Экспрессионные характеристики опухоли как прогностические и предиктивные маркеры резектабельного и местно-распространенного колоректального рака

Введение. Риски рецидива и смерти пациентов с колоректальным раком (КРР) могут значительно различаться даже у пациентов со схожими клинико-патоморфологическими особенностями из-за высокого уровня гетерогенности опухоли. Существующие молекулярные классификации имеют довольно ограниченное значение. Возможно, большую роль будут иметь генные сигнатуры, выделенные с помощью полноэкзомного / полнотранскриптомного анализов.

Цель исследования – систематизирование данных литературы, посвященных экспрессионным сигнатурам, описание их прогностического и предиктивного значения в контексте неметастатического КРР.

Результаты. В данном обзоре описаны современные аспекты персонификации подходов к лечению КРР, применяемые в клинической практике: мутационный и микросателлитный статусы, значение локализации первичной опухоли. Представлены также данные по мультигенным сигнатурам, экспрессионным характеристикам опухоли. Ряд сигнатур позволяют предсказать риск рецидива, безрецидивную и общую выживаемость резектабельного и местно-распространенного КРР. Кроме того, показана корреляция лекарственной чувствительности с сигнатурами генов репарации ДНК, представлены данные по корреляции экспрессионных сигнатур с белками, фосфопротеинами и их роль как прогностических и предиктивных факторов неметастатического КРР.

Заключение. Применение генных сигнатур на сегодняшний момент не имеет практического значения. Ввиду разрозненности данных, большого разнообразия исследуемых сигнатур сделать какие-то значимые выводы по их практическому значению невозможно. Однако, вероятно, в будущем использование генных сигнатур приведет к более точному определению прогноза, новым подходам к лекарственной терапии и улучшению результатов лечения пациентов с КРР.

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