虽然对于遗传性弥漫性胃癌的临床实践指南已有很好的建立，但对家族性肠道胃癌（FIGC）的处理方法尚未达成共识。在低发生率胃癌（GC）地区，如美国或大多数欧洲国家，对于FIGC家族中内窥镜评估没有基于证据的推荐意见。我们的目标是描述在这些家族中胃癌监测的收益，并识别发生GC及其前体病变的流行病学危险因素。这是一项涉及九个西班牙三级医院的多中心观察性研究，在1991年至2020年期间，所有符合FIGC标准并进行内窥镜监测的个体都被纳入研究。共招募了31个家族的41名健康个体。每个个体的上消化道内窥镜次数中位数为3次（四分位数范围IQR为1-4次）。检查之间的时间间隔中位数为2年（IQR为1.5-2.5年），随访时间中位数为9年（IQR为3-14.5年）。随访期间，在18名（43.9％）个体中发现了GC前体病变，在2名（4.9％）个体中发现了早期GC，并提供了治疗。伴有幽门螺杆菌（Hp）感染的个体，经年龄、性别和随访调整后，其发生GC前体病变或GC的风险明显增加，独立关联比（OR）为6.443（1.36-30.6，P值为0.019）。我们首次呈现了支持在FIGC家族中采用活检和Hp检测进行内窥镜监测的结果，尽管尚未定义监测周期。© 2023 UICC。

While clinical practice guidelines for hereditary diffuse gastric cancer are well established, there is no consensus on the approach for familial intestinal gastric cancer (FIGC). In low-incidence gastric cancer (GC) areas such as the United States or most European countries, there are no evidence-based recommendations on endoscopic assessment in FIGC families. We aim to describe the yield of GC surveillance in these families, and to identify epidemiological risk factors for the development of GC and its precursor lesions. This is a multicenter observational study involving nine tertiary Spanish hospitals, in which all individuals fulfilling FIGC criteria who underwent endoscopic surveillance were included between 1991 and 2020. Forty-one healthy individuals of 31 families were recruited. The median number of upper gastrointestinal endoscopies per individual was 3 (interquartile range, IQR, 1-4). The median interval time between tests was 2 years (IQR 1.5-2.5), and the median follow-up was 9 years (IQR 3-14.5). In 18 (43.9%) subjects, a precursor lesion of GC was found during follow-up, and in 2 (4.9%), an early GC was identified, in which curative treatment was offered. Helicobacter pylori (Hp) infection proved to be independently associated with an increased risk of developing precursor lesions or GC, adjusted by age, gender and follow-up, with an Odds Ratio of 6.443 (1.36-30.6, P value .019). We present the first outcomes that support endoscopic surveillance with biopsies and detection of Hp in FIGC families, although the periodicity has yet to be defined.© 2023 UICC.