Differential diagnosis of gastric submucosal masses and external pressure lesions

Lesions of the left triangular ligament of the liver are rare,and there are even fewer cases of vascular tumors misdiagnosed as gastrointestinal stromal tumors.We comment on the two cases reported in the article.The article did not include pictures of laparoscopic surgery,making it unconvincing.For gastric submucosal lesions,enhanced computed tomography venous phase imaging may be beneficial for differential diagnosis.Although endoscopic ultrasound is an effective tool for diagnosing submucosal lesions of the stomach,due to various factors,it cannot achieve an accurate diagnosis.During endoscopic examination,a more accurate diagnosis can be made depending on the personal experience of the operators.

Recent advances in mass spectrometry-based proteomics of gastric cancer

The last decade has witnessed remarkable technological advances in mass spectrometry-based proteomics. The development of proteomics techniques has enabled the reliable analysis of complex proteomes, leading to the identification and quantification of thousands of proteins in gastric cancer cells, tissues, and sera. This quantitative information has been used to profile the anomalies in gastric cancer and provide insights into the pathogenic mechanism of the disease. In this review, we mainly focus on the advances in mass spectrometry and quantitative proteomics that were achieved in the last five years and how these up-andcoming technologies are employed to track biochemical changes in gastric cancer cells. We conclude by presenting a perspective on quantitative proteomics and its future applications in the clinic and translational gastric cancer research.

Metabolomics of gastric cancer metastasis detected by gas chromatography and mass spectrometry

AIM:To elucidate the underlying mechanisms of metastasis and to identify the metabolomic markers of gastric cancer metastasis.METHODS:Gastric tumors from metastatic and nonmetastatic groups were used in this study.Metabolites and different metabolic patterns were analyzed by gas chromatography,mass spectrometry and principal components analysis (PCA),respectively.Differentiation performance was validated by the area under the curve (AUC) of receiver operating characteristic curves.RESULTS:Twenty-nine metabolites were differentially expressed in animal models of human gastric cancer.Of the 29 metabolites,20 were up-regulated and 9 were down-regulated in metastasis group compared to non-metastasis group.PCA models from the metabolite profiles could differentiate the metastatic from the nonmetastatic specimens with an AUC value of 1.0.These metabolites were mainly involved in several metabolic pathways,including glycolysis (lactic acid,alaline),serine metabolism (serine,phosphoserine),proline metabolism (proline),glutamic acid metabolism,tricarboxylic acid cycle (succinate,malic acid),nucleotide metabolism (pyrimidine),fatty acid metabolism (docosanoic acid,and octadecanoic acid),and methylation(glycine).The serine and proline metabolisms were highlighted during the progression of metastasis.CONCLUSION:Proline and serine metabolisms play an important role in metastasis.The metabolic profiling of tumor tissue can provide new biomarkers for the treatment of gastric cancer metastasis.

Gastric splenosis mimicking a gastrointestinal stromal tumor:A case report

BACKGROUND Mass lesions located in the wall of the stomach(and also of the bowel)are referred to as“intramural.”The differential diagnosis of such lesions can be challenging in some cases.As such,it may occur that an inconclusive fine needle aspiration(FNA)result give way to an unexpected diagnosis upon final surgical pathology.Herein,we present a case of an intramural gastric nodule mimicking a gastric gastrointestinal stromal tumor(GIST).CASE SUMMARY A 47-year-old Caucasian woman,who had undergone splenectomy for trauma at the age of 16,underwent gastroscopy for long-lasting epigastric pain and dyspepsia.It revealed a 15 mm submucosal nodule bulging into the gastric lumen with smooth margins and normal overlying mucosa.A thoraco-abdominal computed tomography scan showed in the gastric fundus a rounded mass(30 mm in diameter)with an exophytic growth and intense enhancement after administration of intravenous contrast.Endoscopic ultrasound scan showed a hypoechoic nodule,and fine needle FNA was inconclusive.Gastric GIST was considered the most probable diagnosis,and surgical resection was proposed due to symptoms.A laparoscopic gastric wedge resection was performed.The postoperative course was uneventful,and the patient was discharged on the seventh postoperative day.The final pathology report described a rounded encapsulated accumulation of lymphoid tissue of about 4 cm in diameter consistent with spleen parenchyma implanted during the previous splenectomy.CONCLUSION Splenosis is a rare condition that should always be considered as a possible diagnosis in splenectomized patients who present with an intramural gastric nodule.

