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[分子分类时代胃癌传统病理分类的评估]

[Evaluation of traditional pathological classification at molecular classification era for gastric cancer].

作者信息

Yu Yingyan

机构信息

Shanghai Key Laboratory of Gastric Neoplasms, Shanghai Institute of Digestive Surgery, Department of Surgery, Ruijin Hospital, Shanghai Jiaotong University School of Medicine, Shanghai 200025, China.

出版信息

Zhonghua Wei Chang Wai Ke Za Zhi. 2014 Jan;17(1):18-20.

Abstract

Histopathological classification is in a pivotal position in both basic research and clinical diagnosis and treatment of gastric cancer. Currently, there are different classification systems in basic science and clinical application. In medical literatures, different classifications are used including Lauren and WHO systems, which have confused many researchers. Lauren classification has been proposed for half a century, but is still used worldwide. It shows many advantages of simple, easy handling with prognostic significance. The WHO classification scheme is better than Lauren classification in that it is continuously being revised according to the progress of gastric cancer, and is always used in the clinical and pathological diagnosis of common scenarios. Along with the progression of genomics, transcriptomics, proteomics, metabolomics researches, molecular classification of gastric cancer becomes the current hot topics. The traditional therapeutic approach based on phenotypic characteristics of gastric cancer will most likely be replaced with a gene variation mode. The gene-targeted therapy against the same molecular variation seems more reasonable than traditional chemical treatment based on the same morphological change.

摘要

组织病理学分类在胃癌的基础研究以及临床诊断与治疗中都处于关键地位。目前,基础科学和临床应用中存在不同的分类系统。在医学文献中,使用了不同的分类方法,包括劳伦(Lauren)分类法和世界卫生组织(WHO)分类法,这让许多研究人员感到困惑。劳伦分类法已提出半个世纪,但仍在全球范围内使用。它具有简单、易于操作且具有预后意义等诸多优点。WHO分类方案比劳伦分类法更具优势,因为它会根据胃癌研究进展不断修订,且一直用于常见情况的临床和病理诊断。随着基因组学、转录组学、蛋白质组学、代谢组学研究的进展,胃癌的分子分类成为当前的热门话题。基于胃癌表型特征的传统治疗方法很可能会被基因变异模式所取代。针对相同分子变异的基因靶向治疗似乎比基于相同形态变化的传统化学治疗更为合理。

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