食管癌新辅助治疗后分期和病理评估的最新进展,Annals of the New York Academy of Sciences

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食管癌新辅助治疗后分期和病理评估的最新进展
Annals of the New York Academy of Sciences ( IF 4.1 ) Pub Date : 2020-09-06 , DOI: 10.1111/nyas.14462
Xuchen Zhang ₁ , Dhanpat Jain ₁

Affiliation

食管癌包括两种主要亚型——鳞状细胞癌和腺癌，其发病率在世界范围内差异很大，也取决于食管内的位置。食管癌 (EC) 的分期在各种胃肠道癌中也很独特，因为它考虑了位置、组织学类型和分级。多年来，其管理一直在发展，最近美国癌症分期联合委员会已经更新，以反映不断变化的实践和新数据。很明显，术前新辅助治疗越来越多地用于治疗局部晚期食管癌，随后进行手术切除以提高生存率。新辅助治疗后可观察到多种组织学变化，这对病理学家来说可能具有挑战性。新辅助治疗后手术切除标本和淋巴结中残留肿瘤的存在与预后不良有关。因此，病理学家需要对肿瘤消退分级和准确的肿瘤分期进行彻底的病理评估，以提供有价值的预后信息来指导进一步的治疗。EC 中的肿瘤消退分级需要改进和标准化。

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Updates in staging and pathologic evaluation of esophageal carcinoma following neoadjuvant therapy

Esophageal carcinoma comprises two major subtypes—squamous cell carcinoma and adenocarcinoma, the incidences of which vary widely across the world and also depend on the location within the esophagus. The staging of esophageal cancer (EC) also remains unique among various gastrointestinal carcinomas, as it takes into account the location, histologic type, and grade. Its management has been evolving over the years and the recent American Joint Committee on Cancer staging system has been updated to reflect the changing practice and new data. It is clear that preoperative neoadjuvant therapy is increasingly being used for the treatment of locally advanced esophageal carcinomas, followed by surgical resection that improves survival. A variety of histologic changes can be seen after neoadjuvant therapy, which can be challenging for the pathologists. The presence of residual tumor in the surgically resected specimen and lymph node following neoadjuvant therapy is associated with poor prognosis. Hence, a thorough pathologic assessment of tumor regression grade and accurate tumor staging is required by pathologists to provide valuable prognostic information to guide further management. Tumor regression grading in ECs needs to be improved and standardized.

更新日期：2020-09-06

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