The visualization of gliomas in relation to specific genetic chang

Diagnosis of diffuse gliomas

Diffuse gliomas, including glioblastomas, are the most common type of malignant cancers that arise in the brain or spinal cord of a patient. Depending on the type of glioma that a patient has, standardized treatments are relatively non-specific and can include surgery, radiation, chemotherapy, or a combination of these therapies. Also depending on the type of glioma, there are different predicted average survival times ranging from months to years.

Diagnosis of a glioma (or any brain tumor for that matter) is usually made by a neuropathologist such as myself, using a microscope to examine surgical tissue removed from a patient by biopsy or resection. In addition to microscopic examination of brain tumors, a number of genetic tests are available that can also provide additional information about the relative aggressive behavior that an individual glioma may have. These are limited in number, but provide a powerful addition to diagnosis, and in 2016, the World Health Organisation re-classified diffuse gliomas according to molecular parameters as well as traditional histology. There is a continuous need refine the definitions of gliomas based on their genetic signatures in order to better predict clinical outcome and help guide therapy, which is often referred to under the umbrella of ‘precision medicine’ (for a review, seehere).

A new molecular classification scheme

To better understand the genetics of gliomas,Dr. Eric Holland（弗雷德·哈钦森癌症研究中心的高级副总裁兼人类生物学总监）与同事Hamid Bolouri博士，开发了一种可视化技术，该技术代表了基于其遗传特征的密切相关神经胶质瘤的程度。他们的论文big data visualization for gliomaswas published in 2016 and they have launched a web-based, interactive data mining tool termedOncoscape.

Working in close collaboration with Dr. Holland, we recently used Oncoscape as a platform to visualize gliomas according to the World Health Organization’s (WHO) classification scheme, which is the standard classification by which brain tumors are diagnosed. Importantly, we were able to go beyond standard WHO classifications, and derive a新分子分类方案based on relatively few genetic markers that predicted clinical outcome (seeFigure 6有关视觉摘要）。我们进一步验证了该分子分类在大型胶质母细胞瘤中的预后效用。该分类系统具有潜在的基础，可以将其纳入常规临床实践中，希望通过准确的诊断和风险分层来改善单个脑癌患者的生活质量。

Precision medicine for all cancer types

Moving beyond the brain, our work provides aready-made initial platformto do similar analysis for many other cancer types (breast, lung, gastrointestinal, skin, etc). Refining cancer classifications based upon integrated genetic signatures in a user-friendly visual spatial arena offers the hope of pushing forward precision medicine across all cancer types. For me, this is a truly exciting time to not only be a diagnostician, but a cancer researcher trying to incorporate new technologies and genetic understanding of cancer to improve the lives of glioma patients through a lab bench-to-bedside approach.