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

A pathogenetic mechanism to explain the increased incidence of gastric cancer in patients with pernicious anaemia (P.A.) is proposed. Mean nitrite concentration in gastric juice from thirteen fasting patients with P.A. was nearly fiftyfold greater than that of age-matched controls. The number of bacteria in the gastric juice of P.A. patients was also greatly increased. Small amounts of volatile nitrosamines were detected in simulated P.A. gastric juice in vitro, after addition of nitrite to achieve a concentration approximating to that found in vivo. If similar nitrosation occurs in vivo, the intragastric production of carcinogenic N-nitroso compounds could explain the high incidence of gastric cancer in patients with P.A.
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PMID:Pathogenesis of gastric cancer in pernicious anaemia. 7 69

Using the Lauren approach of histological classification, 300 cases of early gastric cancer (EGC) were analysed with regard to their age distribution, to predisposing lesions, including gastritis, and survival rate. The average age of onset for EGC of the diffuse type is 56, ten years earlier than for the intestinal type. There was a significantly high percentage of EGC of the diffuse type without gastritis. On the other hand, gastritis in pernicious anaemia falls in the high-risk group. The survival rate in our cases is 98%, corrected for age. The results show that it is of utmost importance to differentiate between the histological types of gastric carcinoma; for there may be indeed a difference in pathogenesis and aetiology.
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PMID:Evaluation of histological classification in early gastric cancer (an analysis of 300 cases). 22 52

The use of technetium-99m in the noninvasive investigation of the upper gastrointestinal tract is discussed with particular reference to the evolution of a method of assessing gastric function or gastric acid secretion non-invasively and to the applications of this method in the investigation of surgical patients with disease of the upper gastrointestinal tract. The assessment of maximal acid output and the insulin response is described and the use of the test in the diagnosis of pernicious anaemia, hypo- and hyperchlorhydric states, gastric cancer, hiatus hernia and Barrett's oesophagus, coeliac disease, Meckel's diverticulum, and abdominal aortic aneursym outlined. The use of chemicals labelled with this tracer in hepatobiliary scanning is briefly described.
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PMID:Non-invasive investigation of the upper gastrointestinal tract using technetium-99m. 42 Apr 92

Simultaneous measurement of plasma and gastric immunoreactive carcinoembryonic antigen (CEA) was performed in 108 patients undergoing upper gastrointestinal endoscopy. Gastric immunoreactive CEA was more sensitive than plasma CEA (92% vs. 65% positive) in patients with gastric cancer. In cancer patients gastric CEA was significantly higher than in all other patient groups. The extent of disease, the histologic type of adenocarcinoma, and the macroscopic appearance of the tumor had no influence on gastric CEA results. Gastric CEA was elevated in 44% of patients with gastritis and 26% of patients with benign gastric ulcers, but was never elevated in patients with no gastric pathology. In patients with benign disorders, elevated gastric CEA was significantly correlated with atrophic gastritis especially of moderate or severe degrees. Elevated levels persisted in patients with pernicious anemia and severe atrophic gastritis but returned to normal with healing of benign gastric ulcers. Simultaneous measurement of gastric total protein or potassium content was necessary to correct for variations in sample collection. We conclude that gastric CEA was not useful for distinguishing between benign and malignant lesions but should be studied further for screening high risk patients, for identifying and following patients with "premalignant" conditions, and for following cancer patients before and after surgery and/or chemotherapy.
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PMID:Simultaneous gastric and plasma immunoreactive plasma carcinoembryonic antigen in 108 patients undergoing gastroscopy. 42 1

In order to assess the risk of gastric cancer (GC) developing in patients with pernicious anaemia (PA), the prevalence of PA was analysed in all patients with GC notified to the Danish Cancer Registry in 1972. Among 877 patients with GC, PA had previously been diagnosed in 19 (2.2%). In seven of these, PA had been diagnosed only shortly before GC. Accordingly, the diagnosis of PA could be regarded as unquestionable only in the remaining 12 cases (1.3%). In either case, the frequency of PA was significantly higher than in a reference group of patients with cancer of the colon who had been selected in the same way. Calculation of the incidence of GC in PA patients showed that this was about three times higher than in the general population. The annual risk of GC was calculated to be 0.3%. In PA patients, the tumour was primarily localized to the body and fundus of the stomach, whereas it mainly involved the antral and pyloric region in patients without PA. In view of the low cancer rate it is concluded that routine gastroscopy and barium meal examination are not indicated in PA patients in general. Whenever a patient with PA complains of dyspepsia, examinations with gastroscopy and barium meal should, however, be carried out on liberal indications.
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PMID:Pernicious anaemia as a risk factor in gastric cancer. 50 4

