诊断
用于诊断星形细胞瘤的检查和程序包括：
- 神经系统检查。 在神经系统检查期间，医护团队成员将询问您的症状。他们将检查您的视力、听力、平衡能力、协调能力、力量和反射。其中一个或多个方面的问题可能有助于显示脑肿瘤影响了您大脑中的哪个部位。
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成像检查。 成像检查有助于确定脑肿瘤的位置和大小。MRI 通常用于诊断脑肿瘤。MRI 可与专业化 MRI 成像一起进行，例如功能 MRI、灌注 MRI 或磁共振波谱成像。
其他成像检查可能包括 CT 和正电子发射体层成像扫描，也称为 PET 扫描。
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采集组织样本进行检测。 活检是一种从肿瘤中采集组织样本并进行检测的程序。通常在切除星形细胞瘤的手术过程中采集样本。如果星形细胞瘤位于手术工具难以触及的部位，则可能用针获取样本。使用哪种方法取决于您的情况。将组织送到实验室进行检查。这些检测可以确定细胞的类型以及细胞生长的速度。
特殊检测可显示有关肿瘤细胞的详细信息。这些检测可能会寻找肿瘤细胞遗传物质（称为 DNA）的变化。医护团队可根据检测结果了解预后情况。团队使用这些信息制定治疗计划。
Neurological exam
During this exam, your healthcare team asks about your symptoms. You may have tests to check your vision, hearing, balance, coordination, strength and reflexes. Trouble in one or more of these areas may help show the part of your brain affected by a brain tumor.
Removing a sample of tissue for testing
A biopsy is a procedure to take a sample of tissue from the tumor for testing. After imaging shows a possible tumor, a biopsy is needed to confirm the diagnosis and learn more about the tumor's molecular features. The sample often is taken during surgery to remove the astrocytoma.
If the astrocytoma is in a spot that's hard to reach with surgical tools, a needle might be used to get the sample. The tissue goes to a lab for review under a microscope. Tests can determine the types of cells and how quickly they grow. This is called molecular testing. During this testing, doctors also study the tumor's genes and molecules. Types of molecular testing include:
- IDH (isocitrate dehydrogenase) testing. This test looks for a change in the IDH1 or IDH2 gene. Tumors with this change usually grow more slowly and respond better to treatment.
- MGMT (O-6-methylguanine-DNA methyltransferase) promoter methylation. This test looks at whether this DNA repair gene is "turned off." If it is, the tumor may respond better to chemotherapy with the medicine temozolomide.
- 1p/19q codeletion. This tests whether parts of chromosomes 1 and 19 are missing. This helps confirm whether the tumor is an oligodendroglioma. This type of tumor often responds well to radiation and chemotherapy.
A biopsy is the only way to confirm the diagnosis of astrocytoma and find out what type and grade it is. Testing done on the biopsy sample can help predict how the tumor will grow and behave, and which treatments are most likely to be effective.
Together, these tests help the care team confirm the exact tumor type and predict how it will behave, and choose the most effective treatment plan.
Can spinal taps or blood tests detect astrocytoma?
No, spinal taps and blood tests usually can't detect an astrocytoma. Astrocytomas form inside the brain or spinal cord. Routine blood work or spinal fluid tests don't show clear signs of these tumors.
In some rare cases, a healthcare professional may do a spinal tap (lumbar puncture) to check for tumor cells in the cerebrospinal fluid (CSF). This may be done if there's concern the tumor has spread within the brain or spinal canal. But this test is used only in special situations after imaging suggests the tumor has spread.
Blood tests are mainly used to check general health and to see how the body is handling treatment, not to find the tumor itself.
Imaging tests
To see the tumor more clearly, your care team may use imaging tests. A brain MRI is often used to diagnose brain tumors. Sometimes special types of MRI, such as functional MRI, perfusion MRI, or MR spectroscopy, are used. Other imaging tests may include CT and positron emission tomography (PET) scans.
What scans are best for diagnosing astrocytomas?
MRI with contrast is the main scan for spotting and studying an astrocytoma because it shows brain and spinal cord tissue in much greater detail. CT is mainly used if MRI isn't possible or in emergencies. MRI with contrast helps doctors see both small, slow-growing and aggressive tumors clearly.
Does a pilocytic astrocytoma look different on an MRI?
