胰头癌胰十二指肠切除标本病理规范化处理的方法和意义

Method and significance of specimens standardized pathological treatment in pancreaticoduodenectomy for pancreatic head cancer

胰腺癌恶性程度高、预后差，根治性切除是目前治愈胰腺癌的唯一可能的方法。而R0切除的标准、切缘的定义、病理学检查等尚缺乏统一的标准，胰头癌手术切缘对患者预后的影响仍饱受争议。与以往的观念不同，目前认为R1切除率高不是外科手术质量差的指标，而是说明病理学检查的质量高。期待胰头癌标本病理学检查的国际共识尽早发布，以更好地明确手术切缘与临床预后的关系，指导医师选择更合理的治疗策略。

Pancreatic ductal adenocarcinoma is a highly aggressive disease with a grim prognosis. Surgical resection offers the best chance for long-term survival. Negative-margin resection still remains the goal, the influence of margin status on outcomes in pancreatic head carcinoma remains controversial, as conflicting data have been plagued by a lack of standardization in R0 resection and margin definitions, pathologic analysis, and reporting. In contrast to common belief, a high rate of R1 resections in pancreatic cancer is not a marker of low-quality surgery but rather of high-quality pathology. The international pathological consensus of pancreatic head carcinoma is still needed to fully understand the prognostic value of margin status in order to optimize treatment strategy for this disease.