Abstract
Los gliomas son los tumores más comunes entre las neoplasias primarias del Sistema Nervioso Central. La Organización Mundial de la Salud propone un sistema para su clasificación en cuatro grados crecientes de malignidad, teniendo en cuenta algunos rasgos histológicos. Sin embargo, esta clasificación supone varias limitaciones que afectan la conducta terapéutica y dificultan la predicción pronóstica. Estudios recientes han confirmado el valor pronóstico de alteraciones moleculares específicas, demostrando que la clasificación molecular predice la supervivencia de forma más precisa que el estudio histológico. De estas, las más emblemáticas son la deleción 1p19q y las mutaciones en los genes que codifican para IDH1 y TP53. Las mutaciones en los genes IDH1/2 (80% de los gliomas difusos de grado II), la codeleción 1p19q (70% de los oligodendrogliomas) y las mutaciones en TP53 (60% de astrocitomas difusos) constituyen marcadores de mayor supervivencia, por lo cual deben comprobarse rutinariamente en los pacientes con estos tumores como marcadores de pronóstico.
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