2022年，全球胃癌新发病例约97万例，死亡病例约66万例，其中东亚地区（如中国、日本、韩国）是主要高发区域。尽管2010年至2020年间，我国的胃癌发病率和死亡率呈缓慢下降趋势，但由于人口基数大、早期筛查普及不足，疾病负担依然沉重。2025年，美国胃肠病学会（American College of Gastroenterology， ACG）发布了《美国胃肠病学会临床指南：胃癌前病变诊治指南》。该指南的核心内容包括，①个体化风险评估：基于年龄、幽门螺杆菌（Helicobacter pylori， Hp）感染、家族史等因素筛选高风险人群；②高质量内镜技术规范：指南推荐，采用高清白光内镜联合图像增强技术[如窄带成像技术（narrow band imaging， NBI）]，提高病变检出率，并强调活检病理的标准化；采用可操作的与胃癌风险联系的胃炎评估（operative link for gastritis assessment，OLGA）和可操作的与胃癌风险联系的肠化生评估（operative link for gastric intestinal metaplasia assessment，OLGIM）分期评估胃癌风险，进行风险分层与监测，同时强调了Hp根除的核心地位；③内镜监测和随访间隔。该指南对我国胃癌防治具有重要启示，包括进一步优化筛查策略，如结合国情推行高风险人群精准筛查，探索结直肠癌与胃癌联合筛查模式；继续提升内镜诊疗水平，加强基层医师培训，推广高质量内镜技术（如NBI放大内镜）；强化Hp感染防控，推行家庭聚集性感染的同步筛查与治疗；完善监测体系，如借鉴OLGA/OLGIM分层，制定个体化监测间隔；填补证据缺口，如开展前瞻性研究验证监测间隔的合理性，研发无创生物标志物。尽管ACG指南部分建议证据等级较低，但其规范化框架为我国胃癌早诊、早治提供了重要参考，有助于突破当前筛查覆盖率低、进展期胃癌占比高的困境，最终降低疾病负担。

In 2022, there were approximately 970 000 new cases and 660 000 deaths from gastric cancer worldwide, with East Asia (such as China, Japan, and South Korea) being the main high-incidence regions. Although the incidence rate and mortality rate of gastric cancer in China showed a slow decline from 2010 to 2020, the disease burden remains heavy due to the large population and insufficient early screening coverage. In 2025, the American College of Gastroenterology (ACG) released the American College of Gastroenterology Clinical Guidelines: Diagnosis and Management of Gastric Precancerous Lesions. The core content of the guidelines includes: ① individualized risk assessment: high-risk populations should be screened based on factors such as age, Helicobacter pylori (Hp) infection, and family history. ② High-quality endoscopic technical standards: the guidelines recommend using high-definition white-light endoscopy with image-enhanced technologies (such as narrow band imaging, NBI) to improve lesion detection rates and emphasize the standardization of biopsy pathology. It also recommends using the operative link for gastritis assessment (OLGA) and operative link for gastric intestinal metaplasia assessment (OLGIM) staging systems for gastric cancer risk stratification and surveillance, while emphasizing the core position of Hp eradication. ③ Endoscopic monitoring and follow-up intervals: the guidelines have important implications for the prevention and treatment of gastric cancer in China, including optimizing screening strategies, such as implementing precision screening for high-risk populations based on China's conditions and exploring combined screening models for colorectal and gastric cancer. It is essential to continue to improve the capabilities of endoscopic diagnosis and treatment, strengthen the training of grassroots physicians, advance high-quality endoscopic techniques (such as NBI magnifying endoscopy), strengthen Hp infection prevention and control, and implement synchronous screening and treatment for household clusters of infection. The surveillance system should be improved by referencing OLGA/OLGIM stratification to establish personalized monitoring intervals. Concurrently, evidence gaps must be addressed by conducting prospective studies to validate the rationality of surveillance intervals and developing non-invasive biomar-kers. Although some recommendations in the ACG guidelines are supported by limited evidence, the standardized framework provides important reference for early detection and treatment of gastric cancer in China. This approach helps address current challenges such as low screening coverage and high proportion of advanced-stage cases, ultimately reducing the di-sease burden.