{"id":11969,"date":"2020-05-05T23:16:19","date_gmt":"2020-05-05T20:16:19","guid":{"rendered":"https:\/\/www.synevo.ro\/shop\/hpv-genotipare-in-saliva\/"},"modified":"2025-01-30T15:59:31","modified_gmt":"2025-01-30T13:59:31","slug":"hpv-genotipare-in-saliva","status":"publish","type":"product","link":"https:\/\/old.synevo.md\/ru\/shop\/hpv-genotipare-in-saliva\/","title":{"rendered":"HPV genotipare \u00een saliv\u0103"},"content":{"rendered":"<p><strong><em>Informa\u021bii generale \u0219i recomand\u0103ri <\/em><\/strong><\/p>\n<p>Cancerele capului \u0219i g\u00e2tului &#8211; \u00een majoritatea cazurilor carcinoame cu celule scuamoase (HNSCC \u2013 Head and Neck Squamous Cell Carcinoma, \u00een literatura englez\u0103) includ neoplazii ale cavit\u0103\u021bii orale, orofaringelui, hipofaringelui, laringelui, tractului sinonazal \u0219i nazofaringelui.<\/p>\n<p>HNSCC este al \u0219aselea cancer ca frecven\u021b\u0103 din lume; anual sunt raportate aproximativ 600000 cazuri, dintre care ~ 10% reprezint\u0103 <em>carcinoame orale scuamoase<\/em> (OSCC \u2013 Oral Squamous Cell Carcinoma).<\/p>\n<p>La nivel global, inciden\u021ba \u0219i localizarea HNSCC \u00eenregistreaz\u0103 varia\u021bii mari. Astfel, inciden\u021ba sa este mai mare \u00een \u021b\u0103rile Americii Latine dec\u00e2t \u00een SUA \u0219i Europa de Nord. \u00cen India constituie cea mai frecvent\u0103 form\u0103 de cancer. \u00cen plus, HNSCC este mai frecvent la persoanele de sex masculin.<\/p>\n<p>Cancerul amigdalian \u0219i cel bazei limbii sunt responsabile de 90% dintre OSCC. Prognosticul acestor forme de cancer este rezervat, rata de supravie\u021buire global\u0103 la 5 ani fiind de ~ 25%.<\/p>\n<p>Factorii de risc tradi\u021bionali pentru HNSCC \u0219i OSCC sunt fumatul, consumul de alcool \u0219i obiceiul de a mesteca betel (India)<sup>1<\/sup>. Cu toate acestea, \u00een ultima decad\u0103, date clinice \u0219i epidemiologice au documentat asocierea dintre infec\u021bia HPV (papiloma virus uman) a cavit\u0103\u021bii orale \u0219i OSCC<sup>2;3;4;5<\/sup>. Din acest motiv, infec\u021bia HPV a fost recunoscut\u0103 de c\u0103tre International Agency for Research against Cancer ca factor de risc pentru OSCC<sup>1<\/sup>. Mai mult, se raporteaz\u0103 \u00een ultimul timp o cre\u0219tere a num\u0103rului de cazuri de OSCC indus de HPV la b\u0103rba\u021bii &lt; 50 ani<sup>6<\/sup>.<\/p>\n<p>Infec\u021bia genital\u0103 cu HPV reprezint\u0103 cea mai frecvent\u0103 boal\u0103 viral\u0103 cu transmitere sexual\u0103 \u0219i este implicat\u0103 \u00een marea majoritate a cazurilor de cancer cervical. Pe baza poten\u021bialului oncogen tipurile genitale de HPV sunt \u00eemp\u0103r\u021bite \u00een tipuri cu risc sc\u0103zut \u0219i tipuri cu risc crescut. Acelea\u0219i tipuri de HPV care infecteaz\u0103 zonele genitale pot infecta \u0219i cavitatea oral\u0103 sau orofaringele. Tipurile HPV cu risc crescut pot induce HNSCC, \u00een timp ce tipurile cu risc sc\u0103zut pot cauza condiloame sau veruci bucale \/faringiene<sup>7<\/sup>.<\/p>\n<p>Conform datelor din diverse studii se estimeaz\u0103 o prevalen\u021b\u0103 HPV global\u0103 de 30.1% \u00een OSCC. Subtipurile cel mai frecvent identificate sunt HPV 16 \u0219i HPV 18 (25.4% \u0219i respectiv 18.1%)<sup>8<\/sup>. Alte tipuri HPV, cum ar fi 31, 33, 45, 58, 59 sunt mult mai rar raportate<sup>1<\/sup>.<\/p>\n<p>C\u00e2teva studii au demonstrat expresia oncoproteinelor E6 \u0219i E7 HPV \u00een OSCC, suger\u00e2nd faptul c\u0103 HPV era activ implicat \u00een etiologia acestor tumori. Mai mult, hibridizarea genomic\u0103 comparativ\u0103 a indicat c\u0103, spre deosebire de cancerul amigdalian HPV negativ, cel HPV pozitiv prezint\u0103 adesea amplificarea cromozomului 3q, similar cu cancerul cervical \u0219i cel vulvar HPV-pozitiv, ceea ce sus\u021bine rolul oncogenic al HPV \u00een OSCC<sup>1<\/sup>.<\/p>\n<p>Factorii de risc pentru OSCC HPV-pozitiv includ infec\u021bia HPV \u00een antecedente, parteneri sexuali multipli \u0219i alte comportamente sexual considerate ca av\u00e2nd un risc crescut<sup>9;10<\/sup>.<\/p>\n<p>Studiile au ar\u0103tat de asemenea c\u0103 pacien\u021bii cu OSCC HPV-pozitiv sunt mai tineri \u0219i nu prezint\u0103 factorii de risc tradi\u021bionali \u2013 fumatul \u0219i consumul de alcool. O alt\u0103 caracteristic\u0103 a aceastei forme de cancer este prognosticul favorabil \u2013 comparativ cu OSCC HPV-negativ \u2013 independent de stadiul tumorii, v\u00e2rst\u0103, sex, gradul de diferen\u021biere \u0219i nivelul ploidiei ADN<sup>1<\/sup>.