2022年世界卫生组织泌尿系和男性生殖器肿瘤分类中前列腺癌症的更新

Charles C Guo, Bogdan Czerniak
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引用次数: 0

摘要

前列腺癌是一种异质性疾病,具有广泛的病理、临床和分子特征。随着新数据的加入,前列腺癌的诊断和分类也在不断修改。世界卫生组织(WHO)《泌尿系统和生殖系统肿瘤分类》第五版在第四版出版六年后于近期出版。在新版中,前列腺癌的分类在诊断标准、分级、命名和基因组学方面都进行了细化。本文回顾了世卫组织新版前列腺癌分类的重要更新,包括高级别前列腺上皮内瘤变、尖腺癌、导管内癌、导管癌和神经内分泌肿瘤。我们讨论了格里森分级中存在争议的问题,如导管内癌和三级分级。我们还强调了前列腺癌中不同的基因和表观遗传学改变,这些改变可能导致其临床病理特征的多样性。总之,第五版世卫组织分级通过形态学、免疫组化、基因组和临床数据对前列腺癌进行了全面评估,这可能是诊断和治疗前列腺癌的最佳范例。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Updates of Prostate Cancer from the 2022 World Health Organization Classification of the Urinary and Male Genital Tumors.

Prostate cancer is a heterogeneous disease with a wide spectrum of pathological, clinical, and molecular features. The diagnosis and classification of prostate cancer have been constantly modified with the incorporation of new data. The 5th edition of the World Health Organization (WHO) Classification of Urinary and Genital Tumors was recently published six years after the 4th edition. In this new edition, the classification of prostate cancer has been refined in the diagnostic criteria, grading, nomenclature, and genomics. This paper reviews significant updates to the new WHO classification of prostate cancer, including high-grade prostatic intraepithelial neoplasia, acinar adenocarcinoma, intraductal carcinoma, ductal carcinoma, and neuroendocrine tumors. Controversial issues in the Gleason grading are discussed, such as intraductal carcinoma and tertiary grade. We also highlight distinct genetic and epigenetic alterations in prostate cancer that may contribute to its diverse clinicopathologic features. Overall, the 5th edition of the WHO classification provides a comprehensive assessment of prostate cancer with morphologic, immunohistochemical, genomic, and clinical data, which may represent an optimal paradigm for diagnosing and treating prostate cancer.

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