2021年世界卫生组织中枢神经系统肿瘤分类（第五版）整合及分层诊断解读

doi:10.3969/j.issn.1672-6731.2021.09.006

中国现代神经疾病杂志 ›› 2021, Vol. 21 ›› Issue (9): 764-768. doi: 10.3969/j.issn.1672-6731.2021.09.006

• 2021年WHO中枢神经系统肿瘤分类（第五版）解读 • 上一篇下一篇

2 2021年世界卫生组织中枢神经系统肿瘤分类（第五版）整合及分层诊断解读

杨学军¹, 陈宏², 李佳博³, 孙翠云⁴, 尹洪芳⁵

1 102218 清华大学附属北京清华长庚医院神经外科;
2 102218 清华大学附属北京清华长庚医院病理科;
3 200040 上海, 复旦大学附属华山医院病理科;
4 300052 天津医科大学总医院神经外科;
5 300052 天津医科大学总医院神经病理科

收稿日期:2021-08-31 出版日期:2021-09-25 发布日期:2021-10-09
通讯作者: 杨学军,Email:ydenny@126.com

Integrated and layered diagnoses in the 2021 WHO Classification of Tumors of the Central Nervous System (fifth edition)

YANG Xue-jun¹, CHEN Hong², LI Jia-bo³, SUN Cui-yun⁴, YIN Hong-fang⁵

1 Department of Neurosurgery, Beijing Tsinghua Changgung Hospital, Affiliated Hosptital of Tsinghua University, Beijing 102218, China;
2 Department of Pathology, Beijing Tsinghua Changgung Hospital, Affiliated Hosptital of Tsinghua University, Beijing 102218, China;
3 Department of Pathology, Huashan Hospital, Fudan University, Shanghai 200040, China;
4 Department of Neurosugery, Tianjin Medical University General Hospital, Tianjin 300052, China;
5 Department of Neuropathology, Tianjin Medical University General Hospital, Tianjin 300052, China

Received:2021-08-31 Online:2021-09-25 Published:2021-10-09
Contact: 10.3969/j.issn.1672-6731.2021.09.006

摘要/Abstract

摘要：

中枢神经系统肿瘤整合及分层诊断的提出是基于分子信息在中枢神经系统肿瘤分类中重要性日益增加的需要。2021年世界卫生组织中枢神经系统肿瘤分类（第五版，简称新版肿瘤分类）在第四版修订版的基础上，为展现全部可用的诊断信息，提出诊断报告需第一层给出整合诊断，然后依次为组织病理学分类、WHO分级和分子信息。本文针对新版肿瘤分类的整合及分层诊断要求进行解读。

关键词: 中枢神经系统肿瘤, 指南, 世界卫生组织, 诊断, 病理学, 分子, 综述

Abstract:

The integrated and layered diagnoses of central nervous system tumors is based on the growing importance of molecular information in the classification of central nervous system tumors. The 2021 WHO Classification of Tumors of the Central Nervous System (fifth edition) updated the integrated and layered diagnoses methods based on the previous version of the WHO tumors classification (fourth revised version). Layered report feature an integrated diagnosis at the top, followed by layers that display histopathological classification, WHO classification and molecular information. This review mainly focuses on the interpretation of the integrated diagnosis and grading of central nervous system tumors in the new edition tumors classification.

Key words: Central nervous system neoplasms, Guidelines, World Health Organization, Diagnosis, Pathology, molecular, Review

杨学军, 陈宏, 李佳博, 孙翠云, 尹洪芳. 2021年世界卫生组织中枢神经系统肿瘤分类（第五版）整合及分层诊断解读[J]. 中国现代神经疾病杂志, 2021, 21(9): 764-768.

