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胃癌的诊疗策略
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Abstract:
胃癌是全球最常见恶性肿瘤之一，在中国，其发病率及死亡率均位居“癌谱”第3位，随着预防工作的全面实施及诊疗技术的不断发展，胃癌患者5年生存率也逐步提高，但与日本、韩国等发达国家相比，胃癌的治疗水平仍相对较低。本文通过结合胃癌诊疗指南、相关学术共识以及最新研究成果等，从预防与筛查、诊断、治疗及康复几方面对胃癌的诊疗进行阐述，意旨为胃癌的防治工作提供参考。
Gastric cancer is one of the most common malignant tumors in the world, and its morbidity and mortality rank the third in the malignant tumor in China. With the comprehensive implementation of prevention and continuous development of diagnosis and treatment technology, the 5-year sur-vival rate of patients with gastric cancer has been gradually improved. However, compared with developed countries such as Japan and South Korea, the treatment level of gastric cancer is still rel-atively low. Based on the guidelines for the diagnosis and treatment of gastric cancer, the relevant academic consensus and the latest research achievement, this paper elaborated the diagnosis and treatment of gastric cancer from the aspects of prevention and screening, diagnosis, treatment and rehabilitation, aiming to provide reference for the prevention and treatment of gastric cancer.
| [1] | Sung, H., Ferlay, J., Siegel, R.L., et al. (2021) Global Cancer Statistics 2020: GLOBOCAN Estimates of Incidence and Mortality Worldwide for 36 Cancers in 185 Countries. CA: A Cancer Journal for Clinicians, 71, 209-249.
https://doi.org/10.3322/caac.21660 |
| [2] | 刘宗超, 李哲轩, 张阳, 等. 2020全球癌症统计报告解读[J]. 肿瘤综合治疗电子杂志, 2021, 7(2): 1-13. |
| [3] | Chen, W., Zheng, R., Baade, P.D., et al. (2015) Cancer Statistics in China, 2015. CA: A Cancer Journal for Clinicians, 66, 115-132. https://doi.org/10.3322/caac.21338 |
| [4] | 高梓茗, 徐惠绵. 胃癌精准外科治疗的研究新进展[J]. 中华医学信息导报, 2021, 36(1): 7-8.
https://doi.org/10.3760/cma.j.issn.1000-8039.2021.01.106 |
| [5] | 曹毛毛, 陈万青. 中国恶性肿瘤流行情况及防控现状[J]. 中国肿瘤临床, 2019, 46(3): 145-149. |
| [6] | Lauwers, G.Y., Mullen, J.T., Chelcun Schreiber, K.E. and Chung, D.V. (2014) Familial Gastric Cancers: A Review with Focus on Hereditary Diffuse Gastric Cancer Syndrome. Pathology Case Reviews, 19, 66-73.
https://doi.org/10.1097/PCR.0000000000000030 |
| [7] | Boland, C.R. and Yurgelun, M.B. (2017) Historical Per-spective on Familial Gastric Cancer. Cellular and Molecular Gastroenterology and Hepatology, 3, 192-200. https://doi.org/10.1016/j.jcmgh.2016.12.003 |
| [8] | Pinheiro, H., Oliveira, C., Seruca, R. and Carneiro, F. (2014) Hereditary Diffuse Gastric Cancer—Pathophysiology and Clinical Management. Best Practice & Research Clinical Gas-troenterology, 28, 1055-1068.
https://doi.org/10.1016/j.bpg.2014.09.007 |
| [9] | Kim, J., Cho, Y.A., Choi, W.J. and Jeong, S.H. (2014) Gene-Diet Interactions in Gastric Cancer Risk: A Systematic Review. World Journal of Gastroenterology, 20, 9600-9610. https://doi.org/10.3748/wjg.v20.i28.9600 |
| [10] | Moy, K.A., Fan, Y., Wang, R., et al. (2010) Alcohol and Tobacco Use in Relation to Gastric Cancer: A Prospective Study of Men in Shanghai, China. Cancer Epidemiology Biomarkers & Prevention, 19, 2287-2297.
https://doi.org/10.1158/1055-9965.EPI-10-0362 |
| [11] | Sauid, I. and Lois, N. (2015) Helicobacter pylori and Gastric Cancer: A State of the Art Review. Shaheed Beheshti University of Medical Sciences, 8, S6-S14. |
| [12] | Khatoon, J., Rai, R.P. and Prasad, K.N. (2016) Role of Helicobacter pylori in Gastric Cancer: Updates. World Journal of Gastrointestinal Oncology, 8, 147-158. https://doi.org/10.4251/wjgo.v8.i2.147 |
| [13] | 中国抗癌协会胃癌专业委员会. CACA胃癌整合诊治指南(精简版) [J]. 中国肿瘤临床, 2022, 49(14): 703-710. |
| [14] | 国家癌症中心, 国家肿瘤质控中心胃癌质控专家委员会. 中国胃癌规范诊疗质量控制指标(2022版) [J]. 中华肿瘤杂志, 2022, 44(10): 997-1002. |
| [15] | 中华医学会消化内镜学分会病理学协作组. 中国消化内镜活组织检查与病理学检查规范专家共识(草案) [J]. 中华消化内镜杂志, 2014(9): 481-485. |
| [16] | Bornschein, J., Quante, M. and Jansen, M. (2021) The Complexity of Cancer Origins at the Gastro-Oesophageal Junction. Best Practice & Research Clinical Gastroenterology, 50-51, Article ID: 101729.
