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Query: UMLS:C0024623 (gastric cancer)
 36,219 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

Differential diagnostic problems between gastric carcinomas and precancerous lesions with severe dysplasia have become more perceptible with the increasing number of resected early carcinomas. Although such problems come up for all macroscopic and histologic types of gastric cancer they are particularly marked between early carcinomas of the elevated type and adenomatous polyps. Elevated early carcinomas are usually highly differentiated adenocarcinomas with a morphology which often reminds of of adenomas. But sometimes the carcinomas also demonstrate convincing signs of being developed from adenomas. The criterion of distinction between intramucosal carcinomas and adenomas is invasion through the basal membrane, often difficult to evaluate. The morphological relation between elevated early gastric carcinomas and adenomas and the criterion of distinction between them were studied in 20 early gastric carcinomas of the Japanese types I and IIa, 6 intramucosal and 14 submucosal all highly differentiated adenocarcinomas, and in 42 polyps, of which 5 were of the adenomatous type. All lesions were taken from resection specimens. Among the carcinomas 5 demonstrated convincing signs of being malignant transformed adenomas. In addition, 6 carcinomas had a morphology which more or less reminded of adenomas, but their genetic origin was more uncertain. Nine carcinomas revealed no sign of an adenomatous origin. Among the 5 polyps diagnosed as adenomas 2 revealed an extraordinary degree of severe dysplasia which caused uncertainty on the benign diagnosis. The rest of the polyps were without dysplasia. The significance of invasion through the basal membrane as an indispensable factor of distinction between adenoma and carcinoma in the stomach is discussed. It is concluded that the degree of dysplasia can be so severe and the invasion so difficult to evaluate that the classification of some few tumours depends on the subjectivity of the single pathologist. Four of the tumours, 2 adenomas and 2 intramucosal carcinomas, having a remarkable macroscopic appearance like a large mucosal fold are especially mentioned. Their relation to gastric mucosal prolaps is discussed. Furthermore, a tumour apparently demonstrating only a moderate degree of dysplasia, but even so setting up metastases is mentioned in detail.
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PMID:Elevated early gastric carcinoma. Differential diagnosis as regards adenomatous polyps. 22 35

Gastroscopy is the diagnostic measure of choice in early recognition of gastric carcinoma, offering an accuracy rate of 96-99. However, this goal can only be achieved when biopsies are taken with forceps and snare from all circumscribed lesions which may hide a carcinoma. The common association with hyperplasiogenic polyps (15/86), adenoma and borderline lesion (7/86) and synchronous gastric carcinoma (8/86) request a subtle preoperative diagnosis if one does not perform gastrectomy in principle. Endoscopic resection (5/86) or local excision (6/86) should be debated in carcinomas located close to the cardia, and in high-risk patients. 5-year-survival rates of the "Erlangen early gastric cancer registry", are in accordance with the excellent results reported in the Japanese literature.
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PMID:[Early stomach cancer: new diagnostic and therapeutic aspects]. 29 16

Tumor-specific immunity to carcinoma of the colon, pancreas and stomach was assayed by tube LAI. Cancers of the colon, pancreas and stomach, were shown to possess organ-type specific neoantigens. In 115 patients with colon cancer, 100%, 75%, 61% with Dukes' A, B and C cancer were LAI positive, respectively. Even a microfocus of in situ cancer in a colon adenoma was sufficient to stimulate measurable tumor-specific immunity in the host. In Dukes' D cancer, 25% of patients with widespread metastasis were positive, whereas 100% with solitary lesions were positive. Reactive leukocytes from patients with colon cancer did not react to extracts of normal bowel mucosa or villous adenoma from LAI-negative patients. Leukocytes from 19% (3 of 16) of patients with colon adenomas reacted to the extract of colon cancer but not normal colon mucosa. Moreover, the LAI-positive response of the patients with colon adenomas or colon cancer is directed to a colon cancer TSA which is linked to beta2-microglobulin. These studies suggest that some colon adenomas express TSA before morphological evidence of cancer. It is not known if the acquisition of a cell surface TSA is an irreversible step toward unrestrained growth and metastasis. In pancreatic cancer, 100% of patients with cancers less than 5 cm and without metastasis were LAI positive, whereas 29% were positive when the cancer was greater than 5 cm or had metastasized. In Patients with stomach cancer, 100% with Stage II and 46% with Stage III and IV cancer were LAI-positive. Leukocytes from patients with other GIT cancers and from patients with inflammatory bowel disease or pancreatitis did not react with extracts of colon, stomach or pancreatic cancer. Leukocytes from patients with metastatic cancer, usually did not react in the tube LAI assay because their surfaces were coated in vivo with TSA. LAI reactivity was present when CEA was not detectable and when CEA levels were elevated LAI activity was often absent. The present study suggests that the automated tube LAI shows sufficient promise to warrant studies to determine its efficacy for the diagnosis of GIT cancers.
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PMID:Tube leukocyte adherence inhibition (LAI) assay in gastrointestinal (GIT) cancer. 37 89

