii nnaueHapHnt naxroren TK —ninysanoia diskynsrypa Mos. —Mikictepers0 oxopotn anopos'a MPT — marnituo-pesonakcna Tomorpadia nn —necrepoianini nporusanansenii npenapar 030 — opratioaGepiraiova onepauin O@EKT — oanodoToHHa ewiciata Koun'orepHa romorpacbin ner —nosurponta emiciina romorpadin nan —nepaniio-MHOxUKHa anoAKicHa nyxnnHa nc —napaveonnactasHui campo nica —npoctatwwiii creeps axruren oT —npomesiesa tepanin nr —naparnpeoiaHii ropaion mt —nonixiviorepanis PEA — pakoso-eMOpioxanbnit arrruren PHK — puGonyxneitiosa kvcnora Pon —Baniodapmanjestuvniii npenapat err — comarorponnii ropMon m1 —Tpeotponiinii ropmon ysa — yneTpasaykoee nocninxeniin orac — di6poracrponyoneHocKonia onr — PoowonesoKcurnioxoaa ‘KC — ¢i6poKonoHocKonin xT — xopiowisuti ronanorponin UHC —uerTpanbita Hepeoea cHcTeMa MP — nnepHo-marnitHiRi peaoHaHc EGFR — peuenrop eniaepmansHoro baxropa pocty HGF —@axrop pocry renarouuTia lg —imyornobyriin MCA — Myunononi6Hii pakosoacouliiosanni axTuren PLGF —nnaueHrapniii dakrop pocry TGF — Tpaneopmytowni baktop pocty VEGF akrop pocry ennoreniio cyan . 6 | | | |CNEWIANbHA OHKOSIO“IA. de Yt posal. 148 Posnin7 TOBPOSKICHI SAXBOPIOBAHHS TA PAK MOJIOYHO! SAI03N (kangunar menmwux Hayk, AOUeHT O.C. Boros, 10. Salisenea). "8 Pospin 8 AOBPOSKICH! SAXBOPIOBAHHA TA PAK JIEFEHI. TYXJIMHU CEPEAOCTIHHS. MESOTEJIIOMA MIEBPU (ranangar meqisnnx Hayk, Crapuiuli HayKOBHi CnigpoGITHHK A.B. [Hy]... execs 140) Ao6poakicti nyxnmnu neretb..... " 7 y . 142 Snoskichi nyxnnnn nereHt . a 144 Tiyxnunn cepegocrinin " dl 152 Megorerioa nnespn a +o 187 Posnin9 PAK CTPABOXOAY (aokrop mezimnux Hayx, npomecop C.l. KipKinesoeKii ..... si 160 Posnin 10 PAK LUSIYHKA a (xayanaar meansnnx Hayk 0.1. CHROPYYK) . . : 170 Posin 11 NYXJIMHM FENATONAHKPEATOAYOAEHASIDHO! SOHN (aoxrop menuunux Hayx, npopecop |.6. Uenorix, O.T. Exrem) 188 Tlepaninl paxnesinin . 191 TlepiananynapHtt pak... freee 195 XonanriouentonapHnil pax 2 a 196 Pax riquinyrnosoi sanosn iki ery 198 Pak KoBsHoro Mixypa 3 HEN 201 Tiyxawnn ToHKoro KauesHny. bad sees BOS: Pospin 12 KONOPEKTAMIbHMM PAK (eannmnar mennannx HayK, AOUeHT O.C. 30708, J.E, MaxIy 08)... seve 205 Posnin 13 NYXJIMHM LUKIP (wanannar menueinnx Haye B.B. aly) 231 Posain 14 TYXJIMHM M?AKUX TKAHUH TA KICTOK (aoxrop menu Haye, nouenT B.E. eUsyX) 243 ‘Capnow askin TAH 243 Capkom KICTOK....... 252 Posain 15 . NYXJIMHM FOsIOBM TA LMT (kanangar meansnux Hayx 0.6. SoOaHo8a) 256 Posain 16 TYXSIMHM KIHOYMX CTATEBMX OPTAHIB (aoxrop menmsnux Hays, NpObECOp TO. BAKYMEHKO) ee ove 298 Posain 17 = TYXJIMHM CEYOBMAUIbHO! CHCTEMM TA 4OJIOBIMX CTATEBUX OPTAHIB (aoxrop meni Hayx, npocbecop E.0. Craxosceeui). z ana 332 Posnin 18 JIIM@ONPONIDEPATMBHI SAXBOPIOBAHHA (aoxrop meavnix Hayk LA. Koa0K, O.M. ANEKGHK) .eeevsersee 369 Cnucox pekomexgosanoi nitepatypu. aide fini CBD osKonoris 53ATAJIBHA OHKOJIOLIA POS3JILI 1 ETIOJIOLIA HM EMIQEMIOJOFIA 3JIOAKICHUX HOBOYTBOPEHB BVSHAYEHHS OHKONIOTII SK HAYKM. Onkonoris (sig rpeu. oncos —nyxniiia, logos. cnos0, Hayxa) — ue ranyse MeAMUNAM, AKa BHBAe IDMAMHM SMHIKHEHHA, MeXaHiSMM POSBUTKY, Kn Hi nponeu nyxnvi, pospoGnse meronW ix aiarHoo- THK, HikyBaHHa Ta npodblnakTHKH, ETIONOFIA TA ENIQEMIONOTIA S/IOAKICHMX HOBOYTBOPEHb Eniaemionoris — saranbHomenwuna Hayka, ‘aka BMBYAE 3aKOHOMIPHOCTI aliHUKHEHHS Ta PO3NO- BOIOAKEHHA saxBOpIOBAH® pisHol eTionoril 3 METOIO Pospo6ku npodinakTusiux saxonis. Npeamerom BMBNeHHA enigemionoril € saxsopionanicts — cy- KynnicTe Bunaakia sHHUKHEHHA xBOpO6H Ha neBHiA TepHropli 8 neBHnl 4ac CepeA neBHol rpynh Hace- neHiA Bnepwe 8 csiti oGnik raxux qaHux Gye opra- Hisosanun 8 CPCP y 1948 p. BuBveHHa Ta ananis KinbkicHWx noKasHukis saxBopioBaHocTi Ha 310- akichi HosoyTeopeHHa (3H) piahux rpyn HaceneH- Ha Ta CMepTHicTs Big Hux AossONAIOTE Opratam yhpasninwa cuctemn oxopoun sqopos'a pospo6- aTU Ta BAOCKOHaMOBAT NporpaMu NpoTHpAKO- Boi Gopore6u. Lopivtio Ha ocHosi axepen indopmauil 3 swwena nepevitHix AoKymenTis «FlosigommeHHs no xB0p0- ro Bnepwe 8 xHTTI scTaHOBNeHHM Zar HO3OM paKy Go iMworo snoskicHoro HoBoyTBOpEHHE™ (pop: a N? 080/0) Ta «KoHTponbi kaoTH aucnaHcep- Horo cnocrepexenHa xsopinx Ha ssiosiKicH! HOBOyT- Boperiia» (opma N° 030-6/0) cKnanaereca «Soir po saxgopiosaliha Ha SnoAKicHi HOBOyTBOpeHHA» onKe ria ¢opma NE 7 Ta «Sait npo xeopnx Ha anonkicsi HoBo- yraopenin» opwa N35. Ha ockoel aelry 3a ¢bop- Moi N°7 ausiauaioTe CTpykTypy 2axaopioBaHocTi, Pospaxosyiort noxasiukn saxeopioranocri Ha SH, BUABNAIOTS OCOBAMBOCTI