案例分析2015版WHO肺腺癌病理类型和病理编码
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摘要
2015年第4版《WHO肺、胸膜、胸腺及心脏肿瘤分类》取消了2004版的腺癌、混合亚型和细支气管肺泡癌,并进一步细分;取消2004版的透明细胞癌、印戎细胞癌、黏液性囊腺癌;2015版新增了肠型腺癌。实际工作中,临床医师已应用了新版本病理学分类进行诊断,而编码却仍按照2004年第3版病理学分类进行编码,应利用现有编码尽可能地体现新病理分类。如2015版的肺泡状腺癌与2004版的肺泡状腺癌变化不大,因此可暂用2004版的腺泡状腺癌来表达,即M8550/3。另外,对于有临床意义的组织类型应当优先体现。
Lung cancer is the highest fatality rate in the world.In recent years, the incidence of lung adenocarcinoma rising and has more than the lung squamous carcinoma, caused a great threat to people health.The fourth edition of the WHO classification of tumours of the lung, pleura, thymus and heart is published. The 2015 edition abolished the 2004 edition of adenocarcinoma,mixed subtype and bronchial alveolar carcinoma,and further subdivided;The 2004 edition of transparent cell carcinoma,indo-rong cell carcinoma,mucinous cystic adenocarcinoma was cancelled.Intestinal adenocarcinoma was added to the 2015 edition.In practice,clinicians have applied the new version of the pathological classification for diagnosis,but the coding is still based on the 2004version 3 pathological classification.In this case,we cannot use the new pathological coding immediately,we should use the existing coding to reflect the new pathological classification as much as possible.For example,the alveolar adenocarcinoma in the 2015 edition is not much different from the alveolar adenocarcinoma in the 2004edition,so it can be tentatively expressed as the alveolar adenocarcinoma in the 2004 edition,namely m8550/3.In addition,it should give priority to clinical tissue types.
Lung cancer is the highest fatality rate in the world.In recent years, the incidence of lung adenocarcinoma rising and has more than the lung squamous carcinoma, caused a great threat to people health.The fourth edition of the WHO classification of tumours of the lung, pleura, thymus and heart is published. The 2015 edition abolished the 2004 edition of adenocarcinoma,mixed subtype and bronchial alveolar carcinoma,and further subdivided;The 2004 edition of transparent cell carcinoma,indo-rong cell carcinoma,mucinous cystic adenocarcinoma was cancelled.Intestinal adenocarcinoma was added to the 2015 edition.In practice,clinicians have applied the new version of the pathological classification for diagnosis,but the coding is still based on the 2004version 3 pathological classification.In this case,we cannot use the new pathological coding immediately,we should use the existing coding to reflect the new pathological classification as much as possible.For example,the alveolar adenocarcinoma in the 2015 edition is not much different from the alveolar adenocarcinoma in the 2004edition,so it can be tentatively expressed as the alveolar adenocarcinoma in the 2004 edition,namely m8550/3.In addition,it should give priority to clinical tissue types.
引文
[1]方三高,许春伟,肖华亮.解读2015年WHO肺、胸膜、胸腺及心脏肿瘤分类(肺)[J].重庆医药,2017,46(1):4-23.
[2]陈岗,廖美琳.肺癌WHO新病理分类的临床意义[J].中国肿瘤,2004,13(10):613-615.
[3]张兵林,笪冀平.WHO(2015)肺肿瘤组织学分类解读[J].诊断病理学杂志,2016,23(6):401-410.
[4]张杰,邵晋晨,朱蕾.2015版WHO肺肿瘤分类解读[J].中华病理学杂志,2015,44(9):619-624.
[5]Kadota K,Ville ena-Vargas J,Yoshizawa A,et al.Prognostic significance of adenocarcinoma in situ,minimally invasive adenocarcinoma,and nonmucino ouslepidic predoo minant invasive adenocarcinoma of the lung in patients with stageⅠdisease[J].Am J SurgPathol,2014,38(4):448-460.
[2]陈岗,廖美琳.肺癌WHO新病理分类的临床意义[J].中国肿瘤,2004,13(10):613-615.
[3]张兵林,笪冀平.WHO(2015)肺肿瘤组织学分类解读[J].诊断病理学杂志,2016,23(6):401-410.
[4]张杰,邵晋晨,朱蕾.2015版WHO肺肿瘤分类解读[J].中华病理学杂志,2015,44(9):619-624.
[5]Kadota K,Ville ena-Vargas J,Yoshizawa A,et al.Prognostic significance of adenocarcinoma in situ,minimally invasive adenocarcinoma,and nonmucino ouslepidic predoo minant invasive adenocarcinoma of the lung in patients with stageⅠdisease[J].Am J SurgPathol,2014,38(4):448-460.