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[垂体神经内分泌肿瘤患者病理形态学检查的统一。新分类的争议问题]

[Unification of pathomorphological examination of patients with neuroendocrine tumors of the pituitary gland. Controversial issues of the new classification].

作者信息

Pronin V S, Antsiferov M B, Alekseeva T M, Pronin E V, Lapshina A M, Urusova L S

机构信息

Russian Medical Academy of Continuous Professional Education; Endocrinological Dispensary of the Department of Health of the City of Moscow.

Endocrinological Dispensary of the Department of Health of the City of Moscow.

出版信息

Probl Endokrinol (Mosk). 2023 Nov 14;70(3):31-45. doi: 10.14341/probl13376.

Abstract

The progressive improvement of the classification using modern analytical methods is an essential tool for the development of precise and personalized approaches to the treatment of pituitary adenomas. In recent years, endocrinologists have witnessed evolutionary changes that have occurred in the histopathological identification of pituitary neoplasms, revealing new possibilities for studying tumorigenesis and predicting biological behavior.The paper considers the historical aspects of the gradual improvement of the classification of pituitary adenomas, as well as the new international 2022 WHO classification, according to which pituitary adenomas are included in the list of neuroendocrine tumors (PitNETs) to reflect the biological aggressiveness of some non-metastatic pituitary adenomas. The characteristics of pituitary adenoma are presented, as well as a list of histological subtypes of aggressive neuroendocrine tumors of the pituitary gland, marked by the main potentials for invasive growth, an increased risk of recurrence and a negative clinical prognosis.The expediency of changing the definition of «pituitary adenoma» to «neuroendocrine tumor» is discussed. It is emphasized that the introduction of a unified clinical, laboratory and morphological protocol into national clinical practice will help provide comparable comparative studies on the prognosis of the disease and the effectiveness of secondary therapy and also contribute to adequate management of potentially aggressive PitNETs.

摘要

利用现代分析方法逐步改进分类是制定精确且个性化垂体腺瘤治疗方法的重要工具。近年来,内分泌学家见证了垂体肿瘤组织病理学鉴定中发生的演变,揭示了研究肿瘤发生和预测生物学行为的新可能性。本文探讨了垂体腺瘤分类逐步改进的历史方面,以及新的2022年国际世界卫生组织分类,根据该分类,垂体腺瘤被列入神经内分泌肿瘤(PitNETs)列表,以反映一些非转移性垂体腺瘤的生物学侵袭性。介绍了垂体腺瘤的特征,以及垂体侵袭性神经内分泌肿瘤的组织学亚型列表,这些亚型以侵袭性生长的主要潜能、复发风险增加和负面临床预后为特征。讨论了将“垂体腺瘤”的定义改为“神经内分泌肿瘤”的合理性。强调在国家临床实践中引入统一的临床、实验室和形态学方案将有助于提供关于疾病预后和二线治疗效果的可比对照研究,也有助于对潜在侵袭性PitNETs进行适当管理。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/0885/11334236/d43c6cb0abdd/problendo-70-13376-g001.jpg

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