Müller K-M, Wiethege T
Institut für Pathologie an den Berufsgenossenschaftlichen Kliniken Bergmannsheil der Ruhr-Universität Bochum.
Radiologe. 2004 May;44(5):415-26. doi: 10.1007/s00117-004-1052-6.
The histopathogical, immunohistochemical, and genetic characterization of specimens of, mostly advanced, lung tumors that show variable phenotypes in biopsies of just 1-2 mm does not allow conclusions regarding causal factors (e.g., smoking, radon, asbestos etc.) or further progress of the disease. Therapeutical approach and the still unfavorable prognosis remain essentially, as in the last thirty years, to be characterized by TNM and performance status of the individual patient and, to a lesser extent, by the main histological type of tumor. In recent years, our knowledge of the quite variable biology of tumors has been significantly increased by the use of immunohistochemical methods and molecular biology. These methods facilitated an improved qualitative and quantitative characterization of heterogeneously differentiated lung tumors (e.g., neuroendocrine/blastomatoid portions etc.). The detection of genetic alterations of tumor suppressor genes and oncogenes is, at the moment, only of scientific interest. The heterogeneity of tumors is emphasized by results obtained by molecular genetic techniques. A connection between the detected genetic anomalies and histomorphological growth patterns can not be seen. At the present time, the validity of individual findings for a correlation between operability, tumor progress, chemotherapy and prognosis is not sufficiently elucidated by investigations nor secured.
在仅1 - 2毫米的活检样本中表现出不同表型的大多数晚期肺肿瘤标本的组织病理学、免疫组织化学和基因特征，无法得出关于病因（如吸烟、氡、石棉等）或疾病进一步进展的结论。治疗方法以及仍然不利的预后，在过去三十年中，基本上仍以个体患者的TNM分期和身体状况为特征，在较小程度上以肿瘤的主要组织学类型为特征。近年来，通过使用免疫组织化学方法和分子生物学，我们对肿瘤相当多变的生物学特性的了解有了显著增加。这些方法有助于对异质性分化的肺肿瘤（如神经内分泌/母细胞瘤样部分等）进行更好的定性和定量表征。目前，肿瘤抑制基因和癌基因的基因改变检测仅具有科学意义。分子遗传技术获得的结果强调了肿瘤的异质性。所检测到的基因异常与组织形态学生长模式之间没有关联。目前，研究尚未充分阐明也未确定个体研究结果对于可手术性、肿瘤进展、化疗和预后之间相关性的有效性。
