Zusammenfassung
Das Magenkarzinom stellt uns immer noch vor eine schwere klinische Herausforderung, da wir bei der Mehrzahl der Patienten mit dieser Erkrankung die Diagnose erst im fortgeschrittenen Stadium stellen, in dem die Heilungsaussichten immer noch sehr gering sind. Die Chance ist in der Früherkennung und Prävention zu suchen. Eine valide Screening-Strategie ist bislang nicht etabliert, allerdings ermöglichen uns serologische Verfahren und die Anamnese eine Identifizierung von Risikogruppen. Das größte Potenzial zur Vorbeugung der Erkrankung liegt in der Eradikation der Helicobacter-pylori-Infektion. Die Entwicklung einer „Screen-and-treat-Strategie“ soll unser Ziel sein.
Abstract
Gastric cancer still represents an important clinical challenge, since in the majority of patients the disease is diagnosed at an advanced stage when the chance for cure is very low. Therefore early detection and prevention todate, no valid screening strategy has been established, but serological tests and the evaluation of the patient’s history allow the identification of individuals at high risk. The main potential for prevention of the disease lies in eradication of infection with Helicobacter pylori. The goal should be the development of a “screen-and-treat” strategy.
Literatur
Parkin DM, Bray F, Ferlay J, Pisani P (2005) Global cancer statistics, 2002. CA Cancer J Clin 55: 74–108
Bertz J, Hentschel S, Stabenow R et al. (2006) Krebs in Deutschland – Häufigkeiten und Trends, 5. Ausgabe. Gesellschaft der epidiologische Krebsregister in Deutschland e.V. (Hrsg) in Zusammenarbeit mit dem Robert Koch Institut. Saarbrücken (http://www.rki.de/krebs)
Coleman MP, Gatta G, Verdecchia A et al. (2003) EUROCARE-3 summary: cancer survival in Europe at the end of the 20th century. Ann Oncol (Suppl 5) 14: v128–v149
Schmidt N, Peitz U, Lippert H, Malfertheiner P (2005) Missing gastric cancer in dyspepsia. Aliment Pharmacol Ther 21: 813–820
Wu AW, Xu GW, Wang HY et al. (2007) Neoadjuvant chemotherapy versus none for resectable gastric cancer. Cochrane Database Syst Rev 2: CD005047
Kolfenbach S, Malfertheiner P (2006) [Early gastric cancer–diagnosis and therapy]. Schweiz Rundsch Med Prax 95: 1037–1041
Cunningham D, Allum WH, Stenning SP et al. (2006) Perioperative chemotherapy versus surgery alone for resectable gastroesophageal cancer. N Engl J Med 355: 11–20
Van CE, Moiseyenko VM, Tjulandin S et al. (2006) Phase III study of docetaxel and cisplatin plus fluorouracil compared with cisplatin and fluorouracil as first-line therapy for advanced gastric cancer: a report of the V325 Study Group. J Clin Oncol 24: 4991–4997
Keeney S, Bauer TL (2006) Epidemiology of adenocarcinoma of the esophagogastric junction. Surg Oncol Clin N Am 15: 687–696
Devesa SS, Blot WJ, Fraumeni JF Jr (1998) Changing patterns in the incidence of esophageal and gastric carcinoma in the United States. Cancer 83: 2049–2053
Souza RF, Spechler SJ (2005) Concepts in the prevention of adenocarcinoma of the distal esophagus and proximal stomach. CA Cancer J Clin 55: 334–351
Siewert J, Stein HJ (1998) Classification of adenocarcinoma of the oesophagogastric junction. Br J Surg 85: 1457–1459
Malfertheiner P, Peitz U (2005) The interplay between Helicobacter pylori, gastro-oesophageal reflux disease, and intestinal metaplasia. Gut (Suppl 1) 54: i13–i20
Lauren P (1965) The two histological main types of gastric carcinoma: diffuse and so-called intestinal-type carcinoma. An attempt at a histo-clinical classification. Acta Pathol Microbiol Scand 64: 31–49
Lee KJ, Inoue M, Otani T et al. (2006) Gastric cancer screening and subsequent risk of gastric cancer: a large-scale population-based cohort study, with a 13-year follow-up in Japan. Int J Cancer 118: 2315–2321
Yoshida S, Kozu T, Gotoda T, Saito D (2006) Detection and treatment of early cancer in high-risk populations. Best Pract Res Clin Gastroenterol 20: 745–765
Tashiro A, Sano M, Kinameri K et al. (2006) Comparing mass screening techniques for gastric cancer in Japan. World J Gastroenterol 12: 4873–4874
Dan YY, So JB, Yeoh KG (2006) Endoscopic screening for gastric cancer. Clin Gastroenterol Hepatol 4: 709–716
Cao Q, Ran ZH, Xiao SD (2007) Screening of atrophic gastritis and gastric cancer by serum pepsinogen, gastrin-17 and Helicobacter pylori immunoglobulin G antibodies. J Dig Dis 8: 15–22
Watson SA, Grabowska AM, El-Zaatari M, Takhar A (2006) Gastrin – active participant or bystander in gastric carcinogenesis? Nat Rev Cancer 6: 936–946
Di MF, Moussa AM, Caruana P et al. (2003) ‚Serological biopsy‘ in first-degree relatives of patients with gastric cancer affected by Helicobacter pylori infection. Scand J Gastroenterol 38: 1223–1227
Mukoubayashi C, Yanaoka K, Ohata H et al. (2007) Serum pepsinogen and gastric cancer screening. Intern Med 46: 261–266
Forman D, Burley VJ (2006) Gastric cancer: global pattern of the disease and an overview of environmental risk factors. Best Pract Res Clin Gastroenterol 20: 633–649
