Cao Yue, Wang Dongcai, Mo Guiyun, Peng Yinghui, Li Zengzheng
Emergency of Department, Yunnan Provincial Hospital of Traditional Chinese Medicine, The First Affiliated Hospital of Yunnan University of Traditional Chinese Medicine, Kunming, China.
Emergency Teaching and Research Department of the First Clinical School of Yunnan University of Traditional Chinese Medicine, Kunming, China.
Front Oncol. 2023 Aug 30;13:1226652. doi: 10.3389/fonc.2023.1226652. eCollection 2023.
Patients with gastric precancerous lesions (GPL) have a higher risk of gastric cancer (GC). However, the transformation of GPL into GC is an ongoing process that takes several years. At present, several factors including H.Pylori (Hp), flora imbalance, inflammatory factors, genetic variations, Claudin-4, gastric stem cells, solute carrier family member 26 (SLC26A9), bile reflux, exosomes, and miR-30a plays a considerable role in the transformation of GPL into GC. Moreover, timely intervention in the event of GPL can reduce the risk of GC. In clinical practice, GPL is mainly treated with endoscopy, acid suppression therapy, Hp eradication, a cyclooxygenase-2 inhibitor, aspirin, and diet. Currently, the use of traditional Chinese medicine (TCM) or combination with western medication to remove Hp and the use of TCM to treat GPL are common in Asia, particularly China, and have also demonstrated excellent clinical efficacy. This review thoroughly discussed the combining of TCM and Western therapy for the treatment of precancerous lesions as conditions allow. Consequently, this review also focuses on the causes of the development and progression of GPL, as well as its current treatment. This may help us understand GPL and related treatment.
胃癌前病变（GPL）患者患胃癌（GC）的风险更高。然而，GPL向GC的转变是一个持续数年的过程。目前，包括幽门螺杆菌（Hp）、菌群失调、炎症因子、基因变异、Claudin-4、胃干细胞、溶质载体家族成员26（SLC26A9）、胆汁反流、外泌体和miR-30a等多种因素在GPL向GC的转变中起着相当重要的作用。此外，在GPL发生时及时干预可降低GC的风险。在临床实践中，GPL主要通过内镜检查、抑酸治疗、根除Hp、使用环氧化酶-2抑制剂、阿司匹林和饮食进行治疗。目前，在亚洲尤其是中国，使用中药（TCM）或中西医结合来根除Hp以及使用中药治疗GPL很常见，并且也已显示出优异的临床疗效。本综述在条件允许的情况下深入探讨了中西医结合治疗癌前病变的情况。因此，本综述还聚焦于GPL发生发展的原因及其当前的治疗方法。这可能有助于我们了解GPL及相关治疗。
