Departments of Pathology and Obstetrics, Gynecology and Reproductive Science, University of California San Francisco/Mt Zion Medical Center, 1600 Divisadero St,, San Francisco, CA 94115, USA.
J Low Genit Tract Dis. 2012 Jul;16(3):205-42. doi: 10.1097/LGT.0b013e31825c31dd.
The terminology for human papillomavirus (HPV)-associated squamous lesions of the lower anogenital tract has a long history marked by disparate diagnostic terms derived from multiple specialties. It often does not reflect current knowledge of HPV biology and pathogenesis. A consensus process was convened to recommend terminology unified across lower anogenital sites. The goal was to create a histopathologic nomenclature system that reflects current knowledge of HPV biology, optimally uses available biomarkers, and facilitates clear communication across different medical specialties. The Lower Anogenital Squamous Terminology (LAST) Project was cosponsored by the College of American Pathologists and the American Society for Colposcopy and Cervical Pathology and included 5 working groups; 3 work groups performed comprehensive literature reviews and developed draft recommendations. Another work group provided the historical background and the fifth will continue to foster implementation of the LAST recommendations. After an open comment period, the draft recommendations were presented at a consensus conference attended by LAST work group members, advisors, and representatives from 35 stakeholder organizations including professional societies and government agencies. Recommendations were finalized and voted on at the consensus meeting. The final, approved recommendations standardize biologically relevant histopathologic terminology for HPV-associated squamous intraepithelial lesions and superficially invasive squamous carcinomas across all lower anogenital tract sites and detail the appropriate use of specific biomarkers to clarify histologic interpretations and enhance diagnostic accuracy. A plan for disseminating and monitoring recommendation implementation in the practicing community was also developed. The implemented recommendations will facilitate communication between pathologists and their clinical colleagues and improve accuracy of histologic diagnosis with the ultimate goal of providing optimal patient care.
人乳头瘤病毒（HPV）相关的下生殖道和肛门生殖器区鳞状病变的术语有着悠久的历史，其特点是来自多个专业的诊断术语各不相同。这些术语往往不能反映 HPV 生物学和发病机制的最新知识。因此，召集了一个共识会议来推荐下生殖道和肛门生殖器区统一的术语。目标是创建一个反映 HPV 生物学最新知识、最佳利用现有生物标志物并促进不同医学专业之间清晰沟通的组织病理学命名系统。下生殖道和肛门生殖器区鳞状术语（LAST）项目由美国病理学家学会和美国阴道镜和宫颈病理学会共同赞助，包括 5 个工作组；其中 3 个工作组进行了全面的文献回顾并制定了草案建议。另一个工作组提供了历史背景，第五个工作组将继续推动 LAST 建议的实施。在公开征求意见期后，LAST 工作组的成员、顾问以及来自 35 个利益相关组织（包括专业协会和政府机构）的代表出席了共识会议，会上介绍了草案建议。在共识会议上，对建议进行了最终确定和投票。最终批准的建议规范了所有下生殖道和肛门生殖器区与 HPV 相关的鳞状上皮内病变和表浅浸润性鳞状细胞癌的生物学相关组织病理学术语，并详细说明了特定生物标志物的适当使用，以澄清组织学解释并提高诊断准确性。还制定了在实践社区中传播和监测建议实施的计划。实施的建议将促进病理学家与其临床同事之间的沟通，并提高组织学诊断的准确性，最终目标是为患者提供最佳护理。
