引用文本：吕陈彬, 刘绍群, 陆俊. 胃癌新辅助免疫治疗的进展、争议及展望[J/CD]. 消化肿瘤杂志（电子版）, 2026, 18(1): 57-64.

作者：吕陈彬¹，刘绍群²，陆俊³

单位：1. 福建医科大学附属漳州市医院胃外科，福建 漳州 363000；2. 复旦大学附属闵行区中心医院胃肠外科，上海 201100；3. 复旦大学附属肿瘤医院胃外二科，复旦大学上海医学院肿瘤学系，上海 200032

Authors：Lyu Chenbin¹, Liu Shaoqun², Lu Jun³

Unit：1. Department of Gastric Surgery, Zhangzhou Hospital Affiliated to Fujian Medical University, Zhangzhou 363000, Fujian, China；2. Department of Gastrointestinal Surgery, Minhang Hospital, Fudan University, Shanghai 201100, China；3. Second Department of Gastric Surgery, Fudan University Shanghai Cancer Center; Department of Medical Oncology, Shanghai Medical College, Fudan University, Shanghai 200032, China

摘要：

胃癌是全球范围内发病与死亡负担均较重的消化道恶性肿瘤。手术虽是胃癌治疗的核心手段，但在我国，绝大多数患者初诊时已属进展期，错失根治性手术时机。对于进展期胃癌，新辅助或辅助化学治疗联合手术切除已成为东西方治疗指南的推荐方案，但受限于肿瘤异质性及传统化学治疗的疗效瓶颈，进展期胃癌患者术后复发风险依然较高。近年来，免疫检查点抑制剂在进展期胃癌治疗中取得显著的生存获益，推动免疫治疗不断前移，为新辅助治疗方案提供新的选择。然而，新辅助免疫治疗在进展期胃癌中的应用仍处于探索阶段，面临着如何精准筛选获益人群、有效克服耐药机制等诸多挑战。本文旨在系统梳理胃癌新辅助免疫治疗的最新研究进展，分析当前其存在的争议，并展望未来可能的探索方向。

关键词：胃癌；新辅助治疗；免疫检查点抑制剂；免疫治疗

Abstract：

Gastric cancer represents a significant global health burden as a leading cause of morbidity and mortality among gastrointestinal malignancies. While surgery remains the cornerstone of gastric cancer treatment, the majority of patients in China are diagnosed at an advanced stage, with many no longer candidates for curative resection. For locally advanced gastric cancer, neoadjuvant or adjuvant chemotherapy combined with surgical resection has been established as a standard recommendation in both Eastern and Western clinical guidelines. However, due to limitations such as tumor heterogeneity and the efficacy ceiling of conventional chemotherapy, patients with advanced disease continue to face a high risk of postoperative recurrence. In recent years, immune checkpoint inhibitors have demonstrated significant survival benefits in the treatment of advanced gastric cancer, prompting their investigation in earlier lines of treatment and providing new options for neoadjuvant therapeutic strategies. Nevertheless, the application of neoadjuvant immunotherapy in locally advanced gastric cancer remains exploratory, facing multiple challenges including the precise identification of beneficiary populations and effective strategies to overcome resistance mechanisms. This article aims to systematically review the latest research advances in neoadjuvant immunotherapy for gastric cancer, analyze existing controversies, and discuss potential future directions.

Key words：Gastric cancer; Neoadjuvant therapy; Immune checkpoint inhibitor; Immunotherapy

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