[胃肠道肿瘤预防策略]。

IF 0.6 4区 医学 Q3 MEDICINE, GENERAL & INTERNAL Deutsche Medizinische Wochenschrift Pub Date : 2024-04-01 DOI:10.1055/a-2060-2225
Michael Quante, Susann Schütte
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引用次数: 0

摘要

过去几十年来,胃肠道肿瘤疾病的早期检测和治疗取得了长足的进步。由于治疗和诊断选择的扩大和增强,导致(新)辅助治疗、围手术期治疗和姑息治疗策略的改变,以及个性化分子治疗的出现,患者的生存率得到了显著提高。尽管取得了这些进步,胃肠道肿瘤仍然是全球健康的负担,每年约有 400 万新病例确诊。新的证据表明,干细胞或祖细胞的异常分化与胃肠道肿瘤疾病的发病机制有关。临床公认的风险因素(包括高脂饮食、胆汁酸、微生物组改变和宿主因素)可引发慢性炎症。这破坏了干细胞的平衡,并诱发恶性转化。因此,环境炎症成为临床癌症预防和监测策略中需要考虑的关键风险因素。本综述概述了目前对预防某些胃肠道肿瘤的理解和建议,旨在促进将其纳入临床实践。它强调了继续研究的必要性,以进一步完善诊断和治疗策略并改善患者预后。
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[Gastrointestinal tumour prevention strategies].
Over the past few decades, substantial advancements have been achieved in the early detection and treatment of gastrointestinal oncological diseases. The survival rates of patients have significantly improved due to the expansion and enhancement of therapeutic and diagnostic options, leading to modifications in (neo-)adjuvant, perioperative, and palliative strategies, as well as the advent of personalized molecular therapy. Noteworthy progress has also been observed in primary, secondary, and tertiary prevention domains.Despite these advancements, gastrointestinal tumours continue to be a global health burden, with approximately 4 million new cases diagnosed annually. These constitute over a quarter of all tumour cases, with nearly one-third of all global tumour-related mortalities attributed to gastrointestinal tumours.Emerging evidence implicates aberrant differentiation of stem or progenitor cells in the pathogenesis of gastrointestinal tumour diseases. A confluence of clinically recognized risk factors, including high-fat diet, bile acid, microbiome alterations, and host factors, can instigate chronic inflammation. This disrupts stem cell homeostasis and precipitates malignant transformation. Consequently, environmental inflammation emerges as a critical risk factor warranting consideration in clinical cancer prevention and surveillance strategies.This review encapsulates the current understanding and recommendations in the prevention of selected gastrointestinal tumours, aiming to facilitate their integration into clinical practice. It underscores the need for continued research to further refine diagnostic and therapeutic strategies and improve patient outcomes.
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来源期刊
Deutsche Medizinische Wochenschrift
Deutsche Medizinische Wochenschrift 医学-医学:内科
CiteScore
0.80
自引率
0.00%
发文量
432
审稿时长
3-6 weeks
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