Neves Filho Eduardo Henrique Cunha, de Sant'Ana Rosane Oliveira, Nunes Luiz Vianney Saldanha Cidrão, Pires Adriana Pinheiro Bezerra, da Cunha Maria do Perpétuo Socorro Saldanha
Instituto do Câncer do Ceará, Fortaleza/CE, Brazil.
APMIS. 2017 Feb;125(2):79-84. doi: 10.1111/apm.12642. Epub 2017 Jan 2.
As the perioperative chemotherapy has been widely implemented on the management of gastric cancer patients, heterogeneity of clinical outcomes has been evidenced in parallel to different histopathological regression pattern of gastric cancer cells. Tumor histological response to preoperative therapy has been graded by various systems in order to categorize the amount of regressive changes induced by chemotherapy in relation to residual tumor. In this context, tumor regression grading (TRG) systems might provide important prognostic information as the variety of tumor response may imply on different clinical outcomes with impact in survival rates. Moreover, gastric cancer behavior varies enormously upon individual factors such as histological classification and tumor anatomic site of involvement that have been shown to affect the TRG interpretation. On the other hand, some studies have assessed the role of molecular markers as a predictor of tumor response to neoadjuvant chemotherapy in terms of TRG. Thus, the aim of this review is to evaluate how TRG has been interpreted in gastric cancer, discuss their clinical and prognostic relevance and also address the molecular markers involved in this process.
随着围手术期化疗已广泛应用于胃癌患者的治疗，临床结果的异质性与胃癌细胞不同的组织病理学消退模式同时得到证实。为了根据残留肿瘤对化疗诱导的消退变化量进行分类，肿瘤对术前治疗的组织学反应已通过各种系统进行分级。在这种情况下，肿瘤消退分级（TRG）系统可能提供重要的预后信息，因为肿瘤反应的多样性可能意味着不同的临床结果并影响生存率。此外，胃癌的行为因个体因素（如组织学分类和肿瘤受累的解剖部位）而有很大差异，这些因素已被证明会影响TRG的解读。另一方面，一些研究已评估分子标志物作为TRG方面肿瘤对新辅助化疗反应预测指标的作用。因此，本综述的目的是评估TRG在胃癌中是如何被解读的，讨论其临床和预后相关性，并探讨参与这一过程的分子标志物。
