Do you really understand the pathology report after lung cancer surgery?

Pathological diagnosis is the gold standard for diagnosing cancer, as is lung cancer

 

Pathological typeLung cancer is divided into two categories: small cell lung cancer and non-small cell lung canc.

• Pleural invasion : including the visceral pleura and parietal pleura, if it invades the pleura, it means that the metastasis has begun;

• Vascular and nerve invasion : If vascular tumor thrombus/nerve invasion occurs, it means that the tumor has begun to metastasize, and the prognosis is relatively poor; sometimes it may be necessary to add D2-40 and CD34 to further determine whether there are blood vessels /lymphatic vessels, blood vessels infiltration of cancer cells;

 

• STAS : STAS stands for tumor spread through the airwa.

  
  

Cutting edge

 

The resection margin is the boundary of surgical resection, and the common types of resection margins include bronchial and pulmonary resection margins

 

For complete tumor resection, a safe resection margin was defined as a margin of 2 cm from the tumor or greater than the diameter of the tum.

 

Whether cancer cells can be seen on the margins is the key to evaluating complete resection, and surgical margins are usually classified into 3 categories in the table bel.

 

 

Immunohistochemistry _

 

The tumor type and origin were identified by immunohistochemical staining of various marke.

 

 

In addition, immunohistochemistry can also guide the treatment of tumo.

 

Lymph nodes

 

Lymph node metastasis is a common route of metastasis of lung canc.

 

On the one hand, the pathological report can provide information on whether lymph nodes are involved, which can be used as the basis for staging, and on the other hand, the samples of metastatic lymph nodes can also provide information such as tumor pathological types and gen.

 

In lung cancer staging, lymph nodes are divided into 14 stations (see the figure belo.

 

 

Molecular pathological diagnosis

 

With the advancement of molecular pathology, we can classify tumors into different molecular types at the genetic level , and then carry out targeted treatme.

 

In non-small cell lung cancer, common driver genes include EGFR, MET, HER2, ALK, RET, ROS1, TRK, BRAF, and KR.

 

Current methods for detecting molecular subtypes include FISH, immunohistochemistry and NGS (second generation sequencing.

 

For the interpretation of molecular pathology , we generally focus on class I/II genes, that is, genes with drug availabili.

 

 

Below we try to read a few pathology reports:

 

(1) Interpretation of MPR pathology sheet after neoadjuvant therapy

 

 

(2) Interpretation of CPR pathology sheet after neoadjuvant therapy

 

 

(3) Micro-invasive adenocarcinoma pathology single interpretation

 

 

(4) Interpretation of the pathology of invasive adenocarcinoma

 

(5) Interpretation of the lymph node report

Pathological diagnosis is the gold standard for diagnosing cancer, as is lung cancer

This is a very critical basis in the process of tumor treatme.

How important is the pathology report? It can be said that the pathology report after surgery almost determines everything about the patie.

The stage of the disease, the treatment that needs to be used in the follow-up, the possible development of the disease in the future, and the judgment of prognosis, all of which come from postoperative patholo.

Pathological diagnosis is the gold standard for diagnosing cancer, as is lung cancer

This is a very critical basis in the process of tumor treatme.

How important is the pathology report? It can be said that the pathology report after surgery almost determines everything about the patie.

The stage of the disease, the treatment that needs to be used in the follow-up, the possible development of the disease in the future, and the judgment of prognosis, all of which come from postoperative patholo.

Diagnosing lung cancer

 

Pathological typePathological type Lung cancer is divided into two categories: small cell lung cancer and non-small cell lung cance.

There are many different types of the latter , such as adenocarcinoma, squamous cell carcinoma, adenosquamous carcinoma, large cell neuroendocrine carcinoma, large cell carcinoma and NSCLC -NO.

NSCLC 2011 new pathological classification criteria for lung adenocarcinoma: Lung adenocarcinoma is further divided into adenocarcinoma in situ, minimally invasive adenocarcinoma and invasive adenocarcinoma according to the degree of invasio.

