关键词: AKT1 KLF4 NF2 PI3K = phosphoinositide 3-kinase PIK3CA POLR2 SCNA = somatic copy-number alteration SMO TRAF7 WHO = World Health Organization genomics mTOR = mammalian target of rapamycin meningioma

Mesh : Biomarkers, Tumor / genetics Genomics / methods Humans Kruppel-Like Factor 4 Meningeal Neoplasms / genetics surgery Meningioma / genetics surgery Mutation / genetics Neurofibromin 2 / genetics Neurosurgeons / education trends Smoothened Receptor / genetics

来  源:   DOI:10.3171/2018.2.FOCUS1849

Abstract:
Meningiomas are among the most common intracranial pathological conditions, accounting for 36% of intracranial lesions treated by neurosurgeons. Although the majority of these lesions are benign, the classical categorization of tumors by histological type or World Health Organization (WHO) grade has not fully captured the potential for meningioma progression and recurrence. Many targeted treatments have failed to generate a long-lasting effect on these tumors. Recently, several seminal studies evaluating the genomics of intracranial meningiomas have rapidly changed the understanding of the disease. The importance of NF2 (neurofibromin 2), TRAF7 (tumor necrosis factor [TNF] receptor-associated factor 7), KLF4 (Kruppel-like factor 4), AKT1, SMO (smoothened), PIK3CA (phosphatidylinositol-4,5-bisphosphate 3-kinase catalytic subunit alpha), and POLR2 (RNA polymerase II subunit A) demonstrates that there are at least 6 distinct mutational classes of meningiomas. In addition, 6 methylation classes of meningioma have been appreciated, enabling improved prediction of prognosis compared with traditional WHO grades. Genomic studies have shed light on the nature of recurrent meningioma, distinct intracranial locations and mutational patterns, and a potential embryonic cancer stem cell-like origin. However, despite these exciting findings, the clinical relevance of these findings remains elusive. The authors review the key findings from recent genomic studies in meningiomas, specifically focusing on how these findings relate to clinical insights for the practicing neurosurgeon.
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