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GUT:胃癌前病变监测有效性研究

2018-06-07 zhangfan MedSci原创

研究发现,对于胃癌风险较低地区,规律的内镜监控可有效的发现癌前病变,实现早期干预,降低肿瘤进展风险。同时血清学标志物是对患者进行分层实现精确治疗的有效途径

现行指南推荐使用内镜监测胃癌前病变,然而胃癌前病变的诊断率和对肿瘤的预防效果研究尚不充分。近日研究人员就胃癌前病变进展的发生率和不同血清学标志物检查的效果进行了考察。

研究在胃癌发病率较低的荷兰及挪威开展,患有萎缩性胃炎(AG)、肠上皮化生(IM)或异型增生患者进行内镜监测。所有组织标本依据最新的悉尼分类和胃肠化生(Olgim)系统进行评估,同时测定患者血清胃蛋白酶原(PG)和胃泌素-17(gastrin-17)水平。

279名患者参与研究,平均年龄57.9岁,女性142人,参与者随访期间至少接受了1次内镜检查,随访57个月。随访期间,4名患者(1.4%)确诊为高级别腺瘤/异型增生或侵袭性肿瘤,其中2名患者成功地进行了内镜下黏膜下剥离术,另外2名患者接受了全胃切除术。相比于PGI/II≤3和或 OGLIM分期III-IV期的AG/IM患者,PGI/II>3和或 OGLIM分期0-II期的AG/IM患者随访期间高级别腺瘤/异型增生或侵袭性肿瘤风险较低。

研究发现,对于胃癌风险较低地区,规律的内镜监控可有效的发现癌前病变,实现早期干预,降低肿瘤进展风险。同时血清学标志物是对患者进行分层实现精确治疗的有效途径。

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  2. [GetPortalCommentsPageByObjectIdResponse(id=1587028, encodeId=cf9f158e0280b, content=<a href='/topic/show?id=f27a83229f7' target=_blank style='color:#2F92EE;'>#胃癌前病变#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=87, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=83229, encryptionId=f27a83229f7, topicName=胃癌前病变)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=2e6917418548, createdName=wangbingxhy, createdTime=Sat Jun 09 04:47:00 CST 2018, time=2018-06-09, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=322280, encodeId=d87f322280f3, content=学习了谢谢分享, beContent=null, objectType=article, channel=null, level=null, likeNumber=107, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=http://cacheapi.medsci.cn/resource/upload/20160304/IMG56D94856B1B5D6405.jpg, createdBy=27931687771, createdName=一个字-牛, createdTime=Thu Jun 07 17:05:44 CST 2018, time=2018-06-07, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=322276, encodeId=9b633222e6e3, content=预防胜于治疗., beContent=null, objectType=article, channel=null, level=null, likeNumber=104, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=60791943465, createdName=1e0f8808m18(暂无匿称), createdTime=Thu Jun 07 16:54:26 CST 2018, time=2018-06-07, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=322273, encodeId=bb7b3222e36f, content=不错, beContent=null, objectType=article, channel=null, level=null, likeNumber=134, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://thirdwx.qlogo.cn/mmopen/vi_32/2EVCwc9WmQS6ec99H2TX8ejmR40xYjwrIcrqjAnibV36aicL1sLxc21rhpZnqTOxk33HP44iayEwo6qYXqgZvdRtA/132, createdBy=d0d01573846, createdName=329523732, createdTime=Thu Jun 07 16:10:03 CST 2018, time=2018-06-07, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=322258, encodeId=0df932225879, content=了解一下.谢谢分享!, beContent=null, objectType=article, channel=null, level=null, likeNumber=114, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=http://cdnapi.center.medsci.cn/medsci/head/2019/12/23/2f51002e1349ccda5be11c1eea1e1e60.jpg, createdBy=a22097948, createdName=天地飞扬, createdTime=Thu Jun 07 14:46:51 CST 2018, time=2018-06-07, status=1, ipAttribution=)]
    2018-06-07 一个字-牛

    学习了谢谢分享

    0

  3. [GetPortalCommentsPageByObjectIdResponse(id=1587028, encodeId=cf9f158e0280b, content=<a href='/topic/show?id=f27a83229f7' target=_blank style='color:#2F92EE;'>#胃癌前病变#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=87, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=83229, encryptionId=f27a83229f7, topicName=胃癌前病变)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=2e6917418548, createdName=wangbingxhy, createdTime=Sat Jun 09 04:47:00 CST 2018, time=2018-06-09, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=322280, encodeId=d87f322280f3, content=学习了谢谢分享, beContent=null, objectType=article, channel=null, level=null, likeNumber=107, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=http://cacheapi.medsci.cn/resource/upload/20160304/IMG56D94856B1B5D6405.jpg, createdBy=27931687771, createdName=一个字-牛, createdTime=Thu Jun 07 17:05:44 CST 2018, time=2018-06-07, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=322276, encodeId=9b633222e6e3, content=预防胜于治疗., beContent=null, objectType=article, channel=null, level=null, likeNumber=104, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=60791943465, createdName=1e0f8808m18(暂无匿称), createdTime=Thu Jun 07 16:54:26 CST 2018, time=2018-06-07, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=322273, encodeId=bb7b3222e36f, content=不错, beContent=null, objectType=article, channel=null, level=null, likeNumber=134, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://thirdwx.qlogo.cn/mmopen/vi_32/2EVCwc9WmQS6ec99H2TX8ejmR40xYjwrIcrqjAnibV36aicL1sLxc21rhpZnqTOxk33HP44iayEwo6qYXqgZvdRtA/132, createdBy=d0d01573846, createdName=329523732, createdTime=Thu Jun 07 16:10:03 CST 2018, time=2018-06-07, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=322258, encodeId=0df932225879, content=了解一下.谢谢分享!, beContent=null, objectType=article, channel=null, level=null, likeNumber=114, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=http://cdnapi.center.medsci.cn/medsci/head/2019/12/23/2f51002e1349ccda5be11c1eea1e1e60.jpg, createdBy=a22097948, createdName=天地飞扬, createdTime=Thu Jun 07 14:46:51 CST 2018, time=2018-06-07, status=1, ipAttribution=)]
    2018-06-07 1e0f8808m18(暂无匿称)

