PDF(Pubmed)
Abstract：
Gastric cancer (GC) remains a disease with poor prognosis despite increasing availability of more effective targeted treatment. This may be in part due to the difficulty in selecting patients for appropriate treatment. Conventional taxonomic classifications of GC are ill-suited to make full use of recent advances in personalised therapy. In the past decade a number of molecular classifications have been proposed to address this; however, to date, there has been little implementation in the diagnostic routine. The lack of harmonisation between these classifications, the complexity and unavailability of some of the tests required plus the demands on time and resources, all contribute to poor uptake in the diagnostic routine. In the present study, these classifications were reviewed and an inclusive working classification that includes their main points, focuses on prognosis and treatment options and can be delivered using four on-slide tests (in situ hybridization for Epstein-Barr encoding region and immunohistochemistry for mismatch repair, E-cadherin and p53) is proposed. These tests can be performed on paraffin-embedded tissue and could be available in the majority of histopathology laboratories. The proposed classification also includes reflex testing for specific biomarkers relevant to treatment selection.
摘要：
胃癌（GC）仍然是一种预后不良的疾病，尽管越来越多的更有效的靶向治疗。这可能部分是由于难以选择用于适当治疗的患者。GC的常规分类不适合充分利用个性化治疗的最新进展。在过去的十年中，已经提出了许多分子分类来解决这个问题；然而，到目前为止,在诊断程序中几乎没有实施。这些分类之间缺乏协调，所需的一些测试的复杂性和不可用性，以及对时间和资源的需求，所有这些都导致了诊断程序中的不良摄取。在本研究中,对这些分类进行了审查，并制定了包含其要点的包容性工作分类，侧重于预后和治疗选择，可以使用四个幻灯片上的测试（原位杂交爱泼斯坦-巴尔编码区和免疫组织化学错配修复，提出了E-钙粘蛋白和p53）。这些测试可以在石蜡包埋的组织上进行，并且可以在大多数组织病理学实验室中使用。所提出的分类还包括与治疗选择相关的特定生物标志物的反射测试。