MassARRAY Assay高通量技术检测胃癌LTA单核苷酸多态性及其临床应用

目的探讨LTA基因单核苷酸多态性与胃癌易感性的相关性。方法选择60例胃癌患者和60例健康人群为研究对象。采用Mass ARRAY Assay高通量技术检测淋巴毒素-α（LTA）基因单核苷酸（SNP）位点rs909253基因多态性,分析其出现频率及与胃癌易感性的相关性。结果胃癌组与正常组在AA基因频率（20.00%vs.21.67%）差异无统计学意义;G等位基因、GA、GG＋GA基因型或变异基因型与胃癌易感风险相关[OR（95%CI）：1.48（1.15~1.99）、1.36（1.05~1.68、1.32（1.22~1.65）]。结论 LTA基因rs909253位点单核苷酸多态性与胃癌易感性相关,G等位基因、GG、GA、GG＋GA基因型或变异基因型可能是胃癌发病的危险因素。

Comparing upper gastrointestinal X-ray and endoscopy for gastric cancer diagnosis in Korea

AIM:To compare the cost and accuracy of upper gastrointestinal(GI)X-ray and upper endoscopy for diagnosis of gastric cancer using data from the 2002-2004 Korean National Cancer Screening Program(NCSP). METHODS:The study population included 1 503 646 participants in the 2002-2004 stomach cancer screening program who underwent upper GI X-ray or endoscopy.The accuracy of screening was defined as the probability of detecting gastric cancer.We calculated the probability by merging data from the NCSP and the Korea Central Cancer Registry.We estimated the direct costs of the medical examination and the tests for up- per GI X-ray,upper endoscopy,and biopsy. RESULTS:The probability of detecting gastric cancervia upper endoscopy was 2.9-fold higher than via upper GI X-ray.The unit costs of screening using upper GI X-ray and upper endoscopy were$32.67 and$34.89, respectively.In 2008,the estimated cost of identifying one case of gastric cancer was$53094.64 using upper GI X-ray and$16 900.43 using upper endoscopy.The cost to detect one case of gastric cancer was the same for upper GI X-ray and upper endoscopy at a cost ratio of 1:3.7. CONCLUSION:Upper endoscopy is slightly more costly to perform,but the cost to detect one case of gastric cancer is lower.

Impact of being overweight on the surgical outcomes of patients with gastric cancer: A meta-analysis

AIM: To investigate the effect of being overweight on the surgical results of patients with gastric cancer. METHODS: Comprehensive electronic searches of the PubMed, Web of Science, and Cochrane Library databases were conducted. Studies were identified that included patients with surgical complications from gastric cancer who were classified as normal weight [body mass index (BMI) < 25 kg/m 2 ] or overweight (BMI ≥ 25 kg/m 2 ). The operative time, retrieved lymph nodes, blood loss, and long-term survival were analyzed. A subgroup analysis was conducted based on whether patients received laparoscopic or open gastrectomy procedures. All statistical tests were performed using ReviewerManager 5.1.2 software. RESULTS: This meta-analysis included 23 studies with 20678 patients (15781 with BMI < 25 kg/m 2 ; 4897 with BMI ≥ 25 kg/m 2 ). Overweight patients had significantly increased operation times [MD: -29.14; 95%CI: -38.14-(-20.21); P < 0.00001], blood loss [MD: -194.58; 95%CI: -314.21-(-74.95); P = 0.001], complications (RR: 0.75; 95%CI: 0.66-0.85; P < 0.00001), anastomosis leakages (RR: 0.59; 95%CI: 0.42-0.82; P = 0.002), and pancreatic fistulas (RR: 0.486; 95%CI: 0.34-0.63; P < 0.00001), whereas lymph node retrieval was decreased significantly in the overweight group (MD: 1.69; 95%CI: 0.75-2.62; P < 0.0001). In addition, overweight patients had poorer long-term survival (RR: 1.14; 95%CI: 1.07-1.20; P < 0.0001). No significant difference was detected for the mortality and length of hospital stay. CONCLUSION: This meta-analysis demonstrates that a high BMI not only increases the surgical difficulty and complications but also impairs the long-term survival of patients with gastric cancer.

