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《世界卫生组织2016年中枢神经系统肿瘤分类更新概述》

A Simplified Overview of World Health Organization Classification Update of Central Nervous System Tumors 2016.

作者信息

Gupta Anshu, Dwivedi Tanima

机构信息

Department of Emergency Laboratory, Institute of Human Behaviour and Allied Sciences (IHBAS), Delhi, India.

Department of Pathology and Emergency Laboratory, Institute of Human Behaviour and Allied Sciences (IHBAS), Delhi, India.

出版信息

J Neurosci Rural Pract. 2017 Oct-Dec;8(4):629-641. doi: 10.4103/jnrp.jnrp_168_17.

Abstract

After 8 years, an update of central nervous system (CNS) tumors was published in 2016 after 2007. First time ever, molecular markers along with histology have been used in classification of any tumor. Major changes are seen in glioma and medulloblastoma groups. Few entities have been added such as diffuse midline glioma, H3 K27M-mutant, RELA fusion-positive ependymoma, embryonal tumor with multilayered rosettes, C19MC-altered, and hybrid nerve sheath tumors. Few variants and patterns that no longer have diagnostic and/or biological relevance and have been deleted such as glioblastoma cerebri, protoplasmic and fibrillary astrocytoma, and cellular ependymoma. Other changes include deletion of term "primitive neuroectodermal tumor," addition of criterion of brain invasion in atypical meningioma, separation of melanotic schwannoma from other schwannoma, and combination of solitary fibrous tumors and hemangiopericytoma as one entity. There is also expansion of entities in nerve sheath tumors and hematopoietic/lymphoid tumors of the CNS. In this review article, we tried to review CNS tumors 2016 classification update in a simplified manner; comparing the differences between 2016 and 2007 CNS tumors classifications with brief description of important molecular markers and finally utility as well as challenges of this classification.

摘要

8年后,2016年在2007年之后发布了中枢神经系统(CNS)肿瘤的更新内容。有史以来第一次,分子标志物与组织学一起被用于任何肿瘤的分类。在胶质瘤和髓母细胞瘤组中可见重大变化。增加了一些实体,如弥漫性中线胶质瘤、H3 K27M突变型、RELA融合阳性室管膜瘤、具有多层玫瑰花结的胚胎性肿瘤、C19MC改变型以及混合性神经鞘瘤。删除了一些不再具有诊断和/或生物学相关性的变体和模式,如大脑胶质母细胞瘤、原浆性和纤维性星形细胞瘤以及细胞性室管膜瘤。其他变化包括删除“原始神经外胚层肿瘤”一词、在非典型脑膜瘤中增加脑侵袭标准、将黑色素性神经鞘瘤与其他神经鞘瘤区分开来,以及将孤立性纤维性肿瘤和血管外皮细胞瘤合并为一个实体。中枢神经系统的神经鞘瘤和造血/淋巴肿瘤中的实体也有所扩展。在这篇综述文章中,我们试图以简化方式回顾2016年中枢神经系统肿瘤分类更新;比较2016年和2007年中枢神经系统肿瘤分类之间的差异,并简要描述重要的分子标志物,最后阐述该分类的实用性以及挑战。

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