Gliomas originate from glial cells in the central nervous system.Approximately 80%-85%of malignant brain tumors in adults are gliomas.The most common central nervous system tumor in children is low-grade pediatric gli...Gliomas originate from glial cells in the central nervous system.Approximately 80%-85%of malignant brain tumors in adults are gliomas.The most common central nervous system tumor in children is low-grade pediatric glioma.Diagnosis was determined by histological features until 2016 when the World Health Organization classification integrated molecular data with anatomopathological information to achieve a more integral diagnosis.Molecular characterization has led to better diagnostic and prognostic staging,which in turn has increased the precision of treatment.Current efforts are focused on more effective therapies to prolong survival and improve the quality of life of adult and pediatric patients with glioma.However,improvements in survival have been modest.Currently,clinical guidelines,as well as the article by Mohamed et al accompanying this editorial piece,are adapting treatment recommendations(surgery,chemotherapy,and radiotherapy)according to diagnosis and prognosis guided by molecular biomarkers.Furthermore,this paves the way for the design of clinical trials with new therapies,which is especially important in pediatric gliomas.展开更多
BACKGROUND The rare co-occurrence of oligodendroglioma and arteriovenous malformation(AVM)in the same intracranial location.CASE SUMMARY In a 61-year-old man presenting with progressive headaches,is described in this ...BACKGROUND The rare co-occurrence of oligodendroglioma and arteriovenous malformation(AVM)in the same intracranial location.CASE SUMMARY In a 61-year-old man presenting with progressive headaches,is described in this case study.Preoperative multimodal imaging techniques(computed tomography,magnetic resonance imaging,magnetic resonance spectroscopy,digital subtraction angiography,and computed tomography angiography)were employed to detect hemorrhage,cystic and solid lesions,and arteriovenous shunting in the right temporal lobe.The patient underwent right temporal craniotomy for lesion removal,and postoperative pathological analysis confirmed the presence of oligodendroglioma(World Health Organization grade II,not otherwise specified)and AVM.CONCLUSION The preoperative utilization of multimodal imaging examination can help clinicians reduce the likelihood of misdiagnosis or oversight of these conditions,and provides important information for subsequent treatment.This case supports the feasibility of craniotomy for the removal of glioma with AVM.展开更多
目的探讨I D H突变和1p/19q共缺失型少突胶质细胞瘤的临床病理特征及预后相关影响因素。方法收集54例IDH突变和1p/19q共缺失型少突胶质细胞瘤病例,分析其临床病理特点,包括年龄、组织学分级和肿瘤部位等因素对无进展生存期和总生存期的...目的探讨I D H突变和1p/19q共缺失型少突胶质细胞瘤的临床病理特征及预后相关影响因素。方法收集54例IDH突变和1p/19q共缺失型少突胶质细胞瘤病例,分析其临床病理特点,包括年龄、组织学分级和肿瘤部位等因素对无进展生存期和总生存期的影响。结果 54例患者中,肿瘤发生于1个脑叶者46例,发生于2个脑叶以上者8例。肿瘤组织学WHO分级2级12例,3级42例。FISH检测显示54例均为1p/19q共缺失;免疫组织化学检测显示Olig2均为弥漫强阳性;GFAP均为阳性;p53有6例强阳性;48例患者ATRX未缺失;Ki-67增殖指数5%~60%。Sanger测序显示54例均发生IDH基因突变(40例为IDH1突变,14例为IDH2突变),33例发生TERT启动子突变。16例在治疗过程中发生复发及转移。单因素分析显示,手术后复发转移间隔时间超过2年可以延长患者无进展生存和总生存期。54例患者平均无进展生存期33.5个月,平均总生存期40.7个月。结论 IDH突变和1p/19q共缺失型少突胶质细胞瘤术后联合精准放化疗降低了进展风险,手术后复发转移间隔时间与该型患者预后相关。展开更多
Gliomas are primary brain tumors derived from glial cells of the central nervous system,afflicting both adults and children with distinct characteristics and therapeutic challenges.Recent developments have ushered in ...Gliomas are primary brain tumors derived from glial cells of the central nervous system,afflicting both adults and children with distinct characteristics and therapeutic challenges.Recent developments have ushered in novel clinical and molecular prognostic factors,reshaping treatment paradigms based on classi-fication and grading,determined by histological attributes and cellular lineage.This review article delves into the diverse treatment modalities tailored to the specific grades and molecular classifications of gliomas that are currently being discussed and used clinically in the year 2023.For adults,the therapeutic triad typically consists of surgical resection,chemotherapy,and radiotherapy.In contrast,pediatric gliomas,due to their diversity,require a more tailored approach.Although complete tumor excision can be curative based on the location and grade of the glioma,certain non-resectable cases demand a chemotherapy approach usually involving,vincristine and carboplatin.Addi-tionally,if surgery or chemotherapy strategies are unsuccessful,Vinblastine can be used.Despite recent advancements in treatment methodologies,there remains a need of exploration in the literature,particularly concerning the efficacy of treatment regimens for isocitrate dehydrogenase type mutant astrocytomas and fine-tuned therapeutic approaches tailored for pediatric cohorts.This review article explores into the therapeutic modalities employed for both adult and pediatric gliomas in the context of their molecular classification.展开更多
