Интегральный нейроонкологический диагноз как основа персонализированного лечения опухолей головного мозга (на примере глиом у детей

   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.

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