Yada Tomoyuki, Yokoi Chizu, Uemura Naomi
Department of Gastroenterology, Kohnodai Hospital, National Center for Global Health and Medicine, 1-7-1 Kohnodai, Ichikawa, Chiba 272-8516, Japan.
Diagn Ther Endosc. 2013;2013:241320. doi: 10.1155/2013/241320. Epub 2013 Feb 28.
The prognosis for gastric cancer depends on its stage; so, detection in the early stage of disease is important, when complete and curative removal is possible. Accurate diagnosis can be facilitated by a sound understanding of the basic findings of white light endoscopy of early gastric cancer, and diagnosis can be refined further by the combined use of other imaging modalities such as image-enhanced endoscopy including chromoendoscopy and endoscopic ultrasonography. Minimally invasive endoscopic treatment has come to be the preferred therapeutic approach for early gastric cancer. In addition to conventional endoscopic mucosal resection, a new technique known as endoscopic submucosal dissection (ESD) has spread rapidly worldwide. Indeed, strategies for ESD have been established, devices developed, its indications expanded, and its safety and long-term results extensively reported. Some unique combination therapies involving endoscopy and surgical treatment have also been reported. It is anticipated that the number of patients undergoing endoscopic therapy will continue to increase, and the ongoing developments in endoscopic treatment are expected not only to improve gastric cancer prognosis but also to maintain good quality of life after treatment.
胃癌的预后取决于其分期；因此，在疾病早期进行检测很重要，此时有可能进行完整的根治性切除。对早期胃癌白光内镜的基本表现有充分了解有助于准确诊断，通过联合使用其他成像方式，如图像增强内镜（包括色素内镜）和内镜超声检查，诊断可以进一步细化。微创内镜治疗已成为早期胃癌的首选治疗方法。除了传统的内镜黏膜切除术外，一种名为内镜黏膜下剥离术（ESD）的新技术已在全球迅速推广。事实上，ESD的策略已经确立，设备得到开发，其适应证不断扩大，其安全性和长期结果也有广泛报道。一些涉及内镜和手术治疗的独特联合疗法也有报道。预计接受内镜治疗的患者数量将持续增加，内镜治疗的不断发展不仅有望改善胃癌的预后，还能在治疗后维持良好的生活质量。
