萎缩性胃炎“炎-癌”转化的关键问题与中医药防治研究策略

Key issues in the"inflammation-cancer"transition of atrophic gastritis and research strategies for prevention and treatment with traditional Chinese medicine

胃癌已成为严重威胁我国居民生命健康的重大公共卫生挑战。对胃癌高风险人群进行合理监测和有效干预可有效降低胃癌的发生,其中萎缩性胃炎及其癌前病变作为胃癌发生的重要环节,是胃癌早期诊治和预防的关键。近年来,研究提出解痉多肽表达化生可能是肠上皮化生和异型增生的潜在细胞来源,其相关研究也为萎缩性胃炎“炎-癌”转化的分子调控机制、防治模式和干预策略提供了新视野。本文对萎缩性胃炎“炎-癌”转化的前沿问题进行梳理,提出以解痉多肽表达化生作为胃腺癌二级预防研究靶标的重要意义和可行性,并针对萎缩性胃炎及其癌前病变的中医药研究存在的问题提出建议和对策,以期为推动具有中国特色的中西医协作胃癌二级防治策略的形成提供参考。

Gastric carcinoma presents a formidable public health challenge, significantly imperiling the life quality and longevity of the populace within China. The strategic surveillance and efficacious intervention targeting populations at elevated risk for gastric cancer can markedly diminish the prevalence of this disease. In particular, atrophic gastritis and its associated precancerous lesions, as pivotal precursors in the oncogenesis of gastric carcinoma, are essential for the proactive management and preventative measures against this disease. Recent scholarly endeavors have posited the hypothesis that the spasmolytic polypeptide-expressing metaplasia (SPEM) might represent a prospective cellular source for intestinal metaplasia and dysplasia, thus offering fresh perspectives on the molecular mechanisms underpinning the inflammation-to-carcinoma transition in atrophic gastritis. This discourse systematically examines the avant-garde queries concerning atrophic gastritis to gastric carcinoma continuum, advocating for the investigation of SPEM as a significant and viable target for secondary prophylaxis research in gastric adenocarcinoma. Furthermore, it addresses the prevailing challenges within the realm of traditional Chinese medicinal research related to atrophic gastritis and its precancerous stages. Through proposing recommendations and strategies, this paper aims to catalyze the development of an integrated Chinese and Western medicine paradigm for the secondary prevention and management of gastric cancer, thereby providing a reference for the advancement of this integrative healthcare strategy.