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| 題 名 | 胃癌篩檢和預防的最新進展=Update on the Screening and Prevention of Gastric Cancer |
|---|---|
| 作 者 | 鄭修琦; | 書刊名 | 內科學誌 |
| 卷 期 | 35:6 2024.12[民113.12] |
| 頁 次 | 頁407-411 |
| 分類號 | 415.527 |
| 關鍵詞 | 胃癌; 幽門桿菌; 預防; 篩檢; 監測; Gastric cancer; Helicobacter pylori; Prevention; Screen; Surveillance; |
| 語 文 | 中文(Chinese) |
| DOI | 10.6314/JIMT.202412_35(6).01 |
| 中文摘要 | 胃癌是世界上十大好發和死亡的癌症之一。雖然相對發病率和死亡率在下降,但由於全球人口成長和老化,胃癌的絕對數目與死亡率仍逐年上升。一級預防是減少風險因子,增加保護因子。根除幽門桿菌可以降低47%的胃癌發生率和39%的死亡率。成人幽門桿菌盛行率從1990年代前的52.6%下降到2015年至2022年間的43.9%,而全球胃癌發生率也呈現下降趨勢。保護因子為蔬菜、水果、穀物纖維和魚類;風險因子為吸煙、酗酒、高鹽食物以及紅肉或加工肉類。二級預防是早期發現、診斷、治療。在胃癌高發生率國家如日本和韓國,大規模內視鏡或上消化道攝影篩檢達到40%的胃癌死亡相對風險下降。在胃癌中高發生率國家,有胃癌危險因子者建議接受篩檢。篩檢的方法主要是血清胃蛋白酶原I/II比值、內視鏡檢查併切片,影像增強內視鏡檢查。對於具高風險之胃癌前病變者,如胃蛋白酶原I/II比值<3、OLGA或OLGIM分期III-IV期,建議規則地接受內視鏡監測。目前仍需要一個全球胃癌預防策略,來提高一級和二級預防之效益。 |
| 英文摘要 | Gastric cancer is one of the top ten most common and fatal cancers in the world. Although the relative incidence and mortality rates are decreasing, the absolute number and mortality worldwide are still increasing because of the growth and aging of the global population. Primary prevention is to reduce risk factors and increase protective ones. Helicobacter pylori eradication reduces gastric cancer incidence by 47% and mortality by 39%. The prevalence rate of Helicobacter pylori in adults has decreased from 52.6% before the 1990s to 43.9% between 2015 and 2022, while the global gastric cancer incidence rates has also shown a trend of decreasing. Protective factors include vegetables, fruit, cereal fiber, and fish; however, risk factors include smoking, heavy drinking, high salt foods, and red or processed meat. Secondary prevention is early detection, diagnosis, and treatment. In countries of high gastric cancer incidence, Japan and South Korea, population-based endoscopic screening achieves a 40% relative risk reduction in gastric cancer mortality. In countries of intermediate-high gastric cancer incidence, subjects who have risk factors of gastric cancer are suggested to receive screening. The main methodological approaches of screening are serological pepsinogen I/II ratio, endoscopy with topographic biopsy, and image-enhanced endoscopy with full mucosal visualization. Moreover, those who have high-risk gastric precancerous conditions, such as pepsinogen I/II ratio < 3, OLGA or OLGIM stages III-IV, are suggested to receive endoscopic surveillance at an optimal interval. A global gastric cancer prevention strategy is still needed to improve the effectiveness of primary and secondary prevention methods. |
本系統中英文摘要資訊取自各篇刊載內容。