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Therapieinduzierte Tumorregression und Regressionsgrading bei Lungenkarzinomen

Therapy-induced tumor regression and regression grading in lung cancer

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Zusammenfassung

Bei neoadjuvant behandelten nichtkleinzelligen Lungenkarzinomen stellt das Ausmaß der therapieinduzierten Tumorregression in den Resektionspräparaten des Primärtumors und der Lymphknoten einen unabhängigen Prognosefaktor dar. In der ehemaligen Tumorregion können nach einer neoadjuvanten Therapie unterschiedlich große kokardenartige Herde mit zentraler Nekrose, angrenzendem schmalem Schaumzellsaum, sich zur Peripherie hin anschließendem gefäßreichem Granulationsgewebe und Übergang in eine ausgeprägte narbige Fibrosierung nachgewiesen und hinsichtlich des Ausmaßes der therapieinduzierten Tumorregression nach dem „Bochumer Regressionsgrading“ graduiert werden. Therapieinduzierte zelluläre Veränderungen erlauben für sich allein keine Rückschlüsse auf den Erfolg der durchgeführten neoadjuvanten Therapie und sollten nicht zur Grundlage eines zytopathologischen Gradings gemacht werden.

Abstract

After neoadjuvant therapy of non-small cell lung cancer, the extent of therapy-induced tumor regression in corresponding resection specimens of primary tumors and lymph nodes represents an independent prognostic factor. In the former tumor area, different sized target-like foci with central necrosis, adjoining narrow foam cell rim, peripheral vascular granulation tissue and transition into a marked scarry fibrosis can be found after neoadjuvant therapy. Morphological changes indicating therapy-induced tumor regression can be graded according to the Bochum regression grading system. Therapy-induced cytomorphological changes do not allow reliable conclusions on the success of the applied neoadjuvant therapy and should not form the basis of cytopathological grading.

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Einhaltung ethischer Richtlinien

Interessenkonflikt. K. Junker gibt an, dass kein Interessenkonflikt besteht. Dieser Beitrag beinhaltet keine Studien an Menschen oder Tieren.

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  1. Zentrum für Pathologie, Klinikum Bremen-Mitte, St.-Jürgen-Str. 1, 28177, Bremen, Deutschland

    K. Junker

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Junker, K. Therapieinduzierte Tumorregression und Regressionsgrading bei Lungenkarzinomen. Pathologe 35, 574–577 (2014). https://doi.org/10.1007/s00292-014-1919-x

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