PI3K/Akt/mTOR和MAPK/ERK信号通路在胃癌细胞生长中协同作用及机制

  目的  探讨胃癌家族史及血清学指标联合¹⁴C呼气试验在中老年人群胃癌筛查中的价值。  方法  于2017年5 — 8月在江苏省南京市鼓楼区中央门街道的3个社区随机抽取935名社区居民进行问卷调查、幽门螺杆菌（HP）检测和血样采集，并根据胃癌家族史、HP检测结果和实验室检测结果进行综合分析筛选出高危人群，建议高危人群进行胃镜筛查。  结果  调查的935名社区居民中，共筛出102例高危人群，10例（9.8 %）为有癌胚抗原和糖抗原1项异常者；32例（31.4 %）为有HP强阳性、血常规异常和胃癌家族史3项中任意2项者。102例高危人群中有20例自愿进行胃镜检测，均患有不同程度的胃部疾病，其中2例（10.0 %）为癌前病变，1例（5.0 %）为异常肿块待复查，10例（50.0 %）为慢性萎缩性胃炎，7例（35.0 %）为重度浅表性胃炎。本研究建立的综合筛查方法的癌前病变检出率为10 %。  结论  本研究建立的综合筛查方法的癌前病变检出率较高，优于大多数其他同类研究的筛查方法，可用于中老年人群胃癌筛查和临床胃癌辅助诊断。

Cancer statistics in China, 2015

  Objective  To explore the significance of gastric cancer family history and serological indicators combined with ¹⁴C-urea breath test in gastric cancer screening among middle-aged and elderly community residents.  Methods  We randomly selected 935 residents at ages 40 years and older at 3 communities in Nanking city of Jiangsu province for a survey including questionnaire interview, Helicobacter pylori (HP) detection with ¹⁴C-urea breath test (UBT) and blood sample collection for serum tumor marker measurement from May to August 2017. Then, we screened out individuals at a high-risk of gastric cancer based on their family history of gastric cancer and results of HP and serum tumor marker test and carried out a voluntary gastroscopy examination among the residents with a high gastric cancer risk.  Results  Among all the participants, totally 102 were assessed with a high risk of gastric cancer. Of the high risk individuals, 10 (9.8%) were seropositive for carcinoembryonic antigen or carbohydrate antigen and 32 (31.4%) were positive for any two of three detection items including strong HP infection, abnormality of blood routine examination, family history of gastric cancer. Various pathologic changes of stomach tissues were observed among all the 20 high-risk individuals having gastroscopy examination voluntarily, including 2 (10.0%) precancerous lesions, 1 (5.0%) neoplasm to be reexamined, 10 (50.0%) chronic atrophic gastritis, and 7 (35.0%) severe superficial gastritis, respectively. The overall detection rate of precancerous lesion for the comprehensive screening was 10%.  Conclusion  The comprehensive screening method established in this study has a high detection rate of precancerous lesions, which is superior to other similar studies and can be used for screening and clinical auxiliary diagnosis of gastric cancer among middle-aged and elderly populations.