精准医学视角下胃癌早期诊断的研究现状与进展

Journal: Basic Medical Theory Research DOI: 10.32629/bmtr.v8i3.20451

陈长凯1, 王静坤2, 郭新文1

1. 阿克苏地区第一人民医院消化内科
2. 阿克苏地区第一人民医院乳腺外科

Abstract

胃癌是全球高发病率和高死亡率的恶性肿瘤之一,早期诊断率低是预后不佳的主要原因。本文系统综述了循环肿瘤DNA(ctDNA)、微小RNA(miRNA)及多蛋白联合标志物在胃癌早期筛查中的研究进展,并重点探讨了机器学习算法在生物标志物筛选、内镜图像智能分析及病理影像自动分类中的应用价值。研究表明,ctDNA甲基化检测与miRNA联合面板可显著提升早期诊断效能;基于深度学习的内镜辅助系统在微小病灶识别方面已达专家级水平。未来应推动多中心研究与标准化体系建设,以期实现胃癌精准早筛与个性化干预。

Keywords

胃癌;早期诊断;精准医学;生物标志物;人工智能

References

[1] Iwasaki H, Shimura T, Yamada T, et al. A novel urinary microRNA biomarker panel for detecting gastric cancer[J]. J Gastroenterol, 2019.
[2] Epplein M, Butt J, Zhang Y, et al. Validation of a blood biomarker for identification of individuals at high risk for gastric cancer[J]. Cancer Epidemiol Biomarkers Prev, 2018, 27(7): 946-954.
[3] Zhu X, Ren L, Wang H, et al. Plasma microRNAs as potential new biomarkers for early detection of early gastric cancer[J]. World J Gastroenterol, 2019, 25(12): 1580-1591.
[4] Sung H, Ferlay J, Siegel R, et al. Global Cancer Statistics 2020: GLOBOCAN Estimates of Incidence and Mortality Worldwide for 36 Cancers in 185 Countries. CA Cancer J Clin, 2021, 71: 209-249.
[5] 马福超,刘爱群,谢为舜,等.胃癌发生过程中风险miRNAs筛选及其诊断效能评价的多中心研究[J].中国癌症防治杂志,2024,16(2):193-198.
[6] eske R, Reininger D, Turgu B, et al. Development of Helicobacter pylori whole-proteome arrays and identification of serologic biomarkers for noncardia gastric cancer in the MCC-Spain study[J]. Cancer Epidemiol Biomarkers Prev, 2020, 29(4): 843-853.
[7] So J, Kapoor R, Zhu F, et al. Development and validation of a serum microRNA biomarker panel for detecting gastric cancer in a high-risk population[J]. Gut, 2020, 69(5): 833-841.
[8] 聂宇魁,余超,郭勤平,等.循环肿瘤DNA在消化道肿瘤早期筛查中的研究进展[J].消化肿瘤杂志(电子版),2024,16(2):201-207.
[9] Murtaza M, Dawson SJ, Pogrebniak K, et al. Non-invasive analysis of acquired resistance to cancer therapy by sequencing of plasma DNA[J]. Nature, 2013, 497(7447): 108-112.
[10] Yu M, Stoecklein NH, et al. Circulating tumor cells and their detection in cancer[J]. Curr Opin Genet Dev, 2017, 42: 96-103.
[11] 毕艳娜.基于全蛋白定量分析技术解析胃-食管结合部癌及癌前病变组织分子学特征[D].河北医科大学,2023.
[12] Liu HS, Xiao HS. MicroRNAs as potential biomarkers for gastric cancer[J]. World J Gastroenterol, 2014, 20(25): 8133-8141.
[13] Zheng G, Xiong Y, Xu W, et al. A two-microRNA signature as a potential biomarker for early gastric cancer[J]. Oncol Lett, 2014, 7(4): 1148-1152.
[14] 吴珊珊,颜见钦,刘周发.血清TK1联合CEA、CA125、CA19-9检查在消化道肿瘤风险筛查中的应用研究[J].中国医学创新,2024,21(24):125-129.
[15] Kozak K, Bahl M, Kirtman B, et al. Fecal DNA testing for early detection of gastric cancer: A prospective study[J]. Gastroenterology, 2020, 158(2): 255-262.
[16] Wang Y, Li J, Chen Y, et al. Deep learning-based image recognition in early gastric cancer detection: A clinical study[J]. Gastrointest Endosc, 2022, 96(5): 873-881
[17] Yao K. Image-enhanced endoscopy for early gastric cancer detection[J]. Dig Endosc, 2013, 25(Suppl 1): 16-23.
[18] Song L, Ang TL. Early detection of gastric cancer with narrow-band imaging (NBI) endoscopy[J]. Clin Endosc, 2014, 47(1): 36-39.
[19] Zhang X, Yu L. Magnetic resonance imaging and its application in early gastric cancer diagnosis[J]. World J Gastroenterol, 2020, 26(12): 1520-1531.
[20] Zhang L, Zhao S, Liu W, et al. Machine learning applications in pathological classification of early gastric cancer[J]. J Clin Pathol,2021,74(8):533-540.
[21] Sun C, Wang H, Zhang Q, et al. Serum biomarkers and machine learning for early gastric cancer screening[J]. Clin Chem, 2020, 66(6): 776-786.
[22] Chen H, Zhang Z, Ma Y, et al. Natural language processing in EHR for early gastric cancer risk assessment: A machine learning approach[J]. J Am Med Inform Assoc, 2022, 29(4): 573-582.

Copyright © 2026 陈长凯, 王静坤, 郭新文

Creative Commons License
This work is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License