中国现代神经疾病杂志 ›› 2021, Vol. 21 ›› Issue (9): 791-803. doi: 10.3969/j.issn.1672-6731.2021.09.009

• 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)儿童型弥漫性胶质瘤分类解读

孙崇然1, 许晶虹2, 张布衣2, 许素素2, 董飞3, 卫博星1, 蒋飚3, 张建民1   

  1. 1 310009 杭州, 浙江大学医学院附属第二医院神经外科;
    2 310009 杭州, 浙江大学医学院附属第二医院病理科;
    3 310009 杭州, 浙江大学医学院附属第二医院放射科
  • 收稿日期:2021-09-06 发布日期:2021-10-09
  • 通讯作者: 蒋飚,Email:jiangbiao@zju.edu.cn;张建民,Email:zjm135@zju.edu.cn
  • 基金资助:

    浙江省科技省级重点研发计划项目(项目编号:2021C03067)

Interpretation on pediatric-type diffuse gliomas in the 2021 WHO Classification of Tumors of the Central Nervous System (fifth edition)

SUN Chong-ran1, XU Jing-hong2, ZHANG Bu-yi2, XU Su-su2, DONG Fei3, WEI Bo-xing1, JIANG Biao3, ZHANG Jian-min1   

  1. 1 Department of Neurosurgery, The Second Affiliated Hospital of Zhejiang University School of Medicine, Hangzhou 310009, Zhejiang, China;
    2 Department of Pathology, The Second Affiliated Hospital of Zhejiang University School of Medicine, Hangzhou 310009, Zhejiang, China;
    3 Department of Radiology, The Second Affiliated Hospital of Zhejiang University School of Medicine, Hangzhou 310009, Zhejiang, China
  • Received:2021-09-06 Published:2021-10-09
  • Contact: 10.3969/j.issn.1672-6731.2021.09.009
  • Supported by:

    This study was supported by the Science and Technology Key Research and Development Project of Zhejiang Province (No. 2021C03067).

摘要:

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)与既往分类最大的区别之一为,将儿童型弥漫性低级别胶质瘤和儿童型弥漫性高级别胶质瘤归为独立的肿瘤类型,这是由于儿童型弥漫性胶质瘤虽然与成人型在组织学形态上较为相似,但分子遗传学特征完全不同,不同分子遗传学特征的预后各异,因此需要不同的治疗策略。临床医师亟需了解这些好发于儿童的肿瘤类型的临床诊疗特点。本文拟根据新版肿瘤分类描述的病理学特征并结合文献,总结儿童型弥漫性胶质瘤的影像学和病理学诊断特征,以及临床表现、治疗和预后,从临床诊疗角度对儿童型弥漫性胶质瘤进行初步解读,以为临床同道提供建议。

关键词: 神经胶质瘤, 中枢神经系统肿瘤, 指南, 世界卫生组织, 磁共振成像, 病理学, 儿童, 综述

Abstract:

The 2021 WHO Classification of Tumors of the Central Nervous System (fifth edition) was released. One of the biggest differences between new edition tumors classification and the previous editions is that the pediatric-type diffuse low-grade gliomas and the pediatric-type diffuse high-grade gliomas are classified into independent tumor families. This change is based on the fact that although pediatric-type diffuse gliomas morphologically resemble their adult counterparts, while their molecular genetics features are completely different, and the prognosis of these tumors with different molecular genetics features is different accordingly, so different treatment strategies are needed. Physicians and surgeons need to know of the features of these pediatric-type diffuse gliomas. This paper reviews the existing literature, and the pathological reports and imaging data of our hospital, summarizes the imaging and pathological diagnostic features, as well as the clinical manifestations, prognostic features and treatment suggestions of these pediatric-type diffuse gliomas. This review will provide an annotation from the view of diagnosis and treatment on pediatric-type diffuse gliomas for the physicians and surgeons.

Key words: Glioma, Central nervous system neoplasms, Guidelines, World Health Organization, Magnetic resonance imaging, Pathology, Child, Review