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2021年世界卫生组织肺癌分类:分子生物学研究和放射病学相关性

Tomoaki Sasaki¹, Hirofumi Kuno¹, Takashi Hiyama¹

¹From the Departments of Diagnostic Radiology (T.S., H.K., T.H., S.O., S.M., Y.M., T.K.), Pathology and Clinical Laboratories (T.T., G.I.), and Thoracic Surgery (Y.N., S.J.Y.O.K.), National Cancer Center Hospital East, 6-5-1 Kashiwanoha, Kashiwa, Chiba 277-8577, Japan; Department of Diagnostic Radiology, National Cancer Center Hospital, Tokyo, Japan (S.K.); Department of General Thoracic Surgery, Juntendo University School of Medicine, Tokyo, Japan (Y.N.); and Department of Thoracic Imaging, The University of Texas MD Anderson Cancer Center, Houston, Tex (G.S.S.).

Radiographics : a review publication of the Radiological Society of North America, Inc

|February 15, 2024

概括

2021年世界卫生组织对胸部瘤的分类更新了肺癌诊断新分级和扩大了针对向治疗的基因测试. 这会影响非小细胞肺癌的治疗.

科学领域:

胸部瘤学胸部瘤学
病理学病理学病理学
遗传学遗传学是一个

背景情况:

2015年世界卫生组织 (WHO) 对胸部瘤的分类在肺癌的分级和遗传检测方面存在局限性.
了解肺癌遗传学和向治疗的进步需要更新诊断指南.

研究的目的:

概述2021年世卫组织胸部瘤分类中的关键修订,重点关注肺癌.
突出对综合基因突变测试的重视和对向治疗选择的影响.
要强调放射科医生在肺癌的诊断和管理中的作用,特别是在小的活检样本.

主要方法:

对2021年世卫组织胸部瘤分类系统的审查和综合.
2021年指南与2015年版的比较,重点关注肺癌分类,分级和遗传检测建议的变化.
讨论小型活检样本与切除样本的诊断影响.
强调成像在指导活检和与遗传发现相关的作用.

主要成果:

2021年世界卫生组织分类引入了侵入性非性腺癌的新分级系统,并重新组织了状细胞癌和神经内分泌新生瘤.
遗传测试建议已经远远超出了表皮生长因子受体 (EGFR) 和形淋巴瘤激酶 (ALK) 的范围,包括ROS1,RET,NTRK1-3,KRAS,BRAF和MET.
现在建议在转移性非小细胞肺癌的第一线治疗中对编程死亡连接体1进行测试.
该分类强调了小型诊断样本和切除标本之间的组织病理学解释差异.

结论:

2021年世界卫生组织分类代表了胸部瘤,特别是肺癌的重大更新,这是由于分子病理学和向治疗的进步所推动的.
对于非小细胞肺癌的个性化治疗策略来说,全面的基因分析至关重要.
对小样本活检样本的准确的本病学解释和放射学相关性对于最佳的患者管理至关重要.

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