癌结节在胃癌中的研究进展及未来治疗前景

胃癌是一种严重影响患者预后生存和生活质量的恶性肿瘤，近年来随着病理检测技术的不断提高，癌结节（tumor deposit，TD）的检出率也不断提高，癌结节已成为影响胃癌患者预后不良的重要因素之一。随着对癌结节研究的不断深入，不同研究者对癌结节的命名、特点、分类及对于患者的预后都持有不同的观点，同时将癌结节归为浸润深度(pT)、转移淋巴结的数目(pN)或是直接归为TNM Ⅳ期等，仍存在较大争议。即使许多研究者都发现了重新修订的分期比现有的胃癌分期更准确，但这些都是与第7版TNM分期系统比较，且无高等循证医学证据支持。现如今第8版TNM胃癌分期已正式实施，但癌结节仍未加入其中。在胃癌中癌结节是否像结直肠癌TNM分期一样归为N分期中，以及癌结节阳性的胃癌患者治疗和提高预后生存都需要进一步探索。

Research progressand future treatment prospect of tumor deposit in gastric cancer

Gastric cancer is a malignant tumor that seriously affects the prognosis and lifequality of patients.In recent years,with the continuous improvement of pathological detection technology,the detection rate of tumor deposit has also continuously increased.Tumor deposit has become one of the important factors resulting in poor prognosis of gastric cancer patients.With the study on tumor deposit deepening,different researchers have different views on the nomenclature,characteristics,classification,and prognosis of tumor deposit,and there is still a big controversy in classifying tumor deposit as pT,pN,or directly classifyingit as TNM Ⅳ.Many researchers have found that the revised staging is more accurate than the existing gastric cancer staging,but it is compared with the 7th edition of the TNM staging system,and there is no advanced evidence-based medical support.Now the 8th edition of TNM gastric cancer staging has been officially implemented,but tumor deposit has not yet been added in it.Therefore,further exploration is needed about whether tumor deposit in gastric cancer can be classified as category N like colon-rectal cancer TNM stage and how the patients with positive gastric cancer nodules should be treated to improve the prognosis.