胃黏液分泌性腺癌:胃腺癌病理分型再思考
Gastric mucus-secreting adenocarcinoma:rethinking of the pathological classification of gastric adenocarcinoma
张原 1孙莲慧 1张鹏善 1罗再 1蒋立人 2黄陈1
作者信息
- 1. 上海交通大学医学院附属第一人民医院胃肠外科,上海 200080
- 2. 上海交通大学医学院附属第一人民医院病理科,上海 200080
- 折叠
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.
Abstract
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 re-vealed that mucus secretion is an important factor influencing the pathological characteristics and prognosis of gastric adeno-carcinoma.Therefore,the authors'team divided gastric adeno-carcinoma 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 in-vasion and metastasis,low radical resection rate,poor progno-sis,and other pathological characteristics.Besides,there are many differences between GMA and GNMA in genetics,imag-ing,and therapeutic characteristics.The classification makes the subtyping of gastric adenocarcinoma clearer,has better val-ue in clinical guidance,and may help promote the proposal and application of new pathological classifications to gastric cancer.
关键词
胃腺癌/病理分型/黏液分泌/黏液腺癌/印戒细胞癌Key words
gastric adenocarcinoma/pathological classifica-tion/mucus secretion/mucinous adenocarcinoma/signet ring cell carcinoma引用本文复制引用
基金项目
国家自然科学基金项目(82072662)
国家自然科学基金项目(82203751)
上海交通大学医院高峰高原计划项目(20191425)
上海市抗癌协会"雏鹰"计划项目(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()
出版年
2024
国家科技期刊平台
NSTL
万方数据