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Gastric Adenocarcinoma (gastric + adenocarcinoma)
Kinds of Gastric Adenocarcinoma Selected AbstractsMAGNIFYING ENDOSCOPY WITH NARROW BAND IMAGING FOR EARLY DIFFERENTIATED GASTRIC ADENOCARCINOMADIGESTIVE ENDOSCOPY, Issue 3 2008Kazuyoshi Yagi We have been using magnifying endoscopy with narrow band imaging (NBI) to study early differentiated gastric adenocarcinomas and to assess the relationship between microvessel pattern, pit pattern and histological pattern. The magnified view of the cancerous area showed three types of pattern: (i) a mesh pattern, consisting of mesh-like connected microvessels; (ii) a loop pattern, consisting of loop-like microvessels that were not connected and had tubule-like or villus-like mucosal structures along them; and (iii) an interrupted pattern, consisting of interrupted thick or thin vessels without mucosal structures. The mesh type of microvascular pattern showed a round pit pattern in 88.9% of cases (32/36) and the loop type of microvascular pattern showed a non-round pit pattern in 100% of cases. Among lesions that showed a mesh pattern or a loop pattern, 94.9% (56/59) were mucosal cancer and 5.1% (3/59) were submucosal cancer. However, 92.3% (12/13) of lesions that showed an interrupted pattern were submucosal differentiated adenocarcinoma and 7.7% (1/13) were mucosal differentiated adenocarcinoma. The present findings provide basic data on the characteristics of mucosal differentiated gastric adenocarcinoma revealed by magnifying endoscopy with NBI, as well as invasive changes such as submucosal invasion. [source] Isolated Breast Metastases from Primary Gastric AdenocarcinomaTHE BREAST JOURNAL, Issue 1 2000Dahlia M. Sataloff MD No abstract is available for this article. [source] Gastric adenocarcinoma mistakenly diagnosed as an eating disorder: Case reportINTERNATIONAL JOURNAL OF EATING DISORDERS, Issue 3 2010FRANZCP, Leit-Chin Siew MBBS Abstract Objective: A number of organic conditions may mimic the symptoms of an eating disorder, however, gastric outlet obstruction mimicking anorexia nervosa has rarely been reported. Method: We report the case of a 51-year-old female admitted to an eating disorders unit with an initial diagnosis of anorexia nervosa. Results: The patient's upper gastrointestinal symptoms and weight loss were found to be secondary to gastric outlet obstruction from a gastric adenocarcinoma. Coincidental psychosocial stressors and past psychiatric history, among other factors, had confounded the diagnosis. Discussion: Organic causes of weight loss and upper gastrointestinal symptoms need to be fully excluded prior to making the diagnosis of an eating disorder, particularly when there are atypical features in the presentation. © 2009 by Wiley Periodicals, Inc. Int J Eat Disord 2010 [source] Gastric adenocarcinoma with sister mary joseph's nodule successfully treated with combined chemoradiationJOURNAL OF GASTROENTEROLOGY AND HEPATOLOGY, Issue 1 2003Ming-Yang Lee No abstract is available for this article. [source] MAGNIFYING ENDOSCOPY WITH NARROW BAND IMAGING FOR EARLY DIFFERENTIATED GASTRIC ADENOCARCINOMADIGESTIVE ENDOSCOPY, Issue 3 2008Kazuyoshi Yagi We have been using magnifying endoscopy with narrow band imaging (NBI) to study early differentiated gastric adenocarcinomas and to assess the relationship between microvessel pattern, pit pattern and histological pattern. The magnified view of the cancerous area showed three types of pattern: (i) a mesh pattern, consisting of mesh-like connected microvessels; (ii) a loop pattern, consisting of loop-like microvessels that were not connected and had tubule-like or villus-like mucosal structures along them; and (iii) an interrupted pattern, consisting of interrupted thick or thin vessels without mucosal structures. The mesh type of microvascular pattern showed a round pit pattern in 88.9% of cases (32/36) and the loop type of microvascular pattern showed a non-round pit pattern in 100% of cases. Among lesions that showed a mesh pattern or a loop pattern, 94.9% (56/59) were mucosal cancer and 5.1% (3/59) were submucosal cancer. However, 92.3% (12/13) of lesions that showed an interrupted pattern were submucosal differentiated adenocarcinoma and 7.7% (1/13) were mucosal differentiated adenocarcinoma. The present findings provide basic data on the characteristics of mucosal differentiated gastric adenocarcinoma revealed by magnifying endoscopy with NBI, as well as invasive changes such as submucosal invasion. [source] A case of small-cell gastric carcinoma with an adenocarcinoma component and hepatic metastases: treatment with systemic and intra-hepatic chemotherapyEUROPEAN JOURNAL OF CANCER CARE, Issue 5 2007T. CIOPPA md Primary small-cell carcinoma (SmCC) of the stomach is a rare neoplasm with a poor prognosis and unclear histogenesis: to date, only 50 cases, including ours, have been reported in the literature. In the World Health Organization gastrointestinal tumours' classification, SmCC of the stomach has been recognized as an ,independent entity affecting the stomach'. In this paper, the authors present a clinical case and the surgical treatment of an adult with a SmCC of the stomach associated with gastric adenocarcinoma. After laparotomy, a large neoplasm with locoregional extension and multiple liver metastases were found. A palliative resection, subtotal gastrectomy, was performed, followed by systemic and intra-hepatic chemotherapy: computed tomography scan demonstrated a marked response, but the patient died 15 months after the operation. A review of the literature showed that the diagnosis of gastric SmCC is based on immunohistochemical findings. Our