jsmsJournal of Siberian Medical SciencesJournal of Siberian Medical Sciences2542-1174Federal state budgetary educational institution of higher education "Novosibirsk state medical university" of Ministry of Health of the Russian Federation (FSBEI HE NSMU MOH Russia)jsms-738Research ArticleОРИГИНАЛЬНЫЕ ИССЛЕДОВАНИЯORIGINAL RESEARCHESМолекулярные подтипы уротелиальных карцином мочевого пузыря у пациентов молодого возрастаMolecular subtypes of urothelial carcinomas of the bladder in young patientsМещеряковИ. А.MeshcheryakovI. A.

Мещеряков Игорь Александрович — врач-патологоанатом

197758, г. Санкт-Петербург, пос. Песочный, ул. Ленинградская, 68А, лит. А

Meshcheryakov Igor Aleksandrovich — Pathologist

68А, A, Pesochny, Leningradskaya str., St. Petersburg, 197758, Russia

psychoangel23@mail.ruКрюковК. А.KryukovK. A.

Крюков Кирилл Андреевич — врач-патологоанатом

Kryukov Kirill Andreevich — Pathologist

МитинН. П.MitinN. P.

Митин Николай Павлович — врач клинико-лабораторной диагностики

Mitin Nikolay Pavlovich — Doctor of Clinical and Laboratory Diagnostics

ПономарёваЕ. В.PonomarevaE. V.

Пономарёва Елена Васильевна — врач-патологоанатом

Ponomareva Elena Vasilyevna — Pathologist

ШелеховаК. В.ShelekhovaK. V.

Шелехова Ксения Владимировна — д-р мед. наук, профессор, заведующий патолого-анатомическим отделением; заведующий кафедрой патологической анатомии

Shelekhova Kseniya Vladimirovna — Dr. Sci. (Med.), Professor, Head, Pathology Department; Head, Department of Pathological Anatomy

ГБУЗ «Санкт-Петербургский клинический научно-практический центр специализированных видов медицинской помощи (онкологический)»РоссияSt. Petersburg Clinical Scientific and Practical Center of Specialized Types of Medical Care (Oncologic)Russian FederationГБУЗ «Городской клинический онкологический диспансер» (Санкт-Петербург)РоссияCity Clinical Oncological Health Center (St. Petersburg)Russian FederationГБУЗ «Санкт-Петербургский клинический научно-практический центр специализированных видов медицинской помощи (онкологический)»; ЧОУ ВО «Санкт-Петербургский медико-социальный институт»РоссияSt. Petersburg Clinical Scientifi c and Practical Center of Specialized Types of Medical Care (Oncologic); St. Petersburg Medico-Social InstituteRussian Federation2021250920210382104Copyright © Мещеряков И.А., Крюков К.А., Митин Н.П., Пономарёва Е.В., Шелехова К.В., 20212021Мещеряков И.А., Крюков К.А., Митин Н.П., Пономарёва Е.В., Шелехова К.В.Meshcheryakov I.A., Kryukov K.A., Mitin N.P., Ponomareva E.V., Shelekhova K.V.Данная работа распространяется под лицензией Creative Commons Attribution 4.0.This work is licensed under a Creative Commons Attribution 4.0 License.https://jsms.elpub.ru/jour/article/view/738

Уротелиальные карциномы у молодых пациентов характеризуются специфическими клинико-морфологическими и генетическими особенностями в отличие от их аналогов у пожилых пациентов. Проведено молекулярное профилирование опухолей 56 пациентов моложе 45 лет с использованием метода шведских исследователей из университета Lund, впервые адаптирована молекулярная классификация группы исследователей Lund с применением иммунофенотипирования к когорте молодых пациентов и продемонстрирована четкая воспроизводимость молекулярных подтипов уротелиальных карцином, встречающихся в пожилой группе пациентов.

Выявлено, что у молодых пациентов достоверно преобладает уротелиоподобный А подтип рака мочевого пузыря (78 %, р = 0.005), который ассоциируется с ранней патологической стадией, благоприятным прогнозом и наилучшей выживаемостью. Внутри уротелиоподобного подтипа выделен специфический вариант опухоли (так называемый CK5/6+/p16+) (7 %), отличающийся по иммунофенотипическим и клиническим признакам, имеющий тенденцию к более агрессивному биологическому поведению и, вероятно, отражающий другой путь прогрессии части уротелиальных карцином в отличие от пожилых пациентов. Частота неблагоприятных подтипов (уротелио-подобный В, геномно-нестабильный, базальный/плоскоклеточно-подобный, мезенхимально-подобный) в молодой группе составила не более 6 %; отмечено их появление у пациентов старше 30 лет с зависимостью, пропорциональной возрасту.

Выполненное молекулярное профилирование рака мочевого пузыря у молодых пациентов показало диагностическую значимость, возможность прогностической стратификационной оценки и, следовательно, практическую целесообразность.

Urothelial carcinomas in young patients are characterized by specific clinical and morphological and genetic features in contrast to their counterparts in elderly patients. Molecular profiling of tumors in 56 patients under 45 years has been performed using the method of Swedish researchers from the Lund University, the molecular classification of the Lund group of researchers using immunophenotyping has been adapted to the cohort of young patients for the first time and clear reproducibility of urothelial carcinoma molecular subtypes occurring in the elderly group of patients has been demonstrated.

The urothelial-like A subtype of bladder cancer (78%, p = 0.005), which is associated with an early pathological stage, a favorable prognosis, and the best survival rate, was found to significantly predominate in young patients. Within the urothelial-like subtype, a specific tumor variant (so-called CK5/6+/p16+) (7%) was identified, differing in immunophenotypic and clinical features, tending to a more aggressive biological behavior and probably reflecting a different progression pathway of some urothelial carcinomas in contrast to the elderly patients. The frequency of adverse subtypes (urothelial- like B, genomically unstable, basal/squamous cell-like, mesenchymal-like) in the young group was not more than 6%; their occurrence in patients over 30 years of age with an age-proportional dependence was noted.

The performed molecular profiling of bladder cancer in young patients showed its diagnostic significance, possibility of prognostic stratification and, therefore, reasonable practicality.

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