When early cancer of the colon and rectum is defined as in early gastric cancer, i.e., invasion is limited to the mucosa and submucosa, 38 lesions from 35 patients of early cancer of the colon and rectum were detected during the last 20 years. The macroscopic and histologic findings included cancer-containing adenoma in 35 lesions from 32 patients. When the diagnostic methods were compared in 33 cases of early cancer of the colon and rectum, it was found that positive or suspicious cancer was obtained by an x-ray study in 5 of 18 cases examined (28%), by endoscopy in 19 of 31 cases (61%), by cytologic methods in 18 of 21 cases (86%), by biopsy in 19 of 25 cases (76%) and by polypectomy under direct vision through an endoscope in 13 of 14 cases (93%). When both biopsy and cytologic studies were performed in combination with endoscopy (20 cases), either of them was positive in all cases. These results indicate the possibility of correct diagnosis in many cases through the combined use of the cytologic method and biopsy without polypectomy, if the location is previously checked. On the other hand, 104 polyps from 90 patients were removed by means of the snare-electrocautery technique with the use of coagulation current during the last 4 years. The histologic findings revealed cancer-containing adenoma in 13, even in benign appearing polyps and in small polyps 1.0 cm or less in diameter. These results indicate that diagnosis of early cancer of the colon and rectum is difficult without polypectomy, if cancer is not previously suspected.
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PMID:Diagnosis of early cancer of the colon and rectum. 49 69

A clinical study of a family (Sch.) with a high incidence of death from gastric cancer in the second generation is presented. Endoscopic and/or surgical evaluation of the stomach, upper small intestine, and colon in 14 mainly asymptomatic members of the third and fourth generations revealed single or multiple (solitary) papillary adenomas in the colon or jejunum in 2 members each of the two generations. In addition, single or multiple hyperplastic polyps in the stomach or colon were found in 5 members, in 4 of them in association with papillary adenomas. The findings in family Sch. are consistent with 'minor' adenomatous polyposis coli associated with gastric carcinoma. Gastric carcinoma probably represents another phenotype among the vast variety of extra-colonic and extra-alimentary neoplastic changes known to occur in association with familial polyposis coli (FPC). The relationship of hyperplastic polyps to papillary adenoma in the colon and to gastric carcinoma respectively is discussed. Finally, evidence for a genetic relationship between family Sch. and a case with probable FPC is presented.
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PMID:Familial 'minor' adenomatous polyposis coli associated with gastric carcinoma - a hiterto undescribed phenotype of polyposis coli? 127 1

We studied activated mutations of K-ras gene in three forms of colorectal tumors, i.e., 45 specimens of colorectal adenoma (CA), 10 of 'cancer in adenoma' (CIA), and 24 of colorectal cancer (CC), and in 15 of gastric cancer (GC) as controls. Chromosome aberrations were also examined in 7 specimens of CA, 3 of CIA, 8 of CC, and 7 of GC. Mutation of K-ras Codon 12 was observed in 12 (26.7%) of the 45 specimens of CA, 6 (60.0%) of the 10 specimens of CIA, 6 (25.0%) of the 24 specimens of CC, and 1 (6.7%) of the 15 specimens of GC. In CA, its frequency increased with the degree of histological atypism. In CA and CIA, its frequency increased with the increase in short diameter. The most frequent chromosome aberration was the numerical excess of chromosome 7. Numerical deficiencies of chromosomes 17 and 18 or structural abnormalities of 17p+ and 18q+ were noted in 1 specimen each of CA and CIA, and 2 of CC. Thus, aberrations of these two chromosomes were concurrent. 5q--was observed in 1 specimen each of CA and CC. These findings were not contradictory to the multi-step carcinogenesis model of the colorectum based on the hypothesis that carcinogenesis requires activation of an oncogene by mutation accompanied by defects of several genes that might normally inhibit tumorigenesis.
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PMID:Genetic changes in multi-step development of colorectal cancer. 145 86