Preliminary study of automatic gastric cancer risk classification from photofluorography

AIM To perform automatic gastric cancer risk classificationusing photofluorography for realizing effective mass screening as a preliminary study. METHODS We used data for 2100 subjects including X-ray images, pepsinogen Ⅰ and Ⅱ levels, PGⅠ/PGⅡ ratio, Helicobacter pylori (H. pylori) antibody, H. pylori eradication history and interview sheets. We performed two-stage classification with our system. In the first stage, H. pylori infection status classification was performed, and H. pylori-infected subjects were automatically detected. In the second stage, we performed atrophic level classification to validate the effectiveness of our system.RESULTS Sensitivity, specificity and Youden index(YI) of H. pylori infection status classification were 0.884, 0.895 and 0.779, respectively, in the first stage. In the second stage, sensitivity, specificity and YI of atrophic level classification for H. pylori-infected subjects were 0.777, 0.824 and 0.601, respectively. CONCLUSION Although further improvements of the system are needed, experimental results indicated the effectiveness of machine learning techniques for estimation of gastric cancer risk.

Risk factors for tuberculosis after gastrectomy in gastric cancer

AIM: To examine incidence of tuberculosis(TB) in gastrectomy patients and investigate the risk factors for developing TB after gastrectomy in patients with gastric cancer.METHODS: A retrospective cohort study of gastrectomy patients with gastric cancer was performed at a university-affiliated hospital in Seoul, South Korea between January 2007 and December 2009. We reviewed patient medical records and collected data associated with the risk of TB, surgery, and gastric cancer. Standardized incidence ratios(SIRs) of TB were calculated to compare the incidence of TB in gastrectomy patients with that in the general Korean population, and risk factors for TB after gastrectomies were analyzed.RESULTS: Among the 1776 gastrectomy patients, 0.9%(16/1776) developed post-gastrectomy TB, with an incidence of 223.7 cases per 100000 patients per year. The overall incidence of TB in gastrectomy patients, adjusted by sex and age, was significantly higher thanthat in the general population(SIR = 2.22, 95%CI: 1.27-3.60). Previous TB infection [odds ratio(OR) = 7.1, P < 0.001], lower body mass index(BMI)(kg/m2; OR = 1.21, P = 0.043) and gastrectomy extent(total gastrectomy vs subtotal gastrectomy)(OR = 3.48, P = 0.017) were significant risk factors for TB after gastrectomy in a multivariate analysis.CONCLUSION: TB incidence after gastrectomy is higher than that in the general population. Previous TB infection, lower BMI, and total gastrectomy are risk factors for TB after gastrectomy in patients with gastric cancer.

Impact of body mass index on short-term outcomes of laparoscopic gastrectomy in Asian patients: A meta-analysis

AIM To perform a meta-analysis to investigate the correlation between body mass index(BMI) and the shortterm outcomes of laparoscopic gastrectomy(LG) for gastric cancer(GC) in Asian patients. METHODS The Pub Med, Cochrane, EMBASE, and Web of Science databases were searched for studies that focused on the impact of obesity on the short-term outcomes of LG for GC in Asian patients who were classified into a high BMI(BMI ≥ 25 kg/m^2) or low BMI group(BMI < 25 kg/m^2). The results are expressed using the pooled odds ratio(OR) for binary variables and standard mean difference(SMD) for continuous variables with 95%confidence interval(CI), and were calculated according to the fixed-effects model while heterogeneity was not apparent or a random-effects model while heterogeneity was apparent.RESULTS Nine studies, with a total sample size of 6077, were included in this meta-analysis. Compared with the low BMI group, the high BMI group had longer operative time(SMD = 0.26, 95%CI: 0.21 to 0.32, P < 0.001), greater blood loss(SMD = 0.19, 95%CI: 0.12 to 0.25, P < 0.001), and fewer retrieved lymph nodes(SMD =-0.13, 95%CI: 0.18 to 0.07, P < 0.001). There was no significant difference between the high and low BMI groups in postoperative complications(OR = 1.12, 95%CI: 0.95 to 1.33, P = 0.169), the duration of postoperative hospital stay(SMD = 0.681, 95%CI:-0.05 to 0.07, P = 0.681), postoperative mortality(OR = 1.95, 95%CI: 0.78 to 4.89, P = 0.153), or time to resuming food intake(SMD = 0.00, 95%CI:-0.06 to 0.06, P = 0.973).CONCLUSION Our meta-analysis provides strong evidence that despite being associated with longer operative time, greater blood loss, and fewer retrieved lymph nodes, BMI has no significant impact on the short-term outcomes of LG for GC in Asian patients, including postoperative complications, the duration of postoperative hospital stay, postoperative mortality, and time to resuming food intake. BMI may be a poor risk factor for shortterm outcomes of LG. Other indices should be taken into account.

