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[Classification of gliomas. Current progress and perspectives].

D Capper1, G Reifenberger

  • 1Abteilung Neuropathologie, Universitätsklinikum Heidelberg und Deutsches Konsortium für Translationale Krebsforschung (DKTK), Klinische KooperationseinheitNeuropathologie, Deutsches Krebsforschungszentrum (DKFZ) Heidelberg, Heidelberg, Im Neuenheimer Feld 224, 69120, Heidelberg, Deutschland, David.Capper@med.uni-heidelberg.de.

Der Nervenarzt
|May 21, 2015
PubMed
Summary

Molecular markers improve glioma classification and prognosis prediction. Genetic tests for IDH1/2, ATRX, H3F3A, BRAF, and 1p/19q status, alongside methylation analysis, enhance diagnostic accuracy for brain tumors.

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Area of Science:

  • Neuro-oncology
  • Molecular Pathology
  • Genomics

Context:

  • Traditional glioma classification relies on World Health Organization (WHO) histological features.
  • Recent advancements reveal genetic and epigenetic markers crucial for improved tumor classification.
  • These markers aid in predicting patient response to therapy and overall prognosis.

Purpose:

  • To highlight the significance of molecular markers in refining glioma diagnosis and prognostication.
  • To discuss key molecular tests including IDH1/2, ATRX, H3F3A, BRAF mutations, and 1p/19q codeletions.
  • To explore the role of O-6-methylguanine-DNA methyltransferase (MGMT) promoter methylation and c11orf95/RELA fusion genes in specific glioma subtypes.

Summary:

  • Molecular testing, including IDH1/2, ATRX, H3F3A, BRAF gene mutations, and 1p/19q codeletions, is vital for differentiating astrocytic and oligodendroglial tumors.
  • MGMT promoter methylation and 1p/19q codeletion status are important predictive markers for chemotherapy response in glioblastoma and anaplastic gliomas, respectively.
  • Novel techniques like DNA methylation arrays (450k array test) and next-generation sequencing (NGS) offer robust molecular classification and parallel sequencing of diagnostic and predictive markers.

Impact:

  • These molecular insights are essential for the upcoming revision of the WHO classification of central nervous system tumors.
  • Integration of molecular data with histology promises more accurate glioma subtyping and personalized treatment strategies.
  • Advanced molecular techniques like NGS and methylation arrays facilitate comprehensive genomic profiling for improved glioma management.