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What's new in adrenal gland pathology: WHO 5th edition for adrenal cortex. 肾上腺病理学新进展:世界卫生组织第 5 版肾上腺皮质。
IF 1.7 Q3 PATHOLOGY Pub Date : 2024-07-01 Epub Date: 2024-06-25 DOI: 10.4132/jptm.2024.06.07
Carol N Rizkalla, Maria Tretiakova

The 5th edition of WHO Classification of Endocrine and Neuroendocrine Tumors (2022) introduced many significant changes relevant to endocrine daily practice. In this newsletter, we summarize the notable changes to the adrenal cortex based on the 5th edition of the WHO classification [1].

第五版《世界卫生组织内分泌和神经内分泌肿瘤分类》(2022 年)引入了许多与内分泌日常实践相关的重大变化。在本期通讯中,我们将根据第五版 WHO 分类[1]总结肾上腺皮质的显著变化。
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引用次数: 0
Tubular adenoma arising in tubular colonic duplication: a case report. 管状结肠重复出现的管状腺瘤:一份病例报告。
IF 1.7 Q3 PATHOLOGY Pub Date : 2024-07-01 Epub Date: 2024-07-03 DOI: 10.4132/jptm.2024.06.04
Heonwoo Lee, Hyeong Rok An, Chan Wook Kim, Young Soo Park

Colonic duplication constitutes a rare congenital anomaly, characterized by the presence of hollow cystic or tubular structures exhibiting an epithelial-lined intestinal wall. Diagnostic challenges persist due to its low incidence and manifestation of nonspecific symptoms such as abdominal pain or constipation, resulting in a reluctance to pursue surgical resection. As associated malignancies in colonic duplication are rare, the inherent malignant potential of these anomalies remains undetermined. Additionally, despite reported instances of associated malignancies in colonic duplication, there is an absence of reports in the literature detailing tubular adenoma within these cases. The histologic features of the presented case are particularly noteworthy, situated at the precancerous stage, intimating potential progression towards adenocarcinoma within colonic duplication.

结肠重复是一种罕见的先天性畸形,其特点是存在空心囊状或管状结构,肠壁上皮内衬。由于其发病率较低,且表现为腹痛或便秘等非特异性症状,导致患者不愿进行手术切除,因此诊断上一直存在困难。由于结肠重复的相关恶性肿瘤非常罕见,这些异常的内在恶性潜能仍未确定。此外,尽管有报道称结肠重复畸形伴发恶性肿瘤,但文献中没有关于这些病例中肾小管腺瘤的详细报道。本病例的组织学特征尤其值得注意,它处于癌前病变阶段,预示着结肠重复部可能发展为腺癌。
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引用次数: 0
Clinical practice recommendations for the use of next-generation sequencing in patients with solid cancer: a joint report from KSMO and KSP. 在实体癌患者中使用新一代测序的临床实践建议:KSMO 和 KSP 的联合报告。
IF 1.7 Q3 PATHOLOGY Pub Date : 2024-07-01 Epub Date: 2024-01-10 DOI: 10.4132/jptm.2023.11.01
Miso Kim, Hyo Sup Shim, Sheehyun Kim, In Hee Lee, Jihun Kim, Shinkyo Yoon, Hyung-Don Kim, Inkeun Park, Jae Ho Jeong, Changhoon Yoo, Jaekyung Cheon, In-Ho Kim, Jieun Lee, Sook Hee Hong, Sehhoon Park, Hyun Ae Jung, Jin Won Kim, Han Jo Kim, Yongjun Cha, Sun Min Lim, Han Sang Kim, Choong-Kun Lee, Jee Hung Kim, Sang Hoon Chun, Jina Yun, So Yeon Park, Hye Seung Lee, Yong Mee Cho, Soo Jeong Nam, Kiyong Na, Sun Och Yoon, Ahwon Lee, Kee-Taek Jang, Hongseok Yun, Sungyoung Lee, Jee Hyun Kim, Wan-Seop Kim

In recent years, next-generation sequencing (NGS)-based genetic testing has become crucial in cancer care. While its primary objective is to identify actionable genetic alterations to guide treatment decisions, its scope has broadened to encompass aiding in pathological diagnosis and exploring resistance mechanisms. With the ongoing expansion in NGS application and reliance, a compelling necessity arises for expert consensus on its application in solid cancers. To address this demand, the forthcoming recommendations not only provide pragmatic guidance for the clinical use of NGS but also systematically classify actionable genes based on specific cancer types. Additionally, these recommendations will incorporate expert perspectives on crucial biomarkers, ensuring informed decisions regarding circulating tumor DNA panel testing.

