Leung Wai K, Wu Ming-shiang, Kakugawa Yasuo, Kim Jae J, Yeoh Khay-guan, Goh Khean Lee, Wu Kai-chun, Wu Deng-chyang, Sollano Jose, Kachintorn Udom, Gotoda Takuji, Lin Jaw-town, You Wei-cheng, Ng Enders K W, Sung Joseph J Y
Institute of Digestive Disease, Chinese University of Hong Kong, Hong Kong, China.
Lancet Oncol. 2008 Mar;9(3):279-87. doi: 10.1016/S1470-2045(08)70072-X.
Gastric cancer is the second most common cause of death from cancer in Asia. Although surgery is the standard treatment for this disease, early detection and treatment is the only way to reduce mortality. This Review summarises the epidemiology of gastric cancer, and the evidence for, and current practices of, screening in Asia. Few Asian countries have implemented a national screening programme for gastric cancer; most have adopted opportunistic screening of high-risk individuals only. Although screening by endoscopy seems to be the most accurate method for detection of gastric cancer, the availability of endoscopic instruments and expertise for mass screening remains questionable--even in developed countries such as Japan. Therefore, barium studies or serum-pepsinogen testing are sometimes used as the initial screening tool in some countries, and patients with abnormal results are screened by endoscopy. Despite the strong link between infection with Helicobacter pylori and gastric cancer, more data are needed to define the role of its eradication in the prevention of gastric cancer in Asia. At present, there is a paucity of quality data from Asia to lend support for screening for gastric cancer.
在亚洲，胃癌是癌症致死的第二大常见病因。尽管手术是这种疾病的标准治疗方法，但早期发现和治疗是降低死亡率的唯一途径。本综述总结了胃癌的流行病学，以及亚洲筛查的证据和当前做法。很少有亚洲国家实施全国性的胃癌筛查计划；大多数国家仅对高危个体采用机会性筛查。尽管内镜检查似乎是检测胃癌最准确的方法，但即使在日本这样的发达国家，用于大规模筛查的内镜设备和专业技术的可及性仍存在疑问。因此，在一些国家，钡餐检查或血清胃蛋白酶原检测有时被用作初始筛查工具，结果异常的患者再通过内镜检查进行筛查。尽管幽门螺杆菌感染与胃癌之间存在紧密联系，但仍需要更多数据来确定根除幽门螺杆菌在亚洲预防胃癌中的作用。目前，亚洲缺乏高质量数据来支持胃癌筛查。
