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2015 ; 55
(1
): 28-37
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Pathology and genetics of diffuse gliomas in adults
#MMPMID25744348
Komori T
Neurol Med Chir (Tokyo)
2015[]; 55
(1
): 28-37
PMID25744348
show ga
The current World Health Organization (WHO) classification of tumors of the
central nervous system (CNS) is essentially a lineage-oriented classification
based on a presumable developmental tree of CNS. A four-tiered WHO grading scheme
has been successfully applied to a spectrum of diffusely infiltrative
astrocytomas, but it is not fully applicable to other gliomas, including
oligodendrogliomas and ependymomas. Recent genetic studies have revealed that the
major categories of gliomas, such as circumscribe astrocytomas, infiltrating
astrocytomas/oligodendrogliomas, and glioblastoma, roughly correspond to major
genetic alterations, including isocitrate dehydrogenases (IDHs) 1/2 mutations,
TP53 mutations, co-deletion of chromosome arms 1p/19q, and BRAF mutation/fusion.
These genetic alterations are clinically significant in terms of the response to
treatment(s) and/or the prognosis. It is, thus, rational that future
classification of gliomas should be based on genotypes, rather than phenotypes,
although the genetic features of each tumor are not sufficiently understood at
present to draw a complete map of the gliomas, and genetic testing is not yet
available worldwide, particularly in Asian and African countries. This review
summarizes the current concepts of the WHO classification, as well as the current
understanding of the major genetic alterations in glioma and the potential use of
these alterations as diagnostic criteria.
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