<\/p>\n<p>OSCC este de obicei depistat \u00eentr-un stadiu avansat. Screening-ul regulat poate identifica \u00eens\u0103 persoanele cu tumori \u00een stadiu precoce sau pe cele cu risc crescut de a dezvolta aceast\u0103 form\u0103 de cancer. Persoanele cu risc crescut pot beneficia de o examinare mai frecvent\u0103 \u0219i mai am\u0103nun\u021bit\u0103. Este de asemenea important\u0103 educarea pacien\u021bilor privind factorii de risc \u0219i semnele cancerului oral.<\/p>\n<p>Al\u0103turi de anamnez\u0103 \u0219i examenul fizic, detectarea HPV \u00een saliv\u0103 poate fi inclus\u0103 \u00een screening-ul cancerului oral<sup>11<\/sup>.<\/p>\n<p>De\u0219i infec\u021biile HPV se pot remite spontan infec\u021bia persistent\u0103 cu un tip oncogen reprezint\u0103 un factor de risc semnificativ pentru OSCC. Astfel, un pacient la care testul salivar detecteaz\u0103 un tip HPV cu risc crescut poate fi supus periodic unui screening am\u0103nun\u021bit. Infec\u021biile HPV pot cauza leziuni benigne ale epiteliului oral, leziuni precanceroase sau canceroase. \u00cen plus fa\u021b\u0103 de evaluarea riscului de cancer oral, testarea HPV \u00een saliv\u0103 poate constitui un instrument adjuvant \u00een stabilirea prognosticului pacien\u021bilor cu OSCC, deoarece, a\u0219a cum s-a men\u021bionat mai sus, pacien\u021bii cu test HPV pozitiv au o probabilitate mai mare de a r\u0103spunde favorabil la tratament \u0219i de a avea o rat\u0103 mai mare de supravie\u021buire comparativ cu cei av\u00e2nd OSCC HPV-negativ<sup>11<\/sup>.<\/p>\n<p><strong><em>Preg\u0103tire pacient<\/em><\/strong> &#8211; nu este necesar\u0103 o preg\u0103tire special\u0103<sup>12<\/sup>.<\/p>\n<p><strong><em>Specimen recoltat<\/em><\/strong> &#8211; tampon uscat pe care se va recolta saliv\u0103 prin badijonarea cavit\u0103\u021bii bucale<sup>12<\/sup>.<\/p>\n<p><strong><em>Stabilitate prob\u0103<\/em><\/strong> &#8211; <em>1 s\u0103pt\u0103m\u00e2n\u0103 <\/em>la 2-8\u00baC<sup>2<\/sup><\/p>\n<p><strong><em>Metod\u0103<\/em><\/strong> &#8211; <span style=\"text-decoration: underline;\">multiplexare prin tehnologia xMAP (Luminex)<\/span>. Sunt detectate urm\u0103toarele tipuri HPV cu risc crescut: 16, 18, 26*, 31, 33, 35, 39, 45, 51, 52, 53*, 56, 58, 59, 66*, 68, 73, 82 (* riscul oncogen nu este clarificat). De asemenea pot fi determinate \u0219i urm\u0103toarele tipuri HPV cu risc sc\u0103zut: 6, 11, 42, 43, 54, 57, 70, 72, 90<sup>12<\/sup>.<\/p>\n<p><strong><em>Valori de referin\u021b\u0103<\/em><\/strong> &#8211; ADN HPV nedetectabil pentru genotipurile analizate.<\/p>\n<p>Un rezultat pozitiv include comunicarea genotipurilor HPV prezente \u00een prob\u0103<sup>12<\/sup>.<\/p>\n<p><strong><span style=\"font-size: 10pt;\">\u0411\u0438\u0431\u043b\u0438\u043e\u0433\u0440\u0430\u0444\u0438\u044f<\/span><\/strong><\/p>\n<ol>\n<li><span style=\"font-size: 8pt;\"><span style=\"font-size: 10pt;\">Ramqvist T, Dalianis T. Oropharyngeal Cancer Epidemic and Human Papillomavirus. CDC. Emerging Infectious Diseases. Volume 16, Number 11 &#8211; November 2010.<\/span><\/span><\/li>\n<li><span style=\"font-size: 10pt;\">D\u2019Souza G, Kreimer AR, Viscidi R, et al. Case-control study of human papillomavirus and oropharyngeal cancer. <em>N Engl J Med<\/em>. 2007;356:1944-1956.<\/span><\/li>\n<li><span style=\"font-size: 10pt;\">Miller CS, Johnstone BM. Human papillomavirus as a risk factor for oral squamous cell carcinoma: a meta-analysis, 1982-1997. <em>Oral Surg Oral Med Oral Pathol Oral Radiol Endod<\/em>. 2001;91:622-635.<\/span><\/li>\n<li><span style=\"font-size: 10pt;\">Syrj\u00e4nen S, Lodi G, von B\u00fcltzingsl\u00f6wen I, et al. Human papillomaviruses in oral carcinoma and oral potentially malignant disorders: a systematic review. <em>Oral Dis<\/em>. 2011;17(Suppl 1):58-72.<\/span><\/li>\n<li><span style=\"font-size: 10pt;\">Jayaprakash V, Reid M, Hatton E, et al. Human papillomavirus types 16 and 18 in epithelial dysplasia of oral cavity and oropharynx: A meta-analysis, 1985-2010. <em>Oral Oncol.<\/em> 2011;47:1048-1054.<\/span><\/li>\n<li><span style=\"font-size: 10pt;\">American Cancer Society. Cancer Facts and Figures, 2012. Available at <a href=\"http:\/\/www.cancer.org\/Research\/CancerFactsFigures\/index\" rel=\"nofollow noopener\" target=\"_blank\">http:\/\/www.cancer.org\/Research\/<\/a><a href=\"http:\/\/www.cancer.org\/Research\/CancerFactsFigures\/index\" rel=\"nofollow noopener\" target=\"_blank\">CancerFactsFigures\/index<\/a>.<\/span><\/li>\n<li><span style=\"font-size: 10pt;\">Centers for Disease Control and Prevention. Human Papillomavirus (HPV) and Oropharingeal Cancer \u2013 Fact Sheet. November 2013. http\/\/www.cdc.gov\/std\/hpv\/stdFact-HPVandoralcancer.htm. reference Type: Internet Communication.