Minimally invasive adenocarcinoma refers to early-stage adenocarcinoma with tumor less than 3cm, invasive foci less than 5cm, and no vascular invasion, lymph node metastasis and other invasive manifestatio.

The postoperative survival rate is 100% adenocarcinoma in si.

Micro- invasive adenocarcinoma refers to early-stage adenocarcinoma with tumor less than 3cm, invasive foci less than 5cm, and no vascular invasion, lymph node metastasis and other invasive manifestatio.

The postoperative survival rate is 10

• Pleural invasion : including the visceral pleura and parietal pleura, if it invades the pleura, it means that the metastasis has begun;

Pleural invasion : including the visceral pleura and parietal pleura, if it invades the pleura, it means that the metastasis has begun;

Pleural invasion : including the visceral pleura and parietal pleura, if it invades the pleura, it means that the metastasis has begun;

Pleural invasion Pleural invasion : including visceral pleura and parietal pleura, if it invades the pleura, it means that the metastasis has begun;

• Vascular and nerve invasion : If vascular tumor thrombus/nerve invasion occurs, it means that the tumor has begun to metastasize, and the prognosis is relatively poor; sometimes it may be necessary to add D2-40 and CD34 to further determine whether there are blood vessels /lymphatic vessels, blood vessels infiltration of cancer cells;

Vascular and nerve invasion : If vascular tumor thrombus/nerve invasion occurs, it means that the tumor has begun to metastasize, and the prognosis is relatively poor; sometimes it may be necessary to add D2-40 and CD34 to further determine whether there are blood vessels /lymphatic vessels, blood vessels infiltration of cancer cells;

Vascular and nerve invasion : If vascular tumor thrombus/nerve invasion occurs, it means that the tumor has begun to metastasize, and the prognosis is relatively poor; sometimes it may be necessary to add D2-40 and CD34 to further determine whether there are blood vessels /lymphatic vessels, blood vessels infiltration of cancer cells;

Vascular and nerve invasion Vascular and nerve invasion : If vascular tumor thrombus/nerve invasion occurs, it means that the tumor has begun to metastasize, and the prognosis is relatively poor; sometimes it may be necessary to add D2-40 and CD34 to further determine whether there is vascular / neural invasion Lymphatic, vascular cancer cell infiltration; blood vessels

 

• STAS : STAS stands for tumor spread through the airwa.
  
  It is considered to be a new route of tumor metastasis, which refers to the shedding of tumor cell clusters or single tumor cells at the edge of the tumor into the airways adjacent to the lung parenchy.
  
  According to a number of clinical retrospective studies at home and abroad in recent years, under the same pathological grade, patients with STAS have a poor prognos.
  
  Retrospective studies have pointed out that sublobar resection in stage IA patients with STAS should be carefully select.
  
  

STAS : STAS stands for tumor spread through the airwa.

It is considered to be a new route of tumor metastasis, which refers to the shedding of tumor cell clusters or single tumor cells at the edge of the tumor into the airways adjacent to the lung parenchy.

According to a number of clinical retrospective studies at home and abroad in recent years, under the same pathological grade, patients with STAS have a poor prognos.

Retrospective studies have pointed out that sublobar resection in stage IA patients with STAS should be carefully select.

STAS : STAS stands for tumor spread through the airwa.

It is considered to be a new route of tumor metastasis, which refers to the shedding of tumor cell clusters or single tumor cells at the edge of the tumor into the airways adjacent to the lung parenchy.

According to a number of clinical retrospective studies at home and abroad in recent years, under the same pathological grade, patients with STAS have a poor prognos.

Retrospective studies have pointed out that sublobar resection in stage IA patients with STAS should be carefully select.

STAS STAS : STAS means tumor spread through the airwa.

It is considered to be a new route of tumor metastasis, which refers to the shedding of tumor cell clusters or single tumor cells at the edge of the tumor into the airways adjacent to the lung parenchy.

According to a number of clinical retrospective studies at home and abroad in recent years, under the same pathological grade, patients with STAS have a poor prognos.

