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世界卫生组织食管肿瘤分类和分期的最新进展:对未来临床实践的影响。

Updates on World Health Organization classification and staging of esophageal tumors: implications for future clinical practice.

机构信息

School of Medicine, Griffith University, Gold Coast Campus, Gold Coast, QLD, 4222, Australia; Faculty of Medicine, The University of Queensland, Brisbane, QLD, 4209, Australia.

出版信息

Hum Pathol. 2021 Feb;108:100-112. doi: 10.1016/j.humpath.2020.10.015. Epub 2020 Nov 4.

Abstract

The Fifth edition of the World Health Organization classification of digestive system and American Joint Committee on Cancer staging manual contain substantial refinements of information for esophageal tumors. The epithelial tumors of esophagus are classified as benign, dysplasia, and malignant groups. Dysplasia is divided into Barrett dysplasia and squamous dysplasia and graded into either low-grade or high-grade. Malignant esophageal tumors are often adenocarcinoma or squamous cell carcinoma. The main update in cancer staging in esophageal tumors is the subdivision of the prognostic staging into 3 groups; squamous cell carcinoma, adenocarcinoma, and carcinoma after adjuvant therapy. HER-2 amplification is recognized as a molecular target for therapy of esophagogastric adenocarcinoma. The other esophageal tumors are adenoid cystic carcinoma, mucoepidermoid/adenosquamous carcinoma, undifferentiated carcinoma and neuroendocrine neoplasms. Overall, the incorporation of new data and definitions on histopathology, prognostic factors, and genetics are important for personalized management of patients with esophageal tumors.

摘要

世界卫生组织第五版消化系统肿瘤分类和美国癌症联合委员会分期手册对食管肿瘤信息进行了实质性的细化。食管上皮肿瘤分为良性、发育不良和恶性肿瘤。发育不良分为 Barrett 发育不良和鳞状发育不良,分为低级别或高级别。恶性食管肿瘤通常为腺癌或鳞状细胞癌。食管肿瘤分期的主要更新是将预后分期细分为 3 组:鳞状细胞癌、腺癌和辅助治疗后的癌。HER-2 扩增被认为是治疗胃食管腺癌的分子靶点。其他食管肿瘤包括腺样囊性癌、黏液表皮样癌/腺鳞癌、未分化癌和神经内分泌肿瘤。总的来说,将新的病理组织学、预后因素和遗传学数据和定义纳入其中,对食管肿瘤患者的个体化治疗具有重要意义。

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