From the Department of Pathology, Northwestern University Feinberg School of Medicine, Chicago, Illinois (Brat).
Laboratory of Pathology, National Cancer Institute, Bethesda, Maryland (Aldape).
Arch Pathol Lab Med. 2022 May 1;146(5):547-574. doi: 10.5858/arpa.2021-0295-CP.
CONTEXT.—: The diagnosis and clinical management of patients with diffuse gliomas (DGs) have evolved rapidly over the past decade with the emergence of molecular biomarkers that are used to classify, stratify risk, and predict treatment response for optimal clinical care.
OBJECTIVE.—: To develop evidence-based recommendations for informing molecular biomarker testing for pediatric and adult patients with DGs and provide guidance for appropriate laboratory test and biomarker selection for optimal diagnosis, risk stratification, and prediction.
DESIGN.—: The College of American Pathologists convened an expert panel to perform a systematic review of the literature and develop recommendations. A systematic review of literature was conducted to address the overarching question, "What ancillary tests are needed to classify DGs and sufficiently inform the clinical management of patients?" Recommendations were derived from quality of evidence, open comment feedback, and expert panel consensus.
RESULTS.—: Thirteen recommendations and 3 good practice statements were established to guide pathologists and treating physicians on the most appropriate methods and molecular biomarkers to include in laboratory testing to inform clinical management of patients with DGs.
CONCLUSIONS.—: Evidence-based incorporation of laboratory results from molecular biomarker testing into integrated diagnoses of DGs provides reproducible and clinically meaningful information for patient management.
在过去十年中,随着分子生物标志物的出现,弥漫性神经胶质瘤(DG)患者的诊断和临床管理迅速发展,这些生物标志物用于对患者进行分类、分层风险,并预测治疗反应,以实现最佳临床护理。
为儿科和成人 DG 患者的分子生物标志物检测制定循证建议,并为最佳诊断、风险分层和预测提供适当的实验室检测和生物标志物选择的指导。
美国病理学家学院召集了一个专家小组,对文献进行系统回顾并制定建议。对文献进行了系统回顾,以解决总体问题,“需要哪些辅助检测来对 DG 进行分类,并充分为患者的临床管理提供信息?”建议来自证据质量、公开意见反馈和专家小组共识。
确定了 13 项建议和 3 项良好实践声明,以指导病理学家和治疗医生选择最合适的方法和分子生物标志物纳入实验室检测,为 DG 患者的临床管理提供信息。
将来自分子生物标志物检测的实验室结果纳入 DG 的综合诊断中,为患者管理提供了可重复且具有临床意义的信息。