胃肠肿瘤病理诊断与分期更新要点:从UICC/AJCC第9版TNM分期到结构化报告的同质化实践OA

With the implementation of the UICC/AJCC 9th edition TNM staging system,reporting of gastrointesti-nal tumors is shifting from narrative formats toward structured,clinically actionable models.This review summarizes key updates across tumors of the esophagus,stomach,small intestine,appendix,colorectum,and anal canal,empha-sizing changes with direct implications for diagnostic practice and multidisciplinary management.Major advances in-clude post-therapy staging based on viable tumor assessment;standardized reporting of tumor deposits(TD)alongside extramural vascular invasion(EMVI)and perineural invasion(PNI)in colorectal carcinoma;refined criteria for cir-cumferential resection margin(CRM)and tumor regression grade(TRG)evaluation;subclassification of M1a/M1b disease in appendiceal mucinous neoplasms;and emerging integration of molecular stratification into therapeutic algo-rithms.Drawing on structured datasets from the International Collaboration on Cancer Reporting(ICCR)and the Col-lege of American Pathologists(CAP),we propose core synoptic elements and practical implementation strategies aligned with contemporary precision oncology frameworks.This review underscores the role of structured TNM report-ing in enhancing reproducibility,prognostic stratification,and clinical decision support in gastrointestinal oncology.