The case fatality rate and mortality rate are so high, early screening for gastric cancer should not be taken lightly!

Tumors of the digestive tract mainly refer to esophageal cancer, gastric cancer and intestinal cancer that we common people often say.

Taking gastric cancer as an example, according to data from the National Cancer Center, China had 456,000 new cases and 390,000 deaths in 2018, accounting for 44.

Li Zhaoshen, a member of the National Committee of the Chinese People's Political Consultative Conference, an academician of the Chinese Academy of Engineering, and director of the Department of Gastroenterology, Changhai Hospital of Naval Military Medical University, said that the diagnosis rate of early gastric cancer nationwide is less than 20%, and the 5-year survival rate of gastric cancer patients is only 27.

At the same time, the prognosis of gastric cancer is closely related to the timing of diagnosis and treatment.

In terms of early screening for gastric cancer, Japan and South Korea have provided us with a reliable demonstration.

Academician Li Zhaoshen once said: "Early gastric cancer nine lives and one death, and advanced gastric cancer nine lives.

How to find gastric cancer early? First of all, we must clearly screen the population.

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In the actual application of gastric cancer screening procedures, the proportion of pathological conditions such as chronic atrophic gastritis and intraepithelial neoplasia confirmed by gastroscopy and pathological biopsy (hereinafter referred to as biopsy) is as high as 30%.

In the latest "Expert Consensus on Treatment Strategies for Precancerous Conditions and Precancerous Lesions of Gastric Mucosa (2020)", the definition, diagnosis, staging, treatment, monitoring and follow-up of precancerous conditions and precancerous lesions of gastric mucosa are published in the latest publication.

Among them, it states 11 recommendations: the ratio of serum pepsinogen Ⅰ to pepsinogen Ⅱ (PGR) and gastrin 17 can help determine the scope and degree of gastric mucosal atrophy.

Serum pepsinogen (PG) detection: PG is a good indicator reflecting the exocrine function of gastric antrum mucosa.

Gastrin-17 (gastrin-17, G-17) detection: G-17 is one of the sensitive indicators reflecting the endocrine function of the gastric antrum, which can indicate the atrophy of the gastric antrum mucosa or whether there is abnormal proliferation.
A decrease in G-17 indicates atrophy of the gastric antrum mucosa; an increase in G-17 level indicates a risk of gastric cancer.

The combined detection of PGR and gastrin 17 has been confirmed to be used to screen for gastric mucosal atrophy, including gastric antrum or gastric body mucosal atrophy, which is called "serological biopsy".
A large-scale domestic study showed that the risk of gastric cancer in patients with PGR＜3.
89 and gastrin 17＞＞5.
70pmol/L was 2.
02 and 2.
84 times that of healthy people, respectively.

The National Center for Gastroenterology Clinical Medicine has carried out a big data, multi-center clinical study involving more than 120 hospitals across the country.
The serum PG, G-17 and Hp antibodies were tested in nearly 15,000 patients at risk of gastric cancer.
All screens All subjects under investigation underwent endoscopy.
On the basis of the above research, a new gastric cancer screening scoring system has been established.
The screening results of a verification cohort of more than 5,000 cases confirmed that the effectiveness of the new scoring system for gastric cancer screening has been significantly improved.

The adoption of a new gastric cancer screening scoring system can significantly improve the screening efficiency, adopt endoscopic precision screening strategies for the population with the highest risk of gastric cancer, thereby increasing the early gastric cancer diagnosis rate, and at the same time adopt suitable follow-up strategies for relatively low-risk populations.
Save medical resources.
With reference to previous domestic and foreign gastric cancer screening methods, combined with the latest domestic clinical evidence, the recommended early gastric cancer screening process is shown in Figure 1:

There are many detection methods for pepsinogen, such as radioimmunoassay (RIA), time-resolved fluorescent immunoassay (TRFIA), latex-enhanced turbidimetric immunoassay and enzyme-linked immunoassay (ELISA), etc.
The application of the luminous platform to this project has increasingly adopted this method in clinical practice, because it is more necessary to accurately detect the true values ​​of PG Ⅰ and PG Ⅱ when the ratio is involved.