Children's Haematology/Oncology Centre, Christchurch Hospital, Christchurch, New Zealand; Department of Paediatrics, University of Otago (Christchurch), Christchurch, New Zealand.
Children's Cancer Centre, Royal Children's Hospital, Melbourne, Victoria 3052, Australia; Department of Paediatrics, University of Melbourne, Melbourne, Victoria 3052, Australia; Murdoch Children's Research Institute, Melbourne, Victoria 3052, Australia.
Crit Rev Oncol Hematol. 2017 Mar;111:52-59. doi: 10.1016/j.critrevonc.2017.01.012. Epub 2017 Jan 23.
Paediatric glioma encompasses a wide range of entities with highly variable prognoses. Gliomas are grouped by histopathological features into high- and low-grade glioma but this classification until recently has not taken into account many emerging risk factors in this disease. A comprehensive risk classification has not been published for paediatric glioma despite many risk factors being established in this disease.
A comprehensive literature review was carried out identifying risk factors for paediatric low-grade and high-grade glioma.
The most consistently described risk factors in high-grade glioma included midline location and extent of surgical resection. For patients with progressive unresectable low-grade glioma, age under 1, neurofibromatosis type I status and location were the most consistently prognostic. Molecular classification shows promise in accurately reassigning diagnosis for some gliomas.
Risk profiling in paediatric glioma will require a focused multinational effort but will result in a more accurate and nuanced assessment of prognosis.
小儿脑胶质瘤包含了一系列具有高度不同预后的实体瘤。根据组织病理学特征，胶质瘤分为高级别和低级别胶质瘤，但这种分类直到最近才考虑到该疾病中的许多新出现的危险因素。尽管在该疾病中已经确定了许多危险因素，但尚未为小儿脑胶质瘤制定全面的风险分类。
进行了全面的文献综述，以确定小儿低级别和高级别脑胶质瘤的危险因素。
在高级别脑胶质瘤中，最常描述的危险因素包括中线位置和手术切除范围。对于进行性不可切除的低级别胶质瘤患者，年龄小于 1 岁、神经纤维瘤病 1 型状态和位置是最一致的预后因素。分子分类显示出在准确重新分配某些脑肿瘤诊断方面的前景。
小儿脑胶质瘤的风险评估将需要集中的跨国努力，但将导致对预后进行更准确和细致的评估。
