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<article article-type="research-article" dtd-version="1.3" xmlns:mml="http://www.w3.org/1998/Math/MathML" xmlns:xlink="http://www.w3.org/1999/xlink" xmlns:xsi="http://www.w3.org/2001/XMLSchema-instance" xml:lang="en"><front><journal-meta><journal-id journal-id-type="publisher-id">akusherstvo</journal-id><journal-title-group><journal-title xml:lang="en">Obstetrics, Gynecology and Reproduction</journal-title><trans-title-group xml:lang="ru"><trans-title>Акушерство, Гинекология и Репродукция</trans-title></trans-title-group></journal-title-group><issn pub-type="ppub">2313-7347</issn><issn pub-type="epub">2500-3194</issn><publisher><publisher-name>IRBIS LLC</publisher-name></publisher></journal-meta><article-meta><article-id pub-id-type="doi">10.17749/2313-7347/ob.gyn.rep.2023.385</article-id><article-id custom-type="elpub" pub-id-type="custom">akusherstvo-1566</article-id><article-categories><subj-group subj-group-type="heading"><subject>Research Article</subject></subj-group><subj-group subj-group-type="section-heading" xml:lang="en"><subject>ORIGINAL ARTICLE</subject></subj-group><subj-group subj-group-type="section-heading" xml:lang="ru"><subject>ОРИГИНАЛЬНОЕ ИССЛЕДОВАНИЕ</subject></subj-group></article-categories><title-group><article-title>An impact of neutrophil extracellular traps to the prothrombotic state and tumor progression in gynecological cancer patients</article-title><trans-title-group xml:lang="ru"><trans-title>Вклад внеклеточных ловушек нейтрофилов в протромботическое состояние и прогрессию опухоли у онкогинекологических пациенток</trans-title></trans-title-group></title-group><contrib-group><contrib contrib-type="author" corresp="yes"><contrib-id contrib-id-type="orcid">https://orcid.org/0000-0001-7441-2778</contrib-id><name-alternatives><name name-style="eastern" xml:lang="ru"><surname>Слуханчук</surname><given-names>Е. В.</given-names></name><name name-style="western" xml:lang="en"><surname>Slukhanchuk</surname><given-names>E. V.</given-names></name></name-alternatives><bio xml:lang="ru"><p>Слуханчук Екатерина Викторовна – к.м.н., доцент кафедры акушерства, гинекологии и перинатальной медицины Клинического института детского здоровья имени Н.Ф. Филатова</p><p>119991 Москва, ул. Большая Пироговская, д. 2, стр. 4</p></bio><bio xml:lang="en"><p>Ekaterina V. Slukhanchuk – MD, PhD, Associate Professor, Department of Obstetrics, Gynecology and Perinatal Medicine, Filatov Clinical Institute of Children’s Health</p><p>2 bldg. 4, Bolshaya Pirogovskaya Str., Moscow 119991</p></bio><xref ref-type="aff" rid="aff-1"/></contrib><contrib contrib-type="author" corresp="yes"><contrib-id contrib-id-type="orcid">https://orcid.org/0000-0001-8404-1042</contrib-id><name-alternatives><name name-style="eastern" xml:lang="ru"><surname>Бицадзе</surname><given-names>В. О.</given-names></name><name name-style="western" xml:lang="en"><surname>Bitsadze</surname><given-names>V. O.</given-names></name></name-alternatives><bio xml:lang="ru"><p>Бицадзе Виктория Омаровна – д.м.н., профессор РАН, профессор кафедры акушерства, гинекологии и перинатальной медицины Клинического института детского здоровья имени Н.Ф. Филатова</p><p>Scopus Author ID: 6506003478</p><p>Researcher ID: F-8409-2017</p><p>119991 Москва, ул. Большая Пироговская, д. 2, стр. 4</p></bio><bio xml:lang="en"><p>Victoria O. Bitsadze – MD, Dr Sci Med, Professor of RAS, Professor, Department of Obstetrics, Gynecology and Perinatal Medicine, Filatov Clinical Institute of Children’s Health</p><p>2 bldg. 4, Bolshaya Pirogovskaya Str., Moscow 119991</p></bio><xref ref-type="aff" rid="aff-1"/></contrib><contrib contrib-type="author" corresp="yes"><contrib-id contrib-id-type="orcid">https://orcid.org/0000-0002-7456-2386</contrib-id><name-alternatives><name name-style="eastern" xml:lang="ru"><surname>Солопова</surname><given-names>А. Г.