Picca Alberto, Berzero Giulia, Sanson Marc
AP-HP Groupe Hospitalier Pitié-Salpêtrière, service de Neurologie 2-Mazarin, Paris, France; Neuroscience Consortium, University of Pavia, Monza Policlinico and Pavia Mondino, Italy.
AP-HP Pitié-Salpêtrière, Service de Neurologie 2-Mazarin, 47-83 Boulevard de l'Hôpital, 75013 Paris, France and Université Pierre et Marie Curie, Paris VI, Institut du Cerveau et de la Moelle Epinière, INSERM CNRS U1127, UMR 7225, Paris, France.
Ther Adv Neurol Disord. 2018 Jan 17;11:1756285617752039. doi: 10.1177/1756285617752039. eCollection 2018.
The 2016 WHO classification of Tumors of the Central Nervous System brought major conceptual and practical changes in the classification of diffuse gliomas, by combining molecular features and histology into 'integrated' diagnoses. In diffuse gliomas, molecular profiling has thus become essential for nosological purposes, as well as to plan adequate treatment strategies and identify patients susceptible of target therapy. WHO grade II (low grade) and grade III (anaplastic) diffuse gliomas form a heterogeneous group of neoplasms, also known as 'lower-grade gliomas', characterized by a wide range of malignant potential. Molecular profile accounts for this biological diversity, and provides an accurate prognostic stratification of tumors in this group. Treatment strategies in lower-grade gliomas are ultimately based on molecular profile and WHO grade, as well as on patient characteristics such as age and Karnofsky performance status. The purpose of this review is to summarize recent advances in the classification of grade II and III gliomas, synthesize current treatment schemes according to molecular profile and describe ongoing research and future perspectives for the use of target therapies.
2016年世界卫生组织中枢神经系统肿瘤分类通过将分子特征和组织学结合为“综合”诊断，给弥漫性胶质瘤的分类带来了重大的概念和实践变革。在弥漫性胶质瘤中，分子谱分析因此对于疾病分类、制定适当的治疗策略以及识别适合靶向治疗的患者变得至关重要。世界卫生组织二级（低级别）和三级（间变性）弥漫性胶质瘤构成了一组异质性肿瘤，也被称为“低级别胶质瘤”，其特征是具有广泛的恶性潜能。分子谱解释了这种生物学多样性，并为该组肿瘤提供了准确的预后分层。低级别胶质瘤的治疗策略最终基于分子谱、世界卫生组织分级以及患者特征，如年龄和卡诺夫斯基功能状态。本综述的目的是总结二级和三级胶质瘤分类的最新进展，根据分子谱综合当前的治疗方案，并描述正在进行的研究以及靶向治疗应用的未来前景。
