Commentary on: the management of patients with gastric intestinal metaplasia

IF 23 1区 医学 Q1 GASTROENTEROLOGY & HEPATOLOGY Gut Pub Date : 2024-09-18 DOI:10.1136/gutjnl-2024-333684
David Y Graham, Yi-Chia Lee
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Abstract

Recently, Gut published a review of guidelines for the management of gastric intestinal metaplasia (GIM) with the goal of promoting harmonisation of the guidelines regarding indications for endoscopic screening for gastric cancer and GIM detection/staging, metrics for high-quality endoscopy and non-endoscopic interventions for gastric cancer prevention in patients with GIM.1 GIM is not a disease per se but rather is a reparative response to gastric mucosal injury that may be present, at least temporarily, as part of healing such as of an ulcer.2 Clinically, widespread GIM is best considered a manifestation of healing of another disease, typically Helicobacter pylori infection or autoimmune gastritis. When present in autoimmune gastritis, GIM has no malignant potential and is potentially completely reversible.3 In contrast, when associated with chronic H. pylori infection, GIM is typically permanent and, at most, minimally reversible.4 The underlying H. pylori -induced inflammation is carcinogenic. H. pylori -related GIM is a manifestation of the duration, extent and severity of an H. pylori infection which, in turn, is related to the risk of gastric cancer. Because GIM is easily recognised and reflects the extent and severity of the infection, it is a valuable surrogate for the risk of developing gastric cancer. This has given GIM a role in the determination of an individual’s cancer risk. However, because GIM is neither a disease nor a cause of cancer, eradication of gastric cancer should focus on the eradication of the cause, that is, H. pylori infections. The population …
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评论:胃肠化生患者的管理
最近,Gut 出版了一份关于胃肠化生(GIM)管理指南的综述,目的是促进有关胃癌内镜筛查和 GIM 检测/分期适应症、高质量内镜检查指标和 GIM 患者胃癌预防非内镜干预措施指南的统一。GIM 本身并不是一种疾病,而是胃粘膜损伤的一种修复反应,至少是暂时性的,可能是溃疡愈合的一部分。3 相反,当与慢性幽门螺杆菌感染相关时,GIM 通常是永久性的,最多只有很小的可逆性。与幽门螺杆菌相关的 GIM 是幽门螺杆菌感染持续时间、范围和严重程度的一种表现形式,而幽门螺杆菌感染反过来又与胃癌风险相关。由于 GIM 很容易识别并能反映感染的范围和严重程度,因此它是罹患胃癌风险的重要替代指标。这使得 GIM 在确定个人患癌风险方面发挥了作用。然而,由于 GIM 既不是一种疾病,也不是癌症的病因,因此根除胃癌的重点应放在根除病因(即幽门螺杆菌感染)上。人群 ...
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来源期刊
Gut
Gut 医学-胃肠肝病学
CiteScore
45.70
自引率
2.40%
发文量
284
审稿时长
1.5 months
期刊介绍: Gut is a renowned international journal specializing in gastroenterology and hepatology, known for its high-quality clinical research covering the alimentary tract, liver, biliary tree, and pancreas. It offers authoritative and current coverage across all aspects of gastroenterology and hepatology, featuring articles on emerging disease mechanisms and innovative diagnostic and therapeutic approaches authored by leading experts. As the flagship journal of BMJ's gastroenterology portfolio, Gut is accompanied by two companion journals: Frontline Gastroenterology, focusing on education and practice-oriented papers, and BMJ Open Gastroenterology for open access original research.
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