鼻咽原发性癌的组织学类型——30年经验总结

Histological typing of primary nasopharyngeal carcinomas——a sum-up of experience from past 30 years

目的 :提出既能与“国际接轨”又能充分反映我国鼻咽癌病理学研究成就的鼻咽原发性癌组织学类型的方案。方法 :在总结作者 30年来从事鼻咽癌病理学研究成果的基础上 ,参阅WHO的组织学分类 ,并广泛征求同行的意见后 ,概括出本方案。结果 :鼻咽原发性癌可分为 4种类型 ,即角化性鳞状细胞癌、非角化性癌、腺癌和原位癌。角化性鳞状细胞癌可按分化程度分为分化好、中等分化和分化差。非角化性癌是鼻咽癌高发区常见的癌 ,又可分为分化型、未分化型和混合型 3个亚型。鼻咽腺癌有普通型和涎腺型之分 ;原位癌则有鳞状细胞型和柱状细胞型之别。结论 :上述鼻咽原发性癌的组织学类型既反映了实际情况 ,能与“国际接轨” ,又较易掌握 ,建议在日常病理诊断中试用。

Purpose A proposal for histological typing of primary nasopharyngeal carcinomas is suggested in order to coincide in medical terms used not only by Chinese but also foreign pathologists and reflect the authors' research achievements in this field. Methods This proposal was worked out basing upon the author's experience from the research work in past 30 years and the international criteria for tumour classification. Results Primary nasopharyngeal carcinomas could be classified into four major types, namely keratinizing squamous cell carcinoma, non keratinizing carcinoma, adenocarcinoma and carcinoma in situ. Keratinizing squamous cell carcinoma could be further classified as well, moderately and poorly differentiated according to the grade of squamous differentiation. The non keratinizing carcinomas were the most frequent malignancies seen in the high incidence area of nasopharyngeal carcinoma, and could also be divided into three subtypes, namely differentiated, undifferentiated and mixed. There were two major categories of nasopharyngeal adenocarcinoma, namely traditional and salivary gland type. There were two subtypes of carcinoma in situ, namely squamous and columnar cell type. Conclusion The histological types of primary nasopharyngeal carcinomas suggested above is really a practical proposal and also coincide with the international usage. This proposal can be mastered easily; and the author recommends it to be used routinely in diagnostic pathology.