Retrospective studies have pointed out that sublobar resection in stage IA patients with STAS should be carefully select.

Cutting edge

2, cutting edge 2, cutting edge

 

 

The resection margin is the boundary of surgical resection, and the common types of resection margins include bronchial and pulmonary resection margins

The resection margin is the boundary of surgical resection, and the common types of resection margins include bronchial and pulmonary resection margin.

 

For complete tumor resection, a safe resection margin was defined as a margin of 2 cm from the tumor or greater than the diameter of the tum.

For complete tumor resection, a safe resection margin was defined as a margin of 2 cm from the tumor or greater than the diameter of the tum.

The resection margin was 2 cm from the tumor or greater than the diameter of the tum.

 

Whether cancer cells can be seen on the margins is the key to evaluating complete resection, and surgical margins are usually classified into 3 categories in the table bel.

Surgeons can obtain the results of the resection margin through rapid pathology during the operation, and then judge whether the resection range is sufficient, but the role of paraffin pathology in judging the resection margin is still irreplaceab.

As mentioned in the figure below, "dysplastic cells are seen at the resection margin", which indicates that the patient's tumor is R1 resecti.

Whether cancer cells can be seen on the margin is the key to evaluate the complete resection Whether the tumor can be seen on the margin is the key to evaluate the complete resection , and the surgical margin is usually divided into 3 categories in the following tab.

Surgeons can obtain the results of the resection margin through rapid pathology during the operation, and then judge whether the resection range is sufficient, but the role of paraffin pathology in judging the resection margin is still irreplaceab.

As mentioned in the figure below, "dysplastic cells are seen at the resection margin", which indicates that the patient's tumor is R1 resecti.

 

 

 

Immunohistochemistry _

ImmunohistochemistryImmunohistochemistry _ _ _

 

 

The tumor type and origin were identified by immunohistochemical staining of various marke.

Common markers of lung cancer are listed in the following tabl.

The tumor type and origin were identified by immunohistochemical staining of various marke.

Common markers of lung cancer are listed in the following tabl.

Common markers of lung cancer are listed belo.

 

 

 

 

In addition, immunohistochemistry can also guide the treatment of tumo.

For example, before the use of anti-PD-1 drugs, immunohistochemistry is often required to evaluate the expression of PD-L1 in tumors; ALK fusion protein, c-MET protein overexpression, HER2 Protein overexpression, e.

can also be assessed by immunohistochemist.

In addition, immunohistochemistry can also guide the treatment of tumo.

For example, before the use of anti-PD-1 drugs, immunohistochemistry is often required to evaluate the expression of PD-L1 in tumors; ALK fusion protein, c-MET protein overexpression, HER2 Protein overexpression, e.

can also be assessed by immunohistochemist.

 

 

Lymph nodes

Lymph nodesLymph nodes

 

 

Lymph node metastasis is a common route of metastasis of lung canc.

Lymph node metastasis is a common metastasis pathway of lung cancer, and lymph node metastasis is a common metastasis pathway of lung canc.

 

On the one hand, the pathological report can provide information on whether lymph nodes are involved, which can be used as the basis for staging, and on the other hand, the samples of metastatic lymph nodes can also provide information such as tumor pathological types and gen.

On the one hand, the pathological report can provide information on whether lymph nodes are involved, which can be used as the basis for staging, and on the other hand, the samples of metastatic lymph nodes can also provide information such as tumor pathological types and gen.

 

In lung cancer staging, lymph nodes are divided into 14 stations (see the figure belo.

In addition to the surgical approach, mediastinoscopy can obtain histological samples of mediastinal lymph nodes, and EBUS can obtain histological samples of lymph nodes in groups 2 , 3, 4, 7, 10, 11, and 1 If the tumor involves 10-14 lymph nodes, it is N1; if it involves ipsilateral mediastinal lymph nodes, it is N2; if it involves contralateral or supraclavicular lymph nodes, it is N

In lung cancer staging, lymph nodes are divided into 14 stations (see the figure belo.