YANG Xue-jun, CHEN Hong, LI Jia-bo, SUN Cui-yun, YIN Hong-fang. Integrated and layered diagnoses in the 2021 WHO Classification of Tumors of the Central Nervous System (fifth edition)[J]. Chinese Journal of Contemporary Neurology and Neurosurgery, 2021, 21(9): 764-768.

http://journal11.magtechjournal.com/cjcnn/CN/Y2021/V21/I9/764

参考文献

[1] Louis DN, Perry A, Burger P, Ellison DW, Reifenberger G, von Deimling A, Aldape K, Brat D, Collins VP, Eberhart C, Figarella-Branger D, Fuller GN, Giangaspero F, Giannini C, Hawkins C, Kleihues P, Korshunov A, Kros JM, Beatriz Lopes M, Ng HK, Ohgaki H, Paulus W, Pietsch T, Rosenblum M, Rushing E, Soylemezoglu F, Wiestler O, Wesseling P. International society of neuropathology:Haarlem consensus guidelines for nervous system tumor classification and grading[J]. Brain Pathol, 2014, 24:429-435.
[2] Yang XJ, Jiang T. Interpretation of 《The 2016 World Health Organization classification of tumors of the central nervous system》[J]. Zhongguo Shen Jing Jing Shen Ji Bing Za Zhi, 2016, 42:321-329. [杨学军, 江涛. 解读《世界卫生组织中枢神经系统肿瘤分类(2016年)》[J]. 中国神经精神疾病杂志, 2016, 42:321-329.]
[3] Liu X, Chen HY, Zou WJ, Li GL. Interpretation on the diagnostic molecular parameters in the 2021 WHO Classification of Tumors of the Central Nervous System (fifth edition)[J]. Zhongguo Xian Dai Shen Jing Ji Bing Za Zhi, 2021, 21:751-763. [刘幸, 陈慧媛, 邹婉婧, 李桂林. 2021年世界卫生组织中枢神经系统肿瘤分类(第五版)分子诊断指标解读[J]. 中国现代神经疾病杂志, 2021, 21:751-763.]
[4] Louis DN, Perry A, Wesseling P, Brat DJ, Cree IA, Figarella-Branger D, Hawkins C, Ng HK, Pfister SM, Reifenberger G, Soffietti R, von Deimling A, Ellison DW. The 2021 WHO classification of tumors of the central nervous system:a summary[J]. Neuro Oncol, 2021, 23:1231-1251.
[5] Louis DN, Perry A, Reifenberger G, von Deimling A, Figarella-Branger D, Cavenee WK, Ohgaki H, Wiestler OD, Kleihues P, Ellison DW. The 2016 World Health Organization classification of tumors of the central nervous system:a summary[J]. Acta Neuropathol, 2016, 131:803-820.
[6] Louis DN, Wesseling P, Aldape K, Brat DJ, Capper D, Cree IA, Eberhart C, Figarella-Branger D, Fouladi M, Fuller GN, Giannini C, Haberler C, Hawkins C, Komori T, Kros JM, Ng HK, Orr BA, Park SH, Paulus W, Perry A, Pietsch T, Reifenberger G, Rosenblum M, Rous B, Sahm F, Sarkar C, Solomon DA, Tabori U, van den Bent MJ, von Deimling A, Weller M, White VA, Ellison DW. cIMPACT-NOW update 6:new entity and diagnostic principle recommendations of the cIMPACT-Utrecht meeting on future CNS tumor classification and grading[J]. Brain Pathol, 2020, 30:844-856.
[7] Clarke M, Mackay A, Ismer B, Pickles JC, Tatevossian RG, Newman S, Bale TA, Stoler I, Izquierdo E, Temelso S, Carvalho DM, Molinari V, Burford A, Howell L, Virasami A, Fairchild AR, Avery A, Chalker J, Kristiansen M, Haupfear K, Dalton JD, Orisme W, Wen J, Hubank M, Kurian KM, Rowe C, Maybury M, Crosier S, Knipstein J, Schüller U, Kordes U, Kram DE, Snuderl M, Bridges L, Martin AJ, Doey LJ, Al-Sarraj S, Chandler C, Zebian B, Cairns C, Natrajan R, Boult JKR, Robinson SP, Sill M, Dunkel IJ, Gilheeney SW, Rosenblum MK, Hughes D, Proszek PZ, Macdonald TJ, Preusser M, Haberler C, Slavc I, Packer R, Ng HK, Caspi S, Popovi? M, Faganel Kotnik B, Wood MD, Baird L, Davare MA, Solomon DA, Olsen TK, Brandal P, Farrell M, Cryan JB, Capra M, Karremann M, Schittenhelm J, Schuhmann MU, Ebinger M, Dinjens