A case of pernicious anaemia is described in which the diagnosis of gastric cancer in absence of stomach complaints was established by gastric lavage cytology. A small polypous lesion was detected by gastrotomy and cytologic print smears revealed cancer cells. The value of intraoperative gastric cytology is pointed out. Close cooperation of surgeon, pathologist and cytologist is mandatory.
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PMID:[Value of intraoperative gastric cytology in pernicious anaemia (author's transl)]. 65 81

Although many facts on epidemiology of gastric cancer and on the preceding atrophic gastritis are known, sufficient scientific foundations for planning primary prevention are lacking. It is suggested that with rising standards of living and hygiene and with dissemination of optimal nutrition according to physiologic aspects, incidence of gastric cancer will further decrease. 2. It is possible to identify some high risk groups: elderly persons with familial aggregation of stomach cancer, blood group A, pernicious anemia, atrophic gastritis and intestinal metaplasia, anacidity, and patients operated upon for benign epithelial neoplasms or gastric ulcer. Prophylactic supervision of this segment of the population seems mandatory but by this means, only a small percentage of all gastric cancer can be detected early. 3. Our knowledge is sufficient for the planning of intervention studies, e.g. long tome prophylactic application of ascorbic acid or vitamin A or intensive drug treatment of atrophic gastritis. Therefore we have started such a trial using carbenoxolon. 4. Screening methods for detection of early gastric cancer in asymptomatic persons have been evaluated in Japan. Their application in Europe cannot be generally recommended. The cost-benefit ratio is prohibiting. 5. Today, the main route to detect stomach cancer when curable is the thorough examination of persons with dyspeptic complaints. Radiological examination holds the first place and is supplemented by fibergastroscopy which enables aimed biopsy and cytologic examination of gastric juice. All other methods have only limited value in selected situations. 6. Without resignation we must realize that a solution of the problem cannot be expected in the near future. Further efforts are necessary in order to gain solid scientific foundations and to introduce research results into medical practice.
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PMID:[Scientific foundation of gastric cancer control (author's transl)]. 86 74

By way of introduction, the physiologic alterations of blood cells in old age are described. Besides the well known anemias in younger persons, protein deficiency may be an additional cause of anemia in the elderly. Acquired sideroblastic anemia of varying etiology is more often seen in the elderly than in younger people. In pernicious anemia the daner of gastric cancer has been overestimated. Aggressive treatment of acute leukemias is not indicated in patients over 60. The special form of smouldering leukemia is mentioned. The syndrome of anemia, thrombocytopenia and enzymatic dysfunction of granulocytes may, it is suggested, be a symptom of preleukemia. Anemia with accelerated sedimentation rate responsive to steriods is helpful in diagnosing polymyalgia rheumatica in the oligosymptomatic form.
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PMID:[Hematological problems in geriatrics]. 105 30

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

The commonest malignant tumour of the stomach is gastric carcinoma. Although the incidence of this neoplasm has declined worldwide, it still ranks fifth to seventh as a cause of cancer-related deaths in the West where the overall 5-year survival from the disease remains poor and averages 5-10%. The decline in the incidence of gastric cancer during the past 4 decades is largely confined to antral tumours of the intestinal type. During this period an absolute increase in the prevalence of cancers of the upper third of the stomach has been observed. Japan is the only country where the mortality has declined proportionately more than the decreased incidence of the disease. This is attributed to a successful screening programme for the detection of early gastric cancer, better staging and probably more aggressive surgical treatment with an extended lymphadenectomy. The latter remains unproven and is currently being evaluated prospectively in a Medical Research Council trial being conducted in the United Kingdom. Surgical excision remains the mainstay of therapy. To date there has been no firm evidence that peri-operative radiotherapy imparts any therapeutic advantage. Overall survival is not improved by adjuvant combination chemotherapy although the early results of a modified FAM regimen with cisplatin are encouraging in terms of response rates. Gastric carcinoids most frequently arise in patients with pernicious anaemia due to the prolonged hypergastrinaemia. Although they can metastasize, their prognosis is good and resection is indicated even in the presence of deposits. Gastric lymphoma accounts for 0.5-3% of gastric malignancies and is the prototype of malignant lymphomas arising from mucosa associated lymphoid tissue (MALT) present in the gastrointestinal tract and other organs. The majority of these tumours are B-cell lymphomas which are slow growing and tend to remain localized until late in the course of the disease. The various accepted histological classifications are difficult to apply to MALT lymphomas which are nowadays regarded as a distinct entity the prognosis of which is determined more by stage than histological type. They frequently cause diagnostic problems because of their indolent growth characteristics and their close simulation to benign lymphoid infiltrates. In the past, the term "pseudolymphoma" was applied to those extranodal proliferations of lymphoid tissue the nature of which was uncertain. This problem has been resolved by the advent of immunocytochemical and molecular biological techniques such that it is now always possible to distinguish a reactive from a neoplastic lymphoid infiltrate.(ABSTRACT TRUNCATED AT 400 WORDS)
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PMID:Malignant tumours of the stomach. 170 Dec 66


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