Sakao Yukinori, Kuroda Hiroaki, Saito Yuichi, Yamauchi Yoshikane, Yokote Fumi, Kawamura Masufumi, Yatabe Yasushi
Department of Surgery, Teikyo University School of Medicine, Tokyo, Japan.
Department of Thoracic Surgery, Aichi Cancer Center Hospital, Nagoya, Japan.
J Thorac Dis. 2021 Jan;13(1):366-371. doi: 10.21037/jtd-20-844.
The eighth edition of the Lung Cancer Handling Regulations defines the pathological findings of "invasion" in the pathological diagnosis of lung adenocarcinoma and terms it as adenocarcinoma in situ/minimally invasive carcinoma. In addition, the invasion diameter (tumor diameter excluding the lepidic growth region) was adopted as the pT factor, and the classification further reflected prognosis (degree of invasion/progression). Meanwhile, computed tomography imaging-based classification, where the consolidation (nodule) diameter excluding the ground glass shadow area was defined as cT, and the classification reflected the pathological invasion diameter. It is clear that the revision of the eighth edition has reduced discrepancies in the pathological findings of lung adenocarcinoma in CT imaging and assessment of the degree of invasion and progression. At the same time, the 8th edition is not yet accurate enough. Therefore, we will discuss imaging techniques to better predict the extent of adenocarcinoma invasion and progression, based on our own findings and the literature.
《肺癌诊疗规范(第八版)》明确了肺腺癌病理诊断中“浸润”的病理表现,并将其定义为原位腺癌/微浸润腺癌。此外,采用浸润直径(肿瘤直径不包括贴壁生长区域)作为pT因素,该分类进一步反映了预后(浸润/进展程度)。同时,基于计算机断层扫描成像的分类中,将不包括磨玻璃影区域的实变(结节)直径定义为cT,该分类反映了病理浸润直径。显然,第八版的修订减少了肺腺癌在CT成像中病理表现及浸润和进展程度评估方面的差异。同时,第八版仍不够准确。因此,我们将根据自身研究结果及文献,探讨成像技术以更好地预测腺癌的浸润和进展范围。