https://doi.org/10.1016/j.bpg.2021.101729 |
| [17] | 国际食管疾病学会中国分会(CSDE)食管胃结合部疾病跨界联盟, 中国医师协会内镜医师分会腹腔镜外科专业委员会, 中国医师协会外科医师分会上消化道外科医师专业委员会, 等. 食管胃结合部腺癌外科治疗中国专家共识(2018年版) [J]. 中华胃肠外科杂志, 2018, 21(9): 961-975. |
| [18] | Kim, S.T., Cristescu, R., Bass, A.J., et al. (2018) Comprehensive Molecular Characterization of Clinical Responses to PD-1 Inhibition in Metastatic Gastric Cancer. Nature Medicine, 24, 1449-1458.
https://doi.org/10.1038/s41591-018-0101-z |
| [19] | 中华人民共和国国家卫生和计划生育委员会. 胃癌规范化诊疗指南(试行) [J]. 中国医学前沿杂志(电子版), 2013(8): 56-63. |
| [20] | 张成海, 武爱文, 李子禹, 等. 进展期胃癌脾门区淋巴结转移及其清扫方式[J]. 中华胃肠外科杂志, 2011, 14(8): 589-592. |
| [21] | 焦旭光, 梁寒, 邓靖宇, 等. 进展期胃癌第14v组淋巴结转移的危险因素分析[J]. 中华消化外科杂志, 2014, 13(1): 30-33. |
| [22] | Eom, B.W., Joo, J., Kim, Y.W., et al. (2014) Improved Survival after Adding Dissection of the Superior Mesenteric Vein Lymph Node (14v) to Standard D2 Gastrectomy for Advanced Distal Gastric Cancer. Surgery, 155, 408-416.
https://doi.org/10.1016/j.surg.2013.08.019 |
| [23] | Wu, L., Zhang, C., Liang, Y., et al. (2018) Risk Factors for Metas-tasis to No.14v Lymph Node and Prognostic Value of 14v Status for Gastric Cancer Patients after Surgery. Japanese Journal of Clinical Oncology, 48, 335-342.
https://doi.org/10.1093/jjco/hyy006 |
| [24] | Kurokawa,Y., Takeuchi, H., Doki, Y., et al. (2021) Mapping of Lymph Node Metastasis from Esophagogastric Junction Tumors: A Prospective Nationwide Multicenter Study. Annals of Sur-gery, 274, 120-127.
https://doi.org/10.1097/SLA.0000000000003499 |
| [25] | 李双喜, 李子禹. 食管胃结合部腺癌腹腔镜手术的下纵隔淋巴结清扫边界及质量控制[J]. 中华胃肠外科杂志, 2022, 25(2): 120-123. |
| [26] | Ohira, M., Toyokawa, T., Sa-kurai, K., et al. (2016) Current Status in Remnant Gastric Cancer after Distal Gastrectomy. World Journal of Gastroen-terolog, 22, 2424-2433. https://doi.org/10.3748/wjg.v22.i8.2424 |
| [27] | Yoshida, K., Kodera, Y., Kochi, M., et al. (2019) Addition of Docetaxel to Oral Fluoropyrimidine Improves Efficacy in Patients with Stage III Gastric Cancer: In-terim Analysis of JACCRO GC-07, a Randomized Controlled Trial. Journal of Clinical Oncology, 37, 1296-1304. https://doi.org/10.1200/JCO.18.01138 |
| [28] | Park, S.H., Lim, D.H., Sohn, T.S., et al. (2021) A Randomized Phase III Trial Comparing Adjuvant Single-Agent S1, S-1 with Oxaliplatin, and Postoperative Chemoradiation with S-1 and Oxaliplatin in Patients with Node-Positive Gastric Cancer after D2 Resection: The ARTIST 2 Trial. Annals of Oncology, 32, 368-374.
https://doi.org/10.1016/j.annonc.2020.11.017 |
| [29] | Lee, J., Lim, D.H., Kim, S., et al. (2012) Phase III Trial Com-paring Capecitabine plus Cisplatin versus Capecitabine plus Cisplatin with Concurrent Capecitabine Radiotherapy in Completely Resected Gastric Cancer with D2 Lymph Node Dissection: The ARTIST Trial. Journal of Clinical Oncology, 30, 268-273. https://doi.org/10.1200/JCO.2011.39.1953 |
| [30] | Bang, Y.J., Kim, Y.W., Yang, H.K., et al. (2012) Adjuvant Capecitabine and Oxaliplatin for Gastric Cancer after D2 Gastrectomy (CLASSIC): A Phase 3 Open-Label, Randomised Controlled Trial. The Lancet, 379, 315-321.
