早发性胃癌的发病趋势和治疗挑战及其未来思考

Trends,challenges,and reflections on early-onset gastric cancer

早发性胃癌(EOGC)作为一种特殊类型的胃癌,近年来发病率逐渐上升,给社会和家庭带来了巨大的负面影响,也引起了社会的广泛关注。EOGC在临床表现上呈现出一系列特点,如女性患者较多、病理类型以低分化腺癌或未分化癌为主、Lauren分型多为弥漫型,且更容易发生远处转移。然而,关于其病因和发病机制,目前尚未完全明确。值得注意的是,约有10%的EOGC病例存在家族聚集性,并发生Cadherin-1(CDH1)或α-1连环蛋白(CTNNA1)基因的胚系突变,被称为家族遗传性弥漫型胃癌(HDGC)。上述独特的临床特点给EOGC的诊疗带来了巨大的挑战,强疗效、保功能、促康复、回社会是EOGC的治疗目标,临床上需以多学科协作为基础、以综合治疗为方法,生理与心理并重,疗效与功能兼顾,造福于更多早发型胃癌患者。

Early onset gastric cancer(EOGC),as a distinct type of gastric cancer,has seen a gradually increasing incidence in recent years,imposing significant negative impacts on society and families,and has attracted widespread attention.EOGC presents a series of clinical characteristics,such as a higher prevalence among women,pathological types predominantly being poorly differentiated or undifferentiated,and Lauren classification often being diffuse,making it more prone to distant metastasis.However,the causes and mechanisms of its onset are not yet fully understood.Notably,about 10%of EOGC cases exhibit familial clustering and germline mutations in the Cadherin-1(CDH1)orα-1 catenin(CTNNA1)genes,known as hereditary diffuse gastric cancer(HDGC).These unique clinical features pose significant challenges for the diagnosis and treatment of EOGC.The core of treatment for early onset gastric cancer focuses on strong efficacy,function preservation,rehabilitation,and social reintegration.Clinically,a multidisciplinary approach and comprehensive treatment are essential,with equal emphasis on physiological and psychological aspects,balancing therapeutic effectiveness with functional outcomes,to benefit more patients with EOGC.