{"id":23567,"date":"2026-10-07T08:46:45","date_gmt":"2026-10-07T08:46:45","guid":{"rendered":"https:\/\/genekor.com\/?p=23567"},"modified":"2026-10-07T08:46:51","modified_gmt":"2026-10-07T08:46:51","slug":"precijas-medicina-latvija","status":"publish","type":"post","link":"https:\/\/genekor.com\/lv\/2026\/10\/07\/precijas-medicina-latvija\/","title":{"rendered":"Prec\u012bzijas medic\u012bna Latvij\u0101: k\u0101p\u0113c kr\u016bts v\u0113\u017ea pacient\u0113m par testu, kas pal\u012bdz pie\u0146emt l\u0113mumu par \u0137\u012bmijterapiju, joproj\u0101m j\u0101maks\u0101 pa\u0161\u0101m?\u00a0"},"content":{"rendered":"\n

Anitra Greivule<\/em> <\/p>\n\n\n\n

Genekor Latvija vad\u012bt\u0101ja<\/em> <\/p>\n\n\n\n

Pirms divdesmit gadiem kr\u016bts v\u0113\u017ea \u0101rst\u0113\u0161an\u0101 galvenais princips bija vienk\u0101r\u0161s – lab\u0101k \u0101rst\u0113t intens\u012bv\u0101k, lai nepalaistu gar\u0101m iesp\u0113ju uzveikt slim\u012bbu. Ja \u0101rstam rad\u0101s \u0161aubas, dro\u0161\u0101k\u0101 izv\u0113le bija \u0137\u012bmijterapija. T\u0101 bija medic\u012bnas realit\u0101te laik\u0101, kad \u0101rst\u0113\u0161anas l\u0113mumi galvenok\u0101rt balst\u012bj\u0101s uz audz\u0113ja izm\u0113ru, limfmezglu iesaisti, pacientes vecumu un citiem kl\u012bniskiem r\u0101d\u012bt\u0101jiem. <\/p>\n\n\n\n

M\u016bsdienu onkolo\u0123ij\u0101 \u0161\u012b pieeja strauji main\u0101s. \u0160odien svar\u012bg\u0101kais jaut\u0101jums vairs nav, k\u0101 \u0101rst\u0113t vair\u0101k. Svar\u012bg\u0101kais jaut\u0101jums ir, k\u0101 \u0101rst\u0113t prec\u012bz\u0101k. <\/p>\n\n\n\n

Tie\u0161i \u0161\u012b ir prec\u012bzijas jeb personaliz\u0113t\u0101s medic\u012bnas b\u016bt\u012bba – izv\u0113l\u0113ties \u0101rst\u0113\u0161anu, kas balst\u012bta nevis visp\u0101r\u012bgos pie\u0146\u0113mumos, bet konkr\u0113t\u0101s pacientes slim\u012bbas biolo\u0123ij\u0101 un zin\u0101tniskos pier\u0101d\u012bjumos. T\u0101 nav n\u0101kotnes v\u012bzija. T\u0101 jau \u0161odien ir ikdienas prakse daudz\u0101s Eiropas valst\u012bs. <\/p>\n\n\n\n

Ar\u012b Latvij\u0101 \u0161is ce\u013c\u0161 ir s\u0101cies. R\u012bgas Austrumu kl\u012bnisk\u0101s universit\u0101tes slimn\u012bcas pilotprojekta rezult\u0101ti apliecina to, ko starptautiskie p\u0113t\u012bjumi pier\u0101d\u012bju\u0161i jau iepriek\u0161 – pacient\u0113m ar agr\u012bnu kr\u016bts v\u0113zi, kura aug\u0161anu veicina hormoni un kuram nav paaugstin\u0101tas HER2 olbaltumvielas aktivit\u0101tes (medic\u012bniski – hormonu receptoru pozit\u012bvs, HER2 negat\u012bvs kr\u016bts v\u0113zis), iesp\u0113jams daudz prec\u012bz\u0101k izv\u0113rt\u0113t, vai \u0137\u012bmijterapija konkr\u0113taj\u0101 situ\u0101cij\u0101 patie\u0161\u0101m dos ieguvumu. <\/p>\n\n\n\n

Pilotprojekta laik\u0101 genomisk\u0101 test\u0113\u0161ana tika veikta 208 pacient\u0113m. Rezult\u0101ti bija p\u0101rliecino\u0161i – 76% gad\u012bjumu testa rezult\u0101ti \u013c\u0101va pie\u0146emt l\u0113mumu \u0137\u012bmijterapiju nepiem\u0113rot. <\/p>\n\n\n\n

