The classification of central nervous system(CNS)glioma went through a sequence of developments,between 2006 and 2021,started with only histological approach then has been aided with a major emphasis on molecular sign...The classification of central nervous system(CNS)glioma went through a sequence of developments,between 2006 and 2021,started with only histological approach then has been aided with a major emphasis on molecular signatures in the 4^(th) and 5^(th) editions of the World Health Organization(WHO).The recent reformation in the 5th edition of the WHO classification has focused more on the molecularly defined entities with better characterized natural histories as well as new tumor types and subtypes in the adult and pediatric populations.These new subclassified entities have been incorporated in the 5^(th) edition after the continuous exploration of new genomic,epigenomic and transcriptomic discovery.Indeed,the current guidelines of 2021 WHO classification of CNS tumors and European Association of Neuro-Oncology(EANO)exploited the molecular signatures in the diagnostic approach of CNS gliomas.Our current review presents a practical diagnostic approach for diffuse CNS gliomas and circumscribed astrocytomas using histomolecular criteria adopted by the recent WHO classification.We also describe the treatment strategies for these tumors based on EANO guidelines.展开更多
Colorectal neuroendocrine tumors (NETs) originate from neuroendocrine cells in the intestinal tract, and represent a small area within oncology, but one which has provided increasing new data during the past years. Al...Colorectal neuroendocrine tumors (NETs) originate from neuroendocrine cells in the intestinal tract, and represent a small area within oncology, but one which has provided increasing new data during the past years. Although the World Health Organization has determined clinical and histological features to predict prognosis for such tumors, they may not be valid on an individual basis. We aim to give an overview of the recent findings with regard to pathology, molecular genetics and diagnosis of NETs.展开更多
Background:To describe the epidemiological characteristics of central nervous system(CNS)tumors in children,based on the neurosurgery department of Beijing Tiantan Hospital.Methods:From January 2015 to December 2019,3...Background:To describe the epidemiological characteristics of central nervous system(CNS)tumors in children,based on the neurosurgery department of Beijing Tiantan Hospital.Methods:From January 2015 to December 2019,3180 children were histopathologically diagnosed with CNS tumors based on the 2016 World Health Organization(WHO)classification of tumors.Patients were 0 to 15 years old.We analyzed age-related gender preferences,tumor locations,and the histological grades of the tumors.In addition,the epidemiological characteristics of the five most common intracranial tumors were compared to the previous studies.Results:In this study,intracranial and spinal tumors account for 96.4%(3066)and 3.6%(114)of all tumors,with a preponderance of supratentorial tumors(57.9%).Among all pediatric patients,low-grade tumors comprise 67.1%(2135).The integral gender ratio of males to females is 1.47:1 and the average age of patients is 7.59 years old.The five most common intracranial tumors are craniopharyngioma(15.4%),medulloblastoma(14.3%),pilocytic astrocytoma(11.8%),diffuse astrocytoma(9.8%),and anaplastic ependymoma(4.8%).Conclusions:Due to the lack of national data on childhood brain tumors,we used a large nationally representative population sample based on the largest pediatric neurosurgery center in China.We analyzed the data of the past 5 years,reflecting the incidence of CNS tumors in Chinese children to a certain extent,and laying a data foundation for subsequent clinical studies.展开更多
