共识与指南
ENGLISH ABSTRACT
非小细胞肺癌恶性浆膜腔积液分子病理检测中国专家共识
中华医学会病理学分会细胞学组
作者及单位信息
·
DOI: 10.3760/cma.j.cn112151-20220517-00424
Expert consensus on clinical practice of molecular tests in non-small cell lung cancer with malignant effusion in China
Cytology Section, Chinese Society of Pathology
Zhang Zhihui
Liu Dongge
Jin Mulan
Authors Info & Affiliations
Cytology Section, Chinese Society of Pathology
Zhang Zhihui
Department of Pathology, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing 100021, China
Liu Dongge
Department of Pathology, Beijing Hospital, National Center of Gerontology; Institute of Geriatric Medicine, Chinese Academy of Medical Sciences, Beijing 100730, China
Jin Mulan
Department of Pathology, Beijing Chaoyang Hospital, Capital Medical University, Beijing 100020, China
·
DOI: 10.3760/cma.j.cn112151-20220517-00424
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摘要

精准分子分型是非小细胞肺癌精准治疗的基础和前提,但很多患者常无法获取足够的肿瘤组织进行分子病理诊断。晚期非小细胞肺癌患者常易出现恶性浆膜腔积液,可替代组织样本用于分子检测,但尚需进一步规范。本专家组参考国内外文献数据、结合临床实践经验,基于中国国情以及国内检测方法和治疗药物的可及性,经专家组专家反复讨论制定了此共识,以期指导和规范我国非小细胞肺癌恶性浆膜腔积液样本的分子病理检测。

引用本文

中华医学会病理学分会细胞学组. 非小细胞肺癌恶性浆膜腔积液分子病理检测中国专家共识[J]. 中华病理学杂志,2022,51(12):1198-1204.

DOI:10.3760/cma.j.cn112151-20220517-00424

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肺癌是我国发病率和病死率较高的恶性肿瘤,按组织学类型不同分为小细胞肺癌和非小细胞肺癌(non-small cell lung cancer,NSCLC),其中NSCLC约占85% 1。近10余年来,靶向治疗和免疫治疗药物的研发及临床应用极大地改善了晚期NSCLC的生存现状。因此,基于分子标志物筛选靶向治疗和/或免疫治疗的潜在获益人群显得尤为重要;准确、快速、全面地对NSCLC患者进行分子分型是其后续临床精准治疗的关键。随着临床需求的增加,分子病理检测技术近年来发展迅速,多种不同的检测技术已获批用于临床分子诊断。但是由于真实世界样本的可及性与不同类型检测平台的特点,需根据临床需求和检测目的选择合适的样本类型及检测方法 2。肿瘤组织样本一般被认为是分子病理检测的首选和“金标准”,但对于晚期NSCLC并非所有患者均能顺利获得检测所需的肿瘤组织样本。晚期NSCLC患者,常易在胸腔、腹腔和心包腔内聚集过多液体,这些部位的积液统称为浆膜腔积液 3。从浆膜腔积液中分离出细胞沉渣和/或上清液亦可用于NSCLC分子病理检测。实践证明该方法与组织样本分子检测结果相比具有较高的一致性,因此利用浆膜腔积液进行分子病理检测具有重要的临床应用价值和广泛的临床应用前景 4。然而,我国目前尚缺乏浆膜腔积液用于NSCLC分子检测系统全面的临床实践指导,因此本专家组结合国内外相关文献及临床实践经验,对浆膜腔积液分子病理检测的临床意义、适用人群、样本类型、检测前处理、常用检测方法及推荐检测流程等进行归纳总结并提出了指导性建议,以期能够最大限度地提高我国NSCLC患者浆膜腔积液临床检测应用的统一认识及分子检测流程的规范化。
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备注信息
A
张智慧,国家癌症中心 国家肿瘤临床医学研究中心 中国医学科学院 北京协和医学院 肿瘤医院病理科,北京 100021,Email: mocdef.3ab619hhzgnahz
B
刘东戈,北京医院病理科 国家老年医学中心 中国医学科学院老年医学研究院,北京100730,Email: mocdef.3ab6128157216631
C
金木兰,首都医科大学附属北京朝阳医院病理科,北京 100020,Email: mocdef.3ab61narukomnik
D

中华医学会病理学分会细胞学组. 非小细胞肺癌恶性浆膜腔积液分子病理检测中国专家共识[J]. 中华病理学杂志, 2022, 51(12): 1198-1204. DOI: 10.3760/cma.j.cn112151-20220517-00424.

E

执笔人:李卫华(国家癌症中心 国家肿瘤临床医学研究中心 中国医学科学院 北京协和医学院 肿瘤医院病理科,北京 100021)

F
所有作者声明无利益冲突
G
中国癌症基金会“北京希望马拉松”专项基金 (LC2020L04)
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