摘要
当前胃腺癌病理分型方式繁多复杂,但存在亚型覆盖不全面、关注面不足、预后相关性有限等问题,限制了其推广应用。临床实践发现,黏液的分泌是影响胃腺癌病理特征及预后的重要因素,因此根据黏液分泌情况将胃腺癌分为黏液分泌性腺癌(GMA)及非黏液分泌性腺癌(GNMA)。相较于GNMA,GMA具有TNM分期晚,进展迅速,易发生侵袭转移,根治性切除率低,预后差等病理特征,且在遗传学、影像学、治疗特征等方面与GNMA存在诸多差异。使用该分类对胃腺癌亚型划分更明确,具有更好的临床指导价值,并可能有助于推动胃癌新病理分型的提出和推广应用。
The current pathological classification methods for gastric adenocarcinoma are numerous and complex,but they have issues such as incomplete subtype coverage,insufficient focus,and limited prognostic relevance,which restrict their widespread application.Long-term clinical practice has revealed that mucus secretion is an important factor influencing the pathological characteristics and prognosis of gastric adenocarcinoma.Therefore,the authors’team divided gastric adenocarcinoma into mucus-secretory adenocarcinoma(GMA)and non-mucus-secretory adenocarcinoma(GNMA)according to the situation of mucus secretion.Compared with GNMA,GMA is characterized by late TNM stage,rapid progression,easy invasion and metastasis,low radical resection rate,poor prognosis,and other pathological characteristics.Besides,there are many differences between GMA and GNMA in genetics,imaging,and therapeutic characteristics.The classification makes the subtyping of gastric adenocarcinoma clearer,has better value in clinical guidance,and may help promote the proposal and application of new pathological classifications to gastric cancer.
作者
张原
孙莲慧
张鹏善
罗再
蒋立人
黄陈
ZHANG Yuan;SUN Lian-hui;ZHANG Peng-shan(Department of Gastrointestinal Surgery,Shanghai General Hospital,Shanghai Jiao Tong University School of Medicine,Shanghai 200080,China)
出处
《中国实用外科杂志》
CAS
CSCD
北大核心
2024年第8期947-952,共6页
Chinese Journal of Practical Surgery
基金
国家自然科学基金项目(No.82072662,No.82203751)
上海交通大学医院高峰高原计划项目——“研究型医师”(No.20191425)
上海市抗癌协会“雏鹰”计划项目(No.SACA-CY21C08)
上海市东方英才计划拔尖项目
上海交通大学医工交叉项目重点项目。
关键词
胃腺癌
病理分型
黏液分泌
黏液腺癌
印戒细胞癌
gastric adenocarcinoma
pathological classification
mucus secretion
mucinous adenocarcinoma
signet ring cell carcinoma
