推进CDH1相关的胃癌的评估和管理
Benjamin A Lerner1, Samir Gupta2, Carol A Burke3
1Division of Gastroenterology, Department of Medicine, Yale University, New Haven, CT.
概括
对于CDH1致病变体,晚期胃癌的风险比以前认为的要低. 积极的内镜监测对于一些患者来说,可能是预防性胃切除术的可行替代方案.
科学领域:
- 在瘤学瘤学.
- 胃肠病学 胃肠病学
- 遗传学 遗传学 是一个
背景情况:
- CDH1致病性生殖系变体与遗传性胃癌有关.
- 从历史上看,由于癌症风险高,并且内镜检测密封环细胞癌 (SRCC) 检测不佳,因此建议进行预防性全胃切除术.
研究的目的:
- 审查目前关于CDH1相关胃癌自然史的证据.
- 为了评估胃切除术与内镜监测对管理CDH1变种携带者.
主要方法:
- 文献综述综合了关于CDH1胃癌的最新发现.
- 对手术与内镜治疗策略的风险和益处的分析.
主要成果:
- 在CDH1携带者中,晚期胃癌的累积终身风险可能低于此前估计的.
- 早期标签环细胞癌 (T1a) 在无症状携带者中很常见,可能不会进展到晚期的疾病.
- 活跃的内镜监测显示出作为胃切除术的替代品的潜力,但需要更长的随访时间.
结论:
- 在CDH1变异载体中进行胃切除的反射性建议需要重新评估.
- 个性化,基于证据的管理,考虑到胃切除风险和监视益处,对于患者护理至关重要.
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