WNM, Kerl K, Hettmer S, Pietsch T, Andreiuolo F, Driever PH, Korshunov A, Hiddingh L, Worst BC, Sturm D, Zuckermann M, Witt O, Bloom T, Mitchell C, Miele E, Colafati GS, Diomedi-Camassei F, Bailey S, Moore AS, Hassall TEG, Lowis SP, Tsoli M, Cowley MJ, Ziegler DS, Karajannis MA, Aquilina K, Hargrave DR, Carceller F, Marshall LV, von Deimling A, Kramm CM, Pfister SM, Sahm F, Baker SJ, Mastronuzzi A, Carai A, Vinci M, Capper D, Popov S, Ellison DW, Jacques TS, Jones DTW, Jones C. Infant high-grade gliomas comprise multiple subgroups characterized by novel targetable gene fusions and favorable outcomes[J]. Cancer Discov, 2020, 10:942-963.
[8] Guerreiro Stucklin AS, Ryall S, Fukuoka K, Zapotocky M, Lassaletta A, Li C, Bridge T, Kim B, Arnoldo A, Kowalski PE, Zhong Y, Johnson M, Li C, Ramani AK, Siddaway R, Nobre LF, de Antonellis P, Dunham C, Cheng S, Boué DR, Finlay JL, Coven SL, de Prada I, Perez-Somarriba M, Faria CC, Grotzer MA, Rushing E, Sumerauer D, Zamecnik J, Krskova L, Garcia Ariza M, Cruz O, Morales La Madrid A, Solano P, Terashima K, Nakano Y, Ichimura K, Nagane M, Sakamoto H, Gil-da-Costa MJ, Silva R, Johnston DL, Michaud J, Wilson B, van Landeghem FKH, Oviedo A, McNeely PD, Crooks B, Fried I, Zhukova N, Hansford JR, Nageswararao A, Garzia L, Shago M, Brudno M, Irwin MS, Bartels U, Ramaswamy V, Bouffet E, Taylor MD, Tabori U, Hawkins C. Alterations in ALK/ROS1/NTRK/MET drive a group of infantile hemispheric gliomas[J]. Nat Commun, 2019, 10:4343.
[9] Ellison DW, Hawkins C, Jones DTW, Onar-Thomas A, Pfister SM, Reifenberger G, Louis DN. cIMPACT-NOW update 4:diffuse gliomas characterized by MYB, MYBL1, or FGFR1 alterations or BRAFV600E mutation[J]. Acta Neuropathol, 2019, 137:683-687.
[10] Louis DN, Wesseling P, Paulus W, Giannini C, Batchelor TT, Cairncross JG, Capper D, Figarella-Branger D, Lopes MB, Wick W, van den Bent M. cIMPACT-NOW update 1:not otherwise specified (NOS) and not elsewhere classified (NEC)[J]. Acta Neuropathol, 2018, 135:481-484.
[11] Louis DN, Ellison DW, Brat DJ, Aldape K, Capper D, Hawkins C, Paulus W, Perry A, Reifenberger G, Figarella-Branger D, von Deimling A, Wesseling P. cIMPACT-NOW:a practical summary of diagnostic points from Round 1 updates[J]. Brain Pathol, 2019, 29:469-472.
[12] Louis DN, von Deimling A. Grading of diffuse astrocytic gliomas:Broders, Kernohan, Zülch, the WHO… and Shakespeare[J]. Acta Neuropathol, 2017, 134:517-520.
[13] Yang XJ, Ma WB. Clinical interpretation of the diagnosis and treatment standard of glioma[M]. Beijing:People's Medical Publishing House, 2021. [杨学军, 马文斌. 脑胶质瘤诊疗规范临床解读[M]. 北京:人民卫生出版社, 2021.]
[14] Brat DJ, Aldape K, Colman H, Figrarella-Branger D, Fuller GN, Giannini C, Holland EC, Jenkins RB, Kleinschmidt-DeMasters B, Komori T, Kros JM, Louis DN, McLean C, Perry A, Reifenberger G, Sarkar C, Stupp R, van den Bent MJ, von Deimling A, Weller M. cIMPACT-NOW update 5:recommended grading criteria and terminologies for IDH-mutant astrocytomas[J]. Acta Neuropathol, 2020, 139:603-608.
[15] Brat DJ, Aldape K, Colman H, Holland EC, Louis DN, Jenkins RB, Kleinschmidt-DeMasters BK, Perry A, Reifenberger G, Stupp R, von Deimling A, Weller M. cIMPACTρ-NOW update 3:recommended diagnostic criteria for "Diffuse astrocytic glioma, IDH-wildtype, with molecular features of glioblastoma, WHO grade Ⅳ"[J]. Acta Neuropathol, 2018, 136:805-810.

