肺结节活检和病理诊断在当前医疗实践中的必要性和可行性

荆剑; 张靖

doi:10.3971/j.issn.1000-8578.2019.19.0900

肺结节活检和病理诊断在当前医疗实践中的必要性和可行性

荆剑¹,
张靖²

1.
80045 奥罗拉，美国科罗拉多大学安舒茨医学中心病理系
2.
430070 武汉，湖北省肿瘤医院肿瘤内科

详细信息

作者简介:
荆剑（1975-），男，博士，助理教授，主要从事细胞病理诊断和肺病理诊断
荆剑毕业于山西医科大学医学系，北京大学医学部细胞生物学硕士学位及美国科罗拉多大学细胞生物和发育生物学博士，美国国家犹太健康医学中心和科罗拉多大学医院博士后。研究方向包括细胞内膜泡运输在癌细胞转移中的机制、急性肺损伤中巨噬细胞耐受的表观遗传机制。曾接受美国伊坎医学院西奈山医院病理住院医师和细胞病理专科医生培训、密歇根大学医学中心肺病理学专科培训。曾任密歇根大学医学中心肺病理学临床讲师，现任科罗拉多大学病理系和肺医学系助理教授。以第一作者身份在专业期刊发表与临床专业和研究相关的文章10篇，被引用近300次，1篇肺疾病专著的章节。多次在美国胸科协会年会、病理专业会议和细胞生物专业会议上作专题报告。当前主要专业和研究方向为肺结节小活检的细胞病理和解剖病理诊断、影像引导下现场的细胞病理评估和指导、超声引导下浅表肿物的活检和评判、肺非肿瘤性疾病的病理诊断以及家族性肺纤维化疾病的肺病理形态学

中图分类号: R446.8;R734.2
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出版历程
- 收稿日期: 2019-07-11
- 修回日期: 2019-09-22
- 网络出版日期: 2024-01-12
- 刊出日期: 2019-11-24

Role of Pathology in Early Detection and Management of Lung Cancer-the Necessity and Feasibility of Small Biopsies in Targeted Lung Nodule in Current Clinical Practice

JING Jian¹,
ZHANG Jing²

1.
Department of Pathology, University of Colorado Anschutz Medical Center, Aurora 80045, USA
2.
Department of Medical Oncology, Hubei Cancer Hospital, Wuhan 430070, China

摘要

摘要:
早期发现和准确诊断肺癌是降低肺癌死亡率的关键。低剂量CT影像是早期肺癌起始筛查的主要方法。本文从病理的角度，重点阐述了肺结节活检在早期肺癌筛查中的重要性和在临床实践中的可行性，以及对于影像发现的肺结节，如何在实践中方便高效取样及合理处理样品，以期达到准确诊断、分型、鉴别诊断和指导临床实践的目的。
- 肺结节 /
- 活检 /
- 肺癌筛查 /
- 病理 /
- 分子检测
Abstract:
Early detection and accurate diagnosis for lung cancer is crucial to reduce disease-related mortality. Low-dose CT image is the main method of early lung cancer screening. This review introduces the importance of lung cancer screening and the feasibility of small biopsies of lung nodule in clinical practice, and focuses on how to obtain the sample from lung nodule efficiently with low cost and less side effect, and manage the specimen appropriately in order to achieve accurate diagnosis and following ancillary tests to guide clinical practice. We summarize the common pathological diagnosis and differential diagnosis in small biopsies, and the application of small lung biopsy in the pathological staging and molecular tests.
- Lung nodule /
- Biopsy /
- Lung cancer screening /
- Pathology /
- Molecular test
作者贡献：

荆剑、张靖：撰写及修改文章

HTML全文

作者贡献：

荆剑、张靖：撰写及修改文章

图 1 恶性肿瘤的复杂结构和异型细胞

Figure 1 Adenocarcinoma with complex structure or atypical cytology features

下载: 全尺寸图片幻灯片

图 2 形态学上与分化好的恶性肿瘤细胞类似的常见反应性增生细胞

Figure 2 Benign conditions mimicking malignant cells

下载: 全尺寸图片幻灯片

图 3 肺活检小细胞癌病理特征及鉴别诊断

Figure 3 Small cell carcinoma and mimickers in small biopsy

下载: 全尺寸图片幻灯片

图 4 肺腺癌的多形性

Figure 4 Morphologic variants of lung adenocarcinoma

下载: 全尺寸图片幻灯片

图 5 肺小活检鳞状细胞癌及鳞状化生的特征

Figure 5 Characteristics of squamous metaplasia and SqCC in small biopsy

下载: 全尺寸图片幻灯片

图 6 肺小活检病理在临床诊治中的作用

Figure 6 Pathological role of small lung biopsies on clinical diagnosis and treatment

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表 1 肺结节小活检临床报告相关术语

Table 1 Terminology and interpretation in small biopsies

下载: 导出CSV

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