experience confirmed the high aggressiveness of this neoplasm, which is generally diagnosed in advanced stage and is unresponsive to chemotherapy, but the combined use of systemic and intra-hepatic chemotherapy shows an acceptable result in a palliative care perspective. [source] Gastric adenocarcinoma metastatic to the skin: a reportEUROPEAN JOURNAL OF CANCER CARE, Issue 2 2002C. CHARALAMBOUS MBCHB, FRCS SURGICAL SENIOR HOUSE OFFICER Metastases to the skin from internal tumours are uncommon, yet they may be the first presentation of such malignancies. They usually arise from the breast, lung and large bowel. Skin metastases from gastric adenocarcinoma are extremely rare. We report a case of a patient with gastric adenocarcinoma who at presentation had multiple, clinically benign-looking skin nodules. Biopsy of these revealed metastatic deposits. [source] Helicobacter pylori Infection may be Implicated in the Topography and Geographic Variation of Upper Gastrointestinal Cancers in the Taihang Mountain High-Risk Region in Northern ChinaHELICOBACTER, Issue 5 2010Denggui Wen Abstract Backgrounds:,Helicobacter pylori infection is prevalent in China. Chronic infection of the bacterial not only causes distal stomach cancer, but also confers risk to gastric cardia adenocarcinoma. Because H. pylori infection is inversely associated with esophageal adenocarcinoma, globally the infection rate is significantly correlated with the ratio of squamous carcinoma to adenocarcinoma of the esophagus. These agree with the topography of upper gastrointestinal cancer observed in the Taihang Mountain high-risk region where both gastric cardia and non-cardia adenocarcinoma coincide with esophageal squamous cancer, but with almost no distal esophageal adenocarcinoma. Moreover, as altitude increases from plain to mountains, we observed progressively increasing incidence rates of gastric adenocarcinomas in recent years in the region. Because H. pylori infection is a definite carcinogen to gastric adenocarcinoma and is more prevalent in the mountain than in plain areas due to undeveloped living conditions, the observation gives the impression as though H. pylori infection is implicated. Aims:, This article aims to note the role of H. pylori infection in upper gastrointestinal cancer in the Taihang Mountain high-risk region in northern China. Materials and Methods:, First the unique topography and geographic variation of upper gastrointestinal cancer in the region is described to indicate a possible role of H. pylori infection, then we review studies on prevalence of H. pylori infection in the high-risk region and describe difference in socioeconomic development and water hygiene between the plains and the mountains as related to the prevalence of H. pylori infection. Results:, Coincidence of gastric cancer in the region and a progressively increasing rate of the cancer from the plain towards the mountains indicate H. pylori infection may be implicated in upper gastrointestinal cancer. Conclusion:, International collaboration is needed to study H. pylori and upper gastrointestinal cancer in the region when rapid industrialization is just beginning. [source] Seroprevalence of Helicobacter pylori Infection Among Schoolchildren and Teachers in TaiwanHELICOBACTER, Issue 3 2007Ding-Bang Lin Abstract Background:,Helicobacter pylori are associated with chronic antral gastritis that is related to duodenal ulcer, gastric ulcer, and probably gastric adenocarcinoma. Infection of H. pylori during childhood is considered an important risk factor for gastric carcinoma in adult life. Materials and Methods:, To examine the epidemiologic characteristics of H. pylori infection among schoolchildren in central Taiwan, a community-based survey was carried out using stratified sampling in 10 elementary schools and three junior high schools including students and theirs teachers. Serum specimens of 1950 healthy schoolchildren (aged 9,15 years old) and 253 teachers who were randomly sampled were screened for the H. pylori antibodies by enzyme-linked immunosorbent assay. Statistical analysis was performed by using the spss for Windows statistical software system. Results:, A total of 332 subjects were H. pylori antibodies positive, giving an overall prevalence of 15.1%. The age-specific seropositive rates were 11.0% in 9,12 years age group, 12.3% in 13,15 years age group, and 45.1% in the teacher group. The older the age, the higher the seroprevalence (OR = 11.53; 95% CI = 6.73,19.74; p < .001 for children vs. teachers). There was no difference in the seroprevalence of H. pylori infection by gender, ethnicity, geographical area, socioeconomic level, parental education, sibship size, family members, and source of drinking water. Conclusion:, The teachers had a much higher prevalence of H. pylori antibodies. The finding suggests that these teachers (adults) might be infected in their early childhood and implies that the poor environmental and hygienic conditions might be responsible for it. It seemed that poor water supply system, sewage disposal, and other environmental hygiene in adult might play some roles in H. pylori infection in Taiwan (before early 1980s). [source] The Effect of Ascorbic Acid on Helicobacter pylori Induced Cyclooxygenase 2 Expression and Prostaglandin E2 Production by Gastric Epithelial Cells in vitroHELICOBACTER, Issue 1 2005Geoff V. Smith ABSTRACT Background., Cyclooxygenase 2 (COX-2) is induced by the presence of Helicobacter pylori (H. pylori) on the gastric mucosa as part of the inflammatory response; this results in the synthesis of prostaglandins that amplify the local inflammatory response. The presence of H. pylori inhibits the secretion of