Visualization of sphingolipids and phospholipids in the fundic gland mucosa of human stomach using imaging mass spectrometry

AIM:To analyze the lipid distribution in gastric mucosae.METHODS:Imaging mass spectrometry(MS)is a useful tool to survey the distribution of biomolecules in surgical specimens.Here we used the imaging MS apparatus named i MScope to identify the dominant molecules present in the human gastric mucosa near the fundic glands.Five gastric specimens were subjected to iM Scope analysis.These specimens were also analyzed by immunohistochemistry using MUC5 AC,H(+)-K(+)-ATPaseβ Claudin18 antibodies.RESULTS:Three major molecules with m/z 725.5,780.5,and 782.5 detected in the gastric mucosa were identified as sphingomyelin(SM)(d18:1/16:0),phosphatidylcholine(PC)(16:0/18:2),and PC(16:0/18:1),respectively,through MS/MS analyses.Using immunohistological staining,SM(d18:1/16:0)signals were mainly colocalized with the foveolar epithelium marker MUC5 AC.In contrast,PC(16:0/18:2)signals were observed in the region testing positive for the fundic gland marker H(+)-K(+)-ATPaseβ.PC(16:0/18:1)signals were uniformly distributed throughout the mucosa.CONCLUSION:Our basic data will contribute to the studies of lipid species in physical and pathological conditions of the human stomach.

Metabolomic alterations and chromosomal instability status in gastric cancer

AIM To explore the correlation of metabolomics profiles ofgastric cancer(GC) with its chromosomal instability(CIN) status.METHODS Nineteen GC patients were classified as CIN and nonCIN type by The Cancer Genome Atlas Research Group system, based on 409 oncogenes and tumor suppressor genes sequenced. The aqueous metabolites of the GC tumor and its surrounding adjacent healthy tissues were identified through liquid chromatographymass spectrometry. Groups were compared by defining variable importance in projection score of > 1.2, a fold change value or its reciprocal of > 1.2, and a P value of < 0.05 as a significant difference.RESULTS In total,twelve men and seven women were enrolled, with a median age of 66 years(range, 47-87 years). The numbers of gene alterations in the CIN GC group were significantly higher than those in the non-CIN GC(32-218 vs 2-17; P < 0.0005). Compared with the adjacent healthy tissues, GC tumors demonstrated significantly higher aspartic acid, citicoline, glutamic acid, oxidized glutathione, succinyladenosine, and uridine diphosphate-Nacetylglucosamine levels, but significantly lower butyrylcarnitine, glutathione hydroxyhexanoycarnitine, inosinic acid, isovalerylcarnitine, and threonine levels(all P < 0.05). CIN tumors contained significantly higher phosphocholine and uridine 5'-monophosphate levels but significantly lower beta-citryl-L-glutamic acid levels than did non-CIN tumors(all P < 0.05). CIN GC tumors demonstrated additional altered pathways involving alanine, aspartate, and glutamate metabolism, glyoxylate and dicarboxylate metabolism, histidine metabolism, and phenylalanine, tyrosine, and tryptophan biosynthesis.CONCLUSION Metabolomic profiles of GC tumors and the adjacent healthy tissue are distinct, and the CIN status is associated with downstream metabolic alterations in GC.

模拟胃液环境下谷维素清除亚硝酸钠及阻断亚硝胺的作用

为降低人体内亚硝胺类化合物含量,采用模拟胃液结合液质联用的方法研究谷维素清除亚硝酸钠及阻断亚硝胺的作用。结果表明:在模拟胃液条件下,谷维素能有效清除亚硝酸钠,且亚硝酸钠的清除率与谷维素液添加量呈正相关关系;在膳食样品中添加谷维素能有效降低N-亚硝基-N-乙基苯胺、N-亚硝基二乙基胺、N-亚硝基吡咯烷的含量,其阻断率分别为100%、100%和24.4%。谷维素在模拟胃液条件下能通过降低亚硝酸钠含量减少内源性亚硝胺合成的反应底物,从而阻断亚硝胺的合成。

