Pitfalls in the classification of liver tumors
Pitfalls in the classification of liver tumors
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DOI：
10.1007/s00292-006-0834-1
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发表时间：
2006-07-01
期刊：
影响因子：
--
通讯作者：
Wittekind, C.
中科院分区：
文献类型：
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作者：
Wittekind, C.
现代临床肿瘤学需要一种准确和标准化的肿瘤分类方法。经验表明，在分类程序和文件编制过程中，错误发生的频率可能比一般预期的要高。在这篇文章中将提到几个可能的误差来源。在定位原发性肿瘤的确切部位时可能发生错误，这可能导致淋巴结转移的不正确分类，例如，N1/pN 1而不是M1/pM 1。肝肿瘤组织学分型的困难，特别是在肝细胞癌（HCC）和胆管癌（CC）之间的鉴别诊断，可以通过使用免疫组化最小化。HCC的分级可以根据两个系统进行，即Edmondson和Steiner的系统和WHO的系统。应说明使用的分级制度。对于估计原发性肝肿瘤的解剖范围，血管侵犯是一个重要的参数。切除边缘必须彻底检查，以达到最准确的残留肿瘤分类。
Up-to-date clinical oncology requires an exact and standardized way of classifying tumors. Experience shows that mistakes can occur more frequently than generally expected during the classification procedure and documentation. Several possible sources of errors will be mentioned in this contribution. Errors can occur in localizing the exact site of the primary tumor, which can lead to an incorrect classification of metastases in lymph nodes, e.g., N1/pN1 instead of M1/pM1. Difficulties in histological typing of liver tumors, particularly in the differential diagnosis between hepatocellular carcinoma (HCC) and cholangiocarcinoma (CC) can be minimized by using immunohistochemistry. The grading of HCC can be performed according to two systems, namely those of Edmondson and Steiner and of the WHO. The grading system used should be indicated. For estimating the anatomical extent of primary liver tumors, vascular invasion is an important parameter. Resection margins have to be thoroughly examined to aim at an most exact residual tumor classification.