胃癌精准治疗的进展和思考

Recent advances and reflection on precision medicine in gastric cancer

我国胃癌患者基数大、病期晚、预后差,5年总体生存率仅有35.1%。新技术、新药物和新设备的涌现为改善我国胃癌患者的预后提供了新的契机。组学技术拓展了胃癌分子分型认知,为胃癌生物标志物指导下的精准治疗提供了支持。针对高度微卫星不稳定型患者,围手术期免疫治疗提供了非手术管理的潜在可能。微创技术具有与开放手术相当的长期预后结果,腹腔镜技术可作为Ⅰ~Ⅲ期胃癌患者的常规手术方式。淋巴结的清扫需考虑肿瘤位置、肿瘤大小及侵犯深度。跨学科交叉融合有助于进一步推动胃癌治疗的精准化。

In China,gastric cancer has a large population base,most patients are diagnosed on late-stage and with poor prognosis,5-year overall survival rate is only 35.1%The emergence of new technologies,drugs,and equipment provides new opportunities to improve the prognosis of gastric cancer.Omics technologies have expanded our understanding of molecular subtypes in gastric cancer,supporting biomarker-guided precision treatment.For MSI-H patients,perioperative immunotherapy offers potential non-surgical management options.Minimally invasive techniques have shown long-term prognosis results comparable to open surgery,with laparoscopic technology becoming a routine surgical approach for stageⅠ-Ⅲgastric cancer patients.Lymph node dissection should consider tumor location,size,and depth of invasion.Interdisciplinary integration helps to further promote precision treatment of gastric cancer.