ヨーロッパにおける上皮癌前症および胃病変の管理に関する臨床実務ガイドラインの遵守
Filipa Fontes1,2, Noa E A Kapteijn3, Cesare Hassan4
1Precancerous Lesions and Early Cancer Management Group, Research Center of IPO Porto (CI-IPOP)/CI-IPOP@RISE (Health Research Group), Portuguese Institute of Oncology of Porto (IPO Porto)/Porto Comprehensive Cancer Center (Porto.CCC), Porto, Portugal.
Endoscopy
|September 3, 2025
まとめ
胃前症候群管理ガイドライン (MAPS) の遵守はヨーロッパ各センターで改善されました. しかし,仮想クロモエンドスコーピーとスコアリングの課題は依然として存在し,よりよい監視のためにカスタマイズされた実装戦略が必要である.
科学分野:
- 胃腸内科
- エンドスコピー
- 腫瘍学
背景:
- 胃のプレネオプラスティック状態の管理 (MAPS) のガイドラインは2012年に導入され (MAPS I) 2019年に更新されました (MAPS II).
- これらの国際ガイドラインの遵守を評価することは,効果的な胃がん予防に不可欠です.
研究 の 目的:
- MAPS I と II の導入前と後の欧州センターにおける MAPS ガイドラインの遵守を評価する.
- 改善すべき分野や 胃の不整形前症候群の管理における 持続的なギャップを特定する.
主な方法:
- 欧州7カ国の9つの内視鏡診療所から2,426人の患者を対象に行われた遡及的研究です.
- 3つの期間にわたって収集されたデータ:MAPS I前 (2010/2011年),MAPS I後の (2017/2018年),およびMAPS II後の (2022/2023年).
- 9つのMAPSの推奨事項への遵守の評価,生検の実践,H. pyloriの治療,内視鏡による監視を含む.
主要な成果:
- ほとんどのセンター (57%) は9つの勧告のうち7つで改善しました.
- アントラムとコープスのバイオプシーで 顕著な改善が見られた.
- 仮想クロモエンドスコーピーの使用,標的生検,内視鏡/組織病理学的スコアリングシステムの使用にはギャップが残っています.
結論:
- 一般的に,欧州のセンターでは,MAPSガイドラインの遵守が改善されています.
- 特定の診断とステージ設定のツールの持続的な課題は,監視プロトコルの有効性に影響を与える可能性があります.
- 最適な患者管理のためのMAPSのガイドラインの実施を強化するために,個別化されたアプローチが必要である.
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