vmireavizВестник медицинского института «РЕАВИЗ». Реабилитация, Врач и ЗдоровьеBulletin of the Medical Institute "REAVIZ" (REHABILITATION, DOCTOR AND HEALTH)2226-762X2782-1579РЕАВИЗ10.20340/vmi-rvz.2024.3.CLIN.2vmireaviz-1081Research ArticleКлиническая медицинаClinical medicineВзаимосвязь клиникоморфологических параметров с BRAF-статусом опухоли у пациентов с меланомой кожи I стадииThe relationship of clinical and morphological parameters with the BRAF status of the tumor in patients with stage I skin melanomahttps://orcid.org/0000-0003-4460-9136ТитовК. С.TitovK. S.

Титов Константин Сергеевич - Д-р мед. наук, профессор кафедры онкологии и рентгенорадиологии имени академика В.П. Харченко Медицинского института; ведущий научный сотрудник Вклад автора: концепция и дизайн исследования.

2-й Боткинский проезд, д. 5, г. Москва, 125284;ул. Миклухо-Маклая, д. 6, г. Москва, 117198

Konstantin S. Titov - Dr. Sci. (Med.), Professor of the Department of Oncology and Radiology named after Academician V.P. Kharchenko Medical Institute; Leading Researcher Author's contribution: concept and design of the study.

5 2nd Botkin passage, Moscow, 125284;6 Miklukho-Maklaya str., Moscow, 117198

https://orcid.org/0000-0002-4436-8101СорокинаМ. В.SorokinaM. V.

Сорокина Маргарита Викторовна - Врач-онколог, и.о. заведующего отделением диагностики и лечения заболеваний молочной железы и репродуктивной системы центра амбулаторной онкологической помощи Вклад автора: сбор и обработка материалов, написание текста рукописи.

2-й Боткинский проезд, д. 5, г. Москва, 125284

Margarita V. Sorokina - Oncologist, Acting Head of the Department of Diagnosis and Treatment of diseases of the breast and reproductive system of the Center for Outpatient Oncological Care Author's contribution: collecting and processing materials, writing the text of the manuscript.

6 Miklukho-Maklaya str., Moscow, 117198

https://orcid.org/0000-0001-5366-1281ЛебедевС. С.LebedevS. S.

Лебедев Сергей Сергеевич - Д-р мед. наук, доцент кафедры хирургии; ведущий научный сотрудник, хирург, онколог, заместитель главного врача по онкологии, руководитель AuthorID: 936520 Вклад автора: сбор и обработка материалов, статистическая обработка.

2-й Боткинский проезд, д. 5, г. Москва, 125284;ул. Баррикадная, д. 2/1, стр.1, г. Москва, 125993

Sergey S. Lebedev - Dr. Sci. (Med.), Associate Professor of the Department of Surgery; leading researcher, surgeon, oncologist, Deputy Chief Physician for Oncology, Head AuthorID: 936520 The author's contribution: collection and processing of materials, statistical processing.

5 2nd Botkin passage, Moscow, 125284;2/1 Barricadnaya str., building 1, Moscow, 125993

lebedevssd@yandex.ruhttps://orcid.org/0000-0001-8391-1210ГрековД. Н.GrekovD. N.

Греков Дмитрий Николаевич - Канд. мед. наук, ведущий научный сотрудник, заместитель директора по клинической работе, главный врач; доцент кафедры хирургии хирургического факультета, Российская медицинская академия непрерывного профессионального образования. AuthorID: 989579 Вклад автора: сбор и обработка материалов, статистическая обработка.

2-й Боткинский проезд, д. 5, г. Москва, 125284;ул. Миклухо-Маклая, д. 6, г. Москва, 117198

Dmitriy N. Grekov - Cand. Sci. (Med.), Leading Researcher, Deputy Director for Clinical Work, Chief Physician; Associate Professor of the Department of Surgery, Faculty of Surgery AuthorID: 989579 The author's contribution: collection and processing of materials, statistical processing.

5 2nd Botkin passage, Moscow, 125284;6 Miklukho-Maklaya str., Moscow, 117198

grekov.doc@list.ruhttps://orcid.org/0000-0002-2316-7482НеретинЕ. Ю.NeretinE. Yu.

Неретин Евгений Юрьевич - Д-р мед. наук, врач-онколог высшей категории консультативного отделения №1; доцент кафедры хирургии с курсом онкологии, Медицинский университет «Реавиз». Scopus Author ID: 57016832800; AuthorID: 623726 Вклад автора: обзор публикаций по теме статьи.

ул. Солнечная, д. 50, г. Самара, 443029

Evgeniy Yu. Neretin - Dr. Sci. (Med.), oncologist of the highest category of the consultative department No. 1; Associate Professor of the Department of Surgery with a course in Oncology, Medical University "Reaviz". Scopus Author ID: 57016832800; AuthorID: 623726 Author's contribution: review of publications on the topic of the article.

50 Solnechnaya str., Samara, 443029

evg.neretin2002@mail.ruhttps://orcid.org/0009-0005-2715-3933ЯкушеваТ. А.YakushevaT. A.

Якушева Татьяна Александровна - Врач-онколог, заведующий онкологическим отделением центра амбулаторной онкологической помощи Вклад автора: обзор публикаций по теме статьи.

2-й Боткинский проезд, д. 5, г. Москва, 125284

Tat'yana A. Yakusheva - Oncologist, Head of the Oncology department of the Outpatient Oncology Center Author's contribution: review of publications on the topic of the article.