ascorbate into the gastric lumen. Interestingly, ascorbate inhibits the growth of H. pylori and low dietary levels are associated with an increased risk of gastric adenocarcinoma. We therefore investigated the effect of ascorbate on H. pylori mediated COX-2 induction and prostaglandin production in vitro. Methods.,H. pylori was cocultured with gastric epithelial cells in the presence of ascorbate at physiological concentrations. The expression of COX-2 was assessed by Western blotting and prostaglandin E2 (PGE2) was assessed by ELISA. Results., Ascorbate inhibited gastric cell PGE2 synthesis but not in COX-2 expression in response to H. pylori. In the absence of the organism, ascorbate also reduced PGE2 expression in cells that constitutively express COX-2, again with no reduction of COX-2 protein expression. Conclusions., Physiological concentrations of ascorbate inhibit PGE2 but not COX-2 expression in response to H. pylori in gastric epithelial cells. [source] Is the Association Between Helicobacter pylori and Gastric Cancer Confined to CagA-Positive Strains?HELICOBACTER, Issue 3 2004Maria Held ABSTRACT Background., Infection with Helicobacter pylori is associated with an increased risk of gastric cancer. Several studies have indicated that the association differs with strain type. We aimed to find out if infection with strains lacking the virulence factor CagA is linked to gastric cancer risk. Materials and methods., In a hospital-based case,control study, we collected sera from 100 case patients with a newly diagnosed gastric adenocarcinoma and 96 control patients with diseases unrelated to H. pylori status. Antibodies to H. pylori were analyzed by enzyme-linked immunosorbent assay (ELISA), and antibodies to CagA were detected by immunoblot. Logistic regression was used to obtain odds ratios (ORs) as estimates of relative risk, adjusted for potential confounding. Results., Among the case patients, 81% were ELISA positive and 86% had antibodies to CagA. The corresponding numbers among the controls were 58% and 55%, respectively. ELISA positivity was associated with an increased risk of gastric adenocarcinoma compared to ELISA negativity (OR for gastric cancer regardless of site 3.9, 95% CI 1.9,8.2). The OR was 7.4 (95% CI 3.3,16.6) for CagA-positive relative to CagA-negative subjects. Among ELISA-positive subjects the presence of CagA antibodies increased the risk 3.6 times (95% CI 1.2,11.1). ELISA-positive CagA-negative infections were associated with a fourfold increased risk (OR = 4.2, 95% CI 1.0,17.0) compared to no infection (ELISA-negative and CagA-negative). Conclusions., Although patients with antibodies to CagA have the greatest risk of developing gastric cancer, those with CagA-negative infections run a significantly greater risk than uninfected persons. [source] The utility of cytokeratin subsets in distinguishing Barrett's-related oesophageal adenocarcinoma from gastric adenocarcinomaHISTOPATHOLOGY, Issue 4 2001A H Ormsby Aims: Accurate tumour classification is critical for meaningful epidemiological studies in the assessment of cancer incidence rates and trends. Differentiating primary gastric carcinoma from oesophageal carcinoma can be difficult, especially when tumours are large and involve both the oesophagus and stomach. Furthermore, adenocarcinomas of both organs typically are of intestinal histological type and arise in a background of intestinal metaplasia. Consequently, histological markers that reliably distinguish Barrett's-related oesophageal adenocarcinoma from gastric adenocarcinoma would be useful. Cytokeratins (CK)7 and 20 are cytoplasmic structural proteins with restricted expression that help to determine the origin of many epithelial tumours including those of the gastrointestinal tract. The aim of this study was to determine the utility of co-ordinate CK7 and 20 expression in the distinction of Barrett's-related oesophageal adenocarcinoma from gastric adenocarcinoma arising in a background of intestinal metaplasia. Methods and results: CK7 and 20 immunostaining was performed on randomly selected surgical resection specimens from patients with Barrett's-related oesophageal adenocarcinoma (n = 30) and intestinal type gastric adenocarcinoma (n = 14) arising in a background of intestinal metaplasia. A CK7+ CK20- immunophenotype was demonstrated in 27 of 30 (90%) patients with Barrett's-related oesophageal adenocarcinoma and only three of 14 (21%) gastric adenocarcinomas. The sensitivity, specificity and positive predictive value of a CK7+/20, immunophenotype for a diagnosis of Barrett's-related oesophageal adenocarcinoma was 90%, 79%, and 90%, respectively. Conclusions: A CK7+/20, tumour immunophenotype is associated with Barrett's-related oesophageal adenocarcinoma and may be useful in accurate tumour classification, thus facilitating improving epidemiological evaluation of tumours at the oesophagogastric junction. [source] Oral acanthosis nigricans, tripe palms and sign of leser-trélat in a patient with gastric adenocarcinomaINTERNATIONAL JOURNAL OF DERMATOLOGY, Issue 7 2004M. Pentenero DDS Acanthosis nigricans (AN), tripe palms (TP) and the sign of Leser-Trélat (LT) may be seen with the presence of malignancy. Acanthosis nigricans may have a mucocutaneous localization involving the oral mucosa with papillomatous and verrucous lesions usually on the lips and buccal mucosa. These paraneoplastic dermatoses are generally linked with intra-abdominal malignancy, most often gastric adenocarcinoma. Improvement of the associated dermatoses after the treatment of the malignancy has been frequently observed. We report the case of a 53-year-old man suffering from advanced gastric adenocarcinoma, in