title: [The new classification of lung adenocarcinomas according to the American Thoracic Society and the European Respiratory Society: new recommendations to improve management].
abstract: BACKGROUND
  Lung cancer represents a major public health problem.It represents the first cause of mortality by cancer in Tunisia. Its incidence reaches 40% of lung cancers. Its clinical, radiologic and molecular aspects have been improved inducing the necessity of a new classification which will consider the necessity of a multidisciplinary management.
  
  
  OBJECTIVE
  To highlight the new classification of lung adenocarcinomas and to present the major recommendations.
  
  
  METHODS
  We tried to present the main recommendations of the American Thoracic Society and the European Respiratory Society of lung adenocarcinoma.
  
  
  RESULTS
  This new classification identifies pre-invasive lesions represented by in-situ adenocarcinoma (the ancient bronchioloalveolar), the micro-invasive adenocarcinoma and invasive adenocarcinoma. The latter have been divided in sub-types according to the predominant architectural features. Thus, three groups of invasive adenocarcinoma with presumed different prognoses have been identified: the lepidic predominant adenocarcinoma which has a good prognosis, the micro-papillary and solid predominant adenocarcinomas which have a bad prognosis and the papillary and acinar adenocarcinomas which have an intermediate prognosis. All these entities have specific diagnostic features and criteria. These recommendations are available for biopsies and surgical resected specimen.
  
  
  CONCLUSIONS
  The new classification of lung adenocarcinoma puts emphasis on the necessity of a multi-disciplinary management of these tumors in order to improve their prognosis. It identifies new entities with different prognoses that could justify specific modalities of treatment and follow up.
authors.forename: Mona
authors.initials: M
authors.lastname: Mlika
authors.forename: Aida
authors.initials: A
authors.lastname: Ayadi-Kaddour
authors.forename: Sadok
authors.initials: S
authors.lastname: Boudaya
authors.forename: Soumeya
authors.initials: S
authors.lastname: Laabidi
authors.forename: Hamouda
authors.initials: H
authors.lastname: Boussen
authors.forename: Faouzi
authors.initials: F
authors.lastname: El Mezni
mesh_terms: D000230:Adenocarcinoma / Q000145:classification* / Q000473:pathology*; D006801:Humans; D008175:Lung Neoplasms / Q000145:classification* / Q000473:pathology*; D012955:Societies, Medical