Department of Internal Medicine I, Division of Hematology & Hemostaseology, Ludwig Boltzmann Cluster Oncology, Medical University of Vienna, Vienna, Austria.
Division of Allergy and Clinical Immunology, University of Michigan, Ann Arbor, MI, USA.
EBioMedicine. 2017 Dec;26:17-24. doi: 10.1016/j.ebiom.2017.11.024. Epub 2017 Nov 26.
Cancer evolution is a step-wise non-linear process that may start early in life or later in adulthood, and includes pre-malignant (indolent) and malignant phases. Early somatic changes may not be detectable or are found by chance in apparently healthy individuals. The same lesions may be detected in pre-malignant clonal conditions. In some patients, these lesions may never become relevant clinically whereas in others, they act together with additional pro-oncogenic hits and thereby contribute to the formation of an overt malignancy. Although some pre-malignant stages of a malignancy have been characterized, no global system to define and to classify these conditions is available. To discuss open issues related to pre-malignant phases of neoplastic disorders, a working conference was organized in Vienna in August 2015. The outcomes of this conference are summarized herein and include a basic proposal for a nomenclature and classification of pre-malignant conditions. This proposal should assist in the communication among patients, physicians and scientists, which is critical as genome-sequencing will soon be offered widely for early cancer-detection.
癌症演进是一个逐步的非线性过程，可能在生命早期或成年后开始，包括前恶性（惰性）和恶性阶段。早期的体细胞变化可能无法检测到，或者在看似健康的个体中偶然发现。相同的病变可能在恶性克隆条件中被检测到。在一些患者中，这些病变可能永远不会在临床上产生相关性，而在另一些患者中，它们与其他致癌性打击一起作用，从而有助于形成明显的恶性肿瘤。尽管已经描述了恶性肿瘤的某些前恶性阶段，但目前尚无用于定义和分类这些疾病的全球系统。为了讨论与肿瘤性疾病前恶性阶段相关的未决问题，于 2015 年 8 月在维也纳组织了一次工作组会议。本次会议的结果总结如下，包括前恶性病变的命名和分类的基本建议。该建议将有助于患者、医生和科学家之间的沟通，这一点至关重要，因为基因组测序将很快广泛用于早期癌症检测。
