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早期胃癌的规范化治疗
引用本文:苗儒林,李子禹,季加孚.早期胃癌的规范化治疗[J].普外基础与临床杂志,2014(1):16-20.
作者姓名:苗儒林  李子禹  季加孚
作者单位:北京大学肿瘤医院暨北京市肿瘤防治研究所胃肠肿瘤外科,恶性肿瘤发病机制及转化研究教育部重点实验室,北京100142
摘    要:目的对早期胃癌的规范化治疗进行总结。方法对目前世界各国的早期胃癌诊疗指南进行分析,总结国际范围内对早期胃癌的规范化治疗模式。结果精准的术前评估是早期胃癌规范化治疗的基础。早期胃癌术前评估包括分期诊断及分级诊断,分期诊断的重点是对肿瘤浸润深度及淋巴结转移的评估;分级诊断的重点则是对肿瘤病理类型及分化程度的评估。在精准评估的基础上,早期胃癌的治疗策略包括内镜手术、腹腔镜手术、开放手术、综合治疗等方式。不同治疗方式各有其适应证,但是在不同指南的推荐中,适应证略有差异。结论在临床实践应用中应结合患者的具体情况,诊断优先,通过规范的个体化治疗为患者带来最大获益。

关 键 词:早期胃癌  规范化治疗  内镜手术  腹腔镜手术  开放手术

Standardized Treatment for Early Gastric Cancer
Authors:MIAO Ru-lin  LI Zi-yu  JI Jia-fu
Institution:. (Key Laboratory of Carcinog- enesis and Translational Research (Ministry of Education), Department of Gastrointestinal Surgery, Peking University Cancer Hospital & Institute, Beijing 100142, China)
Abstract:Objective To summary the standard treatment for early gastric cancer. Methods The current early gastric cancer treatment guidelines around the world were analyzed and the standardized treatment patterns for early gastric cancer were concluded. Results The accurate preoperative evaluation for early gastric cancer is the basis of standardized treatment which can be divided into staging evaluation and histological evaluation. The staging evaluation is focused on the gastric wall invasion and lymph node involvement of the tumor while the histologic evaluation emphasize the histological type and grading of the tumor. According to the precise evaluation for early gastric cancer, endoscopic surgery, laparoscopic surgery, open surgery, and multimodal therapy can be applied individually to the patients. Different treatment methods have their indications, but the indications of the therapies in different guidelines are suggested with slight differences. Conclusion In clinical practice, the choice of treatment should be made with comprehensive consideration of diagnosis and individual characteristics of patients to achieve the most benefit on prognosis.
Keywords:Early gastric cancer  Standardized treatment  Endoscopic surgery  Laparoscopic surgery  Opensurgery
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