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世界卫生组织中枢神经系统肿瘤分类第五版(WHO CNS5):有哪些新变化?

World Health Organization Classification of Tumors of the Central Nervous System 5 Edition (WHO CNS5): What's new?

机构信息

Neuropathology Laboratory, Neurosciences Center, All India Institute of Medical Sciences, New Delhi, India.

Department of Pathology, All India Institute of Medical Sciences, New Delhi, India.

出版信息

Indian J Pathol Microbiol. 2022 May;65(Supplement):S5-S13. doi: 10.4103/ijpm.ijpm_48_22.

Abstract

The latest fifth edition of the World Health Organization classification of central nervous system tumors (WHO CNS5) has been built on the prior WHO 2016 classification as well as recommendations put forward by seven updates of the Consortium to Inform Molecular and Practical Approaches to CNS Tumor Taxonomy (cIMPACT). Various new tumor types and subtypes have been recognized which are of clinical significance. Tumor groups have been restructured and the nomenclature of some tumor types has also been revised. The use of terms 'entity' and 'variant' have been replaced by 'type' and 'subtype'. Significant changes have been introduced in the grading of tumors viz. use of Arabic numerals, grading within individual tumor types and combined histological and molecular grading. The terms 'Not otherwise specified' and 'Not elsewhere classified' can now be used for all tumor types. WHO CNS5 also for the first time endorses the use of DNA methylation profiling for the diagnosis of some tumor types/subtypes. Finally, the importance of combining histology with molecular parameters is emphasized for the "layered reporting" and "integrated diagnosis", which will provide valuable diagnostic, prognostic, and predictive information, as well as for some entities, suggest targeted therapies.

摘要

最新版的世界卫生组织中枢神经系统肿瘤分类(WHO CNS5)是在 2016 年版世界卫生组织分类的基础上,以及由旨在为中枢神经系统肿瘤分类的分子和实用方法提供信息的联盟(cIMPACT)的七次更新提出的建议制定的。已经认识到具有临床意义的各种新的肿瘤类型和亚型。肿瘤群已被重组,一些肿瘤类型的命名法也已被修改。术语“实体”和“变体”已被“类型”和“亚型”取代。肿瘤分级也引入了重大变化,即使用阿拉伯数字、在单个肿瘤类型内分级和结合组织学和分子分级。现在,“未另行说明”和“未分类”可用于所有肿瘤类型。WHO CNS5 还首次认可使用 DNA 甲基化分析来诊断某些肿瘤类型/亚型。最后,强调了将组织学与分子参数相结合的重要性,用于“分层报告”和“综合诊断”,这将提供有价值的诊断、预后和预测信息,并且对于某些实体,还建议进行靶向治疗。

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