Department of Neurosurgery, The Aga Khan University, Karachi, Pakistan.
The Aga Khan Medical College and University, Karachi, Pakistan.
J Pak Med Assoc. 2024 Mar;74(3 (Supple-3)):S93-S99. doi: 10.47391/JPMA.S3.GNO-11.
Low-grade gliomas (LGG) are brain tumors of glial cells origin. They are grade 1 and grade 2 tumors according to the WHO classification. Diagnosis of LGG is made through imaging, histopathological analysis, and use of molecular markers. Imaging alone does not establish the grade of the tumor and thus a histopathological examination of tissue is crucial in establishing the definite histopathological diagnosis. Clinical presentation varies according to the location and size of the tumor. Surgical resection is strongly recommended in LGG over observation to improve overall survival as surgery leads to greater benefit due to progression-free survival. Radiation has shown benefits in LGG patients in randomized controlled trials and chemotherapy with temozolomide has also shown good results. This paper covers the principles of low-grade gliomas management and summarizes the recommendations for the LMICs.
低级别胶质瘤(LGG)是源自神经胶质细胞的脑肿瘤。根据世界卫生组织(WHO)的分类,它们属于 1 级和 2 级肿瘤。LGG 的诊断是通过影像学、组织病理学分析和分子标志物来完成的。仅通过影像学并不能确定肿瘤的级别,因此组织的组织病理学检查对于确定明确的组织病理学诊断至关重要。临床表现取决于肿瘤的位置和大小。对于 LGG,强烈建议进行手术切除而非观察,以提高总体生存率,因为手术可以通过无进展生存期带来更大的获益。在随机对照试验中,放疗对 LGG 患者显示出益处,替莫唑胺化疗也取得了良好的效果。本文涵盖了低级别胶质瘤管理的原则,并总结了对中低收入国家的建议。