We investigated whether duodenal reflux through the pylorus is involved in the development of gastric cancer. Male Wistar rats weighing 230-250 g were subjected to three types of operative procedures: (i) allowing reflux through the pylorus; (ii) allowing reflux through a gastrojejunal stoma; and (iii) gastrotomy. No carcinogens were given, and the animals were killed 50 weeks after surgery. No cancers were detected in any of the 18 animals with gastrotomy. In contrast, seven (41%) of 17 animals with reflux through the pylorus and four (31%) of 13 animals with reflux through the stoma had adenocarcinoma. Differences in the incidence between both reflux groups and the gastrotomy group were significant (P < 0.01 and P < 0.05 respectively). All of the adenocarcinomas developed in the pyloric mucosa near the pylorus in the animals with reflux through the pylorus, and in the oxyntic mucosa near the stoma in those with reflux through the stoma. Adenocarcinomas appeared as a polyploid mass with or without slight central erosion. Most of the adenocarcinomas were of the well-differentiated tubular type, and the others were of the mucinous type. No differences in either the histologic type or depth of invasion of the adenocarcinoma were recognized between the two duodenogastric reflux groups. Precancerous or paracancerous lesions, such as adenoma, adenocystic proliferation, and stomal pseudopyloric metaplasia, were more frequently found in the same region as the adenocarcinomas. These findings suggest that duodenogastric reflux in the rat has potent carcinogenic activities not only in the oxyntic mucosa through the stoma, but also in the pyloric mucosa through the pylorus.
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PMID:Duodenal reflux through the pylorus induces gastric adenocarcinoma in the rat. 147 39

Male Wistar rats were subjected to one of three types of operative reflux procedure that allowed part or all of the duodenal contents to flow back into the stomach through the pylorus, thus producing models of bile reflux alone, pancreaticoduodenal reflux alone, and combined reflux. All surviving animals were killed 50 weeks after surgery and the development of gastric cancer was assessed. No cancer was seen in 16 animals with pancreaticoduodenal reflux or in 32 control animals with gastrotomy, whereas 2/8 animals with bile reflux and 11/29 animals with combined reflux had gastric carcinoma. Compared with the control group, the incidence of carcinoma in animals with bile or combined reflux was significantly higher (P less than 0.05 and P less than 0.01 respectively). All carcinomas developed in the antral area near the pylorus. Adenomas were observed only in the groups of animals developing carcinoma and occurred in the same region of the stomach. These results suggest that bile, and not pancreaticoduodenal secretions, is the component of the duodenal contents responsible for the development of gastric carcinoma.
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PMID:Is bile or are pancreaticoduodenal secretions related to gastric carcinogenesis in rats with reflux through the pylorus? 151 78

The stomach cancer develops on dysplastic lesions of gastric mucosa. It can be found in every precancerous condition, as chronic gastritis, gastric adenoma, giant rugal hypertrophy, chronic peptic ulcer, gastric stump after partial resection, pernicious anaemia. So, this dysplastic change is not a specific lesion. Different classifications are known for grading of gastric dysplasia. Authors evaluated them compared with each other. The signs of dysplasia were studied in 306 gastric aimed biopsy specimens from 233 patients between 1979-1990. In this material severe dysplasia occurred in 20.6%. It means a frequency of 0.84% regarding all gastric endoscopies in the same period of time. The endoscopic investigation revealed a protruded lesion in 18.5% and excavated one in 45.9%. What is very important, local change could not be detected in 35.6%. Follow-up study could be performed in 49 patients in a period of 1-7 years. In this group cancer developed in five patients. By the other hand, 22 gastric carcinomas were proved amongst 233 patients. The authors' recommendation is to follow-up the patients bearing gastric dysplasia at least during 10 years after the diagnosis.
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PMID:[Clinical pathology of gastric mucosal dysplasia]. 152 86

Eight years of experience with endoscopic Nd:YAG laser photocoagulation were analyzed in retrospect in an attempt to identify factors relating to both failures and complications of laser therapy, and to delineate its limits and pitfalls in benign and malignant tumors. Three hundred and seventy-eight patients were studied, including 42 with gastroesophageal cancer, 180 with colorectal adenoma and 156 with colorectal malignancy. Patients with gastroesophageal cancer (n = 42) were referred mainly for obstruction in esophageal cancer and for bleeding in gastric cancer, with successful palliation in 86 and 81%. Hemorrhage was the only complication seen, twice during and twice after treatment. Pain, heat and smoke-induced complaints and sometimes temporary increased dysphagia were mentioned. Two white-surfaced tumors did not react at all. Patients with colorectal adenoma (n = 150) were divided into groups according to the size of the lesion. Definitive, histologically documented eradication of adenomatous tissue was achieved in 43% of the extensive, in 69% of the intermediate, and in 97% of the small adenomas. Major complications, mainly stenosis and hemorrhage, occurred in 6.4%, 7.6% and none of the lesions, respectively, and minor complications were seen in 57.4, 30.8 and 13.8%, respectively. Stenosis appeared to be related only to prior electrocoagulation and to excessive delivery of energy. Post-treatment hemorrhage occurred at about day 7. In familial polyposis (n = 30) surveillance of the rectal stump was successful in 84%, with major and minor complications in 4% and 12%. In colorectal cancers (n = 156) treated for palliation of bleeding and obstruction, success was obtained in 91%. major complications (13%) consisted mainly of stenosis and perforation.(ABSTRACT TRUNCATED AT 250 WORDS)
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PMID:Analysis of failures and complications of neodymium: YAG laser photocoagulation in gastrointestinal tract tumors. A retrospective survey of 18 years' experience. 168 58


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