CAJ | 학술논문

胃癌依然是世界范围内最常见的癌症之一。近些年，在日本，早期胃癌(early gastric cancer，EGC)约占胃癌治疗患者的57%，而在中国，该比例却不足10%。包括内镜粘膜下剥离术(endoscopic submucosal dissection，ESD)和内镜下粘膜切除术(endoscopic mucosal resection，EMR)在内的微创手术，对于EGC患者而言是治愈性的治疗，而且患者会获得很好的预后。对于EGC而言，规范化诊治流程非常重要。首先，内镜、超声内镜及组织学检查是筛选微创手术患者的关键步骤。第二，仔细评估微创手术标本可以为将来可能的外科干预提供重要信息，这些信息包括脉管瘤栓、肿瘤体积、组织学类型、浸润深度。此外，淋巴细胞浸润情况，淋巴管侵犯、HER2/neu、Mucin-4、VEGF C、VEGF D过表达是EGC的预后因素。
위암의연시세계범위내최상견적암증지일。근사년，재일본，조기위암(early gastric cancer，EGC)약점위암치료환자적57%，이재중국，해비례각불족10%。포괄내경점막하박리술(endoscopic submucosal dissection，ESD)화내경하점막절제술(endoscopic mucosal resection，EMR)재내적미창수술，대우EGC환자이언시치유성적치료，이차환자회획득흔호적예후。대우EGC이언，규범화진치류정비상중요。수선，내경、초성내경급조직학검사시사선미창수술환자적관건보취。제이，자세평고미창수술표본가이위장래가능적외과간예제공중요신식，저사신식포괄맥관류전、종류체적、조직학류형、침윤심도。차외，림파세포침윤정황，림파관침범、HER2/neu、Mucin-4、VEGF C、VEGF D과표체시EGC적예후인소。
Gastric cancer remains one of the most common cancers worldwide. In Japan, about 57% of gastric cancers that currently treated are early gastric cancer (EGC), but in China, the percentage of EGC that are treated is only 10%. Minimally invasive approaches including endoscopic mucosal resection (EMR) or endoscopic submucosal dissection (ESD) are utilized for curative treatment of EGC and the patients obtained favorable prognosis. It is very important to follow the procedure of the EGC treatment. Firstly, examination of endoscopy, endoscopic ultrasonography and histology are crucial steps of selecting suitable patients for EMR/ESD. Secondly, carefully assessment of EMR/ESD specimens is a very important component to provide information for further surgical intervention, these information including lymph vascular tumor thrombus, tumor size, histological type, and the depth of invasion, Furthermore, lymphoid infiltration, presence of lymphatic invasion, and over-expression of HER2/neu, Mucin-4, VEGF C, VEGF D are associate with prognosis of EGC.