Department of Pediatric Laboratory Medicine, Hospital for Sick Children, Toronto, ON, Canada.
Arthur and Sonia Labatt Brain Tumour Research Centre, Hospital for Sick Children, Toronto, Canada.
Childs Nerv Syst. 2024 Oct;40(10):3223-3228. doi: 10.1007/s00381-024-06639-7. Epub 2024 Oct 8.
Over the past decade, our understanding of the molecular drivers of pediatric low-grade glioma (PLGG) has expanded dramatically. These tumors are predominantly driven by RAS/MAPK pathway activating alterations (fusions and point mutations), most frequently in BRAF, FGFR1, and NF1. Furthermore, additional second hits in tumor suppressor genes (TP53, ATRX, CDKN2A) can portend more aggressive behaviour. Accordingly, comprehensive molecular profiling-specifically genetic sequencing, often plus copy number profiling-has become critical for guiding the diagnosis and management of PLGG. In this review, we discuss the most important genetic alterations that inform on classification and prognosis of PLGG, highlighting their diagnostic and therapeutic relevance.
在过去的十年中,我们对儿童低级别胶质瘤 (PLGG) 的分子驱动因素的理解有了显著的扩展。这些肿瘤主要由 RAS/MAPK 通路激活改变(融合和点突变)驱动,最常见的是 BRAF、FGFR1 和 NF1。此外,肿瘤抑制基因(TP53、ATRX、CDKN2A)的额外二次打击可能预示着更具侵袭性的行为。因此,全面的分子分析——特别是遗传测序,通常还包括拷贝数分析——对于指导 PLGG 的诊断和管理至关重要。在这篇综述中,我们讨论了对 PLGG 的分类和预后有重要影响的最主要的遗传改变,强调了它们的诊断和治疗相关性。