NoWIMpeHOCT! OHKONOTiA= Hux xB9p06. Ha ockosi asiry 3a bopmowo N° 35 eusessioTe KoHTHHTeHTHMxBOpuxHa SH, aki nepe6yBaloTe Ha 06- niixy, 8inoMocti npo nomepnnx Bia snoaKicHnx nyx- ‘aus, Bigomocti npo nikyeaHHn xeopux Ha SH, AKi nignsrairs cneuiansHomy nikyeanHo. Ha ocHosi OTPMiMaHinx .aHHx pospaxoByOTSCR NOKASHMKH 2a- xBopiosanocTi Ta cmepTHoctl TIOKA3HMKH 3AXBOPIOBAHOCTI TA CMEPTHOCTI, IX BA3HAYEHHA TA 3HAYEHHA Tpy6nit (necranaaprnaopannii) nokasHuK 2axsopiosanocti (emeptHocti) (GR) — kinbkicTs Bnepwe siagneninx sunankia saxeopiosake Ha SH (260, sianosinko, sunapxis cmepti sia 3H), wo sin6ynuca 8 nonynauil npotaroM poky, siaNeceHa 80 cepenHeot wncenbHocTi Ulel nonynsuil y ToMy > Poul, BvpaxKeHa Ha 100 Tuc. HaceneHHA. XapaKre- puiaye vacrory saxsoprosanis a perioni (nonynauil) ipukopuctosyeraca ana alaniay enigemionorisHoi curyaulis Heomy. B Ykpain 8 2008 p. nokagHiksa- xBopiosanocri va 3H craHoane 349,4, a cmepTHoo- Ti — 184,5 Ha 100 To. HaceneHHA. Saxsopiosavicrs (cmeprHicts) Ha SH sanexnTb Bia nemorpacbivnoi cTpyktypn HaceneHHs: 4M Ginbwa Yacrka crapuinx sikoBMx rpyn, THM BLA NlokagHik saxsoposaxocti (cmeprHocTi). Ann Hi- BeniosaHHa pisviul y BiKkoBil crpyktypi nonynauil zETIONOLIA W EMIDEMIONOTIA SNORKICHMX HOBOYTS0 PE) BuKOpHCTOBYETECA CTaHAApTHsoBaHUl NloKASHHK saxsopiosanocri (emepTHocti) Crangaprusosanui noxasHuk aaxeopioza- Hocri (emeptHocri) (ASR) — noKasiik aaxsopi0- BaHocti (cMeptHocri) y nonynsuili, pospaxoeanni 3a BikoBOW CTPyKTypoI CraHAapTHO NonynRUll 3a craHaapr nonynauii Moxe Gytm BHGpaHnii cei- TOBUiA CraHAApT HACeNeHHE, WO ROSEONRE NopiB~ Hi0BaTH piseHis saxsopiosaHocTi 3 IMLUMMM KpaiHa- ww oaiy. Ykpaicbknit crakaapT HaceneHHa yo o6sucneHo Ha ockosi sikosol cTpyKtypu HaceneH- Ha Yxpaii 2000 p. Busvavexi sa um cralapToM RokasHUKH AOuinsHO BHKOpcToByBaTH ANA nopie- HaiHl#a mix co6000 piss 3axBopioBaHocti pishaxpe- TioHie Ykpainn, aGo npw eneueHHi AMHaMiku 3axB0- plosarocri s periowi. CraHqapriaorana saxBopi0- sanicTe (cmeptiicTs) s Ykpaiti s 2008 p, craHoanna 333,2 (174,9)a 100 Tuc. HaceneHHs. Cranmaptna noxuGxa (SE) oujii0e cryninb TOU hocTi BsHaveHoro CTaHmapTisosaHoro NoKasHH~ ka Ta BUKOPMCTOBYETECA Np NODaNELOMy OOMNC- enn Horo noBipanx inrepeania, Noxasnux posnoscioaxxonocTi saxaopionan- Him (KOHTHHTeHTH) — KinbkicT HaCeneHHA, y AKUX BiiABNeHO 3H Ha KiNeUb poky 8 rpyni nonynsull, BH- paxera Ha 100 THe. HaceneHHs. Xapakrepnaye Posnoscionxenicts 3H y perioki | ankopucrosy- eTBCA ANA BHSHaYEHHS| HEOBxiqHOrO MaTepiansHO- TexkivHoro Ta KanpoBOTO saGeaneveHHs| OHKONO- Fisnoi cnyx6u. HaviGinsw anexsarHam KpvTepiem a8 OUlH- ku edpexrusocri opranisauil oHKOnori4HOT 20- Nomoru xBopum Ha SH € noKasHik BMxnBAHOCTi. Chin sashasuTa, Wo BHBYeHHA NOKAsHMKia BYKKH- ‘aHocti Ha pishi nonynsuit 8 pisHinx KpalHax calty Aposoaunn RochTs pigko. Nepuli MixkHapoaHi 20 nigpxeHits evoKneanocti xeopHx Ha pak 6ynu npo- BeneHi y 1964 p. Hauiowansinm iMCTHTyTOM paky CIA i ekniovann nauierTis 2 Mani, BenuKo6pu- anil, Oiunanail, Opanuil, Hopgeril ra CLUA, kuna Gyno scranosneHo niarHos pak. ¥ nonaNbWoMy TaKi Aocrigxenns nposggunuica MixtaponHow areHul- 610 9 BMBYEHHA paky Ha OcHosi MaHiNx nonynALit- Hitx Kalluep-peecpis oKpeMux KPa CBiTy 3a yMO- 8 BignosiaHocti ix craHaaptam AkocTi HanaHHA o#konorivnoi onoMorn npocTexeHocTi xBopux, ska nocarae 95%, ockinekn sig Yboro aanexuTe kopextiicts pospaxynxy. Crsopeniia Haulonane- Horo kaHuep-peecrpy Ykpalu 3 nepconicbikona- HOW 6as0!0 AaHMx npo sci BUINaNKM 3axBOpIOBAH Ha SH ha ecif repuropil kpainin ai wopi4iuM no- ROBHEHHAM iKopMauil AOBBONUINO grepWue NpO- BeCTH AOCHIAKeHHA BMxMBAHOCTI HA piBHi nony- asuii. Crig sigsHaunru, wo y eirwaHsHili npaKTHy) B akocTi NoKasHMKa, Aki OUlHIOE AkicTe HAREHHA onKonori¥Mo! AonOMOrM, BYKOpUCTOBYETECA NO- kasHuk neTansHocri 20 poy. ¥ celroai npakru- Lui Takoro noKasHuKa He icHye — OOuMcMOIOTECA aMuwe NoKasHinkH s¥xKHEAHOCTI, | Tomy nopianaTH 8 sikicTe HanaHHA OHKONOi¥Hol AONoMOrH 8 Ykpaii Ta 8 iMWMx Kpaiax HeMoxaHEO. BiaMinHicTe Mixk NoKasHuKom 1-pi¥Hoi suxxuBaHocTi | noKasHA4KOM AeTanbHOCTi AO PoKy Nonsra€ 8 MeTORMMHUK nid xOfax Ro pospaxynky nloKasHnkis — y nepWOMy Bh- Panky Ue sYaHaYeHHA HimmosipHocTi npoxUTA 1 pik ‘3a HaaaHocTi nanixnpo siranbHii CTatyc xBOporo (xnsMii/nomep). 