摘要：

髓母细胞瘤是儿童最常见的中枢神经系统恶性肿瘤，目前以手术辅以放化疗为主要治疗手段。根据危险分层制定的术后精准、综合治疗方案，可有效避免低危组患儿的过度治疗，同时不遗漏高危组患儿的治疗需求。传统临床危险分层主要考虑年龄、临床分期和手术切除程度等，近年随着对髓母细胞瘤分子遗传事件研究的深入，逐渐将分子分型及主要分子遗传学特征纳入危险分层体系，初步形成改良分子危险分层，更有效甄别不同危险分层患儿并指导后续个体化治疗。本文拟综述髓母细胞瘤的病理学特征、基于临床特征的危险分层，以及整合临床和分子遗传学特征的改良分子危险分层，为后续综合诊断与治疗方案的制定提供依据。

关键词: 髓母细胞瘤, 危险分层（非MeSH词）, 病理学，分子, 化放疗, 综述

Abstract:

Medulloblastoma is the most common malignant central nervous system tumor in children. The current treatment approach primarily consists of surgery combined with adjuvant radiotherapy and chemotherapy. Postoperative precision treatment plans based on risk stratification effectively prevent overtreatment in low-risk patients while addressing the therapeutic needs of high-risk groups. Traditional clinical risk stratification primarily considers factors such as age, clinical stage, and extent of surgical resection. In recent years, advances in understanding the key molecular markers of medulloblastoma have led to the integration of molecular subtypes and molecular and genetic characteristics into the risk stratification framework. It has resulted in the development of a revised molecular risk stratification system, which makes it possible to distinguish children in different risk groups more efficiently and guides subsequent precision treatment. This paper intends to summarize the pathological characteristics of medulloblastoma, risk stratification based on clinical features and the revised molecular risk stratification which integrates clinical and molecular genetic characteristics, so as to provide a guideline for the formulation of subsequent comprehensive diagnosis and treatment plans.

Key words: Medulloblastoma, Risk stratification (not in MeSH), Pathology, molecular, Chemoradiotherapy, Review