Gomez Justin M, Wang Andrew Y
Dr Gomez is a clinical instructor in the Department of Medicine and Dr Wang is an associate professor of medicine in the Division of Gastroenterology and Hepatology at the University of Virginia in Charlottesville, Virginia.
Gastroenterol Hepatol (N Y). 2014 Jun;10(6):369-78.
Gastric cancer remains the fifth leading cancer diagnosis worldwide, and it is the third leading cause of cancer-related mortality. The incidence of gastric cancer within the United States, however, has remained substantially lower than elsewhere, which has led to a lack of screening and surveillance in clinical practice. Patients with known premalignant lesions, such as gastric intestinal metaplasia, which can increase the risk of gastric cancer by as much as 6-fold, might benefit from surveillance guidelines to detect gastric cancer at an earlier, potentially curative stage. Chro-moendoscopy with optical magnification, narrow-band imaging, and other image-enhanced endoscopic techniques are commercially available to assist in the diagnosis of premalignant gastric lesions and early gastric cancer. Furthermore, endoscopic mucosal resection and endoscopic submucosal dissection have become more widely available and offer potentially curative endoscopic resection for dysplastic lesions of the stomach and early gastric cancers, which is an alternative to traditional surgical resection.
胃癌仍然是全球第五大常见癌症诊断类型，并且是癌症相关死亡的第三大主要原因。然而，美国国内的胃癌发病率一直显著低于其他地区，这导致临床实践中缺乏筛查和监测。已知的癌前病变患者，如胃化生，其患胃癌的风险可增加多达6倍，这些患者可能会受益于监测指南，以便在更早的、可能治愈的阶段检测出胃癌。带有光学放大功能的染色内镜检查、窄带成像和其他图像增强内镜技术已商业化应用，以协助诊断癌前胃部病变和早期胃癌。此外，内镜下黏膜切除术和内镜黏膜下剥离术已得到更广泛应用，并为胃发育异常病变和早期胃癌提供了可能治愈的内镜切除方法，这是传统手术切除的一种替代方案。
