间隔期胃癌：提高警惕并采取行动。

Interval gastric cancer: A call to attentiveness and action.

机构信息

Cirugía Gastrointestinal y Endoscopia Clínica las Américas, Medellín, Antioquía, Colombia; Grupo de Gastro-Hepatología, Universidad de Antioquia, Medellín, Antioquía, Colombia; Instituto de Cancerología, Clínica las Américas, Medellín, Antioquía, Colombia.

Cirugía Gastrointestinal y Endoscopia Clínica las Américas, Medellín, Antioquía, Colombia; Instituto de Cancerología, Clínica las Américas, Medellín, Antioquía, Colombia.

出版信息

Rev Gastroenterol Mex (Engl Ed). 2023 Apr-Jun;88(2):91-99. doi: 10.1016/j.rgmxen.2022.05.015. Epub 2022 May 31.

DOI:10.1016/j.rgmxen.2022.05.015

PMID:35659441

Abstract

INTRODUCTION AND AIMS

Endoscopy is the most effective method for identifying gastric adenocarcinoma (GAC). Interval gastric cancer (IGC) is GAC that is diagnosed 2-3 years after a normal endoscopy. Its characteristics are unknown in the Colombian environment. The clinical, histopathologic, and endoscopic characteristics were evaluated, along with the presentation rate, proton pump inhibitor (PPI) use, and IGC survival rate, and compared with other types of GAC.

METHODS

A retrospective, analytic study was conducted on a prospective cohort. It evaluated 513 patients with GAC treated at our institution, within the time frame of January 2012 and June 2018. The patients had endoscopic diagnosis of GAC and endoscopy within the past three years that was negative for tumor.

RESULTS

A total of 513 patients diagnosed with GAC were evaluated. Forty-two of the patients had IGC (8.2%): 9 early lesions and 33 advanced lesions (79%). The IGCs were smaller (31 vs. 41 mm; P < .01), as well as flatter and more depressed (P < .01). There was no association with PPI use, but there was an association with a history of gastrectomy and anastomosis (P = .02), as well as the absence of red flags (P < .003). The most frequent locations were the gastric body (52%) and the antrum (26%). Overall two-year survival was similar between IGC and GAC (37.1 vs. 39.3%, P = .72).

CONCLUSION

A total of 8.2% of recently diagnosed GAC were cases of IGC. The presence of anastomosis and the absence of red flags were related to IGC. Overall survival was poor and there were no differences from the other types of GAC detected.

摘要

简介和目的

内镜检查是识别胃腺癌（GAC）最有效的方法。间隔期胃癌（IGC）是指在正常内镜检查后 2-3 年内诊断出的 GAC。在哥伦比亚环境中，其特征尚不清楚。评估了临床、组织病理学和内镜特征，以及表现率、质子泵抑制剂（PPI）的使用情况和 IGC 的生存率，并与其他类型的 GAC 进行了比较。

方法

对前瞻性队列进行回顾性、分析性研究。评估了 2012 年 1 月至 2018 年 6 月在我院治疗的 513 例 GAC 患者。这些患者有 GAC 的内镜诊断和过去三年内无肿瘤的内镜检查。

结果

共评估了 513 例诊断为 GAC 的患者。其中 42 例为 IGC（8.2%）：9 例早期病变和 33 例晚期病变（79%）。IGC 较小（31 与 41mm；P<0.01），更平坦且更凹陷（P<0.01）。与 PPI 使用无关，但与胃切除术和吻合术史有关（P=0.02），且无危险信号（P<0.003）。最常见的部位是胃体（52%）和胃窦（26%）。IGC 和 GAC 的总两年生存率相似（37.1%与 39.3%，P=0.72）。