</given-names></name><name name-style="western" xml:lang="en"><surname>Solopova</surname><given-names>A. G.</given-names></name></name-alternatives><bio xml:lang="ru"><p>Солопова Антонина Григорьевна – д.м.н., профессор кафедры акушерства, гинекологии и перинатальной медицины Клинического института детского здоровья имени Н.Ф. Филатова</p><p>Scopus Author ID: 6505479504</p><p>Researcher ID: Q-1385-2015</p><p>119991 Москва, ул. Большая Пироговская, д. 2, стр. 4</p></bio><bio xml:lang="en"><p>Antonina G. Solopova – MD, Dr Sci Med, Professor, Department of Obstetrics, Gynecology and Perinatal Medicine, Filatov Clinical Institute of Children's Health</p><p>2 bldg. 4, Bolshaya Pirogovskaya Str., Moscow 119991</p></bio><xref ref-type="aff" rid="aff-1"/></contrib><contrib contrib-type="author" corresp="yes"><contrib-id contrib-id-type="orcid">https://orcid.org/0000-0002-0725-9686</contrib-id><name-alternatives><name name-style="eastern" xml:lang="ru"><surname>Хизроева</surname><given-names>Д. Х.</given-names></name><name name-style="western" xml:lang="en"><surname>Khizroeva</surname><given-names>J. Kh.</given-names></name></name-alternatives><bio xml:lang="ru"><p>Хизроева Джамиля Хизриевна – д.м.н., профессор кафедры акушерства, гинекологии и перинатальной медицины Клинического института детского здоровья имени Н.Ф. Филатова</p><p>Scopus Author ID: 57194547147</p><p>Researcher ID: F-8384-2017</p><p>119991 Москва, ул. Большая Пироговская, д. 2, стр. 4</p></bio><bio xml:lang="en"><p>Jamilya Kh. Khizroeva – MD, Dr Sci Med, Professor, Department of Obstetrics, Gynecology and Perinatal Medicine, Filatov Clinical Institute of Children’s Health</p><p>Scopus Author ID: 57194547147</p><p>Researcher ID: F-8384-2017</p><p>2 bldg. 4, Bolshaya Pirogovskaya Str., Moscow 119991</p></bio><xref ref-type="aff" rid="aff-1"/></contrib><contrib contrib-type="author" corresp="yes"><contrib-id contrib-id-type="orcid">https://orcid.org/0000-0002-8100-0189</contrib-id><name-alternatives><name name-style="eastern" xml:lang="ru"><surname>Дегтярева</surname><given-names>Н. Д.</given-names></name><name name-style="western" xml:lang="en"><surname>Degtyareva</surname><given-names>N. D.</given-names></name></name-alternatives><bio xml:lang="ru"><p>Дегтярева Наталья Дмитриевна – студент 5-го курса Клинического института детского здоровья имени Н.Ф. Филатова </p><p>119991 Москва, ул. Большая Пироговская, д. 2, стр. 4</p></bio><bio xml:lang="en"><p>Natalia D. Degtyareva – 5th year Student, Filatov Clinical Institute of Children’s Health</p><p>2 bldg. 4, Bolshaya Pirogovskaya Str., Moscow 119991</p></bio><xref ref-type="aff" rid="aff-1"/></contrib><contrib contrib-type="author" corresp="yes"><contrib-id contrib-id-type="orcid">https://orcid.org/0000-0003-0226-9276</contrib-id><name-alternatives><name name-style="eastern" xml:lang="ru"><surname>Щербаков</surname><given-names>Д. В.</given-names></name><name name-style="western" xml:lang="en"><surname>Shcherbakov</surname><given-names>D. V.</given-names></name></name-alternatives><bio xml:lang="ru"><p>Щербаков Денис Викторович – к.м.н., доцент кафедры общей гигиены института общественного здоровья имени Ф.