Dang Mai, Phillips Peter C
Continuum (Minneap Minn). 2017 Dec;23(6, Neuro-oncology):1727-1757. doi: 10.1212/CON.0000000000000545.
This article describes the most common pediatric brain tumors and highlights recent developments in their diagnosis and treatment strategies.
We are in the midst of a molecular era for pediatric brain tumors. Genetic and epigenetic profiling of tumors has impacted their diagnosis, allowing for the subgrouping of heterogeneous tumor groups and leading to the complete renaming of some tumor types. These advances are reflected in the new 2016 World Health Organization classification. For example, primitive neuroectodermal tumors have been completely eliminated and replaced by subgroups defined by the absence or presence of specific chromosomal amplification. Medulloblastomas, diffuse astrocytomas, and ependymomas now have specific subtypes that are based on defining molecular features. More recent epigenetic-based subgrouping of atypical teratoid/rhabdoid tumors have not yet made it into the official classification system, but will surely have an impact on how these tumors are regarded in future preclinical and clinical trials.
Genetic and epigenetic data are changing how pediatric brain tumors are diagnosed, are leading to new guidelines for how treatment outcome analyses can be organized, and are offering molecular targets that can be used for the development of novel therapies.
本文描述了最常见的儿童脑肿瘤,并重点介绍了其诊断和治疗策略的最新进展。
我们正处于儿童脑肿瘤的分子时代。肿瘤的基因和表观遗传分析对其诊断产生了影响,使得异质性肿瘤群体得以细分,并导致一些肿瘤类型被重新命名。这些进展反映在2016年世界卫生组织的新分类中。例如,原始神经外胚层肿瘤已被完全剔除,取而代之的是根据特定染色体扩增的有无来定义的亚组。髓母细胞瘤、弥漫性星形细胞瘤和室管膜瘤现在都有基于特定分子特征的亚型。最近基于表观遗传学的非典型畸胎样/横纹肌样肿瘤亚组划分尚未纳入官方分类系统,但肯定会对这些肿瘤在未来临床前和临床试验中的认识产生影响。
基因和表观遗传数据正在改变儿童脑肿瘤的诊断方式,为治疗结果分析的组织方式带来新的指导方针,并提供可用于开发新疗法的分子靶点。