Frontiers in Oncology (Mar 2023)

Clinical updates on gliomas and implications of the 5th edition of the WHO classification of central nervous system tumors

  • Xiaopeng Guo,
  • Xiaopeng Guo,
  • Yixin Shi,
  • Yixin Shi,
  • Delin Liu,
  • Delin Liu,
  • Yilin Li,
  • Yilin Li,
  • Wenlin Chen,
  • Yaning Wang,
  • Yuekun Wang,
  • Hao Xing,
  • Yu Xia,
  • Yu Xia,
  • Junlin Li,
  • Junlin Li,
  • Jiaming Wu,
  • Jiaming Wu,
  • Tingyu Liang,
  • Hai Wang,
  • Qianshu Liu,
  • Qianshu Liu,
  • Shanmu Jin,
  • Shanmu Jin,
  • Tian Qu,
  • Tian Qu,
  • Siying Guo,
  • Siying Guo,
  • Huanzhang Li,
  • Huanzhang Li,
  • Tianrui Yang,
  • Tianrui Yang,
  • Kun Zhang,
  • Kun Zhang,
  • Yu Wang,
  • Yu Wang,
  • Wenbin Ma,
  • Wenbin Ma

DOI
https://doi.org/10.3389/fonc.2023.1131642
Journal volume & issue
Vol. 13

Abstract

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BackgroundThe 5th edition of the World Health Organization (WHO) classification of central nervous system tumors incorporated specific molecular alterations into the categorization of gliomas. The major revision of the classification scheme effectuates significant changes in the diagnosis and management of glioma. This study aimed to depict the clinical, molecular, and prognostic characteristics of glioma and its subtypes according to the current WHO classification.MethodsPatients who underwent surgery for glioma at Peking Union Medical College Hospital during 11 years were re-examined for tumor genetic alterations using next-generation sequencing, polymerase chain reaction-based assay, and fluorescence in situ hybridization methods and enrolled in the analysis.ResultsThe enrolled 452 gliomas were reclassified into adult-type diffuse glioma (ntotal=373; astrocytoma, n=78; oligodendroglioma, n=104; glioblastoma, n=191), pediatric-type diffuse glioma (ntotal=23; low-grade, n=8; high-grade, n=15), circumscribed astrocytic glioma (n=20), and glioneuronal and neuronal tumor (n=36). The composition, definition, and incidence of adult- and pediatric-type gliomas changed significantly between the 4th and the 5th editions of the classification. The clinical, radiological, molecular, and survival characteristics of each subtype of glioma were identified. Alterations in CDK4/6, CIC, FGFR2/3/4, FUBP1, KIT, MET, NF1, PEG3, RB1, and NTRK2 were additional factors correlated with the survival of different subtypes of gliomas.ConclusionsThe updated WHO classification based on histology and molecular alterations has updated our understanding of the clinical, radiological, molecular, survival, and prognostic characteristics of varied subtypes of gliomas and provided accurate guidance for diagnosis and potential prognosis for patients.

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