在这篇社论中,我评论了Lin等人的论文,发表在本期《世界胃肠肿瘤学杂志》上。这项工作旨在分析双原发性胃癌和结直肠癌(CRC)患者的同步和异发癌的临床病理特征和预后。作者得出结论,在术后随访期间定期监测异时性癌的必要性,并报告预后受胃癌(GC)分期而不是CRC分期的影响。尽管结论中建议进行监测,作者在他们的研究中没有探索这一领域,也没有包括用于此类监测的测试.这篇社论的重点是关于双重胃和CRC的最典型的胃肠道癌症易感性综合征。这些包括遗传性弥漫性GC,家族性腺瘤性息肉病,遗传性非息肉性结肠癌,林奇综合征,以及与CRC和GC相关的三种主要错构瘤性息肉综合征,即Peutz-Jeghers综合征,青少年息肉综合征,和PTEN错构瘤综合征。仔细评估这些综合症/状况,包括继承,胃癌和结肠直肠癌或其他癌症发展的风险,基因突变和推荐的基因调查,对于这些患者的最佳管理至关重要。
In this editorial, I commented on the paper by Lin et al, published in this issue of the World Journal of Gastrointestinal Oncology. The work aimed at analysing the clinicopathologic characteristics and prognosis of synchronous and metachronous cancers in patients with dual primary gastric and colorectal cancer (CRC). The authors concluded the necessity for regular surveillance for metachronous cancer during postoperative follow-up and reported the prognosis is influenced by the gastric cancer (GC) stage rather than the CRC stage. Although surveillance was recommended in the conclusion, the authors did not explore this area in their study and did not include tests used for such surveillance. This editorial focuses on the most characterized gastrointestinal cancer susceptibility syndromes concerning dual gastric and CRCs. These include hereditary diffuse GC, familial adenomatous polyposis, hereditary nonpolyposis colon cancer, Lynch syndrome, and three major hamartomatous polyposis syndromes associated with CRC and GC, namely Peutz-Jeghers syndrome, juvenile polyposis syndrome, and PTEN hamartoma syndrome. Careful assessment of these syndromes/conditions, including inheritance, risk of gastric and colorectal or other cancer development, genetic mutations and recommended genetic investigations, is crucial for optimum management of these patients.