lowgrade gliomas in adults.docVIP

LowGrade Gliomas in Adults nbsp;nbsp;nbsp;nbsp;nbsp;nbsp;nbsp;nbsp;nbsp;nbsp;nbsp;nbsp; 作者：Jeanine T. Grier, Tracy Batchelor 【关键词】nbsp; Low-grade,glioma nbsp; Key Words. Low-grade glioma ; Astrocytoma ; Oligodendroglioma nbsp; ABSTRACT nbsp; Low-grade gliomas are a heterogeneous group of neoplasms usually encountered in younger patient populations. These tumors represent a unique challenge because most patients will survive a decade or more and may be at a higher risk for treatment-related complications. Clinical observations over the years have identified a subset of low-grade gliomas that tends to manifest more aggressive clinical behavior and require earlier, more aggressive intervention. Clinical and molecular parameters may allow better assessment of prognosis and application of risk-adjusted management strategies that may include resection, radiation, or chemotherapy. Improved methods of long-term cognitive and functional assessment are desperately needed in this patient population. nbsp; INTRODUCTION nbsp; Tumors of the central nervous system (CNS) are grouped according to their cell of origin and are graded based on standard histopathological features. Gliomas comprise a heterogeneous group of neuroectodermal tumors that arise from the glia, the supporting cells of the CNS. Astrocytes, oligodendrocytes, and ependymal cells are types of glial cells that may give rise to astrocytomas, oligodendrogliomas, and ependymomas, respectively. nbsp; According to the World Health Organization (WHO) classification, the most commonly accepted grading system for brain tumors, the surgical specimen should be assessed for atypical cells, mitoses, endothelial proliferation, and necrosis. Tumors with none of these characteristics are classified as grade 1. The more common gliomas in this class are pilocytic astrocytoma (PA), dysembryoplastic neuroepithelial tumor (DNET), pleomorphic xanthoastrocytoma (PXA), and ganglioglioma. Gliom