Currently, there are no internationally accepted consensus guidelines for pathologic evaluation of posttherapy pancreatectomy specimens. The Neoadjuvant Therapy Working Group of Pancreatobiliary Pathology Society was formed in 2018 to review grossing protocols, literature, and major issues and to develop recommendations for pathologic evaluation of posttherapy pancreatectomy specimens. The working group generated the following recommendations: (1) Systematic and standardized grossing and sampling protocols should be adopted for pancreatectomy specimens for treated pancreatic ductal adenocarcinoma (PDAC). (2) Consecutive mapping sections along the largest gross tumor dimension are recommended to validate tumor size by histology as required by the College of American Pathologists (CAP) cancer protocol. (3) Tumor size of treated PDACs should be measured microscopically as the largest dimension of tumor outer limits that is bound by viable tumor cells, including intervening stroma. (4) The MD Anderson grading system for tumor response has a better correlation with prognosis and better interobserver concordance among pathologists than does the CAP system. (5) A case should not be classified as a complete response unless the entire pancreas, peripancreatic tissues, ampulla of Vater, common bile duct, and duodenum adjacent to the pancreas are submitted for microscopic examination. (6) Future studies on tumor response of lymph node metastases, molecular and/or immunohistochemical markers, as well as application of artificial intelligence in grading tumor response of treated PDAC are needed. In summary, systematic, standardized pathologic evaluation, accurate tumor size measurement, and reproducible tumor response grading to neoadjuvant therapy are needed for optimal patient care. The criteria and discussions provided here may provide guidance towards these goals.

目前，对于胰腺切除术后标本的病理评估，尚无国际公认的共识指南。胰胆病理学会新辅助治疗工作组于 2018 年成立，负责审查总体方案、文献和主要问题，并为治疗后胰腺切除标本的病理评估制定建议。工作组提出以下建议：（1）治疗胰腺导管腺癌（PDAC）的胰腺切除标本应采用系统化、标准化的粗略和采样方案。(2) 建议按照美国病理学家学会 (CAP) 癌症方案的要求，沿最大肿瘤总尺寸进行连续绘图切片，以通过组织学验证肿瘤大小。(3) 经处理的 PDAC 的肿瘤大小应在显微镜下测量为由活肿瘤细胞（包括间质基质）结合的肿瘤外部界限的最大尺寸。(4)与CAP系统相比，MD安德森肿瘤反应分级系统与预后具有更好的相关性，并且病理学家之间的观察者间一致性更好。(5)除非整个胰腺、胰周组织、Vater壶腹部、胆总管和邻近胰腺的十二指肠都进行镜检，否则不应将病例归类为完全缓解。(6) 未来需要对淋巴结转移的肿瘤反应、分子和/或免疫组化标记物以及人工智能在治疗 PDAC 的肿瘤反应分级中的应用进行研究。总之，为了获得最佳的患者护理，需要系统、标准化的病理评估、准确的肿瘤大小测量以及对新辅助治疗的可重复的肿瘤反应分级。这里提供的标准和讨论可以为实现这些目标提供指导。