Scoazec Jean-Yves, Couvelard Anne
Service central d'anatomie et cytologie pathologiques, hôpital Édouard-Herriot, 3, place d'Arsonval, 69437 Lyon cedex 03, France.
Service central d'anatomie et cytologie pathologiques, hôpital Bichat Claude Bernard, 75018 Paris, France.
Ann Pathol. 2014 Feb;34(1):40-50. doi: 10.1016/j.annpat.2014.01.003. Epub 2014 Feb 13.
The diagnostic management of a possible case of gastroenteropancreatic neuroendocrine tumor has much changed in the last 10 years. It is now made of four successive steps. The first step is the positive diagnosis, i.e. the definitive identification of the neuroendocrine nature of the tumor: it relies on morphological and immunohistochemical arguments; several national and international recommendations have now clarified the immunohistochemical arguments necessary for, and sufficient to make a diagnosis of gastroenteropancreatic neuroendocrine tumor. The second step is the determination of the grade, essential for the evaluation of the risk of progression: it relies on the determination of the proliferative capacities, according to the proposals of the European NeuroEndocrine Tumor Society (ENETS), later adopted by WHO in 2010. The third step is the histoprognostic classification, which must use a standardized terminology: it is required to use the specific classification proposed in 2010 by WHO in the framework of the revision of the classifications of digestive tumors. The last step is staging, which relies on the use of one of the existing TNM classifications, that, official, proposed by UICC/AJCC or that proposed by ENETS. The minimal informations, which must be present in the pathological report have been stated by the Société Française de Pathologie, at the request of the French National Cancer Institute.
在过去十年中，胃肠胰神经内分泌肿瘤疑似病例的诊断管理发生了很大变化。目前它由四个连续步骤组成。第一步是阳性诊断，即明确肿瘤的神经内分泌性质：这依赖于形态学和免疫组化证据；现在一些国家和国际建议已经阐明了诊断胃肠胰神经内分泌肿瘤所需且足够的免疫组化证据。第二步是确定分级，这对评估进展风险至关重要：它依赖于根据欧洲神经内分泌肿瘤学会（ENETS）的提议确定增殖能力，该提议后来在2010年被世界卫生组织（WHO）采用。第三步是组织预后分类，必须使用标准化术语：需要使用WHO在2010年消化肿瘤分类修订框架内提出的特定分类。最后一步是分期，这依赖于使用现有的TNM分类之一，即国际抗癌联盟（UICC）/美国癌症联合委员会（AJCC）提出的官方分类或ENETS提出的分类。法国病理学会应法国国家癌症研究所的要求，已经说明了病理报告中必须包含的最少信息。