Background Our previous study confirmed that oligodendrogliomas had higher frequency of chromosome 1p/19q deletion. In order to improve the diagnostic criteria and to predict the prognosis of oligodendroglioma patient...Background Our previous study confirmed that oligodendrogliomas had higher frequency of chromosome 1p/19q deletion. In order to improve the diagnostic criteria and to predict the prognosis of oligodendroglioma patients, the status of chromosome 1 p/19q deletion, the methylation of O6-methylguanine-DNA methyltransferase （MGMT）, and the expression of p53 protein were evaluated and investigated in relation to patients＇ outcomes.Methods Methylation of MGMT in 73 cases was analyzed by nested methylation-specific PCR （MSP）. The levels of MGMT and p53 protein were tested with immunohistochemistry. Pearson＇s chi-square test and Fisher＇s exact test were used. Multivariate and Kaplan-Meier analysis were performed to determine patients＇ outcomes.Results Both oligodendrogliomas and astrocytic gliomas exhibited frequent methylation of MGMT. However, the results of MSP did not completely correspond to that of the immunohistochemical staining for MGMT. The expression of p53 protein was more frequently observed in patients without a 1 p or 19q deletion in anaplastic oligodendrogliomas （=0.032,0.025）. In low-grade oligodendrogliomas, methylation of MGMT was more frequent in patients with 1 p/19q deletion than in patients with 1p/19q intact （P=0.038）. Patients with oligodendrogliomas with 1p/19q loss of heterozygosity and p53-negative showed a longer progression-free survival.Conclusion Detection of chromosome 1p/19q status combined with p53 protein immunohistochemistry might be beneficial to improve the pathological diagnosis and to determine the prognosis of patients with oligodendrogliomas.展开更多
文摘Gliomas originate from glial cells in the central nervous system.Approximately 80%-85%of malignant brain tumors in adults are gliomas.The most common central nervous system tumor in children is low-grade pediatric glioma.Diagnosis was determined by histological features until 2016 when the World Health Organization classification integrated molecular data with anatomopathological information to achieve a more integral diagnosis.Molecular characterization has led to better diagnostic and prognostic staging,which in turn has increased the precision of treatment.Current efforts are focused on more effective therapies to prolong survival and improve the quality of life of adult and pediatric patients with glioma.However,improvements in survival have been modest.Currently,clinical guidelines,as well as the article by Mohamed et al accompanying this editorial piece,are adapting treatment recommendations(surgery,chemotherapy,and radiotherapy)according to diagnosis and prognosis guided by molecular biomarkers.Furthermore,this paves the way for the design of clinical trials with new therapies,which is especially important in pediatric gliomas.
文摘BACKGROUND The rare co-occurrence of oligodendroglioma and arteriovenous malformation(AVM)in the same intracranial location.CASE SUMMARY In a 61-year-old man presenting with progressive headaches,is described in this case study.Preoperative multimodal imaging techniques(computed tomography,magnetic resonance imaging,magnetic resonance spectroscopy,digital subtraction angiography,and computed tomography angiography)were employed to detect hemorrhage,cystic and solid lesions,and arteriovenous shunting in the right temporal lobe.The patient underwent right temporal craniotomy for lesion removal,and postoperative pathological analysis confirmed the presence of oligodendroglioma(World Health Organization grade II,not otherwise specified)and AVM.CONCLUSION The preoperative utilization of multimodal imaging examination can help clinicians reduce the likelihood of misdiagnosis or oversight of these conditions,and provides important information for subsequent treatment.This case supports the feasibility of craniotomy for the removal of glioma with AVM.
