Petersen Iver, Warth Arne
Institute of Pathology, University Hospital Jena, Ziegelmühlenweg 1, 07743, Jena, Germany.
Institute of Pathology, University Hospital Heidelberg, Heidelberg, Germany.
J Cancer Res Clin Oncol. 2016 May;142(5):895-904. doi: 10.1007/s00432-015-2004-4. Epub 2015 Jul 22.
Diagnostic methods and algorithms for the diagnosis of pulmonary neoplasms have considerably changed over the recent years. Based on large-scale molecular characterization studies and the development of targeted therapies, precise morphological, immunohistochemical, and molecular pathological tumor subtyping is now of utmost importance for evidence-based treatment decisions. Changes of diagnostic concepts initially referred to biopsies and cytology specimens but are now also transferred to resection specimens.
This review is focused on recent developments in morphological and immunohistochemical subtyping of pulmonary neoplasms and concepts of tumor progression. It also provides perspectives on relevant changes of diagnostic concepts within the context of the new WHO classification.
It becomes apparent that a three-step diagnostic concept based on morphology, immunohistochemistry, and molecular pathology is important to meet the requirements of an increasingly more complex, interdisciplinary care of lung cancer patients and to allow for reliable, clinically meaningful tumor diagnoses.
近年来,肺肿瘤的诊断方法和诊断算法发生了显著变化。基于大规模分子特征研究和靶向治疗的发展,精确的形态学、免疫组织化学和分子病理学肿瘤亚型分类对于基于证据的治疗决策至关重要。诊断概念的变化最初涉及活检和细胞学标本,但现在也应用于切除标本。
本综述聚焦于肺肿瘤形态学和免疫组织化学亚型分类的最新进展以及肿瘤进展的概念。它还在新的世界卫生组织分类背景下提供了诊断概念相关变化的观点。
显然,基于形态学、免疫组织化学和分子病理学的三步诊断概念对于满足日益复杂的肺癌患者跨学科护理需求以及实现可靠的、具有临床意义的肿瘤诊断至关重要。