Pelosi Giuseppe, Laffi Alice, Papotti Mauro, Lantuejoul Sylvie, Scoazec Jean-Yves, Gemelli Maria, Ricotta Riccardo, Harari Sergio, Duregon Eleonora, Papa Riccardo, Sonzogni Angelica, Bianchi Fabrizio, Bruno Antonino, Bassani Barbara, Uccella Silvia, Carnaghi Carlo, Bertuzzi Alexia Francesca
Department of Oncology and Hemato-Oncology, University of Milan, Milan, Italy.
Inter-Hospital Pathology Division, Istituto di Ricovero e Cura a Carattere Scientifico (IRCCS) MultiMedica, Milan, Italy.
Pathologica. 2025 Jun;117(3):220-242. doi: 10.32074/1591-951X-N1102. Epub 2025 Jun 27.
Lung neuroendocrine neoplasms (NENs) make up a variegated ensemble of malignancies encompassing typical carcinoid (TC) and atypical carcinoid (AC). These are low to intermediate grade neuroendocrine tumors (NETs), and large cell neuroendocrine carcinoma (LCNEC) and small cell lung carcinoma (SCLC), which are full-fledged high-grade neuroendocrine carcinomas (NECs) showing similar clinical outcomes. Through a peer interaction between oncologist and pathologist, we herein constructed a practical approach based on questioning and answering regarding 8 practical issues aimed to provide shared solutions for clinical decision-making. These issues were itemized as sequential steps guided by clinical reasoning and concerned differential diagnosis, combined subtypes, primary and metastatic tumors, small diagnostic material, predictive biomarkers, tumor staging and, lastly, standardizing terminology. This study takes advantage of the close interaction between oncologists and pathologists as a tool to better delineate the decision-making on lung NENs.
肺神经内分泌肿瘤（NENs）是一组多样化的恶性肿瘤，包括典型类癌（TC）和非典型类癌（AC）。这些是低至中级别神经内分泌肿瘤（NETs），以及大细胞神经内分泌癌（LCNEC）和小细胞肺癌（SCLC），后者是成熟的高级别神经内分泌癌（NECs），具有相似的临床结局。通过肿瘤学家和病理学家之间的同行互动，我们在此构建了一种基于问答的实用方法，涉及8个实际问题，旨在为临床决策提供共同的解决方案。这些问题按照临床推理指导的顺序步骤列出，涉及鉴别诊断、混合亚型、原发性和转移性肿瘤、少量诊断材料、预测性生物标志物、肿瘤分期，最后是术语标准化。本研究利用肿瘤学家和病理学家之间的密切互动作为工具，以更好地描述肺NENs的决策过程。
