Fan Lei, He Ping
Department of Pathology, First Affiliated Hospital of Guangzhou Medical University, Guangzhou 510120, China.
Zhongguo Fei Ai Za Zhi. 2022 Jan 20;25(1):54-60. doi: 10.3779/j.issn.1009-3419.2021.101.49. Epub 2021 Dec 23.
The concept of spread through air spaces (STAS) was first proposed in the World Health Organization (WHO) Classification of Tumors of the Lung, Pleura, Thymus and Heart (version 2015). STAS is defined as the micropapillary clusters, solid nests or single cells of tumor that exist in the air spaces of the surrounding lung parenchyma beyond the edge of the main tumor. Meanwhile, apart from the traditional invasion modes of lung adenocarcinoma (interstitial, visceral pleura and lym-phovascular invasion), STAS has been identified as the fourth invasion mode of lung adenocarcinoma. In recent years, the research on STAS has been a hot spot in the field of lung adenocarcinoma. The existence of STAS is related to lung cancer histopathology, gene mutation and other factors, and many studies have also confirmed that it can be used as an independent factor for tumor recurrence and prognosis. However, according to some studies, human factors can cause morphological artifacts of STAS, which still needs to be distinguished in clinical work. This paper reviews the research progress of STAS classification, related pathological features, genetic status changes, and human factors that may cause STAS artifacts. .
气腔播散(STAS)的概念最早在世界卫生组织(WHO)《肺、胸膜、胸腺和心脏肿瘤分类》(2015年版)中被提出。STAS被定义为存在于主要肿瘤边缘以外周围肺实质气腔内的肿瘤微乳头簇、实性巢或单个细胞。同时,除了肺腺癌的传统侵袭方式(间质、脏层胸膜和淋巴血管侵袭)外,STAS已被确定为肺腺癌的第四种侵袭方式。近年来,关于STAS的研究一直是肺腺癌领域的热点。STAS的存在与肺癌组织病理学、基因突变等因素有关,许多研究也证实它可作为肿瘤复发和预后的独立因素。然而,根据一些研究,人为因素可导致STAS的形态学假象,在临床工作中仍需加以区分。本文综述了STAS的分类、相关病理特征、基因状态变化以及可能导致STAS假象的人为因素的研究进展。