选择文件类型/文献管理软件名称

选择包含的内容

2 2021年世界卫生组织中枢神经系统肿瘤分类（第五版）整合及分层诊断解读

Integrated and layered diagnoses in the 2021 WHO Classification of Tumors of the Central Nervous System (fifth edition)

RichHTML

PDF

可视化

被引次数

摘要/Abstract

引用本文

使用本文

参考文献

相关文章 15

编辑推荐

Metrics

本文评价

[1]	薛蓉, 张轩. 睡眠障碍对脑血管病的影响[J]. 中国现代神经疾病杂志, 2023, 23(8): 659-662.
[2]	张鹏, 陈涛, 许莉. 成人失眠认知行为疗法关键技术与流程改进建议[J]. 中国现代神经疾病杂志, 2023, 23(8): 663-667.
[3]	张轩, 薛蓉. 特发性快速眼动睡眠期行为障碍向神经系统变性疾病转化的生物学标志物研究进展[J]. 中国现代神经疾病杂志, 2023, 23(8): 668-673.
[4]	刘引, 汤永红, 翟锦霞, 邱媛. 慢性低度炎症与睡眠障碍研究进展[J]. 中国现代神经疾病杂志, 2023, 23(8): 674-677.
[5]	于洁洋, 张亚男, 李惠敏, 黄真灿, 李宛儒, 王赞. 发作性睡病与焦虑研究进展[J]. 中国现代神经疾病杂志, 2023, 23(8): 678-682.
[6]	库成心, 邓丽影, 谢亮. 缺血性卒中继发日间过度思睡研究进展[J]. 中国现代神经疾病杂志, 2023, 23(8): 683-686.
[7]	姜佳凤, 赵莲花, 赵伟. 褪黑素在阿尔茨海默病病理损害机制中的作用[J]. 中国现代神经疾病杂志, 2023, 23(8): 687-692.
[8]	黄沛, 王刚. 功能性帕金森综合征诊断与治疗[J]. 中国现代神经疾病杂志, 2023, 23(8): 738-741.
[9]	洪涛, 唐斌. 如何成为一名优秀的颅底外科医师[J]. 中国现代神经疾病杂志, 2023, 23(7): 571-574.
[10]	马晓丽, 童家杰, 张秀智, 杜倩, 隋爱霞, 赵焕芬. 表现为垂体腺瘤卒中的黄色瘤性垂体炎[J]. 中国现代神经疾病杂志, 2023, 23(7): 599-603.
[11]	张庆硕, 宋丹丹, 周世越, 张金璐, 韩晓旭, 许顺良. 功能性步态障碍诊断与治疗[J]. 中国现代神经疾病杂志, 2023, 23(7): 604-609.
[12]	潘希娟, 邢英琦, 刘玉梅. 脑小血管病影像学评分方法[J]. 中国现代神经疾病杂志, 2023, 23(7): 633-637.
[13]	俞淑凤, 李宁, 徐健, 王鹏. 颈动脉漂浮血栓相关缺血性卒中诊断与治疗进展[J]. 中国现代神经疾病杂志, 2023, 23(7): 638-642.
[14]	魏俊吉. 神经外科重症医学规范化诊断与治疗[J]. 中国现代神经疾病杂志, 2023, 23(6): 477-478.
[15]	杜倩, 邓素君, 邹姗, 金珺, 周青山. 宏基因组第二代测序技术在重症中枢神经系统感染中的应用[J]. 中国现代神经疾病杂志, 2023, 23(6): 479-484.

模态框（Modal）标题

选择文件类型/文献管理软件名称

选择包含的内容

2 2021年世界卫生组织中枢神经系统肿瘤分类（第五版）整合及分层诊断解读

Integrated and layered diagnoses in the 2021 WHO Classification of Tumors of the Central Nervous System (fifth edition)

RichHTML

PDF

可视化

被引次数

摘要/Abstract

引用本文

使用本文

参考文献

相关文章 15

编辑推荐

Metrics

本文评价