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肺癌的分子与形态学剖析:“下一代”病理学家和肿瘤学家的基础。

Molecular and Morphological Profiling of Lung Cancer: A Foundation for "Next-Generation" Pathologists and Oncologists.

作者信息

Kashima Jumpei, Kitadai Rui, Okuma Yusuke

机构信息

Department of Pathology, Tokyo Metropolitan Cancer and Infectious diseases Center Komagome Hospital, Tokyo 113-8677, Japan.

Department of Pathology, Graduate School of Medicine, The University of Tokyo, Tokyo 113-0033, Japan.

出版信息

Cancers (Basel). 2019 Apr 29;11(5):599. doi: 10.3390/cancers11050599.

Abstract

The pathological diagnosis of lung cancer has largely been based on the morphological features observed microscopically. Recent innovations in molecular and genetic technology enable us to compare conventional histological classifications, protein expression status, and gene abnormalities. The introduction of The Cancer Genome Atlas (TCGA) project along with the widespread use of the next-generation sequencer (NGS) have facilitated access to enormous data regarding the molecular profiles of lung cancer. The World Health Organization classification of lung cancer, which was revised in 2015, is based on this progress in molecular pathology; moreover, immunohistochemistry has come to play a larger role in diagnosis. In this article, we focused on genetic and epigenetic abnormalities in non-small cell carcinoma (adenocarcinoma and squamous cell carcinoma), neuroendocrine tumor (including carcinoids, small cell carcinoma, and large cell neuroendocrine carcinoma), and carcinoma with rare histological subtypes. In addition, we summarize the therapeutic targeted reagents that are currently available and undergoing clinical trials. A good understanding of the morphological and molecular profiles will be necessary in routine practice when the NGS platform is widely used.

摘要

肺癌的病理诊断很大程度上基于显微镜下观察到的形态学特征。分子和基因技术的最新创新使我们能够比较传统的组织学分类、蛋白质表达状态和基因异常情况。癌症基因组图谱(TCGA)项目的推出以及新一代测序仪(NGS)的广泛应用,促进了获取有关肺癌分子图谱的大量数据。2015年修订的世界卫生组织肺癌分类就是基于分子病理学的这一进展;此外,免疫组织化学在诊断中发挥着越来越重要的作用。在本文中,我们重点关注非小细胞癌(腺癌和鳞状细胞癌)、神经内分泌肿瘤(包括类癌、小细胞癌和大细胞神经内分泌癌)以及具有罕见组织学亚型的癌中的基因和表观遗传异常。此外,我们总结了目前可用以及正在进行临床试验的治疗靶向试剂。当NGS平台广泛应用时,在常规实践中充分了解形态学和分子图谱将是必要的。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/ef11/6562944/1001b728d50a/cancers-11-00599-g001.jpg

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