早期出现的胃肠癌:一篇综述
Thejus Jayakrishnan1, Kimmie Ng1
1Department of Medical Oncology, Dana-Farber Cancer Institute, Boston, Massachusetts.
JAMA
|July 17, 2025
概括
在全球范围内,早期出现的胃肠道癌症正在增加,其中结肠直肠癌是最常见的. 尽管治疗方法与晚期癌症相似, 但存活率往往更差, 这强调了需要更好的预防和检测.
科学领域:
- 癌症学
- 胃肠病学
- 遗传学
背景情况:
- 在50岁之前诊断的早期胃肠癌在全球范围内增加,并且是美国增长最快的早期癌症.
- 结肠直肠癌 (CRC) 是全球和美国最常见的早期肠胃癌,其次是胃,食道和胰腺癌.
- 可改变的危险因素包括肥胖,饮食不良,久坐不动的生活方式,吸烟和饮酒;不可改变的危险因素包括家族病史和遗传性综合征.
研究的目的:
- 总结目前早期肠道癌的情况,包括发病率,危险因素,诊断,治疗和预后.
- 突出基因检测对治疗指导和评估家族风险的重要性.
- 强调需要改善预防和早期检测策略.
主要方法:
- 2022年全球和美国早期胃肠道癌发病率数据的审查.
- 相关可修改和不可修改风险因素的分析.
- 目前诊断和治疗方法的概述,包括遗传检测.
- 与晚期发生的肠胃癌的结局和存活率的比较.
主要成果:
- 早期发生的胃肠道癌变得越来越普遍,而CRC是最常见的类型.
- 很大一部分早期胃肠道癌与遗传倾向有关.
- 治疗方案与晚期癌症的治疗方案相似,但存活率相似或更差.
- 专门的中心提供生育,心理和经济困难的支持.
结论:
- 早期发生的肠道癌是全球日益严重的健康问题,对年轻人群产生重大影响.
- 基因检测对于个性化治疗和早期胃肠道癌的风险评估至关重要.
- 迫切需要改善预防和早期检测方法以改善患者的治疗结果.
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