Department of Surgery, Hôpital Claude-Huriez, Lille, France.
Departments of Pathology, Centro Hospitalar São João, Faculty of Medicine of Porto University and Institute for Research and Innovation in Health (i3S), Institute of Molecular Pathology and Immunology of the University of Porto (Ipatimup), Porto, Portugal.
Gastric Cancer. 2019 Jan;22(1):1-9. doi: 10.1007/s10120-018-0868-0. Epub 2018 Aug 25.
Clinicopathological characteristics of gastric cancer (GC) are changing, especially in the West with a decreasing incidence of distal, intestinal-type tumours and the corresponding increasing proportion of tumours with Laurén diffuse or WHO poorly cohesive (PC) including signet ring cell (SRC) histology. To accurately assess the behaviour and the prognosis of these GC subtypes, the standardization of pathological definitions is needed.
A multidisciplinary expert team belonging to the European Chapter of International Gastric Cancer Association (IGCA) identified 11 topics on pathological classifications used for PC and SRC GC. The topics were debated during a dedicated Workshop held in Verona in March 2017. Then, through a Delphi method, consensus statements for each topic were elaborated.
A consensus was reached on the need to classify gastric carcinoma according to the most recent edition of the WHO classification which is currently WHO 2010. Moreover, to standardize the definition of SRC carcinomas, the proposal that only WHO PC carcinomas with more than 90% poorly cohesive cells having signet ring cell morphology have to be classified as SRC carcinomas was made. All other PC non-SRC types have to be further subdivided into PC carcinomas with SRC component (< 90% but > 10% SRCs) and PC carcinomas not otherwise specified (< 10% SRCs).
The reported statements clarify some debated topics on pathological classifications used for PC and SRC GC. As such, this consensus classification would allow the generation of evidence on biological and prognostic differences between these GC subtypes.
胃癌（GC）的临床病理特征正在发生变化，尤其是在西方，远端肠型肿瘤的发病率下降，而具有Laurén 弥漫型或 WHO 低黏附性（PC）特征的肿瘤比例相应增加，包括印戒细胞（SRC）组织学。为了准确评估这些 GC 亚型的行为和预后，需要对病理定义进行标准化。
属于国际胃癌协会（IGCA）欧洲分会的多学科专家团队确定了 11 个与 PC 和 SRC GC 病理分类相关的主题。这些主题在 2017 年 3 月于维罗纳举行的专门研讨会上进行了辩论。然后，通过德尔菲法，对每个主题制定了共识声明。
达成了共识，即需要根据最新的世界卫生组织（WHO）分类标准对胃癌进行分类，目前是 WHO 2010 年版。此外，为了规范 SRC 癌的定义，提出只有具有印戒细胞形态的低黏附性细胞超过 90%的 WHO PC 癌才能被归类为 SRC 癌。所有其他非 SRC 型 PC 癌必须进一步细分为具有 SRC 成分的 PC 癌（<90%但>10% SRCs）和未特指的 PC 癌（<10% SRCs）。
报告的声明澄清了一些关于 PC 和 SRC GC 病理分类的有争议的问题。因此，这种共识分类将允许对这些 GC 亚型之间的生物学和预后差异产生证据。
