在基因组学研究的推动下，胶质瘤分子分型近来有了新的进展。癌症基因组图谱（ TCGA）项目依据基因表达谱将胶质母细胞瘤（ WHO Ⅳ级）分为4型，依据1p／19q共缺失、异柠檬酸脱氢酶（ IDH）基因突变、TERTp（端粒酶逆转录酶基因启动子区）突变将较低级别胶质瘤（ WHO Ⅱ、Ⅲ级）分为5型。2016年WHO完成了新版中枢神经系统肿瘤分类的修订，将这些新的分子标志物引入到胶质瘤诊断中，并将分子诊断与传统形态学诊断整合，推动了胶质瘤精准诊断。同样在分子分型的指导下，胶质瘤精准治疗也得到了大力发展。本文就近来胶质瘤分子诊断、精准化疗、靶向治疗和免疫治疗等方面的研究进行回顾，期望为胶质瘤精准诊疗提供新的思路和策略。%With the advance of genomics research, there have been a new breakthrough in the molecular classification of gliomas. Glioblastoma ( WHO gradeⅣ) could be subtyped to proneural, neural, classical, and mesochymal according to the mRNA expression. Lower grade gliomas ( WHO grade Ⅱ andⅢ) could be divided into 5 types using 1p/19q co⁃deletion, isocitrate dehydrogenase( IDH) mutation, and TERTp ( promotor region) mutation. In 2016, a new classification of tumors of the central nervous system was proposed, and some new markers such as IDH1 mutation were introduced into the diagnosis of gliomas. Genotype and phenotype were integrated to diagnose gliomas. In the meantime, precision treatment for gliomas has also been vigorously developed. This article reviewed recent studies on the molecular diagnosis, precise chemotherapy, targeted therapy, and immunotherapy for gliomas to provide new ideas and strategies for precise diagnosis and treatment of gliomas.
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