Leach P A, Estlin E J, Coope D J, Thorne J A, Kamaly-Asl I D
Department of Paediatric Neurosurgery, Royal Manchester Children's Hospital, Manchester, UK.
Br J Neurosurg. 2008 Oct;22(5):619-24. doi: 10.1080/02688690802366198.
The decision to biopsy diffuse pontine gliomas in children remains controversial. There have been many publications over the last 30 years aiming to address this issue. The prognosis for these patients remains extremely poor regardless of treatment and many authors advocate that biopsy carries significant risk for little or no clinical benefit. However, with an increasing knowledge of tumour biology and genetics there is the potential for specific treatments tailored for individual tumours based on their biological or genetic characteristics. The progress of such science in the first instance requires histological diagnosis as part of well conducted clinical trials, then, when treatments have been developed, biopsy samples will be needed to identify the tumours that may respond to such treatments. The authors believe that there is an increasing need for performing a biopsy of these lesions.
对儿童弥漫性脑桥胶质瘤进行活检的决定仍存在争议。在过去30年里有许多出版物旨在解决这个问题。无论接受何种治疗,这些患者的预后仍然极差,许多作者主张活检带来的风险很大,而临床益处却微乎其微或根本没有。然而,随着对肿瘤生物学和遗传学的了解不断增加,有可能根据个体肿瘤的生物学或遗传特征为其量身定制特定的治疗方法。首先,这类科学进展需要组织学诊断作为精心开展的临床试验的一部分,然后,当开发出治疗方法时,将需要活检样本以识别可能对这类治疗有反应的肿瘤。作者认为,对这些病变进行活检的需求日益增加。