模拟胃液结合液质联用研究紫苏对内源性亚硝胺的阻断作用

为研究蔬菜对亚硝胺的阻断效果,在模拟胃液环境下结合液质联用,研究紫苏提取液对内源性亚硝胺的阻断作用。结果表明,在模拟胃液环境下加入紫苏液与亚硝酸钠,亚硝酸钠清除率可达10.4%。加入紫苏液、亚硝酸钠和二乙胺进行液相色谱质谱检测,空白样品和添加紫苏的样品中二乙基亚硝胺生成量分别为0.2、0.1 ng/mL,抑制率达到50%。添加紫苏的膳食中N-亚硝基二甲基(NDMA)、N-亚硝基二乙基(NDEA)、N-亚硝基二丁基(NDBA)、N-亚硝基吡咯烷(NPYR)含量显著降低。NDMA、NDEA在空白膳食中含量均为0.2 ng/g,紫苏试验组均未检出。NDBA空白对照为0.4 ng/g,紫苏试验组为0.2 ng/g,抑制率为50%;NPYR空白对照为8.6 ng/g,紫苏试验组为4.9 ng/g,抑制率为43%。因此,紫苏对内源性亚硝胺有明显的阻断作用。

Roux-en-Y gastric bypass for Chinese type 2 diabetes mellitus patients with a BMI,28kg/m^2:a multi-institutional study

Roux-en-Y gastric bypass surgery（RYGB） has been demonstrated to be successful for treating type-II diabetes2mellitus（T2DM） patients with a body mass index（BMI）,30 kg/m,but reports of RYGB for T2 DM patients with22 a BMI,28 kg/mare lacking.T2 DM patients with a BMI,28 kg/mwere prospectively recruited to participate in this study in four hospitals.The endpoint was T2 DM remission（defined by fasting blood glucose（FBG） level,110 mg/d L and hemoglobin（Hb）A1c level,6.0% at 12 months postoperatively）.Predictors of remission were investigated by univariate and multivariate analyses.Eighty-six patients were assessed.Eighty-five patients underwent RYGB,with one conversion to open surgery.We compared the values of various variables before and after2 surgery.The mean BMI decreased from 24.68±2.12 to 21.72±2.43 kg/m（P,0.001）.Fifty-eight（67.4%） patients were not treated by drugs or insulin after surgery,and 20 patients（23.3%） had complete remission of T2 DM at12 months after surgery with an acceptable number of complications.The mean Hb A1 c level in the remission group was significantly lower than that in the non-remission group.Patients with a higher weight,lower Hb A1 c level,higher C-peptide level,and higher FBG level were more likely to have T2 DM remission in multivariate2 analyses.In conclusion,RYGB was effective and safe for treating T2 DM patients with a BMI,28 kg/m.Complete remission can be predicted by cases having a higher weight,lower Hb A1 c level,higher C-peptide level,and higher FBG level.

磁控胶囊内镜的临床应用

目的 回顾性分析磁控胶囊内镜联合电子胃镜在临床中的应用,包括对胃部及小肠常见疾病的诊断与筛查。方法 收集2018年9月至2022年8月在河北省人民医院进行磁控胶囊内镜检查的患者910例,分析磁控胶囊内镜诊断的准确性,另对此910例患者进行回顾性分析,在不同年龄组方面;以季节分为春夏秋冬4组,分析不同疾病的发病率的差异。结果 910例患者中465例患者3个月内进行过电子胃镜检查,磁控胶囊内镜对于食管的诊断符合率差异有统计学意义(P<0.05),胃部及十二指肠诊断符合率差异无统计学意义(P>0.05)。另对此910例患者进行回顾性分析,在不同年龄组方面,部分疾病的检出率组间比较差异有统计学意义(P<0.05),以中老年组最多见;以性别分组,进行回顾性统计学分析,慢性非萎缩性胃炎和胃息肉两种疾病男性检出率均低于女性,差异有统计学意义(P<0.05);反流性食管炎、十二指肠溃疡、胃溃疡女性检出率均低于男性,差异有统计学意义(P<0.05)。对910例患者的小肠的检查进行统计学分析,其中小肠肿物的检出率为3/910,小肠出血的检出率为2/910,小肠多发淋巴管扩张289/910,回肠多发淋巴滤泡增生的检出率为216/910,小肠炎的检出率为26/910,小肠多发血管扩张检出率为1/910。结论 磁控胶囊内镜应用于胃部检查及十二指肠检查的结果与电子胃镜的检出率相似,食管的诊断较电子胃镜检查有差异,对910例患者进行胃部检查进行回顾性分析,中老年人疾病的发病率更高,男性胃病疾病的发病率高于女性,可用于胃部疾病的筛查,磁控胶囊内镜检查亦可用于小肠疾病的诊断。

