transmedТрансляционная медицинаTranslational Medicine2311-44952410-5155Almazov National Medical Research Centre, Saint Petersburg, Russia10.18705/2311-4495-2024-11-1-65-76DLBDVTtransmed-832Research ArticleОНКОЛОГИЧЕСКИЕ ЗАБОЛЕВАНИЯCANCERИнтегральный нейроонкологический диагноз как основа персонализированного лечения опухолей головного мозга (на примере глиом у детейIntegral neuro-oncological diagnosis As the basis for personalized treatment Of brain tumors (on the example of gliomas In children)https://orcid.org/0000-0001-6165-9544НазаралиеваЭ. Т.NazaralievaE. T.

Элеонора Тууганбаевна Назаралиева, к. м. н., старший научный сотрудник

НИЛ нейрохирургии детского возраста

Санкт-Петербург

Eleonora T. Nazaralieva, Candidate of Medical Sciences, Senior Researcher

Research Laboratory of Pediatric Neurosurgery

Saint Petersburg

neleonora@yandex.ruhttps://orcid.org/0000-0001-6206-2133ЗабродскаяЮ. М.ZabrodskayaYu. M.

Юлия Михайловна Забродская, д. м. н., заведующая НИЛ

НИЛ патоморфологии нервной системы

Санкт-Петербург

Yulia M. Zabrodskaya, Doctor of Medical Sciences, Head of the Laboratory

Research Laboratory of Pathomorphology of the Nervous System

Saint Petersburg

zabrjulia@yandex.ruhttps://orcid.org/0000-0001-9787-8132ГерасимовА. П.GerasimovA. P.

Александр Павлович Герасимов, старший научный сотрудник

НИЛ нейрохирургии детского возраста 

Санкт-Петербург

Aleksandr P. Gerasimov, Senior Researcher

Research Laboratory of Pediatric Neurosurgery

Saint Petersburg

apgerasimow@gmail.comhttps://orcid.org/0000-0002-8539-2239ШевцовМ. А.ShevtsovM. A.

Максим Алексеевич Шевцов, д. б. н., ведущий научный сотрудник, заведующий НИО

НИО трансляционной онкологии

Санкт-Петербург

Maksim A. Shevtsov, Doctor of Biological Sciences, Leading Researcher, Head of Center

Research Center for Translational Oncology

Saint Petersburg

shevtsov-max@mail.ruhttps://orcid.org/0000-0002-0955-9180НазаралиеваЭ. Т.NazaralievaE. T.

Эльнура Тууганбаевна Назаралиева, врач-патологоанатом, ассистент

кафедра патологической анатомии

Бишкек

Elnura T. Nazaralieva, Pathologist, Assistent

Department of Pathological Anatomy

Bishkek

amazanit@yandex.ruhttps://orcid.org/0000-0002-6219-7270КимА. В.KimA. V.

Александр Вонгиевич Ким, д. м. н., заведующий ДНХО, доцент

ДНХО № 7; кафедра нейрохирургии

Санкт-Петербург

Aleksandr V. Kim, Doctor of Medical Sciences, Head ofthe Department, Associate Professor

Children’s Neurosurgical Department No. 7; Department of Neurosurgery

Saint Petersburg

kimoza@mail.ruДжаналиевБ. Р.DjanalievB. R.

Болот Рахманович Джаналиев, д. м. н., профессор

кафедра патологической анатомии

Бишкек

Bolot R. Djanaliev, Doctor of Medical Sciences, Professor

Department of Pathological Anatomy

Bishkek

https://orcid.org/0000-0003-0350-0249СамочерныхК. А.SamochernykhK. A.

Константин Александрович Самочерных, д. м. н., профессор РАН, директор РНХИ, заведующий центром

НЦМУ «Центр персонализированной медицины»; научно-исследовательский центр персонализированной онкологии 

Санкт-Петербург

Konstantin A. Samochernykh, Doctor of Medical Sciences, professor of the Russian Academy of Sciences, director of the Institute, Head of the Center

World-Class Research Centre for Personalized Medicine; Research Center for Personalized Oncology