<\/span><\/li>\n<li><span style=\"font-size: 10pt;\">Kansy K, Thiele O, Freier K. The role of human papillomavirus in oral squamous cell carcinoma: myth and reality. <a href=\"http:\/\/www.ncbi.nlm.nih.gov\/pubmed\/23242943##\" rel=\"nofollow noopener\" target=\"_blank\">Oral Maxillofac Surg.<\/a> 2014 Jun;18(2):165-72.<\/span><\/li>\n<li><span style=\"font-size: 10pt;\">NCCN Clinical Practice Guidelines in Oncology. Head and Neck Cancers. Version 2.2011. <a href=\"http:\/\/www.nccn.org\/professionals\/physician_gls\/pdf\/head-and-neck.pdf\" rel=\"nofollow noopener\" target=\"_blank\">http:\/\/www.nccn.org\/<\/a><a href=\"http:\/\/www.nccn.org\/professionals\/physician_gls\/pdf\/head-and-neck.pdf\" rel=\"nofollow noopener\" target=\"_blank\">professionals\/physician_gls\/pdf\/head-and-neck.pdf<\/a>.<\/span><\/li>\n<li><span style=\"font-size: 10pt;\">Heck JE, Berthiller J, Vaccarella S, et al. Sexual behaviours and the risk of head and neck cancers: a pooled analysis in the International Head and Neck Cancer Epidemiology (INHANCE) consortium. Int J Epidemiol. 2010;39:166-181.<\/span><\/li>\n<li><span style=\"font-size: 10pt;\">Quest Diagnostics. Oral HPV: An Overview of the Infection and Its Role in the Development of Oral Cancer. <a href=\"http:\/\/www.questdisgnostics.com\/\" rel=\"nofollow noopener\" target=\"_blank\">www.questdisgnostics.com<\/a>. Reference Type: Internet Communication.<\/span><\/li>\n<li><span style=\"font-size: 10pt;\">Laborator Synevo. Referin\u021be specifice tehnologiei de lucru utilizate 2015. Ref Type: Catalog.<\/span><\/li>\n<\/ol>","protected":false},"excerpt":{"rendered":"<p>\u0420\u0430\u043a \u0433\u043e\u043b\u043e\u0432\u044b \u0438 \u0448\u0435\u0438 &#8211; \u0432 \u0431\u043e\u043b\u044c\u0448\u0438\u043d\u0441\u0442\u0432\u0435 \u0441\u043b\u0443\u0447\u0430\u0435\u0432 \u043f\u043b\u043e\u0441\u043a\u043e\u043a\u043b\u0435\u0442\u043e\u0447\u043d\u044b\u0439 \u0440\u0430\u043a (HNSCC) \u0432\u043a\u043b\u044e\u0447\u0430\u0435\u0442 \u043d\u043e\u0432\u043e\u043e\u0431\u0440\u0430\u0437\u043e\u0432\u0430\u043d\u0438\u044f \u043f\u043e\u043b\u043e\u0441\u0442\u0438 \u0440\u0442\u0430, \u0440\u043e\u0442\u043e\u0433\u043b\u043e\u0442\u043a\u0438, \u0433\u043e\u0440\u0442\u0430\u043d\u043e\u0433\u043b\u043e\u0442\u043a\u0438, \u0433\u043e\u0440\u0442\u0430\u043d\u0438, \u0441\u0438\u043d\u043e\u043d\u0430\u0437\u0430\u043b\u044c\u043d\u043e\u0433\u043e \u0442\u0440\u0430\u043a\u0442\u0430 \u0438 \u043d\u043e\u0441\u043e\u0433\u043b\u043e\u0442\u043a\u0438.<\/p>\n<p>HNSCC \u044f\u0432\u043b\u044f\u0435\u0442\u0441\u044f \u0448\u0435\u0441\u0442\u044b\u043c \u043d\u0430\u0438\u0431\u043e\u043b\u0435\u0435 \u0440\u0430\u0441\u043f\u0440\u043e\u0441\u0442\u0440\u0430\u043d\u0435\u043d\u043d\u044b\u043c \u0440\u0430\u043a\u043e\u043c \u0432 \u043c\u0438\u0440\u0435 \u0438 \u0435\u0436\u0435\u0433\u043e\u0434\u043d\u043e \u0440\u0435\u0433\u0438\u0441\u0442\u0440\u0438\u0440\u0443\u0435\u0442\u0441\u044f \u043e\u043a\u043e\u043b\u043e 600 000 \u0441\u043b\u0443\u0447\u0430\u0435\u0432, \u0438\u0437 \u043a\u043e\u0442\u043e\u0440\u044b\u0445 ~ 10% \u043f\u0440\u0438\u0445\u043e\u0434\u0438\u0442\u0441\u044f \u043d\u0430 \u043f\u043b\u043e\u0441\u043a\u043e\u043a\u043b\u0435\u0442\u043e\u0447\u043d\u044b\u0439 \u0440\u0430\u043a \u043f\u043e\u043b\u043e\u0441\u0442\u0438 \u0440\u0442\u0430 (OSCC). \u0412\u043e \u0432\u0441\u0435\u043c \u043c\u0438\u0440\u0435 \u0447\u0430\u0441\u0442\u043e\u0442\u0430 \u0438 \u043c\u0435\u0441\u0442\u043e\u043d\u0430\u0445\u043e\u0436\u0434\u0435\u043d\u0438\u0435 HNSCC \u0441\u0438\u043b\u044c\u043d\u043e \u0440\u0430\u0437\u043b\u0438\u0447\u0430\u044e\u0442\u0441\u044f. \u0422\u0430\u043a\u0438\u043c \u043e\u0431\u0440\u0430\u0437\u043e\u043c, \u0435\u0433\u043e \u0440\u0430\u0441\u043f\u0440\u043e\u0441\u0442\u0440\u0430\u043d\u0435\u043d\u043d\u043e\u0441\u0442\u044c \u0432\u044b\u0448\u0435 \u0432 \u0441\u0442\u0440\u0430\u043d\u0430\u0445 \u041b\u0430\u0442\u0438\u043d\u0441\u043a\u043e\u0439 \u0410\u043c\u0435\u0440\u0438\u043a\u0438, \u0447\u0435\u043c \u0432 \u0421\u0428\u0410 \u0438 \u0421\u0435\u0432\u0435\u0440\u043d\u043e\u0439 \u0415\u0432\u0440\u043e\u043f\u0435. \u042d\u0442\u043e \u0441\u0430\u043c\u0430\u044f \u0440\u0430\u0441\u043f\u0440\u043e\u0441\u0442\u0440\u0430\u043d\u0435\u043d\u043d\u0430\u044f \u0444\u043e\u0440\u043c\u0430 \u0440\u0430\u043a\u0430 \u0432 \u0418\u043d\u0434\u0438\u0438. \u041a\u0440\u043e\u043c\u0435 \u0442\u043e\u0433\u043e, HNSCC \u0447\u0430\u0449\u0435 \u0432\u0441\u0442\u0440\u0435\u0447\u0430\u0435\u0442\u0441\u044f \u0443 \u043c\u0443\u0436\u0447\u0438\u043d.