2012年ESGE、EHSG、ESP、SPED幽门螺旋杆菌感染管理指南

Gastric cancer remains a major problem worldwide. The intestinal type of gastric cancer develops through a cascade of well-defined and recognizable precursors (inflammation–metaplasia–dysplasia–carcinoma sequence). It has been argued that the identification and surveillance of patients with such precursor conditions and lesions may lead to early diagnosis of gastric cancer. Indeed, this may be an important measure for prevention of death due to gastric cancer both in Western and Asian countries. However, even though such lesions are commonly found in everyday practice, there are no international recommendations to guide clinicians in their care of individuals with these changes. This leads to wide heterogeneity of practice and to failure to diagnose patients with curable forms of cancer. Standardization of management is likely to benefit patients, and may also be cost-effective by focusing resources on patients with the greatest risk.

This consensus project aimed to summarize current evidence on the management of patients with precancerous conditions and lesions, and to propose guidelines for the diagnosis and management of individuals with chronic gastritis, atrophy, intestinal metaplasia, or dysplasia. This Guideline does not address methodologies for screening these lesions in general populations, or the assessment and management of patients with other precancerous conditions, such as pernicious anemia, Ménétrier disease, or gastric stump, or treatment for gastric adenocarcinoma.