Junker K
Institut für Pathologie der Ruhr-Universität Bochum an den BG-Kliniken Bergmannsheil.
Pathologe. 2004 Nov;25(6):475-80. doi: 10.1007/s00292-004-0719-0.
Especially patients with locally advanced non-small cell lung cancer, but also patients with small cell lung cancer without distant metastases are increasingly treated by means of neoadjuvant multimodality therapy. In corresponding resection specimens of primary tumours and lymph nodes, the extent of therapy-induced tumour regression represents an independent prognostic factor. After neoadjuvant therapy, different-sized target-like foci with central necrosis, adjoining narrow foam cell rim, peripheral vascular granulation tissue and transition into a marked scarry fibrosis can be established in the former tumour area. Morphological changes indicating therapy-induced tumour regression can be graded according to the "Bochum regression grading" system. Cytomorphological changes do not allow reliable conclusions to be drawn about the success of the applied neoadjuvant therapy. In resection specimens, they should not form the basis of a cytopathologic grading or lead to the diagnosis of "large cell anaplastic carcinoma".
尤其是局部晚期非小细胞肺癌患者,以及无远处转移的小细胞肺癌患者,越来越多地接受新辅助多模式治疗。在原发性肿瘤和淋巴结的相应切除标本中,治疗诱导的肿瘤退缩程度是一个独立的预后因素。新辅助治疗后,在前肿瘤区域可形成不同大小的靶样病灶,伴有中央坏死、相邻的狭窄泡沫细胞边缘、外周血管肉芽组织,并过渡为明显的瘢痕纤维化。可根据“波鸿退缩分级”系统对表明治疗诱导肿瘤退缩的形态学变化进行分级。细胞形态学变化无法可靠推断所应用新辅助治疗的成功与否。在切除标本中,它们不应构成细胞病理学分级的基础,也不应导致“大细胞间变性癌”的诊断。