中国癌症杂志 ›› 2024, Vol. 34 ›› Issue (12): 1144-1163.doi: 10.19401/j.cnki.1007-3639.2024.12.009
• 指南与共识 • 上一篇
中国研究型医院学会病理学专业委员会, 上海市抗癌协会肿瘤病理专业委员会
收稿日期:
2024-11-10
出版日期:
2024-12-30
发布日期:
2025-01-21
通信作者:
李媛(ORCID: 0000-0001-5651-819X),主任医师,教授,复旦大学附属肿瘤医院病理科副主任;张智弘(ORCID: 0000-0002-5779-9365),主任医师,教授,江苏省人民医院病理科主任;
林冬梅(ORCID: 0000-0003-0532-7216),主任医师,教授,北京大学肿瘤医院病理科主任;高鹏(ORCID:
0000-0002-4721-0887),主任医师,教授,山东大学齐鲁医院病理科主任;王坚(ORCID: 0000-0002-7848-
803X),主任医师,教授,复旦大学附属肿瘤医院病理科主任。
作者简介:
朱培培(ORCID: 0000-0001-7175-9856),复旦大学附属肿瘤医院病理科,复旦大学上海医学院肿瘤学系。
Expert Committee on Pathology of Chinese Research Hospital Association , Professional Committee on Tumor Pathology of Shanghai Anticancer Association
Received:
2024-11-10
Published:
2024-12-30
Online:
2025-01-21
文章分享
摘要:
为了进一步提高中国间皮瘤的病理学诊断水平和病理学报告规范性,为病理科医师在临床实践中提供借鉴证据,为临床治疗和患者预后判断提供重要信息,中国研究型医院学会病理学专业委员会和上海市抗癌协会肿瘤病理专业委员会组织138位来自国内28个省市自治区的专家,组建《间皮瘤组织病理学诊断临床实践指南(2025年版)》制定专家团,设立指南工作组,涵盖病理、影像、肿瘤内科、胸外科、肿瘤预防、流行病学与卫生统计学等多学科,本着科学化、规范化、透明化和制度化的原则,基于现有循证医学证据,在文献检索和证据收集基础上,围绕间皮瘤病理学诊断最新进展,聚焦间皮瘤病理学诊断原则、免疫组织化学标志物和分子病理学检测,依据推荐分级的评估、制订和评价系统(Grading of Recommendations,Assessment,Development and Evaluation,GRADE)对循证医学证据质量和专家推荐意见强度进行质量等级分级和证据综合,采用德尔菲问卷调查法和共识会议法相结合,就间皮瘤病理学诊断相关“陈述”进行专家函询和投票审议,去重、合并和汇总临床问题,形成推荐意见。参照卫生保健实践指南报告条目(the Reporting Items for practice Guidelines in HealThcare,RIGHT)起草《间皮瘤组织病理学诊断临床实践指南(2025年版)》初稿,召开专家会议进行审核,并送外审专家评议,综合审定意见进行修改,形成终稿。本指南的目标人群为间皮瘤患者,使用人群为从事间皮瘤病理学诊断和辅助检测的医务工作者。本指南在国际实践指南注册与透明化平台(
中国研究型医院学会病理学专业委员会, 上海市抗癌协会肿瘤病理专业委员会. 间皮瘤组织病理学诊断临床实践指南(2025年版)[J]. 中国癌症杂志, 2024, 34(12): 1144-1163.
Expert Committee on Pathology of Chinese Research Hospital Association , Professional Committee on Tumor Pathology of Shanghai Anticancer Association . Practice guideline for the histopathological diagnosis of mesothelioma (2025 version)[J]. China Oncology, 2024, 34(12): 1144-1163.
表5
间皮瘤鉴别诊断相关上皮性肿瘤免疫组织化学标志物"
肺腺癌 | 肺鳞癌 | 卵巢浆液性癌 | 肾细胞癌 | 乳腺癌 | 消化道腺癌 |
---|---|---|---|---|---|
Claudin-4 | p63 | Claudin-4 | RCC | Mammaglobin | CDX2 |
CEA | p40 | BerEP4 | PAX2 | GATA3 | CK20(结直肠腺癌) |
BerEP4 | 34βE12 | MOC-31 | PAX8 | GCDFP-15 | SATB2(结直肠腺癌) |
MOC-31 | claudin-4 | ER | MOC-31 | SOX10(三阴性乳腺癌) | |
TTF1 | CEA | PR | BerEP4 | ||
Napsin A | BerEP4 | PAX8 | claudin-4 | ||
MOC-31 | HNF1β | ||||
NapsinA | |||||
P504S(AMACR) |
表7
间皮瘤活检标本和手术标本病理学检查报告样式"
1. 活检标本 |
---|
标本类型:_________ |
肿瘤部位:_________ |
□ _________侧胸膜 |
□ 腹膜 |
□ 其他,_________ |
送检组织大小:_________ |
组织学类型(WHO)和疾病编码(ICD):_________ |
□ 上皮样间皮瘤 ICD-O编码9052/3 ICD-11编码XH0VP5 |
□ 肉瘤样间皮瘤 ICD-O编码9051/3 ICD-11编码XH54S8 |
□ 促纤维性间皮瘤 ICD-O编码9051/3 ICD-11编码XH54S8 |
□ 双相性间皮瘤 ICD-O编码9053/3 ICD-11编码XH1DX8 |
□ 原位间皮瘤 ICD-O编码9050/2 |
肿瘤级别:_________(仅适用于胸膜上皮样间皮瘤) |
□ 低级别 □ 高级别 |
组织学形态:_________;_________;_________ |
□ 组织结构:(不需要给出百分比) |
□ 细胞形态:_________ |
□ 间质形态:_________ |
辅助检测:_________ |
① 免疫组织化学检测:_________(BAP1,MTAP) |
② 分子检测:_________(FISH检测CDKN2A) |
2. 手术标本 |
标本类型:_________ |
肿瘤部位:_________ |
□ _________侧胸膜 |
□腹膜 |
□ 其他,_________ |
肿瘤病灶:_________ |
□ 弥漫性 |
□ 局限性 |
□ 不能判断 |
肿瘤大小:_________ |
□ _________cm × _________cm× _________cm(长径×纵径×横径) |
□ 最大径_________cm,或总体积:_________cm3 |
□ 最大径范围_________cm ~_________cm |
组织学类型(WHO)和疾病编码(ICD):_________ |
□ 上皮样间皮瘤 ICD-O编码9052/3 ICD-11编码XH0VP5 |
□ 肉瘤样间皮瘤 ICD-O编码9051/3 ICD-11编码XH54S8 |
□ 促纤维性间皮瘤 ICD-O编码9051/3 ICD-11编码XH54S8 |
□ 双相性间皮瘤 ICD-O编码9053/3 ICD-11编码XH1DX8 |
□ 原位间皮瘤 ICD-O编码9050/2 |
肿瘤级别:_________(仅适用于胸膜上皮样间皮瘤) |
□ 低级别 □ 高级别 |
组织学形态:_________ |
□ 组织结构:_________(列出主要结构类型和各种结构百分比) |
□ 细胞形态:_________ |
□ 间质形态:_________ |
浸润范围:_________ |
切缘情况:_________ |
淋巴结:_________ |
pTNM(第8版UICC/AJCC):_________(适用于胸膜间皮瘤) |
腹腔癌症指数(PCI):_________(可用于腹膜间皮瘤) |
辅助检测:_________ |
① 免疫组织化学:_________(BAP1,MTAP) |
② 分子检测:_________(FISH检测CDKN2A) |
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