中枢神经系统肿瘤的分类和分级探讨——4373例病理分析

Classification and grading of tumors of the central nervous system──pathological analysis of 4373 cases

目的 探讨世界卫生组织 (WHO)中枢神经系统肿瘤分类的临床应用。方法 根据 4年来学习和应用WHO分类和分级的情况 ,结合 4373例的病理分析 ,研究具体推行过程中存在的问题。结果 (1) 2 0 0 0分类采用WHO和ICD O(国际疾病分类肿瘤部分 )的双重标准 ,其中的对应关系十分混乱。 (2 )对脑膜上皮的脑膜肿瘤细分为 15种类型 ,存在分歧。 (3)良性、非典型和间变性脑膜瘤的界定有困难。 (4 )间变性胶质瘤的诊断标准含混。 (5 )实际上 ,胶质母细胞瘤是一种混合性胶质瘤。(6 )对特殊类型的神经上皮组织肿瘤的认识不够。

Objective To research on the clinical application of the WHO 1979, 1993 and 2000 classifications of tumours of the central nervous system. Methods With the analysis of 4 373 cases, problems were studied in applying the WHO classifications. Results (1) The 2000 classification used double criteria of WHO and ICD-O. The relationship between them was very confusing. (2) Opinions suggested for about 15 types of the tumours of meningothelial cells. (3) It was difficult to separate benign, atypical or anaplastic meningiomas. (4) The diagnostic criterion of anaplastic gliomas was not clear. (5) Practically, glioblastoma was a type of mixed gliomas. (6) More cases should be studied in order to recognize special types of the tumours of neuroepithelial tissue. Conclusions Suggested to make out a criterion of classification and grading that is more applicable for clinical diagnosis.