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The Molecular Pathology of Primary Brain Tumors

机译：原发性脑肿瘤的分子病理学

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As the molecular basis of brain neoplasia continues to be elucidated, the pathologist is called upon more and more to provide not only a morphological diagnosis according to classic concepts, but also molecular data that offer additional information in terms of biological behavior and potential treatment response. In this review, we discuss the major brain tumor subtypes, some diagnostic issues that emphasize the need for molecular data, and existing putative molecular pathways associated with brain tumor subtypes. We further discuss the role of molecular tumor signatures as a means of determining prognosis and response to specific therapies. At present, it appears that lp/19q assessment, as well as immunohistochemistry for IDH1 and 3-catenin, should be available to all anatomic pathology laboratories that accession brain tumors. O~6-methyl-guanine-DNA methyltransferase methyl-ation analysis is an additional consideration for glioblastoma, although clinicians and patients may choose to forego this analysis if temozolomide will be used regardless of methylation status. Given the evolving nature of cancer biology and progress toward personalized medicine, it is likely, if not axiomatic, that molecular tumor characterization with continues to expand on a routine basis.
机译：随着脑瘤形成的分子基础不断被阐明，越来越多地要求病理学家不仅提供根据经典概念的形态学诊断，而且还提供在生物学行为和潜在治疗反应方面提供更多信息的分子数据。在这篇综述中，我们讨论了主要的脑肿瘤亚型，一些强调分子数据需求的诊断问题以及与脑肿瘤亚型相关的现有推定分子途径。我们进一步讨论了分子肿瘤标志物作为确定预后和对特定疗法反应的手段的作用。目前，似乎所有参与脑肿瘤的解剖病理学实验室都可以进行lp / 19q评估以及IDH1和3-catenin的免疫组织化学。对于胶质母细胞瘤，O〜6-甲基-鸟嘌呤-DNA甲基转移酶甲基化分析是一个额外的考虑因素，尽管无论甲基化状态如何使用替莫唑胺，临床医生和患者都可以选择放弃此分析。鉴于癌症生物学的不断发展的性质和向个性化医学的发展，即使不是无言的，分子肿瘤的表征也有可能在常规基础上继续扩展。

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