Department of Gastroenterology, The University of Tokyo Hospital, 7-3-1, Hongo, Bunkyo-ku, Tokyo 113-8655, Japan.
Curr Oncol. 2022 Jul 4;29(7):4678-4688. doi: 10.3390/curroncol29070371.
Although the mortality rates of gastric cancer (GC) are gradually declining, gastric cancer is still the fourth leading cause of cancer-related death worldwide. This may be due to the high rate of patients who are diagnosed with GC at advanced stages. However, in countries such as Japan with endoscopic screening systems, more than half of GCs are discovered at an early stage, enabling endoscopic resection (ER). Especially after the introduction of endoscopic submucosal dissection (ESD) in Japan around 2000, a high en bloc resection rate allowing pathological assessment of margin and depth has become possible. While ER is a diagnostic method of treatment and may not always be curative, it is widely accepted as standard treatment because it is less invasive than surgery and can provide an accurate diagnosis for deciding whether additional surgery is necessary. The curability of ER is currently assessed by the completeness of primary tumor removal and the possibility of lymph node metastasis. This review introduces methods, indications, and curability criteria for ER of EGC. Despite recent advances, several problems remain unsolved. This review will also outline the latest evidence concerning future issues.
尽管胃癌（GC）的死亡率在逐渐下降，但胃癌仍然是全球癌症相关死亡的第四大主要原因。这可能是由于诊断为 GC 的患者在晚期的比例较高。然而，在日本等拥有内镜筛查系统的国家，超过一半的 GC 在早期被发现，从而能够进行内镜下切除（ER）。特别是在 2000 年左右日本引入内镜黏膜下剥离术（ESD）后，ER 的整块切除率更高，允许对边缘和深度进行病理评估成为可能。虽然 ER 是一种治疗性诊断方法，并不总是能治愈，但由于其侵袭性小于手术，并且能够为是否需要额外手术提供准确的诊断，因此被广泛接受为标准治疗方法。ER 的可治愈性目前通过原发性肿瘤切除的完整性和淋巴结转移的可能性来评估。本综述介绍了 EGC 的 ER 的方法、适应证和可治愈性标准。尽管最近取得了一些进展，但仍存在一些尚未解决的问题。本文还将概述有关未来问题的最新证据。
