肾上腺肿瘤WHO分类的变更与多维度诊疗新思路

Changes in WHO classification of adrenal tumors and new ideas for multi-dimensional diagnosis and treatment

2022年WHO对肾上腺皮髓质肿瘤进行了分类和概念的更新。皮质方面,WHO分类进一步规范了结节性肾上腺皮质病的命名,并细化了原发性醛固酮增多症的病理学分类;髓质方面,WHO分类统一了肾上腺嗜铬细胞瘤和副神经节瘤的概念,并对包括副神经节样神经内分泌肿瘤在内的多种概念进行了重新分类;新的标准不仅涵盖了疾病的临床表现,还包含了疾病的组织学来源、免疫组化表现、病理生理机制、遗传易感性、预后因素等多个内容。本文拟结合最新的分类标准,探讨如何提高肾上腺皮髓质肿瘤诊疗水平。

In 2022,WHO updated the classification and concept of adrenal cortical and medullary tumors.In terms of adrenal cortical tumors,the WHO classification further standardizes the nomenclature of nodular adrenal cortical disease and refines the pathological classification of primary aldosteronism.In terms of adrenal medullary tumors,the WHO classification unifies the concepts of pheochromocytoma and paraganglioma,and reclassifies various concepts,including paraganglioma-like neuroendocrine tumors.The new standards not only cover the clinical manifestations of the disease,but also include other multiple aspects such as the histological origin of the disease,immunohistochemical manifestations,physiological mechanisms of the disease,hereditary susceptibility and prognostic factors.This article intends to explore how to improve the diagnostic and therapeutic level of adrenal tumors.