neurosurgeryНейрохирургияRussian journal of neurosurgery1683-32952587-7569Издательский дом "МедИНК"10.63769/1683-3295-2026-28-2-67-76neurosurgery-1846Research ArticleОРИГИНАЛЬНАЯ РАБОТАORIGINAL REPORTСовременные аспекты стереотаксической биопсии опухолей центральной нервной системы: проблема неинформативных результатовContemporary approaches to stereotactic biopsy of central nervous system tumors: challenges of non-diagnostic resultshttps://orcid.org/0000-0002-0108-0677МаряшевС. А.MaryashevS. A.

125047 Москва, 4-я Тверская-Ямская ул., 16 

16 4th Tverskaya-Yamskaya St., Moscow 125047 

https://orcid.org/0000-0003-2500-3403ВеселковА. А.VeselkovA. A.

Алексей Александрович Веселков

125047 Москва, 4-я Тверская-Ямская ул., 16 

Aleksey Aleksandrovich Veselkov

16 4th Tverskaya-Yamskaya St., Moscow 125047 

AVeselkov@nsi.ruhttps://orcid.org/0009-0005-9446-1469ТрубниковЕ. А.TrubnikovE. A.

125047 Москва, 4-я Тверская-Ямская ул., 16 

16 4th Tverskaya-Yamskaya St., Moscow 125047 

https://orcid.org/0000-0001-7206-6365РыжоваМ. В.RyzhovaM. V.

125047 Москва, 4-я Тверская-Ямская ул., 16 

16 4th Tverskaya-Yamskaya St., Moscow 125047 

https://orcid.org/0000-0002-8732-3114ГаврюшинА. В.GavryushinA. V.

125047 Москва, 4-я Тверская-Ямская ул., 16 

16 4th Tverskaya-Yamskaya St., Moscow 125047 

https://orcid.org/0009-0001-8146-1890БагратунянД. Х.BagratunyanD. Kh.

119435 Москва, Большая Пироговская ул., 2, стр. 4 

Build. 4, 2 Bolshaya Pirogovskaya St., Moscow 119435 

https://orcid.org/0000-0002-7651-4214КобяковГ. Л.KobyakovG. L.

125047 Москва, 4-я Тверская-Ямская ул., 16 

16 4th Tverskaya-Yamskaya St., Moscow 125047 

https://orcid.org/0000-0002-1366-918XПоддубскийА. А.PoddubskiyA. A.

125047 Москва, 4-я Тверская-Ямская ул., 16 

16 4th Tverskaya-Yamskaya St., Moscow 125047 

https://orcid.org/0000-0002-4480-0275ПронинИ. Н.ProninI. N.

125047 Москва, 4-я Тверская-Ямская ул., 16 

16 4th Tverskaya-Yamskaya St., Moscow 125047 

ФГАУ «Национальный медицинский исследовательский центр нейрохирургии им. акад. Н.Н. Бурденко» Минздрава РоссииРоссияNational Medical Research Center of Neurosurgery named after Academician N.N. Burdenko, Ministry of Health of RussiaRussian FederationФГАОУ ВО Первый МГМУ им. И.М. Сеченова Минздрава России (Сеченовский Университет)РоссияSechenov First Moscow State Medical University, Ministry of Health of Russia (Sechenov University)Russian Federation2026190620262826776Copyright © Маряшев С.А., Веселков А.А., Трубников Е.А., Рыжова М.В., Гаврюшин А.В., Багратунян Д.Х., Кобяков Г.Л., Поддубский А.А., Пронин И.Н., 20262026Маряшев С.А., Веселков А.А., Трубников Е.А., Рыжова М.В., Гаврюшин А.В., Багратунян Д.Х., Кобяков Г.Л., Поддубский А.А., Пронин И.Н.Maryashev S.A., Veselkov A.A., Trubnikov E.A., Ryzhova M.V., Gavryushin A.V., Bagratunyan D.K., Kobyakov G.L., Poddubskiy A.A., Pronin I.N.Данная работа распространяется под лицензией Creative Commons Attribution 4.0.This work is licensed under a Creative Commons Attribution 4.0 License.https://www.therjn.com/jour/article/view/1846Введение

Введение. Современная нейроонкология требует морфологической и молекулярно-генетической верификации опухолей центральной нервной системы для выбора оптимальной тактики лечения. Несмотря на высокую информативность методов нейровизуализации, окончательный диагноз в большинстве случаев может быть установлен только на основании данных гистологического исследования ткани. Стереотаксическая биопсия (СТБ) является минимально инвазивным методом получения диагностического материала, однако проблема неинформативных результатов сохраняет клиническую значимость.

Цель исследования – оценить диагностическую эффективность и выявить основные причины неинформативных результатов СТБ опухолей головного мозга.

Материалы и методы

Материалы и методы. Проведен ретроспективный анализ 172 СТБ, выполненных в НМИЦ нейрохирургии им. акад. Н.Н. Бурденко в 2023–2024 гг. Всем пациентам выполнены комплексное нейровизуализационное обследование (компьютерная томография, магнитнорезонансная томография), а также гистологическое и молекулярно-генетическое исследование биопсийного материала.

Результаты

Результаты. Диагностическая информативность СТБ составила 92,4 % (n = 159), при повторном пересмотре препаратов – 95,9 % (n = 165). Основной причиной неинформативных результатов биопсий (n = 7) были технические ошибки при планировании, а именно некорректный выбор точки цели. Наличие диагностически значимого материала при срочном исследовании было статистически значимо ассоциировано с итоговой информативностью биопсии.

Заключение

Заключение. СТБ остается высокоэффективным и относительно безопасным методом получения диагностического материала при опухолях головного мозга. В условиях современной нейроонкологии она имеет ключевое значение для морфологической и молекулярной верификации, определяющей тактику лечения. Для повышения точности и воспроизводимости процедуры целесообразны внедрение интраоперационного контроля и унификация стандартов выполнения СТБ. 

Background

Background. Modern neuro-oncology requires morphological and molecular genetic verification of central nervous system tumors to determine the optimal treatment strategy. Despite the high information yield of neuroimaging methods, a definitive diagnosis in most cases can only be established based on histological tissue examination. Stereotactic biopsy (STB) is a minimally invasive method for obtaining diagnostic material; however, the problem of uninformative results remains clinically significant.

Aim

Aim. To assess the diagnostic effectiveness and identify the main causes of non-diagnostic results of STB in patients with brain tumors.

Materials and methods

Materials and methods. A retrospective analysis of 172 STB performed at the National Medical Research Center of Neurosurgery named after Academician N.N. Burdenko in 2023–2024 was conducted. All patients underwent comprehensive neuroimaging (computed tomography and magnetic resonance imaging) as well as histological and molecular genetic examination of the biopsy specimens.

Results

Results. The diagnostic yield of STB was 92.4 % (n = 159) and increased to 95.9 % (n = 165) after repeat histological review. The main cause of non-diagnostic biopsies (n = 7) was technical planning errors, primarily incorrect target selection. The presence of diagnostically significant tumor tissue at intraoperative (frozen-section) examination was statistically significantly associated with the final diagnostic yield of the procedure.

Conclusion

Conclusion. STB remains a highly effective and relatively safe method for obtaining diagnostic material in patients with brain tumors. In the era of modern neuro-oncology, it plays a key role in morphological and molecular verification, which determines treatment strategy. The implementation of intraoperative histological control and the standardization of STB protocols may further improve diagnostic accuracy and procedural reproducibility. 

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