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A Novel Method: Super-selective Adrenal Venous Sampling
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更新了世卫组织第五版分类,上腺皮层癌的分子特征和瘤微环境
Yuto Yamazaki1, Yuta Tezuka2, Yoshikiyo Ono2
1Department of Pathology, Tohoku University Graduate School of Medicine, Sendai 980-8575, Japan.
Endocrine journal
|November 13, 2024
概括
区分恶性上腺皮层瘤是具有挑战性的,需要多个组织病理学标准和分子亚型. 最近的研究探索了上皮层癌 (ACC) 的新诊断算法和治疗点.
科学领域:
- 内分泌学 在内分泌学.
- 在瘤学瘤学.
- 病理学 病理学 病理学
背景情况:
- 精确诊断上腺皮质瘤对于患者管理至关重要,但仍然具有挑战性.
- 世卫组织第五版建议针对上腺皮层瘤采用多标准诊断算法.
- 目前的风险分层,就像欧洲上腺瘤研究网络 (ENSAT) 的分类一样,严重依赖Ki-67指数.
研究的目的:
- 审查当前对上腺皮层瘤的诊断和风险分层方法.
- 突出新兴的分子分类及其治疗含义.
- 讨论对上腺皮层癌 (ACCs) 的新疗法策略.
主要方法:
- 关于上皮层瘤诊断和管理的最新文献的综述.
- 对组织病理学标准的分析,包括韦斯和赫尔辛基标准,以及Reticulin算法.
- 检查分子亚型 (Wnt/-catenin,p53/Rb1,染色体维护,MMR途径) 和它们的临床相关性.
主要成果:
- 世卫组织第五版整合了多种组织病理学特征用于诊断.
- 在ENSAT分类中,主要使用Ki-67指数进行风险分层.
- 已经确定了四种ACC分子亚型,Wnt/-catenin和p53/Rb1通路在高度瘤中更为常见.
- 预先的ADIUVO研究结果表明,米托坦在切割后可能有利于低度的ACC.
结论:
- 上皮层瘤诊断需要一个综合的方法,结合组织病理学和分子数据.
- 了解分子亚型可以指导未来针对ACC的向疗法.
- 需要进一步的研究来完善诊断标准,并探索新的治疗方法,包括免疫检查点抑制剂.
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