胃外科实验研究的进展与展望

Progress and prospects in experimental study of stomach surgery

作为癌症基因组图谱计划的组成部分，通过全面分析胃癌的分子遗传学特征，一个全新的分子分型系统将胃癌分为4个亚型，并有望用于指导患者靶向治疗的筛选和临床试验。同时，以类器官为代表的模型器官技术迅速发展，为胃外科研究提供了新的平台。近年来，靶向治疗研究给胃癌患者带来了新的希望，抗肿瘤血管新生药物显示出良好的临床应用前景，但肝细胞生长因子（HGF）／MET通路小分子抑制剂却遭遇了挫折。新近研究还发现，肠道菌群的长期改变和循环胆汁酸对代谢的调节，是肥胖患者接受减重手术后体质量减轻和糖尿病得以控制的重要机制。

As a part of Cancer Genome Atlas project, a molecular classification, based on the comprehensive molecular genetics evaluation, divides gastric cancer into four subtypes, and is expected to provide a roadmap for patient stratification and trials of targeted therapies. Meanwhile, organoid cultures develop rapidly and represent the trends of modelling organs, which also furnish a new platform for investi- gations of stomach surgery. Recent years, targeted therapies bring new hope for gastric cancer patients. Al- though tumor angiogenesis inhibitors show good prospects for clinical application, the specific molecule in- hibitor of hepatocyte growth factor （HGF）/MET signaling pathway has suffered setbacks in gastric cancer. Recent studies have also found that long-term alterations in the gut microbiome, as well as regulation of me- tabolism by circulating bile acid, should be accounted for the mechanisms of weight loss and improvements of diabetes mellitus for obese patients receiving bariatric surgery.