Ф. Эрисмана</p><p>119991 Москва, ул. Большая Пироговская, д. 2, стр. 4</p></bio><bio xml:lang="en"><p>Denis V. Shcherbakov – MD, PhD, Associate Professor, Department of General Hygiene, Erisman Institute of Public Health</p><p>2 bldg. 4, Bolshaya Pirogovskaya Str., Moscow 119991</p></bio><xref ref-type="aff" rid="aff-1"/></contrib><contrib contrib-type="author" corresp="yes"><contrib-id contrib-id-type="orcid">https://orcid.org/0000-0002-9899-9910</contrib-id><name-alternatives><name name-style="eastern" xml:lang="ru"><surname>Гри</surname><given-names>Ж.-К.</given-names></name><name name-style="western" xml:lang="en"><surname>Gris</surname><given-names>J.-C.</given-names></name></name-alternatives><bio xml:lang="ru"><p>Гри Жан-Кристоф – д.м.н., профессор кафедры акушерства, гинекологии и перинатальной медицины Клинического института детского здоровья имени Н.Ф. Филатова; профессор гематологии, зав. лабораторией гематологии факультета биологических и фармацевтических наук; иностранный член РАН</p><p>Scopus Author ID: 7005114260</p><p>Researcher ID: AAA-2923-2019</p><p>119991 Москва, ул. Большая Пироговская, д. 2, стр. 4</p><p>Франция, 34090 Монпелье, ул. Огюста Бруссоне, д. 163</p></bio><bio xml:lang="en"><p>Jean-Christophe Gris – MD, Dr Sci Med, Professor, Department of Obstetrics, Gynecology and Perinatal Medicine, Filatov Clinical Institute of Children’s Health; Professor of Haematology, Head of the Laboratory of Haematology, Faculty of Biological and Pharmaceutical Sciences, Montpellier University and University Hospital of Nîmes; Foreign Member of RAS</p><p>Scopus Author ID: 7005114260</p><p>Researcher ID: AAA-2923-2019</p><p>2 bldg. 4, Bolshaya Pirogovskaya Str., Moscow 119991</p><p>163 Rue Auguste Broussonnet, Montpellier 34090</p></bio><xref ref-type="aff" rid="aff-2"/></contrib><contrib contrib-type="author" corresp="yes"><contrib-id contrib-id-type="orcid">https://orcid.org/0000-0002-9576-1368</contrib-id><name-alternatives><name name-style="eastern" xml:lang="ru"><surname>Элалами</surname><given-names>И.</given-names></name><name name-style="western" xml:lang="en"><surname>Elalamy</surname><given-names>I.</given-names></name></name-alternatives><bio xml:lang="ru"><p>Элалами Исмаил – д.м.н., профессор кафедры акушерства, гинекологии и перинатальной медицины Клинического института детского здоровья имени Н.Ф. Филатова; профессор медицинского Университета Сорбонны; директор гематологии Центра Тромбозов, Госпиталь Тенон</p><p>Scopus Author ID: 7003652413</p><p>Researcher ID: AAC-9695-2019</p><p>119991 Москва, ул. Большая Пироговская, д. 2, стр. 4</p><p>Франция, 75006 Париж, Улица медицинского факультета, д. 12</p><p>Франция, 75020 Париж, Китайская улица, д. 4</p></bio><bio xml:lang="en"><p>Ismail Elalamy – MD, Dr Sci Med, Professor, Department of Obstetrics, Gynecology and Perinatal Medicine, Filatov Clinical Institute of Children’s Health; Director of Hematology, Department of Thrombosis Center, Hospital Tenon</p><p>Scopus Author ID: 7003652413</p><p>Researcher ID: AAC-9695-2019</p><p>2 bldg. 4, Bolshaya Pirogovskaya Str., Moscow 119991</p><p>12 Rue de l’École de Médecine, Paris 75006, France</p><p>4 Rue de la Chine, Paris 75020, France</p></bio><xref ref-type="aff" rid="aff-3"/></contrib><contrib contrib-type="author" corresp="yes"><contrib-id contrib-id-type="orcid">https://orcid.org/0000-0001-7415-4633</contrib-id><name-alternatives><name name-style="eastern" xml:lang="ru"><surname>Макацария</surname><given-names>А. Д.</given-names></name><name name-style="western" xml:lang="en"><surname>Makatsariya</surname><given-names>A. D.</given-names></name></name-alternatives><bio xml:lang="ru"><p>Макацария Александр Давидович – д.м.