Rocco Raffaele, Jones David R, Morabito Alessandro, Franco Renato, La Mantia Elvira, Rocco Gaetano
1 Department of Surgery, Campus Biomedico University, Rome, Italy ; 2 Division of Thoracic Surgery, Memorial Sloan Kettering Cancer Center, New York, USA ; 3 Departments of Thoracic Surgery and Oncology and Pathology, Istituto Nazionale Tumori, IRCCS, Fondazione "G.Pascale", Naples, Italy.
J Thorac Dis. 2014 Oct;6(Suppl 5):S547-51. doi: 10.3978/j.issn.2072-1439.2014.06.43.
The conclusions from the new IASLC/ATS/ERS lung adenocarcinoma classification portend important clinical consequences. The interpretation of the histological, biomolecular and radiological correlates of this classification not only allows for the definitive abandonment of the bronchoalveolar carcinoma definition but provides surgeons with significant clues to better understand the adenocarcinoma subsets and their surgical management. Indeed, the information will benefit surgeons who are fully involved in the lung cancer CT screening programs as well as in the diagnostic and therapeutic pathways of both early and locally advanced lung cancer. Moreover, intriguing perspectives are disclosing on the inclusion of the surgical modality among the ones used in the oligometastatic disease status. On the other hand, the new adenocarcinoma classification also emphasizes the need for surgeons working in a multidisciplinary environment to be thoroughly cognizant of the ever evolving lung cancer biomolecular knowledge and, in particular, of the potentially druggable somatic mutations in line with the modern professional profile of the so-called "surgeon scientist".
国际肺癌研究协会（IASLC）/美国胸科学会（ATS）/欧洲呼吸学会（ERS）发布的新版肺腺癌分类标准具有重要的临床意义。对该分类标准中的组织学、生物分子学及影像学关联因素进行解读，不仅能够彻底摒弃细支气管肺泡癌的定义，还能为外科医生提供重要线索，助其更好地理解肺腺癌的各个亚组及其手术治疗方法。事实上，这些信息将使那些深度参与肺癌CT筛查项目以及早期和局部晚期肺癌诊断与治疗路径的外科医生受益。此外，关于将手术方式纳入寡转移疾病状态治疗手段的前景也备受关注。另一方面，新版肺腺癌分类标准还强调，在多学科环境中工作的外科医生需要全面了解不断发展的肺癌生物分子知识，尤其是与所谓“外科科学家”这一现代职业形象相符的潜在可靶向治疗的体细胞突变。
