Petersen I
Institut für Pathologie, Universitätsklinikum Jena, Ziegelmühlenweg 1, 07743 Jena.
Pathologe. 2010 Oct;31 Suppl 2:204-10. doi: 10.1007/s00292-010-1371-5.
Lung carcinoma is the most frequent cause of cancer death in Germany. It is characterized by a considerable morphological complexity that has been reduced by clinicians to the distinction between small cell (SCLC) and non-small cell carcinoma (NSCLC). Underpinned by the possibilities of more differentiated tumor therapy, the classification of lung cancer has undergone a re-evaluation, some essential developments of which are summarized in this article. SCLC and NSCLC do not only differ in gene expression and genetic alterations but also in the ploidy level: SCLC is typically hypodiploid, NSCLC often hyperdiploid/near-triploid. Immunohistochemical analysis is meanwhile standard and includes in particular the markers p63, TTF-1, CK5/6, CK7, CD56/NCAM, synaptophysin, chromogranin and Ki67. A new interdisciplinary classification of adenocarcinoma differentiates between preinvasive, minimally invasive and invasive lesions. Lending new weight to the predominantly histological growth patterns it includes information on molecular genetic alterations such as EGFR mutations.
肺癌是德国癌症死亡的最常见原因。其特点是形态学上相当复杂，临床医生已将其简化为小细胞肺癌（SCLC）和非小细胞肺癌（NSCLC）的区分。在更具针对性的肿瘤治疗可能性的支持下，肺癌的分类已经历了重新评估，本文总结了其中一些重要进展。SCLC和NSCLC不仅在基因表达和基因改变方面存在差异，而且在倍体水平上也不同：SCLC通常为亚二倍体，NSCLC常为超二倍体/近三倍体。免疫组织化学分析目前已成为标准方法，特别包括p63、TTF-1、CK5/6、CK7、CD56/NCAM、突触素、嗜铬粒蛋白和Ki67等标志物。腺癌的一种新的跨学科分类区分了浸润前、微浸润和浸润性病变。它赋予主要的组织学生长模式新的重要性，包括有关分子遗传学改变（如EGFR突变）的信息。