3a ichyiounm anropurMom xBopi, Ons AkWx HeBiqoMa, sHAy'YaIOTECS Ig POSPAXYHKY, B apyromy sunanxy Taxol npoctexenocti He Bi- MaraeTbeR, anropHTm pospaxysky NoKAsHHKa Ne- TanbHocTi 20 poKy nonsrae 8 OO¥NCNeHHi nuTOMO! BATH XBOPX, NPO AKHX BIOMO, WYO BOHM NOMep~ 1M Bin paky npoTaroM poky, cepen scix, xTO aa- xBopis y nonepeanii pik. Tomy ana sizo5paxeHHA PeanbHol AKOCTI HagaNHs| OHKONOFi¥HoT LONOMOr xeopum 8 Ykpaini ta nopisHsHia i's inwMMn Kpa- TkaMn AouiMbHo BusHa¥aTH NoKAsHHKK 1-3-5-piN- Hol BHoxuMBaHOCTI, Ha ockosi nepcovibikowannx nani Hauionany- Horo Kauep-peecTpy npoBeneHo aHanis awxnBa- HocTi ans HaiiGinsw nowmpeHnxs YkpalHicbopm sno- skichux nyxnun. Zine boro 3 Gasn fakin KaHUep- Pescrpy suinineno incpopmauiio npo 668 325 xBopux, SKHM BiarHos OHKONOTiNHOTO saxXBOpIORAHHA BCTa- HoBneHO y 2000-2005 pp., 8 AocninKeHHs He BKMO- asi xBopvixis MHOxMHHMIaM NyxMMHANH Ta TH, AKIN AjarHios BcraHosneHo nocMepTHO. HaiMacriwe ananiayiorenoKaaiik S-pi4Hol avDxH- BaHiocTi, ockinekn came Ha uel nepioa gia Ginbwoc- TixBopux Ha SH sHaveHHs noKasHnka cra6inisyers- con i kpiisa rpadiky noxashnka anxonuTs Ha nnaro, Mopisistii# noKasHinkle metanbHocTi 20 poKy Ta eiexMBaHocTi XBOpMX Ha pak B YxpaiHi Ta 8 CLIA Hapemeno 8 TaGn. 1.1 TaGnnus 1.1 Mopishsnxs noxaakutia neransuocti ao poxy ra 5-piwor ‘voxwBanocri xsopux a 3H 8 Yxpaini ra CUA Toconisayin | etanvniore Spina ‘20 por mpounn _[Yepatna Bei 3H 34,5 Y rouy snc crosoi nopoxwnn | 45,8 | 21,0 Linc 62,2 | 340 (OGonoeh aie 37,5 [190 ipaMoi awn 32,9 | 180 oprent | 30,3 18,0 eres 63,9 | 60.0 Menavona wip 16.1 [20 ‘Monoswo aanoaw 115 | 20 win ware 162 | 12,0 | 638 Tine warn 128 | 80 | 685 ewe 323 {25.0 | 92.9 Mepeawicypovot I seq 29 | 30 | 452 nun 364 | 260 | aa (Cowoaoro winpa 258_| 9.0 | 465 inboma 36.5 [300 | 444 eixeuis 393 [390 [3 | 480 onxonoris—_—— SS 03) | Haiiinbwa pishius y sHa¥eHHax noKasHnkie ne- TansHocri 0 poxy suvaneHa npM MenaHoMi wkipn, 3H MonowHoi, nepenmixypoaol sanosH Ta ce4oB0- Fo mixypa, y NoKasHitkie 5-pivwor emxasanocti — px 3H potosoi nopoxHHHi, nepeamixyposoi sa- ‘OSH, NPSMOi KMWKH Ta ropraHi, S3AXBOPIOBAHICTb HACENEHHA YKPAIHM HA 3/IOSKICHI HOBOYTBOPEHHA ABconiorua KinokicTb xBopux 3 snepule & >KHTTI BoTanoBneHMM piarHosom 3H y 2008 p. craosuna 161 414 (349,4 Ha 100 THC. HaceneHHA). NopisHa- Ho 1995 p. 2aninii noKasHink nigBMWMBCR Ha ~1,8% (158 594 xaopuxa60308, 1 Ha 100 THe. HaceneHHA), Haieuunit piseHs saxsopieanocti Ha 3H y 2008 p. sigmiveno y Sanopianxiti, Muxona- Tscekilt, Kiposorpanoekin o6nactax (401,4— 412,7 Wa 100 Tuc. Hacenenus) Ta 8 Cepactononi (483,7 Ha 100 Tuc. HaceneHia), Havinioxsi — y Bo: auMHicbkift, Saxapnarcskid, leaHo-Dpankiscoxili Ta PisHeHobkili o6 nacrax (238,8~-277,0 Ha 100 Tuo, HaceneHHa), ANanis crareaoaixosol crpykrypw saxsopiosanocri Ha 3H nokasae, wo y airel (ai- KoM 0-17 poxis) o6ox craTeli waliamuyy nuromy Bary Malo neiikemil ra 3H ronoeHoro MoaKy — 49, 1% y xnonuunis Ta 43,1% y aisuaroK. ¥ oci6 Bi kom 18-29 pokis HaiiGinswy nitromy Bary 8 crpyK- Typisaxeopiosanocri satinaioTe xsopo6a XonyKina Ta 3H seuKa (29,7%) y wonoeikle, xsopo6a Xopykxi- a Ta SH witlikn mark (29,6%) y KiHOK. Y sii sin 30 n0 74 poxis y Yonosikis nposiane micue a axeo- prosanocri sa/imators SH nereHi Ta wnyrika, acrap- we 75 poxis — nerevi ta wkipu. Y xiHOK Biko 30— 74 pox 1-wWe Micue 8 crpykrypi saxeopiosanocti saiimae 3H monowHoi sanosu, Ha 2-tay Micui 8 CTpyK- ‘Typiy KiHOK BiKoM 18-54 poKM — pak wiKA MaTKI, ay kiNOK cTapuie 75 pokia — pak wipn PigeHt cmeptHocti aia snoakicHnx nyxnun y 2008 p. craHosms 184,5 a 100 rHc. HaceneH- Hs! (85 200 nomepninx), To6To nopisHAKo 3 1993 p. SHMHBCA Ha ~B% (103 766 a60 200,8 Ha 100 THe. Hacenents). HaliGinbwy 4acTky 8 CTpykTypi cMepT HocTi Big SH quTa¥oro HaceneHHA salimaiors neii- Kemi ta 3H ronosHoro Moaky — 58,3% y xnonwn- kip Ta 48, 1% y aiaarox. ¥ eixoaili rpyni 18-29 poxie 36epiraeTeca akanorivia TeHaeHuiA — 28,5% y 4o- noBikis Ta 25,9% y xinoK. ¥ cTapwinx BiKOBMNX rpynax ysonosivoro Kacenenus nposinle wicue B CrpykTypi omeprHocri satinsaiore SH nereHi Ta uinynika (34,9~ 39,296), y xinoworo HaceneHHiAa — 3H Mono4koi 3a- NO3H, Wik MaTKH Ta wnynKa (31,7-39,7%), Saxsopiosanicrs yonosivaro Haceneniia YepalHn SaransHa kinbkicTe sunaakis saxsoploBaHtn va SH cepea sonosivoro HaceneHia y 2008 p. cra- Hosuna 77 901 aGo 365,8 ia 100 Tuc. Hacenenna (8 1995 p. — 81 866 a0 342,5 Ha 100 Tuc. Hace- sens). ¥ 2008 p. 8 cTpykTypi saxBopiosaHocti 40- onKonoris Aosivoro Hacenenis nepuii § Micue nociaaiors 3H aerevi, Wkipy, wnynKa, nepenmixypoko! sanosn, 0Gog080! Ta npAMOT KuWKK (52,29), Y Tomy k pou cMeptHicTs sin anonkicninx nyxnnt cepen sonosivoro HaceneHHA Ykpainn craHosuna 47 123 punapxn 