н., профессор, академик РАН, зав. кафедрой акушерства, гинекологии и перинатальной медицины Клинического института детского здоровья имени Н.Ф. Филатова</p><p>Scopus Author ID: 57222220144</p><p>Researcher ID: M-5660-2016</p><p>119991 Москва, ул. Большая Пироговская, д. 2, стр. 4</p></bio><bio xml:lang="en"><p>Alexander D. Makatsariya – MD, Dr Sci Med, Academician of RAS, Professor, Head of the Department of Obstetrics, Gynecology and Perinatal Medicine, Filatov Clinical Institute of Children’s Health</p><p>Scopus Author ID: 57222220144</p><p>Researcher ID: M-5660-2016</p><p>2 bldg. 4, Bolshaya Pirogovskaya Str., Moscow 119991</p></bio><xref ref-type="aff" rid="aff-1"/></contrib></contrib-group><aff-alternatives id="aff-1"><aff xml:lang="ru"><institution>ФГАОУ ВО Первый Московский государственный медицинский университет имени И.М. Сеченова Министерства здравоохранения Российской Федерации (Сеченовский университет)</institution><country>Россия</country></aff><aff xml:lang="en"><institution>Sechenov University</institution><country>Russian Federation</country></aff></aff-alternatives><aff-alternatives id="aff-2"><aff xml:lang="ru"><institution>ФГАОУ ВО Первый Московский государственный медицинский университет имени И.М. Сеченова Министерства здравоохранения Российской Федерации (Сеченовский университет); Университет Монпелье</institution><country>Россия</country></aff><aff xml:lang="en"><institution>Sechenov University; University of Montpellier</institution><country>Russian Federation</country></aff></aff-alternatives><aff-alternatives id="aff-3"><aff xml:lang="ru"><institution>ФГАОУ ВО Первый Московский государственный медицинский университет имени И.М. Сеченова Министерства здравоохранения Российской Федерации (Сеченовский университет); Медицинский Университет Сорбонны; Госпиталь Тенон</institution><country>Россия</country></aff><aff xml:lang="en"><institution>Sechenov University; Medicine Sorbonne University; Hospital Tenon</institution><country>Russian Federation</country></aff></aff-alternatives><pub-date pub-type="collection"><year>2023</year></pub-date><pub-date pub-type="epub"><day>06</day><month>03</month><year>2023</year></pub-date><volume>17</volume><issue>1</issue><fpage>53</fpage><lpage>64</lpage><permissions><copyright-statement>Copyright &amp;#x00A9; Slukhanchuk E.V., Bitsadze V.O., Solopova A.G., Khizroeva J.K., Degtyareva N.D., Shcherbakov D.V., Gris J., Elalamy I., Makatsariya A.D., 2023</copyright-statement><copyright-year>2023</copyright-year><copyright-holder xml:lang="ru">Слуханчук Е.В., Бицадзе В.О., Солопова А.Г., Хизроева Д.Х., Дегтярева Н.Д., Щербаков Д.В., Гри Ж., Элалами И., Макацария А.Д.</copyright-holder><copyright-holder xml:lang="en">Slukhanchuk E.V., Bitsadze V.O., Solopova A.G., Khizroeva J.K., Degtyareva N.D., Shcherbakov D.V., Gris J., Elalamy I., Makatsariya A.D.</copyright-holder><license xml:lang="ru" license-type="creative-commons-attribution" xlink:href="https://creativecommons.org/licenses/by/4.0/" xlink:type="simple"><license-p>Данная работа распространяется под лицензией Creative Commons Attribution 4.0.</license-p></license><license xml:lang="en" license-type="creative-commons-attribution" xlink:href="https://creativecommons.org/licenses/by/4.0/" xlink:type="simple"><license-p>This work is licensed under a Creative Commons Attribution 4.0 License.