病理分類—改訂版WHO分類とcIMPACT-NOW

Molecular Diagnostic Approaches for Diffuse Gliomas Based on Updated WHO Classification and cIMPACT-NOW Proposals

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．

　The updated 2016 World Health Organization（WHO）classification of tumors of the central nervous system（CNS）has incorporated molecular parameters into the histopathological diagnosis of the tumor in the name of “integrated diagnosis.” It has enabled more prognostically precise diagnoses of brain tumor entities; however, its practical application has also raised concerns about whether genotypes predominate over phenotypes in tumor diagnostics. In response, cIMAPCT-NOW（the Consortium to Inform Molecular and Practical Approaches to CNS Tumor Taxonomy-“Not Official WHO”）was established to provide a forum for evaluating and recommending proposed changes to future CNS tumor classifications. cIMPACT has thus far published seven updates on the proposal and clarification of existing and new terms and entities. Herein, we highlight the current status of clinical application of the 2016 WHO classification and cIMPACT proposals, and the future endeavor to incorporate comprehensive genomic and epigenomic profiling of CNS tumors with the aid of artificial intelligence technology for better clinical decision-making to achieve the goal of precision medicine for each patient with brain tumors.