<\/p>\n<p>\u0420\u0430\u043a \u043c\u0438\u043d\u0434\u0430\u043b\u0438\u043d\u044b \u0438 \u0440\u0430\u043a \u043e\u0441\u043d\u043e\u0432\u0430\u043d\u0438\u044f \u043e\u0442\u0432\u0435\u0442\u0441\u0442\u0432\u0435\u043d\u043d\u044b \u0437\u0430 90% OSCCs. \u041f\u0440\u043e\u0433\u043d\u043e\u0437 \u044d\u0442\u0438\u0445 \u0432\u0438\u0434\u043e\u0432 \u0440\u0430\u043a\u0430 \u0437\u0430\u0440\u0435\u0437\u0435\u0440\u0432\u0438\u0440\u043e\u0432\u0430\u043d, \u043e\u0431\u0449\u0430\u044f \u0432\u044b\u0436\u0438\u0432\u0430\u0435\u043c\u043e\u0441\u0442\u044c \u0437\u0430 5 \u043b\u0435\u0442 \u0441\u043e\u0441\u0442\u0430\u0432\u043b\u044f\u0435\u0442 ~ 25%.<\/p>\n<p>\u0422\u0440\u0430\u0434\u0438\u0446\u0438\u043e\u043d\u043d\u044b\u043c\u0438 \u0444\u0430\u043a\u0442\u043e\u0440\u0430\u043c\u0438 \u0440\u0438\u0441\u043a\u0430 \u0434\u043b\u044f HNSCC \u0438 OSCC \u044f\u0432\u043b\u044f\u044e\u0442\u0441\u044f \u043a\u0443\u0440\u0435\u043d\u0438\u0435, \u0443\u043f\u043e\u0442\u0440\u0435\u0431\u043b\u0435\u043d\u0438\u0435 \u0430\u043b\u043a\u043e\u0433\u043e\u043b\u044f \u0438 \u043f\u0440\u0438\u0432\u044b\u0447\u043a\u0430 \u0436\u0435\u0432\u0430\u0442\u044c \u0431\u0435\u0442\u0435\u043b\u044c (\u0418\u043d\u0434\u0438\u044f) 1. \u041e\u0434\u043d\u0430\u043a\u043e \u0437\u0430 \u043f\u043e\u0441\u043b\u0435\u0434\u043d\u0435\u0435 \u0434\u0435\u0441\u044f\u0442\u0438\u043b\u0435\u0442\u0438\u0435 \u043a\u043b\u0438\u043d\u0438\u0447\u0435\u0441\u043a\u0438\u0435 \u0438 \u044d\u043f\u0438\u0434\u0435\u043c\u0438\u043e\u043b\u043e\u0433\u0438\u0447\u0435\u0441\u043a\u0438\u0435 \u0434\u0430\u043d\u043d\u044b\u0435 \u043f\u043e\u0434\u0442\u0432\u0435\u0440\u0434\u0438\u043b\u0438 \u0441\u0432\u044f\u0437\u044c \u043c\u0435\u0436\u0434\u0443 \u0412\u041f\u0427 (\u0432\u0438\u0440\u0443\u0441 \u043f\u0430\u043f\u0438\u043b\u043b\u043e\u043c\u044b \u0447\u0435\u043b\u043e\u0432\u0435\u043a\u0430) \u0438\u043d\u0444\u0435\u043a\u0446\u0438\u0438 \u043f\u043e\u043b\u043e\u0441\u0442\u0438 \u0440\u0442\u0430 \u0438 OSCC 2; 3; 4; 5. \u041f\u043e \u044d\u0442\u043e\u0439 \u043f\u0440\u0438\u0447\u0438\u043d\u0435 \u0438\u043d\u0444\u0435\u043a\u0446\u0438\u044f \u0412\u041f\u0427 \u0431\u044b\u043b\u0430 \u043f\u0440\u0438\u0437\u043d\u0430\u043d\u0430 \u041c\u0435\u0436\u0434\u0443\u043d\u0430\u0440\u043e\u0434\u043d\u044b\u043c \u0430\u0433\u0435\u043d\u0442\u0441\u0442\u0432\u043e\u043c \u043f\u043e \u0438\u0441\u0441\u043b\u0435\u0434\u043e\u0432\u0430\u043d\u0438\u044e \u0440\u0430\u043a\u0430 \u043a\u0430\u043a \u0444\u0430\u043a\u0442\u043e\u0440 \u0440\u0438\u0441\u043a\u0430 \u0434\u043b\u044f OSCC1. \u041a\u0440\u043e\u043c\u0435 \u0442\u043e\u0433\u043e, \u0432 \u043f\u043e\u0441\u043b\u0435\u0434\u043d\u0435\u0435 \u0432\u0440\u0435\u043c\u044f \u043d\u0430\u0431\u043b\u044e\u0434\u0430\u0435\u0442\u0441\u044f \u0443\u0432\u0435\u043b\u0438\u0447\u0435\u043d\u0438\u0435 \u0447\u0438\u0441\u043b\u0430 \u0441\u043b\u0443\u0447\u0430\u0435\u0432 \u0412\u041f\u0427, \u0432\u044b\u0437\u0432\u0430\u043d\u043d\u044b\u0445 \u0412\u041f\u0427, \u0443 \u043c\u0443\u0436\u0447\u0438\u043d \u043c\u043e\u043b\u043e\u0436\u0435 50 \u043b\u0435\u0442 6.<\/p>\n<p>\u0413\u0435\u043d\u0438\u0442\u0430\u043b\u044c\u043d\u0430\u044f \u0412\u041f\u0427-\u0438\u043d\u0444\u0435\u043a\u0446\u0438\u044f \u044f\u0432\u043b\u044f\u0435\u0442\u0441\u044f \u043d\u0430\u0438\u0431\u043e\u043b\u0435\u0435 \u0440\u0430\u0441\u043f\u0440\u043e\u0441\u0442\u0440\u0430\u043d\u0435\u043d\u043d\u044b\u043c \u0432\u0438\u0440\u0443\u0441\u043d\u044b\u043c \u0437\u0430\u0431\u043e\u043b\u0435\u0432\u0430\u043d\u0438\u0435\u043c, \u043f\u0435\u0440\u0435\u0434\u0430\u0432\u0430\u0435\u043c\u044b\u043c \u043f\u043e\u043b\u043e\u0432\u044b\u043c \u043f\u0443\u0442\u0435\u043c, \u0438 \u0432\u043e\u0437\u043d\u0438\u043a\u0430\u0435\u0442 \u0432 \u043f\u043e\u0434\u0430\u0432\u043b\u044f\u044e\u0449\u0435\u043c \u0431\u043e\u043b\u044c\u0448\u0438\u043d\u0441\u0442\u0432\u0435 \u0441\u043b\u0443\u0447\u0430\u0435\u0432 \u0440\u0430\u043a\u0430 \u0448\u0435\u0439\u043a\u0438 \u043c\u0430\u0442\u043a\u0438. \u0418\u0441\u0445\u043e\u0434\u044f \u0438\u0437 \u043e\u043d\u043a\u043e\u0433\u0435\u043d\u043d\u043e\u0433\u043e \u043f\u043e\u0442\u0435\u043d\u0446\u0438\u0430\u043b\u0430, \u0433\u0435\u043d\u0438\u0442\u0430\u043b\u044c\u043d\u044b\u0435 \u0442\u0438\u043f\u044b \u0412\u041f\u0427 \u0434\u0435\u043b\u044f\u0442\u0441\u044f \u043d\u0430 \u0442\u0438\u043f\u044b \u043d\u0438\u0437\u043a\u043e\u0433\u043e \u0440\u0438\u0441\u043a\u0430 \u0438 \u0432\u044b\u0441\u043e\u043a\u043e\u0433\u043e \u0440\u0438\u0441\u043a\u0430. \u0422\u0435 \u0436\u0435 \u0442\u0438\u043f\u044b \u0412\u041f\u0427, \u043a\u043e\u0442\u043e\u0440\u044b\u0435 \u043f\u043e\u0440\u0430\u0436\u0430\u044e\u0442 \u043f\u043e\u043b\u043e\u0432\u044b\u0435 \u043e\u0440\u0433\u0430\u043d\u044b, \u043c\u043e\u0433\u0443\u0442 \u043f\u043e\u0440\u0430\u0436\u0430\u0442\u044c \u043f\u043e\u043b\u043e\u0441\u0442\u044c \u0440\u0442\u0430 \u0438\u043b\u0438 \u0440\u043e\u0442\u043e\u0433\u043b\u043e\u0442\u043a\u0443. \u0422\u0438\u043f\u044b HPV \u0432\u044b\u0441\u043e\u043a\u043e\u0433\u043e \u0440\u0438\u0441\u043a\u0430 \u043c\u043e\u0433\u0443\u0442 \u0432\u044b\u0437\u044b\u0432\u0430\u0442\u044c HNSCC, \u0442\u043e\u0433\u0434\u0430 \u043a\u0430\u043a \u0442\u0438\u043f\u044b \u043d\u0438\u0437\u043a\u043e\u0433\u043e \u0440\u0438\u0441\u043a\u0430 \u043c\u043e\u0433\u0443\u0442 \u0432\u044b\u0437\u044b\u0432\u0430\u0442\u044c \u0431\u043e\u0440\u043e\u0434\u0430\u0432\u043a\u0438 \u0438\u043b\u0438 \u0431\u043e\u0440\u043e\u0434\u0430\u0432\u043a\u0438 \u0432\u043e \u0440\u0442\u0443 \/ \u0433\u043b\u043e\u0442\u043a\u0435 7.<\/p>\n<p>\u0421\u043e\u0433\u043b\u0430\u0441\u043d\u043e \u0434\u0430\u043d\u043d\u044b\u043c \u0440\u0430\u0437\u043b\u0438\u0447\u043d\u044b\u0445 \u0438\u0441\u0441\u043b\u0435\u0434\u043e\u0432\u0430\u043d\u0438\u0439, \u043e\u0431\u0449\u0430\u044f \u0440\u0430\u0441\u043f\u0440\u043e\u0441\u0442\u0440\u0430\u043d\u0435\u043d\u043d\u043e\u0441\u0442\u044c \u0412\u041f\u0427 \u0441\u043e\u0441\u0442\u0430\u0432\u043b\u044f\u0435\u0442 30,1% \u0432 OSCC. \u041d\u0430\u0438\u0431\u043e\u043b\u0435\u0435 \u0447\u0430\u0441\u0442\u043e \u043e\u043f\u0440\u0435\u0434\u0435\u043b\u044f\u0435\u043c\u044b\u043c\u0438 \u043f\u043e\u0434\u0442\u0438\u043f\u0430\u043c\u0438 \u044f\u0432\u043b\u044f\u044e\u0442\u0441\u044f \u0412\u041f\u0427 16 \u0438 \u0412\u041f\u0427 18 (25,4% \u0438 18,1% \u0441\u043e\u043e\u0442\u0432\u0435\u0442\u0441\u0442\u0432\u0435\u043d\u043d\u043e) 8. \u041e \u0434\u0440\u0443\u0433\u0438\u0445 \u0442\u0438\u043f\u0430\u0445 \u0412\u041f\u0427, \u0442\u0430\u043a\u0438\u0445 \u043a\u0430\u043a 31, 33, 45, 58, 59, \u0441\u043e\u043e\u0431\u0449\u0430\u0435\u0442\u0441\u044f \u0433\u043e\u0440\u0430\u0437\u0434\u043e \u0440\u0435\u0436\u0435 1.<\/p>\n<p>\u041d\u0435\u0441\u043a\u043e\u043b\u044c\u043a\u043e \u0438\u0441\u0441\u043b\u0435\u0434\u043e\u0432\u0430\u043d\u0438\u0439 \u043f\u0440\u043e\u0434\u0435\u043c\u043e\u043d\u0441\u0442\u0440\u0438\u0440\u043e\u0432\u0430\u043b\u0438 \u044d\u043a\u0441\u043f\u0440\u0435\u0441\u0441\u0438\u044e \u043e\u043d\u043a\u043e\u043f\u0440\u043e\u0442\u0435\u0438\u043d\u043e\u0432 \u0412\u041f\u0427 \u04156 \u0438 \u04157 \u0432 OSCC, \u0447\u0442\u043e \u043f\u043e\u0437\u0432\u043e\u043b\u044f\u0435\u0442 \u043f\u0440\u0435\u0434\u043f\u043e\u043b\u043e\u0436\u0438\u0442\u044c, \u0447\u0442\u043e \u0412\u041f\u0427 \u0430\u043a\u0442\u0438\u0432\u043d\u043e \u0443\u0447\u0430\u0441\u0442\u0432\u0443\u0435\u0442 \u0432 \u044d\u0442\u0438\u043e\u043b\u043e\u0433\u0438\u0438 \u044d\u0442\u0438\u0445 \u043e\u043f\u0443\u0445\u043e\u043b\u0435\u0439. \u041a\u0440\u043e\u043c\u0435 \u0442\u043e\u0433\u043e, \u0441\u0440\u0430\u0432\u043d\u0438\u0442\u0435\u043b\u044c\u043d\u0430\u044f \u0433\u0435\u043d\u043e\u043c\u043d\u0430\u044f \u0433\u0438\u0431\u0440\u0438\u0434\u0438\u0437\u0430\u0446\u0438\u044f \u043f\u043e\u043a\u0430\u0437\u0430\u043b\u0430, \u0447\u0442\u043e, \u0432 \u043e\u0442\u043b\u0438\u0447\u0438\u0435 \u043e\u0442 \u0412\u041f\u0427-\u043e\u0442\u0440\u0438\u0446\u0430\u0442\u0435\u043b\u044c\u043d\u043e\u0433\u043e \u0440\u0430\u043a\u0430 \u043c\u0438\u043d\u0434\u0430\u043b\u0438\u043d, \u0412\u041f\u0427-\u043f\u043e\u043b\u043e\u0436\u0438\u0442\u0435\u043b\u044c\u043d\u044b\u0439 \u0440\u0430\u043a \u0447\u0430\u0441\u0442\u043e \u0434\u0435\u043c\u043e\u043d\u0441\u0442\u0440\u0438\u0440\u0443\u0435\u0442 \u0430\u043c\u043f\u043b\u0438\u0444\u0438\u043a\u0430\u0446\u0438\u044e \u0445\u0440\u043e\u043c\u043e\u0441\u043e\u043c\u044b 3q, \u0430\u043d\u0430\u043b\u043e\u0433\u0438\u0447\u043d\u043e \u0446\u0435\u0440\u0432\u0438\u043a\u0430\u043b\u044c\u043d\u043e\u043c\u0443 \u0438 \u0412\u041f\u0427-\u043f\u043e\u043b\u043e\u0436\u0438\u0442\u0435\u043b\u044c\u043d\u043e\u043c\u0443 \u0440\u0430\u043a\u0443 \u0432\u0443\u043b\u044c\u0432\u044b, \u0447\u0442\u043e \u043f\u043e\u0434\u0442\u0432\u0435\u0440\u0436\u0434\u0430\u0435\u0442 \u043e\u043d\u043a\u043e\u0433\u0435\u043d\u043d\u0443\u044e \u0440\u043e\u043b\u044c \u0412\u041f\u0427 \u0432 OSCC 1.