Clinical importance of molecular markers of adult diffuse glioma.

Autor:	Molinari E; Department of Neurology, Queen Elizabeth University Hospital, Glasgow, UK., Curran OE; Neuropathology Unit, Department of Pathology, Western General Hospital, Edinburgh, UK., Grant R; Department of Neurology and Neurosurgery, Western General Hospital, Edinburgh, UK robin.grant@nhslothian.scot.nhs.uk.
Jazyk:	angličtina
Zdroj:	Practical neurology [Pract Neurol] 2019 Oct; Vol. 19 (5), pp. 412-416. Date of Electronic Publication: 2019 Jun 06.
DOI:	10.1136/practneurol-2018-002116
Abstrakt:	In 2016, the WHO incorporated molecular markers, in addition to histology, into the diagnostic classification of central nervous system (CNS) tumours. This improves diagnostic accuracy and prognostication: oligo-astrocytoma no longer exists as a clinical entity; isocitrate dehydrogenase (IDH) mutant and 1p/19q co-deleted oligodendroglioma is a smaller category with better prognosis; IDH wild-type 'low-grade' glioma has a much poorer prognosis; and glioblastoma is divided into IDH mutant (with an better prognosis than pre-2016 glioblastoma) and IDH wild type (with a poorer prognosis). Previous advice based on phenotype alone will change with respect to median survival, best management plan and response to treatment. There are implications for routine neuropathology reporting and future trial design. Cases that are difficult to classify may need more advanced molecular genetic classification through DNA methylation-based classification of CNS tumours (Heidelberg Classifier). We discuss the practical implications. Competing Interests: Competing interests: None declared. (© Author(s) (or their employer(s)) 2019. No commercial re-use. See rights and permissions. Published by BMJ.)
Databáze:	MEDLINE
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