5 2nd Botkin passage, Moscow, 125284

t.a.y.2017@mail.ruМосковский многопрофильный научно-клинический центр им. С.П. Боткина; Российский университет дружбы народовРоссияMoscow Multidisciplinary Scientific and Clinical Center named after S.P. Botkin; Peoples' Friendship University of RussiaRussian FederationМосковский многопрофильный научно-клинический центр им. С.П. БоткинаРоссияPeoples' Friendship University of RussiaRussian FederationМосковский многопрофильный научно-клинический центр им. С.П. Боткина; Российская медицинская академия непрерывного профессионального образованияРоссияMoscow Multidisciplinary Scientific and Clinical Center named after S.P. Botkin; Russian Medical Academy of Continuing Professional EducationRussian FederationСамарский областной клинический онкологический диспансерРоссияSamara Regional Clinical Oncological DispensaryRussian FederationМосковский многопрофильный научно-клинический центр им. С.П. БоткинаРоссияMoscow Multidisciplinary Scientific and Clinical Center named after S.P. BotkinRussian Federation2024040920241437482Copyright © Титов К.С., Сорокина М.В., Лебедев С.С., Греков Д.Н., Неретин Е.Ю., Якушева Т.А., 20242024Титов К.С., Сорокина М.В., Лебедев С.С., Греков Д.Н., Неретин Е.Ю., Якушева Т.А.Titov K.S., Sorokina M.V., Lebedev S.S., Grekov D.N., Neretin E.Y., Yakusheva T.A.Данная работа распространяется под лицензией Creative Commons Attribution 4.0.This work is licensed under a Creative Commons Attribution 4.0 License.https://vestnik.reaviz.ru/jour/article/view/1081

Цель: изучение взаимосвязи клинико-морфологических параметров меланомы кожи BRAF-статусом опухоли у пациентов с I стадией заболевания. Материалы и методы. Исследование носило ретроспективный характер и включало 200 пациентов с меланомой кожи I стадии (рТ1-2aN0M0), из которых BRAF-статус был оценен у 88 пациентов. Всем пациентам был проведён анализ клинических данных, расширенное морфологическое исследование и молекулярно-генетическое исследование на определение в первичной опухоли мутации BRAF V600E. Результаты. Медиана возраста пациентов общей выборки составила 61,5 года. Мутация в гене BRAF V600E была выявлена у 25 пациентов (28,4%). Независимыми предикторами BRAF-статуса меланомы кожи I стадии были признаны возраст пациента, локализация опухоли и толщина по Бреслоу. При увеличении возраста пациента на 1 год шанс наличия мутации BRAF V600E уменьшался на 3,4% или в 1,04 раза (ОШ = 0,966; 95% ДИ = 0,935–0,999; р = 0,045). При локализации меланомы в поясничной области шанс наличия мутации BRAF V600E возрастал в 15,311 раза (95% ДИ = 1,239–189,142; р = 0,033). При толщине опухоли по Бреслоу более 0,7 мм шанс наличия мутации BRAF V600E возрастал в 2,939 раза (95% ДИ = 1,031–8,376; р = 0,044). При пороговом значении логистической функции 50% чувствительность и специфичность предложенной модели составили 28,0% и 93,7% соответственно. При снижении значения пороговой функции до 25,3% чувствительность модели возрастает до 68% с одновременным падением специфичности до 61,9%. Заключение. Более молодой возраст, большая толщина опухоли по Бреслоу и локализация опухоли в поясничной области у пациентов с меланомой кожи I стадии увеличивают шанс наличия мутации BRAF V600E, в то время как остальные морфологические параметры опухоли не ассоциированы с BRAF-статусом. Однако умеренная чувствительность не позволяет достаточно точно определять наличие мутации, укрепляя тем самым убеждение о необходимости выполнения молекулярно-генетического исследования.

Aim: to study the relationship between clinical and morphological parameters of skin melanoma and the BRAF status of the tumor in patients with stage I of the disease. Materials and methods. The study was retrospective and included 200 patients with stage I skin melanoma (pT1-2aN0M0), of which BRAF status was assessed in 88 patients. All patients underwent clinical data analysis, an extended morphological study and a molecular genetic study to determine the BRAF V600E mutation in the primary tumor. Results. The median age of patients in the total sample was 61.5 years. Mutation in the BRAF V600E gene was detected in 25 patients (28.4%). Patient age, tumor location and Breslow thickness were recognized as independent predictors of BRAF status of stage I skin melanoma. With an increase in the patient's age by 1 year, the chance of having a BRAF V600E mutation decreased by 3.4% or 1.04 times (OR = 0.966; 95% CI = 0.935–0.999; p = 0.045). When melanoma was localized in the lumbar region, the chance of having a BRAF V600E mutation increased by 15.311 times (95% CI = 1.239–189.142; p = 0.033). With a tumor thickness according to Breslow of more than 0.7 mm, the chance of having a BRAF V600E mutation increased by 2.939 times (95% CI = 1.031-8.376; p = 0.044). With a threshold value of the logistic function of 50%, the sensitivity and specificity of the proposed model were 28.0% and 93.7%, respectively. When the threshold function value is reduced to 25.3%, the sensitivity of the model increases to 68% with a simultaneous drop in specificity to 61.9%. Conclusion. Younger age, greater tumor thickness according to Breslow, and tumor localization in the lumbar region in patients with stage I skin melanoma increase the chance of having a BRAF V600E mutation, while other morphological parameters of the tumor are not associated with BRAF status. However, moderate sensitivity does not allow for a sufficiently accurate determination of the presence of a mutation, thereby strengthening the belief in the need for molecular genetic testing.

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