近年来,基于新一代测序(NGS)的基因检测已成为癌症治疗的关键。虽然其主要目的是确定可操作的基因改变以指导治疗决策,但其范围已扩大到包括辅助病理诊断和探索抗药性机制。随着 NGS 应用和依赖的不断扩大,有必要就其在实体癌中的应用达成专家共识。为满足这一需求,即将发布的建议不仅为 NGS 的临床应用提供了实用指导,还根据特定癌症类型对可操作基因进行了系统分类。此外,这些建议还将纳入专家对关键生物标志物的观点,确保在循环肿瘤 DNA 面板检测方面做出明智的决定。
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引用次数: 0
Welcoming the new, revisiting the old: a brief glance at cytopathology reporting systems for lung, pancreas, and thyroid. 喜新厌旧:肺、胰腺和甲状腺细胞病理学报告系统简评。
IF 1.7 Q3 PATHOLOGY Pub Date : 2024-07-01 Epub Date: 2024-07-15 DOI: 10.4132/jptm.2024.06.11
Rita Luis, Balamurugan Thirunavukkarasu, Deepali Jain, Sule Canberk

This review addresses new reporting systems for lung and pancreatobiliary cytopathology as well as the most recent edition of The Bethesda Reporting System for Thyroid Cytopathology. The review spans past, present, and future aspects within the context of the intricate interplay between traditional morphological assessments and cutting-edge molecular diagnostics. For lung and pancreas, the authors discuss the evolution of reporting systems, emphasizing the bridge between past directives and more recent collaborative efforts of the International Academy of Cytology and the World Health Organization in shaping universal reporting systems. The review offers a brief overview of the structure of these novel systems, highlighting their strengths and pinpointing areas that require further refinement. For thyroid, the authors primarily focus on the third edition of The Bethesda System for Reporting Thyroid Cytopathology, also considering the two preceding editions. This review serves as an invaluable resource for cytopathologists, offering a panoramic view of the evolving landscape of cytopathology reporting and pointing out the integrative role of the cytopathologist in an era of rapid diagnostic and therapeutic advancements.

本综述探讨了肺部和胰胆细胞病理学的新报告系统以及最新版的《甲状腺细胞病理学贝塞斯达报告系统》。在传统形态学评估与前沿分子诊断之间错综复杂的相互作用背景下,综述涵盖了过去、现在和未来的各个方面。在肺部和胰腺方面,作者讨论了报告系统的演变,强调了过去的指示与国际细胞学学会和世界卫生组织最近在形成通用报告系统方面的合作努力之间的桥梁作用。综述简要概述了这些新系统的结构,强调了它们的优势,并指出了需要进一步完善的领域。对于甲状腺,作者主要关注《贝塞斯达甲状腺细胞病理学报告系统》第三版,同时也考虑了前两版。这篇综述是细胞病理学家的宝贵资源,它提供了细胞病理报告不断发展的全景,并指出了细胞病理学家在诊断和治疗快速发展的时代所扮演的综合角色。
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引用次数: 0
Liquid-based cytology features of pancreatic acinar cell carcinoma: comparison with other non-ductal neoplasms of the pancreas. 胰腺尖细胞癌的液基细胞学特征:与胰腺其他非导性肿瘤的比较。
IF 1.7 Q3 PATHOLOGY Pub Date : 2024-07-01 Epub Date: 2024-07-09 DOI: 10.4132/jptm.2024.06.25
Minji Kwon, Seung-Mo Hong, Kyoungbun Lee, Haeryoung Kim

Background: Acinar cell carcinoma (ACC) is a rare malignant epithelial neoplasm, which shares many cytomorphological features with other non-ductal pancreatic neoplasms such as pancreatic neuroendocrine neoplasm (PanNEN) and solid-pseudopapillary neoplasm (SPN). Due to the relative rarity of these tumors, pathologists are less familiar with the cytological features, especially on liquid-based cytology (LBC) which has been relatively recently introduced for endoscopic ultrasound-guided fine needle aspiration specimens.

