【CSCO 2022 Preview】Precision diagnosis and treatment of brain tumors opens a new chapter!

Gliomas are tumors that originate in brain glial cells and are the most common primary intracranial tumors, accounting for about 46%
of intracranial tumors.
The 2021 edition of WHO central nervous system tumor classification will be glioma divided into grade 1~4, grade 1, 2 for low-grade glioma, grade 3, 4 for high-grade glioma, because of the high degree of malignancy of glioma, the survival of patients is generally short, there is no particularly good treatment, of which the average survival of glioblastoma is about 1 year, and the 5-year survival rate is less than 5%.

The annual incidence of glioma in China is 5~8/100,000, and the 5-year mortality rate is second only to pancreatic cancer and lung cancer
in systemic tumors.
The pathogenesis of glioma is unknown, and two risk factors have been identified: exposure to high doses of ionizing radiation and genetic mutations
in high-penetrance genes associated with rare syndromes.
In addition, carcinogenic factors such as nitrite foods, viral or bacterial infections may also be involved in the development
of gliomas.

At present, the treatment of glioma is surgical resection, radiotherapy, chemotherapy, but due to the high degree of malignancy of glioma, especially glioblastoma, surgical resection and chemoradiotherapy are still prone to recurrence, with molecular pathology research, it has been found that the detection of some molecular markers can indicate the sensitivity of drug treatment, such as the sensitivity of temozolomide approved in glioma can be indicated by detecting MGMT promoter methylation.
At the same time, with the study of clinical trial drugs, it has also been found that some targeted drugs also have positive anti-tumor effects
in glioma.
Precise molecular pathological detection is required before targeted therapy, so in the diagnosis and treatment of glioma, the diagnosis of glioma requires comprehensive diagnosis of molecular pathology combined with histopathology, and molecular pathological detection is particularly important
.

Gliomas have made significant progress in recent years, one of which is a breakthrough
in molecular pathology.
Especially after the Haram consensus in 2014, the concept of integrated diagnosis of glioma was proposed, and molecular indicators were incorporated into the diagnosis of glioma
.
The fifth edition of the World Health Organization Classification of Central Nervous System Tumors (WHO CNS5) in 2021 is the latest international standard for the classification of brain and spinal cord tumors, and the WHO CNS5 guidelines are more detailed in the classification of central nervous system tumors, adding more molecular indicators and variant types
on the basis of histological morphology.
Molecular testing plays an increasingly important
role in clinically guiding tumor molecular typing, auxiliary diagnosis, treatment and prognosis assessment.

On November 7, 2022, the 25th National Congress of Clinical Oncology and the 2022 CSCO Annual Conference invited Professor Chai Ruichao from Beijing Institute of Neurosurgery to give a keynote speech
on "How to Conduct Molecular Pathological Testing of Glioma under the Fifth Edition of WHO Guidelines".

Resources:

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