Department of Medical Oncology, Institut Régional du Cancer de Montpellier (ICM) - Val d'Aurelle, 208 Rue des Apothicaires, 34298 Montpellier, France; Institute for Neuroscience of Montpellier, INSERM U1051, Team "Plasticity of Central Nervous System, Human Stem Cells and Glial Tumors," Saint Eloi Hospital, Montpellier University Medical Center, 34295 Montpellier, France.
Institute for Neuroscience of Montpellier, INSERM U1051, Team "Plasticity of Central Nervous System, Human Stem Cells and Glial Tumors," Saint Eloi Hospital, Montpellier University Medical Center, 34295 Montpellier, France; Tumor and Cell Biology Laboratory, Arnaud de Villeneuve Hospital, 371 Avenue du Doyen Gaston Giraud, Montpellier University Medical Center, 34295 Montpellier, France.
Crit Rev Oncol Hematol. 2017 Jan;109:51-62. doi: 10.1016/j.critrevonc.2016.11.014. Epub 2016 Nov 27.
The origins of diffuse low-grade gliomas (DLGG) are unknown. Beyond some limited data on their temporal and cellular origins, the mechanisms and risk factors involved are poorly known. First, based on strong relationships between DLGG development and the eloquence of brain regions frequently invaded by these tumors, we propose a "functional theory" to explain the origin of DLGG. Second, the biological pathways involved in DLGG genesis may differ according to tumor location (anatomo-molecular correlations). The cellular and molecular mechanisms of such "molecular theory" will be reviewed. Third, the geographical distribution of diffuse WHO grade II-III gliomas within populations is heterogeneous, suggesting possible environmental risk factors. We will discuss this "environmental theory". Finally, we will summarize the current knowledge on genetic susceptibility in gliomas ("genetic predisposition theory"). These crucial issues illustrate the close relationships between the pathophysiology of gliomagenesis, the anatomo-functional organization of the brain, and personalized management of DLGG patients.
弥漫性低级别胶质瘤（DLGG）的起源尚不清楚。除了关于其时间和细胞起源的一些有限数据外，其涉及的机制和风险因素知之甚少。首先，基于 DLGG 发展与这些肿瘤经常侵袭的脑区的功能之间的密切关系，我们提出了一个“功能理论”来解释 DLGG 的起源。其次，参与 DLGG 发生的生物学途径可能因肿瘤位置而异（解剖-分子相关性）。将回顾这种“分子理论”的细胞和分子机制。第三，人群中弥漫性 WHO 分级 II-III 级胶质瘤的地理分布是不均匀的，提示可能存在环境风险因素。我们将讨论这种“环境理论”。最后，我们将总结胶质瘤中遗传易感性的现有知识（“遗传易感性理论”）。这些关键问题说明了胶质瘤发生的病理生理学、大脑的解剖-功能组织以及 DLGG 患者的个体化管理之间的密切关系。
