BRAIN and NERVE－神経研究の進歩74巻6号

2022年06月発行

総説

WHO脳腫瘍分類2021第5版—主な変更点

著者： 小森隆司¹

所属機関： ¹東京都立神経病院検査科

ページ範囲：P.803 - P.809

文献概要

WHO脳腫瘍分類2021第5版では組織発生分類から分子分類への移行がさらに推し進められ，悪性度分類にも導入された。定義が曖昧であった腫瘍を整理した結果，浸潤性グリオーマは成人型と小児型に分離，腫瘍型の数は110余りに減り，22の新規腫瘍型が採択された。病理診断に際して，組織所見のみならず，発生部位，遺伝子情報，悪性度を統合的に勘案して最終的な診断を決定する統合診断が採用された。本論では重要な変更点について概説した。

参考文献

1）WHO Classification of Tumours Editorial Board: Central nervous system tumours, 5th ed. WHO classification of tumours series. International Agency for Research on Cancer, Lyon, 2021

2）Louis DN, Ohgaki H, Wiestler OD, Cavenee WK: WHO classification of tumours of the central nervous system, revised 4th ed. WHO classification of tumours series. International Agency for Research on Cancer, Lyon, 2016

3）Louis DN, Wesseling P, Paulus W, Giannini C, Batchelor TT, et al: cIMPACT-NOW update 1: Not Otherwise Specified (NOS) and Not Elsewhere Classified (NEC). Acta Neuropathol 135: 481-484, 2018

4）Louis DN, Giannini C, Capper D, Paulus W, Figarella-Branger D, 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

5）Brat DJ, Aldape K, Colman H, Holland EC, Louis DN, 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

6）Ellison DW, Hawkins C, Jones DTW, Onar-Thomas A, Pfister SM, et al: cIMPACT-NOW update 4: diffuse gliomas characterized by MYB, MYBL1, or FGFR1 alterations or BRAF (V600E) mutation. Acta Neuropathol 137: 683-687, 2019

7）Brat DJ, Aldape K, Colman H, Figrarella-Branger D, Fuller GN, et al: cIMPACT-NOW update 5: recommended grading criteria and terminologies for IDH-mutant astrocytomas. Acta Neuropathol 139: 603-608, 2020

8）Louis DN, Wesseling P, Aldape K, Brat DJ, Capper D, 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

9）Ellison DW, Aldape KD, Capper D, Fouladi M, Gilbert MR, et al: cIMPACT-NOW update 7: advancing the molecular classification of ependymal tumors. Brain Pathol 30: 863-866, 2020

10）Brat DJ, Verhaak RG, Aldape KD, Yung WK, Salama SR: Comprehensive, integrative genomic analysis of diffuse lower-grade gliomas. N Engl J Med 372: 2481-2498, 2015

11）Capper D, Jones DTW, Sill M, Hovestadt V, Schrimpf D, et al: DNA methylation-based classification of central nervous system tumours. Nature 555: 469-474, 2018

12）Louis DN, Perry A, Wesseling P, Brat DJ, Cree IA, et al: The 2021 WHO Classification of Tumors of the Central Nervous System: a summary. Neuro Oncol 23: 1231-1251, 2021

13）Louis DN, Perry A, Burger P, Ellison DW, Reifenberger G, et al: International Society Of Neuropathology--Haarlem consensus guidelines for nervous system tumor classification and grading. Brain Pathol 24: 429-435, 2014

14）Louis DN, Wesseling P, Brandner S, Brat DJ, Ellison DW, et al: Data sets for the reporting of tumors of the central nervous system: recommendations from the international collaboration on cancer reporting. Arch Pathol Lab Med 144: 196-206, 2020

15）Komori T: Updated 2016 WHO classification of tumors of the CNS: turning the corner where molecule meets pathology. Brain Tumor Pathol 34: 139-140, 2017

16）Komori T: The anticipated revision of the grading criteria for adult isocitrate dehydrogenase-mutant diffuse glioma within the neuro-oncology community. Neuro Oncol 21: 1485-1486, 2019

17）Komori T: Grading of adult diffuse gliomas according to the 2021 WHO Classification of Tumors of the Central Nervous System. Lab Invest 102: 126-133, 2022

18）Komori T: The molecular framework of pediatric-type diffuse gliomas: shifting toward the revision of the WHO classification of tumors of the central nervous system. Brain Tumor Pathology 38: 1-3, 2021

19）Sturm D, Pfister SM, Jones DTW: Pediatric gliomas: current concepts on diagnosis, biology, and clinical management. J Clin Oncol 35: 2370-2377, 2017

20）Santosh V, Sravya P, Gupta T, Muzumdar D, Chacko G, et al: ISNO consensus guidelines for practical adaptation of the WHO 2016 classification of adult diffuse gliomas. Neurol India 67: 173-182, 2019

21）Sonoda Y, Yokoo H, Tanaka S, Kinoshita M, Nakada M, et al: Practical procedures for the integrated diagnosis of astrocytic and oligodendroglial tumors. Brain Tumor Pathol 36: 56-62, 2019