which metastases seemed to sustain all three paraneoplastic dermatoses. To the best of our knowledge this is the first case of a patient showing manifestations of all three paraneoplastic dermatoses. Patients presenting with this set of dermatoses should be suspected to harbor an occult malignancy, or have persistence of a known malignancy. [source] Gastric adenocarcinoma mistakenly diagnosed as an eating disorder: Case reportINTERNATIONAL JOURNAL OF EATING DISORDERS, Issue 3 2010FRANZCP, Leit-Chin Siew MBBS Abstract Objective: A number of organic conditions may mimic the symptoms of an eating disorder, however, gastric outlet obstruction mimicking anorexia nervosa has rarely been reported. Method: We report the case of a 51-year-old female admitted to an eating disorders unit with an initial diagnosis of anorexia nervosa. Results: The patient's upper gastrointestinal symptoms and weight loss were found to be secondary to gastric outlet obstruction from a gastric adenocarcinoma. Coincidental psychosocial stressors and past psychiatric history, among other factors, had confounded the diagnosis. Discussion: Organic causes of weight loss and upper gastrointestinal symptoms need to be fully excluded prior to making the diagnosis of an eating disorder, particularly when there are atypical features in the presentation. © 2009 by Wiley Periodicals, Inc. Int J Eat Disord 2010 [source] STAT3 expression in gastric cancer indicates a poor prognosisJOURNAL OF GASTROENTEROLOGY AND HEPATOLOGY, Issue 4 2009Dae-Young Kim Abstract Background and Aim:, Signal transducers and activators of transcription (STAT) behave as signal transducers in the cytoplasm and as transcription factors in the nucleus. In the current study, we analyzed the immunohistochemical staining patterns of gastrectomy tissue specimens. We investigated the expression of STAT3 and STAT5 and estimated the relationship between STAT and cancer prognosis. Methods:, One hundred patients who underwent gastrectomy due to gastric adenocarcinoma at Bundang CHA hospital between January 2000 and May 2005 were studied. Immunohistochemistry was carried out using antibodies against STAT3 and STAT5. The interpretation of the immunohistochemical staining was based on the proportion of stained cells in the field: positive, > 10% stained cells; and negative, < 10% stained cells. Results:, The longest diameter of tumor was 4.67 cm in the positive group and 3.76 cm in the negative group, and these results were not statistically different (P -value = 0.112). Higher T (primary tumor) value (P -value = 0.05), more regional lymph node invasion (P -value = 0.008) and higher TNM staging (P -value = 0.069) were significantly related to STAT3 positivity, but Helicobacter pylori infection or atrophic gastritis were not related. A lower survival rate was observed in the STAT3-positive group (P -value = 0.001). The results of STAT5 were not statistically different with respect to TNM staging and survival (P -value = 0.958). We thus report that the immunohistochemical results of STAT3 revealed a significant association with TNM staging and survival. Conclusion:, We anticipate that STAT3 may be used as a molecular staging biomarker predicting poor prognosis of gastric cancer. [source] Biopsy site for detecting Helicobacter pylori infection in patients with gastric cancerJOURNAL OF GASTROENTEROLOGY AND HEPATOLOGY, Issue 3 2009Chan Gyoo Kim Abstract Background:,Helicobacter pylori eradication is recommended in post-gastric cancer resection, but premalignant changes may prevent the detection of H. pylori. The aim of this study was to determine appropriate biopsy site for detecting H. pylori in gastric cancer patients. Materials and Methods:, Consecutive patients (194) with gastric adenocarcinoma were prospectively enrolled. Helicobacter pylori was evaluated by serology, histology and rapid urease test. Biopsy sites included antrum lesser curvature, upper body lesser curvature (UBLC) and upper body greater curvature (UBGC). Two biopsy specimens were obtained from each site for histological examination. One additional specimen was obtained from UBGC for the rapid urease test. Results:, The overall infection rate of H. pylori was 84.0% (95% CI 78.9,89.2). The sensitivity of histology for detecting H. pylori at various sites was: antrum (54.9%; 95% CI 45.7,63.9), UBLC (80.3%; 95% CI 72.2,87.0) and UBGC (95.1%; 95% CI 89.6,98.2). Specificities of all three biopsy sites were more than 95%. Sensitivity and specificity of the rapid urease test performed at UBGC were 96% and 100%, respectively. Sensitivities of histology decreased in correlation with increasing severity of atrophy and intestinal metaplasia (both P < 0.001 using the chi-square test for trend). The proportions of moderate to marked atrophy/intestinal metaplasia at UBGC (12.8%/14.7%) were significantly lower than those at antrum (50.0%/57.8%, P < 0.001 respectively) or UBLC (40.0%/48.9%, P < 0.001 respectively). Conclusions:, The UBGC side is the most sensitive and specific biopsy site to detect H. pylori in gastric cancer patients due to less frequent atrophy and intestinal metaplasia than at the antrum or UBLC side. [source] Deregulation of E-cadherin,catenin complex in precancerous lesions of gastric adenocarcinomaJOURNAL OF GASTROENTEROLOGY AND HEPATOLOGY, Issue 5 2003ANNIE ON-ON CHAN Abstract Background and Aim: Decrease in expression of the E-cadherin,catenin complex is an important element in gastric carcinogenesis. However, the expression of the complex in gastric precancerous lesions has not been well studied. The present study aimed to examine the serial change in expression of E-cadherin,catenin complex in the precancerous lesions