2025 ERS/ATS间质性肺炎国际多学科分类的诊断新范式和挑战OA

In 2025,the European Respiratory Society(ERS)and the American Thoracic Society(ATS)jointly released the Update of the International Multidisciplinary Classification of the Interstitial Pneumonias,representing a systematic revision of the classification framework for interstitial pneumonia(IP).A major advancement of this update is the expansion of its scope from idiopathic interstitial pneumonias(IIP)to encompass IP of all etiologies,thereby es-tablishing a unified classification framework.The revised classification formally recognizes bronchiolocentric intersti-tial pneumonia(BIP)as an independent pathological pattern,replaces desquamative interstitial pneumonia(DIP)with the more pathologically appropriate term alveolar macrophage pneumonia(AMP),and substitutes acute intersti-tial pneumonia(AIP)with diffuse alveolar damage(DAD).Based on anatomical localization and disease behavior,the updated system establishes a new framework centered on interstitial diseases(subdivided into fibrotic and non-fibrotic types)and airspace-filling diseases,and introduces a diagnostic confidence stratification system.From patho-logical and radiological perspectives,this article systematically reviews the key elements of this classification update,with particular emphasis on the transition toward a three-dimensional"pattern-etiology-behavior"diagnostic paradigm and its implications for clinical practice.