In addition to the surgical approach, mediastinoscopy can obtain histological samples of mediastinal lymph nodes, and EBUS can obtain histological samples of lymph nodes in groups 2 , 3, 4, 7, 10, 11, and 1 If the tumor involves 10-14 lymph nodes, it is N1; if it involves ipsilateral mediastinal lymph nodes, it is N2; if it involves contralateral or supraclavicular lymph nodes, it is N 14 stations of EBUS can obtain histological samples of 2, 3, 4, 7, 10, 11, and 12 lymph nod.

If the tumor involves 10-14 lymph nodes, it is N1; if it involves ipsilateral mediastinal lymph nodes, it is N2; if it involves contralateral or supraclavicular lymph nodes, it is N

 

 

 

Molecular pathological diagnosis

Molecular pathological diagnosisMolecular pathological diagnosis

 

 

With the advancement of molecular pathology, we can classify tumors into different molecular types at the genetic level , and then carry out targeted treatme.

With the advancement of molecular pathology, we can classify tumors into different molecular types at the genetic level , and then carry out targeted treatme.

 

In non-small cell lung cancer, common driver genes include EGFR, MET, HER2, ALK, RET, ROS1, TRK, BRAF, and KR.

In non-small cell lung cancer, common driver genes include EGFR, MET, HER2, ALK, RET, ROS1, TRK, BRAF, and KR.

EGFR, MET, HER2, ALK, RET, ROS1, TRK, BRAF, KR.

 

Current methods for detecting molecular subtypes include FISH, immunohistochemistry and NGS (second generation sequencing.

NGS has significant advantages in molecular typing due to its wide detection coverage and high sensitivi.

Predicting drug sensitivity by molecular typing maximizes patient benef.

Current methods for detecting molecular subtypes include FISH, immunohistochemistry and NGS (second generation sequencing.

NGS has significant advantages in molecular typing due to its wide detection coverage and high sensitivi.

Predicting drug sensitivity by molecular typing maximizes patient benef.

FISH, immunohistochemistry and NGS (second generation sequencing)

 

For the interpretation of molecular pathology , we generally focus on class I/II genes, that is, genes with drug availabili.

I: Gene mutation corresponds to FDA /NMPA approval, NCCN guidelines recommend this cancer drug or is in clinical trials II: Gene mutation corresponds to FDA/NMPA approval for other cancer dru.

For the interpretation of molecular pathology , we generally focus on class I/II genes, that is, genes with drug availabili.

I: Gene mutation corresponds to FDA /NMPA approval, NCCN guidelines recommend this cancer drug or is in clinical trials II: Gene mutation corresponds to FDA/NMPA approval for other cancer dru.

Interpreting FDA Guidelines

 

 

Below we try to read a few pathology reports:

Let's try to read a few pathology reports: Let's try to read a few pathology reports:

 

(1) Interpretation of MPR pathology sheet after neoadjuvant therapy

(1) Interpretation of MPR pathology sheet after neoadjuvant therapy (1) Interpretation of MPR pathology sheet after neoadjuvant therapy

 

 

 

(2) Interpretation of CPR pathology sheet after neoadjuvant therapy

(2) Interpretation of CPR pathology sheet after neoadjuvant therapy (2) Interpretation of CPR pathology sheet after neoadjuvant therapy

 

 

 

(3) Micro-invasive adenocarcinoma pathology single interpretation

(3) Interpretation of pathology sheet for slightly invasive adenocarcinoma (3) Interpretation of pathology sheet for minimally invasive adenocarcinoma

 

 

(4) Interpretation of the pathology of invasive adenocarcinoma

(4) Interpretation of pathology of invasive adenocarcinoma (4) Interpretation of pathology of invasive adenocarcinoma

 

(5) Interpretation of the lymph node report

(5) Interpretation of the lymph node report (5) Interpretation of the lymph node report

 

Source : Guangdong Lung Cancer Research Institute

Source : Guangdong Lung Cancer Research Institute left a message here