problendoПроблемы ЭндокринологииProblems of Endocrinology0375-96602308-1430Endocrinology Research Centre10.14341/probl13376problendo-13376Research ArticleКлиническая эндокринологияClinical endocrinologyУнификация патоморфологического обследования пациентов с нейроэндокринными опухолями гипофиза. Спорные вопросы новой классификацииUnification of pathomorphological examination of patients with neuroendocrine tumors of the pituitary gland. Controversial issues of the new classificationhttps://orcid.org/0000-0001-5045-798XПронинВ. С.ProninV. S.

Пронин Вячеслав Сергеевич, д.м.н., профессор

Москва

Vyacheslav S. Pronin, MD, PhD

Moscow

vspronin@yandex.ruhttps://orcid.org/0000-0002-9944-2997АнциферовМ. Б.AntsiferovM. B.

Анциферов Михаил Борисович, д.м.н., профессор 

Москва

Mikhail B. Antsiferov, MD, PhD

Moscow

antsiferovmb@zdrav.mos.ruhttps://orcid.org/0000-0003-0066-845XАлексееваТ. М.AlekseevaT. M.

Алексеева Татьяна Марковна 

Москва

Tatiana M. Alekseeva

Moscow

 

mamamarka@yandex.ruhttps://orcid.org/0000-0001-6094-3623ПронинЕ. В.ProninE. V.

Пронин Евгений Вячеславович 

Москва

Evgeny V. Pronin

Moscow

r-wp@mail.ruhttps://orcid.org/0000-0003-4353-6705ЛапшинаА. М.LapshinaA. M.

Лапшина Анастасия Михайловна, к.м.н. 

Москва

Anastasiya M. Lapshina

Moscow

anastasya.lapshina@endocrincentr.ruhttps://orcid.org/0000-0001-6891-0009УрусоваЛ. С.UrusovaL. S.

Урусова Лилия Сергеевна, д.м.н. 

Москва

Liliya S. Urusova

Moscow

Urusova.Lilia@endocrincentr.ruРоссийская медицинская академия непрерывного профессионального образования; Эндокринологический диспансер Департамента здравоохранения города МосквыРоссияRussian Medical Academy of Continuous Professional Education; Endocrinological Dispensary of the Department of Health of the City of MoscowRussian FederationЭндокринологический диспансер Департамента здравоохранения города МосквыРоссияEndocrinological Dispensary of the Department of Health of the City of MoscowRussian FederationНациональный медицинский исследовательский центр эндокринологииРоссияEndocrinology Research CentreRussian Federation2024141120237033145Copyright © Пронин В.С., Анциферов М.Б., Алексеева Т.М., Пронин Е.В., Лапшина А.М., Урусова Л.С., 20242024Пронин В.С., Анциферов М.Б., Алексеева Т.М., Пронин Е.В., Лапшина А.М., Урусова Л.С.Pronin V.S., Antsiferov M.B., Alekseeva T.M., Pronin E.V., Lapshina A.M., Urusova L.S.Данная работа распространяется под лицензией Creative Commons Attribution 4.0.This work is licensed under a Creative Commons Attribution 4.0 License.https://www.probl-endojournals.ru/jour/article/view/13376

Поступательное совершенствование классификации с использованием современных аналитических методов является важнейшим инструментом для развития прецизионного и персонализированного подходов к лечению аденом гипофиза. В последние годы эндокринологи стали свидетелями эволюционных изменений, произошедших в гистопатологической идентификации новообразований гипофиза, открывающих новые возможности для изучения туморогенеза и прогнозирования биологического поведения.

В работе рассмотрены исторические аспекты поэтапного совершенствования классификации аденом гипофиза, а также новая международная классификация ВОЗ (2022 г.), согласно которой аденомы гипофиза включены в список нейроэндокринных образований (ГипНЭО), чтобы отразить биологическую агрессивность некоторых неметастатических гипофизарных аденом. Представлены клинические характеристики аденом гипофиза, а также перечень гистологических подтипов агрессивных нейроэндокринных опухолей гипофиза, отличающихся высоким потенциалом инвазивного роста, повышенным риском рецидивирования и негативным клиническим прогнозом.

Обсуждается целесообразность смены дефиниции «аденома гипофиза» на «нейроэндокринную опухоль гипофиза». Подчеркивается, что внедрение в отечественную клиническую практику унифицированного клинико-лабораторного и морфологического протокола поможет обеспечить сопоставимые сравнительные наблюдения по прогнозу заболевания и эффективности вторичной терапии, а также способствовать адекватной курации потенциально агрессивных ГипНЭО.

The progressive improvement of the classification using modern analytical methods is an essential tool for the development of precise and personalized approaches to the treatment of pituitary adenomas. In recent years, endocrinologists have witnessed evolutionary changes that have occurred in the histopathological identification of pituitary neoplasms, revealing new possibilities for studying tumorigenesis and predicting biological behavior.

The paper considers the historical aspects of the gradual improvement of the classification of pituitary adenomas, as well as the new international 2022 WHO classification, according to which pituitary adenomas are included in the list of neuroendocrine tumors (PitNETs) to reflect the biological aggressiveness of some non-metastatic pituitary adenomas. The characteristics of pituitary adenoma are presented, as well as a list of histological subtypes of aggressive neuroendocrine tumors of the pituitary gland, marked by the main potentials for invasive growth, an increased risk of recurrence and a negative clinical prognosis.

The expediency of changing the definition of «pituitary adenoma» to «neuroendocrine tumor» is discussed. It is emphasized that the introduction of a unified clinical, laboratory and morphological protocol into national clinical practice will help provide comparable comparative studies on the prognosis of the disease and the effectiveness of secondary therapy and also contribute to adequate management of potentially aggressive PitNETs.

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