«Մասնակից:Shush.hovsepyan/Ավազարկղ»–ի խմբագրումների տարբերություն

 

=== Հյուսվածաբանություն ===

 

 

 

As discussed previously, the category of adenocarcinoma includes are range of subtypes, and any one tumor tends to be heterogeneous in composition. Several major subtypes are currently recognized by the World Health Organization (WHO) <ref name="who2004" /> and the [[International Association for the Study of Lung Cancer]] (IASLC) / [[American Thoracic Society]] (ATS) / [[European Respiratory Society]] (ERS):<ref name="pmid21828029">{{cite journal | vauthors = Van Schil PE, Asamura H, Rusch VW, Mitsudomi T, Tsuboi M, Brambilla E, Travis WD | title = Surgical implications of the new IASLC/ATS/ERS adenocarcinoma classification | journal = The European Respiratory Journal | volume = 39 | issue = 2 | pages = 478–86 | date = February 2012 | pmid = 21828029 | doi = 10.1183/09031936.00027511 }}</ref><ref>{{cite journal | vauthors = Travis WD, Brambilla E, Van Schil P, Scagliotti GV, Huber RM, Sculier JP, Vansteenkiste J, Nicholson AG | title = Paradigm shifts in lung cancer as defined in the new IASLC/ATS/ERS lung adenocarcinoma classification | journal = The European Respiratory Journal | volume = 38 | issue = 2 | pages = 239–43 | date = August 2011 | pmid = 21804158 | doi = 10.1183/09031936.00026711 }}</ref><ref>{{cite journal | vauthors = Vazquez M, Carter D, Brambilla E, Gazdar A, Noguchi M, Travis WD, Huang Y, Zhang L, Yip R, Yankelevitz DF, Henschke CI | title = Solitary and multiple resected adenocarcinomas after CT screening for lung cancer: histopathologic features and their prognostic implications | journal = Lung Cancer | volume = 64 | issue = 2 | pages = 148–54 | date = May 2009 | pmid = 18951650 | pmc = 2849638 | doi = 10.1016/j.lungcan.2008.08.009 | author12 = International Early Lung Cancer Action Program Investigators }}</ref> ''lepidic predominant adenocarcinoma, acinar predominant adenocarcinoma, papillary predominant adenocarcinoma, micropapillary predominant adenocarcinoma, solid predominant adenocarcinoma, and solid predominant with mucin production.'' In as many as 80% of these tumors, components of more than one subtype will be recognized. Surgically resected tumors should be classified by comprehensive histological subtyping, describing patterns of involvement in increments of 5%. The predominant histologic subtype is then used to classify the tumor overall.<ref name=":4">{{cite journal|display-authors=6|vauthors=Travis WD, Brambilla E, Noguchi M, Nicholson AG, Geisinger KR, Yatabe Y, Beer DG, Powell CA, Riely GJ, Van Schil PE, Garg K, Austin JH, Asamura H, Rusch VW, Hirsch FR, Scagliotti G, Mitsudomi T, Huber RM, Ishikawa Y, Jett J, Sanchez-Cespedes M, Sculier JP, Takahashi T, Tsuboi M, Vansteenkiste J, Wistuba I, Yang PC, Aberle D, Brambilla C, Flieder D, Franklin W, Gazdar A, Gould M, Hasleton P, Henderson D, Johnson B, Johnson D, Kerr K, Kuriyama K, Lee JS, Miller VA, Petersen I, Roggli V, Rosell R, Saijo N, Thunnissen E, Tsao M, Yankelewitz D|date=February 2011|title=International association for the study of lung cancer/american thoracic society/european respiratory society international multidisciplinary classification of lung adenocarcinoma|journal=Journal of Thoracic Oncology|volume=6|issue=2|pages=244–85|doi=10.1097/JTO.0b013e318206a221|pmc=4513953|pmid=21252716}}</ref> The predominant subtype is prognostic for survival after complete resection.<ref>{{cite journal|vauthors=Russell PA, Wainer Z, Wright GM, Daniels M, Conron M, Williams RA|date=September 2011|title=Does lung adenocarcinoma subtype predict patient survival?: A clinicopathologic study based on the new International Association for the Study of Lung Cancer/American Thoracic Society/European Respiratory Society international multidisciplinary lung adenocarcinoma classification|journal=Journal of Thoracic Oncology|volume=6|issue=9|pages=1496–504|doi=10.1097/JTO.0b013e318221f701|pmid=21642859}}</ref>

 

=== Վիրահատություն ===

 

 

=== Քիմիոթերապիա ===

 

=== Ճառագայթային թերապիա ===

 

=== Թիրախային բուժում ===

 

First-generation EGFR TKIs, including [[gefitinib]] and [[erlotinib]], have been shown to be more effective in treating EGFR-mutated patients with respect to cytotoxic chemotherapy. Second-generation inhibitors such as [[afatinib]] and [[dacomitinib]] provided a broader scope of application as they are able to target not only the protein [[Epidermal growth factor receptor|EGFR]] itself but also other members of the [[EGFR family]], such as [[HER2/neu|HER2]] and [[ERBB4|HER4]] (also known as ERBB2 and ERBB4), and they have shown improved [[progression-free survival]] compared to gefitinib. As the most common cause of acquired resistance to first-generation TKIs is a second EGFR mutation on codon 790, a third-generation EGFR TKI, [[osimertinib]], has been developed to target this new mutation as well.<ref name=":5" /> MET amplification is another known mechanism of acquired resistance.<ref name=":4" />

 

==Համաճարակաբանություն==

 

== Ծանոթագրություններ ==