INTRODUCTION: The American Thoracic Society is a cosponsor of a newly published lung adenocarcinoma classification. METHODS: An international multidisciplinary panel of experts was formed. A systematic review was performed and recommendations were graded by strength and quality of the evidence using the Grading of Recommendations, Assessment, Development and Evaluation (GRADE) approach. RESULTS: The classification addresses both resection specimens and small biopsies/cytology. The terms bronchioloalveolar carcinoma and mixed subtype adenocarcinoma are no longer used. For resection specimens, new concepts are introduced such as adenocarcinoma in situ and minimally invasive adenocarcinoma for small solitary adenocarcinomas with pure lepidic growth and predominant lepidic growth with ≤ 5 mm invasion, respectively. Invasive adenocarcinomas are classified by predominant pattern after using comprehensive histologic subtyping with lepidic, acinar, papillary, and solid patterns; micropapillary is added. In the new aspect of this classification that provides guidance for small biopsies and cytology specimens, non-small cell lung carcinomas (NSCLC), in patients with advanced stage disease, are to be classified into more specific types, such as adenocarcinoma or squamous cell carcinoma, whenever possible, for several reasons: (1) adenocarcinoma or NSCLC not otherwise specified should be tested for EGFR mutations, because the presence of these mutations is predictive of responsiveness to EGFR tyrosine kinase inhibitors, (2) adenocarcinoma histology is a strong predictor for improved outcome with pemetrexed therapy, and (3) squamous histology is a risk factor for life-threatening hemorrhage with bevacizumab therapy. NSCLC- not otherwise specified by light microscopy alone should be studied with immunohistochemistry and/or mucin stains. CONCLUSIONS: This classification is intended to support clinical practice as well as research investigation and clinical trials.
INTRODUCTION: The American Thoracic Society is a cosponsor of a newly published lung adenocarcinoma classification. METHODS: An international multidisciplinary panel of experts was formed. A systematic review was performed and recommendations were graded by strength and quality of the evidence using the Grading of Recommendations, Assessment, Development and Evaluation (GRADE) approach. RESULTS: The classification addresses both resection specimens and small biopsies/cytology. The terms bronchioloalveolar carcinoma and mixed subtype adenocarcinoma are no longer used. For resection specimens, new concepts are introduced such as adenocarcinoma in situ and minimally invasive adenocarcinoma for small solitary adenocarcinomas with pure lepidic growth and predominant lepidic growth with ≤ 5 mm invasion, respectively. Invasive adenocarcinomas are classified by predominant pattern after using comprehensive histologic subtyping with lepidic, acinar, papillary, and solid patterns; micropapillary is added. In the new aspect of this classification that provides guidance for small biopsies and cytology specimens, non-small cell lung carcinomas (NSCLC), in patients with advanced stage disease, are to be classified into more specific types, such as adenocarcinoma or squamous cell carcinoma, whenever possible, for several reasons: (1) adenocarcinoma or NSCLC not otherwise specified should be tested for EGFR mutations, because the presence of these mutations is predictive of responsiveness to EGFR tyrosine kinase inhibitors, (2) adenocarcinoma histology is a strong predictor for improved outcome with pemetrexed therapy, and (3) squamous histology is a risk factor for life-threatening hemorrhage with bevacizumab therapy. NSCLC- not otherwise specified by light microscopy alone should be studied with immunohistochemistry and/or mucin stains. CONCLUSIONS: This classification is intended to support clinical practice as well as research investigation and clinical trials.
Authors: Adrian Huber; Julia Landau; Lukas Ebner; Yanik Bütikofer; Lars Leidolt; Barbara Brela; Michelle May; Johannes Heverhagen; Andreas Christe Journal: Eur Radiol Date: 2016-01-26 Impact factor: 5.315
Authors: Morgan L Cox; Chi-Fu Jeffrey Yang; Paul J Speicher; Kevin L Anderson; Zachary W Fitch; Lin Gu; Robert Patrick Davis; Xiaofei Wang; Thomas A D'Amico; Matthew G Hartwig; David H Harpole; Mark F Berry Journal: J Thorac Oncol Date: 2017-01-08 Impact factor: 15.609
Authors: Marina Suárez-Piñera; José Belda-Sanchis; Alvaro Taus; Albert Sánchez-Font; Antoni Mestre-Fusco; Marcel Jiménez; Lara Pijuan Journal: Am J Nucl Med Mol Imaging Date: 2018-04-25
Authors: Dijana Djureinovic; Björn M Hallström; Masafumi Horie; Johanna Sofia Margareta Mattsson; Linnea La Fleur; Linn Fagerberg; Hans Brunnström; Cecilia Lindskog; Katrin Madjar; Jörg Rahnenführer; Simon Ekman; Elisabeth Ståhle; Hirsh Koyi; Eva Brandén; Karolina Edlund; Jan G Hengstler; Mats Lambe; Akira Saito; Johan Botling; Fredrik Pontén; Mathias Uhlén; Patrick Micke Journal: JCI Insight Date: 2016-07-07
Authors: Dirk Van Raemdonck; Robin Vos; Jonas Yserbyt; Herbert Decaluwe; Paul De Leyn; Geert M Verleden Journal: J Thorac Dis Date: 2016-11 Impact factor: 2.895