Saint Petersburg

neurobaby12@gmail.comРоссийский научно-исследовательский нейрохирургический институт имени профессора А. Л. Поленова — филиал Федерального государственного бюджетного учреждения «Национальный медицинский исследовательский центр имени В. А. Алмазова» Министерства здравоохранения Российской ФедерацииРоссияPolenov Russian Scientific Research Institute of Neurosurgery — branch Almazov National Medical Research CentreRussian FederationФедеральное государственное бюджетное учреждение науки «Институт цитологии Российской академии наук»; Федеральное государственное бюджетное учреждение «Национальный медицинский исследовательский центр имени В. А. Алмазова» Министерства здравоохранения Российской Федерации, Научный центр мирового уровня «Центр персонализированной медицины»РоссияInstitute of Cytology of the Russian Academy of Sciences; Almazov National Medical Research Centre, World-Class Research Centre for Personalized MedicineRussian FederationКыргызская государственная медицинская академия имени И. К. АхунбаеваКыргызстанI. K. Akhunbaev Kyrgyz State Medical AcademyKyrgyzstanФедеральное государственное бюджетное учреждение «Национальный медицинский исследовательский центр имени В. А. Алмазова» Министерства здравоохранения Российской Федерации, Научный центр мирового уровня «Центр персонализированной медицины»РоссияAlmazov National Medical Research Centre, World-Class Research Centre for Personalized MedicineRussian Federation2024130320241116576Copyright © Назаралиева Э.Т., Забродская Ю.М., Герасимов А.П., Шевцов М.А., Назаралиева Э.Т., Ким А.В., Джаналиев Б.Р., Самочерных К.А., 20242024Назаралиева Э.Т., Забродская Ю.М., Герасимов А.П., Шевцов М.А., Назаралиева Э.Т., Ким А.В., Джаналиев Б.Р., Самочерных К.А.Nazaralieva E.T., Zabrodskaya Y.M., Gerasimov A.P., Shevtsov M.A., Nazaralieva E.T., Kim A.V., Djanaliev B.R., Samochernykh K.A.Данная работа распространяется под лицензией Creative Commons Attribution 4.0.This work is licensed under a Creative Commons Attribution 4.0 License.https://transmed.almazovcentre.ru/jour/article/view/832

   Опухоли головного мозга представляют собой наиболее распространенную группу новообразований у детей, входящую в топ-3 причин детской смертности от онкопатологии.

   Целью работы был анализ литературных данных о современных подходах к персонализации лечения опухолей ЦНС у детей на основании изучения молекулярно-генетических, иммуногистохимических, визуализационных характеристик.

   В статье дана полная и детальная характеристика часто встречающихся видов новообразований нервной системы — глиом низкой степени злокачественности (LGG), глиом высокой степени злокачественности (HGG), смешанных глионевральных опухолей и др. Описаны молекулярно-генетические, иммуногистохимические, визуализационные характеристики каждого вида глиом. Также представлены современные сведения о прогнозе и лечении новообразований. Установлено, например, что прогноз течения LGG/GNT у детей чаще зависит от возраста ребенка, гистологии и локализации опухоли, а также ее молекулярного профиля. У более старших пациентов прогноз более благоприятный, чем у младших детей. Хорошо визуализирующиеся опухоли, расположенные поверхностно (полушарные или мозжечковые), чаще характеризуются лучшим исходом, чем диффузные глиомы, а также глубоко расположенные опухоли. BRAF-мутации и перегруппировки FGFR могут свидетельствовать о лучшем прогнозе, чем при наличии SNV. В то же время точечные мутации BRAF с сопутствующей делецией CDKN2A, а также мутации с H3.3 pK27 являются наиболее опасными.

   Brain tumors are the most common group of neoplasms in children, which is in the top-3 causes of infant mortality from oncopathology.

   The aim of the study is to make a literature review of modern approaches to the personalization of treatment of CNS tumors in children based on the study of molecular genetics, immunohistochemical and imagingт characteristics.

   The article provides a description of the most common types of neoplasms of the nervous system — low grade gliomas (LGG), high grade gliomas (HGG), mixed glioneural tumors, etc. The molecular genetics, immunohistochemical, visualization characteristics of each type of gliomas are described. Modern information on prognosis and treatment of tumors is also given in the publication. The prognosis of the course of LGG/GNT in children depends more often on the patient’s age, histology, and location of the tumor, as well as its molecular profile. Older patients have a more favorable prognosis than younger children. Well-visualized tumors located superficially have a better outcome than diffuse gliomas, as well as deeply located tumors. Detection of BRAF mutations and FGFR rearrangements may indicate a better prognosis than in the presence of SNV. Local mutations of BRAF with concomitant deletion of CDKN2A, as well as mutations with H3.3 pK27 are the most dangerous.

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The authors declare that there are no conflicts of interest present.