Zusammenfassung
Hintergrund
Nichtkleinzellige Lungenkarzinome (NSCLC) machen ca. 75 % der malignen epithelialen Lungentumoren aus. In den vergangenen Jahren konnten profunde Erkenntnisse über molekulare Mechanismen der Krebsentstehung der Lunge gewonnen werden und in der Folge zielgerichtete Substanzen („targeted drugs“) und immuntherapeutisch wirksame Medikamente entwickelt werden. Diese Fortschritte haben den Ablauf der pathologischen Diagnostik maßgeblich beeinflusst.
Ziel
Der vorliegende Artikel soll einen Überblick über die häufigsten histologischen Subtypen der NSCLC, ihre morphologischen, immunhistochemischen und molekularpathologischen Charakteristika geben.
Material und Methoden
Eine selektive Literaturrecherche der Datenbank Pubmed wurde durchgeführt.
Ergebnisse und Diskussion
Adenokarzinome, Plattenepithelkarzinome und großzellige Karzinome sind die häufigsten histologischen Subtypen. Durch die in der pathologischen Routine verfügbaren Zusatzuntersuchungen lassen sich in der Regel auch gering differenzierte Tumoren gut zuordnen. NSCLC zeigen eine Reihe genetischer Veränderungen, therapeutisch nutzbar sind Alterationen von EGFR, MET, ALK1 und ROS1.
Abstract
Background
Non-small cell lung cancer (NSCLC) accounts for ca. 75% of malignant epithelial neoplasms of the lungs. In recent years profound insight has been gained regarding the molecular mechanisms of lung carcinogenesis and subsequently new targeted therapies as well as immunotherapies have been developed. These advances have had a significant impact on routine diagnostics in pathology.
Objective
The article aims to give an overview of the most common histological subtypes of NSCLC as well as the morphological, immunohistochemical and molecular characteristics.
Material and methods
Selective search of the PubMed database.
Results and discussion
Adenocarcinomas, squamous cell carcinomas and large cell carcinomas are the most common histological subtypes. With the ancillary methods available in routine pathology even poorly differentiated tumors can be assigned to these entities. The NSCLC show numerous genetic changes of which alterations of EGFR, MET, ALK1 and ROS1 are target structures for personalized therapy.
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M. Wittersheim, S. Schallenberg und R. Büttner geben an, dass kein Interessenkonflikt besteht.
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Wittersheim, M., Schallenberg, S. & Büttner, R. Nichtkleinzelliges Lungenkarzinom – Pathologie und Biologie. Onkologe 24, 958–966 (2018). https://doi.org/10.1007/s00761-018-0461-5
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DOI: https://doi.org/10.1007/s00761-018-0461-5