Verbeke Caroline, Häberle Lena, Lenggenhager Daniela, Esposito Irene
Dept of Pathology, Institute of Clinical Medicine, University of Oslo, Norway; Dept of Pathology, Oslo University Hospital, Norway.
Institute of Pathology, Heinrich-Heine University and University Hospital of Düsseldorf, Germany.
Pancreatology. 2018 Jul;18(5):467-476. doi: 10.1016/j.pan.2018.04.010. Epub 2018 Apr 25.
Neoadjuvant treatment has increasingly become an integral part of the multimodal management of patients with pancreatic cancer. In patients who are able to undergo surgery following preoperative therapy, tumour regression grading remains the diagnostic gold standard for the histomorphological assessment of the effect of neoadjuvant treatment. In recent years, however, there has been growing concern about inherent flaws of tumour regression grading systems as well as their imprecise and impractical criteria that result in divergence of practice and lack of interobserver agreement. Furthermore, existing tumour regression systems differ in their defining criteria and thresholds, leading to incomparability of data. In this review, the principles and limitations of the main existing tumour regression systems are discussed, and potential alternative assessment approaches and novel markers are presented.
新辅助治疗日益成为胰腺癌患者多模式管理的一个组成部分。对于术前治疗后能够接受手术的患者，肿瘤退缩分级仍然是新辅助治疗效果组织形态学评估的诊断金标准。然而，近年来，人们越来越关注肿瘤退缩分级系统的固有缺陷及其不精确和不实用的标准，这些标准导致了实践上的差异和观察者间缺乏一致性。此外，现有的肿瘤退缩系统在定义标准和阈值方面存在差异，导致数据缺乏可比性。在这篇综述中，讨论了主要现有肿瘤退缩系统的原则和局限性，并介绍了潜在的替代评估方法和新的标志物。
