Berlth Felix, Bollschweiler Elfriede, Drebber Uta, Hoelscher Arnulf H, Moenig Stefan
Felix Berlth, Elfriede Bollschweiler, Arnulf H Hoelscher, Stefan Moenig, Department of General, Visceral and Cancer Surgery, University of Cologne, 50937 Cologne, Germany.
World J Gastroenterol. 2014 May 21;20(19):5679-84. doi: 10.3748/wjg.v20.i19.5679.
Several pathohistological classification systems exist for the diagnosis of gastric cancer. Many studies have investigated the correlation between the pathohistological characteristics in gastric cancer and patient characteristics, disease specific criteria and overall outcome. It is still controversial as to which classification system imparts the most reliable information, and therefore, the choice of system may vary in clinical routine. In addition to the most common classification systems, such as the Laurén and the World Health Organization (WHO) classifications, other authors have tried to characterize and classify gastric cancer based on the microscopic morphology and in reference to the clinical outcome of the patients. In more than 50 years of systematic classification of the pathohistological characteristics of gastric cancer, there is no sole classification system that is consistently used worldwide in diagnostics and research. However, several national guidelines for the treatment of gastric cancer refer to the Laurén or the WHO classifications regarding therapeutic decision-making, which underlines the importance of a reliable classification system for gastric cancer. The latest results from gastric cancer studies indicate that it might be useful to integrate DNA- and RNA-based features of gastric cancer into the classification systems to establish prognostic relevance. This article reviews the diagnostic relevance and the prognostic value of different pathohistological classification systems in gastric cancer.
目前存在多种用于胃癌诊断的病理组织学分类系统。许多研究探讨了胃癌的病理组织学特征与患者特征、疾病特定标准及总体预后之间的相关性。关于哪种分类系统能提供最可靠的信息仍存在争议，因此，在临床实践中分类系统的选择可能会有所不同。除了最常用的分类系统，如劳伦（Laurén）分类和世界卫生组织（WHO）分类外，其他作者还试图根据微观形态并参考患者的临床结局对胃癌进行特征描述和分类。在对胃癌病理组织学特征进行系统分类的50多年里，没有一种单一的分类系统在全球范围内的诊断和研究中得到一致应用。然而，一些国家的胃癌治疗指南在治疗决策方面参考了劳伦分类或WHO分类，这凸显了可靠的胃癌分类系统的重要性。胃癌研究的最新结果表明，将基于DNA和RNA的胃癌特征纳入分类系统以建立预后相关性可能是有用的。本文综述了不同病理组织学分类系统在胃癌诊断中的相关性及预后价值。