</license-p></license></permissions><self-uri xlink:href="https://www.gynecology.su/jour/article/view/1566">https://www.gynecology.su/jour/article/view/1566</self-uri><abstract><sec><title>Introduction</title><p>Introduction. One of the leading causes in the mortality pattern of cancer patients is accounted for by thrombotic complications. Recent studies have shown that neutrophil extracellular traps (NETs) are involved in the activation of coagulation, contribute to the initiation and progression of thrombosis. In addition, NET-related effect on tumor progression and metastasis has been actively studied.</p></sec><sec><title>Aim</title><p>Aim: to evaluate NET-related procoagulant activity in gynecological cancer patients.</p></sec><sec><title>Materials and Methods</title><p>Materials and Methods. From April 2020 to October 2022, a prospective controlled interventional non-randomized study was conducted with 120 women. The main group included 87 patients aged 32 to 72 years with malignant neoplasms of the female genital organs and mammary glands who were hospitalized for elective surgical treatment or chemotherapy: uterine body cancer (subgroup 1; n = 18), ovarian cancer (subgroup 2; n = 26), cervical cancer – adenocarcinoma of the cervical canal (subgroup 3; n = 13), breast cancer (subgroup 4; n = 30). The control group consisted of 33 healthy women aged 32 to 68 years. In all women, plasma concentrations of citrullinated histone H3 (citH3), myeloperoxidase antigen (MPO:Ag), D-dimer, and thrombin–antithrombin (TAT) complexes were evaluated.</p></sec><sec><title>Results</title><p>Results. The magnitude of NETosis in cancer patients, assessed by level of citH3 (2.5 ± 0.7; 1.9 ± 0.8; 2.5 ± 0.7; 0.7 ± 0.5 ng/ml in four subgroups, respectively) and MPO:Ag (29.5 ± 13.1; 12.8 ± 3.7; 22.8 ± 8.7; 6.6 ± 2.5 ng/ml in four subgroups, respectively) was significantly higher compared to women in the control group (0.3 ± 0.1 ng/ml; p = 0.0001 and 2.5 ± 0.2 ng/ml; p = 0.0001). In parallel with increased NETosis markers in accordance with the disease stage, there was an increase in the concentration of hemostasis activation markers – D-dimer (1.7 ± 0.6; 2.0 ± 0.7; 1.4 ± 0.5; 1.5 ± 0.7 µg/ml in four subgroups, respectively) and TAT complexes (729.8 ± 43.9; 794.1 ± 164.8; 636.2 ± 149.5; 699.6 ± 165.7 pg/ml in four subgroups, respectively) exceeding their level in the control group (respectively, 0.4 ± 0.1 μg/ml; p = 0.0001 and 362.3 ± 0.1 pg/ml; p = 0.0001). The maximum values of parameters occurred at later stages according to the Classification of Malignant Tumours (tumor, nodus, metastasis, TNM). A significant correlation between TAT level and the concentrations of citH3 (r = 0.586; р = 0.04) and MPO:Ag was revealed (r = 0.631; р = 0.04).</p></sec><sec><title>Conclusion</title><p>Conclusion. Tumor tissue creates milieu that stimulates NETs release, which, in turn, not only contribute to the creating a procoagulant state, but also might act as one of the factors that ensure tumor progression and metastasis. The development of targeted therapies acting on NETs has a potential to affect hemostasis in cancer patients and reduce rate of tumor growth and metastasis.</p></sec></abstract><trans-abstract xml:lang="ru"><sec><title>Введение</title><p>Введение. Одной из ведущих причин в структуре смертности онкологических пациентов являются тромботические осложнения. В недавних исследованиях было показано, что внеклеточные ловушки нейтрофилов (англ. neutrophil extracellular traps, NETs) участвуют в активации свертывания, способствуют инициации и прогрессированию тромбоза. Помимо этого, активно изучается вклад NETs в прогрессию опухоли и метастазирование.</p></sec><sec><title>Цель</title><p>Цель: оценка прокоагулянтной активности NETs у онкогинекологических пациенток.