病理科-胶质瘤分子分型.ppt

* Popova SN,et al.Histopathology 2014, 64, 365–379 * 小 结 胶质瘤的任何分子亚型均不是由单个分子标记物确定的，需联合检测多个相关指标以综合判断 高级别胶质瘤分子分型常用指标：EGFR; NF1; PTEN; P53; IDH1; PDGFRα；MGMT启动子甲基化 低级别胶质瘤分子分型常用指标： IDH1；1p/19q 胶质瘤的不同分子亚型对应着不同的临床特征，对于判断预后、治疗方式选择等具有重要意义 * 展 望 * 胶质瘤分子分型是肿瘤研究热点之一，尚有不少问题亟待研究 胶质瘤分子分型是大势所趋，分型标准得到统一后将很快进入WHO分类，并列入肿瘤治疗规范 肿瘤分子分型是病理诊断的方向，对病理医生提出了更高要求； 有条件的单位应配合好临床，积极开展肿瘤分子分型临床检测及科研工作 tumor1 Figure 1. Expression profiling reveals three major patterns of gene expression related to survival in HGG A: Unsupervised clustering of 76 primary astrocytomas by expression of 108 genes positively or negatively correlated with survival (gene clusters labeled positive or negative) reveals three sample clusters (red lines). B: PN, Prolif, and Mes tumor subsets are identified using 35 signature genes. Centroids from k-means clustering are depicted using Z score-normalized gene expression values (scale from 21 to * C and D: Kaplan-Meier plots showing survival of all MDA cases (C) or of UCSF grade IV cases with necrosis (D). p values from log-rank tests shown. Green, blue, and red lines correspond to PN, Prolif, and Mes subclasses, respectively. Vertical ticks indicate censored survival observations. E: Survival of PN HGG as a function of histological grade. F and G: Strong expression of PN markers and strong expression of Mes markers are mutually exclusive. Each bar depicts mRNA determinations by microarray (F) or TaqMan real-time PCR (G) of four marker genes in an individual sample. Genes include BCAN, DLL3, YKL40, and CD44 as indicated. Values displayed represent Z scores for gene expression of individual samples relative to the entire sample set. H: In situ hybridization of BCAN and YKL40 in tissue microarray cores of five glioma cases. Arrows indicate focal YKL40 expression in BCAN-positive cores. * * * A model depicting parallels between tumor subtypes and stages in neurogenesis Verhaak RG,et al. Integrated genomic analysis identifies clinically relevant subtypes of glioblastoma