AIM: To evaluate the efficacy of endoscopic ultrasonography-guided fine needle aspiration(EUS-FNA) for grading pancreatic neuroendocrine tumors(PNETs).METHODS: A total of 22 patients were diagnosed with PNET by EUS-FN...AIM: To evaluate the efficacy of endoscopic ultrasonography-guided fine needle aspiration(EUS-FNA) for grading pancreatic neuroendocrine tumors(PNETs).METHODS: A total of 22 patients were diagnosed with PNET by EUS-FNA between October 2001 and December 2013 at Fukushima Medical University Hospital.Among these cases,we targeted 10 PNET patients who were evaluated according to the World Health Organization(WHO) 2010 classification.Surgery was performed in eight patients,and chemotherapy was performed in two patients due to multiple liver metastases.Specimens obtained by EUS-FNA were first stained with hematoxylin and eosin and then stained with chromogranin,synaptophysin,CD56,and Ki-67.The specimens were graded by the Ki-67 index according to the WHO 2010 classification.Specimens obtained by surgery were graded by the Ki-67 indexand mitotic count(WHO 2010 classification).For the eight specimens obtained by EUS-FNA,the Ki-67 index results were compared with those obtained by surgery.In the two cases treated with chemotherapy,the effects and prognoses were evaluated.RESULTS: The sampling rate for histological diagnosis by EUS-FNA was 100%.No adverse effects were observed.The concordance rate between specimens obtained by EUS-FNA and surgery was 87.5%(7/8).Fo r t h e t w o c a s e s t re a t e d w i t h c h e m o t h e ra p y,case 1 received somatostatin analog therapy and transcatheter arterial infusion(TAI) targeting multiple liver metastases.Subsequent treatment consisted of everolimus.During chemotherapy,the primary tumor remained unconfirmed,although the multiple liver metastases diminished dramatically.Case 2 was classified as neuroendocrine carcinoma(NEC) according to the Ki-67 index of a specimen obtained by EUS-FNA; therefore,cisplatin and irinotecan therapy was started.However,severe adverse effects,including renal failure and diarrhea,were observed,and the therapy regimen was changed to cisplatin and etoposide.TAI targeting multiple liver metastases was performed.Although the liver metastases diminished,the primary tumor remained unconfirmed.These chemotherapy regimens had immediate effects for both unresectable neuroendocrine tumor(NET) and NEC cases.These two subjects are still alive.CONCLUSION: EUS-FNA was effective for PNET diagnosis and Ki-67 index grading for WHO 2010 classification,enabling informed decisions on unresectable PNET treatment by identifying NET or NEC.展开更多
AIM To describe magnetic resonance(MR) imaging features of pancreatic neuroendocrine neoplasms(Pan NENs) according to their grade and tumor-nodes-metastases stage by comparing them to histopathology and todetermine th...AIM To describe magnetic resonance(MR) imaging features of pancreatic neuroendocrine neoplasms(Pan NENs) according to their grade and tumor-nodes-metastases stage by comparing them to histopathology and todetermine the accuracy of MR imaging features in predicting their biological behavior.METHODS This study was approved by our institutional review board; requirement for informed patient consent was waived due to the retrospective nature of the study. Preoperative MR examinations of 55 Pan NEN patients(29 men, 26 women; mean age of 57.6 years, range 21-83 years) performed between June 2013 and December 2015 were reviewed. Qualitative and quantitative features were compared between tumor grades and stages determined by histopathological analysis.RESULTS Ill defined margins were more common in G2-3 and stage Ⅲ-Ⅳ PanN ENs than in G1 and low-stage tumors(P < 0.001); this feature had high specificity in the identification of G2-3 and stage Ⅲ-Ⅳ tumors(90.3% and 96%, 95%CI: 73.1-97.5 and 77.7-99.8). The mean apparent diffusion coefficient value was significantly lower in G2-3 and stage Ⅲ-Ⅳ lesions compared to well differentiated and low-stage tumors(1.09 × 10-3 mm2/s vs 1.45 × 10-3 mm2/s and 1.10 × 10-3 mm2/s vs 1.53 × 10-3 mm2/s, P = 0.003 and 0.001). Receiving operator characteristic analysis determined optimal cutoffs of 1.21 and 1.28 × 10-3 mm2/s for the identification of G2-3 and stage Ⅲ-Ⅳ tumors, with sensitivity and specificity values of 70.8/80.7% and 64.5/64%(95%CI: 48.7-86.6/60-92.7 and 45.4-80.2/42.6-81.3).CONCLUSION MR features of PanN ENs vary according to their grade of differentiation and their stage at diagnosis and could predict the biological behavior of these tumors.展开更多
