Haruma Ken, Kamada Tomoari, Murao Takahisa, Yamanaka Yoshiyuki, Ohsawa Motoyasu, Shiotani Akiko, Inoue Kazuhiko
Department of Gastroenterology, Kawasaki Medical School.
Nihon Rinsho. 2013 Aug;71(8):1479-84.
Atrophic gastritis, intestinal metaplasia, and Helicobacter pylori (H. pylori) infection are commonly recognized as the risk factor of gastric cancer. In Japan mass screening by the X-ray examination or endoscopy has been performed for a long time in general population or in work place because of the high death rate and high incidence of gastric cancer. Periodic endoscopy has been recommended for the subjects with atrophic gastritis and/or intestinal metaplasia to detect gastric cancer in early stage. On the other hand, there was no guideline to manage premalignant conditions such as atrophic gastritis, intestinal metaplasia, and dysplasia in foreign countries. Recently the guideline for the management of precancerous conditions and lesions in the stomach (MAPS) has been published by the combined efforts of the European Society of Gastrointestinal Endoscopy, European Helicobacter Study Group, European Society of Pathology, and the Sociedade Portuguesa de Endoscopia Digestiva. In this article the main statements have been discussed on comparing the understandings as the premalignant conditions in Japan.
萎缩性胃炎、肠化生和幽门螺杆菌(H. pylori)感染通常被认为是胃癌的危险因素。在日本,由于胃癌的高死亡率和高发病率,长期以来一直在普通人群或工作场所通过X线检查或内镜进行大规模筛查。对于患有萎缩性胃炎和/或肠化生的受试者,建议定期进行内镜检查以早期发现胃癌。另一方面,在国外没有针对萎缩性胃炎、肠化生和发育异常等癌前病变的管理指南。最近,欧洲胃肠内镜学会、欧洲幽门螺杆菌研究组、欧洲病理学会和葡萄牙消化内镜学会共同努力发布了胃癌前状况和病变管理指南(MAPS)。在本文中,我们将主要讨论日本对癌前状况的理解并进行比较。