Präneoplastische Bedingungen des Magens

Überwachungsstrategien
Schwerpunkt
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Zusammenfassung

Das Magenkarzinom ist weiterhin einer der häufigsten Krebsarten in der Welt und mit einer hohen Mortalität vergesellschaftet. Das Nicht-Kardia-Magenkarzinom entwickelt sich typischerweise auf dem Boden einer Kaskade mukosaler Veränderungen beginnend von der nichtatrophischen Gastritis zur atrophischen Gastritis (AG), der intestinalen Metaplasie (IM) zur Dysplasie bis hin zum Adenokarzinom des Magens. Von daher werden die atrophische Gastritis und die intestinale Metaplasie als präneoplastische Bedingungen des Magens angesehen. Die Ätiologie der atrophischen Gastritis ist auf die Helicobacter (H.)-pylori-Infektion und die autoimmune Gastritis beschränkt. Die H.-pylori-Eradikationstherapie bietet die einmalige Chance, das Magenkarzinom und ein Fortschreiten der präneoplastischen Bedingungen zu verhindern. Hierbei sollte die Infektion mit H. pylori zum frühsten möglichen Zeitpunkt ausgeschaltet werden, um die Kaskade hin zum Magenkarzinom noch rechtzeitig abfangen zu können. Bei Patienten mit dem Nachweis einer präneoplastischen Bedingung des Magens sollten endoskopische Überwachungsstrategien des Magens angewendet werden. Diese Arbeit bietet einen Überblick über präneoplastische Bedingungen des Magens, Therapieoptionen und mögliche Überwachungsstrategien.

Schlüsselwörter

Helicobacter pylori Atrophische Gastritis Endoskopie Histologie Magenkarzinom 

Preneoplastic conditions of the stomach

Monitoring strategies

Abstract

Gastric cancer is one of the most common cancers in the world and is associated with a high mortality. Noncardia gastric cancer usually develops through a cascade of mucosal changes from nonatrophic gastritis to atrophic gastritis, intestinal metaplasia, dysplasia, and adenocarcinoma. Atrophic gastritis and intestinal metaplasia are therefore considered as preneoplastic conditions in the stomach. The etiology of atrophic gastritis is based on Helicobacter pylori infection and/or autoimmune gastritis. H. pylori eradication therapy offers the unique chance to prevent gastric cancer and to improve preneoplastic conditions of the stomach. Eradication therapy should be offered at the earliest stage with the goal to interrupt the cascade leading to gastric cancer. Patients with preneoplastic conditions of the stomach should be monitored using clinically meaningful endoscopic surveillance strategies. This review focuses on preneoplastic conditions of the stomach, therapeutic options, and possible surveillance strategies.

Keywords

Helicobacterpylori Atrophic gastritis Endsoscopy Histology Gastric cancer 

Notes

Einhaltung ethischer Richtlinien

Interessenkonflikt

M. Selgrad und M. Müller-Schilling geben an, dass kein Interessenkonflikt besteht.

Dieser Beitrag beinhaltet keine von den Autoren durchgeführten Studien an Menschen oder Tieren.

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Copyright information

© Springer Medizin Verlag GmbH, ein Teil von Springer Nature 2018

Authors and Affiliations

  1. 1.Klinik und Poliklinik für Innere Medizin IUniversitätsklinikum RegensburgRegensburgDeutschland

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