Tas nav tikai medic\u012bnisks fakts. Tas noz\u012bm\u0113 simtiem sievie\u0161u, kur\u0101m nav j\u0101piedz\u012bvo \u0101rst\u0113\u0161ana ar b\u016btisk\u0101m blakn\u0113m, ja t\u0101 vi\u0146\u0101m nesniedz papildu ieguvumu. Tas noz\u012bm\u0113 maz\u0101k ilgsto\u0161as darbnesp\u0113jas, maz\u0101k fizisku un emocion\u0101lu seku, liel\u0101kas iesp\u0113jas \u0101tr\u0101k atgriezties \u0123imen\u0113, darb\u0101 un ikdienas dz\u012bv\u0113. <\/p>\n\n\n\n

Tie\u0161i \u0161eit ar\u012b sl\u0113pjas viena no b\u016btisk\u0101kaj\u0101m p\u0101rmai\u0146\u0101m m\u016bsdienu onkolo\u0123ij\u0101. Ne vienm\u0113r intens\u012bv\u0101ka \u0101rst\u0113\u0161ana ir lab\u0101ka \u0101rst\u0113\u0161ana. <\/p>\n\n\n\n

Sabiedr\u012bb\u0101 joproj\u0101m valda priek\u0161stats, ka p\u0113c kr\u016bts v\u0113\u017ea oper\u0101cijas \u0137\u012bmijterapija ir gandr\u012bz neizb\u0113gama. Daudz\u0101m pacient\u0113m diagnozes br\u012bd\u012b \u0161\u0137iet pa\u0161saprotami, ka sekos matu izkri\u0161ana, slikta d\u016b\u0161a, nogurums un m\u0113ne\u0161iem ilga \u0101rst\u0113\u0161an\u0101s. Ta\u010du zin\u0101tne p\u0113d\u0113jo gadu laik\u0101 ir b\u016btiski main\u012bjusi m\u016bsu izpratni par to, k\u0101 tiek pie\u0146emti \u0101rst\u0113\u0161anas l\u0113mumi. <\/p>\n\n\n\n

Ja iesp\u0113jams dro\u0161i izvair\u012bties no terapijas, kas konkr\u0113tajai pacientei nesniedz papildu ieguvumu, tas nav kompromiss. Tas ir m\u016bsdien\u012bgas medic\u012bnas m\u0113r\u0137is. Viens no starptautiski atz\u012bt\u0101kajiem instrumentiem \u0161\u0101du \u0101rst\u0113\u0161anas l\u0113mumu pie\u0146em\u0161an\u0101 ir Oncotype DX\u00ae genomiskais tests, kas analiz\u0113 audz\u0113ja biolo\u0123iju un pal\u012bdz \u0101rstam izv\u0113rt\u0113t, vai konkr\u0113t\u0101 paciente no \u0137\u012bmijterapijas patie\u0161\u0101m g\u016bs ieguvumu. Tie\u0161i \u0161\u012b testa izmanto\u0161ana tika izv\u0113rt\u0113ta ar\u012b Latvijas pilotprojekt\u0101. <\/p>\n\n\n\n

Katru gadu Latvij\u0101 ar kr\u016bts v\u0113zi saslimst aptuveni 1200 sievie\u0161u. Apm\u0113ram 80% gad\u012bjumu tas ir \u0161\u0101da veida agr\u012bns kr\u016bts v\u0113zis – pacientu grupa, kurai starptautisk\u0101s kl\u012bnisk\u0101s vadl\u012bnijas rekomend\u0113 izmantot genomisko test\u0113\u0161anu, lai izv\u0113rt\u0113tu iesp\u0113jamo ieguvumu no \u0137\u012bmijterapijas. Starptautiskie dati liecina, ka aptuveni 80% \u0161o pacientu no \u0137\u012bmijterapijas papildu ieguvumu neg\u016bst. <\/p>\n\n\n\n

Tas liek uzdot \u013coti vienk\u0101r\u0161u jaut\u0101jumu. Ja m\u016bsu r\u012bc\u012bb\u0101 ir pier\u0101d\u012bjumos balst\u012bti diagnostikas instrumenti, kas pal\u012bdz izvair\u012bties no nevajadz\u012bgas \u0101rst\u0113\u0161anas, k\u0101p\u0113c tie joproj\u0101m nav vienl\u012bdz pieejami vis\u0101m pacient\u0113m? <\/p>\n\n\n\n

