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Historically, central nervous system tumors have been subdivided according to histopathological criteria. The introduction of specific markers has led to a shift from purely histological and immunohistochemical classification to one predominantly centered on molecular aspects. The WHO 2021 classification represents a milestone in this integration process, leading to a redefinition of the diagnostic and prognostic aspects of central nervous system tumors. In particular, the last editions re-evaluated the prognostic impact of IDH mutation in glioma pathologies, stressed its clinical importance in decision planning, and introduced novel molecular features describing new tumor types. This review aimed to summarize the major changes in the classification of glioma tumors, focusing on an integrative approach to improve diagnostic classification and make treatment choices more targeted. In doing so, new biomarkers are identified, and new strategies are described; for example, by combining imaging features with specific molecular pathways, radiogenomics may become a new frontier in neuro-oncology. Although the current WHO classification is a valuable tool, there are still several aspects to be improved, which underlines the need to evolve the current classification toward a patient-oriented type of precision medicine and to further stratify this type of neoplasm.

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Brief Insight Into Central Nervous System Tumors: An Update on Current Status in Glioma Classification

  • 章节

  • 发表日期：

    2025年

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  • Francesca Rizzo,
  • Alberto Morello,
  • Roberta Rudà,
  • Diego Garbossa,
  • Fabio Cofano

摘要

Historically, central nervous system tumors have been subdivided according to histopathological criteria. The introduction of specific markers has led to a shift from purely histological and immunohistochemical classification to one predominantly centered on molecular aspects. The WHO 2021 classification represents a milestone in this integration process, leading to a redefinition of the diagnostic and prognostic aspects of central nervous system tumors. In particular, the last editions re-evaluated the prognostic impact of IDH mutation in glioma pathologies, stressed its clinical importance in decision planning, and introduced novel molecular features describing new tumor types. This review aimed to summarize the major changes in the classification of glioma tumors, focusing on an integrative approach to improve diagnostic classification and make treatment choices more targeted. In doing so, new biomarkers are identified, and new strategies are described; for example, by combining imaging features with specific molecular pathways, radiogenomics may become a new frontier in neuro-oncology. Although the current WHO classification is a valuable tool, there are still several aspects to be improved, which underlines the need to evolve the current classification toward a patient-oriented type of precision medicine and to further stratify this type of neoplasm.