Neurological Surgery 脳神経外科49巻3号

2021年05月発行

特集 グリオーマ—現在の常識と近未来のスタンダード Ⅱグリオーマの疫学と診断

病理分類—改訂版WHO分類とcIMPACT-NOW

著者： 増井憲太¹ 小森隆司²

所属機関： ¹東京女子医科大学医学部病理学（病態神経科学分野） ²東京都立神経病院検査科

ページ範囲：P.510 - P.519

Point
・2016 WHO分類でのグリオーマの診断には，分子情報を含む「統合診断」が要求される．
・WHO分類に基づく分子診断の実践的問題に対し，cIMPACT-NOWの提言がなされた．
・加速する脳腫瘍の分子分類に対し，遺伝子パネルやAIの利用が期待されている．

参考文献

1）Louis DN, et al：International Society of Neuropathology-Haarlem Consensus Guidelines for Nervous System Tumor Classification and Grading. Brain Pathol 24：429-435, 2014

2）Louis DN, et al：The 2016 World Health Organization Classification of Tumors of the Central Nervous System：a summary. Acta Neuropathol 131：803-820, 2016

3）Louis DN, et al：Announcing cIMPACT-NOW：the Consortium to Inform Molecular and Practical Approaches to CNS Tumor Taxonomy. Acta Neuropathol 133：1-3, 2017

4）Hartmann C, et al：Type and frequency of IDH1 and IDH2 mutations are related to astrocytic and oligodendroglial differentiation and age：a study of 1,010 diffuse gliomas. Acta Neuropathol 118：469-474, 2009

5）Sahm F, et al：Farewell to oligoastrocytoma：in situ molecular genetics favor classification as either oligodendroglioma or astrocytoma. Acta Neuropathol 128：551-559, 2014

6）Louis DN, et al：cIMPACT-NOW update 1：not otherwise specified（NOS）and not elsewhere classified（NEC）. Acta Neuropathol 135：481-484, 2018

7）Louis DN, et al：cIMPACT-NOW update 2：diagnostic clarifications for diffuse midline glioma, H3 K27M-mutant and diffuse astrocytoma/anaplastic astrocytoma, IDH-mutant. Acta Neuropathol 135：639-642, 2018

8）Brat DJ, et al：cIMPACT-NOW update 3：recommended diagnostic criteria for “diffuse astrocytic glioma, IDH-wildtype, with molecular features of glioblastoma, WHO grade Ⅳ”. Acta Neuropathol 136：805-810, 2018

9）Shirahata M, et al：Novel, improved grading system（s） for IDH-mutant astrocytic gliomas. Acta Neuropathol 136：153-166, 2018

10）Brat DJ, et al：cIMPACT-NOW update 5：recommended grading criteria and terminologies for IDH-mutant astrocytomas. Acta Neuropathol 139：603-608, 2020

mutation. Acta Neuropathol 137：683-687, 2019

12）Ryall S, et al：Pediatric low-grade glioma in the era of molecular diagnostics. Acta Neuropathol Commun 8：30, 2020

13）Ellison DW, et al：cIMPACT-NOW update 7：advancing the molecular classification of ependymal tumors. Brain Pathol 30：863-866, 2020

14）Louis DN, et al：cIMPACT-NOW update 6：new entity and diagnostic principle recommendations of the cIMPACT-Utrecht meeting on future CNS tumor classification and grading. Brain Pathol 30：844-856, 2020

15）Capper D, et al：DNA methylation-based classification of central nervous system tumours. Nature 555（7697）：469-474, 2018

16）Ceccarelli M, et al：Molecular profiling reveals biologically discrete subsets and pathways of progression in diffuse glioma. Cell 164：550-563, 2016

17）Jin L, et al：Artificial intelligence neuropathologist for glioma classification using deep learning on hematoxylin and eosin stained slide images and molecular markers. Neuro Oncol 23：44-52, 2021

18）Komori T：AI Neuropathologist：an innovative technology enabling a faultless pathological diagnosis? Neuro Oncol 23：1-2, 2021