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[良性结肠上皮肿瘤分类中的一种新类型(世界卫生组织,2019年,第5版)]

[A new one in the classification of benign colon epithelial tumors (WHO, 2019, 5th edition)].

作者信息

Oleynikova N A, Malkov P G, Danilova N V

机构信息

Lomonosov Moscow State University, Medical Research and Educational Center, 119192, Russian Federation, Moscow, Lomonosovsky Prospekt, 27-10.

Lomonosov Moscow State University, Medical Research and Educational Center, 119192, Russian Federation, Moscow, Lomonosovsky Prospekt, 27-10; Russian Medical Academy of Postgraduate Professional Education 125993, Russian Federation, Moscow, Barrikadnaya, 2/1, build 1.

出版信息

Arkh Patol. 2020;82(2):35-42. doi: 10.17116/patol20208202135.

Abstract

The 2019 WHO Classification of Benign Colon Epithelial Neoplasms includes serrated dysplasia, adenomatous polyps, and glandular intraepithelial neoplasia. Serrated dysplasia (ICD-O 8213/0 and 8213/2) is former serrated masses. There is an expected change in its terminology: it is proposed to use the term 'sessile serrated lesion' (SSL) instead of that 'sessile serrated polyp/adenoma' that causes a lot of discussion. The 2019 WHO Classification versus the 2010 WHO classification more clearly defines the TSA criteria: slit-like serration and high elongated cells with pronounced eosinophilic cytoplasm and an elongated pencillate nucleus. The traditional adenomas are renamed in the classification; the term 'adenomatous polyps' that still includes tubular, tubulovillous, and villous adenomas is adopted instead of the term 'adenomas'. The criteria for adenomas remain the same (by the area occupied by villous structures). The 5th edition introduces a separate large section devoted to inflammatory bowel disease-associated dysplasia that is defined as obvious epithelial neoplastic changes that are limited to the basement membrane. The diagnosis can only be used for specific lesions, such as Crohn's colitis and ulcerative colitis.

摘要

《2019年世界卫生组织良性结肠上皮性肿瘤分类》包括锯齿状发育异常、腺瘤性息肉和腺上皮内瘤变。锯齿状发育异常(ICD-O 8213/0和8213/2)是既往的锯齿状肿物。其术语有预期变化:建议使用“无蒂锯齿状病变”(SSL)这一术语,而非引发诸多讨论的“无蒂锯齿状息肉/腺瘤”。与《2010年世界卫生组织分类》相比,《2019年世界卫生组织分类》更明确地界定了TSA标准:裂隙状锯齿和高柱状细胞,胞质嗜酸性明显,核呈细长铅笔状。在该分类中传统腺瘤有了新名称;采用仍包含管状、管状绒毛状和绒毛状腺瘤的“腺瘤性息肉”这一术语,而非“腺瘤”。腺瘤的标准保持不变(依据绒毛结构所占面积)。第5版新增了一个单独的大章节,专门论述炎症性肠病相关发育异常,其定义为局限于基底膜的明显上皮肿瘤性改变。该诊断仅适用于特定病变,如克罗恩结肠炎和溃疡性结肠炎。

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