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

Although nonspecific chronic gastritis and gastric dysplasia are considered as risk factors in the development of gastric cancer, the magnitude of this risk has not been well established. We made an endoscopic and histologic follow-up of 24 patients with an initial diagnosis of atrophic chronic gastritis and some degree of dysplasia over a period of 8 years. The first study revealed slight dysplasia in 8 patients, moderate dysplasia in 13 and severe dysplasia in 3. In our observation, dysplasia considered overall shows a probability of almost 54% of evolution to regression. In our study, the association of atrophic chronic gastritis and severe dysplasia is a reliable marker of gastric cancer. We think it is opportune to carry out periodic follow-ups by endoscopy and biopsy of patients with chronic gastritis and dysplasia.
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PMID:[Non-specific chronic gastritis and gastric dysplasia, what is their clinical values?]. 262 9

Campylobacter pylori is now known to be the most common and important cause of gastritis, and C. pylori infections have been associated with duodenal ulcer, gastric ulcer, nonulcer dyspepsia, and gastric cancer. Although it has been only possible to culture C. pylori for about 5 yr, there are already sufficient data available to allow us to develop the basic framework that relates C. pylori gastritis to the causation of peptic ulcer disease. We review the data and propose mechanisms that implicate C. pylori as an important factor in the pathogenesis of peptic ulcer disease and consider the therapeutic implications. What we now know about C. pylori begins to unravel some of the mysteries surrounding peptic ulcer disease.
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PMID:Campylobacter pylori and peptic ulcer disease. 226 88

There are reasons to believe that chronic antral gastritis and chronic body gastritis are different clinical conditions. While both are associated with aging, chronic antral gastritis is much more commonly associated with gastric or duodenal ulcer. The natural history of chronic antral gastritis in asymptomatic normals and patients with peptic ulcer appears the same. Chronic body gastritis deteriorates rapidly with age in patients with gastric ulcer, but does not progress in patients with duodenal ulcer. With spontaneous healing of duodenal ulcer, chronic antral gastritis improves but persists. All these observations suggest that gastric ulcer, duodenal ulcer, and chronic antral gastritis are involved in a common mucosal inflammatory process. C. pylori occurs commonly on the antral mucosa affected by chronic gastritis, but is found to a much less extent at the site of peptic ulceration, and spontaneous ulcer healing is not affected by the presence of the organisms. It remains to be established whether C. pylori is the cause of chronic antral gastritis, is an aggravating factor of the gastritis, or is simply an inhabitant of the inflamed antral mucosa. Other known associations of chronic gastritis include pernicious anemia, bile reflux, and gastric cancer. Whether chronic antral or body gastritis is associated with clinical symptoms remains controversial. Histological improvement can be obtained with the use of prostaglandins, sucralfate, or bismuth compounds, which have one common property--they all possess mucosal-protective mechanisms.
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PMID:Etiology and management of chronic gastritis. 264 23

CT has become an important tool in the diagnosis and management of diseases that affect the stomach and duodenum. By depicting the bowel lumen, wall, and extramural structures, CT can provide unique information that complements standard air contrast radiography and endoscopy. Proper scanning methods and knowledge of normal anatomy are necessary for optimal results. We utilize the gas contrast technique for organ-specific examination in patients with known or suspected gastroduodenal disease. Gastric adenocarcinoma is an important indication for CT evaluation. Unfortunately, early hopes that CT could accurately stage gastric cancer have not been realized. CT is not as accurate as laparotomy in staging early gastric cancer, primarily owing to its inability to detect small peritoneal implants, diagnose metastases in normal-sized lymph perigastric nodes, and predict pancreatic invasion. Nevertheless, CT retains an important role in depicting gross metastatic disease and guiding percutaneous biopsy, particularly in patients who are deemed poor surgical candidates or have undergone prior gastric resection. A variety of conditions other than primary gastric adenocarcinoma produce recognizable abnormalities on CT. Gastric lipoma, leiomyosarcoma, and varices have a distinctive appearance. Others, including gastritis and uncomplicated peptic ulcer, produce nonspecific gastric wall thickening. Endoscopic correlation and biopsy are required for specific diagnosis in these cases. The duodenum, by virtue of its location in the anterior pararenal compartment of the retroperitoneum, may be involved by numerous benign and malignant conditions. In blunt trauma, complicated pancreatitis, and peptic ulcer disease, as well as primary and metastatic malignancy, CT can provide data that may alter patient management.
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PMID:CT of the stomach and duodenum. 265 48

Thyroid status was evaluated in 265 patients with gastric pathology. The degree of tissue triiodothyronine (T3) deficiency was assessed versus stage and histologic pattern of tumor. Also, it was measured before and after surgery. No correlation was found in gastric cancer patients between T3 concentration, degree of blood--T3 level decrease and tissue T3 deficiency, on the one hand, and stage and histologic pattern of tumor, radical surgery and postoperative treatment, on the other. Said T3 parameters differed significantly in cases of chronic gastritis, gastric ulcer and polyps.
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PMID:[Deficiency of the triiodothyronine pool in patients with stomach cancer]. 270 12

Relationships between chronic gastric diseases and gastric cancer are discussed. Mucosal epithelial dysplasia may be regarded as the most reliable sign of increased risk of gastric cancer. Endoscopy with biopsy is the principal method for the assessment of the dysplasia-cancer relationship. A retrospective study of histologic preparations and smear imprints from gastric biopsy specimens and operative samples, obtained from 292 patients with chronic gastritis, gastric ulcers, gastric polyps and polyposis, and conditions following gastric resection for nontumorous diseases and cancer (group 1) and 80 patients with verified gastric cancer (group 2), is reported. In both groups, there was mucosal dysplasia of varying markedness. Endoscopic monitoring revealed gastric cancer in 48 first-group patients. Gastric cancer, combined with dysplasia, was detected in 128 patients from both groups, its early stages, in 37 of those. Convincing evidence in favor of a relationship between dysplasia and cancer is presented.
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PMID:[Epithelial dysplasia and cancer of the stomach]. 273 71

