Department of Oncology, University of Turin, Turin, Italy.
Inter-Hospital Pathology Division, Servizio Interaziendale di Anatomia Patologica, IRCCS MultiMedica, Via Gaudenzio Fantoli 16/15, 20138, Milan, Italy.
Virchows Arch. 2021 Jan;478(1):5-19. doi: 10.1007/s00428-020-03015-z. Epub 2021 Jan 21.
Neuroendocrine neoplasms (NENs) of the lung encompass neuroendocrine tumors (NETs) composed of typical (TC) and atypical (AC) carcinoids and full-fledged carcinomas (NECs) inclusive of large cell neuroendocrine carcinoma (LCNEC) and small cell carcinoma (SCLC). NETs and NECs are thought to represent distinct and separate lesions with neither molecular overlap nor common developmental continuum. Two perspectives were addressed regarding the morphologic and molecular classification of lung NENs: (i) a supervised approach by browsing the traditional classification, the relevant gene alterations, and their clinical implications; and (ii) an unsupervised approach, by reappraising neoplasms according to risk factors and natural history of disease to construct an interpretation model relied on biological data. We herein emphasize lights and shadows of the current classification of lung NENs and provide an alternative outlook on these tumors focused on what we currently know about the biological determinants and the natural history of disease.
肺神经内分泌肿瘤（NENs）包括典型（TC）和非典型（AC）类癌组成的神经内分泌肿瘤（NETs）以及真正的癌，包括大细胞神经内分泌癌（LCNEC）和小细胞癌（SCLC）。NETs 和 NECs 被认为是具有不同和独立病变的，它们之间没有分子重叠，也没有共同的发育连续性。本文针对肺 NENs 的形态学和分子分类提出了两种观点：（i）通过浏览传统分类、相关基因改变及其临床意义进行有监督的方法；（ii）通过根据疾病的危险因素和自然史重新评估肿瘤进行无监督的方法，构建一个基于生物学数据的解释模型。本文强调了肺 NENs 当前分类的优缺点，并提供了一种关注我们目前对疾病的生物学决定因素和自然史的了解的肿瘤的替代观点。
