胃上皮内瘤变的演变和逆转治疗  

Gastric Intraepithelial Neoplasia:Evolvement and Reversal Treatment

作　　者：吕宾[1] 

机构地区：[1]浙江中医药大学附属第一医院消化科,310006

出　　处：《胃肠病学》2011年第10期577-579,共3页Chinese Journal of Gastroenterology

摘　　要：胃上皮内瘤变是胃黏膜癌变过程中的重要环节,临床随访研究显示部分低级别上皮内瘤变是可逆的,经适当的治疗,大部分可以消退,仅少数加重或癌变。促进胃上皮内瘤变逆转对预防胃癌具有积极意义。根除幽门螺杆菌有助于减轻胃黏膜萎缩,逆转部分低级别上皮内瘤变,延缓肠化生的发展,补充各种抗氧化剂和微量元素可能有助于预防胃癌,但有限的临床试验证据尚不足以证明其逆转效果;环氧合酶(COX)-2有望成为治疗的靶点:中医中药在治疗胃上皮内瘤变方面积累了许多经验,但尚需更多高质量的循证医学证据。Gastric intraepithelial neoplasia is an important process in gastric carcinogenesis. Clinical follow-up studies showed that part of the low grade intraepithelial neoplasia is reversible and could regress after suitable treatment, and only a few will progress to cancer. Enhancing the reversal of intraepithelial neoplasia is of key importance for the prevention of gastric cancer. Eradication of Helicobacter pylori infection might reduce gastric mucosal atrophy, reverse intraepithelial neoplasia, and delay the progress of intestinal metaplasia. Antioxidant and micronutrients supplement might be helpful for preventing gastric cancer. However, the limited clinical trial evidence is not yet adequate for verifying the reversal effect. Inhibiting cyclooxygenase （COX）-2 expression might be a hopeful therapeutic target. Chinese traditional medicine has accumulated many experiences for the treatment of gastric intraepithelial neoplasia, however, high quality proofs of evidence-based medicine are needed for verification.

关 键 词：胃上皮内瘤变 演变 螺杆菌 幽门 环氧合酶 治疗 

分 类 号：R735.2[医药卫生—肿瘤]