Department of Neurosurgery, Faculty of Medicine, Yamagata University, 2-2-2, Iida-Nishi, Yamagata, 990-9585, Japan.
Department of Human Pathology, Gunma University Graduate School of Medicine, Maebashi, Japan.
Brain Tumor Pathol. 2019 Apr;36(2):56-62. doi: 10.1007/s10014-019-00337-y. Epub 2019 Mar 7.
The publication of the 2016 World Health Organization Classification of Tumors of the Central Nervous System (2016 WHO CNS) represented a major change in the classification of brain tumors. However, many pathologists in Japan cannot diagnose astrocytic or oligodendroglial tumors according to the 2016 WHO CNS due to financial or technical problems. Therefore, the Japan Society of Brain Tumor Pathology established a committee for molecular diagnosis to facilitate the integrated diagnosis of astrocytic and oligodendroglial tumors in Japan. We created three levels of diagnoses: Level 1 was defined as simple histopathological diagnosis using hematoxylin and eosin staining and routine cell lineage-based immunostaining. Level 2 was defined as immunohistochemical diagnosis using immunohistochemical examinations using R132H mutation-specific IDH1, ATRX, and/or p53 antibodies. Level 3 was defined as molecular diagnosis, such as diagnosis based on 1p/19q status or the mutation status of the IDH1 and IDH2 genes. In principle, astrocytic and oligodendroglial tumors should be diagnosed based on the 2016 WHO CNS and/or cIMPACT-NOW criteria; however, the findings obtained through our diagnostic flowchart can be added to the histological diagnosis in parentheses. This classification system would be helpful for pathologists with limited resources.
2016 年世界卫生组织中枢神经系统肿瘤分类（2016 年 WHO CNS）的出版标志着脑肿瘤分类的重大变化。然而，由于财务或技术问题，许多日本病理学家无法根据 2016 年 WHO CNS 诊断星形细胞瘤或少突胶质细胞瘤。因此，日本脑肿瘤病理学学会成立了一个分子诊断委员会，以促进日本星形细胞瘤和少突胶质细胞瘤的综合诊断。我们创建了三个级别的诊断：一级定义为使用苏木精和伊红染色和基于常规细胞谱系的免疫组化进行简单的组织病理学诊断。二级定义为使用 R132H 突变特异性 IDH1、ATRX 和/或 p53 抗体进行免疫组化诊断。三级定义为分子诊断，例如基于 1p/19q 状态或 IDH1 和 IDH2 基因突变状态的诊断。原则上，星形细胞瘤和少突胶质细胞瘤应根据 2016 年 WHO CNS 和/或 cIMPACT-NOW 标准进行诊断；然而，通过我们的诊断流程图获得的结果可以添加到括号中的组织学诊断中。该分类系统将有助于资源有限的病理学家。