<br \/>\n\u0424\u0430\u043a\u0442\u043e\u0440\u044b \u0440\u0438\u0441\u043a\u0430 \u0434\u043b\u044f \u0412\u041f\u0427-\u043f\u043e\u0437\u0438\u0442\u0438\u0432\u043d\u043e\u0433\u043e OSCC \u0432\u043a\u043b\u044e\u0447\u0430\u044e\u0442 \u0438\u0441\u0442\u043e\u0440\u0438\u044e \u0412\u041f\u0427-\u0438\u043d\u0444\u0435\u043a\u0446\u0438\u0438, \u043c\u043d\u043e\u0436\u0435\u0441\u0442\u0432\u0435\u043d\u043d\u044b\u0435 \u0441\u0435\u043a\u0441\u0443\u0430\u043b\u044c\u043d\u044b\u0435 \u043f\u0430\u0440\u0442\u043d\u0435\u0440\u044b \u0438 \u0434\u0440\u0443\u0433\u0438\u0435 \u0441\u0435\u043a\u0441\u0443\u0430\u043b\u044c\u043d\u044b\u0435 \u043f\u043e\u0432\u0435\u0434\u0435\u043d\u0438\u044f, \u043a\u043e\u0442\u043e\u0440\u044b\u0435 \u0441\u0447\u0438\u0442\u0430\u044e\u0442\u0441\u044f \u043f\u043e\u0434\u0432\u0435\u0440\u0436\u0435\u043d\u043d\u044b\u043c\u0438 \u043f\u043e\u0432\u044b\u0448\u0435\u043d\u043d\u043e\u043c\u0443 \u0440\u0438\u0441\u043a\u0443 9; 10.<\/p>\n<p>\u0418\u0441\u0441\u043b\u0435\u0434\u043e\u0432\u0430\u043d\u0438\u044f \u0442\u0430\u043a\u0436\u0435 \u043f\u043e\u043a\u0430\u0437\u0430\u043b\u0438, \u0447\u0442\u043e \u043f\u0430\u0446\u0438\u0435\u043d\u0442\u044b \u0441 \u0412\u041f\u0427-\u043f\u043e\u043b\u043e\u0436\u0438\u0442\u0435\u043b\u044c\u043d\u044b\u043c OSCC \u043c\u043e\u043b\u043e\u0436\u0435 \u0438 \u043d\u0435 \u0438\u043c\u0435\u044e\u0442 \u0442\u0440\u0430\u0434\u0438\u0446\u0438\u043e\u043d\u043d\u044b\u0445 \u0444\u0430\u043a\u0442\u043e\u0440\u043e\u0432 \u0440\u0438\u0441\u043a\u0430 &#8211; \u043a\u0443\u0440\u0435\u043d\u0438\u044f \u0438 \u0443\u043f\u043e\u0442\u0440\u0435\u0431\u043b\u0435\u043d\u0438\u044f \u0430\u043b\u043a\u043e\u0433\u043e\u043b\u044f. \u0414\u0440\u0443\u0433\u043e\u0439 \u043e\u0441\u043e\u0431\u0435\u043d\u043d\u043e\u0441\u0442\u044c\u044e \u044d\u0442\u043e\u0439 \u0444\u043e\u0440\u043c\u044b \u0440\u0430\u043a\u0430 \u044f\u0432\u043b\u044f\u0435\u0442\u0441\u044f \u0431\u043b\u0430\u0433\u043e\u043f\u0440\u0438\u044f\u0442\u043d\u044b\u0439 \u043f\u0440\u043e\u0433\u043d\u043e\u0437 &#8211; \u043f\u043e \u0441\u0440\u0430\u0432\u043d\u0435\u043d\u0438\u044e \u0441 \u0412\u041f\u0427-\u043e\u0442\u0440\u0438\u0446\u0430\u0442\u0435\u043b\u044c\u043d\u044b\u043c OSCC &#8211; \u043d\u0435\u0437\u0430\u0432\u0438\u0441\u0438\u043c\u043e \u043e\u0442 \u0441\u0442\u0430\u0434\u0438\u0438 \u043e\u043f\u0443\u0445\u043e\u043b\u0438, \u0432\u043e\u0437\u0440\u0430\u0441\u0442\u0430, \u043f\u043e\u043b\u0430, \u0441\u0442\u0435\u043f\u0435\u043d\u0438 \u0434\u0438\u0444\u0444\u0435\u0440\u0435\u043d\u0446\u0438\u0440\u043e\u0432\u043a\u0438 \u0438 \u0443\u0440\u043e\u0432\u043d\u044f \u043f\u043b\u043e\u0438\u0434\u043d\u043e\u0441\u0442\u0438 \u0414\u041d\u041a 1.<\/p>\n<p>OSCC \u043e\u0431\u044b\u0447\u043d\u043e \u043e\u0431\u043d\u0430\u0440\u0443\u0436\u0438\u0432\u0430\u0435\u0442\u0441\u044f \u043d\u0430 \u043f\u043e\u0437\u0434\u043d\u0435\u0439 \u0441\u0442\u0430\u0434\u0438\u0438. \u0422\u0435\u043c \u043d\u0435 \u043c\u0435\u043d\u0435\u0435, \u0440\u0435\u0433\u0443\u043b\u044f\u0440\u043d\u044b\u0439 \u0441\u043a\u0440\u0438\u043d\u0438\u043d\u0433 \u043c\u043e\u0436\u0435\u0442 \u0432\u044b\u044f\u0432\u0438\u0442\u044c \u043b\u044e\u0434\u0435\u0439 \u0441 \u043e\u043f\u0443\u0445\u043e\u043b\u044f\u043c\u0438 \u043d\u0430 \u0440\u0430\u043d\u043d\u0435\u0439 \u0441\u0442\u0430\u0434\u0438\u0438 \u0438\u043b\u0438 \u0441 \u0432\u044b\u0441\u043e\u043a\u0438\u043c \u0440\u0438\u0441\u043a\u043e\u043c \u0440\u0430\u0437\u0432\u0438\u0442\u0438\u044f \u044d\u0442\u043e\u0439 \u0444\u043e\u0440\u043c\u044b \u0440\u0430\u043a\u0430. \u041b\u044e\u0434\u0438 \u0441 \u0432\u044b\u0441\u043e\u043a\u0438\u043c \u0440\u0438\u0441\u043a\u043e\u043c \u043c\u043e\u0433\u0443\u0442 \u0432\u044b\u0438\u0433\u0440\u0430\u0442\u044c \u043e\u0442 \u0431\u043e\u043b\u0435\u0435 \u0447\u0430\u0441\u0442\u043e\u0433\u043e \u0438 \u0442\u0449\u0430\u0442\u0435\u043b\u044c\u043d\u043e\u0433\u043e \u043e\u0431\u0441\u043b\u0435\u0434\u043e\u0432\u0430\u043d\u0438\u044f. \u0422\u0430\u043a\u0436\u0435 \u0432\u0430\u0436\u043d\u043e \u0438\u043d\u0444\u043e\u0440\u043c\u0438\u0440\u043e\u0432\u0430\u0442\u044c \u043f\u0430\u0446\u0438\u0435\u043d\u0442\u043e\u0432 \u043e \u0444\u0430\u043a\u0442\u043e\u0440\u0430\u0445 \u0440\u0438\u0441\u043a\u0430 \u0438 \u043f\u0440\u0438\u0437\u043d\u0430\u043a\u0430\u0445 \u0440\u0430\u043a\u0430 \u043f\u043e\u043b\u043e\u0441\u0442\u0438 \u0440\u0442\u0430.<\/p>\n<p>\u041d\u0430\u0440\u044f\u0434\u0443 \u0441 \u0430\u043d\u0430\u043c\u043d\u0435\u0437\u043e\u043c \u0438 \u0444\u0438\u0437\u0438\u0447\u0435\u0441\u043a\u0438\u043c \u043e\u0431\u0441\u043b\u0435\u0434\u043e\u0432\u0430\u043d\u0438\u0435\u043c, \u0432\u044b\u044f\u0432\u043b\u0435\u043d\u0438\u0435 \u0412\u041f\u0427 \u0432 \u0441\u043b\u044e\u043d\u0435 \u043c\u043e\u0436\u0435\u0442 \u0431\u044b\u0442\u044c \u0432\u043a\u043b\u044e\u0447\u0435\u043d\u043e \u0432 \u0441\u043a\u0440\u0438\u043d\u0438\u043d\u0433 \u0440\u0430\u043a\u0430 \u0440\u043e\u0442\u043e\u0432\u043e\u0439 \u043f\u043e\u043b\u043e\u0441\u0442\u0438 11.