The initial levels of soluble Fas antigen (sFas), leptin, and vascular endothelium growth factor (VEGF) were measured in the sera of 100 patients with ovarian cancer and benign tumors and in 60 healthy women aged 28-65 years. Serum levels of sFas and VEGF were elevated in the total group of patients with ovarian tumors, while leptin levels were the same as in healthy women. The studied parameters did not depend on the age of patients and healthy women. The levels of sFas and leptin were virtually the same in benign and malignant ovarian tumors, while VEGF concentration was higher in patients with ovarian cancer. The mean serum levels of sFas, VEGF, and leptin in patients with poorly and moderately differentiated serous ovarian cancer were 2-fold higher than in well-differentiated tumors (p<0.05), while serum concentrations of sFas and leptin increased with the disease stage progress in patients with ovarian cancer (p<0.05). According to the data of unifactorial analysis, the increase in serum levels of sFas and VEGF in ovarian cancer patients correlated with short duration of the relapse-free period. Multifactorial analysis showed that the disease stage (p=0.006), presence of ascites (p=0.03), VEGF concentration (p=0.02), and the sFas/leptin coeffi cient (p=0.045) are highly signifi cant independent factors for predicting the relapse-free survival of patients with serous ovarian cancer.Ovarian cancer ranks fi rst in the structure of mortality from malignant tumors of the female reproductive sys tem [2]. Analysis of the Russian and foreign publications showed unsatisfactory results of treatment of patients with ovarian cancer, because by the moment of diagnosis about 70% patients have advanced stages of the tumor process [3]. In addition, ovarian cancer unites the histogenetic variants of tumors, the majo rity of which are characterized by aggressive clinical course and are liable to early metastasizing. The aggressive nature of the tumor manifests by its capacity to invasion and metastasis development. This can be due to histogenesis, differentiation degree, and genome damage, all this leading to activation of the factors closely related to "biological" behavior of the tumor.Studies of biological factors essential for tumor growth and metastasizing will lead to better understanding of some stages in the pathogenesis of ovarian tumors. Inhibition of Fas-dependent apoptosis is an important component in the system of transformed cell defense from antitumor immunity. The Fas receptor triggers apoptosis in the target cell after interactions with its ligand (FasL). Soluble Fas (sFas) distantly

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И.б. мАнуХИн, д.м.н., профессор, н.А. СеменцоВА, к.м.н., ю.ю. мИтроФАноВА, л.ю. лИВШИц

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The review considers the role of intestinal endotoxin in the pathogenesis of a number of obstetric and gynecological diseases, as well as the results of their treatment with the use of enterosorption in order to correct endotoxin aggression. The well-known methods for determining anti-endotoxin immunity and modern classification of enterosorbents were presented. The analysis of the main results of more than 30 years experience in the use of enterosorbent polymethylsiloxane polyhydrate was conducted, taking into account the mechanisms of its medical and prophylactic effects in the treatment of pre-eclampsia, arterial hypertension of pregnant women, miscarriage, endometriosis, chronic pelvic inflammatory disease, urogenital disorders, vulvar lichen sclerosus. The evaluation of therapeutic properties of the drug polymethylsiloxane polyhydrate was carried out, and prospective directions for its further use in obstetric and gynecological practice were planned. Key words: pregnancy loss, pre-eclampsia, vulvar lichen sclerosus, endometriosis, endotoxin, endotoxin aggression, enterosgel