■世界卫生组织(WHO)第5版中枢神经系统肿瘤分类将特定的分子改变纳入神经胶质瘤的分类。分类方案的主要修订实现了神经胶质瘤的诊断和管理的重大变化。本研究旨在描述临床,分子,根据目前的WHO分类,胶质瘤及其亚型的预后特征。
■在北京协和医院接受了为期11年的胶质瘤手术的患者使用下一代测序重新检查肿瘤遗传改变,基于聚合酶链反应的检测,和荧光原位杂交方法,并纳入分析。
■将452例胶质瘤重新分类为成人型弥漫性胶质瘤(ntotal=373;星形细胞瘤,n=78;少突胶质细胞瘤,n=104;胶质母细胞瘤,n=191),小儿型弥漫性神经胶质瘤(ntotal=23;低度,n=8;高档,n=15),星形胶质细胞瘤(n=20),神经胶质神经和神经元肿瘤(n=36)。组成,定义,成人和儿童型神经胶质瘤的发病率在分类的第4和第5版之间发生了显着变化。临床,放射学,分子,并确定了胶质瘤各亚型的生存特征。CDK4/6、CIC、FGFR2/3/4,FUBP1,KIT,MET,NF1,PEG3,RB1和NTRK2是与不同亚型胶质瘤的生存相关的其他因素。
■基于组织学和分子改变的最新WHO分类更新了我们对临床的理解,放射学,分子,生存,和不同亚型胶质瘤的预后特征,并为患者的诊断和潜在预后提供准确的指导。
UNASSIGNED: The 5th edition of the World Health Organization (WHO) classification of central nervous system tumors incorporated specific molecular alterations into the categorization of gliomas. The major revision of the classification scheme effectuates significant changes in the diagnosis and management of glioma. This study aimed to depict the clinical, molecular, and prognostic characteristics of glioma and its subtypes according to the current WHO classification.
UNASSIGNED: Patients who underwent surgery for glioma at Peking Union Medical College Hospital during 11 years were re-examined for tumor genetic alterations using next-generation sequencing, polymerase chain reaction-based assay, and fluorescence in situ hybridization methods and enrolled in the analysis.
UNASSIGNED: The enrolled 452 gliomas were reclassified into adult-type diffuse glioma (ntotal=373; astrocytoma, n=78; oligodendroglioma, n=104; glioblastoma, n=191), pediatric-type diffuse glioma (ntotal=23; low-grade, n=8; high-grade, n=15), circumscribed astrocytic glioma (n=20), and glioneuronal and neuronal tumor (n=36). The composition, definition, and incidence of adult- and pediatric-type gliomas changed significantly between the 4th and the 5th editions of the classification. The clinical, radiological, molecular, and survival characteristics of each subtype of glioma were identified. Alterations in CDK4/6, CIC, FGFR2/3/4, FUBP1, KIT, MET, NF1, PEG3, RB1, and NTRK2 were additional factors correlated with the survival of different subtypes of gliomas.
UNASSIGNED: The updated WHO classification based on histology and molecular alterations has updated our understanding of the clinical, radiological, molecular, survival, and prognostic characteristics of varied subtypes of gliomas and provided accurate guidance for diagnosis and potential prognosis for patients.