摘要
随着对胃癌认识不断深入和新技术发展,多种针对不同阶段胃癌的综合治疗模式逐渐被广泛认可。以内镜下黏膜剥离术为主的内镜技术是胃癌诊断重要手段,也是早期胃癌不可或缺的治疗手段。手术治疗是局部进展期胃癌的首选治疗方式,主要包括全胃切除术、远端胃切除术、保留幽门胃切除术、近端胃切除术等,并需要针对区域淋巴结进行淋巴结清扫术。新辅助化疗、辅助化疗以及腹腔热灌注化疗等方式对于术前、术后的辅助治疗具有重要作用,而放疗在胃癌治疗中的作用需要进一步观察。近年来,包括针对人表皮生长因子受体⁃2阳性的曲妥珠单克隆抗体和程序性死亡受体⁃1抑制剂等胃癌靶向治疗和免疫治疗均取得重要进展,然而其要成为胃癌一线治疗方案还需要进一步证明。笔者相信:随着更多胃癌研究结果的不断涌现,胃癌综合治疗方式必将更加丰富,使胃癌治疗更加个体化和精确化,最终让更多患者获益。
With the deep understanding of gastric cancer and the development of new technology,various comprehensive treatment modes for different stages of gastric cancer have been widely recognized.Endoscopic technology represented by endoscopic submucosal dissection is an important method for diagnosis of gastric cancer and treatment for early gastric cancer.Surgical operation is the preferred treatment for locally advanced gastric cancer,mainly including total gastrectomy,distal gastrectomy,pylorus preserving gastrectomy,proximal gastrectomy and the corresponding regional lymph node dissection.Neoadjuvant chemotherapy,adjuvant chemotherapy and hyperthermic intraperitoneal chemotherapy play important roles in preoperative and postoperative adjuvant therapy of gastric cancer,while the role of radiotherapy needs to be further observed.In recent years,targeted therapy represented by trastuzumab which is positive for human epidermal growth factor receptor-2 and immunotherapy represented by programmed death-1 inhibitors have made important progress in the treatment of gastric cancer.However,they need to be further proved to become the first-line treatment for gastric cancer.The authors believe that with more research results of gastric cancer,the comprehensive treatment of gastric cancer will be more diversified,which will make the treatment of gastric cancer individualized and accurate and finally benefit more patients.
作者
徐泽宽
王森
汪未知
Xu Zekuan;Wang Sen;Wang Weizhi(Department of Gastric Surgery,the First Affiliated Hospital with Nanjing Medical University,Nanjing 210029,China)
出处
《中华消化外科杂志》
CAS
CSCD
北大核心
2022年第3期335-341,共7页
Chinese Journal of Digestive Surgery
基金
国家自然科学基金面上项目(81871946、82072708)
江苏省医学重点学科(普通外科ZDXKA2016005)
江苏高等教育机构重点学科建设项目(PAPD、JX10231801)。
关键词
胃肿瘤
综合治疗
内窥镜
手术
化疗
免疫治疗
Stomach neoplasms
Comprehensive treatment
Endoscopy
Surgery
Chemotherapy
Immunotherapy
