食管癌新辅助治疗后的病理评估

Pathologic assessment of esophageal cancer following neoadjuvant therapy

中国是食管癌高发国家,多数患者在首诊时已为局部晚期,新辅助联合手术治疗已成为这些患者的标准治疗方式。肿瘤治疗反应与预后关系密切,因此对于肿瘤治疗反应的评价至关重要,实体瘤反应评价标准是评价肿瘤治疗反应的金标准,但需要病变符合测量标准才能进行评价。肿瘤退缩分级(tumor regression grading,TRG)系统依据肿瘤新辅助治疗后的组织病理学改变对治疗后肿瘤的退缩情况进行分级,以揭示其预后信息。该文就食管癌新辅助治疗后的组织病理学改变、食管癌常用的TRG分级系统及存在的问题进行综述。

China is a country with a high incidence of esophageal cancer.Most patients are already in the locally advanced stage when first diagnosed.Preoperative neoadjuvant therapy followed by surgery has become the standard treatment mode for them.Closely related to prognosis,the evaluation of tumor response is essential.Response evaluation criteria in solid tumors is the gold standard to evaluate tumor response,but the lesions must meet the measurement standards.Tumor regression grading(TRG)systems are designed to classify regressive changes after neoadjuvant treatment based on histopathological results to reveal prognostic information.Concentrating on pathologic assessment of esophageal cancer following neoadjuvant therapy,this article reviews histopathological changes,commonly used TRG systems and current debate.