of gastric cancer patients. Methods: Gastrectomy specimens of 40 patients with gastric cancer were retrieved. Areas with chronic gastritis, atrophic gastritis, intestinal metaplasia and adenocarcinoma were identified and immunostained for ,-catenin, ,-catenin and E-cadherin. The results were scored semiquantitatively by two independent pathologists using a validated scoring system. Results: A significant decrease in score was observed in 5% (1/22) of ,-catenin, 0% (0/22) of ,-catenin and 9% (2/22) of E-cadherin in chronic atrophic gastritis patients, and in 28% (5/18) of ,-catenin, 67% (10/15) of ,-catenin and 57% (8/14) of E-cadherin in intestinal metaplasia patients. The scoring of ,-catenin, ,-catenin and E-cadherin correlated with each other. Forty-three percent of patients had concordant changes of scores along the gastritis,adenocarcinoma sequence. There was no association between Helicobacter pylori status and E-cadherin,catenin complex expression. Conclusion: Deregulation of the E-cadherin,catenin complex was observed in the majority of precancerous lesions in patients with gastric adenocarcinoma, which has potential diagnostic and therapeutic implications. © 2003 Blackwell Publishing Asia Pty Ltd [source] Laparoscopic scar: A mimicker of Sister Mary Joseph's nodule on positron emission tomography/CTJOURNAL OF MEDICAL IMAGING AND RADIATION ONCOLOGY, Issue 5 2006B Setty Summary Positron emission tomography/CT is an established imaging method in the diagnosis and staging of cancers. 18F-fluoro-2-deoxy- d -glucose (FDG) is the most commonly used radiotracer in positron emission tomography/CT. It is a tumour viability agent and usually its uptake within a lesion reflects the presence of a viable tumour tissue. However, false-positive FDG uptake is known to occur in benign processes of either inflammatory or infectious aetiology. We describe FDG uptake at the site of laparoscopic scar that mimicked Sister Mary Joseph's nodule in a patient with gastric adenocarcinoma. Here, the knowledge of the patient's history and subtle imaging findings helped in accurate staging of the patient. In this case report, we emphasize the value of the knowledge of the patient history and awareness of different pitfalls of FDG to achieve a correct diagnosis on positron emission tomography/CT. [source] Chronic Atrophic Gastritis and Metachronous Gastric Cancer in Japanese Alcoholic Men With Esophageal Squamous Cell CarcinomaALCOHOLISM, Issue 5 2009Akira Yokoyama Background:, The risk of metachronous gastric cancer is high in Japanese with esophageal squamous cell carcinoma (SCC), especially in alcoholic men, suggesting a common background underlying the gastric and esophageal cancers. Methods:, Endoscopic follow-up ranging from 7 to 160 months (median, 47 months) after the initial diagnosis was performed in 99 Japanese gastric-cancer-free alcoholic men (56.8 ± 6.4 years) with esophageal SCC detected by an endoscopic screening examination. Chronic atrophic gastritis (CAG) assessed by the serum pepsinogen test and Helicobacter pylori status was compared between 90 of the 99 esophageal SCC cases and 180 age-matched Japanese gastric- and esophageal-cancer-free alcoholic men. Results:, The serum pepsinogen test showed a higher seroprevalence of severe CAG among the cases than among the age-matched controls (35.4% vs. 14.2% for H. pylori -seropositive, 71.4% vs. 7.7% for H. pylori -indeterminate, and 17.1% vs. 9.8% for H. pylori -negative, respectively; H. pylori status-adjusted p = 0.0008), whereas their H. pylori status was similar. The accelerated progression of severe CAG observed in the Japanese alcoholic men with esophageal SCC suggests the existence of common mechanisms by which both esophageal SCC and H. pylori -related severe CAG develop in this population. Metachronous gastric adenocarcinoma was diagnosed in 11 of the 99 gastric-cancer-free patients, and the cumulative rate of metachronous gastric cancer within 5 years was estimated to be 15% according to the Kaplan,Meier method. The age-adjusted hazard ratios were 7.87 (95% confidence interval: 1.43 to 43.46) and 4.84 (1.16 to 20.21), respectively, in the patients with severe CAG in comparison with those without CAG and those without severe CAG. Inactive heterozygous aldehyde dehydrogenase-2, a very strong risk factor for esophageal SCC in the alcoholics, was not associated with an increased risk of metachronous gastric cancer. Conclusions:, Accelerated development of severe CAG at least partially explained the very high frequency of development of metachronous gastric cancer in this population. [source] Florid cutaneous and mucosal papillomatosis with acanthosis nigricans revealing a primary lung cancerJOURNAL OF THE EUROPEAN ACADEMY OF DERMATOLOGY & VENEREOLOGY, Issue 3 2000Ugo Bottoni Abstract This is the report of an 80-year-old patient with diffuse brownish hyperpigmentation and velvety thickening of the skin with onset 1 year before. Warty lesions on his limbs were present as well as papillomatous and verrucous lesions on his lips, mouth and eyelid conjunctivae with hyperkeratosis of the nipples. Biopsies, performed at different sites, showed histological pictures consistent with a diagnosis of acanthosis nigricans (AN) with florid cutaneous and mucosal papillomatosis. This type of AN is frequently associated with internal malignancy. In our patient serum levels of tissue polypeptide antigen, carcinoembryonic antigen, cytokeratin fragment and squamous cell carcinoma antigen were high and chest computed tomography scan indicated a large tumour infiltrating the right lung and extending to the mediastinum. Cytological examination of bronchial drainage revealed the presence