回眸2018--聚焦胃癌研究领域

Looking back 2018-focused on gastric cancer

中国是胃癌发病大国,拥有世界上约半数的新发病例,且诊断时多为进展期胃癌。2018年,胃癌研究领域在病因学、分子病理学、诊断及治疗方面均取得了重大进展。(1)病因:环境因素在胃癌的发生、发展中起到至关重要的作用,幽门螺杆菌和Epstein Barr病毒感染已被证实为胃癌发生的重要致病因素之一。(2)分子病理学与诊断:随着分子生物学及基因测序技术的发展应用,基于患者基因特征的、用于指导精准治疗及预测预后的分子分型相继被提出。(3)治疗:外科手术是胃癌治疗的基石,近20多年来,胃癌外科手术趋于精准和微创。腹腔镜借其微创及放大视野、精细化解剖等技术特点的临床应用优势赢得了飞速的发展,现已成为早期胃癌的标准治疗选择之一,并继续拓展着其在胃癌治疗中的适应证。而早期胃癌内镜治疗及缩小手术的应用,进一步改善了患者的生活质量。手术联合放疗和化疗的综合治疗策略为局部进展期胃癌的标准治疗方式,对药物及给药模式的探索是当前此领域的研究热点,而靶向及免疫治疗的研发应用为其提供了更多选择。晚期胃癌的治疗更是着重于化疗、靶向治疗及免疫治疗等综合治疗模式的探索,部分研究展示出了良好的应用前景,为转化治疗提供了更多的契机。本文将借此机会与各位同道分享2018年胃癌研究领域的一些新进展。

China is a country with high incidence of gastric cancer,most of which are advanced gastric cancer,accounting for about half of the new cases in the world.Environmental factors play a crucial role in the occurrence and development of gastric cancer.Helicobacter pylori and Epstein Barr virus(EBV)infection have been confirmed as one of the important pathogenic factors of gastric cancer.With the development and application of molecular biology and sequencing technology,molecular typing based on patient genetic characteristics has been proposed to guide accurate treatment and predict prognosis.Surgery is the cornerstone of gastric cancer treatment.Laparoscopy has been developing rapidly in the past 20 years on account of its clinical application advantages such as minimally invasive and magnified visual field and refined anatomy,making it one of the standard treatment options for early gastric cancer,with its indications for the treatment of gastric cancer continuously expanding.The application of endoscopic treatment and reduction surgery for early gastric cancer further improves the quality of life of patients,and surgical treatment of gastric cancer tends to be precise and minimally invasive.The comprehensive treatment of surgery combined with radiotherapy and chemotherapy is a standard treatment of local advanced gastric cancer.The exploration of related drugs and treatment models is the current research hotspot,and the development and application of targeted therapy and immunotherapy provide more choices in this field.The treatment of advanced gastric cancer is focused on the exploration of chemotherapy,targeted therapy and immunotherapy.Some studies have shown good prospects and provided more opportunities for conversion therapy.This article will share the new developments in the field of gastric cancer research in 2018.