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[关于胃肠道高分化腺癌诊断的思考]

[Consideration of diagnosing extremely well differentiated adenocarcinoma of gastrointestinal tract].

作者信息

Zhou W X, Chen J

机构信息

Department of Pathology, Peking Union Medical College Hospital, Peking Union Medical College, Chinese Academy of Medical Sciences, Beijing 100730, China.

出版信息

Zhonghua Bing Li Xue Za Zhi. 2022 Aug 8;51(8):693-695. doi: 10.3760/cma.j.cn112151-20220517-00425.

Abstract

For gastrointestinal adenocarcinoma with excellent differentiation, some diagnostic names have emerged in recent years, which have overlapping and different meanings. Low-grade well differentiated adenocarcinoma and very well differentiated adenocarcinoma are terms for a group of adenocarcinomas with good differentiation and little cellular atypia, including a variety of histological types. It is suggested that specific histological types should be listed as far as possible in diagnosis, instead of using "low-grade well differentiated adenocarcinoma" or "very well differentiated adenocarcinoma" as a complete diagnosis. This kind of adenocarcinomas may lack cellular pleomorphism, so it is necessary to observe the structural atypia for diagnosis. At the same time, attention should be paid to the differentiation of reactive changes, low grade dysplasia, epithelial misplacement and other lesions.

摘要

对于高分化的胃肠道腺癌,近年来出现了一些诊断名称,其含义存在重叠和差异。低级别高分化腺癌和极高分化腺癌是一组分化良好且细胞异型性小的腺癌的术语,包括多种组织学类型。建议在诊断中尽可能列出具体的组织学类型,而不是使用“低级别高分化腺癌”或“极高分化腺癌”作为完整诊断。这类腺癌可能缺乏细胞多形性,因此诊断时需要观察结构异型性。同时,应注意鉴别反应性改变、低级别发育异常、上皮错位等病变。

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