of neoplastic cells, non-small cell type carcinoma. The most frequent cancer associated with malignant AN is gastric adenocarcinoma. Lung tumour has rarely been reported with AN. Malignant AN is sometimes associated with other cutaneous and mucosal warty lesions, as in our patient. These various skin and mucosal lesions are the expression of a systemic epithelial disorder and may help clinicians to suspect a malignant form of AN. [source] Recent incidence trends and sociodemographic features of oesophageal and gastric cancer types in an English regionALIMENTARY PHARMACOLOGY & THERAPEUTICS, Issue 8 2009C. GAJPERIA Aliment Pharmacol Ther,30, 873,880 Summary Background, Oesophageal and gastric cancers comprise various common tumour types with possible different aetiology and historically different incidence trends. Aim, To enhance and update evidence about the descriptive epidemiology of oesophageal and gastric cancers. Methods, Population-based information from the East of England was available on 16 319 (65% male) incident cases of oesophago-gastric cancer (ICD-10 C150,169) diagnosed during 1995,2006. Age-standardized incidence trends by gender and deprivation groups and sex ratios were compared for four different tumour types [oesophageal squamous cell carcinoma (OSCC), oesophageal adenocarcinoma (OAC), junctional/cardia adenocarcinoma (JCA), and non-cardia gastric adenocarcinoma (NCGA)]. Results, Between 1995,1997 and 2004,2006, the age-standardized incidence of OAC and JCA increased slightly (by 4% and 6% in men and 17% and 8% in women respectively), with a sex ratio >4 for both. Conversely, OSCC and NCGA incidence decreased (,20% and ,32% in men and ,15% and ,26% in women respectively), with sex ratio of <2 for both. In men, OSCC and NCGA incidence was associated with increasing deprivation. Conclusions, Within the study context, there was a modest rise in OAC and JCA incidence. OAC and JCA share common incidence trends and sociodemographic features (contrasting with those of OSCC and NCGA cancers). [source] Helicobacter pylori vaccines,the current statusALIMENTARY PHARMACOLOGY & THERAPEUTICS, Issue 9 2000Sutton In this review, we take a look at the current status in the development of a vaccine against the human pathogenic bacterium, Helicobacter pylori, a major aetiological factor in peptic ulcer disease and gastric adenocarcinoma. Various animal models are now in use from mice infected with H. pylori, through gnotobiotic pigs and primates to ferrets naturally infected with their own Helicobacter, H. mustelae. A significant problem remains the requirement for a suitable mucosal adjuvant. Detoxification or the use of low doses of adjuvants already available may provide a solution and new immune stimulating compounds have been tested with some success. New approaches include the delivery of Helicobacter antigens by DNA immunization, microparticles or live vectors such as attenuated salmonella and the examination of alternative routes of vaccine administration. The phenomenon of post-immunization gastritis and improvements in vaccine efficacy are also discussed. A major area of interest is the mechanism by which immunization actually influences Helicobacter colonization. This remains a mystery: antibodies appear to be unimportant whereas CD4+ T-cells essential. Finally, a viewpoint is given on whom should be immunized when a final vaccine becomes available. [source] Review article: potential gastrointestinal effects of long-term acid suppression with proton pump inhibitorsALIMENTARY PHARMACOLOGY & THERAPEUTICS, Issue 6 2000Laine This review examines the evidence for the development of adverse effects due to prolonged gastric acid suppression with proton pump inhibitors. Potential areas of concern regarding long-term proton pump inhibitor use have included: carcinoid formation; development of gastric adenocarcinoma (especially in patients with Helicobacter pylori infection); bacterial overgrowth; enteric infections; and malabsorption of fat, minerals, and vitamins. Prolonged proton pump inhibitor use may lead to enterochromaffin-like cell hyperplasia, but has not been demonstrated to increase the risk of carcinoid formation. Long-term proton pump inhibitor treatment has not been documented to hasten the development or the progression of atrophic gastritis to intestinal metaplasia and gastric cancer, although long-term studies are required to allow definitive conclusions. At present, we do not recommend that patients be tested routinely for H. pylori infection when using proton pump inhibitors for prolonged periods. Gastric bacterial overgrowth does increase with acid suppression, but important clinical sequelae, such a higher rate of gastric adenocarcinoma, have not been seen. The risk of enteric infection may increase with acid suppression, although this does not seem to be a common clinical problem with prolonged proton pump inhibitor use. The absorption of fats and minerals does not appear to be significantly impaired with chronic acid suppression. However, vitamin B12 concentration may be decreased when gastric acid is markedly suppressed for prolonged periods (e.g. Zolllinger,Ellison syndrome), and vitamin B12 levels should probably be assessed in patients taking high-dose proton pump inhibitors for many years. Thus, current evidence suggests that prolonged gastric acid suppression with proton pump inhibitors rarely, if ever, produces adverse events. Nevertheless, continued follow-up of patients taking proton pump inhibitors for extended periods will provide greater experience regarding the potential gastrointestinal adverse effects of long-term acid suppression. [source] Microsatellite instability of papillary