Российский биотерапевтический журнал. 2024; 23: 22-29
Влияние спонтанной регрессии опухоли на прогрессию меланомы
https://doi.org/10.17650/1726-9784-2024-23-4-22-29Аннотация
Введение. Меланома кожи (МК) – злокачественная неэпителиальная опухоль из трансформированных меланоцитов с преимущественной локализацией на коже (более 90 % случаев). Согласно статистике за 2021 г., в России МК составила 1,82 % всех злокачественных новообразований взрослого населения и 12,65 % всех опухолей кожи. Отмечается неуклонный и ежегодный рост заболеваемости МК во всем мире, особенно в странах с населением преимущественно европеоидной расы. В России за последние 10 лет смертность от МК увеличилась на 17,6 %. МК – гетерогенная опухоль с высоким метастатическим потенциалом, вследствие чего, помимо стандартных клинических и патоморфологических прогностических факторов, выявление дополнительных факторов прогрессии и неблагоприятного прогноза заболевания остается актуальной и не решенной до конца проблемой современной онкологии.
Цель исследования – определить роль спонтанной регрессии опухоли при возникновении прогрессии МК на основе анализа данных литературы и их систематизации.
Результаты. Представленный обзор литературы отражает различные мировые данные исследователей о роли спонтанной регрессии МК при прогрессировании. Спонтанная регрессия МК представляет собой иммунологический процесс, при котором наблюдается исчезновение опухолевых клеток, что приводит к разделению опухоли на отдельные островки с промежуточными участками неопухолевой ткани. Механизм возникновения спонтанной регрессии первичной МК, как и ее прогностическая значимость, недостаточно понятен и изучен. Большинство исследователей в первую очередь связывают возникновение спонтанной регрессии меланомы с иммунным ответом, так как во всех случаях регрессии отмечалась лимфоцитарная инфильтрация опухоли. Наличие лимфоидной инфильтрации, а также количественное и качественное соотношение ее клеток имеют значение в развитии опухолевого процесса, влияют на эффективность иммунотерапии и являются в большей степени фактором благоприятного прогноза для пациента.
Заключение. Прогностическая роль спонтанной регрессии меланомы до сих пор остается нерешенным и спорным вопросом. Интересно то, что ряд исследований демонстрируют следующее: регрессия есть независимый предиктор прогрессирования МК.
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40. El Sharouni M., Aivazian K., Witkamp A.J. et al. Association of histologic regression with a favorable outcome in patients with stage 1 and stage 2 cutaneous melanoma. JAMA Dermatol 2021;157(2):166–73. DOI:10.1001/jamadermatol.2020.5032
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43. Morrison S., Han G., Elenwa F. et al.; Sentinel Lymph Node Working Group. Is there a relationship between TILs and regression in melanoma? Ann Surg Oncol 2022;29(5):2854–66. DOI: 10.1245/s10434-021-11251-z
Russian Journal of Biotherapy. 2024; 23: 22-29
The effect of spontaneous tumor regression on melanoma progression
https://doi.org/10.17650/1726-9784-2024-23-4-22-29Abstract
Background. Skin melanoma (SM) is a malignant non-epithelial tumor of transformed melanocytes with predominant localization on the skin (more than 90 % of cases). According to statistics for 2021, SM in Russia accounted for 1.82 % of all malignant neoplasms of the adult population and 12.65 % of all skin tumors. There has been a steady and annual increase in the incidence of SM throughout the world, especially in countries with a predominantly Caucasian population. In Russia, over the past 10 years, mortality from SM has increased by 17.6 %. SM is a heterogeneous tumor with a high metastatic potential, because in addition to standard clinical and pathomorphological prognostic factors, the identification of additional factors of progression and unfavorable prognosis of the disease remains an urgent and unresolved problem of modern oncology.
Aim. To determine the role of spontaneous tumor regression in the occurrence of SM progression based on the analysis of literature data and their systematization.
Results. This literature review reflects various global research data on the role of spontaneous regression of SM in progression. Spontaneous regression of SM is an immunological process in which the disappearance of tumor cells is observed, which leads to the division of the tumor into separate islands with intermediate areas of non-tumor tissue. The mechanism of spontaneous regression of primary SM, as well as its prognostic significance, is not well understood and studied. Of course, most researchers primarily associate the occurrence of spontaneous regression of melanoma with an immune response, since lymphocytic infiltration of the tumor was noted in all cases of regression. The presence of lymphoid infiltration, as well as the quantitative and qualitative ratio of its cells, are important in the development of the tumor process, affect the effectiveness of immunotherapy and is to a greater extent a factor in a favorable prognosis.
Conclusion. The prognostic role of spontaneous melanoma regression is still an unresolved and controversial issue. Interestingly, a number of studies demonstrate that regression is an independent predictor of the progression of SM.
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