Otani Koji, Hang Dao Viet, Pittayanon Rapat, Liu Henry, Chuah Kee Huat, Hsiang John, Zhang Ning, Higashimori Akira, Fujiwara Yasuhiro
Department of Gastroenterology, Graduate School of Medicine, Osaka Metropolitan University, Osaka, Japan.
Internal Medicine Faculty, Hanoi Medical University, Hanoi, Vietnam.
J Gastroenterol Hepatol. 2025 Apr;40(4):832-843. doi: 10.1111/jgh.16862. Epub 2024 Dec 26.
Gastric cancer (GC)-related incidence and mortality rates remain high owing to Helicobacter pylori infection in Asia, and the importance of primary and secondary prevention of GC has been well recognized. We aimed to investigate the extent of overall agreement among clinicians in the Asia-Pacific region regarding the management of H. pylori infection.
The Upper Gastrointestinal (GI) Focus Group of the Asian Pacific Association of Gastroenterology-Emerging Leaders Committee developed an international survey, which was distributed to 98 clinicians in the Asia-Pacific region, compromising an online questionnaire focusing on the management of H. pylori infection.
Participants responded from Japan (15, 15.3%), Hong Kong (15, 15.3%), Thailand (33, 33.7%), Vietnam (23, 23.5%), Malaysia (4, 4.1%), Singapore (3, 3.1%), and others (5, 5.1%). The most common first-line eradication regimen was clarithromycin (CAM) triple therapy, including proton pump inhibitor (PPI), amoxicillin (AMPC), and CAM (64.3%) for 14 days (70.4%). The most common second-line eradication regimen was levofloxacin (LVX) triple therapy, including PPI, AMPC, and LVX (22.4%) for 14 days (67.3%). Eradication therapy was deemed necessary for all asymptomatic adults and minors (aged ≤ 17 years) currently infected with H. pylori by 81.6% and 64.3% of respondents, respectively, with 82.7% considering upper GI endoscopy for GC screening useful in the secondary prevention of GC.
There appears to be a growing consensus among clinicians, acknowledging the necessity of eradication therapy. We anticipate that this study will establish a new benchmark in preventive medicine aimed at eradicating GC in the Asia-Pacific region.
在亚洲,由于幽门螺杆菌感染,胃癌(GC)相关的发病率和死亡率仍然很高,胃癌一级和二级预防的重要性已得到充分认识。我们旨在调查亚太地区临床医生在幽门螺杆菌感染管理方面的总体共识程度。
亚太胃肠病学会新兴领导者委员会上消化道(GI)焦点小组开展了一项国际调查,该调查分发给亚太地区的98名临床医生,其中包括一份侧重于幽门螺杆菌感染管理的在线问卷。
参与者来自日本(15人,15.3%)、中国香港(15人,15.3%)、泰国(33人,33.7%)、越南(23人,23.5%)、马来西亚(4人,4.1%)、新加坡(3人,3.1%)以及其他地区(5人,5.1%)。最常见的一线根除方案是克拉霉素(CAM)三联疗法,包括质子泵抑制剂(PPI)、阿莫西林(AMPC)和CAM(64.3%),疗程为14天(70.4%)。最常见的二线根除方案是左氧氟沙星(LVX)三联疗法,包括PPI、AMPC和LVX(22.4%),疗程为14天(67.3%)。分别有81.6%和64.3%的受访者认为,对于目前感染幽门螺杆菌的所有无症状成年人和未成年人(年龄≤17岁),根除治疗是必要的,82.7%的受访者认为上消化道内镜检查用于胃癌筛查对胃癌二级预防有用。
临床医生之间似乎越来越达成共识,承认根除治疗的必要性。我们预计这项研究将在旨在根除亚太地区胃癌的预防医学领域树立一个新的标杆。