Department of Medicine (DIMED), Surgical Pathology and Cytopathology Unit, University of Padova, Padova, Italy.
Veneto Tumor Registry (RTV), Veneto Regional Authority, Padova, Italy.
Helicobacter. 2019 Apr;24(2):e12571. doi: 10.1111/hel.12571. Epub 2019 Feb 17.
Gastric cancer (GC) ranks among the most lethal epithelial malignancies, and its striking mortality rate prompts a global prevention strategy. Helicobacter pylori (H. pylori) gastritis is the main GC promoter, and the 2014 Global Kyoto conference recognized H. pylori gastritis as a (treatable) infectious disease. It is therefore plausible that any large-scale intervention for H. pylori eradication would result in cleansing the world of the fifth cause of cancer-related death. Atrophic gastritis is the cancerization field in which GCs (both intestinal and diffuse histotypes) mainly develop. Discontinuing the inflammatory cascade triggered by H. pylori is tantamount to preventing GC. For patients (still infected or eradicated) who have already developed gastric atrophy, the severity/topography of the atrophic changes correlates with their cancer risk. Gastritis OLGA (Operative Link for Gastritis Assessment) staging consistently ranks the atrophy-associated cancer risk, providing a solid clinical/biological rationale for establishing patient-specific surveillance programs. By combining primary and secondary prevention strategies, gastric cancer is a preventable disease.
胃癌（GC）是最致命的上皮恶性肿瘤之一，其惊人的死亡率促使人们制定了全球预防策略。幽门螺杆菌（H. pylori）胃炎是主要的 GC 促进因素，2014 年全球京都会议将 H. pylori 胃炎确认为（可治疗的）传染病。因此，大规模根除 H. pylori 的干预措施很可能会清除世界上第五大致癌死亡原因。萎缩性胃炎是 GC（肠型和弥漫型组织学类型）主要发生的癌前病变领域。阻止 H. pylori 引发的炎症级联反应等同于预防 GC。对于已经患有胃萎缩的患者（仍被感染或已根除），萎缩的严重程度/部位与他们的癌症风险相关。胃炎 OLGA（胃炎评估操作链接）分期一致地评估与萎缩相关的癌症风险，为制定针对特定患者的监测计划提供了坚实的临床/生物学依据。通过结合一级和二级预防策略，胃癌是一种可预防的疾病。
