Revolution in Lung Cancer New Challenges for the Surgical Pathologist
Revolution in Lung Cancer New Challenges for the Surgical Pathologist
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DOI：
10.1043/2010-0567-ra.1
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发表时间：
2011-01-01
影响因子：
4.6
通讯作者：
Kerr, Keith M.
中科院分区：
文献类型：
--
作者：
Cagle, Philip T.;Allen, Timothy C.;Kerr, Keith M.
背景。-传统上，肺癌被视为一种侵袭性的、无情的进展性疾病，几乎没有治疗选择，存活率也很低。病理学家的传统角色主要是在活检和细胞学标本上区分小细胞癌和非小细胞癌，并对接受切除的非小细胞癌进行分期。近年来，我们对肺癌的概念经历了一场革命，包括(1)成功的、新的、分子靶向治疗肺癌的出现，其中许多与特定的组织细胞类型和亚型有关；(2)正在进行的高分辨率CT筛查研究和最近的组织学发现对肺癌的自然历史进行了新的观察；以及(3)建议修改肺癌的分类，特别是腺癌，部分原因是前两项进展。目的-总结肺癌的重要新进展，强调外科病理学家在肺癌患者个性化护理中的作用。数据来源。-关于肺癌新进展的信息是从同行评议的医学文献和作者的经验中获得的。结论-几十年来，我们一直认为肺癌是一种侵袭性极强的疾病，外科病理学家的作用有限。今天，外科病理学家在肺癌的诊断和治疗中发挥着越来越重要的作用，及时了解新的进展是至关重要的。(ARCH Pathol Lab Med.2011；135：110-116)
Context.-Traditionally, lung cancer has been viewed as an aggressive, relentlessly progressive disease with few treatment options and poor survival. The traditional role of the pathologist has been primarily to differentiate small cell carcinoma from non-small cell carcinoma on biopsy and cytology specimens and to stage non-small cell carcinomas that underwent resection. In recent years, our concepts of lung cancer have undergone a revolution, including (1) the advent of successful, new, molecular-targeted therapies for lung cancer, many of which are associated with specific histologic cell types and subtypes; (2) new observations on the natural history of lung cancer derived from ongoing high-resolution computed tomography screening studies and recent histologic findings; and (3) proposals to revise the classification of lung cancers, particularly adenocarcinomas, in part because of the first 2 developments.Objective.-To summarize the important, new developments in lung cancer, emphasizing the role of the surgical pathologist in personalized care for patients with lung cancer.Data Sources.-Information about the new developments in lung cancer was obtained from the peer-review medical literature and the authors' experiences.Conclusions.-For decades, we have perceived lung cancer as a relentlessly aggressive and mostly incurable disease for which the surgical pathologist had a limited role. Today, surgical pathologists have an important and expanding role in the diagnosis and treatment of lung cancer, and it is essential to keep informed of new advances. (Arch Pathol Lab Med. 2011;135:110-116)