文摘目的探讨I D H突变和1p/19q共缺失型少突胶质细胞瘤的临床病理特征及预后相关影响因素。方法收集54例IDH突变和1p/19q共缺失型少突胶质细胞瘤病例,分析其临床病理特点,包括年龄、组织学分级和肿瘤部位等因素对无进展生存期和总生存期的影响。结果 54例患者中,肿瘤发生于1个脑叶者46例,发生于2个脑叶以上者8例。肿瘤组织学WHO分级2级12例,3级42例。FISH检测显示54例均为1p/19q共缺失;免疫组织化学检测显示Olig2均为弥漫强阳性;GFAP均为阳性;p53有6例强阳性;48例患者ATRX未缺失;Ki-67增殖指数5%~60%。Sanger测序显示54例均发生IDH基因突变(40例为IDH1突变,14例为IDH2突变),33例发生TERT启动子突变。16例在治疗过程中发生复发及转移。单因素分析显示,手术后复发转移间隔时间超过2年可以延长患者无进展生存和总生存期。54例患者平均无进展生存期33.5个月,平均总生存期40.7个月。结论 IDH突变和1p/19q共缺失型少突胶质细胞瘤术后联合精准放化疗降低了进展风险,手术后复发转移间隔时间与该型患者预后相关。
文摘Gliomas are primary brain tumors derived from glial cells of the central nervous system,afflicting both adults and children with distinct characteristics and therapeutic challenges.Recent developments have ushered in novel clinical and molecular prognostic factors,reshaping treatment paradigms based on classi-fication and grading,determined by histological attributes and cellular lineage.This review article delves into the diverse treatment modalities tailored to the specific grades and molecular classifications of gliomas that are currently being discussed and used clinically in the year 2023.For adults,the therapeutic triad typically consists of surgical resection,chemotherapy,and radiotherapy.In contrast,pediatric gliomas,due to their diversity,require a more tailored approach.Although complete tumor excision can be curative based on the location and grade of the glioma,certain non-resectable cases demand a chemotherapy approach usually involving,vincristine and carboplatin.Addi-tionally,if surgery or chemotherapy strategies are unsuccessful,Vinblastine can be used.Despite recent advancements in treatment methodologies,there remains a need of exploration in the literature,particularly concerning the efficacy of treatment regimens for isocitrate dehydrogenase type mutant astrocytomas and fine-tuned therapeutic approaches tailored for pediatric cohorts.This review article explores into the therapeutic modalities employed for both adult and pediatric gliomas in the context of their molecular classification.
文摘Background Our previous study confirmed that oligodendrogliomas had higher frequency of chromosome 1p/19q deletion. In order to improve the diagnostic criteria and to predict the prognosis of oligodendroglioma patients, the status of chromosome 1 p/19q deletion, the methylation of O6-methylguanine-DNA methyltransferase （MGMT）, and the expression of p53 protein were evaluated and investigated in relation to patients＇ outcomes.Methods Methylation of MGMT in 73 cases was analyzed by nested methylation-specific PCR （MSP）. The levels of MGMT and p53 protein were tested with immunohistochemistry. Pearson＇s chi-square test and Fisher＇s exact test were used. Multivariate and Kaplan-Meier analysis were performed to determine patients＇ outcomes.Results Both oligodendrogliomas and astrocytic gliomas exhibited frequent methylation of MGMT. However, the results of MSP did not completely correspond to that of the immunohistochemical staining for MGMT. The expression of p53 protein was more frequently observed in patients without a 1 p or 19q deletion in anaplastic oligodendrogliomas （=0.032,0.025）. In low-grade oligodendrogliomas, methylation of MGMT was more frequent in patients with 1 p/19q deletion than in patients with 1p/19q intact （P=0.038）. Patients with oligodendrogliomas with 1p/19q loss of heterozygosity and p53-negative showed a longer progression-free survival.Conclusion Detection of chromosome 1p/19q status combined with p53 protein immunohistochemistry might be beneficial to improve the pathological diagnosis and to determine the prognosis of patients with oligodendrogliomas.