To the Editor:Meningiomas are the most common central nervous system neoplasms.[1] The World Health Organization (WHO) 2016 classification system classifies meningiomas into three grades:grade Ⅰ (benign),grade Ⅱ (at...To the Editor:Meningiomas are the most common central nervous system neoplasms.[1] The World Health Organization (WHO) 2016 classification system classifies meningiomas into three grades:grade Ⅰ (benign),grade Ⅱ (atypical),and grade Ⅲ (anaplastic/malignant) meningioma.[1] Benign meningiomas are usually associated with favorable prognosis;however,higher grade (WHO grades Ⅱ and Ⅲ) menigiomas are more aggressive,resulting in less favorable outcome.展开更多
文摘The classification of central nervous system(CNS)glioma went through a sequence of developments,between 2006 and 2021,started with only histological approach then has been aided with a major emphasis on molecular signatures in the 4^(th) and 5^(th) editions of the World Health Organization(WHO).The recent reformation in the 5th edition of the WHO classification has focused more on the molecularly defined entities with better characterized natural histories as well as new tumor types and subtypes in the adult and pediatric populations.These new subclassified entities have been incorporated in the 5^(th) edition after the continuous exploration of new genomic,epigenomic and transcriptomic discovery.Indeed,the current guidelines of 2021 WHO classification of CNS tumors and European Association of Neuro-Oncology(EANO)exploited the molecular signatures in the diagnostic approach of CNS gliomas.Our current review presents a practical diagnostic approach for diffuse CNS gliomas and circumscribed astrocytomas using histomolecular criteria adopted by the recent WHO classification.We also describe the treatment strategies for these tumors based on EANO guidelines.
基金Supported by The Science and Technology Commission of Shanghai Municipality
文摘Colorectal neuroendocrine tumors (NETs) originate from neuroendocrine cells in the intestinal tract, and represent a small area within oncology, but one which has provided increasing new data during the past years. Although the World Health Organization has determined clinical and histological features to predict prognosis for such tumors, they may not be valid on an individual basis. We aim to give an overview of the recent findings with regard to pathology, molecular genetics and diagnosis of NETs.
文摘Background:To describe the epidemiological characteristics of central nervous system(CNS)tumors in children,based on the neurosurgery department of Beijing Tiantan Hospital.Methods:From January 2015 to December 2019,3180 children were histopathologically diagnosed with CNS tumors based on the 2016 World Health Organization(WHO)classification of tumors.Patients were 0 to 15 years old.We analyzed age-related gender preferences,tumor locations,and the histological grades of the tumors.In addition,the epidemiological characteristics of the five most common intracranial tumors were compared to the previous studies.Results:In this study,intracranial and spinal tumors account for 96.4%(3066)and 3.6%(114)of all tumors,with a preponderance of supratentorial tumors(57.9%).Among all pediatric patients,low-grade tumors comprise 67.1%(2135).The integral gender ratio of males to females is 1.47:1 and the average age of patients is 7.59 years old.The five most common intracranial tumors are craniopharyngioma(15.4%),medulloblastoma(14.3%),pilocytic astrocytoma(11.8%),diffuse astrocytoma(9.8%),and anaplastic ependymoma(4.8%).Conclusions:Due to the lack of national data on childhood brain tumors,we used a large nationally representative population sample based on the largest pediatric neurosurgery center in China.We analyzed the data of the past 5 years,reflecting the incidence of CNS tumors in Chinese children to a certain extent,and laying a data foundation for subsequent clinical studies.
