Department of Pathology, University Hospital Zurich, Zurich, Switzerland.
Instituto de Patología e Investigación, Facultad de Ciencias Médicas, Universidad Nacional de Asunción, San Lorenzo, Paraguay.
Eur Urol. 2016 Jul;70(1):93-105. doi: 10.1016/j.eururo.2016.02.029. Epub 2016 Feb 28.
The fourth edition of the World Health Organization (WHO) classification of urogenital tumours (WHO "blue book"), published in 2016, contains significant revisions. These revisions were performed after consideration by a large international group of pathologists with special expertise in this area. A subgroup of these persons met at the WHO Consensus Conference in Zurich, Switzerland, in 2015 to finalize the revisions. This review summarizes the most significant differences between the newly published classification and the prior version for renal, penile, and testicular tumours. Newly recognized epithelial renal tumours are hereditary leiomyomatosis and renal cell carcinoma (RCC) syndrome-associated RCC, succinate dehydrogenase-deficient RCC, tubulocystic RCC, acquired cystic disease-associated RCC, and clear cell papillary RCC. The WHO/International Society of Urological Pathology renal tumour grading system was recommended, and the definition of renal papillary adenoma was modified. The new WHO classification of penile squamous cell carcinomas is based on the presence of human papillomavirus and defines histologic subtypes accordingly. Germ cell neoplasia in situ (GCNIS) of the testis is the WHO-recommended term for precursor lesions of invasive germ cell tumours, and testicular germ cell tumours are now separated into two fundamentally different groups: those derived from GCNIS and those unrelated to GCNIS. Spermatocytic seminoma has been designated as a spermatocytic tumour and placed within the group of non-GCNIS-related tumours in the 2016 WHO classification.
The 2016 World Health Organization (WHO) classification contains new renal tumour entities. The classification of penile squamous cell carcinomas is based on the presence of human papillomavirus. Germ cell neoplasia in situ of the testis is the WHO-recommended term for precursor lesions of invasive germ cell tumours.
2016 年出版的第四版世界卫生组织（WHO）泌尿生殖系统肿瘤分类（WHO“蓝皮书”）包含了重大修订。这些修订是在具有该领域专业知识的大量国际病理学家审议后进行的。其中一组人员于 2015 年在瑞士苏黎世的世界卫生组织共识会议上会面，以敲定修订内容。本综述总结了新出版的分类与之前版本在肾、阴茎和睾丸肿瘤方面的最显著差异。新认识的肾上皮性肿瘤包括遗传性平滑肌瘤病和肾细胞癌（RCC）综合征相关 RCC、琥珀酸脱氢酶缺陷型 RCC、管状囊性 RCC、获得性囊性疾病相关 RCC 和透明细胞乳头状 RCC。推荐使用世界卫生组织/国际泌尿病理学会肾肿瘤分级系统，并修改了肾腺瘤的定义。新的 WHO 阴茎鳞状细胞癌分类基于人乳头瘤病毒的存在，并相应定义组织学亚型。睾丸生殖细胞肿瘤的原位生殖细胞肿瘤（GCNIS）是侵袭性生殖细胞肿瘤的前体病变的 WHO 推荐术语，并且睾丸生殖细胞肿瘤现在分为两个截然不同的组：来源于 GCNIS 的肿瘤和与 GCNIS 无关的肿瘤。精原细胞瘤已被指定为精原细胞瘤，并被归类为 2016 年 WHO 分类中非 GCNIS 相关肿瘤组中的一种肿瘤。
2016 年世界卫生组织（WHO）分类包含新的肾肿瘤实体。阴茎鳞状细胞癌的分类基于人乳头瘤病毒的存在。睾丸生殖细胞肿瘤的原位生殖细胞肿瘤是侵袭性生殖细胞肿瘤前体病变的 WHO 推荐术语。
