Icaza-Chávez M E, Tanimoto M A, Huerta-Iga F M, Remes-Troche J M, Carmona-Sánchez R, Ángeles-Ángeles A, Bosques-Padilla F J, Blancas-Valencia J M, Grajales-Figueroa G, Hernández-Mondragón O V, Hernández-Guerrero A I, Herrera-Servín M A, Huitzil-Meléndez F D, Kimura-Fujikami K, León-Rodríguez E, Medina-Franco H, Ramírez-Luna M A, Sampieri C L, Vega-Ramos B, Zentella-Dehesa A
Gastroenterología, Consulta privada, Hospital Star Médica de Mérida, Mérida, Yucatán, México.
Departamento de Servicios Auxiliares y Diagnósticos, Instituto Nacional de Ciencias Médicas y Nutrición «Salvador Zubirán», Ciudad de México, México.
Rev Gastroenterol Mex (Engl Ed). 2020 Jan-Mar;85(1):69-85. doi: 10.1016/j.rgmx.2019.10.001. Epub 2019 Dec 16.
Gastric cancer is one of the most frequent neoplasias in the digestive tract and is the result of premalignant lesion progression in the majority of cases. Opportune detection of those lesions is relevant, given that timely treatment offers the possibility of cure. There is no consensus in Mexico on the early detection of gastric cancer, and therefore, the Asociación Mexicana de Gastroenterología brought together a group of experts and produced the "Mexican consensus on the detection and treatment of early gastric cancer" to establish useful recommendations for the medical community. The Delphi methodology was employed, and 38 recommendations related to early gastric cancer were formulated. The consensus defines early gastric cancer as that which at diagnosis is limited to the mucosa and submucosa, irrespective of lymph node metástasis. In Mexico, as in other parts of the world, factors associated with early gastric cancer include Helicobacter pylori infection, a family history of the disease, smoking, and diet. Chromoendoscopy, magnification endoscopy, and equipment-based image-enhanced endoscopy are recommended for making the diagnosis, and accurate histopathologic diagnosis is invaluable for making therapeutic decisions. The endoscopic treatment of early gastric cancer, whether dissection or resection of the mucosa, should be preferred to surgical management, when similar oncologic cure results can be obtained. Endoscopic surveillance should be individualized.
胃癌是消化道最常见的肿瘤之一，在大多数情况下是癌前病变进展的结果。鉴于及时治疗有可能治愈，对这些病变进行适时检测至关重要。在墨西哥，对于胃癌的早期检测尚无共识，因此，墨西哥胃肠病学协会召集了一组专家，制定了《墨西哥早期胃癌检测与治疗共识》，为医学界提供有用的建议。采用了德尔菲法，制定了38条与早期胃癌相关的建议。该共识将早期胃癌定义为诊断时局限于黏膜和黏膜下层的癌症，无论有无淋巴结转移。在墨西哥，与世界其他地区一样，与早期胃癌相关的因素包括幽门螺杆菌感染、家族病史、吸烟和饮食。建议采用色素内镜检查、放大内镜检查和基于设备的图像增强内镜检查进行诊断，准确的组织病理学诊断对于做出治疗决策非常重要。当能获得相似的肿瘤治愈效果时，早期胃癌的内镜治疗，无论是黏膜剥离还是切除，都应优先于手术治疗。内镜监测应个体化。
