胶质瘤的流行病及分子病理学.pdfVIP

REVIEW /clinicalpractice/neuro Epidemiology and molecular pathology of glioma Judith A Schwartzbaum*, James L Fisher, Kenneth D Aldape and Margaret Wrensch SUMMARY This article offers the opportunity to earn one Category 1 credit toward the AMA Physician’s Gliomas account for almost 80% of primary malignant brain tumors, and Recognition Award. they result in more years of life lost than do any other tumors. Glioblastoma, the most common type of glioma, is associated with very poor survival, so INTRODUCTION glioma epidemiology has focused on identifying factors that can be modified to prevent this disease. Only two relatively rare factors have so far been The term ‘glioma’ encompasses all tumors that are conclusively shown to affect glioma risk—exposure to high doses of ionizing thought to be of glial cell origin. These include radiation, and inherited mutations of highly penetrant genes associated astrocytic tumors (World Health Organization with rare syndromes. In addition, preliminary evidence points to a lower classification astrocytoma grades I, II [astro- glioma risk among people with allergic conditions and high levels of serum cytoma], III [anaplastic astrocytoma], and IV IgE. Recent research has focused on identifying germline polymorphisms [glioblastoma or GM]), oligodendrogliomas, associated with risk of glioma, and using molecular markers to classify ependy momas, and mixed gliomas.1,2 In this