\u0160odien daudz\u0101m Latvijas sieviet\u0113m \u0161\u0101da iesp\u0113ja ir atkar\u012bga nevis tikai no medic\u012bnisk\u0101m indik\u0101cij\u0101m, bet ar\u012b no person\u012bgaj\u0101m finansi\u0101laj\u0101m iesp\u0113j\u0101m. Da\u013ca pacien\u0161u par testu maks\u0101 pa\u0161as vai mekl\u0113 finansi\u0101lu atbalstu, savuk\u0101rt cit\u0101m \u0161\u0101das iesp\u0113jas nav. Rezult\u0101t\u0101 piek\u013cuve starptautiskaj\u0101s kl\u012bniskaj\u0101s vadl\u012bnij\u0101s rekomend\u0113tai diagnostikai nav vienl\u012bdz\u012bga. Pacientes finansi\u0101laj\u0101m iesp\u0113j\u0101m nevajadz\u0113tu noteikt to, vai \u0101rstam ir pieejama inform\u0101cija, kas \u013cauj izv\u0113l\u0113ties vi\u0146ai piem\u0113rot\u0101ko \u0101rst\u0113\u0161anu. <\/p>\n\n\n\n

Bie\u017ei tiek pie\u0146emts, ka modern\u0101ku diagnostikas meto\u017eu ievie\u0161ana noz\u012bm\u0113 papildu slogu vesel\u012bbas apr\u016bpes bud\u017eetam. Latvijas pilotprojekta rezult\u0101ti r\u0101da pret\u0113jo. <\/p>\n\n\n\n

KPMG ekonomisk\u0101 anal\u012bze apliecina, ka prec\u012bz\u0101ka diagnostika nav tikai medic\u012bniski pamatota – t\u0101 ir ar\u012b ekonomiski pamatota. Katrs genomiskaj\u0101 test\u0113\u0161an\u0101 ieguld\u012btais eiro rada vair\u0101k nek\u0101 divu eiro ekonomisko atdevi, jo samazin\u0101s nevajadz\u012bgas \u0137\u012bmijterapijas, darbnesp\u0113jas un ar \u0101rst\u0113\u0161anas blakn\u0113m saist\u012bt\u0101s izmaksas. <\/p>\n\n\n\n

Tas b\u016bt\u012bb\u0101 noz\u012bm\u0113, ka diskusija nav tikai par papildu naudas pie\u0161\u0137ir\u0161anu vesel\u012bbas apr\u016bpei. Diskusija ir ar\u012b par to, k\u0101 gudr\u0101k izmantot jau eso\u0161os resursus. <\/p>\n\n\n\n

Prec\u012bzijas medic\u012bna nav grezn\u012bba. T\u0101 ir m\u016bsdienu medic\u012bnas lo\u0123iska att\u012bst\u012bba – iesp\u0113ja \u0101rst\u0113t cilv\u0113ku p\u0113c iesp\u0113jas prec\u012bz\u0101k un izvair\u012bties no terapijas, kas konkr\u0113taj\u0101 situ\u0101cij\u0101 nesniedz papildu ieguvumu. <\/p>\n\n\n\n

Latvijas pilotprojekts ir apliecin\u0101jis, ka \u0161\u0101da pieeja darbojas ar\u012b m\u016bsu vesel\u012bbas apr\u016bpes sist\u0113m\u0101 un var sniegt ieguvumu gan pacient\u0113m, gan valstij. N\u0101kamais solis ir pan\u0101kt, lai genomisk\u0101 test\u0113\u0161ana pacient\u0113m, kur\u0101m t\u0101 ir medic\u012bniski pamatota, b\u016btu sistem\u0101tiski pieejama un \u0101rst\u0113\u0161anas izv\u0113li noteiktu medic\u012bnisk\u0101s indik\u0101cijas, nevis pacientes finansi\u0101l\u0101s iesp\u0113jas. <\/p>\n\n\n\n

<\/p>\n\n\n\n

KPMG report<\/strong>  https:\/\/aslimnica.lv\/wp-content\/uploads\/2026\/09\/Parskats-par-ekonomisko-un-veselibas-ieguvumu-analizi-Oncotype_12022026.pdf<\/a>\u202f (sada\u013c\u0101 – https:\/\/aslimnica.lv\/veza-centrs\/specialistiem\/<\/a>) <\/p>\n\n\n\n

1) Centre for Disease Prevention and Control of Latvia (SPKC) \u2014 breast cancer incidence\/statistics<\/strong> 
The official SPKC oncology database provides newly registered malignant tumour cases, including incidence per 100,000 population.  
SPKC \u2013 Newly registered cancer cases (ONKO030)<\/a>  <\/p>\n\n\n\n

2) NCCN Clinical Practice Guidelines in Oncology \u2013 Breast Cancer <\/strong>NCCN Guidelines \u2013 Breast Cancer<\/a>  <\/p>\n\n\n\n

3) Published clinical evidence on genomic testing \/ Oncotype DX\u00ae<\/strong> the prospective TAILORx and RxPONDER studies:  <\/p>\n\n\n\n