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新的中枢神经系统肿瘤分类:在小儿神经外科实践中的重要性。

New CNS tumor classification: The importance in pediatric neurosurgical practice.

作者信息

Del Río Ramiro José, Cicutti Santiago Ezequiel, Moreira Daniel C, Ramos Javier Danilo Gonzalez

机构信息

Department of Neurosurgery, Hospital de Pediatría Juan P. Garrahan, Ciudad Autónoma de Buenos Aires, Argentina.

Department of Oncology, St. Jude Children's Research Hospital, Memphis, United States.

出版信息

Surg Neurol Int. 2024 Apr 12;15:130. doi: 10.25259/SNI_681_2023. eCollection 2024.

Abstract

BACKGROUND

The management of the central nervous system (CNS) tumors in the pediatric population is crucial in neurosurgical practice. The World Health Organization (WHO) has evolved its classification of CNS tumors from the 19 century to the 5 edition, published in 2021, incorporating molecular advancements. This transition from morphology to molecular characterization is ongoing.

METHODS

This manuscript analyzes the modifications introduced in the 5 edition of WHO's CNS tumor classification, particularly focusing on pediatric tumor families. The paper integrates clinical, morphological, and molecular information, aiming to guide pediatric neurosurgeons in their daily practice and interdisciplinary discussions.

RESULTS

The 5 edition of the WHO classification introduces a hybrid taxonomy that incorporates both molecular and histological components. The terminology shifts from "entity" to "type" and "subtype," aiming to standardize terminology. Tumor grading experiences changes, integrating molecular biomarkers for prognosis. The concept of integrated layered diagnosis is emphasized, where molecular and histological information is combined systematically.

CONCLUSION

The 5 edition of the WHO CNS classification signifies a paradigm shift toward molecular characterization. The incorporation of molecular advances, the layered diagnostic approach, and the inclusion of clinical, morphological, and molecular information aim to provide comprehensive insights into pediatric CNS tumors. This classification offers valuable guidance for pediatric neurosurgeons, aiding in precise diagnosis and treatment planning for these complex neoplasms.

摘要

背景

小儿中枢神经系统(CNS)肿瘤的管理在神经外科实践中至关重要。世界卫生组织(WHO)已将其CNS肿瘤分类从19世纪发展到2021年发布的第5版,纳入了分子学进展。这种从形态学向分子特征的转变仍在进行中。

方法

本手稿分析了WHO中枢神经系统肿瘤分类第5版中引入的修改,特别关注小儿肿瘤类别。本文整合了临床、形态学和分子信息,旨在指导小儿神经外科医生的日常实践和跨学科讨论。

结果

WHO第5版分类引入了一种结合分子和组织学成分的混合分类法。术语从“实体”转变为“类型”和“亚型”,旨在使术语标准化。肿瘤分级发生了变化,纳入了用于预后的分子生物标志物。强调了综合分层诊断的概念,即系统地结合分子和组织学信息。

结论

WHO中枢神经系统分类第5版标志着向分子特征的范式转变。分子学进展的纳入、分层诊断方法以及临床、形态学和分子信息的纳入旨在全面了解小儿中枢神经系统肿瘤。这种分类为小儿神经外科医生提供了有价值的指导,有助于对这些复杂肿瘤进行精确诊断和治疗规划。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/37af/11090558/810fcd2cff70/SNI-15-130-g001.jpg

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