早发型胃癌的特点及研究进展

The characteristics and research progress of early-onset gastric cancer

近年来,流行病学显示胃癌的总体发病率呈现下降趋势。然而在年轻人群中,胃癌的发病率并未降低,甚至有增加的趋势。发生于年轻患者的胃癌被称作早发型胃癌(early-onset gastric cancer,EOGC)。目前,关于EOGC尚无明确的年龄限定,多数研究将40岁以前发病的胃癌定义为EOGC。与晚发型胃癌相比,EOGC更多见于女性患者,同时具有低分化癌、Lauren弥漫型、腹膜转移发生率高等特点。EOGC常见的分子分型为EBV病毒阳性型和基因组稳定型,且更易发生CDH1、TGFBR1等基因突变。由此可见,EOGC恶性度更高并具有独特的临床和分子病理特点。为加强对EOGC了解,本文从流行病学、病因学、临床病理特征和基因特征等多方面对EOGC研究现状进行综述。

Recent epidemiological data have demonstrated a decrease in the overall incidence of gastric cancer.However,in young and middle-aged adults,the incidence of gastric cancer has not decreased;in fact,it has increased to some extent.The particular type of gastric cancer affecting young and middle-aged patients is referred to as early-onset gastric cancer(EOGC).To date,the precise age of onset for EOGC remains uncertain,but most studies have proposed an age cut-off of 40 years for its diagnosis.Compared with late-onset gastric cancer,EOGC is more commonly observed in female patients,and is associated with specific characteristics including low differentiation,diffuse type,and a high incidence of peritoneal metastasis.Common subtypes of EOGC include the Epstein-Barr virus(EBV)-positive type and the genomically stable type.Moreover,EOGC is commonly associated with mutations in the CDH1 and TGFBR1 genes.These factors contribute to a higher malignancy,and are unique clinical,pathological,and molecular characteristics of EOGC.To gain a better understanding of EOGC,this study aimed to summarize recent research findings on this disease,including its epidemiology,etiology,clinical features,and pathological characteristics.