2015梅奥诊所及肾脏病理学会关_省略_肾炎病理分类诊断及报告共识的解读_曾彩虹.pdf

870 Chinese Journal of Practical Internal Medicine October 2016 Vol. 36 No. 10 指南与共识 2015梅奥诊所及肾脏病理学会关于肾小球肾炎 病理分类 诊断及报告共识的解读 曾彩虹，刘志红 DOI：10.7504/nk2016090203　　中图分类号：R5　　 文献标识码：A 摘要 ： 目前肾小球肾炎分类和病理报告模式缺乏标准化，疾病诊断之间的层次关系缺乏统一性。2015年2月肾脏 病理学家和肾病学家在美国梅奥医学中心举行会议，提出了基于病因学和发病机制将肾小球肾炎分为五类，并制定 出标准化、统一的描述性语言和层次分明的疾病诊断体系，最终达成了“梅奥诊所及肾脏病理学会关于肾小球肾炎 病理分类、诊断及报告的共识”。共识将增生性肾小球肾炎根据病因和发病机制分为5类：免疫复合物相关性肾小 球肾炎、寡免疫复合物性肾小球肾炎、抗肾小球基底膜肾炎、单克隆免疫球蛋白相关性肾小球肾炎和C3肾病。共识 提出病理诊断应包括主要诊断和次要诊断，主要诊断应包含病种(或损伤的类型)、病种的评分和(或)分级和(或) 分类，次要诊断单独列出，包含其他合并存在的、不足以导致主要诊断的病变。共识最后对光镜、免疫荧光、电镜和 其他辅助诊断手段的报告模式进行了规范。 关键词 ： 梅奥诊所；肾小球肾炎；病理分类；病理诊断 Interpretation of Mayo Clinic/Renal Pathology Society consensus report on pathologic classification, diagnosis, and reporting of GN. ZENG Cai-hong, LIU Zhi-hong. National Clinical Research Center of Kidney Diseases, Nanjing University School of Medicine, Nanjing 210016, China Corrspongding author: LIU Zhi-hong, E-mail: liuzhihong@nju.edu.cn Abstract: At present, there is a lack of standardization in the classification of glomerular nephritis and pathological report, and the lack of unity between the levels of the disease diagnosis. A group of renal pathologists and nephrologists met at the Mayo Clinic (Rochester, MN) on February 20, 2015 to reach a consensus on an etiology/pathogenesis-based classification and standardize reporting of GN,, finally achieved the Mayo Clinic/renal pathology society glomerulonephritis pathological classification, diagnosis and report on the consensus. In this consensus, glomerulonephritis (GN) is classified into the following five etiology/pathogenesis-based types, each with specific disease entities: immune-complex GN, pauci-immune GN, antiglomerular basement membrane GN, monoclonal Ig GN and C3 glomerulopathy. A pattern dia