Gliomas account for 40-50% of all intracranial tumors and are the most common intracranial tumor. Some people have long viewed gliomas as the same as cancers in the brain, but this is not the case. First of all, a huge difference is that gliomas do not usually metastasize or spread like other malignant tumors. Secondly, glioma has different pathological grade or malignancy, and the pathological grade and malignancy are important for the treatment and prognosis of the tumor. The most malignant glioma can have a recurrence period shorter than half a year, and some low-grade glioma can have a survival period of more than 10 years or even be cured, which is not available for other systemic tumors. The pathological grade of glioma is made by pathologists under the microscope according to the tissue structure and cellular characteristics of the tumor, which is generally divided into 3-4 grades, in order of glioma grade 1, 2, 3 and 4. Grade 1 is generally benign, mainly hairy cell astrocytes, accounting for about 5% of gliomas, and is curable; grade 2 is a general astrocytoma or astro-oligodendroglioma, accounting for about 40% of gliomas, with a prognosis of 5-10 years or even longer; grade 3 is a mesenchymal astrocytoma, accounting for about 15-25% of gliomas, generally evolving from grade 2, with an average survival of about 2-3 years; grade 4 is glioblastoma, accounting for about 1/3 of gliomas, with an average survival time of about six months-two years. However, it is common for glioma heterogeneity to cause differences in sampling and subjective judgment errors among pathologists, resulting in high or low pathological grade. Prognosis of glioma The current treatment principle of glioma is mainly surgery, supplemented by different radiotherapy and chemotherapy depending on the surgical resection. Grade 1 glioma is not infiltrated, so we should strive for total excision, because total excision can cure the tumor, otherwise it will recur; Grade 2 glioma is more complicated to treat, because not all grade 2 tumors are operated immediately after diagnosis. The author does not recommend immediate surgical treatment for such patients. I have had some patients with low grade gliomas in functional areas who were diagnosed and then operated on after 3-5 years of follow-up to obtain the same therapeutic effect, but the important thing is that they have gained 3-5 years of near normal life and work time, but for non-functional areas, occupying effects and mature grade 2 gliomas can be operated on as early as possible. Glioma should be removed as much as possible while preserving function, especially the areas showing enhancement, because these areas are the most malignant parts of the tumor residuals can recur quickly; Grade 4 glioma should be removed as thoroughly and extensively as possible including some non-functional areas of the edematous zone due to rapid tumor growth and severe infiltration into the surrounding area while preserving function.