In the era of molecular targeted therapy,the drugs selection for lung cancer depends on accurate patholog-ic diagnosis. The pathologic progress of diagnosis and subtypes of lung cancer associated with molecular targeted thera-py changes as following recently. There are different types of driver mutations in different types of lung cancer,and ac-cordingly different kinds of molecular targeted drugs could be selected. Different kind of tissue subtypes or morphology changes of lung cancer may imply some kinds of molecular targets. Large cell carcinoma of lung cancer defined not on-ly by morphology changes but also depends on immunohistochemical phenotypes. According to this new concept,most of large cell carcinoma diagnosed in the past can be reclassified into adenocarcinoma or squmous cell carcinoma. The heterogeneity of lung cancer changes our understanding of unusual results of tests of molecular target. More and more simple and economic test methods of molecular targets have been exploided and used in pathologic diagnosis. Distinct mutations specific antibodies have been produced and immohistochemistry stain can be used as routine method to di-rect molecular therapy of lung cancer.%精准的病理诊断对于肺癌的分子靶向治疗尤为重要。为此，近年来在肺癌病理诊断及分型方面取得了许多重要进展。不同组织学类别的驱动基因谱及相应的分子靶向治疗靶点日渐明确，不同的组织学亚型和癌组织特殊形态特征可预测潜在的分子靶点，既往的大细胞癌诊断已为新标准所替代，大多数过去的大细胞癌已转归为腺癌或鳞癌，肺癌的异质性对其分子靶点的检测和结果的解释具有一定的影响，分子靶点的检测趋于多样化和更简便，突变特异性的免疫组化检测正成为可直接指导分子靶向治疗的常规方法。
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