分级(工程)
腺癌
医学
肺
病态的
组织病理学
病理
内科学
癌症
生物
生态学
作者
Stefano De Luca,Giuseppa Zannini,Floriana Morgillo,Carminia Maria Della Corte,Alfonso Fiorelli,Federica Zito Marino,Severo Campione,Giovanni Vicidomini,Gianluca Guggino,Andrea Ronchi,Marina Accardo,Renato Franco
标识
DOI:10.1080/14737140.2023.2179990
摘要
ABSTRACTABSTRACTIntroduction An accurate histological evaluation of invasive lung adenocarcinoma is essential for a correct clinical and pathological definition of the tumour. Different grading systems have been proposed to predict the prognosis of invasive lung adenocarcinoma.Areas covered Invasive non mucinous lung adenocarcinoma is often morphologically heterogeneous, consisting of complex combinations of architectural patterns with different proportions. Several grading systems for non-mucinous lung adenocarcinoma have been proposed, being the main based on architectural differentiation and the predominant growth pattern. Herein we perform a thorough review of the literature using PubMed, Scopus and Web of Science and we highlight the peculiarities and the differences between the main grading systems and compare the data about their prognostic value. In addition, we carried out an evaluation of the proposed grading systems for less common histological variants of lung adenocarcinoma, such as fetal adenocarcinoma and invasive mucinous adenocarcinoma.Expert opinion The current IASLC grading system, based on the combined score of predominant growth pattern plus high-grade histological pattern, shows the stronger prognostic significance than the previous grading systems in invasive non mucinous lung adenocarcinoma.KEYWORDS: Grading systemsHigh-grade patternhistological subtypeindependent prognostic valuelung adenocarcinomapredominant growth pattern Article highlights Invasive non mucinous lung adenocarcinoma is usually histologically heterogeneous, consisting of complex combinations of architectural patterns with different proportions.Several grading systems for invasive non mucinous lung adenocarcinoma have been proposed and the main ones are based on the histological growth pattern.A comparison between the prognostic significance of the different grading systems was performed.The IASLC grading system provides the best and the most accurate stage-independent prognostic stratification of invasive non mucinous lung adenocarcinoma and overcomes all the limitations of the previous grading systems.There isn't a shared and established grading system for invasive mucinous lung adenocarcinoma.The newly proposed grading system by UK group proved a good prognostic value, proving to be a useful predictor of OS, although it is characterized by a high inter-observer variability due to the many histological features considered.The presence of high-grade fetal lung adenocarcinoma histological component, regardless of its proportion, is an independent poor prognostic factor in lung adenocarcinoma.Declaration of interestThe authors have no relevant affiliations or financial involvement with any organization or entity with a financial interest in or financial conflict with the subject matter or materials discussed in the manuscript. This includes employment, consultancies, honoraria, stock ownership or options, expert testimony, grants or patents received or pending, or royalties.Reviewer disclosuresPeer reviewers on this manuscript have no relevant financial or other relationships to disclose.Author contribution statementLS and FR: contributed to reviewed the international literature and to the writing the manuscript. AM, RA and ZMF: contributed to reviewed the international literature and editing the manuscript. ZG: contributed to the preparation of figures. CS: contributed to the preparation of figures and tables. MF, DCC, FA, VG and GG: contributed to reviewed the international literature. All authors have read and agreed to the published version of the manuscript.Additional informationFundingThis paper was not funded.
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