【Video】Luo Huiyan: Win the battle to protect the "stomach" and enjoy a better life

The incidence and mortality rate of gastric cancer in mainland China have been declining in recent years, but the situation is still not optimistic. According to the World Health Organization, there were about 480,000 and 370,000 new cases of gastric cancer in mainland China in 2020, accounting for 44% and 48.6% of the new cases and deaths of gastric cancer in the world, respectively. The incidence of gastric cancer ranks fourth in the incidence of malignant tumors and the third in terms of mortality, which is a disease that seriously threatens people's lives and health.

April 15-21 this year is the 30th National Cancer Prevention and Treatment Publicity Week and China Anti-Cancer Day. Under the specific guidance of the Guangdong Provincial Health Commission, the Cancer Center of Sun Yat-sen University and Yangcheng Evening News jointly launched the "Healthy Guangdong" Science Popularization Live Broadcast Room - Sun Yat-sen University Cancer Prevention and Treatment Center. Luo Huiyan, chief physician of the Department of Internal Medicine of Sun Yat-sen University Cancer Prevention and Treatment Center, was a guest in the live broadcast room and answered hot questions related to gastric cancer, such as if the physical test was positive for Helicobacter pylori antibody, does it need treatment?

Is Helicobacter pylori "infected" with stomach cancer and need to be treated?

When it comes to stomach cancer, many people will think of Helicobacter pylori, and in recent years, more and more units have included Helicobacter pylori antibodies in physical examinations. If Helicobacter pylori antibody is found to be positive, does it need treatment? Chief Physician Luo Huiyan answered in the live broadcast room that Helicobacter pylori is a bacterium that parasitizes the human stomach and is classified as a class 1 carcinogen, that is, it has a clear carcinogenic effect on humans. According to statistics, the infection rate of Helicobacter pylori in mainland China is more than 50%, and about 700 million people may be infected. However, among patients infected with Helicobacter pylori, only 15%-20% of them will develop peptic ulcers, while only 5%-10% of them will develop dyspepsia, and only 1% of infected people will eventually develop stomach cancer.

Chief Physician Luo Huiyan said that theoretically, all infected people need to be treated. This is because Helicobacter pylori causes damage in the stomach and is a harmful bacterium to the human body. Therefore, treatment against H. pylori is necessary. If a child is infected with H. pylori, the approach is different from that of an adult. Most children infected with Helicobacter pylori are mild (without any discomfort symptoms or have mild gastrointestinal symptoms, such as abdominal pain, nausea and vomiting, abdominal distension, etc.), most of them are self-limiting, do not need anti-Helicobacter pylori treatment, if necessary, they can be appropriately protected gastric mucosa and inhibition of gastric acid and other treatments, the more commonly used drugs are magnesium aluminum carbonate, omeprazole, etc. When some children are infected with Helicobacter pylori and have peptic ulcers, gastrointestinal bleeding, and even the risk of gastrointestinal tumors, they need to be treated with anti-Helicobacter pylori as soon as possible.

吃粗粮预防胃癌OR诱发胃癌？

Many elderly people like to eat coarse grains for health reasons, but there are reports that coarse grains hide the risk of stomach cancer, what is going on? Can you still eat them in the future? Chief Physician Luo Huiyan replied that coarse grains generally refer to corn, millet, sorghum and other food crops, and proper consumption of coarse grains has the effect of preventing stomach cancer, but eating a large amount of coarse grains for a long time will have the risk of stomach cancer. This is because coarse grains are crude fiber foods, and if you eat too much, it may increase the burden on the gastrointestinal tract and cause indigestion, and long-term indigestion may cause damage to the gastric mucosa and increase the risk of gastric cancer.

It is also important to note that although whole grains contain more vitamins and dietary fiber, they also contain a certain amount of Helicobacter pylori. If not properly disinfected, you may become infected with H. pylori after eating whole grains contaminated with H. pylori. When infected with Helicobacter pylori, it may damage the gastric mucosa and increase the risk of stomach cancer.

What should I do if I want to do a gastroscopy but am afraid of suffering from gastroscopy?

Regular gastroscopy can detect stomach problems in time and take appropriate treatment measures. For high-risk groups, if there is a family history, chronic gastric diseases and other people, they should have regular examinations, and through gastroscopy, they can intuitively understand the condition of the stomach and find early lesions. Chief physician Luo Huiyan introduced in the live broadcast room that gastroscopy is still the gold standard for gastric cancer screening and diagnosis, but with the development of detection technology and instruments, there are many ways to reduce the pain of gastroscopy. For example, you can choose to do painless gastroscopy, the patient sleeps and the gastroscopy is done, which can greatly reduce the pain of doing gastroscopy, and now there is also a combination of artificial intelligence and endoscopy, through the help of AI, the time of gastroscopy can be reduced, the accuracy of diagnosis can be improved, and the pain of the patient's gastroscopy can be reduced to a certain extent. In addition, the use of capsule endoscopy also provides a more comfortable detection method, the subject only needs to eat the capsule endoscope like a capsule drug, and the gastric examination can be completed after 15 to 30 minutes, truly realizing non-invasive, painless and anesthetic gastroscopy.

Capsule gastroscopy is suitable for patients with digestive system history for regular reexamination, including polyps, inflammation, ulcers, bleeding, etc., patients with digestive tract symptoms that need to be diagnosed, including chronic abdominal pain, diarrhea, anorexia, black or tarry stools, unexplained weight loss, anemia, etc., high-risk groups of upper gastrointestinal tumors, including family history, poor eating habits, often working under high pressure, irregular life, frequent heavy drinking, etc., and routine physical examination for healthy people. Screening for people at high risk of gastrointestinal disease.

Chief Physician Luo Huiyan reminded that at present, capsule endoscopy has not been able to completely replace gastroscopy, mainly because compared with conventional gastroscopy, the missed diagnosis rate of capsule endoscopy is still high, and there is no way to take a biopsy if the problem is found, and there is a possibility of being stuck in a small part, or diverticulum and ulcer.

Expert Profile

Luo Huiyan, Chief Physician of the Department of Internal Medicine, Sun Yat-sen University Cancer Center

He is mainly engaged in the clinical treatment of digestive tract tumors, targeted immunotherapy, exploration of drug resistance mechanisms, early diagnosis and screening of predictive molecular markers

He has presided over a number of scientific research projects such as sub-projects of national key R&D projects, major projects and general projects of the National Natural Science Foundation of China, and projects of the Natural Science Foundation of Guangdong Province, and has carried out and completed a number of phase I, II, III clinical studies

He has successively won the titles of "National Famous Doctor - Excellent Style", "People's Good Doctor - Outstanding Contribution Expert in the Field of Gastric Cancer of the Golden Camellia Program", and Guangdong Strength Young and Middle-aged Doctors

策划 | 龚丹枫 刘卓炜 王倩

统筹 | 黄海昀 陈辉 文朝阳 陈鋆 汪芳

Text | Chen Hui

Moderator | Lin Qingqing

执行 | 郑敏珊 陈辉 汪芳 聂俗琴 赵现廷

导播、拍摄、剪辑 | 林添杰 蔡昭旭

Posters, live packaging | Guo Si