PDF(Pubmed)
Abstract：
Prostate cancer is a heterogeneous disease with a wide spectrum of pathological, clinical, and molecular features. The diagnosis and classification of prostate cancer have been constantly modified with the incorporation of new data. The 5th edition of the World Health Organization (WHO) Classification of Urinary and Genital Tumors was recently published six years after the 4th edition. In this new edition, the classification of prostate cancer has been refined in the diagnostic criteria, grading, nomenclature, and genomics. This paper reviews significant updates to the new WHO classification of prostate cancer, including high-grade prostatic intraepithelial neoplasia, acinar adenocarcinoma, intraductal carcinoma, ductal carcinoma, and neuroendocrine tumors. Controversial issues in the Gleason grading are discussed, such as intraductal carcinoma and tertiary grade. We also highlight distinct genetic and epigenetic alterations in prostate cancer that may contribute to its diverse clinicopathologic features. Overall, the 5th edition of the WHO classification provides a comprehensive assessment of prostate cancer with morphologic, immunohistochemical, genomic, and clinical data, which may represent an optimal paradigm for diagnosing and treating prostate cancer.
摘要：
前列腺癌是一种异质性疾病，具有广泛的病理特征，临床,和分子特征。随着新数据的结合，前列腺癌的诊断和分类一直在不断进行修改。世界卫生组织（WHO）第5版《泌尿和生殖器肿瘤分类》在第4版之后的6年最近出版。在这个新版本中，前列腺癌的分类在诊断标准中得到了完善，分级,命名法，和基因组学。本文回顾了WHO前列腺癌新分类的重要更新，包括高级别前列腺上皮内瘤,腺泡腺癌,导管内癌，导管癌,和神经内分泌肿瘤。讨论了格里森分级中的有争议的问题，如导管内癌和三级癌。我们还强调了前列腺癌中不同的遗传和表观遗传改变，这可能有助于其不同的临床病理特征。总的来说,世界卫生组织第5版的分类提供了一个全面的评估前列腺癌的形态学,免疫组织化学，基因组，和临床数据，这可能是诊断和治疗前列腺癌的最佳范例。
