The 2022 WHO classification of thyroid tumors: novel concepts in nomenclature and grading.

IF 4.1 2区 医学 Q2 ENDOCRINOLOGY & METABOLISM
C Christofer Juhlin, Ozgur Mete, Zubair W Baloch
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引用次数: 19

Abstract

The fifth edition of the Classification of Endocrine and Neuroendocrine Tumors has been released by the World Health Organization. This timely publication integrates several changes to the nomenclature of non-neoplastic and neoplastic thyroid diseases, as well as novel concepts that are essential for patient management. The heterogeneous group of non-neoplastic and benign neoplastic lesions are now collectively termed as 'thyroid follicular nodular disease' to better reflect the clonal and non-clonal proliferations that clinically present as multinodular goiter. Thyroid neoplasms originating from follicular cells are distinctly divided into benign, low-risk and malignant neoplasms. The new classification scheme stresses that papillary thyroid carcinoma (PTC) should be subtyped based on histomorphologic features irrespective of tumor size to avoid treating all sub-centimeter/small lesions as low-risk disease. Formerly known as the cribriform-morular variant of PTC is redefined as cribriform-morular thyroid carcinoma since this tumor is now considered a distinct malignant thyroid neoplasm of uncertain histogenesis. The 'differentiated high-grade thyroid carcinoma' is a new diagnostic category including PTCs, follicular thyroid carcinomas and oncocytic carcinomas with high-grade features associated with poorer prognosis similar to the traditionally defined poorly differentiated thyroid carcinoma as per Turin criteria. In addition, squamous cell carcinoma of the thyroid is now considered a morphologic pattern/subtype of anaplastic thyroid carcinoma. In this review, we will highlight the key changes in the newly devised fifth edition of the WHO classification scheme of thyroid tumors with reflections on its applicability in patient management and future directions in this field.

2022年WHO甲状腺肿瘤分类:命名和分级的新概念。
世界卫生组织发布了第五版《内分泌和神经内分泌肿瘤分类》。这个及时的出版物整合了几个变化,以非肿瘤性和肿瘤性甲状腺疾病的命名,以及对患者管理至关重要的新概念。非肿瘤性和良性肿瘤病变的异质性现在统称为“甲状腺滤泡性结节病”,以更好地反映临床表现为多结节性甲状腺肿的克隆性和非克隆性增生。起源于滤泡细胞的甲状腺肿瘤明显分为良性、低危和恶性肿瘤。新的分类方案强调,甲状腺乳头状癌(PTC)应根据组织形态学特征进行分型,而不考虑肿瘤大小,以避免将所有亚厘米/小病变视为低风险疾病。由于这种肿瘤现在被认为是一种组织发生不确定的独特的恶性甲状腺肿瘤,因此以前被称为PTC的筛状-桑葚样变体被重新定义为筛状-桑葚样甲状腺癌。“分化的高级别甲状腺癌”是一个新的诊断类别,包括ptc、滤泡性甲状腺癌和癌细胞癌,它们具有与预后较差相关的高级别特征,与传统定义的低分化甲状腺癌相似。此外,甲状腺鳞状细胞癌现在被认为是间变性甲状腺癌的一种形态模式/亚型。在这篇综述中,我们将重点介绍新制定的第五版WHO甲状腺肿瘤分类方案的主要变化,以及对其在患者管理中的适用性和该领域未来发展方向的思考。
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来源期刊
Endocrine-related cancer
Endocrine-related cancer 医学-内分泌学与代谢
CiteScore
7.80
自引率
2.60%
发文量
138
审稿时长
6-12 weeks
期刊介绍: Endocrine-Related Cancer is an official flagship journal of the Society for Endocrinology and is endorsed by the European Society of Endocrinology, the United Kingdom and Ireland Neuroendocrine Society, and the Japanese Hormones and Cancer Society. Endocrine-Related Cancer provides a unique international forum for the publication of high quality original articles describing novel, cutting edge basic laboratory, translational and clinical investigations of human health and disease focusing on endocrine neoplasias and hormone-dependent cancers; and for the publication of authoritative review articles in these topics. Endocrine neoplasias include adrenal cortex, breast, multiple endocrine neoplasia, neuroendocrine tumours, ovary, prostate, paraganglioma, parathyroid, pheochromocytoma pituitary, testes, thyroid and hormone-dependent cancers. Neoplasias affecting metabolism and energy production such as bladder, bone, kidney, lung, and head and neck, are also considered.
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