中国早期胃癌筛查检验技术专家共识

Chinese expert consensus on detection technologies for early-stage gastric cancer screening

我国是胃癌高发国家,由于早期胃癌无明显症状,临床发现的胃癌约90%属于进展期,严重降低了5年生存率。胃镜和活检是公认的诊断胃癌的金标准,但我国人口众多,资源分配有限,难以实现大规模筛查,而早期诊断相关检验技术具有无创、便捷、灵敏度高等特点,能够实现早期胃癌的筛查。通过分析近年来已用于临床早期诊断胃癌的相关检验技术,包括呼气检测、血清学免疫检测和分子检测技术,探讨早期胃癌相关标志物,例如幽门螺杆菌、胃蛋白酶原、胃泌素、肿瘤标志物及DNA甲基化在早期胃癌诊断中的临床应用及特点,并提出了共识性意见,旨在为患者、临床医师及卫生行政管理部门提供规范、临床应用价值高的检验技术指导和筛查策略。

Gastric cancer(GC)is one of the most prevalent malignant tumors in China.Since gastric cancer exhibits less severe symptoms and signs in the early stages,about 90%of patients are already in the intermediate-stage or advanced stage at the time of first diagnosis,which is related to the lower five-year survival rate of these patients.Endoscopy and biopsy are widely considered as the"gold standard"for detecting GC,it is challenging to use them as large-scale screening methods due to the large population and limited distribution of resources and services in China.In contrast,the detection technologies for early cancer diagnosis exhibit great potential in screening of early-stage GC due to non-invasiveness,convenience,and high sensitivity.This consensus document summarizes recent detection techniques associated with the early diagnosis of GC,including breath test,serological and immunological test,and molecular diagnostics technologies.We also discussed the clinical application and characteristics of early gastric cancer-related markers,such as Helicobacter pylori,PGI/II,gastrin-17,tumor markers,and DNA methylation markers in diagnosing early GC.This consensus aims to provide patients,clinicians,and health administrative departments with standardized screening strategies and guidance on detection technologies with significant clinical values.