aDepartment of Pathology, Massachusetts General Hospital, Harvard Medical School, Boston, Massachusetts, USA bDivision of Experimental Neurosurgery, Department of Neurosurgery cDepartment of Medical Oncology, National Center for Tumor Diseases (NCT), Heidelberg University Hospital, Heidelberg, Germany.
Curr Opin Neurol. 2017 Dec;30(6):643-649. doi: 10.1097/WCO.0000000000000490.
PURPOSE OF REVIEW: The 2016 WHO classification of tumors of the central nervous system (2016 CNS WHO) features many changes that are relevant to neurologists treating patients with brain tumors as well as neurologists involved in basic, clinical, and epidemiological research. This review summarizes what neurologists need to know and will need to know in the next years. RECENT FINDINGS: The 2016 CNS WHO introduces diagnostic terms that 'integrate' histological and molecular information and suggests presenting diagnoses in a four-layered reporting format. In addition, it utilizes a 'not otherwise specified' designation to identify diagnostic categories that are not precisely defined. A better understanding of the biology of entities further led to changes in the tumor nosology, for example, diffuse gliomas based on IDH gene status. Meaningful molecular subgroups could also be identified in embryonal tumors and other entities. Given the pace of change in the field of brain tumor classification, there will likely be additional practical advances that emerge over the next few years. A new initiative entitled Consortium to Inform Molecular and Practical Approaches to CNS Tumor Taxonomy intends to formulate recommendations between WHO updates. SUMMARY: The 2016 CNS WHO includes major changes in the way brain tumors are classified, with molecular parameters being incorporated into diagnostic criteria for a substantial number of such entities.
目的综述:2016 年世界卫生组织中枢神经系统肿瘤分类(2016 年 CNSWHO)有许多变化,与治疗脑肿瘤的神经科医生以及从事基础、临床和流行病学研究的神经科医生都息息相关。这篇综述总结了神经科医生现在需要了解和在未来几年中需要了解的内容。
最新发现:2016 年 CNSWHO 采用了“整合”组织学和分子信息的诊断术语,并建议采用四层报告格式呈现诊断结果。此外,它还使用了“未特指”的指定来确定未被精确定义的诊断类别。对实体生物学的进一步了解导致肿瘤分类学发生了变化,例如,根据 IDH 基因状态对弥漫性神经胶质瘤进行分类。在胚胎性肿瘤和其他实体肿瘤中也可以识别出有意义的分子亚群。鉴于脑肿瘤分类领域的变化速度,未来几年可能会出现更多的实际进展。一项名为“旨在制定 CNS 肿瘤分类分子和实用方法建议的联盟”的新倡议,旨在在 WHO 更新之间制定建议。
总结:2016 年 CNSWHO 对脑肿瘤的分类方式进行了重大修改,将分子参数纳入了大量此类实体的诊断标准中。
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