4种肺部肿瘤ICD-O-3形态学编码探讨  

Discussion on ICD-O-3 Morphological Coding of Four Types of Lung Tumors

作　　者：徐晓丽 汪刚 Xu Xiaoli;Wang Gang(Shanghai Chest Hospital,Shanghai Jiao Tong University School of Medicine,Shanghai 200030,China)

机构地区：[1]上海市胸科医院(上海交通大学医学院附属胸科医院),上海市200030

出　　处：《中国病案》2025年第1期33-35,共3页Chinese Medical Record

摘　　要：按照ICD-10肿瘤编码查找方法,结合WHO肿瘤分类和ICD-O-3形态学编码内容,确定肺错构瘤(M8992/0)、硬化性肺细胞瘤(M8832/0)、肺良性转移性平滑肌瘤(M8898/1)、细支气管腺瘤(M8140/0)的形态学编码,讨论肿瘤诊断编码特点和难点。细支气管腺瘤和硬化性肺细胞瘤的形态学编码要关注WHO肿瘤分类,细支气管腺瘤是2021年WHO胸部肿瘤分类肺腺瘤中的新增类型;2015年肺硬化性血管瘤更名为硬化性肺细胞瘤,以主导词“血管瘤”-硬化性,方可查阅到正确的形态学编码;肺错构瘤和肺良性转移性平滑肌瘤在ICD-10中无法查找到相应的形态学编码,在国家临床版编码中也没有相应的扩展更新,编码员要结合WHO肿瘤分类和ICD-O确定形态学编码。为提高肿瘤编码准确性,建议编码员正确熟练掌握肿瘤编码步骤,丰富WHO肿瘤组织学分类等专业相关知识,学会阅读分析病案,加强与医师沟通,努力提高专业能力;在ICD-10更新不及时的情况下,定期维护编码库并切实规范管理;通过定期质控,发现问题后及时修正和总结。Based on the challenging cases of four types of lung tumors encountered in daily practice,and in conjunction with the WHO tumor classification and ICD-O-3 morphological codes,the morphological codes for pulmonary hamartoma(M8992/0),pulmonary sclerosing pneumocytoma(M8832/0),pulmonary benign metastasizing leiomyoma(M8898/1),and bronchiolar adenoma(M8140/0)were confirmed according to the ICD-10 tumor coding.When discussing the characteristics and challenges of tumor diagnosis coding,special attention should be given to the morphological coding of bronchiolar adenoma and pulmonary sclerosing pneumocytoma in accordance with the WHO tumor classification.Bronchiolar adenoma is a newly added type within the lung adenomas in the 2021 WHO classification of thoracic tumors.Pulmonary sclerosing hemangioma was renamed as pulmonary sclerosing pneumocytoma in 2015 WHO classification of tumors of lung.The correct morphological coding can only be found by using the main term"hemangioma"-sclerosing.The morphological codes for pulmonary hamartoma and pulmonary benign metastatic leiomyomatosis cannot be found in the ICD-10,nor are there corresponding extensions or updates in the national clinical code.Therefore,coders should determine morphological coding by combining the WHO classification of tumors with ICD-O.Countermeasures to improve the accuracy of tumor coding were analyzed.It is recommended that coders correctly and skillfully master the steps for tumor coding,expand their knowledge of WHO tumor histological classifications,learn to interpret and analyze medical records,strengthen communication with doctors,and strive to enhance their professional abilities.In the event that ICD-10 is not updated in a timely manner,the coding library should be regularly maintained and effectively managed in a standardized manner;through regular quality control,problems should be corrected and summarized in a timely manner when discovered.

关 键 词：ICD-O-3 肺错构瘤 硬化性肺细胞瘤 肺良性转移性平滑肌瘤 细支气管腺瘤 

分 类 号：R734.2[医药卫生—肿瘤]