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1除菌后胃癌的临床特征及发病机制概述显示文摘胃癌是全世界最常见的癌症之一,其中幽门螺杆菌(Helicobacter pylori,H.pylori)是胃癌发生的重要因素之一,随着成功根除H.pylori患者数量的增加,除菌后发生胃癌的患者数目也相应增加。除菌后1年以上被发现的胃癌称为除菌后胃癌,由于H.pylori根除后胃黏膜的炎症消失,背景黏膜的改变使此类胃癌也发生了相应改变,本文将对除菌后胃癌的临床特征及发病机制进行概述。郭君燕 戴一扬 2022胃肠病学和肝病学杂志2022,31,5:0
2Kyoto classification of gastritis:Advances and future perspectives in endoscopic diagnosis of gastritis显示文摘This editorial provides an update of the recent evidence on the endoscopy-based Kyoto classification of gastritis,clarifying the shortcomings of the Kyoto classification,and providing prospects for future research,with particular focus on the histological subtypes of gastric cancer(GC)and Helicobacter pylori(H.pylori)infection status.The total Kyoto score is designed to express GC risk on a score ranging from 0 to 8,based on the following five endoscopic findings:Atrophy,intestinal metaplasia(IM),enlarged folds(EF),nodularity,and diffuse redness(DR).The total Kyoto score reflects H.pylori status as follows:0,≥2,and≥4 indicate a normal stomach,H.pylori-infected gastritis,and gastritis at risk for GC,respectively.Regular arrangement of collecting venules(RAC)predicts noninfection;EF,nodularity,and DR predict current infection;map-like redness(MLR)predicts past infection;and atrophy and IM predict current or past infection.Atrophy,IM,and EF all increase the incidence of H.pylori-infected GC.MLR is a specific risk factor for H.pylori-eradicated GC,while RAC results in less GC.Diffuse-type GC can be induced by active inflammation,which presents as EF,nodularity,and atrophy on endoscopy,as well as neutrophil and mononuclear cell infiltration on histology.In contrast,intestinal-type GC develops via atrophy and IM,and is consistent between endoscopy and histology.However,this GC risk-scoring design needs to be improved.Osamu Toyoshima Toshihiro Nishizawa 2022World Journal of Gastroenterology2022,28,43:0
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