Department of Surgery, Department of Urology, University of Medicine and Pharmacy of Craiova, Romania;
Rom J Morphol Embryol. 2023 Apr-Jun;64(2):251-261. doi: 10.47162/RJME.64.2.16.
Gastric cancer (GC), despite the current possibilities of early diagnosis and curative treatment, remains a major public health problem, being one of the main causes of cancer, due to its detection in advanced stages. Screening programs applied in Western countries led to low incidence rates in these countries. Helicobacter pylori bacterial infection is considered to be the highest risk factor for the onset of GC because it causes chronic inflammation of the gastric mucosa and damages hydrochloric acid secretory glands, eventually leading to atrophic gastritis, which has a potential to progress to GC. In our study, we aimed at assessing the tumor microenvironment in gastric adenocarcinomas as approximately 90% of GCs are adenocarcinomas. Our study showed that the tumor microenvironment has an extremely complex morphological structure, totally different from the microscopic structure of the gastric wall, consisting of stromal cells, lymphocytes, plasma cells, macrophages, blood vessels, collagen fibers, extracellular connective matrix, other cells. The tumor microenvironment presents phenotypic, cellular and molecular heterogeneity; therefore, the microscopic aspect differs from one tumor to another and even from one region to another in the same tumor. Poorly or moderately differentiated adenocarcinomas show a more intense desmoplastic reaction than well-differentiated ones. Alpha-smooth muscle actin (α-SMA)-positive stromal cells (tumor-associated fibroblasts) and tumor macrophages were the most numerous cells of the tumor microenvironment. The tumor microenvironment is the result of cooperation between tumor cells, cancer-associated fibroblasts, immune system cells and blood vessels. It allows tumor cells to multiply, grow and metastasize.
胃癌（GC），尽管目前有早期诊断和治疗的可能性，但仍然是一个主要的公共卫生问题，是癌症的主要原因之一，因为它在晚期被发现。西方国家应用的筛查计划导致这些国家的发病率较低。幽门螺杆菌细菌感染被认为是 GC 发病的最高风险因素，因为它会导致胃黏膜的慢性炎症，并损害盐酸分泌腺，最终导致萎缩性胃炎，有发展为 GC 的潜力。在我们的研究中，我们旨在评估胃腺癌的肿瘤微环境，因为大约 90%的 GC 是腺癌。我们的研究表明，肿瘤微环境具有极其复杂的形态结构，与胃壁的微观结构完全不同，由基质细胞、淋巴细胞、浆细胞、巨噬细胞、血管、胶原纤维、细胞外连接基质和其他细胞组成。肿瘤微环境表现出表型、细胞和分子异质性；因此，微观方面在不同的肿瘤之间甚至在同一肿瘤的不同区域之间都有所不同。低分化或中分化腺癌比高分化腺癌表现出更强的促结缔组织增生反应。α-平滑肌肌动蛋白（α-SMA）阳性基质细胞（肿瘤相关成纤维细胞）和肿瘤巨噬细胞是肿瘤微环境中数量最多的细胞。肿瘤微环境是肿瘤细胞、癌症相关成纤维细胞、免疫系统细胞和血管之间合作的结果。它允许肿瘤细胞增殖、生长和转移。
