Global Progression Rates of Precursor Lesions for Gastric Cancer: A Systematic Review and Meta-Analysis.

IF 11.6 1区 医学 Q1 GASTROENTEROLOGY & HEPATOLOGY
Anne I Hahn, Duco T Mülder, Robert J Huang, Margaret J Zhou, Benjamin Blake, Omonefe Omofuma, John D Murphy, Daniela S Gutiérrez-Torres, Ann G Zauber, James F O'Mahony, M Constanza Camargo, Uri Ladabaum, Jennifer M Yeh, Chin Hur, Iris Lansdorp-Vogelaar, Reinier Meester, Monika Laszkowska
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Abstract

Background & aims: Whether gastric cancer (GC) precursor lesions progress to invasive cancer at similar rates globally remains unknown. We conducted a systematic review and meta-analysis to determine the progression of precursor lesions to GC in countries with low versus medium/high incidence.

Methods: We searched relevant databases for studies reporting the progression of endoscopically confirmed precursor lesions to GC. Studies were stratified by low (<6 per 100,000) or medium/high (≥6 per 100,000) GC incidence countries. Random-effects models were used to estimate the progression rates of atrophic gastritis (AG), intestinal metaplasia (IM), and dysplasia to GC per 1000 person-years.

Results: Among the 5829 studies identified, 44 met our inclusion criteria. The global pooled estimates of the progression rate per 1000 person-years were 2.09 (95% confidence interval, 1.46-2.99), 2.89 (2.03-4.11), and 10.09 (5.23-19.49) for AG, IM, and dysplasia, respectively. The estimated progression rates per 1000 person-years for low versus medium/high GC incidence countries, respectively, were 0.97 (0.86-1.10) versus 2.47 (1.70-2.99) for AG (P < .01), 2.37 (1.43-3.92) versus 3.47 (2.13-5.65) for IM (P = .29), and 5.51 (2.92-10.39) versus 14.80 (5.87-37.28) for dysplasia (P = .08). There were no differences for progression of AG between groups when high-quality studies were compared.

Conclusions: Similar progression rates of IM and dysplasia were observed among low and medium/high GC incidence countries. This suggests that the potential benefits of surveillance for these lesions in low-risk regions may be comparable with those of population-wide interventions in high-risk regions. Further prospective studies are needed to confirm these findings and inform global screening and surveillance guidelines.

胃癌前驱病变的全球进展率:系统回顾与元分析》。
背景和目的:全球胃癌(GC)前驱病变进展为浸润性癌症的比例是否相似仍是未知数。我们进行了一项系统性回顾和荟萃分析,以确定低发病率国家与中/高发病率国家的胃癌前病变进展情况:我们在相关数据库中检索了报告内镜确诊前驱病变发展为 GC 的研究。研究按照低发病率和中/高发病率进行了分层:在确定的 5829 项研究中,有 44 项符合我们的纳入标准。每千人年AG、IM和发育不良的进展率全球汇总估计值分别为2.09(95% CI 1.46-2.99)、2.89(2.03-4.11)和10.09(5.23-19.49)。低 GC 发病率国家与中/高 GC 发病率国家的每千人年估计进展率分别为 0.97(0.86-1.10) vs. AG 2.47(1.70-2.99)(p 结论:低GC发病率国家和中/高GC发病率国家的IM和发育不良进展率相似。这表明,在低风险地区监测这些病变的潜在益处可能与在高风险地区采取全民干预措施的益处相当。需要进一步的前瞻性研究来证实这些发现,并为全球筛查和监测指南提供信息。
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来源期刊
CiteScore
16.90
自引率
4.80%
发文量
903
审稿时长
22 days
期刊介绍: Clinical Gastroenterology and Hepatology (CGH) is dedicated to offering readers a comprehensive exploration of themes in clinical gastroenterology and hepatology. Encompassing diagnostic, endoscopic, interventional, and therapeutic advances, the journal covers areas such as cancer, inflammatory diseases, functional gastrointestinal disorders, nutrition, absorption, and secretion. As a peer-reviewed publication, CGH features original articles and scholarly reviews, ensuring immediate relevance to the practice of gastroenterology and hepatology. Beyond peer-reviewed content, the journal includes invited key reviews and articles on endoscopy/practice-based technology, health-care policy, and practice management. Multimedia elements, including images, video abstracts, and podcasts, enhance the reader's experience. CGH remains actively engaged with its audience through updates and commentary shared via platforms such as Facebook and Twitter.
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