260 21,3 Ha 100 THC. HaceneHHA, Saxeoprosanicts xivovoro Hacenenna Ykpaiin SaranbHa KinbkjoTs svnaakis aaxsoplosania Ha 3H cepen xinoworo HaceneHiia y 2008 p. cra- Hosuna 83 513 abo 335,5Ha 100 Tuc. HaceneHHa (y 1995 p. — 76 728 a6o 278,3 Ha 100 Tuc. Hace- sIeHHs)). ¥ 2008 p. 8 ctpykTypi saxeoplosatocri xi- HoNoro Hacenenns nepuui 5 Mic nociqaiors 3H Mo- nosHoT sanoan, ukipy, Tina MaTKH, OB0A0BOI KHU- KM, WHAliKA maTKH (53,5%) Yueh xe nepion cmeptaicts sig anoskicuuxnyx- ‘ninH Cepen xino4oro HaceneHHs Ykpainu CraHoBAna 38077 aunankis aGo 183,0 Ha 100 Tig. HaceneHia, Saxsopiosavicns Auravoro Hacenenna Yxpainit Kinbxiors nepsmHHux xsopux cepen auTayoro: Haceneits Yxpaitiu 8 2008 p. craHoauna 1037 a60 12,4.Ha 100 Tuc. amrsuoro Hacenehna (y 1995 p.— 1053 a60 10,0 Ha 100 tc. HaceneHH). Hat6inow Rowmpesi ceper aireit anonKichi nyxnvHA KpOBO- ‘TBOPHO! Ta ninoiAHo! TkaHNHH, FonoBHOrO Mo3- ky, Hitpkn, KicToK, cyrnoGoanx xpauis Ta wyrTono- i601 sanosn, Piser cmeptuocri sin 3H cepen alreti 8 2008 p. CTakosne 378 sunagkis a60 4,5 xa 100 tc. aura Yoro Hacenexus, ETIONOTIA TA HATOPEHES 3JIOAKICHOTO POCTY Mpn4nin BHinkHeHHA i poseiTKy snoAKicHMx AYAnIAH 8 opraHism nioniiHM Ha NaH MOMeHT ocTa- TOWHO He euiBNeni. OHaK He aakninkae CyMHisy TOM bakr, Wo 3noskichi nyxnHH BMHAKAIOTS B pesynb- Tari KOMGiKOBaHOi ali GaraTeox dakTopie pusuKy, iki GynyT» posrasiyri 8 nahomy posaini. HeO6xin- HO sasHasTH, WO dakTopH pusUKy He SaBKN € APHYMHOW saxsoplosakHs Ta MOKYTe OyTH NUE Mapxepanu ninamujenoi siporigHocri poseurky 3H B opraviaai, Ha skit BOHM BNNMBAIOTS, OMAK Ue He SMeHuye ix poni 8 nporHoayeanHl BHMKKHEHHS Ta/a6o possurky an0AkicHnx nyxau, a) axropn, axi cnpusiore poseurky nyxnu (ximisni cnonyku, sunpominosanna, cnagKo- Bice, ropMonaneHi, Bipycu). Ximinni cronyxu. Ximivui xanueporenn onuca- Hi OAHUMM 3 NepUIKK B akOCTi eTionoriuHorO daK- Topa paky. ¥ 1675 p. axrnificekuii xipypr Nep- cian Norr (Percivall Pott) onncae pax KanuTkn (nepenmixypoeo! sanosu), wo Yacro euaenany y caxKorpycis. Nonansuli Sararopiuni gocniaxen- Ha NOKagaNH, WYO ByrneBOAH, aHgineKi 3 AbOTTO, maior KakWeporeHHi nactnaocti. Motim Gyn IneHTMdixonani A inwi KaNYeporeHH gna moaKHA Ta Teapi ximisni cnonyku. Sa aanumn U. Saffiotti 9ETIONOTIA H ENIDEMIONOFIA 3NOAKICHMX HOBOYTSOPEH> (1982), kinbxicTs 1x wanisye a0 50 Tuc. Cepen xi- Mishix pevosny HaliGinouy kaHileporeniy aKrHe- ict MaoTs Hactynii 1. Tlosiunksisii apomatasii ayrnesontl (AB) — 3,4-Gensnnpen, 20-meTunxonanTpel,7,12-MBA. 2, Apomatini amiss, aniau, ximivni GapaHu- sen — Gexsnains, 2-rac>runaamin, 4-aminonmebenin, 2-ayernnaminodniooper 7a i. 8, Hirposocnonyxm — anidbarnii unknini cno- ‘yk 3 aminorpynowo 8 crpyktypi — Hirpomermnce- osuria, MHA, nierankirposamin, 4. Adnoroxcnn Ta iMusl nponyira xuTTepiaie- HocTi pocnui Ta rpubie (unKasins, Cadpon Ta in). 5. Terepounksiivni apomatu¥Hi eyrnesonki — 1,2,5,6,- Ta 3,4,5,6-nGeHsKap6aaon, 1,2,5,6-2n- Gersaxpnaun. 6. IMui (enoxcnan, weranw, nmiacrmac). Binowicre ximisnix kaxueporenie norpannsiors 8 opravio 8 HeaxTHBHoMy crani fl axTHsisyioTbcA 8 opraviami s npoueci meraGoniomy. Bown Haanaa- ‘oTeoR Cnpasxninan 200 Kinesis KaHLeporeHaM, va siamity sia npamnx karueporenis, aki He novpe- Gyore axrneauli s yMosax opraviamy. Sriano 3 naHnmn MixnaponHoi arenuil 3 en- ueHHA paky (International Agency for Research on Cancer (IARC) — MABP), Mt. SiON, 20 60-70% Bcix sinaakis paky Tie 4H inWoW mipoto nos'ngaki ai wkignnenn xivishunen pesosMHaMn HaaKOnMUl- Hsoro cepenosnuja. 3a crynenem KaHueporeHHocTi Ana nioginin, ariqno is knacurpixauic MABP, Buko- PUCTOBYIOTECR TPH KaTerOpiT OUjHKH XiMisHIDX cnO- ‘yk, Fyn chomyk Ta BMPOGHASiX npouEcia: 1. Ximiani cronyki,, rpynn choayk Ta eupo6si- sani npouec 260 npodeciiiHnii anniv Kakueporen- iana monn. Jana Kareropin ankopucroayeraca ‘Mie 3a HaseHOcTi nocToBipHMx enigewionoriviu ‘oKasie, Fki CBiq4aT NPO NpKAKHHMT 38'RO0K Mix Bninii80OM Ta BUHMKHeHHAM SH. Zo ulel rpynu Hane~ xa Taki saOpynniosasi Aoakinna: GeHz0n, xpom, Sepunii, mmw'ak, wikens, Kamil, aioKCMHn, AeA ki Ha@ronpopy«rn 2. Xiuisi cnonyeh, rpyn cnonyx Ta epoGHMN npouec a6o npodecifixnit annie, MOXMMBO, KaH- usporexhi ann niognnn, ava Kareropia posnine- va Ha niarpynia: 3 Gino sucoKue (2A) Ta HSER (25) ctynetem noxasoB0cTi. Haiieinomiunwunpen- CTaBHnkamn ull rpyni € KOBanbT, CBMHEL, WMH, vikens, mpaayKTM nepeposkn adh, 3,4-GeHa(a}ni- Pek, @opmansaerin, Lliximisl enementy Ta ix cno- AYKM 3HaNHOWD MIO! BsHaYAIOTS akTpONOreHHe HasaHTaxeHHA Ha npupony. 