<\/p>\n<p>\u0425\u043e\u0442\u044f \u0438\u043d\u0444\u0435\u043a\u0446\u0438\u0438 \u0412\u041f\u0427 \u043c\u043e\u0433\u0443\u0442 \u043f\u0440\u043e\u0445\u043e\u0434\u0438\u0442\u044c \u0441\u0430\u043c\u043e\u043f\u0440\u043e\u0438\u0437\u0432\u043e\u043b\u044c\u043d\u043e, \u043f\u043e\u0441\u0442\u043e\u044f\u043d\u043d\u0430\u044f \u043e\u043d\u043a\u043e\u0433\u0435\u043d\u043d\u0430\u044f \u0438\u043d\u0444\u0435\u043a\u0446\u0438\u044f \u044f\u0432\u043b\u044f\u0435\u0442\u0441\u044f \u0437\u043d\u0430\u0447\u0438\u0442\u0435\u043b\u044c\u043d\u044b\u043c \u0444\u0430\u043a\u0442\u043e\u0440\u043e\u043c \u0440\u0438\u0441\u043a\u0430 \u0434\u043b\u044f OSCC. \u0422\u0430\u043a\u0438\u043c \u043e\u0431\u0440\u0430\u0437\u043e\u043c, \u043f\u0430\u0446\u0438\u0435\u043d\u0442, \u0443 \u043a\u043e\u0442\u043e\u0440\u043e\u0433\u043e \u0442\u0435\u0441\u0442 \u0441\u043b\u044e\u043d\u044b \u043e\u0431\u043d\u0430\u0440\u0443\u0436\u0438\u0432\u0430\u0435\u0442 \u0412\u041f\u0427 \u0432\u044b\u0441\u043e\u043a\u043e\u0433\u043e \u0440\u0438\u0441\u043a\u0430, \u043c\u043e\u0436\u0435\u0442 \u043f\u0435\u0440\u0438\u043e\u0434\u0438\u0447\u0435\u0441\u043a\u0438 \u0442\u0449\u0430\u0442\u0435\u043b\u044c\u043d\u043e \u043e\u0431\u0441\u043b\u0435\u0434\u043e\u0432\u0430\u0442\u044c\u0441\u044f. \u0412\u041f\u0427-\u0438\u043d\u0444\u0435\u043a\u0446\u0438\u0438 \u043c\u043e\u0433\u0443\u0442 \u0432\u044b\u0437\u044b\u0432\u0430\u0442\u044c \u0434\u043e\u0431\u0440\u043e\u043a\u0430\u0447\u0435\u0441\u0442\u0432\u0435\u043d\u043d\u044b\u0435 \u043f\u043e\u0440\u0430\u0436\u0435\u043d\u0438\u044f \u044d\u043f\u0438\u0442\u0435\u043b\u0438\u044f \u043f\u043e\u043b\u043e\u0441\u0442\u0438 \u0440\u0442\u0430, \u043f\u0440\u0435\u0434\u0440\u0430\u043a\u043e\u0432\u044b\u0435 \u0438\u043b\u0438 \u0440\u0430\u043a\u043e\u0432\u044b\u0435 \u043f\u043e\u0440\u0430\u0436\u0435\u043d\u0438\u044f. \u0412 \u0434\u043e\u043f\u043e\u043b\u043d\u0435\u043d\u0438\u0435 \u043a \u043e\u0446\u0435\u043d\u043a\u0435 \u0440\u0438\u0441\u043a\u0430 \u0440\u0430\u0437\u0432\u0438\u0442\u0438\u044f \u0440\u0430\u043a\u0430 \u043f\u043e\u043b\u043e\u0441\u0442\u0438 \u0440\u0442\u0430, \u0442\u0435\u0441\u0442\u0438\u0440\u043e\u0432\u0430\u043d\u0438\u0435 HPV \u043d\u0430 \u0441\u043b\u044e\u043d\u0435 \u043c\u043e\u0436\u0435\u0442 \u0431\u044b\u0442\u044c \u0434\u043e\u043f\u043e\u043b\u043d\u0438\u0442\u0435\u043b\u044c\u043d\u044b\u043c \u0444\u0430\u043a\u0442\u043e\u0440\u043e\u043c \u043f\u0440\u0438 \u043e\u043f\u0440\u0435\u0434\u0435\u043b\u0435\u043d\u0438\u0438 \u043f\u0440\u043e\u0433\u043d\u043e\u0437\u0430 \u043f\u0430\u0446\u0438\u0435\u043d\u0442\u043e\u0432 \u0441 OSCC, \u043f\u043e\u0442\u043e\u043c\u0443 \u0447\u0442\u043e, \u043a\u0430\u043a \u0443\u043f\u043e\u043c\u0438\u043d\u0430\u043b\u043e\u0441\u044c \u0432\u044b\u0448\u0435, HPV-\u043f\u043e\u0437\u0438\u0442\u0438\u0432\u043d\u044b\u0435 \u043f\u0430\u0446\u0438\u0435\u043d\u0442\u044b \u0441 \u0431\u043e\u043b\u044c\u0448\u0435\u0439 \u0432\u0435\u0440\u043e\u044f\u0442\u043d\u043e\u0441\u0442\u044c\u044e \u0440\u0435\u0430\u0433\u0438\u0440\u0443\u044e\u0442 \u043d\u0430 \u0441\u043b\u044e\u043d\u0443 \u0431\u043b\u0430\u0433\u043e\u043f\u0440\u0438\u044f\u0442\u043d\u043e. \u043b\u0435\u0447\u0435\u043d\u0438\u044f \u0438 \u0438\u043c\u0435\u044e\u0442 \u0431\u043e\u043b\u0435\u0435 \u0432\u044b\u0441\u043e\u043a\u0443\u044e \u0432\u044b\u0436\u0438\u0432\u0430\u0435\u043c\u043e\u0441\u0442\u044c \u043f\u043e \u0441\u0440\u0430\u0432\u043d\u0435\u043d\u0438\u044e \u0441 \u0442\u0435\u043c\u0438, \u0443 \u043a\u043e\u0433\u043e \u0412\u041f\u0427-\u043e\u0442\u0440\u0438\u0446\u0430\u0442\u0435\u043b\u044c\u043d\u044b\u0439 OSCC 11.<\/p>\n<p><strong>\u041f\u043e\u0434\u0433\u043e\u0442\u043e\u0432\u043a\u0430 \u043f\u0430\u0446\u0438\u0435\u043d\u0442\u0430<\/strong> &#8211; \u0441\u043f\u0435\u0446\u0438\u0430\u043b\u044c\u043d\u0430\u044f \u043f\u043e\u0434\u0433\u043e\u0442\u043e\u0432\u043a\u0430 \u043d\u0435 \u0442\u0440\u0435\u0431\u0443\u0435\u0442\u0441\u044f 12.<\/p>\n<p><strong>\u041c\u0430\u0442\u0435\u0440\u0438\u0430\u043b<\/strong> &#8211; \u0441\u0443\u0445\u043e\u0439 \u043c\u0430\u0437\u043e\u043a, \u043d\u0430 \u043a\u043e\u0442\u043e\u0440\u043e\u043c \u0431\u0443\u0434\u0435\u0442 \u0441\u043e\u0431\u0438\u0440\u0430\u0442\u044c\u0441\u044f \u0441\u043b\u044e\u043d\u0430 \u043f\u0443\u0442\u0435\u043c \u043c\u0430\u0437\u043a\u0430 \u043f\u043e\u043b\u043e\u0441\u0442\u0438 \u0440\u0442\u043012.