subtype of human gastric adenocarcinoma and hMLH1 promoter hypermethylation in the surrounding mucosaPATHOLOGY INTERNATIONAL, Issue 4 2001Rong-Jun Guo Gastric cancer has striking heterogeneity in histological pattern, cellular phenotype, genotype, biomarkers, and biological behavior. We focused on the specific morphological papillary phenotype of gastric adenocarcinoma and attempted to identify its distinct molecular characteristics. In our comparative study, early stage papillary (papillary-dominant) gastric cancer showed a significantly higher and more widespread high-frequency microsatellite instability (MSI-H) than other morphological types. Analysis of mutations in a panel of five putative microsatellite instability (MSI)-associated genes in the MSI-H cases revealed that papillary or papillary-dominant cancer displays a unique profile of mutations compared to profiles previously reported in gastric cancer. Immunohistochemical staining and methylation analysis revealed that silencing of hMLH1 by methylation in its promoter region was responsible for the failure of mismatch repair in papillary-type gastric cancer, whereas aberrant promoter methylation of hMLH1 was not found in any cases without the unique mutator phenotype. Promoter hypermethylation of the hMLH1 genes was found to a lesser degree in the adjacent non-tumor mucosa in four of the 10 cases with tumor having the mutator phenotype. Microsatellite instability itself could not be detected in the adjacent non-tumor mucosa. Inactivation of hMLH1 expression by promoter hypermethylation may be an early event in carcinogenesis of this type of gastric cancer, preceding the development of the clear MSI phenotype of papillary carcinoma. [source] Reduced expression and novel splice variants of ING4 in human gastric adenocarcinoma,THE JOURNAL OF PATHOLOGY, Issue 1 2009Ming Li Abstract ING4, a new member of the ING (inhibitor of growth) family of tumour suppressor genes, has been found to be deleted or down-regulated in gliomas, breast tumours, and head and neck squamous cell carcinomas. The goal of the present study was to investigate whether the expression and alternative splicing of ING4 transcripts are involved in the initiation and progression of stomach adenocarcinoma. ING4 mRNA and protein expression was examined in gastric adenocarcinoma tissues and human gastric adenocarcinoma cell lines by RT-PCR, real-time RT-PCR, tissue microarray immunohistochemistry, and western blot analysis. Alterations in ING4 transcripts were determined through sequence analysis of ING4 cDNA. Our data showed that ING4 mRNA and protein were dramatically reduced in stomach adenocarcinoma cell lines and tissues, and significantly less in female than in male patients. We also found that reduced ING4 mRNA expression correlated with the stage of the tumour. Interestingly, by sequence analysis, we discovered five novel aberrantly spliced variant forms of ING4_v1 and ING4_v2. These variants cause a codon frame-shift and, eventually, deletion of the NLS or PHD domain contributing to the mislocalization of p53 and/or HAT/HDAC complexes and, subsequently, altered gene expression in gastric adenocarcinoma. These results suggest that attenuated and aberrant ING4 expression may be involved in the initiation and progression of stomach adenocarcinoma. Copyright © 2009 Pathological Society of Great Britain and Ireland. Published by John Wiley & Sons, Ltd. [source] Impact of splenectomy on circulating T-lymphocyte subsets in stage III gastric cancerANZ JOURNAL OF SURGERY, Issue 6 2002Min Young Cho Background: The role of splenectomy remains unclear in patients with gastric cancer who undergo total gastrectomy. The aim of this study was to prospectively evaluate the impact of splenectomy on circulating T-lymphocyte subsets and survival in advanced gastric cancer. Methods: Analysis of lymphocyte subsets was performed in 40 patients with American Joint Committee on Cancer (AJCC) stage III gastric adenocarcinoma located on the upper one-third of the stomach, who underwent a curative total gastrectomy with or without splenectomy. Circulating T-lymphocyte subsets were measured on venous blood by using flow cytometry and monoclonal antibodies at preoperative day 1, and postoperative months 1, 3, 6, 12 and 18. Results: The proportion of lymphocytes and the values of CD3, CD8, CD16 and CD25 subsets were higher in the splenectomy group of patients at postoperative month 3. In the spleen preservation group at the same point of treatment, the proportion of granulocytes and the values of CD4 and CD4 : CD8 ratio were higher. Except for CD16 levels, all T-lymphocyte subsets showed no significant difference between splenectomy and spleen preservation groups after postoperative month 3. Increased CD16 levels in the splenectomy group were not associated with improvement in patients' 5-year survival rates. Conclusion: These results suggest that the long-term impact of splenectomy does not play an important role in postoperative quantitative changes of circulating T-lymphocyte subsets of patients with stage III gastric cancer who have undergone total gastrectomy. Furthermore, splenectomy does not give a prognostic benefit, based on tumour recurrence and survival of patients with proximal one-third gastric cancer who undergo total gastrectomy. [source] Expression of activated signal transducer and activator of transcription 3 predicts poor clinical outcome in gastric adenocarcinomaAPMIS, Issue 8 2009JEEYUN LEE Lee J, Kang WK, Park JO, Park SH, Park YS, Lim HY, Kim J, Kong J, Choi MG, Sohn TS, Noh JH, Bae JM, Kim S, Lim DH, Kim K-M, Park CK. Expression of activated signal transducer and activator of transcription 3 