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胃癌:临床特征、筛查、诊断、治疗与预防

Gastric Cancer: Clinical Features, Screening, Diagnosis, Treatment, and Prevention.

作者信息

Ramachandran Rajarajeshwari, Grantham Tyler, Parvataneni Swetha, Budh Deepa, Gollapalli Sindhu, Reddy Madhavi, Gaduputi Vinaya

机构信息

Department of Gastroenterology, The Brooklyn Hospital Center, 121 Dekalb Avenue, Brooklyn, NY 11201, USA.

Department of Internal Medicine, Staten Island University Hospital, 475 Seaview Avenue, Staten Island, NY 10305, USA.

出版信息

J Community Hosp Intern Med Perspect. 2024 Mar 4;14(2):49-57. doi: 10.55729/2000-9666.1304. eCollection 2024.

Abstract

The objective of this article is to highlight the clinical features, screening, diagnosis, treatment, and prevention of gastric cancer (GC). Early GC is often asymptomatic leading to frequent delays in diagnosis. Weight loss and persistent abdominal pain are the most common symptoms at initial diagnosis. The diagnosis of GC typically involves a combination of endoscopy, biopsy, and imaging studies. Endoscopic resection techniques are emerging as successful treatment options for early GC. Treatment options for advanced GC include surgery and chemotherapy. The first line chemotherapy for advanced GC consists of doublet therapy with a combination of platinum and fluoropyrimidines. Trastuzumab, a monoclonal antibody, is used in the treatment of human epidermal growth factor 2 positive GCs. Antiangiogenic agents and immunotherapy are also useful in the treatment of GC. Currently there are no GC screening guidelines in the United States, but they exist in other regions where there is increased prevalence of GC. Prevention strategies for GC include eradication and adoption of a healthy diet consisting of fruits and vegetables.

摘要

本文的目的是强调胃癌(GC)的临床特征、筛查、诊断、治疗和预防。早期胃癌通常无症状,导致诊断经常延迟。体重减轻和持续性腹痛是初诊时最常见的症状。胃癌的诊断通常需要内镜检查、活检和影像学检查相结合。内镜切除技术正在成为早期胃癌成功的治疗选择。晚期胃癌的治疗选择包括手术和化疗。晚期胃癌的一线化疗由铂类和氟嘧啶联合的双联疗法组成。曲妥珠单抗,一种单克隆抗体,用于治疗人表皮生长因子2阳性的胃癌。抗血管生成药物和免疫疗法在胃癌治疗中也很有用。目前美国没有胃癌筛查指南,但在胃癌患病率较高的其他地区有相关指南。胃癌的预防策略包括根除幽门螺杆菌以及采用由水果和蔬菜组成的健康饮食。

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