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[从病理学角度看原发性涎腺肿瘤:形态分子特征及诊断与治疗挑战]

[Primary salivary gland tumors from a pathology perspective : Morphomolecular peculiarities and diagnostic and therapeutic challenges].

作者信息

Agaimy Abbas

机构信息

Pathologisches Institut, Universitätsklinikum Erlangen, Krankenhausstr. 8-10, 91054, Erlangen, Deutschland.

出版信息

HNO. 2023 Apr;71(4):207-214. doi: 10.1007/s00106-023-01281-2. Epub 2023 Mar 22.

Abstract

Similar to tumors of other organs, salivary gland neoplasms were historically viewed as a single neoplastic entity and mostly treated as such. Accordingly, only the clinical tumor stage, and not the histological subtype, was considered to be of significant prognostic impact. However, over the years, several distinct sub-entities have been characterized based on morphological features, such as adenoid cystic carcinoma, mucoepidermoid carcinoma, acinic cell carcinoma, and salivary duct carcinoma. Most importantly, the nosology of salivary gland carcinomas has undergone a dynamic "splitting" on the basis of morphological, immunophenotypic, and molecular characteristics, so that 21 independent carcinomas are now listed in the current World Health Organization (WHO) classification. Moreover, it has become evident that splitting of these carcinoma subtypes no longer represents a "pathologist's hobby," but carries significant prognostic and therapeutic relevance for optimized cancer surgery and potentially systemic therapy. The current review summarizes the major features of salivary gland tumors, both benign and malignant, and gives an account of their classification systems and genetic profiles.

摘要

与其他器官的肿瘤相似,涎腺肿瘤在历史上被视为单一的肿瘤实体,并且大多也如此进行治疗。因此,只有临床肿瘤分期而非组织学亚型被认为对预后有显著影响。然而,多年来,基于形态学特征已鉴定出几种不同的亚实体,如腺样囊性癌、黏液表皮样癌、腺泡细胞癌和涎腺导管癌。最重要的是,涎腺癌的疾病分类学已基于形态学、免疫表型和分子特征经历了动态的“细分”,因此目前世界卫生组织(WHO)分类中列出了21种独立的癌。此外,很明显这些癌亚型的细分不再仅仅是“病理学家的爱好”,而是对优化癌症手术及可能的全身治疗具有重要的预后和治疗意义。本综述总结了涎腺肿瘤(包括良性和恶性)的主要特征,并介绍了它们的分类系统和基因概况。

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