编者按：在刚刚举办的第十八届胃癌学术会议（CGCC 2024）上，众多国内外胃癌知名专家学者齐聚一堂，坐而论道，共普胃癌诊疗新篇章。《肿瘤瞭望-消化时讯》特邀国际胃癌协会秘书长、韩国科学院院士梁汉光教授分享他对于这次大会的感受及胃癌的诊疗经验和未来展望。
肿瘤瞭望-消化时讯：能否分享一下您对此次会议的整体感受？您认为本次会议在推动胃癌领域国际交流方面有哪些积极作用？
Oncology Frontier: As the co-chair of this CGCC conference and chairman of the Gastric Cancer China, Japan, Korea dialogue section, could you share your overall feelings about this conference? What positive role do you think this conference will play in promoting international exchanges in the field of gastric cancer?梁汉光教授：首先，我要热烈祝贺李乐平教授在济南成功举办了第十八届胃癌学术会议。本次大会汇聚了国内外胃癌治疗领域的顶尖专家，共同为抗击胃癌贡献力量。其次，我要强调一点，在中国每年新发胃癌病例约50万，他们中可能大多数在确诊后两年内不幸离世，这是我们必须面对的现实。所以对于中国的年轻医生们，我尤其想强调的是当前我们的职责已经不仅仅是日常诊疗，更应积极与各国优秀同道一同探索并改进胃癌的治疗方法。
我十年前首次访问中国时，曾与很多年轻医生们就胃癌的诊疗进行过深入地探讨，当时许多中国外科医生仍在参照日本和韩国的数据进行临床诊疗。我当时指出，中国应该要拥有自己的数据作为指导，如今我很开心看到中国在科研领域已取得巨大进步，同时也拥有丰富的数据和资源。另外，在今天的展览位上，我也注意到中国自主研发的手术机器人系统，其先进性超越了许多国外同类产品，这些资源充分说明中国已经足以引领胃癌治疗领域的新发展。最后，此次会议让我深刻感受到中国的科学家们对于提高胃癌治疗水平的迫切愿望。我相信，通过中国、日本和韩国之间的科学合作，我们定能战胜胃癌这一共同的“敌人”。
Prof. Han-Kwang Yang：First of all, I would like to congratulate Professor Li Lei Ping for successfully organizing this Chinese Gastric Cancer Congress here in Jinan. You may have noticed that all the experts in Chinese gastric cancer treatment are gathered here. However, I want to remind everyone that in China, half a million new gastric cancer patients are diagnosed every year, and most of them may die within two to three years. This is the current situation in China.
I particularly want to remind young Chinese doctors about their responsibility—not just to practice medicine, but to work with leading Chinese professors to explore new treatments or improve existing treatments for gastric cancer patients. About ten years ago, when I was visiting China, young doctors often referenced Japanese and Korean data. I mentioned that they needed their own Chinese data to show. Now, science has advanced significantly in China. You have all the data and resources. I noticed at the exhibition booth that the Chinese surgical robot system is very sophisticated, possibly even better than some from outside China. This means you are ready to lead in gastric cancer treatment research.
Whenever I come to China, I feel that our scientific friends here are eager to improve. Together with China, Japan, and Korea, we can conquer our common enemy, gastric cancer, through our scientific camaraderie.
肿瘤瞭望-消化时讯：在中日韩三国胃癌诊疗技术和策略方面，您认为有哪些异同之处？您如何看待这些差异对于胃癌患者治疗效果的影响？
Oncology Frontier: What do you think are the similarities and differences in the diagnosis and treatment technologies and strategies for gastric cancer in China, Japan and South Korea? How do you think these differences impact the treatment outcomes for gastric cancer patients?梁汉光教授：中国、日本、韩国三国有一个不幸的共同点，即我们都面临着胃癌高发病率这一挑战。在这点上，不同之处在于韩国和日本早期便实施了健康筛查计划。举例来说，在韩国，40岁以上的人每两年就能收到政府保险的通知，鼓励他们接受胃肠镜检查。正是这样的筛查机制，使得韩国早期胃癌的发现率超过70%，这大大提高了患者的存活率，使胃癌不再是致命的疾病。然而，在中国由于地域辽阔，普及筛查具有一定的难度。因此，我建议中国现在必须专注于研发具备高效、经济等特点的新型诊断设备和方法，以期改善早期胃癌检出率。
此外，我们还有一个共同点，即长相相似且相互间建立了深厚的科学友谊，这种友谊推动着我们携手合作，共同应对挑战。地理上的邻近性和心灵上的契合性都让我们能够更紧密地合作。在这里我分享十年前的一个例子，当时中国、日本、韩国的政府共同支持并发起了“中日韩前瞻计划（A3）”，致力于专注于胃癌甲基化研究。三国科学家和临床医生携手合作，轮流在中国、日本、韩国召开会议，不仅增进了科学友谊，还加深了彼此文化的理解。如今中国、日本、韩国日益繁荣，为何我们不进一步加大投入，深化这种合作呢？这是我的建议，希望我们携手并进，共同对抗胃癌。
Prof. Han-Kwang Yang：The commonality among China, Japan, and Korea is our high incidence of gastric cancer. This is why we are fighting together. The difference at this moment is that in Korea and Japan, we have health screening programs. In Korea, for example, after age 40, every two years, government insurance sends a notice to everyone to receive a gastroscope. This results in over 70% early detection of gastric cancer in Korea, dramatically improving survival rates.
