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上腺皮层癌的诊断和分级
Giulia Vocino Trucco1, Eleonora Duregon2, Mauro Papotti2
1Pathology Unit, AOU San Luigi Gonzaga, Orbassano, Turin, Italy.
Virchows Archiv : an international journal of pathology
|October 7, 2025
概括
世卫组织第五版分类改进了使用组织病理学和分子数据对上腺皮癌 (ACC) 的诊断. 结合方法和利用像SF1这样的标记器可以提高准确性,尽管人工智能由于ACC而面临挑战.
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:
- 世卫组织内分泌瘤分类的第五版更新了上腺皮癌 (ACC) 的诊断标准.
- 组织病理学仍然是核心的,但存在解释性挑战,需要结合诊断策略.
- 整合了新的分子洞察力,以提高诊断准确性和预后评估.
研究的目的:
- 根据世卫组织最新的分类,概述ACC的关键组织病理特征和诊断策略.
- 在临床实践中为ACC评估和分级提供一个实际的框架.
- 讨论免疫组织化学和新兴技术 (如AI) 在ACC诊断中的作用.
主要方法:
- 对ACC的组织病理特征和诊断标准的审查.
- 基于线粒数的世卫组织两层分级系统的分析.
- 评估免疫组织化学标记物 (SF1,Ki-67,MMR蛋白,p53,β-catenin) 用于诊断和预后.
主要成果:
- 更新的世卫组织分类强调多参数组织病理学,但承认解释性挑战.
- 为了提高机构间的一致性,建议采用双层分级系统.
- SF1对于上腺皮质起源具有高度特异性;其他标志物有助于预后和遗传查.
结论:
- 准确的ACC诊断需要整合组织病理学,分子数据和免疫组织化学.
- 结合诊断方法对于模两可的病例至关重要.
- 虽然人工智能显示出希望,但其在ACC诊断中的应用目前受到数据稀缺和疾病稀有性的限制.
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