Methods: We evaluated the detailed cytological features of 15 histologically confirmed ACC (7 conventional smears [CS], 8 LBC), and compared them with the LBC features of SPN (n = 9) and PanNEN (n = 9).

Results: Compared with CS, LBCs of ACC demonstrated significantly less bloody background. All ACCs demonstrated prominent nucleoli and macronucleoli on LBC. On comparison with the LBC features of SPN and PanNEN, most ACCs demonstrated a necrotic background with apoptotic debris while PanNEN and SPN did not show these features. Acinar structures were predominantly observed in ACC, while frequent pseudopapillary structures were seen only in SPN. Prominent nucleoli and macronucleoli were only seen in ACC.

Conclusions: ACC had characteristic cytological features that could be observed on LBC preparations, such as high cellularity, necrotic/apoptotic background, nuclear tangles, acinar arrangement of cells, and macronucleoli. These findings also help distinguish ACC from PanNEN and SPN on LBC. It is important to be familiar with these features, as an accurate diagnosis on endoscopic ultrasound-guided fine needle aspiration cytology would have impact on the management of the patient.

背景:胰腺腺细胞癌(ACC)是一种罕见的恶性上皮肿瘤,与胰腺神经内分泌肿瘤(PanNEN)和实性假乳头状肿瘤(SPN)等其他非胰腺导管性肿瘤有许多共同的细胞形态学特征。由于这些肿瘤相对罕见,病理学家对其细胞学特征不太熟悉,尤其是最近才在内镜超声引导下细针穿刺标本中引入的液基细胞学(LBC):我们评估了 15 例经组织学确诊的 ACC(7 例常规涂片 [CS]、8 例液基细胞学检查)的详细细胞学特征,并将其与 SPN(9 例)和 PanNEN(9 例)的液基细胞学检查特征进行了比较:结果:与CS相比,ACC的LBC血性背景明显减少。所有 ACC 的 LBC 均显示出突出的核小体和大核小体。与SPN和PanNEN的LBC特征相比,大多数ACC表现出坏死背景和凋亡碎片,而PanNEN和SPN则没有这些特征。在 ACC 中主要观察到针状结构,而只有在 SPN 中经常看到假乳头状结构。突出的核小体和大核小体仅见于 ACC:结论:ACC具有可在LBC制备物上观察到的特征性细胞学特征,如高细胞度、坏死/凋亡背景、核缠结、针状细胞排列和巨核细胞。这些发现也有助于在 LBC 上将 ACC 与 PanNEN 和 SPN 区分开来。熟悉这些特征非常重要,因为内镜超声引导下细针穿刺细胞学检查的准确诊断将对患者的治疗产生影响。
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引用次数: 0
Concurrent intestinal plasmablastic lymphoma and diffuse large B-cell lymphoma with a clonal relationship: a case report and literature review. 具有克隆关系的并发肠浆细胞淋巴瘤和弥漫大 B 细胞淋巴瘤:病例报告和文献综述。
IF 1.7 Q3 PATHOLOGY Pub Date : 2024-07-01 Epub Date: 2024-06-25 DOI: 10.4132/jptm.2024.05.14
Nao Imuta, Kosuke Miyai, Motohiro Tsuchiya, Mariko Saito, Takehiro Sone, Shinichi Kobayashi, Sho Ogata, Fumihiko Kimura, Susumu Matsukuma

Herein, we report a case of plasmablastic lymphoma (PBL) and diffuse large B-cell lymphoma (DLBCL) that occurred concurrently in the large intestine. An 84-year-old female presented with a palpable rectal tumor and ileocecal tumor observed on imaging analyses. Endoscopic biopsy of both lesions revealed lymphomatous round cells. Hartmann's operation and ileocecal resection were performed for regional control. The ileocecal lesion consisted of a proliferation of CD20/CD79a-positive lymphoid cells, indicative of DLBCL. In contrast, the rectal tumor showed proliferation of atypical cells with pleomorphic nuclei and abundant amphophilic cytoplasm, with immunohistochemical findings of CD38/CD79a/MUM1/MYC (+) and CD20/CD3/CD138/PAX5 (-). Tumor cells were positive for Epstein-Barr virus- encoded RNA based on in situ hybridization and MYC rearrangement in fluorescence in situ hybridization analysis. These findings indicated the rectal tumor was most likely a PBL. Sequencing analysis for immunoglobulin heavy variable genes indicated a common B-cell origin of the two sets of lymphoma cells. This case report and literature review provide new insights into PBL tumorigenesis.

