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Как цитировать
Аннотация
Введение. Со временем все глиомы низкой степени злокачественности (ГНСЗ) (grade 2), неизбежно подвергаются злокачественной трансформации (ЗТ) (grade 3/grade 4).
Цель. Изучить факторы, влияющие на злокачественную трансформацию, по данным литературы у пациентов с астроцитомой grade 2 с мутацией в генах IDH1/2 и олигодендроглиомой (ОДГ) grade 2 с мутацией в генах IDH1/2 и коделецией 1p19q.
Материалы и методы. Нами проанализированы литературные источники и определены факторы, которые влияют на скорость рецидива и анапластической трансформации у больных с глиомами низкой степени злокачественности. Изучены клинические, рентгенологические и биологические критерии, а также роль хирургического удаления опухоли, морфогенетических характеристик и адъювантной терапии.
Результаты. Было выделено 32 различных параметра, которые достоверно оказывают влияние на возникновение рецидива и частоту ЗТ. Некоторые из них (n = 8) замедляют процесс, способствуя более длительному безрецидивному периоду и меньшим рискам анапластической трансформации (р < 0,05). К таким факторам относят эписиндром, функциональный статус по шкале Карновского>90 %, отграниченный характер роста опухоли, тотальное (близко к тотальному) удаление опухоли, наличие коделеции 1p19q (ОДГ) и проведение адъювантной терапии (ЛТ и ХТ).
Выводы. Злокачественная трансформация с наступлением рецидива у больных с астроцитомой grade 2 и олигодендроглиомой grade 2 — процесс неизбежный. Определены факторы, которые в большей степени влияют на возникновение рецидива и частоту ЗТ.
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