Detection and surveillance of gastric cancer precursors: evolving guidelines and technologies

IF 0.5 4区 医学 Q4 SURGERY
Jennifer Koh, Miranda V. Shum, Joo Ha Hwang, Robert J. Huang
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引用次数: 0

Abstract

: Non-cardiac gastric adenocarcinoma (NCGA) remains a leading source of global morbidity and mortality. Despite its lower incidence in the United States and Western Europe, the overall poor survival and prognosis from this cancer suggest a need for earlier detection. NCGA develops through a well-known stepwise progression of precursor lesions, including chronic gastritis, atrophic gastritis, intestinal metaplasia, and dysplasia. Identification and surveillance of high-risk individuals carrying these precursors may be one important avenue to improve NCGA outcomes through earlier detection. In addition, identifying NCGA precursors creates an opportunity for definitive management with early endoscopic resection, and therefore a potential for reduction in cancer morbidity and mortality. This review has two main objectives. The first aim is to describe and evaluate various imaging technologies that are currently used to aid and improve the endoscopic detection of NCGA precursor lesions. These modalities include image-enhanced endoscopy (both dye-based and virtual), confocal laser endomicroscopy, and auto-fluorescence imaging. The second aim is to appraise current surveillance strategies for individuals carrying precursor lesions, with an emphasis on synthesizing recommendations from several recent surveillance guidelines published in the United States and Europe. In this review, we also highlight future innovative technologies and directions, including the utilization of artificial intelligence for rapid lesion recognition and molecular-based individual risk stratification.
胃癌前体的检测和监测:不断发展的指南和技术
非心性胃腺癌(NCGA)仍然是全球发病率和死亡率的主要来源。尽管其在美国和西欧的发病率较低,但这种癌症的总体生存率和预后较差,这表明需要早期发现。NCGA通过众所周知的前体病变逐步发展,包括慢性胃炎、萎缩性胃炎、肠化生和不典型增生。识别和监测携带这些前体的高危个体可能是通过早期检测改善NCGA结果的一个重要途径。此外,识别NCGA前体为早期内镜切除的明确治疗创造了机会,因此有可能降低癌症发病率和死亡率。这次审查有两个主要目标。第一个目的是描述和评估各种成像技术,目前用于帮助和改进内镜检测NCGA前驱病变。这些方式包括图像增强内窥镜检查(染料和虚拟),共聚焦激光内窥镜检查和自动荧光成像。第二个目的是评估目前对携带前体病变个体的监测策略,重点是综合美国和欧洲最近发表的几项监测指南的建议。在这篇综述中,我们还强调了未来的创新技术和方向,包括利用人工智能进行快速病变识别和基于分子的个体风险分层。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
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来源期刊
CiteScore
1.40
自引率
0.00%
发文量
20
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