Department of Pathology, University of California San Diego, MC 8720, Room 2-129, 200 West Arbor Drive, San Diego, CA, 92103, USA.
Virchows Arch. 2018 Jun;472(6):897-905. doi: 10.1007/s00428-018-2312-6. Epub 2018 Feb 5.
In this article, we review a novel risk stratification system for endocervical adenocarcinoma, developed by an international consortium of pathologists after reviewing over 350 such tumors. Their analysis culminated in a three-tiered histopathologic system based on morphologic examination of the tumor, independent of clinical features and stage (depth of invasion). It resulted in better determination of patients' tumors and likelihood of lymph node metastasis as well as aggressive behavior. A non-destructive pattern (that in some cases was in the histologic differential diagnosis with adenocarcinoma in situ) had an indolent behavior and was labeled pattern A. The other two patterns had destructive invasion, one only focally (pattern B) while pattern C showed diffuse destructive invasion. This system can help select appropriate treatment modalities avoiding unnecessary complications. We comment on specifics of this system as well as issues in differentiation of the tumor patterns, its clinical utility and recent advances in the molecular arena.
在这篇文章中，我们回顾了一个新的子宫内膜腺癌风险分层系统，该系统由一个国际病理学家联盟开发，他们在回顾了超过 350 例此类肿瘤后得出了这一系统。他们的分析最终基于肿瘤的形态学检查，形成了一个三级组织病理学系统，独立于临床特征和分期（浸润深度）。这有助于更好地确定患者肿瘤和淋巴结转移的可能性以及侵袭性行为。一种非破坏性模式（在某些情况下与原位腺癌的组织学鉴别诊断）具有惰性行为，并被标记为模式 A。另外两种模式具有破坏性浸润，一种仅局灶性（模式 B），而模式 C 则表现为弥漫性破坏性浸润。该系统有助于选择合适的治疗方式，避免不必要的并发症。我们将对该系统的具体内容、肿瘤模式的鉴别、其临床应用以及分子领域的最新进展进行评论。