Gonzalez CA, Riboli E (2006) Diet and cancer prevention: where we are, where we are going. Nutr Cancer 56: 225–231
Correa P, Piazuelo MB, Camargo MC (2004) The future of gastric cancer prevention. Gastric Cancer 7: 9–16
Nardone G, Rocco A (2004) Chemoprevention of gastric cancer: role of COX-2 inhibitors and other agents. Dig Dis 22: 320–326
Cui G, Takaishi S, Ai W et al. (2006) Gastrin-induced apoptosis contributes to carcinogenesis in the stomach. Lab Invest 86: 1037–1051
Nyren O, McLaughlin JK, Gridley G et al. (1995) Cancer risk after hip replacement with metal implants: a population-based cohort study in Sweden. J Natl Cancer Inst 87: 28–33
Fall K, Ye W, Nyren O (2006) Antibiotic treatment and risk of gastric cancer. Gut 55: 793–796
You WC, Brown LM, Zhang L et al. (2006) Randomized double-blind factorial trial of three treatments to reduce the prevalence of precancerous gastric lesions. J Natl Cancer Inst 98: 974–983
Wong BC, Lam SK, Wong WM et al. (2004) Helicobacter pylori eradication to prevent gastric cancer in a high-risk region of China: a randomized controlled trial. JAMA 291: 187–194
Leung WK, Ng EK, Chan FK et al. (2006) Effects of long-term rofecoxib on gastric intestinal metaplasia: results of a randomized controlled trial. Clin Cancer Res 12: 4766–4772
Malfertheiner P, Megraud F, O’Morain C et al. (2007) Current concepts in the management of Helicobacter pylori infection: the Maastricht III Consensus Report. Gut 56: 772–781
Malfertheiner P, Sipponen P, Naumann M et al. (2005) Helicobacter pylori eradication has the potential to prevent gastric cancer: a state-of-the-art critique. Am J Gastroenterol 100: 2100–2115
Vauhkonen M, Vauhkonen H, Sipponen P (2006) Pathology and molecular biology of gastric cancer. Best Pract Res Clin Gastroenterol 20: 651–674
Thun MJ, Namboodiri MM, Calle EE et al. (1993) Aspirin use and risk of fatal cancer. Cancer Res 53: 1322–1327
Farrow DC, Vaughan TL, Hansten PD et al. (1998) Use of aspirin and other nonsteroidal anti-inflammatory drugs and risk of esophageal and gastric cancer. Cancer Epidemiol Biomarkers Prev 7: 97–102
Zaridze D, Borisova E, Maximovitch D, Chkhikvadze V (1999) Aspirin protects against gastric cancer: results of a case-control study from Moscow, Russia. Int J Cancer 82: 473–476
Coogan PF, Rosenberg L, Palmer J et al. (2000) Nonsteroidal anti-inflammatory drugs and risk of digestive cancers at sites other than the large bowel. Cancer Epidemiol Biomarkers Prev 9: 119–123
Langman MJ, Cheng KK, Gilman EA, Lancashire RJ (2000) Effect of anti-inflammatory drugs on overall risk of common cancer: case-control study in general practice research database. BMJ 320: 1642–1646
Akre K, Ekstrom AM, Signorello LB et al. (2001) Aspirin and risk for gastric cancer: a population-based case-control study in Sweden. Br J Cancer 84: 965–968
Sorensen HT, Friis S, Norgard B et al. (2003) Risk of cancer in a large cohort of nonaspirin NSAID users: a population-based study. Br J Cancer 88: 1687–1692
Uemura N, Mukai T, Okamoto S et al. (1997) Effect of Helicobacter pylori eradication on subsequent development of cancer after endoscopic resection of early gastric cancer. Cancer Epidemiol Biomarkers Prev 6: 639–642
Saito K, Arai K, Mori M et al. (2000) Effect of Helicobacter pylori eradication on malignant transformation of gastric adenoma. Gastrointest Endosc 52: 27–32
Uemura N, Okamoto S, Yamamoto S et al. (2001) Helicobacter pylori infection and the development of gastric cancer. N Engl J Med 345: 784–789
Zhou LY, Lin SR, Ding SG et al. (2005) The changing trends of the incidence of gastric cancer after Helicobacter pylori eradication in Shandong area. Chin J Dig Dis 6: 114–115
Leung WK, Lin SR, Ching JY et al. (2004) Factors predicting progression of gastric intestinal metaplasia: results of a randomised trial on Helicobacter pylori eradication. Gut 53: 1244–1249
Take S, Mizuno M, Ishiki K et al. (2005) The effect of eradicating Helicobacter pylori on the development of gastric cancer in patients with peptic ulcer disease. Am J Gastroenterol 100: 1037–1042
Ogura K, Hirata Y, Yanai A et al. (2006) The effect of Helicobacter pylori eradication on incident of gastric cancer. Gastroenterology (Suppl 2) 130: A183 (abstract)
Malfertheiner P, Fry LC, Monkemuller K (2006) Can gastric cancer be prevented by Helicobacter pylori eradication? Best Pract Res Clin Gastroenterol 20: 709–719
Interessenkonflikt
Der korrespondierende Autor weist auf folgende Beziehung/en hin: Vorträge/Beratungen Altana, Nycomed, AstraZeneca, Abbott.
Author information
Authors and Affiliations
Corresponding author
Rights and permissions
About this article
Cite this article
Malfertheiner, P., Bornschein, J. Magenkarzinom: Früherkennung und Prävention. Gastroenterologe 2, 330–338 (2007). https://doi.org/10.1007/s11377-007-0108-3
Published:
Issue Date:
DOI: https://doi.org/10.1007/s11377-007-0108-3