A Consensus for Classification and Pathologic Reporting of Pseudomyxoma Peritonei and Associated Appendiceal Neoplasia The Results of the Peritoneal Surface Oncology Group International (PSOGI) Modified Delphi Process
A Consensus for Classification and Pathologic Reporting of Pseudomyxoma Peritonei and Associated Appendiceal Neoplasia The Results of the Peritoneal Surface Oncology Group International (PSOGI) Modified Delphi Process
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DOI：
10.1097/pas.0000000000000535
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发表时间：
2016-01-01
影响因子：
5.6
通讯作者：
Moran, Brendan J.
中科院分区：
文献类型：
--
作者：
Carr, Norman J.;Cecil, Thomas D.;Moran, Brendan J.
腹膜假性粘液瘤是一种具有独特生物学行为的复杂疾病，通常起源于腹膜粘液性肿瘤。PMP及其原发性阑尾瘤的分类存在争议，国际改良德尔菲共识程序被用来解决术语和定义问题。发展了一种粘液性阑尾瘤的分类，并同意“粘液腺癌”应保留用于浸润性浸润的病变。支持“低度阑尾粘液性肿瘤”一词，并同意不再建议使用“囊腺瘤”。一个新的术语“高级别阑尾粘液性肿瘤”被提出，用于没有浸润性浸润但有高级别细胞学异常的病变。锯齿状息肉伴或不伴异型增生是肿瘤的首选，锯齿状特征局限于粘膜，粘膜肌层完整。在PMP的病理分类上达成了共识，定义为由于粘液性瘤形成导致的以再分布现象为特征的粘液腹腔内积聚。三种类型的PMP是一致的-低级别，高级别，高级别与印戒细胞。脱细胞粘蛋白应单独分类。一致认为低度和高度粘液性腹膜癌应分别被认为是播散性腹膜腺粘蛋白病和腹膜粘液性癌病的同义词。还制定了PMP和阑尾粘液性肿瘤的病理报告清单。通过采用商定的分类和定义，不同的中心将能够使用统一的术语，从而能够对其结果进行有意义的比较。
Pseudomyxoma peritonei (PMP) is a complex disease with unique biological behavior that usually arises from appendiceal mucinous neoplasia. The classification of PMP and its primary appendiceal neoplasia is contentious, and an international modified Delphi consensus process was instigated to address terminology and definitions. A classification of mucinous appendiceal neoplasia was developed, and it was agreed that “mucinous adenocarcinoma” should be reserved for lesions with infiltrative invasion. The term “low-grade appendiceal mucinous neoplasm” was supported and it was agreed that “cystadenoma” should no longer be recommended. A new term of “high-grade appendiceal mucinous neoplasm” was proposed for lesions without infiltrative invasion but with high-grade cytologic atypia. Serrated polyp with or without dysplasia was preferred for tumors with serrated features confined to the mucosa with an intact muscularis mucosae. Consensus was achieved on the pathologic classification of PMP, defined as the intraperitoneal accumulation of mucus due to mucinous neoplasia characterized by the redistribution phenomenon. Three categories of PMP were agreed—low grade, high grade, and high grade with signet ring cells. Acellular mucin should be classified separately. It was agreed that low-grade and high-grade mucinous carcinoma peritonei should be considered synonymous with disseminated peritoneal adenomucinosis and peritoneal mucinous carcinomatosis, respectively. A checklist for the pathologic reporting of PMP and appendiceal mucinous neoplasms was also developed. By adopting the classifications and definitions that were agreed, different centers will be able to use uniform terminology that will allow meaningful comparison of their results.