helmholtzeyeinstituteРоссийский офтальмологический журналRussian Ophthalmological Journal2072-00762587-5760Real time Publishers10.21516/2072-0076-2025-18-1-131-137helmholtzeyeinstitute-1729Research ArticleОБЗОРЫ ЛИТЕРАТУРЫREVIEWSЦиркулирующая опухолевая ДНК. Современные представления о возможности использования при увеальной меланомеCirculating tumor DNA. Modern views about the possibility of use in uveal melanomaБогатыревА. М.BogatyrevA. M.

Богатырев Александр Михайлович — научный сотрудник офтальмологического отделения.

ул. Щепкина, д. 61/2, Москва, 129110

Aleksandr M. Bogatyrev — researcher, ophthalmology department.

61/2, Shchepkina St., Moscow, 129110

ГришинаЕ. Е.GrishinaE. E.

Гришина Елена Евгеньевна — д-р мед. наук, профессор, главный научный сотрудник онкологического отделения хирургических методов лечения.

ул. Щепкина, д. 61/2, Москва, 129110

Elena E. Grishina — Dr. of Med. Sci., professor, principal researcher, oncology department of surgical treatment methods.

61/2, Shchepkina St., Moscow, 129110

eyelena@mail.ruЗарецкийА. Р.ZaretskyA. R.

Зарецкий Андрей Ростиславович — научный сотрудник НИИ трансляционной медицины.

ул. Островитянова, д. 1, Москва, 117997

Andrey R. Zaretsky — researcher, Research Institute of Translational Medicine.

1, Ostrovityanova St., Moscow, 117997

СеменихинаП. И.SemenikhinaP. I.

Семенихина Полина Ивановна — младший научный сотрудник офтальмологического отделения.

ул. Щепкина, д. 61/2, Москва, 129110

Polina I. Semenikhina — junior researcher, ophthalmology department.

61/2, Shchepkina St., Moscow, 129110

ГБУЗ МО МОНИКИ им. М.Ф. ВладимирскогоРоссияMoscow Regional Research and Clinical Institute (MONIKI)Russian FederationФГАОУ ВО «РНИМУ им. Н.И. Пирогова» Минздрава РоссииРоссияN.I. Pirogov Russian National Research Medical UniversityRussian Federation202528032025181131137Copyright © Богатырев А.М., Гришина Е.Е., Зарецкий А.Р., Семенихина П.И., 20252025Богатырев А.М., Гришина Е.Е., Зарецкий А.Р., Семенихина П.И.Bogatyrev A.M., Grishina E.E., Zaretsky A.R., Semenikhina P.I.Данная работа распространяется под лицензией Creative Commons Attribution 4.0.This work is licensed under a Creative Commons Attribution 4.0 License.https://roj.igb.ru/jour/article/view/1729

Меланома сосудистой оболочки — это самая распространенная и крайне злокачественная внутриглазная опухоль в связи со склонностью к гематогенному метастазированию. В подавляющем большинстве случаев поражается печень. Метастазы при увеальной меланоме (УМ) развиваются у половины пациентов в среднем в течение 4,4 года после проведенного лечения. В настоящее время появляются единичные препараты, которые могут применяться для адъювантной терапии метастатической УМ, однако эти препараты показывают ограниченную эффективность. До сих пор единственным радикальным методом лечения метастатической болезни при УМ является хирургическое разрушение единичных метастазов в печени. В обзоре рассмотрена возможность определения циркулирующей опухолевой ДНК как высокоспецифичного, чувствительного, доступного и неинвазивного метода диагностики и мониторинга лечения онкологических заболеваний. Циркулирующая опухолевая ДНК может являться одним из прогностических признаков УМ, что помогает сформировать группы высокого риска раннего метастазирования для персонифицированного подхода к частоте проведения лучевых методов диагностики и выявления единичных метастазов в печени. При появлении эффективных методов системной лекарственной терапии метастатической УМ циркулирующая опухолевая ДНК может применяться для контроля эффективности лечения. Исследование циркулирующей ДНК позволяет также определять мутационные особенности первичной опухоли, что в свою очередь может быть использовано для дифференциальной диагностики первичной УМ и других опухолей сосудистой оболочки, в том числе метастазов кожной меланомы в хориоидею. В обзоре рассматривается возможность ипользования циркулирующей опухолевой ДНК при УМ в качестве прогностического фактора и диагностического инструмента, а также метода оценки эффективности проводимой терапии метастатической УМ.

Choroidal melanoma is the most common and highly malignant intraocular tumor due to its tendency to hematogenous metastasis. In the vast majority of cases, the liver is affected. Metastases in uveal melanoma (UM) develop in half of patients on average within 4.4 years after treatment. Currently, single drugs are appearing that can be used for adjuvant therapy of metastatic UM, but these drugs show limited efficacy. Until now, the only radical method of treating metastatic disease in UM is surgical destruction of single metastases in the liver. The review considers the possibility of determining circulating tumor DNA as a highly specific, sensitive, accessible and non-invasive method for diagnosing and monitoring the treatment of oncological diseases. Circulating tumor DNA can be one of the prognostic signs of UM, which helps to form high-risk groups of early metastasis for a personalized approach to the frequency of radiation diagnostic methods and detection of single metastases in the liver. With the emergence of effective methods of systemic drug therapy for metastatic UM, circulating tumor DNA can be used to monitor the effectiveness of treatment. The study of circulating DNA also allows us to determine the mutational features of the primary tumor, which in turn can be used for the differential diagnosis of primary UM and other tumors of the choroid, including metastases of cutaneous melanoma to the choroid. The review considers the possibility of using circulating tumor DNA in UM as a prognostic factor and diagnostic tool, as well as a method for assessing the effectiveness of therapy for metastatic UM.

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