The 2015 WHO Classification of Tumors of the Lung, Pleura, Thymus and Heart has just been published recently. In this newly classification, WHO almost completely accepted the International Association for the Study of Lung Cancer/American Thoracic Society/European Respiratory Society International Multidisciplinary Classification of Lung Adenocarcinoma. A lot of high-quality studies in the past five years have demonstrated important guiding significance of the newly classification in surgical treatment of adenocarcinoma. Surgeons should consider not only the tumor size but also the biological behavior of different subtypes of adenocarcinomas. For adjuvant chemotherapy, more aggressive subtypes of adenocarcinomas may have more survival benefit. Different biological behavior of different subtypes of adenocarcinomas also need different follow-up strategies. The precision surgical treatment strategies of lung adenocarcinoma under the guidance of the WHO new classification is discussed in this paper.
2015年WHO推出新版肺部肿瘤分型，其中肺腺癌分类几乎完全接受2011年肺腺癌国际多学科分类。近五年来，多项重要研究从不同角度探索了肺腺癌新分型对临床实践的指导意义。在外科切除范围方面，不仅要考虑肿瘤解剖学指标，更需要考量腺癌的生物学行为。在辅助化疗方面，选择恶性程度更高的亚型进行化疗，生存获益可能更加显著。在术后随访方面，根据不同腺癌亚型的生物学行为，需要制定不同的随访策略。本文从外科视角，探讨了新分型指导下的肺腺癌精准治疗模式。