6 3. Ximiani cnonyxas, rpynn cnonyx Ta anpoGHn- wit npouec a6o npodecitinnit sn, ski HoMOx- ‘nwBo Knacudixysatu 3 TONKH 2opy Tk KaHUeporeH- ocTi ana monn. Pismani xanueporenn. Cepen dismsinx cpaK- ‘opis HaliGinswy pon y possHTky anoAKicHINX nyx- ‘nH Bigirpavors ionisyiove Ta ynsTpacbioneToRe Bit 10 Npomiliosania, a Takox Heloniayiove enextpomar- HiTHe BHTOMIKIOBAHHA, lonisyiove sunpominosanHa HesanexHo ein, Buay Ta cnoco6y Bnimay sywosmioe KakueporeH- nit edbexr sHacnigok NowKOAKeHHA reHeTHM4HOrO anapary kniran. Doionisyiovoro aunpomiriosaniin s kanyeporen- HiiMit BnacTMBOCTAMM HanexaTs anbda- Ta 6eTa- SacrMHKn, raMna-npoMeHi Ta HeltTpOHN, Tig sninteom iovisyiouoro sunpominiosais 3H Moxy BiHHKaTH 8 ycix opranax, ane HaMBinswAl PUSHK possHTKy reMoGnacTosis, nyXnHH WKipH, kicTox, nereni, uonowHoi Ta uyxTonopIGHO! sanoaM, flesHKa, Hui npvitHaTa Gesnoporoea KoHUeNLiA Papiauiiivioro Kaxueporenesy. YytnuBicts TKAHMH Ao nil iokisyovoro BHNpoMinioBAHHs sanexitTe Bia NponieparMBHol akruBHocr kninun. B nepioguaK- TweHOro noainy Ta ANepenulauii KniTMH TkAHMMH HaFGinow wyTnnsi 0 pit ioHisyio4oro auNpOMiHtiO- Banus. laTeHTHMli nepiog ana remoGnacrosie cra- HoBHT» 2-5 pokis, anna coninHixnyxnay — 6nvab- Ko 10 poxie. 3a sincytHocTi asapivinux curyauii paniayit- He HapaHTaxkeHHiA Ha Oprakiam nloAKHn cnpUAuHs- lore npvpoani Axepena BunpoMiniosaHia (nepe- AYCiM panok 8 xuTNOBHX NMiMIeHHEX), @ TAKOX AiarHocTuuni Ta nikysanbHi saxon. Tomy npose- AeHHs panionorivinx meTonis piarHocTuKu Ta sii KyBaHHa nue 3a MeAMYHMMH NOKAgaHHEMM, 2 BL KOPHCTAHHAM MiKiMaTbHo MoXxNMBHX 103, CYBOpHT CanirapHiii KoTpont rpysty Ta GynisensHux mare- Pianis alot Benake aHaveHHs! jn SHUDKEHHA p= SUKy BMHMKHEHHR SH. Bnepuie kakueporeny alto ynsrpadionerosux npomenia Gyno oncaxo i go8emeHo G.M. Findflay y 1928 p. 8 npaui «Uitra-violet light and skin cancer». Ynbtpadionerora vactua coHAYHOrO oaitna 3 noBxnHoOW xeuni 280-320 HM mae 3naT- HicTe NPOHMKATH 8 TkAHHH Nlo~NHM Hepes WKipy i mowkomkysarH KniThHn piskux wapis wip sa nexHo Bia AOBXkiHM xBni. Ha CboronHl BIqOMO, LO 20 95% sunapkis paky wikip BnHikae Ha BiakpuTHx Ainalkax wipy, ski nignsraiore Toveanomy enn By ynoTpadioneTosux npomenis. OnHax enigenio~ norisni qocnipKenna csiavare, wo npH aneKearHlls otopeuienuii kanyeporenva gia coHs4HOI paajaulT He nposansetsca, a Haenaku, Bin6yeacteca 380- POTHit possuToK nepenpaKosux amin wkipH. Taki ApoTunexni peaynbTarH annuay coHRHOTO CBiT- Ja norcHioTeca dismuMviMi enactusoctaMn Horo oxnanosnx. Consune caitno cknanaeTeca 2 sMan- Moro BiinpoMiHioBaHHA (BACHE cBiTha) Ta Hes Aumoro (i4paepsororo Ta ybTpadioneTaBoro BunpoMiniosaHNs). HalakTuBHiwe yntpadione- ‘Tose aHNPOMiKIOBAHHS, Ake CKNARAETECA 3 OBTO- (ynbtpadioner A), cepenreo- (yntrpadioner B) ‘Ta kopoTKoxsunb0BOTO (ynbTpadionet C) cexrpis, Npoweni gosroxeunsosoro cnextpa A smaTHi ran- Goko npoHuKarH 6 wkipy Ta yuIKOByBATH CTpyK- onkonorisTyPY COny'HOT TKaHMHN, WYO CTBOPIOE cnpusTAN- Bn oH ans poseuTKy paky, CepeaHboxennbosiii cnextp B mac Cinbwy saarHicte nowkomkyeaTa KAiTHHM wkipy, Hix eneKTp A, ane fioro aKrMBHa ais npossnaerecs Tinka Birey (3 10:00 po 16:00) Cnextp Cale nepesaxio Ha eninepmic, ninenuy. 104 THM CaMMM plisiK BHHHKHEHKA MenaHOMu, Yawtpadionetosi npomeni cnpyannsioTe He Tie kW micuesy imyHocynpecio, nowKomxyiouN Kaiti ku Jlanrepranca, ane izaranbiy imyHocynpecuaHy Alo Ha Opraniom (Gallardo V. et al., 2000) PesncrentHicrs wikipn Ao KanueporenHoro Bnaney ConAYHO! papiauil susHaNaeTecR EMicTOM Bxitt nirmenty Menaniny, ski norauHae ynsrpacbio- AeToBi NpoMeHi, nepeUIKORKaIOWN Ix NPOHMKHEH- Hio 8 ranGuHy TkaHiMH. YroopeHiA MenaHiny Bia Gysaerbos 6 pesynstari nocnigosHux ¢oroxinaiu- Hix PeaKuii 8 knitaHax — MenaHounTax. Mia aie yaetpadioneToBoro sunpomikioBaHiia MenaHoun- TH HO Tinbk cHHTesyIoTs Menahin, ane A ainaTe- on. Mia yao noginy MenaHounri, sik i IMU xan Opraviigmy, craiore Sinbw vytaMBueAM fo ail KaHUe- DoreHinx daxropis. SatHicrs cHMresysaru i Ha- Konmuyeari Menakin 8 kniTaHax opraniamy y pis- Hix monet Nporensetbos no-pishoMy | sHaHaac Cxmnbhiort Ta peaucreHTHicTe 20 posBHITky yXAMH wip, Busianexo, wo peauctenrHicTs TemHowiKl- Pux (GpioHeris) 20 kakueporenioi ail ynsrpadio. aeTOBMX NpoMeHié nos'agaHa 3 BENHKOIO KinbKioTIO Menaniny 8 kniruax Gagansioro, winnonoaiGHoro Ta Haqumonogi6Horo wapia eninepmicy, a cxune- icTs 20 SHHiKHeHHA HOBoyTBOPEHD y CsiTnOLUKipiix (Gnonqvitia) — smicron nirmenty Tinsk e kniTinax