Gastric Cancer Working Group Report
Gastric Cancer Working Group Report
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DOI：
10.1093/jjco/hyq124
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发表时间：
2010-09-01
影响因子：
2.4
通讯作者：
Ohtsu, Atsushi
中科院分区：
文献类型：
--
作者：
Sasako, Mitsuru;Inoue, Manami;Ohtsu, Atsushi
胃癌是亚洲第二大常见癌症，世界上一半以上的胃癌病例发生在东亚地区，亚洲绝大多数病例仍发生在胃的远端。胃癌的病因包括遗传易感性、幽门螺杆菌感染和环境危险因素。根除幽门螺杆菌治疗、食用新鲜蔬菜和水果以及使用阿司匹林和非甾体抗炎药似乎可以降低胃癌的风险。在胃癌高发国家进行胃癌筛查具有成本效益。风险分层可能会增加在中度风险人群中筛查的成本效益。内镜下切除术对部分早期癌症患者是有效的，R 0切除术联合D2淋巴结清扫术的生存率最高。D2手术后建议进行包括S-1在内的术后辅助化疗，作为胃癌化疗，氟尿嘧啶联合铂类是最广泛接受的一线方案，而紫杉烷类或伊立替康多用于二线和三线。批准和医疗保险制度的差异可能会影响这些方案的地位。曲妥珠单抗联合氟尿嘧啶/铂将成为HER 2阳性胃癌的标准治疗方案。目前正在研究许多新的靶向药物，亚洲国家在研究和开发这种恶性肿瘤的新的更好的治疗方法方面发挥着重要作用。
Gastric cancer is the second most common cancer in Asia, more than half of the world's gastric cancer cases arise in Eastern Asia, and the majority of Asia's cases still occur in the distal part of the stomach.The etiology of gastric cancer consists of genetic susceptibility, Helicobacter pylori infection and environmental risk factors. Helicobacter pylori eradication treatment, consumption of fresh vegetables and fruits and use of aspirin and non-steroidal anti-inflammatory drugs seem to reduce the risk of gastric cancer.Screening for gastric cancer is cost-effective in countries with high incidence. Risk stratification may increase the cost-effectiveness of screening in populations at moderate risk. Endoscopic resection is curative in a subset of patients with early cancer.R0 resection with D2 lymph node dissection has produced the best survival data. Some kind of post-operative adjuvant chemotherapy including S-1 is recommended after D2 surgery.As chemotherapy for gastric cancer, fluorouracils plus platinum are the most widely accepted first-line regimens, whereas taxanes or irinotecan are mostly used in second- and third-line settings. Differences in the approval and medical insurance systems may influence the status of these regimens. Trastuzumab in combination with fluorouracils/platinum will be a standard regimen for HER2-positive gastric cancer. Many new targeting agents are currently under investigation, and Asian countries are playing important roles in investigation and development of new and better treatments for this malignancy.