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自1926年Bailey和Cushing提出基于组织发生概念的系统的胶质瘤组织形态分类以来,脑肿瘤分类几经更迭,至最近的WHO分类(2000年),其基本构架仍以组织形态学为主。长期实践证明,脑肿瘤的组织病理学分类和分级十分有效,不要求特殊技术条件,多数具有较好的重复性,是临床病理工作的重要支柱。但是,亦有一部分脑肿瘤类型或分级的形态学诊断标准不易确立,或难以避免主观因素影响。从治疗学角度看,一些脑肿瘤虽然组织形态相似而对治疗反应不一。因此,人们希望分子水平的检测可以有助于更为客观地进行脑肿瘤分类和分级。日益发展的针对特定基因改变的靶向治疗,亦需要更准确地了解脑肿瘤分子改变,或从分子变化的角度进行分子分类,以便于决定治疗方案和估计预后。
Since the classification of glioma histomorphological systems based on the concept of tissue generation by Bailey and Cushing in 1926, the classification of brain tumors has been changed to the most recent WHO classification (2000), with its basic architecture still dominated by histomorphology. Long-term proven, histopathological classification and grading of brain tumors is very effective, does not require special technical conditions, most have good repeatability, is an important pillar of clinical pathology. However, some brain tumor types or grading criteria for morphological diagnosis are not easily established or subjective factors are difficult to avoid. From a therapeutic point of view, some brain tumors respond differently to treatment, albeit similar in histology. Therefore, it is hoped that the detection of molecular level can help to classify and grade brain tumors more objectively. Increasingly targeted therapies targeting specific genetic changes also require a more accurate understanding of molecular changes in brain tumors or molecular classification from the perspective of molecular changes in order to facilitate treatment decisions and prognosis.