韩国内镜筛查间隔 1 年对胃癌临床病理特征和治疗的影响。
Effect of endoscopic screening at 1-year intervals on the clinicopathologic characteristics and treatment of gastric cancer in South Korea.
机构信息
Department of Internal Medicine and Liver Research Institute, Seoul National University College of Medicine, Seoul, South Korea.
出版信息
J Gastroenterol Hepatol. 2012 May;27(5):928-34. doi: 10.1111/j.1440-1746.2011.07038.x.
BACKGROUND AND AIM
The recommended interval of endoscopic screening for gastric cancer (GC) in a general population is 2 years in Korea. However, it has not been determined whether endoscopic screening with a shorter interval is beneficial, especially for high-risk groups.
METHODS
A total of 415 patients with GC were categorized according to whether they had (vigilant screening group) or not (non-vigilant screening group) undergone endoscopic screening within 1 year before being diagnosed with GC. Clinicopathologic GC characteristics of the two groups were compared. Next, the same analyses were conducted in subgroups of patients with high risk for GC including males, current smokers, first-degree relatives of GC; and patients with Helicobacter pylori infection, gastric atrophy, or intestinal metaplasia (IM).
RESULTS
The proportion of vigilant screening patients was 36.1%. Early gastric cancer (EGC) was more frequently observed in the vigilant screening group than the non-vigilant screening group (62.7% vs 49.4%, P = 0.009). In the high-risk factor analyses, EGC was more frequently detected among patients with severe IM in the vigilant screening group than the non-vigilant screening group (66.7% vs 35.5%, P = 0.047). In addition, more patients in the vigilant screening group had undergone endoscopic submucosal dissection (ESD; 26.7% vs 0%, P = 0.008) and had stage I (84.6% vs 41.7%, P = 0.012) than in the non-vigilant screening group.
CONCLUSIONS
Endoscopic screening for GC at 1-year intervals would be beneficial for patients with severe IM in South Korea; this method could detect EGC for which the curative modality would be ESD.
背景与目的
在韩国，一般人群进行胃癌（GC）内镜筛查的推荐间隔为 2 年。然而，尚未确定较短间隔的内镜筛查是否有益，特别是对于高危人群。
方法
总共 415 例 GC 患者根据是否在诊断为 GC 之前的 1 年内接受过内镜筛查（警惕性筛查组）或未接受过内镜筛查（非警惕性筛查组）进行分类。比较两组的临床病理 GC 特征。然后，在包括男性、现吸烟者、GC 一级亲属的 GC 高危人群以及 H. pylori 感染、胃萎缩或肠化生（IM）的患者亚组中进行了相同的分析。
结果
警惕性筛查患者的比例为 36.1%。警惕性筛查组的早期胃癌（EGC）比例高于非警惕性筛查组（62.7% vs 49.4%，P=0.009）。在高危因素分析中，警惕性筛查组中严重 IM 患者中 EGC 的检出率高于非警惕性筛查组（66.7% vs 35.5%，P=0.047）。此外，警惕性筛查组中更多的患者接受了内镜黏膜下剥离术（ESD；26.7% vs 0%，P=0.008）和 I 期（84.6% vs 41.7%，P=0.012）。
结论
在韩国，每 1 年进行一次 GC 内镜筛查对严重 IM 患者有益；这种方法可以检测到 EGC，其治疗方式为 ESD。
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