    预防胜于治疗.

    0

  4. [GetPortalCommentsPageByObjectIdResponse(id=1587028, encodeId=cf9f158e0280b, content=<a href='/topic/show?id=f27a83229f7' target=_blank style='color:#2F92EE;'>#胃癌前病变#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=87, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=83229, encryptionId=f27a83229f7, topicName=胃癌前病变)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=2e6917418548, createdName=wangbingxhy, createdTime=Sat Jun 09 04:47:00 CST 2018, time=2018-06-09, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=322280, encodeId=d87f322280f3, content=学习了谢谢分享, beContent=null, objectType=article, channel=null, level=null, likeNumber=107, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=http://cacheapi.medsci.cn/resource/upload/20160304/IMG56D94856B1B5D6405.jpg, createdBy=27931687771, createdName=一个字-牛, createdTime=Thu Jun 07 17:05:44 CST 2018, time=2018-06-07, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=322276, encodeId=9b633222e6e3, content=预防胜于治疗., beContent=null, objectType=article, channel=null, level=null, likeNumber=104, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=60791943465, createdName=1e0f8808m18(暂无匿称), createdTime=Thu Jun 07 16:54:26 CST 2018, time=2018-06-07, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=322273, encodeId=bb7b3222e36f, content=不错, beContent=null, objectType=article, channel=null, level=null, likeNumber=134, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://thirdwx.qlogo.cn/mmopen/vi_32/2EVCwc9WmQS6ec99H2TX8ejmR40xYjwrIcrqjAnibV36aicL1sLxc21rhpZnqTOxk33HP44iayEwo6qYXqgZvdRtA/132, createdBy=d0d01573846, createdName=329523732, createdTime=Thu Jun 07 16:10:03 CST 2018, time=2018-06-07, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=322258, encodeId=0df932225879, content=了解一下.谢谢分享!, beContent=null, objectType=article, channel=null, level=null, likeNumber=114, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=http://cdnapi.center.medsci.cn/medsci/head/2019/12/23/2f51002e1349ccda5be11c1eea1e1e60.jpg, createdBy=a22097948, createdName=天地飞扬, createdTime=Thu Jun 07 14:46:51 CST 2018, time=2018-06-07, status=1, ipAttribution=)]
    2018-06-07 329523732

    不错

    0

  5. [GetPortalCommentsPageByObjectIdResponse(id=1587028, encodeId=cf9f158e0280b, content=<a href='/topic/show?id=f27a83229f7' target=_blank style='color:#2F92EE;'>#胃癌前病变#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=87, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=83229, encryptionId=f27a83229f7, topicName=胃癌前病变)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=2e6917418548, createdName=wangbingxhy, createdTime=Sat Jun 09 04:47:00 CST 2018, time=2018-06-09, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=322280, encodeId=d87f322280f3, content=学习了谢谢分享, beContent=null, objectType=article, channel=null, level=null, likeNumber=107, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=http://cacheapi.medsci.cn/resource/upload/20160304/IMG56D94856B1B5D6405.jpg, createdBy=27931687771, createdName=一个字-牛, createdTime=Thu Jun 07 17:05:44 CST 2018, time=2018-06-07, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=322276, encodeId=9b633222e6e3, content=预防胜于治疗., beContent=null, objectType=article, channel=null, level=null, likeNumber=104, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=60791943465, createdName=1e0f8808m18(暂无匿称), createdTime=Thu Jun 07 16:54:26 CST 2018, time=2018-06-07, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=322273, encodeId=bb7b3222e36f, content=不错, beContent=null, objectType=article, channel=null, level=null, likeNumber=134, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://thirdwx.qlogo.cn/mmopen/vi_32/2EVCwc9WmQS6ec99H2TX8ejmR40xYjwrIcrqjAnibV36aicL1sLxc21rhpZnqTOxk33HP44iayEwo6qYXqgZvdRtA/132, createdBy=d0d01573846, createdName=329523732, createdTime=Thu Jun 07 16:10:03 CST 2018, time=2018-06-07, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=322258, encodeId=0df932225879, content=了解一下.谢谢分享!, beContent=null, objectType=article, channel=null, level=null, likeNumber=114, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=http://cdnapi.center.medsci.cn/medsci/head/2019/12/23/2f51002e1349ccda5be11c1eea1e1e60.jpg, createdBy=a22097948, createdName=天地飞扬, createdTime=Thu Jun 07 14:46:51 CST 2018, time=2018-06-07, status=1, ipAttribution=)]
    2018-06-07 天地飞扬

    了解一下.谢谢分享!

    0

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