Pathology Grand Rounds | Dr. PJ Cimino скачать в хорошем качестве

Pathology Grand Rounds | Dr. PJ Cimino

"Incorporating Molecular Criteria into Grading of Diffuse Gliomas" Patrick J. Cimino, MD, PhD Assistant Professor, Department of Laboratory Medicine & Pathology, University of Washington Affiliate Investigator, Division of Human Biology, Fred Hutchinson Cancer Research Center Diffuse gliomas comprise the most common primary malignant intracranial neoplasms in adults. In 2016, the World Health Organization (WHO) introduced a classification system for diffuse gliomas that integrates histomorphology with genetic alterations in isocitrate dehydrogenase 1/2 (IDH1/2) to yield a more predictive system for clinical outcome than histopathology alone. However, historical grading schemes of diffuse astrocytoma (WHO grade II), anaplastic astrocytoma (WHO grade III), and glioblastoma (WHO grade IV) based solely on histopathological features were not updated with the integrated classification system, and do not take into account IDH-mutational status. Looking beyond IDH status, several recent studies have recognized somatic copy number alterations (SCNAs) as prognostic factors for diffuse glioma, and further stratify IDH-mutant and IDH-wildtype astrocytic gliomas. Indeed, SCNAs are being incorporated into the upcoming WHO molecular grading system for diffuse gliomas. In addition to prognosis, incorporating SCNAs into biomarker-driven clinical trial stratification has the potential to develop molecular signature specific therapies for subsets of adult diffuse gliomas.