[Expert consensus on pathological diagnosis of lung cancer in county-level and prefectural medical institutions (2025 edition)].

Lung cancer is the malignant tumor with the highest morbidity and mortality in China. Standardized pathological diagnosis of lung cancer is crucial for determining clinical strategy and evaluating prognosis. Currently, there are issues such as relatively lagging overall construction, uneven diagnostic levels and inaccessibility to advanced diagnostic techniques in the pathology departments of county-level and prefectural medical institutions within the close-knit medical alliance in China. To implement the national policy on the hierarchical diagnosis and treatment of lung cancer, standardize the pathological diagnosis of lung cancer in county-level and prefectural medical institutions to meet the basic needs of lung cancer diagnosis and treatment, and support the advancement of the Healthy China strategy and the construction of a close-knit medical alliance, experts were organized by the Lung Cancer Group of the Pathology Committee of the China Anti-Cancer Association, to develop comprehensive consensus recommendations and their levels to promote the standardization of the entire process of lung cancer pathological diagnosis. This was done by combining domestic and international guidelines and current domestic situation, focusing on three types of specimen: cytology, biopsy and surgical resection. The consensus framework is constructed and elaborated from five aspects: pre-processing of specimen standardization, morphological pathological assessment, immunohistochemistry, special staining, molecular pathological detection and standardized reporting. It also covers issues of concern in industry such as postoperative pathological assessment after neoadjuvant therapy and intraoperative frozen diagnosis. During the process of consensus formation, the Delphi questionnaire survey and consensus conference method were used, by combination of online and offline forms. The consensus focuses on the standardization and feasibility of application, aiming to promote the standardization of lung cancer pathological diagnosis and provide guiding suggestions for clinical diagnosis, treatment, and prognosis evaluation of lung cancer in county-level and prefectural medical institutions.