From the Department of Pathology and Laboratory Medicine, University of Pittsburgh Medical Center, Pittsburgh, Pennsylvania.
Arch Pathol Lab Med. 2024 Nov 1;148(11):1183-1195. doi: 10.5858/arpa.2023-0001-RA.
CONTEXT.—: Salivary gland tumors are rare tumor types for which the molecular understanding has resulted in a rapid expansion and shuffling of entities. These changes are reflected in the 5th edition World Health Organization Classification of Head and Neck Tumours (WHO 5th edition), although many nuances still remain.
OBJECTIVE.—: To review how molecular alterations have helped recategorize, justify, and reinstate entities into our lexicon as well as defining interrelationships between categories, new entities, and subtypes. Furthermore, newer theranostic applications to molecular phenotype will be summarized.
DATA SOURCES.—: World Health Organization Classification of Head and Neck Tumours (WHO 3rd through 5th editions), literature review, and personal and institutional experience.
CONCLUSIONS.—: Molecular alterations have helped reclassify, retain, and create new categories by augmenting rather than replacing standard criteria. Key entities that have emerged include sclerosing polycystic adenoma, microsecretory adenocarcinoma, and mucinous adenocarcinoma. Molecular phenotypes solidify the range of morphology in established entities such as mucoepidermoid carcinoma and facilitate connectivity between entities. Molecular characteristics now allow for targeted therapeutic approaches for secretory carcinoma and adenoid cystic carcinoma.
唾液腺肿瘤是罕见的肿瘤类型，其分子认识导致实体的快速扩展和重组。这些变化反映在第五版世界卫生组织头颈部肿瘤分类（WHO 第五版）中，尽管仍有许多细微差别。
回顾分子改变如何帮助我们重新分类、证明合理性并将实体重新纳入我们的词汇表，以及定义类别、新实体和亚型之间的相互关系。此外，还将总结分子表型的新治疗应用。
头颈部肿瘤世界卫生组织分类（WHO 第 3 至 5 版）、文献回顾以及个人和机构经验。
分子改变通过增强而非取代标准标准，有助于重新分类、保留和创建新类别。出现的关键实体包括硬化性多囊性腺瘤、微分泌性腺癌和黏液性腺癌。分子表型使既定实体（如黏液表皮样癌）的形态范围更加明确，并促进实体之间的连接。分子特征现在允许针对分泌癌和腺样囊性癌进行靶向治疗方法。