在此,我们报告了一例同时发生在大肠的浆细胞淋巴瘤(PBL)和弥漫大 B 细胞淋巴瘤(DLBCL)病例。一名 84 岁的女性患者在影像学分析中发现可触及的直肠肿瘤和回盲部肿瘤。对这两个病灶进行的内镜活检发现了淋巴瘤圆形细胞。为了进行区域控制,患者接受了哈特曼手术和回盲部切除术。回盲部病变由 CD20/CD79a 阳性淋巴细胞增生组成,显示为 DLBCL。相比之下,直肠肿瘤表现为非典型细胞增生,细胞核多形,胞浆丰富,免疫组化结果为CD38/CD79a/MUM1/MYC(+)和CD20/CD3/CD138/PAX5(-)。根据原位杂交和荧光原位杂交分析,肿瘤细胞的Epstein-Barr病毒编码RNA和MYC重排均呈阳性。这些结果表明,直肠肿瘤很可能是一种 PBL。免疫球蛋白重型可变基因测序分析表明,两组淋巴瘤细胞来源于共同的 B 细胞。这篇病例报告和文献综述为我们提供了关于PBL肿瘤发生的新见解。
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引用次数: 0
Immunohistochemical expression in idiopathic inflammatory myopathies at a single center in Vietnam. 越南一家中心特发性炎症性肌病的免疫组化表达。
IF 1.7 Q3 PATHOLOGY Pub Date : 2024-07-01 Epub Date: 2024-06-25 DOI: 10.4132/jptm.2024.05.02
Dat Quoc Ngo, Si Tri Le, Khanh Hoang Phuong Phan, Thao Thi Phuong Doan, Linh Ngoc Khanh Nguyen, Minh Hoang Dang, Thien Thanh Ly, Thu Dang Anh Phan

Background: The identification of idiopathic inflammatory myopathies (IIMs) requires a comprehensive analysis involving clinical manifestations and histological findings. This study aims to provide insights into the histopathological and immunohistochemical aspects of IIMs.

Methods: This retrospective case series involved 56 patients diagnosed with IIMs at the Department of Pathology, University of Medicine and Pharmacy at Ho Chi Minh City, from 2019 to 2023. The histology and immunohistochemical expression of HLA-ABC, HLA-DR, C5b-9, Mx1/2/3, and p62 were detected.

Results: We examined six categories of inflammatory myopathy, including immunemediated necrotizing myopathy (58.9%), dermatomyositis (DM; 23.2%), overlap myositis (8.9%), antisynthetase syndrome (5.4%), inclusion body myositis (IBM; 1.8%), and polymyositis (1.8%). The average age of the patients was 49.7 ± 16.1 years, with a female-to-male ratio of 3:1. Inflammatory cell infiltration in the endomysium was present in 62.5% of cases, perifascicular atrophy was found in 17.8%, and fiber necrosis was observed in 42 cases (75.0%). Rimmed vacuoles were present in 100% of cases in the IBM group. Immunohistochemistry showed the following positivity rates: HLA-ABC (89.2%), HLA-DR (19.6%), C5b-9 (57.1%), and Mx1/2/3 (10.7%). Mx1/2/3 expression was high in DM cases. p62 vacuole deposits were noted in the IBM case. The combination of membrane attack complex and major histocompatibility complex I helped detect IIMs in 96% of cases.

Conclusions: The diagnosis of IIMs and their subtypes should be based on clinical features and histopathological characteristics. Immunohistochemistry plays a crucial role in the diagnosis and differentiation of these subgroups.

