肺癌是全世界最常见的恶性肿瘤之一，肺科医师通常是第一个与患者会面并决定针对每个具体病例优选哪种肿瘤取样方法的医疗专业人员。肺科医师必须意识到诊断过程的复杂性，并了解从组织标本离开办公室并被送往病理实验室的那一刻起，直到诊断结果到达患者手中并获得诊断结果为止所遇到的多重挑战。 2021 年新的世界卫生组织胸部肿瘤分类建议对非小细胞肺癌 (NSCLC) 进行最低限度的免疫组织化学 (IHC) 诊断，并在不同机构和国家指南发布后，提倡对上皮生长因子受体进行基本分子检测(EGFR)、间变性淋巴瘤激酶 (ALK) 和程序性细胞死亡配体 1 (PD-L1) 由诊断病理学家在所有活检或切除标本中启动。一般来说，由于组织浪费，不建议对分子生物标志物进行连续检测，而是支持下一代测序 (NGS) 诊断小组。肺癌标本必须通过一组 IHC 研究进行组织学诊断，并且最好是反射NGS 的分子研究，包括几个可靶向基因。充分的沟通和临床信息可防止病理学家“过度使用”组织进行其他研究，同时专注于保存用于分子测试的材料。版权所有 © 2023 Wolters Kluwer Health, Inc. 保留所有权利。

Lung cancer is one of the most common malignancies in the whole world, and the pulmonologist is generally the first medical professional to meet the patient and decide what method of tumour sampling is preferable in each specific case. It is imperative for pulmonary physicians to be aware of the intricacies of the diagnostic process, and understand the multiple challenges that are encountered, from the moment the tissue specimen leaves their offices and is sent to the pathology laboratory, until the diagnosis reaches the patient and treating physician.The new 2021 WHO classification of thoracic tumours recommended a minimum immunohistochemical (IHC) diagnostic panel for nonsmall cell lung cancer (NSCLC), and following publications of different institutional and country-based guidelines, advocated basic molecular testing for epithelial growth factor receptor (EGFR), anaplastic lymphoma kinase (ALK) and programmed cell death ligand 1 (PD-L1) to be initiated by the diagnosing pathologist in all cases of biopsy or resection specimens. In general, sequential testing for molecular biomarkers was not recommended due to tissue wastage, instead next generation sequencing (NGS) diagnostic panel was supported.The lung cancer specimen has to undergo histologic diagnosis through a panel of IHC studies, and -preferably, a reflex molecular study by NGS including several targetable genes. Adequate communication and clinical information preclude the pathologist from "overusing" the tissue for additional studies, while focusing on preservation of material for molecular testing.Copyright © 2023 Wolters Kluwer Health, Inc. All rights reserved.