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多形性胶质母细胞瘤的概念与历史——形态学、遗传学和表观遗传学

On the Concepts and History of Glioblastoma Multiforme - Morphology, Genetics and Epigenetics.

作者信息

Stoyanov George St, Dzhenkov Deyan L

机构信息

Department of General and Clinical Pathology, Forensic Medicine and Deontology, Prof Dr. Paraskev Stoyanov Medical University, Varna, Bulgaria.

出版信息

Folia Med (Plovdiv). 2018 Mar 1;60(1):48-66. doi: 10.1515/folmed-2017-0069.

Abstract

Glioblastoma multiforme (GBM) is a grade IV WHO malignant tumor with astrocytic differentiation. As one of the most common clinically diagnosed central nervous system (CNS) oncological entries, there have been a wide variety of historical reports of the description and evolution of ideas regarding these tumors. The first recorded reports of gliomas were given in British scientific reports, by Berns in 1800 and in 1804 by Abernety, with the first comprehensive histomorphological description being given in 1865 by Rudolf Virchow. In 1926 Percival Bailey and Harvey Cushing gave the base for the modern classification of gliomas. Between 1934 and 1941 the most prolific researcher in glioma research was Hans-Joachim Scherer, who postulated some of the clinico-morphological aspects of GBM. With the introduction of molecular and genetic tests the true multifomity of GBM has been established, with different genotypes bearing the same histomorphological and IHC picture, as well as some of the aspects of gliomagenesis. For a GBM to develop, a specific trigger mutation needs to occur in a GBM stem cell - primary GBM, or a slow aggregation of individual mutations, without a distinct trigger mutation - secondary GBM. Knowledge of GBM has been closely related to general medical knowledge of the CNS since these malignancies were first described more than 200 years ago. Several great leaps have been made in that time, in the footsteps of both CNS and advancements in general medical knowledge.

摘要

多形性胶质母细胞瘤(GBM)是世界卫生组织(WHO)分级为IV级的具有星形胶质细胞分化的恶性肿瘤。作为临床诊断中最常见的中枢神经系统(CNS)肿瘤之一,关于这些肿瘤的描述和观念演变有着各种各样的历史报道。最早记录的胶质瘤报告发表在英国科学报告中,1800年由伯恩斯(Berns)发表,1804年由阿伯内蒂(Abernety)发表,鲁道夫·魏尔啸(Rudolf Virchow)于1865年给出了首个全面的组织形态学描述。1926年,珀西瓦尔·贝利(Percival Bailey)和哈维·库欣(Harvey Cushing)奠定了现代胶质瘤分类的基础。1934年至1941年间,胶质瘤研究领域最多产的研究者是汉斯 - 约阿希姆·谢勒(Hans-Joachim Scherer),他提出了多形性胶质母细胞瘤的一些临床形态学特征。随着分子和基因检测的引入,多形性胶质母细胞瘤真正的多形性得以确立,不同的基因型具有相同的组织形态学和免疫组化特征,以及胶质瘤发生的一些方面。对于多形性胶质母细胞瘤的发生,需要在多形性胶质母细胞瘤干细胞中发生特定的触发突变——原发性多形性胶质母细胞瘤,或者是单个突变的缓慢聚集,而没有明显的触发突变——继发性多形性胶质母细胞瘤。自从这些恶性肿瘤在200多年前首次被描述以来,多形性胶质母细胞瘤的知识一直与中枢神经系统的一般医学知识密切相关。在那段时间里,沿着中枢神经系统和一般医学知识进步的脚步,已经取得了几次重大飞跃。

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