肺浸润性黏液腺癌的临床病理诊断和分子研究进展

Clinicopathological Diagnosis and Molecular Research Advances in Invasive Mucinous Adenocarcinoma of the Lung

摘要: 肺浸润性黏液腺癌(Invasive Mucinous Adenocarcinoma, IMA)是肺腺癌的一种独特亚型，以肿瘤细胞产生大量黏液为主要特征，其临床表现、病理学形态及分子特征与非黏液性腺癌存在显著差异。近年来，随着分子遗传技术的进步，IMA的分子机制研究取得重要进展，包括更加常见的KRAS突变、NRG1融合等驱动基因的发现。本综述详细介绍了IMA的临床与病理特征、免疫组化、分级及鉴别诊断，并重点探讨了分子遗传学最新研究进展，包括关键信号通路异常、潜在治疗靶点及预后相关标志物，旨在为IMA的精准诊断和个体化治疗提供理论依据。

Abstract: Invasive mucinous adenocarcinoma (IMA) of the lung is a distinct subtype of pulmonary adenocarcinoma characterized by abundant intracytoplasmic mucin production, exhibiting significant differences from non-mucinous adenocarcinomas in clinical presentation, histopathological features, and molecular profiles. Recent advances in molecular genetics have uncovered critical insights into IMA pathogenesis, including frequent KRAS mutations, NRG1 fusions, and other driver alterations. This review comprehensively summarizes the clinicopathological characteristics, immunohistochemical markers, histological grading, and differential diagnosis of IMA, focusing on emerging molecular research. Key topics include dysregulated signaling pathways, potential therapeutic targets, and prognostic biomarkers, providing a theoretical foundation for precise diagnosis and personalized treatment of IMA.