WHO/ISUP classification, grading and pathological staging of renal cell carcinoma: standards and controversies.
WHO/ISUP classification, grading and pathological staging of renal cell carcinoma: standards and controversies.
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DOI：
10.1007/s00345-018-2447-8
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发表时间：
2018-12
影响因子：
3.4
通讯作者：
Harrison D
中科院分区：
文献类型：
--
作者：
Warren AY;Harrison D
活检和切除标本的病理参数评估在肾细胞癌（RCC）患者的诊断、预后和治疗中具有关键作用。进行了一项非系统性文献检索，更新至2018年1月，以确定RCC病理分类、分级和分期的关键标准和争议。虽然大多数RCC表现出特征性形态，易于分类，但RCC显示出相当大的形态异质性，并且难以分配肿瘤类型并不罕见，尤其是罕见的肿瘤亚型。良性和恶性嗜酸细胞肿瘤之间的区分仍然是一个特别的挑战。由于预后和治疗的影响，需要开发额外的免疫组化和分子检测来促进肿瘤分型，并能够更可靠地识别低分化转移性肿瘤为肾源性。任何新的检测都需要适用于小的活检样本，以克服肾肿瘤的异质性。还需要促进对具有遗传影响的肿瘤类型的识别，以便在专科中心进行转诊和管理。数字病理学在这种转诊实践中具有潜在的作用。近年来，对肾细胞癌的病理学评价已做了大量工作，但对这些异质性肿瘤的分类和分级仍存在一些困难。
Pathological parameters assessed on biopsies and resection specimens have a pivotal role in the diagnosis, prognosis and management of patients with renal cell carcinoma (RCC). A non-systematic literature search was performed, updated to January 2018, to identify key standards and controversies in the pathological classification, grading and staging of RCC. Although most RCCs exhibit characteristic morphology that enables easy categorisation, RCCs show considerable morphological heterogeneity and it is not uncommon for there to be difficulty in assigning a tumour type, especially with rarer tumour subtypes. The differentiation between benign and malignant oncocytic tumours remains a particular challenge. The development of additional immunohistochemical and molecular tests is needed to facilitate tumour typing, because of the prognostic and therapeutic implications, and to enable more reliable identification of poorly differentiated metastatic tumours as being of renal origin. Any new tests need to be applicable to small biopsy samples, to overcome the heterogeneity of renal tumours. There is also a need to facilitate identification of tumour types that have genetic implications, to allow referral and management at specialist centres. Digital pathology has a potential role in such referral practice. Much has been done to standardise pathological assessment of renal cell carcinomas in recent years, but there still remain areas of difficulty in classification and grading of these heterogeneous tumours.
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影响因子：
2.3
作者：
Argani, Pedram
通讯作者：
Argani, Pedram
影响因子：
--
作者：
AMTRUP, F;HANSEN, JB;THYBO, E
通讯作者：
THYBO, E
影响因子：
7.5
作者：
Bonsib, SM
通讯作者：
Bonsib, SM
影响因子：
5.6
作者：
Adeniran, Adebowale J.;Shuch, Brian;Humphrey, Peter A.
通讯作者：
Humphrey, Peter A.
影响因子：
5.6
作者：
Bonsib, SM;Gibson, D;Greene, GF
通讯作者：
Greene, GF