应重视儿童脑胶质瘤的分子病理诊断

Pay attention to molecular pathological diagnosis of pediatric glioma

胶质瘤是儿童常见的中枢神经系统肿瘤之一。越来越多的研究显示与成人相比,有些肿瘤尽管在形态学上与成人表现相似,诊断名称也一样,但却具有独特的分子遗传学特征及完全不同的生物学行为,因此儿童的脑胶质瘤绝非成人的"微缩版"。2021年末发布的第5版世界卫生组织中枢神经系统肿瘤分类中,相当重要的修订之一就是将儿童常见的一些弥漫性胶质瘤单独区分开来,并进一步分成了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两大类。而分类的依据除了组织学形态和临床特点,更多地包含了分子特征。因此医师在临床实践中,一定要重视分子病理诊断对儿童胶质瘤诊治的重要意义。

Glioma is one of the most common central nervous system tumors in children.Increasing studies show that compared with adults,some gliomas in children have unique molecular genetic characteristics and completely different biological behaviors,although they are similar to adults in morphology and nomenclature.Therefore,pediatric glioma is by no means a"miniature version"of adults.In the 5th edition of WHO classification of central nervous system tumors published in the end of 2021,one of the most important revisions is the division of the classification into adult-type and pediatric-type diffuse gliomas,and the latter is further divided into pediatric-type diffuse low-grade gliomas and pediatric-type diffuse high-grade gliomas.In addition to histological morphology and clinical features,the basis of classification includes more molecular features.Therefore,in clinical practice,we need to pay more attention to the significance of molecular pathological diagnosis in the diagnosis and treatment of gliomas in children.