On MRI, a pilocytic astrocytoma looks smoother and more organized. Higher grade tumors look rougher and more destructive in the surrounding tissue. A grade 1 pilocytic astrocytoma usually looks different from higher grade astrocytomas because it grows slowly. It also tends to stay well defined instead of blending into nearby brain tissue.
Pilocytic astrocytomas often look like cysts. They are round or oval masses with a fluid pocket. The tumor's solid part lights up clearly on the scan after the contrast is given. Pilocytic astrocytomas have clear borders and less swelling around them.
Higher grade astrocytomas, such as diffuse, anaplastic or glioblastoma types, often look more uneven and spread into nearby brain tissue. They usually have blurred edges, swelling around the tumor and patchy bright areas after contrast is given. These bright spots happen because parts of the tumor may have dead cells. Or they may have new and unusual looking blood vessels.
Special tests can provide detailed information about the tumor cells. Tests might look for changes in the genetic material of the tumor cells, called DNA. The information helps your healthcare team understand what to expect and decide on the best treatment for you.
治疗
星形细胞瘤的治疗方法包括：
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通过手术切除星形细胞瘤。 脑外科医生（也称为神经外科医生）会设法尽可能多地切除星形细胞瘤。目标是完全切除肿瘤。有时肿瘤位于难以触及的部位。将其全部切除可能会太过冒险。即便如此，切除部分星形细胞瘤可能会减轻症状。
对于一些患者来说，手术可能是唯一需要的治疗方法。对于其他患者，可能会建议进行更多的治疗以便杀死任何剩余肿瘤细胞并降低肿瘤复发风险。
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放射疗法。 放射疗法利用强能量束来杀死肿瘤细胞。能量可能来自 X 线、质子和其他来源。进行放射疗法时，患者躺在治疗床上，同时有一台机器在其周围移动。机器将能量束发送到脑部的准确位置。治疗仅需几分钟。
放射疗法可能在外科手术后进行。如果癌症未完全切除或癌症复发风险较高，则可采用放射疗法。放射疗法可与化疗一起用于治疗生长迅速的癌症。对于无法进行手术的患者，放射疗法和化疗可作为主要治疗方法。
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化疗。 化疗使用强效药物杀死肿瘤细胞。化疗药物可能是口服药剂，也可能通过静脉注射给药。有时，可能在术后将覆有化疗药物的圆形晶片放置在脑部。在该处，它会慢慢溶解并释放出药物。
术后通常会使用化疗来杀死可能残留的任何肿瘤细胞。化疗可与放射疗法一起用于治疗生长迅速的肿瘤。
- 临床试验。 临床试验是对新治疗方法进行的研究。这些研究让患者有机会尝试最新的治疗方案。发生副作用的风险可能未知。询问医护团队成员您是否可以参加临床试验。
- 支持性护理。 支持性护理也称为姑息治疗，侧重于缓解严重疾病的疼痛和其他症状。姑息治疗专科医生与您、您的家人和您的其他医护团队成员合作以提供额外支持。可以在接受其他治疗（如手术、化疗或放射疗法）的同时使用姑息治疗。通常，姑息治疗从您开始星形细胞瘤治疗时就可开始。您可能不需要等待至出现并发症才接受姑息治疗。
Astrocytoma treatment: Watchful waiting
Watchful waiting for low-grade astrocytoma, also called active surveillance, can be safe for some small, slow-growing tumors when the risks of surgery outweigh the benefits. But close monitoring is essential, and treatment should begin at the first sign of change.
Watchful waiting can be considered in select cases of low-grade astrocytoma, but it depends on several key factors:
- The tumor is small and does not cause symptoms. If the tumor was found by chance and does not affect brain function, your care team may monitor it closely with MRI scans instead of treating it right away.
- Surgery would cause high risk. If the tumor is in a deep or critical area of the brain where surgery could harm important functions, watchful waiting can sometimes be safer until there is clear growth or change.
- Diagnosis is uncertain. When the imaging suggests a low-grade tumor but a biopsy would be risky, watchful waiting can help track tumor growth over time.
