扬州大学：《外科学》课程教学课件（PPT讲稿，Surgery）Chapter 14. Brain Tumors

蘇北人民医院Braintumors-Glioma

蘇北人民医院Primary brain tumorsSkinSkull·Meningioma（35%)Meninges·Glioma（30%）AAstrocytomaBrainGlioblastoma·Oligodendroglioma·OligoastrocytomaNeuron·Ependymoma·PituitaryAdenoma（13%Astrocyte.Within skullOligodendrocyte·BeneathbrainEpendyma

Skin Skull Meninges Brain Neuron Astrocyte Oligodendrocyte Ependyma

北人民医院INTRODUCTIONAny tumorthat arisesfrom theglial or supportivetissue,of thebrainiscalleda“glioma."能相器婴形Distortedbrain-tissR炎

Any tumor that arises from the glial or supportive tissue, of the brain is called a “glioma

蘇北人民医院INTRODUCTIONAglioma is a type of brain tumor that grows from glial cellsGlial cells support neurons with energy and nutrientsand helpmaintain the blood-brain barrier.There are various types ofglial cells,eachwithadifferentfunctionGlioma isan umbrella termusedto describethedifferenttypes of glial tumors:AstrocytomaOligodendrogliomaGioblastomaGliomasvary intheir aggressiveness,or malignancy.Someareslow-growingandarelikely curableOthers are fast-growing,invasive,difficult to treat,and arelikelyto recur

• A glioma is a type of brain tumor that grows from glial cells. • Glial cells support neurons with energy and nutrients and help maintain the blood-brain barrier. There are various types of glial cells, each with a different function • Glioma is an umbrella term used to describe the different types of glial tumors: • Astrocytoma, • Oligodendroglioma • Gioblastoma. • Gliomas vary in their aggressiveness, or malignancy. Some are slow-growing and are likely curable. • Others are fast-growing, invasive, difficult to treat, and are likely to recur

蘇北人民医院INTRODUCTIONInthisnewera,2016WorldHealthOrganizationclassificationhasincorporatedmolecularinformationintodiagnosesWHO Classification of TumourswHo Ciassification of Tumoursothe Central Nervous Systemofthe Central NervousSystemWHO/ARCClassificationofTumours,4thEditionRevised,Volume1EditedbyLouisDN,Ohgaki H,Wiestler OD,CaveneeWKISBN-13(PrintBook)978-92-832-4492-9phenotypic andgenotypic parametersforCNstumorclassificationdiagnosticimproved Patient managementaccurate determinations of prognosis andtreatment response

In this new era, 2016 World Health Organization classification has incorporated molecular information into diagnoses. phenotypic and genotypic parameters for CNS tumor classification • diagnostic • improved Patient management • accurate determinations of prognosis and treatment response

INTRODUCTION-methylatedMGMTTumorwith methylated MGMT(inactive gene)have been found to predict a longer length ofsurvival,andrespondsbettertochemotherapeutic agents in the treatment ofglioblastoma蘇北人民医院

• Tumor with methylated MGMT (inactive gene) have been found to predict a longer length of survival, and responds better to chemotherapeutic agents in the treatment of glioblastoma

INTRODUCTION--IDH1mutationThe IDH1mutationwas discovered ina small percentageof glioblastoma samples,but majority oflow-grade gliomasandsecondaryhigh-gradegliomasThis mutationwas present in 12%of GBM.These markersare beginning to be used as a diagnostic test for predictinglonger survival andforevaluating theefficacyof newtargetedmoleculardrugsIDH1mutationsmay serveasapredictivebiomarker toguide aggressive surgical resection.Patients withIDH1-mutant glioma were found to have a better overallprognosis thanthosewithwild-type IDH1glioma蘇北人民医院

• The IDH1 mutation was discovered in a small percentage of glioblastoma samples, but majority of low-grade gliomas and secondary high-grade gliomas. • This mutation was present in 12% of GBM. These markers are beginning to be used as a diagnostic test for predicting longer survival and for evaluating the efficacy of new targeted molecular drugs. • IDH1 mutations may serve as a predictive biomarker to guide aggressive surgical resection. Patients with IDH1- mutant glioma were found to have a better overall prognosis than those with wild-type IDH1 glioma

蘇北人民医院CAUSEBrain tumors cannot be prevented. The cause ofthese tumors and other types of brain tumors isunknownScientists have identified abnormalities in the genes ofdifferent chromosomes which may play a role inthedevelopment of tumors. However, what causes thoseabnormalities is still uncertain.Scientists are conducting environmental,occupationalfamilial and genetic research to identify common linksamong patients. Despite a great deal of research onenvironmental hazards, no direct causes have beenfound.The majority of brain tumors are not hereditary

⚫ Brain tumors cannot be prevented. The cause of these tumors and other types of brain tumors is unknown ⚫ Scientists have identified abnormalities in the genes of different chromosomes which may play a role in the development of tumors. However, what causes those abnormalities is still uncertain. ⚫ Scientists are conducting environmental, occupational, familial and genetic research to identify common links among patients. Despite a great deal of research on environmental hazards, no direct causes have been found. ⚫ The majority of brain tumors are not hereditary

蘇北人民医院How do braintumorsCause problems?·Masseffect·Tumor pusheson normal brainLocalinvasion.Tumorsinvade normal brain·MicroscopicEdema·Swelling of normal brain

FRONTALLOBEPARIETALLOBEOCCIPITALMovementLOBESensationSensory PerceptionSpatial RelationsHearingThoughtReasoningLeft:Speech,Motion,SensationBehaviorRight:AbstractConceptsMemoryBehavior(ForRight-HandedIndividuals)MemoryVisionHearing & Vision PathwaysEmotionPONSTEMPORAL LOBECEREBELLUMBalance CoordinationMEDULLAAsabraintumorgrows,itmayinterferewiththenormal functionsofthe brain.Symptomsareanoutwardsignofthisinterference