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磁共振成像技术的最新发展,用于评估质瘤的分子微环境

Hanwen Zhang^1,2, Hongbo Zhang², Fan Lin¹

¹Department of Radiology, the First Affiliated Hospital of Shenzhen University, Health Science Center, Shenzhen Second People's Hospital, 3002 SunGangXi Road, Shenzhen, China.

Current medical imaging

|February 28, 2024

概括

2021年世卫组织中枢神经系统瘤分类根据分子IDH突变状态重新定义了成年质瘤,影响了预后. 像ATRX,1p19q共删除和IDH野生类型状态这样的遗传标志物完善了诊断和治疗策略.

科学领域:

神经瘤学神经瘤学
分子病理学分子病理学
遗传学遗传学是一种遗传学.

背景情况:

2021年世界卫生组织 (WHO) 中枢神经系统瘤分类标志着成人质瘤分类的范式转变.
这个新系统优先考虑分子基因型,特别是异酸脱酶 (IDH) 突变,而不是传统的组织学亚型.

研究的目的:

详细介绍2021年世卫组织中枢神经系统瘤指南引入的成年质瘤分类中的变革性变化.
突出分子标记在分化质瘤亚型中的预后意义.

主要方法:

根据IDH突变体和IDH野生型状态进行分类.
进一步细化使用阿尔法-血症/精神障碍综合征X相关 (ATRX) 基因表达,1p19q共删除状态和CDKN2A/B表达用于IDH突变质瘤.
识别IDH野生型质瘤预后指标,包括TERT促进子突变,EGFR放大和+7/-10共删除.

主要成果:

质瘤现在主要被归类为IDH突变或IDH野生型,具有不同的预后结果.
用ATRX,1p19q共删除和CDKN2A/B来分类IDH突变结质瘤.
IDH野生型质瘤与更差的预后有关,特别是与特定的遗传改变有关.

结论:

2021年世卫组织分类代表了通过分子分析来理解和管理成年质瘤的重大进步.
结合基因标记物和潜在的先进成像技术,如MRI,可以提高诊断准确性,治疗计划和预后.
尽管MGMT的甲基化状态不是主要分类的一部分,但对于化剂治疗决策至关重要.

关键词:

质瘤; 分子亚型; 磁共振成像; 瘤微环境.

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