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早期胃癌的本质与临床实践中的困惑 被引量:3

Essence of early gastric cancer and confusion in clinical practic
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摘要 分期是医生对胃癌客观进展程度的主观评估,而胃癌的进展则是胃癌依其固有的生物学特性突破机体免疫力限制的结果,这两方面不易量化的因素导致主观的评估方法难以完整地反映胃癌客观进展程度。早期胃癌从其概念问世之初到内镜黏膜下剥离术(ESD)广泛应用于临床一直面临的最大困惑就是如何排除淋巴结转移,迄今为止始终未能圆满解决。因此,日本各版《胃癌治疗指南》中,阐述ESD适应证之后一定附有内镜切除后的评价与治疗方针,用以进一步治疗可能的癌残留。了解早期胃癌的本质与影响其进展的相关因素,有助于提高早期胃癌的治疗质量,使病人获益。 Staging is a subjective assessment of objective progress of gastric cancer by doctors.However,the progress of gastric cancer is the result of tumor breaking through the limitation of immunity according to its inherent characteristics.The subjective evaluation methods are difficult to fully reflect the progress of gastric cancer.From the beginning of the concept of early gastric cancer to the wide application of endoscopic submucosal dissection(ESD)in clinic,the biggest puzzle is how to exclude lymph node metastasis.So far,it has not been satisfactorily solved.Therefore,in all previous Japanese Gastric Cancer Treatment Guidelines,the indications of ESD must be accompanied by the evaluation and treatment after endoscopic resection for possible residual cancer.Comprehending the essence of early gastric cancer and the related factors affecting its progress will help us to improve the quality of treatment for early gastric cancer and benefit patients.
作者 李国立 相小松 马龙 LI Guo-li;XIANG Xiao-song;MA Long(Department of General Surgery,General Hospital of Eastern Theater Command,Nanjing 210002,China)
出处 《中国实用外科杂志》 CSCD 北大核心 2019年第5期442-444,共3页 Chinese Journal of Practical Surgery
关键词 早期胃癌 内镜黏膜下剥离术 转移 追加手术 early gastric cancer endoscopic submucosal dissection metastasis additional surgery
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