胃癌肝转移诊疗现状与临床问题

Current status and clinical challenges in diagnosis and treatment of gastric cancer liver metastasis

  • 摘要: 胃癌肝转移因其高发生率、高度异质性与极差的预后,始终是胃癌诊疗领域的核心难题。近10年来,随着肿瘤分子机制研究不断深入、临床诊断持续革新以及综合治疗方案的逐步优化,胃癌肝转移的精准诊疗体系得以构建和发展。然而,分子分型的临床转化进程缓慢、转化治疗的获益人群界定模糊、外科适应证尚缺乏高级别循证医学依据是制约患者生存改善的临床瓶颈。笔者围绕胃癌肝转移的发病机制与分子特征、诊断评估与风险预测、个体化分层治疗策略3个方面进行论述,梳理领域研究热点与尚存争议的问题,旨在为优化胃癌肝转移诊疗方案、改善患者远期预后提供临床参考与研究思路。

     

    Abstract: Gastric cancer liver metastasis (GCLM) has long been a core challenge in the management of gastric cancer owing to its high incidence, profound heterogeneity, and extremely poor prognosis. Over the past decade, advances in tumor molecular research, diagnostic innovation, and the progressive refinement of comprehensive therapy have laid a critical foundation for building precision oncology frameworks. However, key bottlenecks persist: clinical translation of molecular classification lags behind, the population likely to benefit from conversion therapy is not well delineated, and surgical indications still lack high‑level medicine evidence, collectively limiting meaningful survival improvement. The authors examine three core dimensions of GCLM-patho-genesis and molecular characteristics, diagnostic evaluation and risk prediction, and individualized stratified treatment strategies-to clarify the current landscape, pinpoint major controversies, and outline avenues for extending survival.

     

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