Truini Anna, Santos Pereira Poliana, Cavazza Alberto, Spagnolo Paolo, Nosseir Sofia, Longo Lucia, Jukna Agita, Lococo Filippo, Vincenzi Giada, Bogina Giuseppe, Tiseo Marcello, Rossi Giulio
a 1 Lung Cancer Unit, IRCCS AOU San Martino - IST and Dipartimento di Medicina Interna e Specialità Mediche (DIMI), Università di Genova, Genova, Italy.
b 2 Operative Unit of Pathologic Anatomy Hospital "Maggiore della Carità" of Novara, Novara, Italy.
Expert Rev Respir Med. 2015 Oct;9(5):571-86. doi: 10.1586/17476348.2015.1083428. Epub 2015 Aug 27.
The epidemic increase of adenocarcinoma histology accounting for more than 50% of primary lung malignancies and the advent of effective molecular targeted-therapies against specific gene alterations characterizing this tumor type have led to the reconsideration of the pathologic classification of lung cancer. The new 2015 WHO classification provided the basis for a multidisciplinary approach emphasizing the close correlation among clinical, radiologic and molecular characteristics and histopathologic pattern of lung adenocarcinoma. The terms 'bronchioloalveolar carcinoma' and 'mixed adenocarcinoma' have been eliminated, introducing the concepts of 'adenocarcinoma in situ', 'minimally invasive adenocarcinoma' and the use of descriptive predominant patterns in invasive adenocarcinomas (lepidic, acinar, papillary, solid and micropapillary patterns). 'Invasive mucinous adenocarcinoma' is the new definition for mucinous bronchioloalveolar carcinoma, and some variants of invasive adenocarcinoma have been included, namely colloid, enteric and fetal-type adenocarcinomas. A concise update of the immunomorphologic, radiological and molecular characteristics of the different histologic patterns of lung adenocarcinoma is reported here.
腺癌组织学类型的流行率增加，在原发性肺恶性肿瘤中占比超过50%，并且针对该肿瘤类型特征性特定基因改变的有效分子靶向治疗的出现，促使人们重新思考肺癌的病理分类。2015年世界卫生组织（WHO）的新分类为多学科方法提供了基础，该方法强调肺腺癌的临床、放射学和分子特征与组织病理学模式之间的密切相关性。“细支气管肺泡癌”和“混合性腺癌”这两个术语已被摒弃，引入了“原位腺癌”“微浸润腺癌”的概念，以及在浸润性腺癌中使用描述性主要模式（鳞屑状、腺泡状、乳头状、实体状和微乳头状模式）。“浸润性黏液腺癌”是黏液性细支气管肺泡癌的新定义，并且纳入了浸润性腺癌的一些变体，即胶样癌、肠型癌和胎儿型腺癌。本文报告了肺腺癌不同组织学模式的免疫形态学、放射学和分子特征的简要更新情况。
