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首页> 外文期刊>International Journal of Cancer =: Journal International du Cancer >Carcinogenesis, prevention and early detection of gastric cancer: where we are and where we should go.
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Carcinogenesis, prevention and early detection of gastric cancer: where we are and where we should go.

机译：胃癌的癌变，预防和早期发现：我们在哪里，应该去哪里。

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Helicobacter pylori is the most common cause of gastric cancer (GC), though smoking, alcohol, diet, genetics and epigenetic factors may also have a role in the occurrence of the disease. Why H. pylori cause GC in only a minority of those infected remains unknown. Although mechanisms of H. pylori-induced carcinogenesis are not yet well understood, several genotypes of H. pylori have been associated with strain virulence and disease risk. Primary prevention of GC should be addressed by avoiding exposure to factors that increase the risk and to promote factors associated with decrease risk. Vaccines against H. pylori are an ongoing promise and not yet available. Chemoprevention through vitamin supplementation has shown no benefit. Screening and eradication of H. pylori in the general population is not advised. Given that GC is a multiple-steps process, the identification of patients with preneoplastic lesions with high risk of progression, and periodic endoscopic surveillance of them represents the most effective way for early diagnosis of GC. However, clinical guidelines for surveillance are lacking and there are no clear criteria to classify patients into high or low risk of progressing to GC. No study has shown the potential usefulness of combining the information on the type of preneoplastic lesions, genetic and epigenetic, lifestyle and virulence bacterial factors in order to identify high risk patients who need more intensive surveillance. The integration of all this information, in a prediction model requires further research and could be the most important contribution for reducing the burden of GC.
机译：幽门螺杆菌是胃癌（GC）的最常见原因，尽管吸烟，饮酒，饮食，遗传和表观遗传因素也可能与胃癌的发生有关。为什么幽门螺杆菌仅在少数感染者中引起GC的原因仍然未知。尽管尚未充分了解幽门螺杆菌诱导的致癌机理，但是幽门螺杆菌的几种基因型与毒株毒力和疾病风险相关。应通过避免暴露于增加风险的因素并促进与降低风险相关的因素来解决GC的一级预防。针对幽门螺杆菌的疫苗是一个有前途的承诺，尚无可用。通过补充维生素进行化学预防没有益处。不建议在一般人群中进行幽门螺杆菌的筛查和根除。鉴于GC是一个多步骤的过程，因此识别出具有高度进展风险的肿瘤前病变的患者，并定期对其进行内窥镜检查是GC早期诊断的最有效方法。然而，缺乏用于监测的临床指南，并且没有明确的标准将患者分为进展为GC的高风险或低风险。尚无研究表明将有关肿瘤前病变类型，遗传和表观遗传，生活方式和毒力细菌因素的信息相结合以识别需要进一步加强监测的高危患者的潜在有用性。将所有这些信息集成到预测模型中需要进一步的研究，并且可能是减轻GC负担的最重要的贡献。

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