胃癌前病变的治疗

The Treatment for Gastric Precancerous Lesions

胃黏膜在多种因素作用下,经正常胃黏膜-浅表性胃炎-慢性萎缩性胃炎(CAG)-肠上皮化生(IM)-异型增生(ATP)的过程,逐步发展为胃癌。癌前病变主要指萎缩、肠上皮化生和不典型增生,在此阶段及时干预是预防胃癌的有效手段。因此针对胃癌前病变的及时监测、有效的处理成了防治肿瘤发生的关键。目前的临床实践中,治疗癌前病变主要包括根除幽门螺杆菌、叶酸、维甲酸、抗氧化剂等,必要时还可结合内镜治疗。同时中医药治疗的疗效也值得关注,主要为辨证论治和中成药治疗。

Under a multifactor-induced situation, the gastric mucosa begins to change in a sequence of histopathologic evolution consisting of initial superficial erosive gastritis, followed by gastric atrophy, intestinal metaplasia, dysplasia, and eventually cancer. Since the onset of carcinoma is usually preceded by precancerous lesions including atrophy, intestinal metaplasia and dysplasia, prompt intervention during precancerous phase is very efficacious of preventing gastric cancers. Therefore, the vigorous surveillance and treatment strategies become the key to cancer prevention. Currently the clinical practice in treating precancerous lesions mainly includes the H. pylori. Eradication, folic acid supplements, retinoie acids and antioxidants. Further intervention can be performed under the endoscope if necessary. Meanwhile, traditional Chinese Medicine treatment such as syndrome differentiation and Chinese patent medicine should also be considered.