2022版世界卫生组织垂体神经内分泌肿瘤的病理新分类和临床启示  

New pathological classification and clinical implications of pituitary neuroendocrine tumors of the 2022 WHO version

作　　者：谢静[1] 吴哲褒[2] Xie Jing;Wu Zhebao(Department of Pathology,Ruijin Hospital,Shanghai Jiaotong University School of Medicine,Shanghai 200025,China;Department of Neurosurgery,Ruijin Hospital,Shanghai Jiaotong University School of Medicine,Shanghai 200025,China)

机构地区：[1]上海交通大学医学院附属瑞金医院病理科,上海200025 [2]上海交通大学医学院附属瑞金医院神经外科,上海200025

出　　处：《中华医学杂志》2022年第47期3723-3726,共4页National Medical Journal of China

基　　金：国家自然科学基金(82141114)。

摘　　要：2022年世界卫生组织对垂体腺瘤再次提出新分类,其命名正式进入垂体神经内分泌肿瘤(PitNETs)的时代。新分类中,常规使用垂体转录因子(PIT1、TPIT、SF1、GATA3和ERα)和激素等抗体提供了PitNETs的详细组织学亚型。PIT1、TPIT和SF1谱系定义的PitNETs类型和亚型具有明显的形态学、分子和临床差异。与2017版相比,主要改变包括:(1)嗜酸细胞干细胞型和泌乳素生长激素细胞瘤、混合性泌乳-生长激素细胞腺瘤,在2022版中均作为一个独立的类型;(2)未成熟PIT1谱系肿瘤和成熟多激素PIT1谱系肿瘤,取代原先的多激素PIT1阳性腺瘤;(3)提倡用"转移性PitNET"来取代之前的"垂体癌"。新版分类强调了PitNETs病理分型的重要性,很显然,准确的病理解读是判断临床治疗路径和预后的关键。In 2022,the World Health Organization proposed a new classification for pituitary adenomas.The major nomenclature change from the previous edition was the transition from"adenoma"to"pituitary neuroendocrine tumor"(PitNETs).The new classification provided the detailed histological subtypes of PitNETs for routine use of antibodies such as pituitary transcription factors(PIT1,TPIT,SF1,GATA3,and ERα)and hormones.The major PIT1,TPIT,and SF1 lineage-defined PitNETs types and subtypes featured distinct morphologic,molecular,and clinical differences.Unlike the 2017 WHO classification,the 2022 WHO version updated some concepts as follows:(1)Mammosomatotroph,acidophil stem cell tumors and mixed somatotroph/lactotroph tumor represented distinct PIT1-lineage PitNETs;(2)The diagnostic category of PIT1-positive plurihormonal tumor was replaced by the immature PIT1-lineage tumor and the mature plurihormonal PIT1-lineage tumor;(3)The term"metastatic PitNET"was advocated to replace the previous terminology"pituitary carcinoma".The new classification emphasizes the importance of pathological classification of PitNETs.Obviously,accurate pathological interpretation is the key to judge the clinical treatment pathway and prognosis of patients.

关 键 词：世界卫生组织 垂体神经内分泌肿瘤 垂体腺瘤 肿瘤细胞谱系 肿瘤分类 

分 类 号：R736.4[医药卫生—肿瘤]