In China, due to its vast size and limited availability of gastroscopes, we need to develop new diagnostic devices or methods that are not time-consuming, not costly, and not invasive. Another commonality is the strong affection and warm-hearted scientific friendship among the three countries. This has promoted not only scientific collaboration but also cultural understanding. For instance, about ten years ago, the governments of China, Japan, and Korea supported the "A3, Asian three countries project" to support methylation studies in gastric cancer, allow basic and clinical scientists to gether. This collaborative effort fostered both scientific and cultural exchange. As our countries become wealthier, we should allocate more resources to these collaborative efforts.
肿瘤瞭望-消化时讯：作为国际知名的胃癌专家，能否请您谈谈未来胃癌研究的方向和趋势？
Oncology Frontier：As an internationally renowned gastric cancer expert, could you please talk about the future directions and trends of gastric cancer research?梁汉光教授：首先，我要强调一个严峻的事实：中国每年新增的胃癌患者接近50万，全球范围内更是高达100万。令人瞩目的是，日本和韩国在胃癌防控上取得了显著成效，晚期胃癌比例极低，这主要归功于他们超过70%的胃癌筛查率。相比之下，许多国家的患者在被诊断时往往已处于胃癌的Ⅲ期或Ⅳ期。因此，我认为我们应当从这两个国家的成功经验中汲取经验，更多地致力于胃癌的早期发现与干预，而不是等到疾病晚期才采取行动，这将成为我们未来工作的重中之重。
其次，在医学领域我们已经在过去的20年里验证了微创手术——特别是腹腔镜手术与开放手术具有相同的疗效，当前腹腔镜手术已成为治疗胃癌的主要手段。我们接下来的挑战是如何实现肿瘤更精准的切除，这里我要特别提及荧光引导手术技术，该技术借助特定波长的激发光，使肿瘤自身荧光、荧光分子或外源性荧光物质发出光信号，从而精确指导医生进行肿瘤切除，这一前沿技术是我们未来发展的关键方向。
最后，手术视频可视技术不仅为我们手术提供了精准辅助，还使手术过程的分享变得前所未有的便捷。无论是实时直播还是开放搜索，都能助力我们轻松地将手术画面传递给全球的医学同行，这在过去是不可想象的。但如今在腹腔镜手术中，操作者的视角可以即时传输到世界的每一个角落，这无疑为医学教育提供了绝佳的机遇。更重要的是，这些手术视频还可以被先进的AI系统——即计算机视觉技术深入分析，从而帮助我们提高手术水平、评估手术质量、分析并发症与操作之间的关系，甚至识别出某些手术习惯与技巧。我相信通过不断的探索与创新，我们一定能够为胃癌患者提供更加精准、有效的治疗。
Prof. Han-Kwang Yang：Every year, there are half a million new gastric cancer cases in China and one million worldwide. Only Japan and Korea have significantly reduced the impact of gastric cancer through early detection. Our priority should be to focus on early detection methods, avoiding the late-stage symptoms that currently predominate.
Over the last 20 years, we have proven that minimally invasive laparoscopic surgery is as effective as open surgery. Most cases now utilize laparoscopic surgery. The next target is enhancing this approach with advanced imaging techniques, such as fluorescence-guided surgery using indocyanine green or cancer-specific imaging. This is our future direction.
Moreover, with video-assisted surgery, we can easily share operative videos globally, providing excellent educational opportunities. These videos can also be analyzed by AI systems to improve surgical techniques and evaluate procedures, identifying causes of complications and improving outcomes. These advancements represent the future direction for surgeons in the fight against gastric cancer.
