一种新的肿瘤分类方法
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New tumor classification scheme unlinks tumor type from tumor site
Reuters Health
Posting Date: March 24, 2004
Last Updated: 2004-03-24 16:52:15 -0400 (Reuters Health)
NEW YORK (Reuters Health) - A radically different new system for classification of tumors has been set forth by a National Cancer Institute official.
Dr. Jules J. Berman, the Program Director for Pathology Informatics in the NCI's Cancer Diagnosis Program, presents the classification as an open-access document in BioMedCentral Cancer, published online at http://www.biomedcentral.com/bmccancer.
Dr. Berman points out that traditional classification schemes "are created piecemeal for specific sites or organ systems....(and) are often based on medical disciplines, rather than on any biologic principles." Also, a given tumor may have more than one "slot" when subclassifications are merged.
Furthermore, he says, because there is no standard format for tumor classification, it has not been possible "to exchange, merge, or analyze heterogeneous biological data."
Dr. Berman's system groups tumors according to their histogenesis -- that is, their embryonic lineage. According to his paper, there were several reasons to take this approach.
First, while an organ may consist of cells with multiple embryologic lineages, each cell has only one lineage. Therefore, "a histogenetic classification can assign any tumor to a unique position with the classification," he says.
Second, most tumors have a developmental stage. "For instance, blastomas are thought to arise from a cell type that precedes organ differentiation," Dr. Berman writes. "Squamous cell carcinomas...have features of cell type that developed from one of the embryonic layers."
Furthermore, tumor behavior is linked to developmental histogenetics. "Ectoderm and endoderm-derived tumors metastasize via lymphatics," the author notes. "Mesenchyme-derived tumors tend to metastasize by hematogenous spread."
Finally, the histogenetic approach to classification is "consistent with modern molecular analysis of tumors," he says. For example, "Primitive blastomas share similar markers regardless of the organ of origin."
In Dr. Berman's classification, the first division is between embryonic or trophoblastic cell lineage. The next highest levels are the "primitive" tumors, including teratomas and primitive blastic tumors; the tumors with endoderm/ectoderm lineage; tumors of mesodermal lineage, including sarcomas; and tumors of neuroectodermal lineage.
"The most important value of this classification is the disengagement of tumor type and tumor place of origin," Dr. Berman says. "A primitive blastoma may occur in the bone or the brain or the lung, but it is classified along with the other primitive blastomas regardless of location. This permits tumors with similar molecular profiles to be classified according to biological attributes rather than anatomic location."
BMC Cancer 2004.
http://www.biomedcentral.com/bmccancer.
Reuters Health
Posting Date: March 24, 2004
Last Updated: 2004-03-24 16:52:15 -0400 (Reuters Health)
NEW YORK (Reuters Health) - A radically different new system for classification of tumors has been set forth by a National Cancer Institute official.
Dr. Jules J. Berman, the Program Director for Pathology Informatics in the NCI's Cancer Diagnosis Program, presents the classification as an open-access document in BioMedCentral Cancer, published online at http://www.biomedcentral.com/bmccancer.
Dr. Berman points out that traditional classification schemes "are created piecemeal for specific sites or organ systems....(and) are often based on medical disciplines, rather than on any biologic principles." Also, a given tumor may have more than one "slot" when subclassifications are merged.
Furthermore, he says, because there is no standard format for tumor classification, it has not been possible "to exchange, merge, or analyze heterogeneous biological data."
Dr. Berman's system groups tumors according to their histogenesis -- that is, their embryonic lineage. According to his paper, there were several reasons to take this approach.
First, while an organ may consist of cells with multiple embryologic lineages, each cell has only one lineage. Therefore, "a histogenetic classification can assign any tumor to a unique position with the classification," he says.
Second, most tumors have a developmental stage. "For instance, blastomas are thought to arise from a cell type that precedes organ differentiation," Dr. Berman writes. "Squamous cell carcinomas...have features of cell type that developed from one of the embryonic layers."
Furthermore, tumor behavior is linked to developmental histogenetics. "Ectoderm and endoderm-derived tumors metastasize via lymphatics," the author notes. "Mesenchyme-derived tumors tend to metastasize by hematogenous spread."
Finally, the histogenetic approach to classification is "consistent with modern molecular analysis of tumors," he says. For example, "Primitive blastomas share similar markers regardless of the organ of origin."
In Dr. Berman's classification, the first division is between embryonic or trophoblastic cell lineage. The next highest levels are the "primitive" tumors, including teratomas and primitive blastic tumors; the tumors with endoderm/ectoderm lineage; tumors of mesodermal lineage, including sarcomas; and tumors of neuroectodermal lineage.
"The most important value of this classification is the disengagement of tumor type and tumor place of origin," Dr. Berman says. "A primitive blastoma may occur in the bone or the brain or the lung, but it is classified along with the other primitive blastomas regardless of location. This permits tumors with similar molecular profiles to be classified according to biological attributes rather than anatomic location."
BMC Cancer 2004.
http://www.biomedcentral.com/bmccancer.
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