OBJECTIVE: To review primarily 3 examples of liver tumors and to briefly illustrate how recent molecular discoveries have altered clinical liver pathology practice.
METHODS: First, we will discuss fibrolamellar carcinoma, which will be the main focus of discussion, as an example for new diagnostic tests that have been developed as a result of molecular discoveries. Additional information on the role of molecular diagnostics in hepatocellular adenoma and hepatocellular carcinoma will be provided. Second, we will use the example of epithelioid hemangioendothelioma as an example of how new diagnostic tools, based on molecular discoveries, may support improved prognostication. Finally, we will use the example of intrahepatic cholangiocarcinoma as an example of a liver tumor where new molecular discoveries have identified tractable therapeutic targets and led to new effective therapies. This portion of the manuscript will also include a description of the anatomic and molecular differences between intrahepatic, hilar, and extrahepatic cholangiocarcinoma.
CONCLUSIONS: Fueled by molecular discoveries, new and better diagnostic tests and therapeutic targets have improved clinical care in patients affected by liver tumors.
目的:主要回顾3例肝肿瘤,并简要说明最近的分子发现如何改变临床肝脏病理学实践。
方法:首先,我们将讨论纤维板层癌,这将是讨论的主要焦点,作为分子发现结果开发的新诊断测试的一个例子。将提供有关分子诊断在肝细胞腺瘤和肝细胞癌中的作用的其他信息。第二,我们将以上皮样血管内皮瘤为例,说明新的诊断工具,基于分子的发现,可能支持改进的预测。最后,我们将使用肝内胆管癌的例子作为肝肿瘤的一个例子,其中新的分子发现已经确定了可处理的治疗目标,并导致新的有效疗法。手稿的这一部分还将包括肝内解剖和分子差异的描述,hilar,和肝外胆管癌.
结论:受分子发现的推动,新的和更好的诊断测试和治疗目标改善了肝肿瘤患者的临床护理。