How is glioma graded?

Written by Jiang Fang Shuai
Neurosurgery
Updated on September 02, 2024
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According to the characteristics of pathology, gliomas are divided into grades one to four. Grade one is a low-grade malignancy, more benign tumor, accounting for about 5%, with a relatively high probability of successful surgical outcomes. Grade two accounts for about 35%, and after comprehensive treatment including surgery, the survival rate can reach five to ten years, or even longer. Grade three usually develops from grade two, with relatively poor prognosis, and the average survival period is about two years. Grade four, the most malignant glioma, also known as glioblastoma, accounts for about 30%-40%, with an average survival period of less than one year, and very poor outcomes.

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Written by Gao Yi Shen
Neurosurgery
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Can gliomas be inherited?

Gliomas have a certain hereditary proportion, but this is not an absolute concept. In clinical practice, there is no clear explanation for the pathogenic factors of gliomas, and theories are generally speculative. For instance, one factor is genetic nature, and there is also some familial clustering which supports the idea of a genetic predisposition. However, it is usually easier to identify purely genetic diseases, but gliomas often involve the inheritance of multiple genes, making it difficult to pinpoint the fundamental factors directly. Additionally, other factors include exposure to radiation and engaging in harmful work, such as producing methanol or solvents, etc. These can also cause genetic mutations leading to gliomas, so the issue is not necessarily solely genetic.

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Written by Chen Yu Fei
Neurosurgery
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The etiology of glioma

At present, there is no definitive conclusion regarding the specific causes of glioma. Clinically, it is generally considered the result of a combination of congenital genetic factors and acquired environmental factors. Usually, it is believed that there is a significant familial aggregation tendency in the family medical history of patients with gliomas, with a higher incidence of gliomas among family members. Additionally, acquired factors, such as severe cranial trauma followed by extensive proliferation of neuroglial cells, may induce incidents. Furthermore, severe intracranial infections, including unhealthy lifestyles, poor living environments, and the influence of radioactive materials, could potentially lead to the occurrence of gliomas.

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Written by Gao Yi Shen
Neurosurgery
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Is a glioma benign or malignant?

Glioblastoma is the most common form of malignant tumor inside the skull, and the vast majority of glioblastomas are highly malignant. Once changes in this condition are detected, generally, the patient doesn't have much time left. If it is a relatively better glioblastoma, which means it is highly differentiated, the survival time is about 1-2 years. For some poorer glioblastomas, or those with low differentiation, their survival period is often only about six months, and they continuously spread along with nerve fibers to the surrounding areas. They might even metastasize to distant places through cerebrospinal fluid, blood, lymph, and other means. Therefore, even if surgery is used to remove a single lesion, other parts of the body may still demonstrate metastatic lesions. Hence, the treatment approach for this is comprehensive.

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Written by Guo Zhi Fei
Neurosurgery
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Glioma is a type of disease

Glioma is a very common malignant tumor in the brain, with malignancy levels divided into grades I, II, III, and IV. Grade I has the lowest malignancy, close to benign, and patients have a good prognosis after complete surgical removal. Grade IV gliomas have the highest malignancy and are also known as glioblastomas. These tumors do not have clear boundaries, making complete surgical removal impossible, and they are highly prone to recur after surgery, leading to poor prognosis. Even with the most advanced treatments, such as surgery combined with radiotherapy, chemotherapy, and gene therapy, the average survival time is only 12-14 months, and without treatment, the average survival time is only four months.

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Written by Gao Yi Shen
Neurosurgery
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Glioma causes

In clinical practice, the etiology of gliomas is not very clear. It is not as straightforward as how smoking can easily lead to lung cancer or how cirrhosis can easily lead to liver cancer; many factors are speculative. For example, the most common theory in clinical practice involves genetics. Any form of genetic mutation or chromosomal mutation can induce the development of a glioma. For instance, excessive radiation exposure and drug abuse, and even maternal-fetal transmission or a genetic predisposition, could cause chromosomal abnormalities in patients, potentially leading to the formation of gliomas. However, the most fundamental cause has not yet been clearly identified.