進行胃癌に対する病理診断・バイオマーカー検査

Pathology Diagnosis and Biomarker Testing for Advanced Gastric Cancers

要旨●進行胃癌に対する分子標的治療薬適応判定に必要な4つのバイオマーカーが存在する．いずれも患者の治療方針決定に直結する情報であり，日本胃癌学会は「切除不能進行・再発胃癌バイオマーカー検査の手引き」において，一次治療前にすべてのバイオマーカー検査の実施を推奨している．胃癌の病理診断に関わるすべての病理医は，これらバイオマーカー検査の意味を理解し，適切なタイミングで検査を実施できる体制を整える必要がある．あわせて，バイオマーカー検査で求められる病理組織検体の品質について，検体採取に関わる診療科を含めた施設内での情報共有も重要である．

　Four established biomarkers are necessary for identifying the applicability of molecular targeted therapy for advanced gastric cancer. Each biomarker result provides crucial information directly related to determining the patient's treatment plan. The Japanese Gastric Cancer Association recommends performing all biomarker tests before first-line therapy, as outlined in the “Guidelines for Biomarker Testing in Unresectable Advanced and Recurrent Gastric Cancer.” All pathologists involved in the pathological diagnosis of gastric cancer should understand the significance of these biomarker tests and develop a system to perform them at the appropriate time. Additionally, sharing information within the institution is essential. Additionally, clinical departments, such as endoscopy and surgery, involved in specimen collection should cooperate with the pathology department to achieve the high quality of pathological tissue specimens necessary for biomarker testing.