2015 年世界卫生组织肺肿瘤分类:自 2004 年分类以来遗传、临床和放射学进展的影响。

The 2015 World Health Organization Classification of Lung Tumors: Impact of Genetic, Clinical and Radiologic Advances Since the 2004 Classification.

机构信息

Department of Pathology, Memorial Sloan Kettering Cancer Center, New York, New York.

Dept d'Anatomie et Cytologie Pathologiques, CHU Albert Michallon, University Joseph Fourier; INSERM U823 Institut Albert Bonniot, Grenoble, France.

出版信息

J Thorac Oncol. 2015 Sep;10(9):1243-1260. doi: 10.1097/JTO.0000000000000630.

Abstract

The 2015 World Health Organization (WHO) Classification of Tumors of the Lung, Pleura, Thymus and Heart has just been published with numerous important changes from the 2004 WHO classification. The most significant changes in this edition involve (1) use of immunohistochemistry throughout the classification, (2) a new emphasis on genetic studies, in particular, integration of molecular testing to help personalize treatment strategies for advanced lung cancer patients, (3) a new classification for small biopsies and cytology similar to that proposed in the 2011 Association for the Study of Lung Cancer/American Thoracic Society/European Respiratory Society classification, (4) a completely different approach to lung adenocarcinoma as proposed by the 2011 Association for the Study of Lung Cancer/American Thoracic Society/European Respiratory Society classification, (5) restricting the diagnosis of large cell carcinoma only to resected tumors that lack any clear morphologic or immunohistochemical differentiation with reclassification of the remaining former large cell carcinoma subtypes into different categories, (6) reclassifying squamous cell carcinomas into keratinizing, nonkeratinizing, and basaloid subtypes with the nonkeratinizing tumors requiring immunohistochemistry proof of squamous differentiation, (7) grouping of neuroendocrine tumors together in one category, (8) adding NUT carcinoma, (9) changing the term sclerosing hemangioma to sclerosing pneumocytoma, (10) changing the name hamartoma to "pulmonary hamartoma," (11) creating a group of PEComatous tumors that include (a) lymphangioleiomyomatosis, (b) PEComa, benign (with clear cell tumor as a variant) and

摘要

2015 年世界卫生组织(WHO)肺、胸膜、胸腺和心脏肿瘤分类刚刚出版,与 2004 年的 WHO 分类相比有许多重要的变化。这一版中最重要的变化涉及:(1)在整个分类中使用免疫组织化学;(2)新强调遗传研究,特别是整合分子检测,以帮助为晚期肺癌患者制定个体化治疗策略;(3)类似于 2011 年肺癌研究协会/美国胸科学会/欧洲呼吸学会分类提出的对小活检和细胞学的新分类;(4)根据 2011 年肺癌研究协会/美国胸科学会/欧洲呼吸学会分类提出的对肺腺癌的完全不同的方法;(5)仅将大细胞癌的诊断限制在缺乏任何明确形态或免疫组织化学分化的切除肿瘤中,并将其余前大细胞癌亚型重新分类为不同类别;(6)将鳞状细胞癌重新分类为角化型、非角化型和基底样亚型,而非角化型肿瘤需要免疫组织化学证明鳞状分化;(7)将神经内分泌肿瘤归类为一类;(8)增加 NUT 癌;(9)将硬化性血管瘤更名为硬化性细支气管肺泡细胞瘤;(10)将错构瘤更名为“肺错构瘤”;(11)创建一组 PeComatous 肿瘤,包括(a)淋巴管平滑肌瘤病,(b)PeComa,良性(有透明细胞肿瘤作为变异型)和

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