Advances in molecular classification of diffuse WHO grade II/III glioma in adults / 肿瘤

ABSTRACT

Objective: Glioma is the most common malignant primary central nervous system tumor. The traditional histologic classification has been applied for predicting biological behavior of glioma and deciding the treatment strategy. The scope of survival in WHO grade II/III is very broad, some progress to glioblastoma in a few months, and some in stable for many years; some is sensitive to radiation and chemotherapy, but some are not sensitive. In recent years, the studies have found that the molecular classification is more accurate in judging prognosis than traditional histologic classification. Almost all grade II/III glioma can be separated into two subtypes according to mutation status of isocitrate dehydrogenase 1/2 (IDH 1/2), and further classification is based on 1 p19q, ATRX (alpha thalassemia/mental retardation syndrome X-linked) and TP 53 (tumor protein p53) status. IDH mutation combined with 1p19q co-deletion most harbored in oligodendroglioma, often accompanies with mutation in CIC, far upstream element binding protein 1 (FUBP 1), Notch1 and telomerase reverse transcriptase (TERT) promoter. The IDH wild type can be further divided into three subtypes with different prognosis based on DNA-methylation platform.