</p></sec><sec><title>Материалы и методы</title><p>Материалы и методы. С апреля 2020 г. по октябрь 2022 г. проведено проспективное контролируемое интервенционное нерандомизированное исследование с участием 120 женщин. В основную группу вошли 87 пациенток в возрасте от 32 до 72 лет со злокачественными новообразованиями женских половых органов и молочных желез, госпитализированных в стационар для планового оперативного лечения или проведения химиотерапии: рак тела матки (подгруппа 1; n = 18), рак яичников (подгруппа 2; n = 26), рак шейки матки – аденокарцинома цервикального канала (подгруппа 3; n = 13), рак молочной железы (подгруппа 4; n = 30). Контрольную группу составили 33 здоровые женщины в возрасте от 32 до 68 лет. У всех женщин в плазме крови были оценены концентрации цитруллинированного гистона Н3 (англ. citrullinated histone H3, citH3), антигена миелопероксидазы (МПО:Аг), D-димера и комплексов тромбин–антитромбин (ТАТ).</p></sec><sec><title>Результаты</title><p>Результаты. Выраженность процессов нетоза, оцененная у онкологических пациенток в концентрациях citH3 (2,5 ± 0,7 нг/мл, 1,9 ± 0,8 нг/мл, 2,5 ± 0,7 нг/мл, 0,7 ± 0,5 нг/мл в четырех подгруппах, соответственно) и МПО:Аг (29,5 ± 13,1 нг/мл, 12,8 ± 3,7 нг/мл, 22,8 ± 8,7 нг/мл, 6,6 ± 2,5 нг/мл в четырех подгруппах, соответственно), оказалась достоверно выше по сравнению с женщинами контрольной группы (соответственно, 0,3 ± 0,1 нг/мл; р = 0,0001 и 2,5 ± 0,2 нг/мл; р = 0,0001). Параллельно повышению маркеров нетоза в зависимости от стадии заболевания происходило и нарастание концентрации маркеров активации гемостаза – D-димера (1,7 ± 0,6 мкг/мл, 2,0 ± 0,7 мкг/мл, 1,4 ± 0,5 мкг/мл, 1,5 ± 0,7 мкг/мл в четырех подгруппах, соответственно) и комплексов ТАТ (729,8 ± 43,9 пг/мл, 794,1 ± 164,8 пг/мл, 636,2 ± 149,5 пг/мл, 699,6 ± 165,7 пг/мл в четырех подгруппах, соответственно), превышая их содержание в контрольной группе (соответственно, 0,4 ± 0,1 мкг/мл; р = 0,0001 и 362,3 ± 0,1 пг/мл; р = 0,0001). Максимальные значения показателей приходились на более поздние стадии по Международной классификации стадий злокачественных новообразований (англ. tumor, nodus, metastasis, TNM). Выявлена достоверная корреляция уровня ТАТ от содержания citH3 (r = 0,586; р = 0,04) и МПО:Аг (r = 0,631; р = 0,04).</p></sec><sec><title>Заключение</title><p>Заключение. Опухолевая ткань создает условия, стимулирующие нейтрофилы к высвобождению NETs, которые, в свою очередь, не только способствуют созданию прокоагулянтного состояния, но также, возможно, являются одним из факторов, обеспечивающих прогрессию опухоли и метастазирование. Разработка таргетной терапии, направленной на NETs, потенциально способна оказать влияние на систему гемостаза у онкологических пациентов и снизить интенсивность опухолевого роста и метастазирования.</p></sec></trans-abstract><kwd-group xml:lang="ru"><kwd>нейтрофилы</kwd><kwd>внеклеточные ловушки нейтрофилов</kwd><kwd>NETs</kwd><kwd>миелопероксидаза</kwd><kwd>МПО</kwd><kwd>D-димер</kwd><kwd>цитруллинированный гистон Н3</kwd><kwd>citH3</kwd><kwd>рак</kwd></kwd-group><kwd-group xml:lang="en"><kwd>neutrophils</kwd><kwd>neutrophil extracellular traps</kwd><kwd>NETs</kwd><kwd>myeloperoxidase</kwd><kwd>MPO</kwd><kwd>D-dimer</kwd><kwd>citrullinated histone H3</kwd><kwd>citH3</kwd><kwd>cancer</kwd></kwd-group></article-meta></front><back><ref-list><title>References</title><ref id="cit1"><label>1</label><citation-alternatives><mixed-citation xml:lang="ru">Timp J.F., Braekkan S.K., Versteeg H.H., Cannegieter S.C. Epidemiology of cancer-associated venous thrombosis. 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