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Int J Clin Exp Pathol 2013;6(7):1211-1222

Review Article
Signaling pathway and molecular subgroups of medulloblastoma

Kay Ka-Wai Li, Kin-Mang Lau, Ho-Keung Ng

Department of Anatomical and Cellular Pathology, The Chinese University of Hong Kong, Hong Kong

Received April 19, 2013; Accepted May 21, 2013; Epub June 15, 2013; Published July 1, 2013

Abstract: Medulloblastoma (MB) is the most common malignant brain tumor in children. Although multimodality treatment regimens including
surgery, radiotherapy and chemotherapy have greatly improved disease outcome, about one-third of MB patient remains incurable, and many
long-term survivors are suffered from deleterious effects due to aggressive treatment. Understanding the signaling pathways and the genetic
mechanisms contributed to MB development would be the key to develop novel therapeutic treatment strategies for improving survival and
outcome of MB. In this review, we discuss the biological signaling pathways involved in MB pathogenesis. We also go through the current
international consensus of four core MB subgroups namely, SHH, WNT, Group 3, and Group 4. This is adopted based on the knowledge of
genomic complexity of MB as analyzed by recent high-throughput genomic technology. We talk about immunohistochemistry assays
established to determine molecular subgroup affiliation. In the last part of review, we discuss how identification of molecular subgroups is
going to change our routine disease diagnosis and clinical management. (IJCEP1304029).

Keywords: Medulloblastoma, signaling pathway, molecular subgroups

Address correspondence to: Dr. Ho-Keung Ng, Department of Anatomical and Cellular Pathology, The Chinese University of Hong Kong,
Hong Kong. Tel: 852-26376249; Fax: 852-26497286; E-mail: hkng@cuhk.edu.hk