Изучение Сарком мягких тканей: от иммуногистохимии до молекулярной биологии. Практический подход

БЛАГОДАРНОСТИ. Настоящее исследование проводилось при поддержке и в рамках проектов PROTHETS (Prognosis and Therapeutic Targets in the Ewing Family of Tumors - прогнозирование и терапевтические мишени при опухолях Юинга; контракт № 503036) и EuroBoNeT (European Network to Promote Research into Uncommon Cancers in Adults and Children): Pathology, Biology and Genetics of Bone Tumors - Европейская сеть в поддержку исследований редких видов опухолей у взрослых и детей: патологические, биологические и генетические аспекты опухолей кости; контракт № 018814) 6-й рамочной исследовательской программы Евросоюза. Клинико-патологическая классификация сарком в целом и сарком мягких тканей в частности постоянно усложняется не только благодаря выявлению в последние годы возрастающего количества новых видов опухолей, но и вследствие того, что большинство этих новообразований имеет общую мезенхимальную природу. Эти опухоли могут иметь различный фенотип с многочисленными гистологическими разновидностями и совпадающими признаками, что затрудняет их идентификацию. Поэтому в дополнение к любому гистологическому исследованию нужно проводить иммуногистохимический анализ и электронно-микроскопическое исследование, а также использовать новые вспомогательные методики, такие как цитогенетический анализ и в особенности молекулярно-биологические исследования. Таким образом, в настоящее время для получения ясной картины определенной саркомы и прогнозирования ее исхода необходимо сочетать характеристику клинической стадии, гистологической степени злокачественности, гистологической разновидности опухоли и иммуногистохимическую характеристику. Кроме того, с позиции цитогенетики и молекулярной биологии выделяют две очевидно различные подгруппы сарком: к первой группе относится небольшое число сарком, характеризующихся специфическими хромосомными и генетическими транслокациями; вторая группа представлена более значительным количеством новообразований, возникающих вследствие комплексных перестроек кариотипа и многочисленных генетических отклонений. Хотя среди этих генетических перестроек лишь немногие имеют дополнительное значение для прогнозирования исхода заболевания, информация о них позволяет построить более точную классификацию, дополнить обычные гистологические исследования и одновременно создать новые возможности для таргетной терапии. В настоящем обзоре данных о саркомах мягких тканей представлены последние открытия в этих областях, а также рассматриваются клинические стадии, гистопатологические, иммуногистохимические и молекулярно-биологические характеристики основных типов опухолей мягких тканей по классификации Всемирной организации здравоохранения (ВОЗ).

иммуногистохимия, саркомы мягких тканей, типы сирком, цитогенетика

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