背景:鉴别特发性炎症性肌病(IIMs)需要对临床表现和组织学发现进行综合分析。本研究旨在深入了解特发性炎症性肌病的组织病理学和免疫组化方面:这项回顾性病例系列研究涉及胡志明市医药大学病理学系在 2019 年至 2023 年期间诊断出的 56 例 IIMs 患者。我们检测了组织学和免疫组化表达的 HLA-ABC、HLA-DR、C5b-9、Mx1/2/3 和 p62:我们检测了六类炎症性肌病,包括免疫介导坏死性肌病(58.9%)、皮肌炎(DM;23.2%)、重叠性肌炎(8.9%)、抗合成酶综合征(5.4%)、包涵体肌炎(IBM;1.8%)和多发性肌炎(1.8%)。患者的平均年龄为 49.7 ± 16.1 岁,男女比例为 3:1。62.5%的病例出现肌内膜炎性细胞浸润,17.8%的病例出现筋膜周围萎缩,42例(75.0%)病例出现纤维坏死。在 IBM 组中,100% 的病例都出现了边缘空泡。免疫组化显示了以下阳性率:HLA-ABC(89.2%)、HLA-DR(19.6%)、C5b-9(57.1%)和 Mx1/2/3(10.7%)。Mx1/2/3在DM病例中表达较高。膜攻击复合体和主要组织相容性复合体I的组合有助于在96%的病例中检测出IIMs:结论:IIMs 及其亚型的诊断应基于临床特征和组织病理学特征。免疫组化在这些亚型的诊断和鉴别中起着至关重要的作用。
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引用次数: 0
Revisiting the utility of identifying nuclear grooves as unique nuclear changes by an object detector model. 通过物体检测器模型重新审视将核凹槽识别为独特核变化的实用性。
IF 2.4 Q3 PATHOLOGY Pub Date : 2024-05-01 Epub Date: 2024-04-30 DOI: 10.4132/jptm.2024.03.07
Pedro R F Rende, Joel Machado Pires, Kátia Sakimi Nakadaira, Sara Lopes, João Vale, Fabio Hecht, Fabyan E L Beltrão, Gabriel J R Machado, Edna T Kimura, Catarina Eloy, Helton E Ramos

Background: Among other structures, nuclear grooves are vastly found in papillary thyroid carcinoma (PTC). Considering that the application of artificial intelligence in thyroid cytology has potential for diagnostic routine, our goal was to develop a new supervised convolutional neural network capable of identifying nuclear grooves in Diff-Quik stained whole-slide images (WSI) obtained from thyroid fineneedle aspiration.

Methods: We selected 22 Diff-Quik stained cytological slides with cytological diagnosis of PTC and concordant histological diagnosis. Each of the slides was scanned, forming a WSI. Images that contained the region of interest were obtained, followed by pre-formatting, annotation of the nuclear grooves and data augmentation techniques. The final dataset was divided into training and validation groups in a 7:3 ratio.

Results: This is the first artificial intelligence model based on object detection applied to nuclear structures in thyroid cytopathology. A total of 7,255 images were obtained from 22 WSI, totaling 7,242 annotated nuclear grooves. The best model was obtained after it was submitted 15 times with the train dataset (14th epoch), with 67% true positives, 49.8% for sensitivity and 43.1% for predictive positive value.

Conclusions: The model was able to develop a structure predictor rule, indicating that the application of an artificial intelligence model based on object detection in the identification of nuclear grooves is feasible. Associated with a reduction in interobserver variability and in time per slide, this demonstrates that nuclear evaluation constitutes one of the possibilities for refining the diagnosis through computational models.

背景:核沟是甲状腺乳头状癌(PTC)的主要结构之一。考虑到人工智能在甲状腺细胞学中的应用具有常规诊断的潜力,我们的目标是开发一种新的有监督卷积神经网络,该网络能够在甲状腺细针穿刺术获得的 Diff-Quik 染色全切片图像(WSI)中识别核沟:我们选择了 22 张经 Diff-Quik 染色的细胞学切片,细胞学诊断为 PTC,组织学诊断一致。对每张切片进行扫描,形成 WSI。获取包含感兴趣区的图像,然后进行预格式化、核沟标注和数据增强技术。最终数据集按 7:3 的比例分为训练组和验证组:这是首个应用于甲状腺细胞病理学核结构的基于物体检测的人工智能模型。从 22 个 WSI 共获得 7255 张图像,共计 7242 个注释核沟。最佳模型是用训练数据集提交 15 次(第 14 个 epoch)后获得的,真阳性率为 67%,灵敏度为 49.8%,预测阳性值为 43.1%。结论该模型能够制定结构预测规则,表明基于物体检测的人工智能模型在核凹槽鉴定中的应用是可行的。该模型可减少观察者之间的差异和每张切片的时间,这表明核评价是通过计算模型完善诊断的可能性之一。
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引用次数: 0
What's new in thyroid pathology 2024: updates from the new WHO classification and Bethesda system. 2024年甲状腺病理学的新进展:世界卫生组织新分类和贝塞斯达系统的更新。
IF 2.4 Q3 PATHOLOGY Pub Date : 2024-03-01 Epub Date: 2024-03-13 DOI: 10.4132/jptm.2024.03.06
Andrey Bychkov, Chan Kwon Jung

