HISTOPATHOLOGY, CLASSIFICATION, AND GRADING OF GLIOMAS
HISTOPATHOLOGY, CLASSIFICATION, AND GRADING OF GLIOMAS
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DOI：
10.1002/glia.440150303
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发表时间：
1995-11-01
期刊：
影响因子：
6.2
通讯作者：
BURGER, PC
中科院分区：
文献类型：
--
作者：
KLEIHUES, P;SOYLEMEZOGLU, F;BURGER, PC
肿瘤转化发生在人类神经系统的所有胶质细胞类型中，产生各种各样的临床病理实体和形态变体。星形细胞瘤是最常见的，并且跨越异常广泛的谱，从缓慢生长的幼年毛细胞星形细胞瘤到高度恶性的多形性胶质母细胞瘤。大脑半球的弥漫性浸润性星形细胞瘤表现出向更恶性表型发展的固有趋势。这种变化在组织学分级方案中进行形态学分类（例如，WHO II级至TV级），并与遗传改变的连续获得相关，包括p53突变和p16肿瘤抑制基因的纯合缺失。染色体10和19 q的杂合性丢失以及EGF受体的扩增主要限于恶性胶质瘤，因此被认为是星形细胞瘤进展的晚期事件。神经胶质瘤通常显示不同神经胶质细胞谱系的表型表达（例如，寡星形细胞瘤）。最近的研究表明，混合性胶质瘤的发生并不表明多克隆起源，而是反映了基因表达的改变，导致影响胶质瘤分化的生长因子平衡的变化。(C)1995 Wiley-Liss，Inc.
Neoplastic transformation occurs in all glial cell types of the human nervous system, producing a wide variety of clinico-pathological entities and morphological variants. Astrocytomas are most common and span an unusually wide spectrum, ranging from the slowly growing juvenile pilocytic astrocytoma to the highly malignant glioblastoma multiforme. Diffusely infiltrating astrocytomas of the cerebral hemispheres show an inherent tendency for progression towards a more malignant phenotype. This change is morphologically categorized in histologic grading schemes (e.g., WHO Grade II to TV) and is associated with the sequential acquisition of genetic alterations, including mutations in the p53 and homozygous deletions of the p16 tumor suppressor genes. Loss of heterozygosity on chromosomes 10 and 19q as well as amplification of the EGF receptor are largely restricted to malignant gliomas and thus considered late events in astrocytoma progression. Gliomas often show phenotypic expression of different glial cell lineages (e.g., oligoastrocytoma). Recent studies suggest that the occurrence of mixed gliomas is not indicative of a polyclonal origin but rather reflects altered gene expression, leading to a change in the balance of growth factors influencing glioma differentiation. (C) 1995 Wiley-Liss, Inc.