Märkl B, Martin B
Institut für Pathologie, Klinikum Augsburg, Stenglinstraße 2, 86157, Augsburg, Deutschland.
Chirurg. 2018 May;89(5):333-338. doi: 10.1007/s00104-018-0602-9.
Early stage cancers of the gastrointestinal tract are malignant tumors that are eligible for local therapy regimens and show an excellent prognosis.
This article explains the histopathological aspects of the various diseases that are covered by this topic.
Organ-preserving therapies are discussed according to their locations and under consideration of the current guidelines and the relevant literature.
The exact histopathological evaluation of early cancers of the gastrointestinal tract is of crucial importance. It is the essential basis for all further therapy decisions. In most cases, an option for a local resection is given. In comparison to partial or complete organ resections, local resection is associated with a significantly decreased morbidity and reduced length of hospital stays; however, it must be ensured that local therapies do not become responsible for increased rates of tumor recurrence and progression. Therefore, an optimal risk estimation based on a sophisticated histopathological classification is mandatory. This includes the evaluation of the infiltration depth, grading, lymphovascular invasion and resection margins.
Molecular analyses have not yet entered clinical practice. The only exceptions are investigations to detect hereditary diseases. The exact histopathological diagnostic of early gastrointestinal cancers is the basis of an effective and organ-preserving therapy.
胃肠道早期癌症是适合局部治疗方案且预后良好的恶性肿瘤。
本文解释了该主题所涵盖的各种疾病的组织病理学方面。
根据保器官治疗的位置，并参照当前指南和相关文献进行讨论。
胃肠道早期癌症的确切组织病理学评估至关重要。它是所有进一步治疗决策的重要依据。在大多数情况下，可选择局部切除。与部分或完全器官切除相比，局部切除的发病率显著降低，住院时间缩短；然而，必须确保局部治疗不会导致肿瘤复发和进展率增加。因此，基于完善的组织病理学分类进行最佳风险评估是必不可少的。这包括浸润深度、分级、淋巴管侵犯和手术切缘的评估。
分子分析尚未进入临床实践。唯一的例外是用于检测遗传性疾病的研究。早期胃肠道癌症的确切组织病理学诊断是有效保器官治疗的基础。
