Bone and soft tissue sarcomas, tumors of the skinBone and soft tissue sarcomas, tumors of the skinСаркомы костей, мягких тканей и опухоли кожи2219-46142782-3687Publishing House ABV Press64410.17650/2219-4614-2024-16-1-11-24REVIEWSОБЗОРНЫЕ СТАТЬИMechanisms of sexual dimorphism in the pathogenesis of sarcomasМеханизмы полового диморфизма в патогенезе саркомhttps://orcid.org/0000-0002-3167-7204BelitskyG. A.БелицкийГ. А.
Russian Federation

24 Kashirskoe Shosse, Moscow 115522

115522 Москва, Каширское шоссе, 24

https://orcid.org/0000-0002-5082-9883FetisovT. I.ФетисовТ. И.
Russian Federation

24 Kashirskoe Shosse, Moscow 115522

115522 Москва, Каширское шоссе, 24

https://orcid.org/0009-0000-8673-597XShtompelP. A.ШтомпельП. А.
Russian Federation

24 Kashirskoe Shosse, Moscow 115522

115522 Москва, Каширское шоссе, 24

https://orcid.org/0000-0002-1967-9637LesovayaE. A.ЛесоваяЕ. А.
Russian Federation

24 Kashirskoe Shosse, Moscow 115522

9 Vysokovol’tnaya St., Ryazan 390026

115522 Москва, Каширское шоссе, 24

390026 Рязань, ул. Высоковольтная, 9

https://orcid.org/0000-0002-1396-3434BokhyanB. Yu.БохянБ. Ю.
Russian Federation

24 Kashirskoe Shosse, Moscow 115522

115522 Москва, Каширское шоссе, 24

https://orcid.org/0000-0002-9710-8178YakubovskayaM. G.ЯкубовскаяМ. Г.
Russian Federation

Marianna Gennadievna Yakubovskaya

24 Kashirskoe Shosse, Moscow 115522

Марианна Геннадиевна Якубовская

115522 Москва, Каширское шоссе, 24

mgyakubovskaya@mail.ruhttps://orcid.org/0000-0002-8599-6833KirsanovK. I.КирсановК. И.
Russian Federation

24 Kashirskoe Shosse, Moscow 115522

6 Miklukho-Maklaya St., Moscow 117198

115522 Москва, Каширское шоссе, 24

117198 Москва, ул. Миклухо-Маклая, 6

N.N. Blokhin National Medical Research Center of Oncology, Ministry of Health of RussiaФГБУ «Национальный медицинский исследовательский центр онкологии им. Н.Н. Блохина» Минздрава РоссииI.P. Pavlov Ryazan State Medical UniversityФГБОУ ВО «Рязанский государственный медицинский университет им. акад. И.П. Павлова»Peoples’ Friendship University of RussiaФГАОУ ВО «Российский университет дружбы народов»0804202416111240804202408042024Copyright ©; 2024, Belitsky G.A., Fetisov T.I., Shtompel P.A., Lesovaya E.A., Bokhyan B.Y., Yakubovskaya M.G., Kirsanov K.I.Copyright ©; 2024, Белицкий Г.А., Фетисов Т.И., Штомпель П.А., Лесовая Е.А., Бохян Б.Ю., Якубовская М.Г., Кирсанов К.И.2024Belitsky G.A., Fetisov T.I., Shtompel P.A., Lesovaya E.A., Bokhyan B.Y., Yakubovskaya M.G., Kirsanov K.I.Белицкий Г.А., Фетисов Т.И., Штомпель П.А., Лесовая Е.А., Бохян Б.Ю., Якубовская М.Г., Кирсанов К.И.https://creativecommons.org/licenses/by/4.0https://sarbon.abvpress.ru/jour/article/view/644

Sarcomas of non-genital organs affect women 1.5–3 times less often than men. The mechanism of such dimorphism is studied at various levels, mainly in the field of influence on the pathogenesis of sex hormones and their receptors, the effect of which is significantly related to the histogenesis of the tumor, its localization, the mechanism of malignant transformation and the stage of progression. Sex hormone receptors are often found in the early stages of tumor development and are lost during progression. At the same time, the expression of the same receptors in tumors of different histogenesis sometimes correlates with the opposite prognosis of the disease and sensitivity to hormonal therapy. For example, in uterine leiomyosarcomas, the expression of estrogen and androgen receptors correlates with a better prognosis and greater effectiveness of therapy, and in osteo- and fibrosarcomas, vice versa. Estrogens stimulate proliferation of osteosarcoma cells, and androgens that of rhabdomyosarcoma and small round cell tumor, which growth is inhibited by antiandrogens used in the treatment of prostate cancer. In this regard, when trying to include a hormonal component in a therapeutic complex, an individual study of the hormonal sensitivity of the tumor is necessary. One of the methodological approaches to this could be testing a culture of tumor cells from surgical material for sensitivity to agonists/antagonists of hormonal receptors separately and in combination with chemotherapy drugs.

Саркомы органов, не относящихся к половой сфере, поражают женщин в 1,5–3 раза реже, чем мужчин. Механизм подобного диморфизма изучается на различных уровнях, главным образом в области влияния на патогенез половых гормонов и их рецепторов, эффект которых значительно связан с гистогенезом опухоли, ее локализацией, процессом злокачественного превращения и стадией прогрессии. Рецепторы половых гормонов чаще обнаруживаются на ранних этапах развития новообразования и утрачиваются в ходе его прогрессии. При этом экспрессия одних и тех же рецепторов в разных по гистогенезу опухолях может коррелировать с противоположным прогнозом течения заболевания и чувствительностью к гормональной терапии. В лейомиосаркомах матки экспрессия эстрогенового и андрогенового рецепторов ассоциирована с лучшим прогнозом и большей эффективностью терапии, а в остеои фибросаркомах – наоборот. Эстрогены стимулируют пролиферацию клеток остеосаркомы, а андрогены – рабдомиосаркомы и мелкокруглоклеточной опухоли, рост которой ингибируют препараты, применяемые при раке простаты. В связи с этим при попытке включения гормонального компонента в терапевтический комплекс необходимо индивидуальное исследование гормональной чувствительности опухоли. Одним из методических подходов является тестирование культуры опухолевых клеток из биопсийного или операционного материала на чувствительность к агонистам/антагонистам гормональных рецепторов по отдельности и в сочетании с химиотерапевтическими препаратами.

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