重新定义非小细胞肺癌的肿瘤床评估：新辅助免疫治疗时代的组织病理学挑战和未来方向
Reframing tumor bed evaluation in non-small cell lung cancer: histopathological challenges and future directions in the era of neoadjuvant immunotherapy.
摘要(中文译文)
新辅助免疫治疗在非小细胞肺癌（NSCLC）中的引入带来了复杂的肿瘤反应，对传统病理评估提出了挑战。因此，主要病理缓解（MPR）和病理完全缓解（pCR）等传统终点可能已不足以捕捉免疫介导变化的全部谱系。事实上，这些参数最初是在细胞毒性化疗背景下制定的，可能无法反映免疫介导现象及间质重塑，而这些变化可显著改变瘤床的外观。因此，MPR和pCR可能低估了接受免疫治疗患者真实生物学反应的程度。本综述概述了形态学评估的当前局限性，并强调了对免疫适应性标准的需求。此外，本文探讨了数字病理学和人工智能的附加价值，它们能够对组织学特征进行客观且可重复的量化。将这些工具与影像学和分子数据整合，支持多维度的反应评估方法，旨在优化预后判断、指导辅助治疗，并确保临床试验设计的一致性。
Abstract
The introduction of neoadjuvant immunotherapy in non-small cell lung cancer (NSCLC) has led to complex tumor responses that challenge conventional pathological assessment. Thus, traditional endpoints such as major pathological response (MPR) and pathological complete response (pCR) may become insufficient to capture the full spectrum of immune-mediated changes. Indeed, these parameters were originally developed in the context of cytotoxic chemotherapy and may not reflect immune-mediated phenomena and stromal remodeling which can significantly alter the appearance of the tumor bed. As a result, MPR and pCR may underrepresent the true extent of biological response in patients treated with immunotherapy. This review outlines current limitations in morphologic evaluation and highlights the need for immune-adapted criteria. Furthermore, it explores the additional value of digital pathology and AI that offer objective and reproducible quantification of histologic features. Integrating these tools with radiologic and molecular data supports a multidimensional approach to response assessment, aiming to refine prognostication, guide adjuvant therapy, and ensure consistency in clinical trial designs.
如何引用
AMA
Federica Pezzuto, Eleonora Faccioli, Omar El Mnif, Giuseppe Maggioni, Francesca Lunardi, Francesco Fortarezza, et al. Reframing tumor bed evaluation in non-small cell lung cancer: histopathological challenges and future directions in the era of neoadjuvant immunotherapy.. Frontiers in oncology. 2026; doi:10.3389/fonc.2026.1716992.
APA
Federica Pezzuto, Eleonora Faccioli, Omar El Mnif, Giuseppe Maggioni, Francesca Lunardi, Francesco Fortarezza, et al (2026). Reframing tumor bed evaluation in non-small cell lung cancer: histopathological challenges and future directions in the era of neoadjuvant immunotherapy.. Frontiers in oncology. https://doi.org/10.3389/fonc.2026.1716992
GB/T 7714
Federica Pezzuto, Eleonora Faccioli, Omar El Mnif, Giuseppe Maggioni, Francesca Lunardi, Francesco Fortarezza, et al. Reframing tumor bed evaluation in non-small cell lung cancer: histopathological challenges and future directions in the era of neoadjuvant immunotherapy.[J]. Frontiers in oncology, 2026 doi:10.3389/fonc.2026.1716992.
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