Gasansioro wapy eniaepmicy. InreHcHeHicTs Heionisylounx enexrpomarniran BuNpOMinOBaN» NoGrnay nivi enexrponepenadi, Panio- Ta Tenesisivinix craHyil, aacobis panionoKa. ull, anaparypy Haykosoro, MenuMHoro, noSyroBoro NpwaHaventa nepesvusye @oHOBI sHaveHHse 100 100 000 pasis. Hacniaku usoro snninsy ocrarouHo He BcTaHoBneHo, onHak Beeceitia opraisauin oxo- POH snopos's (BOOS) signecna nigenueHis in- TeHCHaHOCTI enekTpomarHirHoro BuNpoMilNOBaH- H81RO BaXxnMBHX exONOTi¥HiNXNpOBNEM. Migr’pyHTAM ‘ANA Weoro CTAanH nani npo aGinbIUeHHA YaCTOTH re. MoGnacroais Ta nyxnn woaky y alrefi, ki niansra- fu goBroTpusanomy BnanayinTeHCHBHiNK eneKTpO- MarHiaix BynpoMiHioBaHt, Pons nioriononaminta y BHHMKHEHHI 3H. Haii- Sins sasyuii, winpoKO PosnoBciomKeHAM Ta NO- TeHullivo NepeGopHinw KaHWeporeHHin dakTopoM BeaxaeTbcA naniiHA. Y aKTHBHHX Kypuis naniiia WHTapOK MacKye xpoHivHi HecneyndivHi, a 4ac- 70 i cneumcisni TpaxeoGpoHxiru, ski np YacTomy 3arocTpeHHi BuKAUKAIOTS aTHnitO KniTHH eniTeniiO, "pn akTHeHomy Ta nacuaHomy nanisisi noTOHOBIAi ‘AM, 8 8KOMY MicTSTSCR aKTHBHi noni\nKni4i apo- Marui Byrnesonni (3,4-GeHa(a)nipex), apomari- HiaMili, Hirposocnonyki, HeopravivHi peyosnin — oria Po3gin 1 Palit, mnw'aK, nonovii, panioakTHBHnli canHeyb, ApH Gesnocepenrtomy KoHTAKT ia BHYTpIWHbOI cTilikolo 6ponxie Ta anbBeonamu euKniKae BsaeMo- lio kakueporenia s Mem6paHowo arunosix aGo uyr- ‘fMBHx RO KaHUepOreHia THNOBHK KniTHN, ninEMUy- tou TaN Canna fimoBipHicTs nyxnmHHol tpaHccbop- Maul. JacTuna kaxueporeis notpanase a winyHoK Si Cnanoio, axkaHueporenn 3 inepTHOI snaTHicnO Ancynayeatn & MikTKAHMHHY pinnHy i posHMnA- foTeca 8 Kposi, SOinbwyloTs aMicT KaHUeporeHHHX Pevopm 8 opratiomi. Sental ra cnisasropu (1951) BeaxKaNM, LO NepeHoCHiKaMu KaHUeporenia 8 op- Fakismi € WupKymoiosi 8 kposoHoCHOMY pycni xino- ikon, Sa gaHnmn BOOS, 3 naninisim ToTOHy BcoulioeTecR Gnviabko 80-85% evmankis paxy ne- ren, 85% paxy roprani, 80% paxy ry6u, 75% pay Crpasoxony, 40% paxy cesogoro mixypa, Hosene- HO, YO HiKkOTMH, Bnokyiown cuitMara4ni raHrnil, Bi- KAWKae SHinKeHH Mictlesoro IMyHiTery anKanoninx uunsxis, ane cam He shires KaHueporeHHO! ail, Alenki seHi spaxaioT, wo xaHueporeHn TIOTIO- HoBOro Aum Ta aTMociepHoro noBiTpA plloTs CH- Heprivio. Sa craTcTHMHuMn 2aHiMn, BinMoBe Ha- CenenHs gin MoTIOKONaniMHA sKanna 6 saxBOpIO- Bavicrs wa 3H Ha 25-30%. Si6pani earomi noKasn cunepriamy KanYepo- FenKOI aif nails Ta snopxuBaHHA ankoronio, Era HON — nOTYXHNIA KaHUepOreH, AKT MONMHA BI. B8€ cBiqOMO. 3a'ASOK BxuBaHHA ANKOFOMIO 3 BCO- iM PHSHKOM possHiTky snoRKicHNX NyKAMH poToBOT ROPOKHKHM, FnOTKH, CTPABOXOAy, ropTaHi, NeviNKh, MOnONHO! 3anosM, nereHi, TOSCTO KHLKM ninTBep- axennii Marepianau Garareox enigemionorianinx AocrigkeHb. Kalljeporenn MiCTATEOA AK B Mihi, Tak iB cna6oankoronsHux Hanosx. Ponb mixpoopranismia 8 possurky 3H. Ha choronni He eiknikae cymuisia snaTuicre ne- akux sipycia BaknuKaTu 3H. Taki sipycu orpumann HasBy OnKoreHH. Ak eTionoriui areHTu QeskKuUx yx: ‘MH BAHAYEHI HACTyNHI HHHHIAKH 1. Bipycnaninomn nionnnn (HPV) — onus 3 npo- BinHnx eTionoriwHix akTopie SMHMKHEHHA Lep- sikanbHo-inTpaenireniansioi Heonnaaman (CIN) 7a paky wniikH Marky. BinoMo 6nusbKo 74 reHoTi- nis HPV. Cepen Winx anginaiors: * AoGpORKicHi TNH (6 ra 11), 2AKMMMNOB'RayIors PosaHtTOK rocrpoKinuesinx KOMAWNOM aHOreHi- ‘TanbHOT AlnsHKH Ta iHwMx AO6poRKicHHx HOBO- yreoperie; * Snonkichi TaNH (16, 18, 31, 33, 35, 52), aKi YaCTO BYABAAIOTS y xopux 3 YepsikaneHo- lrpaeniteniansto1 Heonnasmow ra reHiranbe umm pakou, Maninomasipyc mioani, Tun 16, nos'aaywrs 3 PoaBitTKoM paky synseH, nixeu, akyca, crpaBoxo- AY, Muraannia. BniwseKo 800 Tic, HOBUX eunanKis Paky WKH MarkH y calri nos'aayioTe 3 HPV. 2. Tepnecsipycu. Tpusana nepcucrenuia rep- Necaipycis, soxpema sipycy Enureiiva — Bapp 1(EBV), 8 opranismi moan craopios cnpuarnu- ai yon ana daxropie iniujaull ta ApoMouil 3H (Ctpyx B.1., 1987). Natorexes nyxmnn, acouiiosa~ nix 3 EBV, cknanHil isanexuTs Bin Garareox daK- Topie (ropMonanbiin, iMyHHHX, TeHETIMHINK). ¥ 10- ann 3 EBV acoulosani HacTynni nyxamei: tae oma Bepkirra, Hasobapuireanbuini pak Ta pax luni mari 3, Bipycu renariy Tuny B 1a C (HBV Ta HCV). Bipyen renanmryB 1a C, nowKomxyiown renaro- erm, e4acTum bakTopoM 8 poseHTKy renaTouenio- AABHOTO paky. 3a ulxKamn BOOS, Ennabko 80% acix eunagkis nepsitnnlx 3H nevivKn inpyKoBaHi UM Bipycamn. BritabKo 200 mH oci6 Ha nnanerie Hociamm HBV Ta HCV, Llopisio 8 cairl aiarHoctyeTe~ oR Aekinbka CoTeHb THOR HOBHX euInanKia renaTo- uenionspHoro paky, acouiliozaHoro 3 HBV ra HCV, 4. Bipyc T-KninaiHoT nelikeMil moan (HTLV), HTLV snepuue snseneno x 1979-1980 pp. 3 nyx- nv knit Bopocninx nauleHTi8 3 T-KniTHHHOIO sniucponeiixemie. 