胶质瘤WHO新分类分子遗传学基础.pptVIP

CNS肿瘤分类与相关分子遗传学改变 Brain Tumors Definition： Neoplasms arising in the cranial cavity A large number of histological types and subtypes The histological classification is essential for studies and treatment of brain tumors. Pathological diagnosis of brain tumors Assessment of the histogenesis and grading of malignancy CNS肿瘤分类的历史 1926, Bailey Cushing 组织学分类: 胚胎学说：以肿瘤的细胞形态模拟神经系统胚胎发育过程的组织形态学表现进行命名和分类，如髓母细胞瘤，胶质母细胞瘤等。 间变学说：以成熟脑组织中存在的正常细胞来命名，根据发生核异型、多核、核分裂、和坏死间变的现象把肿瘤分成恶性程度不同的等级。 History of WHO classification The aim： to provide a standardized system to facilitate communication between researchers worldwide. WHO Collaborating Center for CNS Tumors was established in 1970. The Director was K.J. Zülch. The Committee reviewed 230 cases, and made the WHO classification of tumors of the CNS. The first edition was published in 1979 as a “blue book”. In 1993, the book was revised as the second edition. IARC published the third edition of WHO classification as a book, “Pathology and Genetics of Tumours of the Nervous System” in 2000. Features and advantages of  WHO classification A classification of tumors of the nervous system. Includes 126 types and subtypes. The book is not merely a simple chart of classification, but a compact handbook of tumors. Contains the most up-to-date findings of “Pathology and Genetics” of brain tumors. Has been spread worldwide, and highly admired. Influenced on other classifications. Does not cover all intracranial tumors A classification of tumors of the nervous system. Entities deleted from the second edition Cysts and Tumor-like lesions, Local extensions from regional tumors, Unclassified tumors, Pituitary adenoma and carcinoma Includes extra-cranial tumors Tumors of the PNS, Adrenal neuroblastoma It is surely scientific, but not practical ! Grading of astrocytomas according to Kernohan (1950) Grade 1 normal astrocytes, no anaplasia Grade 2 early anaplasia; no mitoses Grade 3 moderate anaplasia; mitoses (1 / 2 HPF) Grade 4