文摘AIM: To evaluate the efficacy of endoscopic ultrasonography-guided fine needle aspiration(EUS-FNA) for grading pancreatic neuroendocrine tumors(PNETs).METHODS: A total of 22 patients were diagnosed with PNET by EUS-FNA between October 2001 and December 2013 at Fukushima Medical University Hospital.Among these cases,we targeted 10 PNET patients who were evaluated according to the World Health Organization(WHO) 2010 classification.Surgery was performed in eight patients,and chemotherapy was performed in two patients due to multiple liver metastases.Specimens obtained by EUS-FNA were first stained with hematoxylin and eosin and then stained with chromogranin,synaptophysin,CD56,and Ki-67.The specimens were graded by the Ki-67 index according to the WHO 2010 classification.Specimens obtained by surgery were graded by the Ki-67 indexand mitotic count(WHO 2010 classification).For the eight specimens obtained by EUS-FNA,the Ki-67 index results were compared with those obtained by surgery.In the two cases treated with chemotherapy,the effects and prognoses were evaluated.RESULTS: The sampling rate for histological diagnosis by EUS-FNA was 100%.No adverse effects were observed.The concordance rate between specimens obtained by EUS-FNA and surgery was 87.5%(7/8).Fo r t h e t w o c a s e s t re a t e d w i t h c h e m o t h e ra p y,case 1 received somatostatin analog therapy and transcatheter arterial infusion(TAI) targeting multiple liver metastases.Subsequent treatment consisted of everolimus.During chemotherapy,the primary tumor remained unconfirmed,although the multiple liver metastases diminished dramatically.Case 2 was classified as neuroendocrine carcinoma(NEC) according to the Ki-67 index of a specimen obtained by EUS-FNA; therefore,cisplatin and irinotecan therapy was started.However,severe adverse effects,including renal failure and diarrhea,were observed,and the therapy regimen was changed to cisplatin and etoposide.TAI targeting multiple liver metastases was performed.Although the liver metastases diminished,the primary tumor remained unconfirmed.These chemotherapy regimens had immediate effects for both unresectable neuroendocrine tumor(NET) and NEC cases.These two subjects are still alive.CONCLUSION: EUS-FNA was effective for PNET diagnosis and Ki-67 index grading for WHO 2010 classification,enabling informed decisions on unresectable PNET treatment by identifying NET or NEC.
文摘AIM To describe magnetic resonance(MR) imaging features of pancreatic neuroendocrine neoplasms(Pan NENs) according to their grade and tumor-nodes-metastases stage by comparing them to histopathology and todetermine the accuracy of MR imaging features in predicting their biological behavior.METHODS This study was approved by our institutional review board; requirement for informed patient consent was waived due to the retrospective nature of the study. Preoperative MR examinations of 55 Pan NEN patients(29 men, 26 women; mean age of 57.6 years, range 21-83 years) performed between June 2013 and December 2015 were reviewed. Qualitative and quantitative features were compared between tumor grades and stages determined by histopathological analysis.RESULTS Ill defined margins were more common in G2-3 and stage Ⅲ-Ⅳ PanN ENs than in G1 and low-stage tumors(P < 0.001); this feature had high specificity in the identification of G2-3 and stage Ⅲ-Ⅳ tumors(90.3% and 96%, 95%CI: 73.1-97.5 and 77.7-99.8). The mean apparent diffusion coefficient value was significantly lower in G2-3 and stage Ⅲ-Ⅳ lesions compared to well differentiated and low-stage tumors(1.09 × 10-3 mm2/s vs 1.45 × 10-3 mm2/s and 1.10 × 10-3 mm2/s vs 1.53 × 10-3 mm2/s, P = 0.003 and 0.001). Receiving operator characteristic analysis determined optimal cutoffs of 1.21 and 1.28 × 10-3 mm2/s for the identification of G2-3 and stage Ⅲ-Ⅳ tumors, with sensitivity and specificity values of 70.8/80.7% and 64.5/64%(95%CI: 48.7-86.6/60-92.7 and 45.4-80.2/42.6-81.3).CONCLUSION MR features of PanN ENs vary according to their grade of differentiation and their stage at diagnosis and could predict the biological behavior of these tumors.
基金This study was supported by a grant from the Natural Science Foundation of Zhejiang Province, China (No. LQ13H160007).
文摘To the Editor:Meningiomas are the most common central nervous system neoplasms.[1] The World Health Organization (WHO) 2016 classification system classifies meningiomas into three grades:grade Ⅰ (benign),grade Ⅱ (atypical),and grade Ⅲ (anaplastic/malignant) meningioma.[1] Benign meningiomas are usually associated with favorable prognosis;however,higher grade (WHO grades Ⅱ and Ⅲ) menigiomas are more aggressive,resulting in less favorable outcome.
