熬夜喝酒撸串 胃癌盯上年轻人？
近期，国家癌症中心发布的数据显示，全国胃癌的年发病人数超过35万，位列所有恶性肿瘤第5位；死亡人数超过26万，位列恶性肿瘤第3位，年轻人发病呈上升趋势。哪些生活方式容易导致胃癌的发生？如何实现早筛早治？内镜治疗到底吓不吓人？近日，北京青年报记者专门采访了首都医科大学附属北京友谊医院消化中心副主任医师邢洁。她提醒，坚持健康生活方式、提高生活质量、合理管理压力、定期开展体检是防治胃癌的有效措施。
饮食作息不规律 29岁胃癌晚期
为何现在胃癌发病率越来越高？邢洁表示，这些年人们生活水平提高、健康意识也在增强，胃肠镜检查越来越普及。同时，内镜诊疗技术也在不断提高，检出率在增加。“值得关注的是，胃癌发生确实出现年轻化趋势，许多人20多岁、30多岁就确诊胃癌晚期了。”
邢洁发现，在门诊中，这种年轻患者并不少见。近期，29岁的女白领陈鸣（化名）在友谊医院确诊了胃癌晚期。陈鸣出现胃部不适症状已经很长一段时间了，但一直没有在意，生完孩子后发现症状越来越严重，整个人越发消瘦、精神不振。来到友谊医院后，正是邢洁给她做的胃镜检查。术中发现，患者胃部癌变占位面积很大，已是晚期，失去了内镜手术处理的机会，只能通过外科手术切除了部分胃。命虽保住了，但也影响后续生活质量。
回顾陈鸣平日里的生活状态，存在不少危险因素：因为工作、生活压力大，一日三餐饮食总是不规律，而且进食速度很快，咀嚼不充分，无形中增加了胃部负担。平时工作一忙就会点外卖，爱吃高油高盐高糖食物，新鲜水果蔬菜摄入较少。工作繁忙也影响了作息，老是熬夜、睡眠不足。
胃癌或与这些不良生活习惯有关
邢洁表示，一些不良的生活方式很容易增加患胃癌的风险。从饮食习惯来说，高盐高油食物，以及腌制、烧烤类食物可能含有致癌物质，比如亚硝酸盐、多环芳烃等，这些物质会刺激胃黏膜。新鲜蔬菜水果中的抗氧化剂和维生素有助于保护胃黏膜，但摄入不足也可能增加胃癌风险。酒精、烟草中的尼古丁也会刺激胃黏膜，增加细胞癌变风险。另外，精神压力大、熬夜，则会影响胃酸分泌和胃黏膜修复，不利于胃部健康。
许多年轻人动不动就爱呼朋引伴，半夜出去喝酒撸串。其实，肉类食物经高温炙烤烹饪可能会产生致癌物质，如多环芳烃，这种物质会刺激胃黏膜，导致其损伤、炎症、溃疡。高盐食物会增加胃黏膜的氧化应激反应，导致细胞损伤、基因突变，都会增加患癌风险。幽门螺杆菌也是影响因素之一。一般认为，幽门螺杆菌感染可能与慢性胃炎相关，因为这种细菌会分泌一种毒素，会破坏胃黏膜的保护屏障，导致炎症、溃疡的出现，应及时治疗。
胃镜检查没有想象中那么可怕
胃镜检查是发现胃部病变的关键手段。“消化道是一个空腔脏器，常规的CT、B超等影像学手段诊断准确性不高，消化道早期病变多是通过内镜检查实现早发现。近年来，随着内镜技术的不断发展，无论是检出诊断还是治疗都有了飞跃性的突破。内镜检查不仅能发现早期病变，而且通过一些放大内镜、超声内镜等手段，可以对病变的边界、性质、浸润深度做出判断，医生据此决策是否需要进行内镜下微创治疗。胃肠镜检查非常有必要。”
邢洁提醒，40岁以上人群定期做胃肠镜检查，如果第一次检查没有问题，检查间隔时间可适当延长。如果前期检查发现了问题，需根据病理结果和医嘱定期复查。
不过，仍有部分人抗拒做内镜。邢洁表示，从门诊上来看，大多数患者的顾虑在于，以前普通胃肠镜是在非麻醉状态下进行检查，内镜进入身体后会恶心想吐，患者容易有畏惧心理；有的年轻人觉得肠镜检查隐私部位，怕尴尬；还有的人怕不安全，担心有不良反应。“内镜虽然是侵入性检查，但实际上已非常成熟，且并发症发生率很低，专业医生肯定会在保证安全的前提下操作，一般不会对身体产生伤害。”邢洁说，随着无痛内镜技术的发展，检查也在朝着舒适化的方向改进，“基本上相当于睡一觉就能把胃肠镜检查都做了。”(蒋若静)
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