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施万细胞瘤的分类及“神经纤维瘤病2型”的新命名规范:遗传学进展与国际共识推荐

Classification of schwannomas and the new naming convention for "neurofibromatosis-2": Genetic updates and international consensus recommendation.

作者信息

Rai Pranjal, Bathla Girish, Soni Neetu, Desai Amit, Rao Dinesh, Vibhute Prasanna, Agarwal Amit

机构信息

Department of Radiology, Tata Memorial Hospital, India.

Department of Radiology, Mayo Clinic, USA.

出版信息

Neuroradiol J. 2025 Jan 9:19714009251313510. doi: 10.1177/19714009251313510.

Abstract

Despite their similar nomenclature, Neurofibromatosis type 1 (NF1) and "Neurofibromatosis type 2" are discrete and clinically distinguishable entities. The name of "neurofibromatosis type 2" has been changed to NF2-related schwannomatosis, to reflect the fact that neurofibromas do not occur in this syndrome and therefore the name "Neurofibromatosis" is factually incorrect. Furthermore, multiple schwannomas, a hallmark feature of NF2, can also occur in patients with mutations in genes including SMARCB1 and LZTR1, all exhibiting overlapping clinical features. Current understanding suggests that schwannomatosis (SWN) encompasses a range of clinical presentations consisting of clearly defined, separate subtypes which share a common phenotype of schwannomas. Recognizing these newly emerging subtypes, the International Consensus Group on Neurofibromatosis Diagnostic Criteria (I-NF-DC) proposed a revised nomenclature for NF2 and related disorders in 2022. This review article focuses on this critical update in diagnostic terminology, highlighting the key gene-related SWN subtypes relevant to neuroradiologists. By emphasizing molecular testing alongside clinical features, the revised system facilitates a more precise diagnosis, potentially paving the way for personalized treatment strategies. Additionally, the flexible structure accommodates future discoveries of genes associated with SWN.

摘要

尽管1型神经纤维瘤病(NF1)和“2型神经纤维瘤病”名称相似,但它们是不同的且在临床上可区分的实体。“2型神经纤维瘤病”的名称已改为NF2相关的神经鞘瘤病,以反映该综合征中不会出现神经纤维瘤这一事实,因此“神经纤维瘤病”这一名称实际上并不准确。此外,多发性神经鞘瘤是NF2的一个标志性特征,也可出现在包括SMARCB1和LZTR1等基因突变的患者中,所有这些都表现出重叠的临床特征。目前的认识表明,神经鞘瘤病(SWN)包括一系列临床表现,由明确界定的、不同的亚型组成,这些亚型具有神经鞘瘤的共同表型。认识到这些新出现的亚型,国际神经纤维瘤病诊断标准共识小组(I-NF-DC)在2022年提出了NF2及相关疾病的修订命名法。这篇综述文章重点关注诊断术语的这一关键更新,强调与神经放射科医生相关的关键基因相关SWN亚型。通过强调分子检测以及临床特征,修订后的系统有助于更精确的诊断,可能为个性化治疗策略铺平道路。此外,灵活的结构能够适应未来与SWN相关基因的发现。

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