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Updated: Jun 25, 2026
Digital Spatial Profiling for Characterization of the Microenvironment in Adult-Type Diffusely Infiltrating Glioma
Published on: September 13, 2022
Classification of adult-type diffuse gliomas: Impact of the World Health Organization 2021 update
Benjamin T Whitfield1, Jason T Huse1
1Departments of Pathology and Translational Molecular Pathology, University of Texas MD Anderson Cancer Center, Houston, Texas, USA.
Abstract:
Over the last decade, developments in molecular profiling have radically altered the diagnosis, classification, and management of numerous cancer types, with primary brain tumors being no exception. Although historically brain tumors have been classified based on their morphological characteristics, recent advances have allowed refinement of tumor classification based on molecular alterations. This shift toward molecular classification of primary brain tumors is reflected in the 2021 5th edition of the WHO classification of central nervous system tumors (WHO 2021). In this review, we will discuss the most recent updates to the classification of adult-type diffuse gliomas, a group of highly infiltrative and largely incurable CNS malignancies. It is our hope continued that refinement of molecular criteria will improve diagnosis, prognostication, and eventually treatment of these devastating tumors.
Insights
Molecular profiling is revolutionizing primary brain tumor classification, moving beyond morphology to molecular alterations. This update, reflected in the WHO 2021 CNS tumor classification, aims to improve diagnosis and treatment for diffuse gliomas.
Area of Science:
- Neuro-oncology
- Molecular Pathology
- Cancer Genomics
Background:
- Historically, brain tumors were classified by morphology.
- Molecular profiling has transformed cancer diagnosis and management.
- Primary brain tumors, including diffuse gliomas, are increasingly classified by molecular alterations.
Purpose of the Study:
- To review recent updates in the classification of adult-type diffuse gliomas.
- To highlight the shift towards molecular criteria in CNS tumor classification.
- To emphasize the impact of molecular profiling on brain tumor diagnosis and treatment.
Main Methods:
- Review of the 5th edition of the WHO classification of central nervous system tumors (WHO 2021).
- Analysis of recent advancements in molecular profiling techniques for brain tumors.
- Synthesis of literature on molecular alterations in adult-type diffuse gliomas.
Main Results:
- The WHO 2021 classification incorporates molecular alterations for refined brain tumor classification.
- Molecular criteria are essential for accurate diagnosis and prognostication of diffuse gliomas.
- Advancements enable a more precise understanding of these CNS malignancies.
Conclusions:
- Molecular classification is crucial for improving the diagnosis, prognostication, and treatment of primary brain tumors.
- The WHO 2021 update signifies a paradigm shift in classifying CNS tumors.
- Continued refinement of molecular criteria holds promise for better outcomes in diffuse glioma patients.