FTO、GSDMD在胃癌组织中的表达及其作用机制研究

目的探讨肥胖相关蛋白(FTO)与消皮素D(GSDMD)在胃癌(GC)组织中的表达及其作用机制。方法通过TIMER 2.0数据库分析FTO及GSDMD在GC组织中的差异表达。收集2022年1月至2023年3月广西医科大学第二附属医院手术切取的GC组织及其对应癌旁组织(距离肿瘤边缘3~5 cm)各45例,并收集患者的临床病理资料。采用免疫组织化学染色法检测组织中FTO、GSDMD的表达情况,分析其与患者临床病理特征的关联性。通过转染低表达FTO慢病毒构建低表达FTO的AGS细胞(FTO低表达组),并以转染空载体慢病毒的细胞作为对照组。采用实时荧光定量聚合酶链式反应(RT-PCR)法检测两组细胞FTO mRNA、GSDMD mRNA的表达水平;采用细胞划痕实验及细胞迁移实验分析两组细胞迁移能力。结果基于TIMER 2.0数据库的分析结果及免疫组织化学染色结果显示,FTO、GSDMD在GC组织中呈高表达(P<0.05)。FTO和GSDMD高表达均与肿瘤侵犯深度、淋巴结转移密切相关(P<0.05)。细胞实验结果显示,FTO低表达组的GSDMD mRNA表达水平显著低于对照组(P<0.05),划痕愈合率更低,细胞迁移数更少,差异均有统计学意义(P<0.05)。结论FTO可能通过调控GSDMD表达促进GC细胞转移。

健脾化瘀汤联合化疗对胃癌患者免疫功能及肿瘤标志物水平的影响

目的探讨健脾化瘀汤联合化疗对胃癌患者免疫功能及肿瘤标志物水平的影响。方法选取2021年1月—2022年12月收治的62例胃癌患者,以随机数字表法分为对照组(31例,接受替吉奥联合奥沙利铂治疗)和观察组(31例,在对照组基础上联合健脾化瘀汤治疗)。比较2组治疗效果。结果观察组治疗总有效率高于对照组(P<0.05);2组治疗后血清肿瘤标志物水平均降低,且观察组更低(P<0.05);2组治疗后免疫功能指标均上升,且观察组更高(P<0.05)。结论健脾化瘀汤联合化疗可抑制胃癌患者肿瘤细胞复制,增强免疫功能,临床疗效显著。

单腔与双腔内镜下闭合内镜黏膜下剥离术相关创面或穿孔的疗效比较

目的观察比较单腔内镜(SCE)与双腔内镜(DCE)下荷包缝合内镜黏膜下剥离术(ESD)相关手术创面或穿孔的临床效果。方法胃黏膜或黏膜下肿块患者38例,随机分成A、B两组,并行ESD术。其中SCE组予以SCE下闭合创面或穿孔,DCE组予以DCE下闭合。结果 38例行ESD术后,创面或穿孔均予以SCE或DCE下尼龙绳成功闭合。结论应用SCE或DCE下尼龙绳和钛夹成功闭合ESD创面或大穿孔,两者疗效相当,但SCE应用更加广泛。SCE有望取代DCE用于ESD创面或大穿孔的闭合,这为内镜下闭合大面积胃肠穿孔或ESD创面提供了新的途径。

胃癌前病变癌变机制及筛查研究进展

胃癌前病变是胃癌发生和发展过程中的一个重要阶段,早期发现和干预是防控胃癌的重要手段。内镜作为筛查的最终手段,存在诸多制约,通过对胃癌前病变的机制研究,发现操作简便、灵敏度高的标志物用于对胃癌前病变的筛查是目前研究的着重点。本文就现阶段胃癌前病变的癌变机制研究及筛查手段进展作一阐述。