【摘要】 目的 总结消化道癌（食管癌、胃癌和结直肠癌）新辅助治疗（NAT）后原发肿瘤及淋巴结病理评估的现状及存在问题，并探讨未来可能的发展方向。方法 以“食管癌、胃癌、结直肠癌、新辅助治疗、原发肿瘤、淋巴结、肿瘤退缩分级”为中文关键词；以“esophageal cancer、gastric cancer、colorectal cancer、neoadjuvant therapy、primary tumor、lymph node、tumor regression grading”为英文关键词，检索PubMed及中国知网数据库2005-01-01-2025-01-01相关文献。纳入标准：与消化道癌NAT后原发肿瘤及淋巴结肿瘤退缩分级相关的研究。排除标准：重复及质量差的文献。最终共纳入文献48篇。结果 研究表明，NAT后准确的病理评估可以反映临床治疗方案的疗效，同时也为后续治疗方案提供依据和指导。但目前国内、外NAT后消化道癌的病理评估主要着眼于原发肿瘤，且体系众多，尚未完全达成一致的标准及共识；同时存在一些问题亟待解决。另外，近年来针对NAT后消化道癌转移性淋巴结内的肿瘤退缩评估，也不乏一些具有创新意义的研究。结论 对于NAT后的消化道癌病例，原发肿瘤和淋巴结转移病灶的肿瘤退缩评估对患者的生存和预后非常重要。但评估体系种类繁多，各有优劣，尚需更庞大、更有力的循证医学依据，逐步建立统一的分级标准，从而形成更有执行性、更具预测性的指南共识以指导临床实践工作。更多还原

【Abstract】 Objective To summarize the current status and existing problems in pathological evaluation of primary tumors and lymph nodes after neoadjuvant therapy(NAT)for gastrointestinal cancers(esophageal cancer,gastric cancer,and colorectal cancer),and to investigate future potential developments.Methods Literature searches were systematically conducted in the PubMed and CNKI databases by using combined Chinese and English keywords,including "esophageal cancer,gastric cancer,colorectal cancer,neoadjuvant therapy,primary tumor,lymph node,tumor regression grading" from January 1,2005,to January 1,2025.Inclusion criteria:Studies related to tumor regression grading of primary tumors and lymph nodes after NAT for gastrointestinal cancers.Exclusion criteria:Duplicate or low-quality literature.A total of 48 articles were finally included.Results Studies have demonstrated that accurate pathological evaluation following NAT can reliably reflect the efficacy of clinical treatment protocols and offer a robust foundation for subsequent therapeutic planning.However,current domestic and international pathological evaluations of gastrointestinal cancers after NAT predominantly focus on primary tumors.Moreover,numerous disparate systems exist,and no universally consistent standards or consensus have been established.Furthermore,several critical issues persist and require urgent resolution.Notably,recent years have seen emerging studies on innovative evaluation of tumor regression in metastatic lymph nodes of gastrointestinal cancers after NAT.Conclusion For gastrointestinal cancer cases after NAT,tumor regression evaluation of both primary tumors and lymph node metastases is crucial for patient survival and prognosis.However,owing to the diversity of evaluation systems,each with its own advantages and disadvantages,more robust evidence from largescale studies is needed to gradually establish universally accepted grading standards and form more actionable and predictive guidelines for clinical practice.更多还原