<\/p>\n<p><strong>\u0421\u0442\u0430\u0431\u0438\u043b\u044c\u043d\u043e\u0441\u0442\u044c \u043e\u0431\u0440\u0430\u0437\u0446\u0430<\/strong> &#8211; 1 \u043d\u0435\u0434\u0435\u043b\u044f \u043f\u0440\u0438 2-8\u00baC 2<\/p>\n<p><strong>\u041c\u0435\u0442\u043e\u0434<\/strong> &#8211; \u043c\u0443\u043b\u044c\u0442\u0438\u043f\u043b\u0435\u043a\u0441\u0438\u0440\u043e\u0432\u0430\u043d\u0438\u0435 \u0441 \u0438\u0441\u043f\u043e\u043b\u044c\u0437\u043e\u0432\u0430\u043d\u0438\u0435\u043c \u0442\u0435\u0445\u043d\u043e\u043b\u043e\u0433\u0438\u0438 xMAP (Luminex). \u041e\u0431\u043d\u0430\u0440\u0443\u0436\u0435\u043d\u044b \u0441\u043b\u0435\u0434\u0443\u044e\u0449\u0438\u0435 \u0442\u0438\u043f\u044b \u0412\u041f\u0427 \u0432\u044b\u0441\u043e\u043a\u043e\u0433\u043e \u0440\u0438\u0441\u043a\u0430: 16, 18, 26 *, 31, 33, 35, 39, 45, 51, 52, 53 *, 56, 58, 59, 66 *, 68, 73, 82 (* \u0440\u0438\u0441\u043a \u043e\u043d\u043a\u043e\u0433\u0435\u043d \u043d\u0435 \u0432\u044b\u044f\u0441\u043d\u0435\u043d). \u0422\u0430\u043a\u0436\u0435 \u043c\u043e\u0433\u0443\u0442 \u0431\u044b\u0442\u044c \u043e\u043f\u0440\u0435\u0434\u0435\u043b\u0435\u043d\u044b \u0441\u043b\u0435\u0434\u0443\u044e\u0449\u0438\u0435 \u0442\u0438\u043f\u044b \u0412\u041f\u0427 \u043d\u0438\u0437\u043a\u043e\u0433\u043e \u0440\u0438\u0441\u043a\u0430: 6, 11, 42, 43, 54, 57, 70, 72, 90 12.<\/p>\n<p><strong>\u0420\u0435\u0444\u0435\u0440\u0435\u043d\u0442\u043d\u044b\u0435 \u0437\u043d\u0430\u0447\u0435\u043d\u0438\u044f<\/strong>&#8211; \u043d\u0435\u043e\u043f\u0440\u0435\u0434\u0435\u043b\u044f\u0435\u043c\u0430\u044f \u0414\u041d\u041a \u0412\u041f\u0427 \u0434\u043b\u044f \u0430\u043d\u0430\u043b\u0438\u0437\u0438\u0440\u0443\u0435\u043c\u044b\u0445 \u0433\u0435\u043d\u043e\u0442\u0438\u043f\u043e\u0432.<\/p>\n<p>\u041f\u043e\u043b\u043e\u0436\u0438\u0442\u0435\u043b\u044c\u043d\u044b\u0439 \u0440\u0435\u0437\u0443\u043b\u044c\u0442\u0430\u0442 \u0432\u043a\u043b\u044e\u0447\u0430\u0435\u0442 \u0441\u043e\u043e\u0431\u0449\u0435\u043d\u0438\u0435 \u043e \u0433\u0435\u043d\u043e\u0442\u0438\u043f\u0430\u0445 \u0412\u041f\u0427, \u043f\u0440\u0438\u0441\u0443\u0442\u0441\u0442\u0432\u0443\u044e\u0449\u0438\u0445 \u0432 \u043e\u0431\u0440\u0430\u0437\u0446\u043512.<\/p>\n<p>\u0411\u0438\u0431\u043b\u0438\u043e\u0433\u0440\u0430\u0444\u0438\u044f<br \/>\nRamqvist T, Dalianis T. Oropharyngeal Cancer Epidemic and Human Papillomavirus. CDC. Emerging Infectious Diseases. Volume 16, Number 11 \u2013 November 2010.<br \/>\nD\u2019Souza G, Kreimer AR, Viscidi R, et al. Case-control study of human papillomavirus and oropharyngeal cancer. N Engl J Med. 2007;356:1944-1956.<br \/>\nMiller CS, Johnstone BM. Human papillomavirus as a risk factor for oral squamous cell carcinoma: a meta-analysis, 1982-1997. Oral Surg Oral Med Oral Pathol Oral Radiol Endod. 2001;91:622-635.<br \/>\nSyrj\u00e4nen S, Lodi G, von B\u00fcltzingsl\u00f6wen I, et al. Human papillomaviruses in oral carcinoma and oral potentially malignant disorders: a systematic review. Oral Dis. 2011;17(Suppl 1):58-72.<br \/>\nJayaprakash V, Reid M, Hatton E, et al. Human papillomavirus types 16 and 18 in epithelial dysplasia of oral cavity and oropharynx: A meta-analysis, 1985-2010. Oral Oncol. 2011;47:1048-1054.<br \/>\nAmerican Cancer Society. Cancer Facts and Figures, 2012. Available at http:\/\/www.cancer.org\/Research\/CancerFactsFigures\/index.<br \/>\nCenters for Disease Control and Prevention. Human Papillomavirus (HPV) and Oropharingeal Cancer \u2013 Fact Sheet. November 2013. http\/\/www.cdc.gov\/std\/hpv\/stdFact-HPVandoralcancer.htm. reference Type: Internet Communication.<br \/>\nKansy K, Thiele O, Freier K. The role of human papillomavirus in oral squamous cell carcinoma: myth and reality. Oral Maxillofac Surg. 2014 Jun;18(2):165-72.<br \/>\nNCCN Clinical Practice Guidelines in Oncology. Head and Neck Cancers. Version 2.2011. http:\/\/www.nccn.org\/professionals\/physician_gls\/pdf\/head-and-neck.pdf.<br \/>\nHeck JE, Berthiller J, Vaccarella S, et al. Sexual behaviours and the risk of head and neck cancers: a pooled analysis in the International Head and Neck Cancer Epidemiology (INHANCE) consortium. Int J Epidemiol. 2010;39:166-181.<br \/>\nQuest Diagnostics. Oral HPV: An Overview of the Infection and Its Role in the Development of Oral Cancer. www.questdisgnostics.com. Reference Type: Internet Communication.<br \/>\n\u041b\u0430\u0431\u043e\u0440\u0430\u0442\u043e\u0440\u0438\u044f Synevo. \u041a\u043e\u043d\u043a\u0440\u0435\u0442\u043d\u044b\u0435 \u0441\u0441\u044b\u043b\u043a\u0438 \u043d\u0430 \u0442\u0435\u0445\u043d\u043e\u043b\u043e\u0433\u0438\u0438 \u0440\u0430\u0431\u043e\u0442\u044b \u0438\u0441\u043f\u043e\u043b\u044c\u0437\u043e\u0432\u0430\u043d\u044b 2015. 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