White Jonathan R, Banks Matthew
NIHR Nottingham Biomedical Research Centre, Nottingham University Hospitals NHS Trust and the University of Nottingham, Nottingham, UK.
Nottingham Digestive Diseases Centre, The University of Nottingham, Nottingham, UK.
Transl Gastroenterol Hepatol. 2022 Jan 25;7:8. doi: 10.21037/tgh.2020.03.03. eCollection 2022.
Gastric adenocarcinoma develops after stepwise progression from normal mucosa through to adenocarcinoma most commonly after being triggered by (. ) infection. As disease is often diagnosed late, the prognosis for gastric adenocarcinoma is poor. Identifying pre-malignant mucosal lesions such as atrophic gastritis, intestinal metaplasia and dysplasia is one strategy adopted by clinicians to reduce cancer related mortality. Surveillance of high-risk individuals and endoscopic resection of dysplastic lesions is recommended by international and UK guidelines. The early detection and endoscopic management reduce the need for invasive surgery. The advancement of image enhanced endoscopy technology, endoscopic training, risk stratification and histological assessment has proven pivotal to the management of pre-malignant lesions. In this review we outline the development of a high-risk stomach, endoscopic assessment and review practical guidelines on identifying pre-malignant gastric mucosa.
胃腺癌通常在（.）感染引发后，从正常黏膜逐步发展至腺癌。由于疾病往往在晚期才被诊断出来，胃腺癌的预后较差。识别癌前黏膜病变，如萎缩性胃炎、肠化生和发育异常，是临床医生为降低癌症相关死亡率所采用的一种策略。国际和英国指南建议对高危个体进行监测，并对发育异常病变进行内镜切除。早期检测和内镜治疗减少了侵入性手术的需求。图像增强内镜技术、内镜培训、风险分层和组织学评估的进步已被证明对癌前病变的管理至关重要。在本综述中，我们概述了高危胃的发展、内镜评估，并回顾了识别癌前胃黏膜的实用指南。