Astrocytoma clinical trials and emerging treatments
Researchers are testing new astrocytoma treatments through clinical trials, including targeted therapy, immunotherapy and Tumor-Treating Fields (TTFields). Many of these treatments are still in clinical trials, where experts test new medicines and technologies to see how safe and effective they are. Clinical trials test new treatments such as vaccines, chimeric antigen receptor (CAR)-T cell therapy and viral therapies that target tumor cells directly.
A clinical trial may be an option for some people, especially if the tumor returns or stops responding to standard treatments. Some trials study targeted therapy, which uses medicines designed to act on certain proteins or genes in tumor cells. Other trials look at immunotherapy, which helps your body's defense system fight the tumor. Trials also are exploring better ways to combine surgery, radiation and chemotherapy.
Treatments being studied include:
- Temozolomide. Temozolomide is a chemotherapy medicine already used with radiation therapy to treat higher grade astrocytomas. Researchers are studying ways to make it work even better, such as changing how it's given or combining it with new treatments to improve results and lower side effects.
- IDH inhibitors. Some astrocytomas have changes in a gene called IDH. Medicines known as IDH inhibitors are being tested for people with this gene change. Studies suggest these treatments might help slow tumor growth, and more research is underway.
- Tumor-treating fields, also called TTFields. TTFields use low-intensity electrical fields to disrupt how cancer cells grow and divide. This treatment is already approved for glioblastoma, which is a high-grade astrocytoma. Studies show that TTFields can help people live longer when used with standard treatments such as radiation therapy. Researchers continue to study how best to combine TTFields with other therapies.
Taking part in a trial may give you access to these options before they are widely available. Because these treatments are still being studied, the risks and benefits may not yet be fully known. Your healthcare team can help you decide if a clinical trial is right for you.
How treatment differs for spinal cord or brainstem astrocytomas
Treatment for spinal cord astrocytoma and brainstem astrocytoma differs because surgery in these areas can affect vital nerves and functions.
| Location |
Typical first treatment |
Other treatments |
Why it's different |
| Spinal cord |
Surgery to remove as much tumor as is safely possible |
Radiation or chemotherapy if the tumor can't be fully removed or if it's high grade. |
The tumor grows inside the spinal cord. Surgeons must protect the nerve pathways that control feeling and movement. |
| Brainstem |
Often biopsy only or very limited surgery, if safe |
Radiation is the main treatment. Chemotherapy may be added, especially in children. |
The brainstem controls breathing, heart rate and swallowing, so surgery is often too risky. |
临床试验
探索 Mayo Clinic 的研究 测试新的治疗、干预与检查方法，旨在预防、检测、治疗或控制这种疾病。
准备您的预约
如果出现任何令您担心的症状，请与医生或其他医务人员约诊。如果医务人员认为您患有星形细胞瘤，您可能会被转诊给专科医生。该专科医生可能是一位癌症医生，称为肿瘤科医生。您还可以到专门从事脑手术的外科医生（称为神经外科医生）处就诊。
就诊时间可能很短，做好准备可能会有所帮助。以下信息可能有助于您做好准备。
您能做些什么
在约诊时，询问是否需要提前做好任何准备，例如进行某项特定检查前是否需要禁食。请列出以下内容：
- 您的症状，包括看似与约诊原因无关的任何症状。
- 关键个人信息，包括重大压力、近期生活变化和家族病史。
- 服用的所有药物、维生素或其他补充剂，包括剂量。
- 要向医生咨询的问题。
如果可能，请家人或朋友陪同就诊，他们可以帮忙记住医生提供的信息。
关于星形细胞瘤，要向医务人员咨询的一些基本问题包括：
- 我是否患有癌症？
- 如果肿瘤不是癌性的，我还需要将其切除吗？
- 我是否需要做更多检查？
- 有哪些可选的治疗方案？
- 这些治疗方案有哪些潜在风险？
- 这些治疗是否会治好我的癌症？
- 能否给我一份病理报告副本？
- 我有多少时间来考虑选择哪个治疗方案？
- 是否有我可以带走的手册或其他印刷材料？ 您推荐哪些网站？
- 如果我选择不接受治疗，会怎样？
如果还有其他问题，请随时提出。
医生可能会做什么
医务人员可能会询问一些问题，例如：
- 何时开始出现症状？
- 症状是持续存在，还是偶尔出现？
- 您的症状有多严重？
- 有没有什么因素似乎会改善症状？
- 有没有什么因素似乎会加重症状？
Nov. 07, 2025