In line with the release of the 5th edition WHO Classification of Tumors of Endocrine Organs (2022) and the 3rd edition of the Bethesda System for Reporting Thyroid Cytopathology (2023), the field of thyroid pathology and cytopathology has witnessed key transformations. This digest brings to the fore the refined terminologies, newly introduced categories, and contentious methodological considerations pivotal to the updated classification.

随着第五版《世界卫生组织内分泌器官肿瘤分类》(2022 年)和第三版《贝塞斯达甲状腺细胞病理学报告系统》(2023 年)的发布,甲状腺病理学和细胞病理学领域发生了重大变革。本文摘将对更新分类中的术语、新引入的类别以及有争议的方法学考虑因素进行重点介绍。
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引用次数: 0
Exploring histological predictive biomarkers for immune checkpoint inhibitor therapy response in non-small cell lung cancer. 探索非小细胞肺癌免疫检查点抑制剂治疗反应的组织学预测生物标志物。
IF 2.4 Q3 PATHOLOGY Pub Date : 2024-03-01 Epub Date: 2024-02-26 DOI: 10.4132/jptm.2024.01.31
Uiju Cho, Soyoung Im, Hyung Soon Park

Treatment challenges persist in advanced lung cancer despite the development of therapies beyond the traditional platinum-based chemotherapy. The early 2000s marked a shift to tyrosine kinase inhibitors targeting epidermal growth factor receptor, ushering in personalized genetic-based treatment. A further significant advance was the development of immune checkpoint inhibitors (ICIs), especially for non-small cell lung cancer. These target programmed death-ligand 1 (PD-L1) and cytotoxic T lymphocyte antigen 4, which enhanced the immune response against tumor cells. However, not all patients respond, and immune-related toxicities arise. This review emphasizes identifying biomarkers for ICI response prediction. While PD-L1 is a widely used, validated biomarker, its predictive accuracy is imperfect. Investigating tumor-infiltrating lymphocytes, tertiary lymphoid structure, and emerging biomarkers such as high endothelial venule, Human leukocyte antigen class I, T-cell immunoreceptors with Ig and ITIM domains, and lymphocyte activation gene-3 counts is promising. Understanding and exploring additional predictive biomarkers for ICI response are crucial for enhancing patient stratification and overall care in lung cancer treatment.

尽管除了传统的铂类化疗外,晚期肺癌的治疗难题依然存在。本世纪初,以表皮生长因子受体为靶点的酪氨酸激酶抑制剂出现了转变,开创了基于基因的个性化治疗。另一个重大进展是免疫检查点抑制剂(ICIs)的开发,尤其是针对非小细胞肺癌的治疗。这些药物以程序性死亡配体 1(PD-L1)和细胞毒性 T 淋巴细胞抗原 4 为靶点,增强了针对肿瘤细胞的免疫反应。然而,并非所有患者都会产生反应,而且还会出现与免疫相关的毒性反应。本综述强调识别用于 ICI 反应预测的生物标志物。虽然 PD-L1 是一种广泛使用、经过验证的生物标志物,但其预测准确性并不完美。对肿瘤浸润淋巴细胞、三级淋巴结构以及高内皮静脉、人类白细胞抗原 I 类、具有 Ig 和 ITIM 结构域的 T 细胞免疫受体和淋巴细胞活化基因-3 计数等新兴生物标志物进行研究很有希望。了解和探索 ICI 反应的其他预测性生物标志物对于加强肺癌治疗中的患者分层和整体护理至关重要。
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引用次数: 0
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Journal of Pathology and Translational Medicine
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