胃食管反流病致食管胃结合部癌变的机制及预防策略

Mechanisms and preventive strategies of gastroesophageal reflux disease in causing esophagogastricjunctioncancer

胃食管反流病(GERD)作为常见疾病,多表现为反酸、烧心等不适症状,且被认为是导致上消化道恶性肿瘤的主要危险因素。因GERD导致的肿瘤中,关注较多的为Barrett食管所致的食管腺癌,然而近年来发现其在贲门癌等其他类型的食管胃结合部恶性肿瘤的发生、发展中同样发挥重要作用。长期慢性胃酸、胆汁反流会引起食管胃结合部黏膜的炎症反应以及组织学转变等多种机制导致食管胃结合部肿瘤的发生。笔者就GERD在食管胃结合部恶性肿瘤发生中的机制及研究现状进行综述,并探讨当前基于GERD的多种预防策略,以期为GERD的合理预防和治疗提供更为科学的依据。

Gastroesophageal reflux disease(GERD)is one of the most common diseases,which is characterized by acid reflux,heartburn and other discomfort symptoms,and is considered to be the main risk factor leading to upper gastrointestinal malignant tumors.Previous studies on tumors caused by GERD have focused more on esophageal adenocarcinoma associated with Barrett's esophagus.However,in recent years,it has been found that GERD also plays a crucial role in the occurrence and development of other types of esophagogastric junction malignant tumors such as cardia cancer A variety of mechanisms,such as inflammation and histological transformation of the esophagogastric junction mucosa caused by long-term chronic gastric acid and bile reflux,lead to the occurrence of esophagogastric junction tumors.The authors review the mechanism and research status of GERD in the occurrence of esophagogastric junction malignant tumors,and discuss a variety of current prevention strategies based on GERD,in order to provide a more scientific basis for the reasonable prevention and treatment of the disease.