predicts poor clinical outcome in gastric adenocarcinoma. APMIS 2009; 117: 598,606. There are no known reliable biomarkers which can predict poor clinical outcome following curative resection of gastric adenocarcinoma. Given the importance of signal transducer and activator of transcription 3 (STAT3) activation in carcinogenesis, we attempted to determine whether STAT3 activation is prognostic of survival in curatively resected gastric cancer patients. We analyzed 311 surgically resected gastric cancer specimens for STAT3 activation and its downstream molecules such as matrix metalloproteinase (MMP)-9, MMP-10, cyclin D1, survivin, vascular endothelial growth factor (VEGF)-C, and VEGFR-3 using immunohistochemical studies and assessed their correlation with clinical outcome. Using immunohistochemistry, 303 specimens were interpretable for pSTAT3tyr705 expression. The pSTAT3 was detected in 79 (26.1%) of 303 gastric cancers. Of the downstream molecules tested, STAT3 activation was significantly associated with MMP-9 and MMP-10 expressions. On univariate analyses, 5-year disease-free survival (DFS) and overall survival (OS) for the tumors with STAT3 activation were considerably poorer than for those without STAT3 activation with statistical significance (5-year DFS 58.2% vs 68.3%; pSTAT3(,) vs pSTAT3(+); p = 0.0223; 5-year OS 59.5% vs 70.5%; pSTAT3(,) vs pSTAT3(+); p = 0.0128). On multivariate analyses, STAT3 activation was independently associated with inferior DFS (p = 0.049, hazard ratio [HR] = 1.445, 95% CI, 1.025, 2.120) along with AJCC stage IIIA or IIIB (p = 0.004, HR = 1.708, 95% CI, 1.178, 2.475). The STAT3 activation was also strongly correlated with inferior OS (p = 0.042, HR = 1.506, 95% CI, 1.025, 2.213). Based on our data, pSTAT3tyr705 may be a novel prognostic marker for poorer clinical outcome following curative resection and adjuvant therapy in gastric cancer. The clinical impact of a STAT3-targeted agent should be investigated in gastric cancer patients. [source] Genetic and epigenetic analysis of the KLF4 gene in gastric cancer,APMIS, Issue 7 2007YONG GU CHO KLF4, which is also known as the gut-enriched Kruppel-like factor, plays important roles during the proliferation and differentiation of gastrointestinal epithelial cells. A loss of KLF4 expression has been observed in human tumors, particularly in the gastrointestinal tract. In this study, the molecular basis of the KLF4 inactivation in gastric cancer was investigated by analyzing the somatic mutation, the allelic loss with two microsatellite markers, D9S53 and D9S105, and hypermethylation of the KLF4 gene in 47 gastric adenomas and 81 gastric adenocarcinomas. Mutational analysis revealed one mutation of the KLF4 gene in a diffuse-type advanced gastric adenocarcinoma, but not in the gastric adenoma. This mutation was a somatic missense mutation, GGG,AGG (Gly,Arg) at codon 107 in exon 3, which encodes a transcriptional activation domain of the protein. An allelic loss was found in 7 (22.6%) of the 31 informative gastric adenoma cases and 15 (31.3%) of the 48 informative cancer cases at one or both markers. In addition, promoter hypermethylation of the KLF4 gene was observed in only two gastric cancers. These results suggest that genetic and epigenetic alterations of the KLF4 gene might play a minor role in gastric carcinogenesis. [source] Overexpression of S100A4 is closely related to the aggressiveness of gastric cancerAPMIS, Issue 5 2003YONG GU CHO Elevated levels of the calcium-binding protein S100A4 cause metastasis of benign rat mammary tumor cells. To investigate whether S100A4 plays an important role in the invasion and metastasis of gastric cancers, we examined the gene mutations in the coding regions and expression patterns of the S100A4 in gastric adenocarcinoma in Korea. Moderate to strong expression of S100A4 was found in 53 (68.8%) of the 77 gastric adenocarcinomas, whilst normal gastric epithelium either failed to stain or showed weak staining. Interestingly, S100A4 expression was more frequently observed in gastric cancer patients with advanced gastric cancer (p=0.039), positive lymph node metastasis (p=0.001), and peritoneal dissemination (p=0.022). No gene mutations were found in the analyzed genomic area in 77 gastric adenocarcinomas and 15 gastric cancer cell lines. We found one single nucleotide polymorphism without an amino acid change, A99G, in two cases. These data suggest that the overexpression of S100A4 may be closely related to the aggressiveness of gastric cancer in Korea. [source] Synthesis and In-Vitro Antitumor Activities of Some Mannich Bases of 9-Alkyl-1,2,3,4-tetrahydrocarbazole-1-onesARCHIV DER PHARMAZIE, Issue 3 2009Jing Chen Abstract A novel series of 2-substituted aminomethyl-9-alkyl-1,2,3,4-tetrahydrocarbazole-1-ones 5a,q was synthesized via aminomethylation of 9-alkyl-1,2,3,4-tetrahydrocarbazole-1-ones 4a,e with hydrochlorides of the respective amines 6a,m. The structures of these newly synthesized compounds were characterized by 1H-NMR, MS, and elemental analysis. All the compounds were tested for their cytotoxic activity in vitro against four human tumor cell lines including human non-small lung cancer cells (A549), human gastric adenocarcinoma (SGC), human colon cancer cell (HCT116), human myeoloid leukemia cells (K562), and one multi-drug resistant subline (KB-VCR). Most compounds showed moderate to potent cytotoxic activity against the tested cell lines. Preliminary mechanism research indicated that the most promising compound, 2-diethylaminomethyl-9-methyl-1,2,3,4-tetrahydrocarbazole-1-one 5c, exhibited a potential inhibitory effect against microtubule. [source] | |||||||||||||||||||||||||||||||||||||