Hua W, Mao Y
Department of Neurosurgery, Huashan Hospital, Fudan University, Shanghai 200040, China.
Zhonghua Wai Ke Za Zhi. 2017 Jan 1;55(1):63-66. doi: 10.3760/cma.j.issn.0529-5815.2017.01.016.
With the advance of genomics research, there have been a new breakthrough in the molecular classification of gliomas. Glioblastoma (WHO grade Ⅳ) could be subtyped to proneural, neural, classical, and mesochymal according to the mRNA expression. Lower grade gliomas (WHO grade Ⅱ and Ⅲ) could be divided into 5 types using 1p/19q co-deletion, isocitrate dehydrogenase(IDH) mutation, and TERTp (promotor region) mutation. In 2016, a new classification of tumors of the central nervous system was proposed, and some new markers such as IDH1 mutation were introduced into the diagnosis of gliomas. Genotype and phenotype were integrated to diagnose gliomas. In the meantime, precision treatment for gliomas has also been vigorously developed. This article reviewed recent studies on the molecular diagnosis, precise chemotherapy, targeted therapy, and immunotherapy for gliomas to provide new ideas and strategies for precise diagnosis and treatment of gliomas.
随着基因组学研究的进展,胶质瘤的分子分类有了新的突破。胶质母细胞瘤(世界卫生组织IV级)可根据mRNA表达分为神经前型、神经型、经典型和间充质型。低级别胶质瘤(世界卫生组织II级和III级)可利用1p/19q共缺失、异柠檬酸脱氢酶(IDH)突变和TERTp(启动子区域)突变分为5种类型。2016年,提出了一种新的中枢神经系统肿瘤分类方法,并将一些新的标志物如IDH1突变引入胶质瘤的诊断中。将基因型和表型相结合用于诊断胶质瘤。与此同时,胶质瘤的精准治疗也得到了大力发展。本文综述了近年来关于胶质瘤分子诊断、精准化疗、靶向治疗和免疫治疗的研究,为胶质瘤的精准诊断和治疗提供新的思路和策略。