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Gastric cancer: Prevention, screening and early diagnosis

医学 幽门螺杆菌 癌症 癌症筛查 活检 癌症预防 重症监护医学 不利影响 内科学
作者
Pasechnikov Vd,Sergey Z Chukov,Е. Д. Федоров,Ilze Ķikuste,Mārcis Leja
出处
期刊:World Journal of Gastroenterology [Baishideng Publishing Group Co]
卷期号:20 (38): 13842-13842 被引量:355
标识
DOI:10.3748/wjg.v20.i38.13842
摘要

Gastric cancer continues to be an important healthcare problem from a global perspective.Most of the cases in the Western world are diagnosed at late stages when the treatment is largely ineffective.Helicobacter pylori (H.pylori ) infection is a well-established carcinogen for gastric cancer.While lifestyle factors are important, the efficacy of interventions in their modification, as in the use of antioxidant supplements, is unconvincing.No organized screening programs can be found outside Asia (Japan and South Korea).Although several screening approaches have been proposed, including indirect atrophy detection by measuring pepsinogen in the circulation, none of them have so far been implemented, and more study data is required to justify any implementation.Mass eradication of H. pylori in high-risk areas tends to be cost-effective, but its adverse effects and resistance remain a concern.Searches for new screening biomarkers, including mi-croRNA and cancer-autoantibody panels, as well as detection of volatile organic compounds in the breath, are in progress.Endoscopy with a proper biopsy follow-up remains the standard for early detection of cancer and related premalignant lesions.At the same time, new advanced high-resolution endoscopic technologies are showing promising results with respect to diagnosing mucosal lesions visually and targeting each biopsy.New histological risk stratifications (classifications), including OLGA and OLGIM, have recently been developed.This review addresses the current means for gastric cancer primary and secondary prevention, the available and emerging methods for screening, and new developments in endoscopic detection of early lesions of the stomach.
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