https://doi.org/10.1016/S0140-6736(11)61873-4 |
| [31] | Kang, Y.K., Yook, J.H., Park, Y.K., et al. (2021) PRODIGY: A Phase III Study of Neoadjuvant Docetaxel, Oxaliplatin, and S-1 Plus Surgery and Adjuvant S-1 versus Surgery and Adjuvant S-1 for Resectable Advanced Gastric Cancer. Journal of Clinical Oncology, 39, 2903-2913. https://doi.org/10.1200/JCO.20.02914 |
| [32] | Al-Batran, S.E., Homann, N., Pauligk, C., et al. (2019) Perioperative Chemotherapy with Fluorouracil plus Leucovorin, Oxaliplatin, and Docetaxel versus Fluorouracil or Capecitabine plus Cisplatin and Epirubicin for Locally Advanced, Resectable Gastric or Gastro-Oesophageal Junction Adenocarcinoma (FLOT4): A Randomised, Phase 2/3 Trial. The Lancet, 393, 1948-1957. https://doi.org/10.1016/S0140-6736(18)32557-1 |
| [33] | Wagner, A.D., Grabsch, H.I., Mauer, M., et al. (2019) EORTC-1203-GITCG—The “INNOVATION”-Trial: Effect of Chemotherapy Alone versus Chemotherapy plus Trastuzumab, versus Chemotherapy plus Trastuzumab plus Pertuzumab, in the Perioperative Treatment of HER2 Positive, Gastric and Gastroesophageal Junction Adenocarcinoma on Pathologic Response Rate: A Randomized Phase II-Intergroup Trial of the EORTC-Gastrointestinal Tract Cancer Group, Korean Cancer Study Group and Dutch Upper GI-Cancer Group. BMC Cancer, 19, Article No. 494.
https://doi.org/10.1186/s12885-019-5675-4 |
| [34] | Wilke, H., Muro, K., Van Cutsem, E., et al. (2014) Ramucirumab plus Paclitaxel versus Placebo plus Paclitaxel in Patients with Previously Treated Advanced Gastric or Gas-tro-Oesophageal Junction Adenocarcinoma (RAINBOW): A Double-Blind, Randomised Phase 3 Trial. The Lancet On-cology, 15, 1224-1235.
https://doi.org/10.1016/S1470-2045(14)70420-6 |
| [35] | Xu, R.H., Zhang, Y., Pan, H., et al. (2021) Efficacy and Safety of Weekly Paclitaxel with or without Ramucirumab as Second-Line Therapy for the Treatment of Advanced Gas-tric or Gastroesophageal Junction Adenocarcinoma (RAINBOW-Asia): A Randomised, Multicentre, Double-Blind, Phase 3 Trial. The Lancet Gastroenterology and Hepatology, 6, 1015-1024. https://doi.org/10.1016/S2468-1253(21)00313-7 |
| [36] | Peng, Z., Liu, T., Wei, J., et al. (2021) Efficacy and Safety of a Novel Anti-HER2 Therapeutic Antibody RC48 in Patients with HER2-Overexpressing, Locally Advanced or Metastat-ic Gastric or Gastroesophageal Junction Cancer: A Single-Arm Phase II Study. Cancer Communications, 41, 1173-1182. https://doi.org/10.1002/cac2.12214 |
| [37] | Pang, X., Wei, W., Leng, W., et al. (2014) Radiotherapy for Gastric Can-cer: A Systematic Review and Meta-Analysis. Tumour Biology, 35, 387-396. https://doi.org/10.1007/s13277-013-1054-y |
| [38] | Hiramoto, S., Kikuchi, A., Tetsuso, H., et al. (2018) Efficacy of Palliative Radiotherapy and Chemo-Radiotherapy for Unresectable Gastric Cancer Demonstrating Bleeding and Obstruc-tion. International Journal of Clinical Oncology, 23, 1090-1094. https://doi.org/10.1007/s10147-018-1317-0 |
| [39] | 石汉平. 营养治疗的疗效评价[J]. 肿瘤代谢与营养电子杂志, 2017, 4(4): 364-370. |
| [40] | Braga, M., Ljungqvist, O., Soeters, P., et al. (2009) ESPEN Guidelines on Parenteral Nutrition: Surgery. Clinical Nutrition, 28, 378-386. https://doi.org/10.1016/j.clnu.2009.04.002 |
| [41] | Liu, X.X., Jiang, Z.W., Wang, Z.M. and Li, J.S. (2010) Multimodal Optimization of Surgical Care Shows Beneficial Outcome in Gastrectomy Surgery. Journal of Parenteral and Enteral Nutrition, 34, 313-321.
https://doi.org/10.1177/0148607110362583 |
