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浙江大学学报（医学版）
浙江大学学报（医学版）  2016, Vol. 45 Issue (1): 36-44    DOI: 10.3785/j.issn.1008-9292.2016.01.06
神经内分泌肿瘤专题     
肺神经内分泌肿瘤病理诊断进展
滕晓东1, 赵明2, 来茂德3
1. 浙江大学医学院附属第一医院病理科, 浙江 杭州 310003;
2. 浙江省人民医院病理科, 浙江 杭州 310014;
3. 浙江大学医学院基础医学院, 浙江 杭州 310058
Update of pathological diagnosis of pulmonary neuroendocrine tumor
TENG Xiaodong1, ZHAO Ming2, LAI Maode3
1. Department of Pathology, the First Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou 310003, China;
2. Department of Pathology, Zhejiang Provincial People's Hospital, Hangzhou 310014, China;
3. School of Basic Medical Sciences, Zhejiang University School of Medicine, Hangzhou 310058, China
全文: PDF(1224 KB)  
摘要: 

在临床诊断实践中肺神经内分泌肿瘤并不少见,其组织学分类、分级与消化道和胰腺神经内分泌肿瘤的分类分级标准并不完全相同。在2015年最新的WHO分类中,肺神经内分泌肿瘤分为类癌(包括典型类癌和不典型类癌)、小细胞肺癌、大细胞神经内分泌癌以及癌前病变——弥漫性特发性神经内分泌细胞增生等几个范畴,各自具有独特的形态学、免疫表型以及预后特征。神经内分泌肿瘤的诊断主要依据形态学的组织结构和细胞特征,免疫组织化学检测同样也起着重要的作用。此外,不同的标本类型中的诊断要点也明显不同。基于治疗和处理的不同,准确地诊断和鉴别诊断各范畴的肺神经内分泌肿瘤具有重要的临床意义。文中就肺神经内分泌肿瘤的临床病理进展作一简要总结, 着重强调其诊断和鉴别诊断要点。
关键词 ： 癌,神经内分泌/诊断,  癌,神经内分泌/病理学,  肺肿瘤/诊断,  肺肿瘤/病理学,  小细胞肺癌/病理学,  诊断,鉴别,  综述    
Abstract：

Pulmonary neuroendocrine tumors are common in pathological practice and its pathological classification and histological grading are not exactly the same as that of those in the digestive tract and pancreas. In 2015 edition of World Health Organization classification, pulmonary neuroendocrine tumors are classified as carcinoid tumors (including typical carcinoid and atypical carcinoid), small cell lung carcinoma, large cell neuroendocrine carcinoma, and precursor lesion diffuse idiopathic neuroendocrine cell hyperplasia; each category has distinctive morphological and immunohistochemical features. The morphologic features including growth patterns and cytological appearances are keys for the diagnosis of neuroendocrine tumor, and immunohistochemical findings are also critical for its diagnosis. Furthermore, the diagnostic criteria vary for different types of specimen. In this article, we present a concise review and summary of the update of clinicopathological characterizations of pulmonary neuroendocrine tumor, with an emphasis on its diagnostic criteria and differential diagnosis.
Key words： Carcinoma, neuroendocrine/diagosis    Carcinoma, neuroendocrine/pathology    Lung neoplasms/diagnosis    Lung neoplasms/pathology    Small-cell lung carcinoma/pathology    Diagnosis, differential    Review
收稿日期: 2015-12-20     
CLC:  R73  
基金资助:

浙江省科技计划项目(2012C13014-3)
通讯作者: 来茂德(1960-),男,博士,教授,主任医师,主要从事大肠癌病理学研究;E-mail:lmd@zju.edu.cn;http://orcid.org/0000-0001-6830-9774     E-mail: lmd@zju.edu.cn
作者简介: 滕晓东(1964-),男,硕士,主任医师,主要从事临床病理诊断工作;E-mail:teng1723@163.com;http://orcid.org/0000-0003-3717-3370
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滕晓东 等. 肺神经内分泌肿瘤病理诊断进展[J]. 浙江大学学报（医学版）, 2016, 45(1): 36-44.
TENG Xiaodong, ZHAO Ming, LAI Maode. Update of pathological diagnosis of pulmonary neuroendocrine tumor. Journal of ZheJiang University(Medical Science), 2016, 45(1): 36-44.

链接本文:

http://www.zjujournals.com/xueshu/med/CN/10.3785/j.issn.1008-9292.2016.01.06      或      http://www.zjujournals.com/xueshu/med/CN/Y2016/V45/I1/36

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