3a aannmneninemionoria, naro- oriA, acouiliogana 3 Ynm sipycom, o6mexera nis- AeHHIMNN palioHaMN AnoHil Ta IMall. LocnimxennA @MEpHKAHCEHKUK Ta RNOHCEKHX BUEHHX NOKASYIOTS, wo @ 90-98% eunankis roctporo nim@oneiikosy y Aopocnnx npw THNOBKK NpoRBAX y KpoBi BaKA- alot arutrina 20 HTLV. Ha ceoroani orpawatii paromt apryMeHTi a KO- puicre sipycHoro noxomxeHHa nimborparynemaro~ 3y, capkomu Kanowii, MenaHom, rio6nacromu. Oxpim sipycie, possurroxnyxnni MoxyT> 3yMOB~ oBaTi ft iwi wixpoopravinn, Enigemionorivsi 2ocninxeHHa ninraepaxyor’ nigenwenna YactorH svinaakls paky winysKa, aco~ uilioBakoro 3 Helicobacter pylori. ¥ 1994 p. Mixwa- ona arenuin 3 BHBYeHHA paky sinHecna Wo BaKTe- iio m0 Kariueporenis nepuioro knacy Ta susHauiina ak npwannty possirky paky wnyska Ta WAyRKOBOI MALT-nimomu y moni. Zosrorpupana Konoxi- ‘au H. pylori 8 cnwaosila OGonowUi winyHKa cTBO- ioe cnpiaaTnvsi ywosn an ail KaHeporeHnnx pe- MOBIH Ha KniTMHW CeDMiHATHBHINX 20H Ta MOK BicT® camux GaxrepM inayrysaTu nponkpepaTasti inn eniteniio uinyska 3 aKTMBauicio NpOTOOHKO~ revis | reHeTH4HOWO HeCTiiKicTIO CTOBBYPOBUK Kni- TWH, WO NPMSBOANTS AO PosBHTKy Myraulli Ta re- HoMHix nepe6yaoB. Pursik posBHTKy paky wnyHKa cyrreso aGintwiytoTs usrama H. pylori, acouitiosani 8 Binkatan CagA (uurtoToKcHHacouilioBannii ren A) Ta Vac (Baxyonisyiosni wxToToKCHH A). 3a ouik- koWo D. Forman (1996), 3 inbikyaaniian H. pylori NOB ato nO 75% paky whyHika 8 pogeMHyTuK Kpa- ‘imax a Gnmabko 90% 8 Kpalliax, io possuBaioTecs, UWnctocromos cynposomxyeTeca ninsnieHHAN pwauky possutky 3H cevonoro mixypa, onicrop- x03 — XOBYOBUBIAHMK Linas. Mexakiann KaMUe- Poretesy iMosiprio nos'agaiis nocHneHHAM KaHue PoreHHoro edexry Hitposaminie 8 peaynrati xuT- TenianeHocti napasnra. 12 HONOFIA HM EMIDEMIONOFIA 3NORKICHMX HOBOYTS0? EH) TS Crapxoea cxunenicre. Cnanxosa oxnnshicte AO BHHIKHeHHA SH He O3HaYae, WO pak yonanKO- BYETHCA 3 NOKONIKHA B NOKORIHHR. [pH OOTAKEHO- My S7}08KicHMINH nyxninHaM aHaMHesi yonaaKoRy- erbca niqauuyera vytausicTs 20 all kaHueporenie. Cnanxosa cnpuiinatnsicrs anauexa | goseneHa SMW AF AEAKHX saxsopIOBAHE, NDA sIKHX HiMOBID- ics axsopir sa HaneHocTi reHeTHHOT GxMNBHOC: TicTahosiTs 80-90%. 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BUSHaYaioTS. cxmnsHicTs 20 posBuTky HOBOyTBOpeHE nimdopeTH- KynApHoi TkaHWHn, Sanne! npo pons cnaaKosocri 8 possuITKy SH HeoGxinvo spaxosysari now opmyaanni rpyn pu- onKonoris|eR OE POZL |S 1 ‘SliKy Ta KOHTPONIO ga HHIMM 3 MeTOIO NonepenKeH HS BVHARHEHHS Daky. Engoxpunni nopywenrsa, HopmanbHa ainnb- HicTe dyHxuionanbunx cucTem opravismy sane XT BID NPABMABHOTO dbyHkuloHyeaHHA rinoTana- mo-rinodisapHo-HanHnpHnkosol Ta chMNaToARpe- Hanogoi cuctem. ci eHOKpUHH opraH TicHO noB'aaaHi Mx CO- Gow i nianopsaxoayioreca peryniogansHomy ennugy Hepsosoi cuctemm. Mlaronorina aKTHsnicTe nepn- Pepiuiux enaoKpuHinxaanoa, NopyweHHA perynR- TOpHO; dyHKUii HepBOBO! cHicTeMH Ta scys MeTaGO- siisax npouecie 8 TKaHnHax Ta OpraHax npVGBOnsATE ‘Ao yTs0peHHR eHAOTeHHMX KaHLISpOreHHMK pe4oBMH B.M. Ainemax (1983) ssaxas axnuenm nara reHeTHuHHM axTopom BHHMKHEHHA paKy nigen- leHHa nopory 4yTnMBocTi rinoranamyca go ennn- gy eHgoreHHUx dakTopis. 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Nopyweta MeraGonismy 3 Hagmmukosum BMicTom @ KpoBi KoprHsonyy, incyniny, xonecTepn- Hy, ake eninusae Ka nepeGir nyxnMHHOrO Npo“e- cy, B.M. lineman waeas crugpomom KalkDOGinil CutHapom kauxpodinil xapaxrepnayereca nocunen- HaM nponidepauil comatHsHMx KsITHH Ta FanbMy- BaHHaM noginy nimdounris, Wo BnKriMKae MeTa- Soni imyHonenpecito, ska aymoenioe posauToK snosKicix nyxnin 6) Teopii ra eranu kaxueporenesy. Ienye 6araro Teopiii, aki HaMaraioTeca noRCHH- TW mexaitism possuTky 3H, ecl BOHN npeacrasneni onKonoria Bra6n. 1.2. OnMaK xonHa s Hix He snaTHa nOsCHH- ‘T™Mscix acnextis ysoro cknanHoro npauecy, a Sinb- WicTe 3 Hix Ma1oTe Mule icTOpH4ne sHaYeHHA Mpouec onKoreHesy KOpoTKO MoxHa onMoaTH. Hactynhiia 4aHoM. 