Department of Pathology and Laboratory Medicine, Advanced Medical Research Institute and CORE Diagnostics, Gurgaon, 122016, India.
Department of Pathology and Laboratory Medicine, Kapoor Center of Urology and Pathology, Raipur, 490042, India.
Hum Pathol. 2023 Jun;136:123-143. doi: 10.1016/j.humpath.2022.08.006. Epub 2022 Sep 6.
The fifth edition of the World Health Organization (WHO) classification of urinary and male genital organ tumors has been recently published in 2022. The application of molecular profiling has made a substantial impact on the classification of urologic tumors. The new WHO classification introduces a group of molecularly well-defined renal tumor subtypes. The significant changes include addition of a category of "other oncocytic tumors" with oncocytoma/chromophobe renal cell carcinoma (chRCC)-like features, elimination of the subcategorization of type 1/2 papillary RCC, and inclusion of eosinophilic solid and cystic RCC as an independent tumor entity. The WHO/ISUP grading now has been recommended for all RCCs. Major nomenclature changes include replacement of histologic "variants" by "subtypes," "clear cell papillary renal cell carcinoma" to "clear cell renal cell tumor," "TCEB1-mutated RCC" to "ELOC-mutated RCC," "hereditary leiomyomatosis and renal cell carcinoma" to "fumarate hydratase-deficient RCC," "RCC-Unclassified" to "RCC-NOS," "primitive neuroectodermal tumor" to "embryonic neuroectodermal tumor," "testicular carcinoid" to "testicular neuroendocrine tumor," and "basal cell carcinoma of the prostate" to "adenoid-cystic (basal-cell) carcinoma of the prostate." Metastatic, hematolymphoid, mesenchymal, melanocytic, soft tissue, and neuroendocrine tumors are collectively discussed in separate chapters. It has been suggested that the morphological classification of urothelial cancer be replaced with a new molecular taxonomic classification system.
世界卫生组织（WHO）第五版泌尿生殖器官肿瘤分类已于 2022 年最近出版。分子谱分析的应用对泌尿系统肿瘤的分类产生了重大影响。新的 WHO 分类引入了一组分子上明确界定的肾肿瘤亚型。重大变化包括增加了一类具有嗜酸性粒细胞特征的“其他嗜酸细胞瘤”，其中包括嗜酸细胞瘤/嫌色细胞肾细胞癌（chRCC）样特征，取消了 1/2 型乳头状肾细胞癌的亚分类，并将嗜酸粒细胞实性和囊性肾细胞癌作为独立的肿瘤实体纳入其中。WHO/ISUP 分级现在已被推荐用于所有肾细胞癌。主要命名法变化包括用“亚型”代替组织学“变体”，将“透明细胞乳头状肾细胞癌”改为“透明细胞肾细胞肿瘤”，将“TCEB1 突变型 RCC”改为“ELOC 突变型 RCC”，将“遗传性平滑肌瘤病和肾细胞癌”改为“富马酸水解酶缺陷型 RCC”，将“未分类肾细胞癌”改为“NOS 肾细胞癌”，将“原始神经外胚层肿瘤”改为“胚胎性神经外胚层肿瘤”，将“睾丸类癌”改为“睾丸神经内分泌肿瘤”，以及将“前列腺基底细胞癌”改为“前列腺腺样囊性（基底细胞）癌”。转移性、血液淋巴、间叶、黑素细胞、软组织和神经内分泌肿瘤在单独的章节中进行了讨论。有人建议用新的分子分类系统取代尿路上皮癌的形态分类。