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Bren | Geta inbinsrpar, ax | op moro [iC inswan | 1057 — Tapa aera nape IR Saatep | 1855 Snycorenerna wep oa rom spy, enor Rives IK |Mnieionoria eon: Tar +i nope ra vr | ps vzbronauisoro cepenoan-ETIONOFIA A EMIDEMIONOTIA 3NOAKICHUX HOBOYTSO PH) TT HopMantHy dyHKujio renia Ta Ginkis, wo Koayiore- Coa Hunan. Oncadi emule nopyWieHHs NpHaBOMATS 2o isonauit Kniruin, cnoTsopents Ti cirHansHoro Ta reHermHoro anapary I, sk HaCniMoK, NO TpaHC- opmaui xniran Tyxnuiia xnirana xapakrepnayerbon KoMntek- ‘com nopyuwieHs Ha reHHOMY, xpomocOMHOMY Ta re- HOMHOMY pink, six apaxxaroTbCA 8 pishoNaninHinx Tunax TONKOBMx MyTaUli, XDOMOCOMHHK aBepauinK Ta SMiMi kinskocTi xpomocom. Ha nani ac einoMo Sinswe 100 rpancnoxaui, Twnopinx knirns neliKosie Ta nivoM, 2TaKOX neCAT- xn TpancnoKauit Ta neneuii nA KniTMH coniaHu Hosoyrsopel» mon. Npn YLoMy BcTAHOSMeHO, lo nyxnukna nporpecia xapaxrepuayersea nocu- eHHAM NOpyWeHs B reHeTM4HOMy anapaTi Kniti- Hu Ta aGinoweHHAM reTeporeHocT! 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Lie crB0~ ioe yMOBM AANA HeKOHTpONbOBaKOro pocTy, Nopy- lye nporpami KiHueso! andepeHuiauil i cMepri Knit, a TaKOX BMKNAKae 3faTHicT’ 20 MeTacTa- aysaHia i nineueHiia crivikocTi (pesMcTeHTHoC- 7) kniTnH go pishux snnvsia, Taka Knitwna Aae no- TOMCTBO, Ake SnaTHe poscensTucA sa Mexamn Ga- sanbHlx meM6pan. opmysakis nepsvHHoro Ta MeTacTaTH4Horo, BOrHMUa BKMOYAE HEOBACKyAApHSALIO, iHBasiIO YXNMHHIX KRITHH 8 HABKONMWHO TKAHMHY, Mirpa- ilo 8 KPOBOHOCHI Ta nimcarHuHi cyqMHM, UAPKY- aul 8 Hx 3 NoganbUMM npMKpinneHHAM AO eH- ‘AOTenio 8 opravi-miweHi, a noTiM eunxig 8 TKAHVHy 3 yTaopeHHAM MeTacTaTWMHOrO BorHiula. Kil04o- VM Ha UboMy eTani OHKOreHeay ¢ npouech iHEa- sii Ta Heoeackynspusauil ‘na sniacHents ineaail nyxninika kniruHa ceKpe: Tye Ha CBO! nosepxHi Ta suninse 8 MiKKniTMHHMis npoctip nporeoninmuni dbepmerTn, sii cnpunioTs pylitiyaannio crpykTyp GazanbHinx knitwitTa MiKKni- ‘TuHHOro MaTpiikcy. OaHO¥acHO 3 YM Ha nosepx- Hi nyxamninc Kaira sig6yeaeTsca nepeposnoain cneundisix kniruHinx MoreKyn anreail: MomeKy- ‘an, cnpsiMosaHi Ha romonorivHi 3B'asKM, SHKAIOTE, gaMicTe HMX a’ aBNAOTRCA MOneKyAM, ski CNDURIOTS 38’ AgyRaniio reTepONOTNHMx KnITHH. IHLLIAM ¢baKTO- POM, HaliGinbw BaxAVeKMG MexakisMi iMBASil, BBA .xai0Te aMIHy pyxomocr! nyxAMHHinx KaiTII. ICHye ‘yma, Wyo nyxnnita KniTHHa npencTasnre Co60I0 ximiomexanivity Maw, Wo npaLioe sa cHicTeMo¥o s 8B. PpyOWi noKashux saxsoprosaHocri C. Mownpenicrs D. lnrencuaH E, Maroma gara onKonor 3. Zina nisemosania planmul y aikositi erpykrypi no- nynauii enKopucToByeTben: ‘A. Tloxasiuxu saxsoposanocri ra cmepTHocr! B. Ppy6nii nokasink saxeoprosaHocri C. Craneprnsosannii noxesnnk saxaoproeaHocT! D. Moxasiix posnoscionKenocri saxsoprosannin E. Crannaptaa nox6ia 4, Sixnit craTHcTHSHHit NOKASHUK € HaiIGinbus ameK- earunm kphTepiem oulKkx opranisaulf onKonorisHOT onoMorn xsopym Ha SH? ‘A, Tloxaanink suoxusanocri B. [pyGnii nokasinx saxeoproBaHocri . Crannaprnsosavnit noxaanink saxeoproeaxocr D. Mokasninc poanoscioaxeHocri aaxsopiosannn E. Crannaptia noxvOKa 5. Shanii craTHcTHMHMH NOKASHAK BHKOPUCTOBYETECR naananavenin Heo6xinHoro MaTepianbHO-TexHiNHO~ Fora xaqposoro 2aGeaneventin onKonori¥NGiCAYKGH? "A. Morasnnkn saxeoproeanocTi Ta cMepTHoCT! 'B. [py6nit nokasHnx saxsopiosanocri C. CrannaprnsoBanni noxashik saxsoproBanocri . Morasnnx posnoacimxexocr! axsopiosanrs! E. Cranaaprua noxu6xa 6. Ski 3H # 2008 p. aaitmann neputi mars micue y etpyxrypi Saxeopioganocri yononivoro HaceneH- ia Vpalin? ‘A. Tiereti, wxipn, winynea, nepenuixyposot sanosH, ‘260n0801 Ta NpAMOT KAUKH B. fonostoro mosky, Re¥Ka, uinynKa, nepemMxyDo~ ‘soi saosit, 06020801 Ta NPRMOT KHL ©. Mlereni, win, wnynea, nepenseixypoeol sano- ‘ou, HHDKM D. TemoGnacrosn, wnyrxa, npanoF Keun, unuuny= oof sanoa, cevoaoro Mixypa E Mlevines, npn, wip, cevogoro Mixypa, Nps oT Kn iHol saxeopiosanocri isETIONOFIA A EMIAEMIONIOFIA 3NOARKICHUX HOB 794i GHy 2008 p. saimanunepuin'sTemicusy CTPYK- ‘typi saxeoprosanocri xinoworo nacenenus Ypain? ‘A. UjaronaaiGnoi san0aH, wxipn, rina maren, o6on¢ f20T KIL, wn MATE B.Jlereni, rina marks, OOOAOsO! KMUIRH, wifes 4a CC. Wnyrxa, monownorsanosis, ©GonoB0! KALUKH, WHi- i mare, wwrTonoaiGno! sano3H D. Tina Markit, 06020807 KML, UIMIRH MAK, AA- MoT KHIM, wKipH E. Monowoi sanosh, wxipn, Tina marx, oGon080% wi, unin marie 8, ki 3H y 2008 p. sarimann nepull n’ate micue y etpykrypi saxeopiosanocti aurauoro HaceneHHa Yepainn? ‘A, KposoTBopHoi ra nitaboianol rkaHunnis, FONOBHOFO Mo3Ky, HNpRM, KICTOK Ta CyrnOOOBHX XDSUiO Ta Wi~ ‘onogiOHoT sanosin B. Monosot san0aM, ronoBHoro MOsKY, MRM, KICTOK ra cyrno6osHx xpauis, uwaTOnonIOHO! sans . 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