The upper gastrointestinal microflora was evaluated in relation to gastric diseases and gastric surgery. Postoperative septic complications and microorganisms found in primary infections were studied in 750 gastric operations. The overall rate of primary infections was 23%. Enterobacteriaceae, enterococci and Bacteroides fragilis were more frequently found in postoperative infections in patients with gastric bleeding or carcinoma. The microbial colonization of the oropharynx, esophagus and stomach was studied in 60 patients. Patients with gastritis, carcinoma and a history of gastric resection harboured more microorganisms in their stomachs than patients with gastric or duodenal ulcers. Patients with gastric carcinoma were colonized with the highest numbers of different microorganisms. The microbial colonization in 23 patients with gastric carcinoma was studied. The tumor was colonized in all patients. Clostridium species were isolated from 57% of the patients. Antibiotic agents used as prophylaxis in gastric cancer surgery should cover both aerobic and anaerobic microorganisms, including B. fragilis. The effect of 400 mg ofloxacin on the microflora in gastric juice was evaluated in 24 patients undergoing gastric surgery. Both the aerobic and anaerobic flora were suppressed on the day of surgery, but increased in number afterwards. There was a significant correlation between gastric pH and the number of microorganisms isolated in the gastric juice. The degree of Campylobacter pylori colonization in relation to other microorganisms on antral mucosal biopsies was investigated in 53 patients with dyspeptic symptoms. Microbial colonization was found in 94% of the patients. Microorganisms other than C. pylori were found irrespective of the diagnoses. C. pylori was with one exception only found in patients with gastritis. No relation between the gastric pH and the microbial colonization of the mucosa was found. The relationship between hospital and catchment area utilization of antimicrobial agents and antibiotic susceptibility of isolated bacteria in primary infections after gastric operations were studied. Over 80% of the antibiotics were used in the catchment area. No major problems with bacterial resistance to antimicrobial agents were found. The pattern of bacterial resistance reflected the use of antimicrobial agents in the catchment area more than that in the hospital.
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PMID:The upper gastrointestinal microflora in relation to gastric diseases and gastric surgery. 274 34

A series of 169 consecutive patients from low socioeconomic strata attending the gastroenterology clinic of Charity Hospital in New Orleans were evaluated clinically and endoscopically. This general New Orleans population is known to be at increased risk of developing gastric carcinoma. The type of gastritis was identified histologically, and the presence of Campylobacter pylori was determined by culture and/or histology. The overall prevalence of C. pylori infection in this patient population was 71% (126/169). These findings were correlated with serum IgG antibody to C. pylori using an ELISA. Fifteen patients with neither demonstrable gastritis nor C. pylori served as negative controls and had low levels of IgG antibody to C. pylori. A strong correlation was found between Campylobacter detection by morphologic and/or culture technique and the presence of serum IgG antibody. For all patients examined, the sensitivity of the ELISA was 94.2% and the specificity 75.5%. The highest ELISA values for IgG antibody (sensitivity = 89%, specificity = 75%) were detected in patients positive for C. pylori, who also had diffuse antral gastritis with prominent lymphoid follicles. For patients with chronic atrophic gastritis and intestinal metaplasia, the sensitivity of the ELISA was 96% and the specificity 67%. The latter number may indicate underrepresentation of foveolar epithelium in biopsies with extreme intestinal metaplasia. Results suggest a high prevalence of chronic infection of C. pylori in this clinic population. The possible role of C. pylori in the development of precursor lesions of gastric cancer is discussed.
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PMID:Campylobacter pylori-associated gastritis and immune response in a population at increased risk of gastric carcinoma. 274 87

Ascorbic acid, the reduced form of vitamin C, may protect against gastric cancer. Accordingly, this study assessed the variability of ascorbic acid and vitamin C in the gastric juice of 77 patients with dyspepsia. There was a vitamin C concentration gradient from gastric juice down to plasma in subjects with normal gastric mucosa, but not in those with chronic gastritis. Patients with chronic gastritis had significantly lower gastric concentrations of vitamin C and ascorbic acid, and ascorbic acid concentrations were especially low in subjects with hypochlorhydria. The presence of the concentration gradient suggests that a mechanism for the secretion of vitamin C into the stomach exists. This is compromised by chronic gastritis. The very low ascorbic acid concentrations in hypochlorhydria may be a consequence of oxidation by bacterial nitrite. Those patients who by the Correa model are at greatest risk for gastric cancer have the lowest gastric levels of ascorbic acid.
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PMID:Ascorbic acid in the human stomach. 274 55

The presence of Campylobacter pylori was studied in biopsy material from gastric mucosa taken by guided biopsy during fiber gastroduodenoscopy from 101 patients with chronic gastritis (n = 50), peptic gastric ulcer (n = 28), peptic duodenal ulcer (n = 7), gastric cancer (n = 10) and gastric polyposis (n = 6). Campylobacter pylori was found in various quantity--moderate (++) and considerable ( )--in 64% of the patients with chronic gastritis, in 85.7% of the patients with peptic gastric ulcer and in 100% of the patients with peptic duodenal ulcer as well as in half of the patients with gastric cancer and polyposis. The quantity of Campylobacter pylori correlated with the severity of the inflammatory process and the degree of atrophy of the gastric antral mucosa. A tendency toward seasonal incidence of Campylobacter pylori infection of gastric mucosa was established: 78.69% of the patients examined during spring time (April-May) and 60.0% of the patients examined during winter time (January-February) had Campylobacter pylori infection. This explains to a certain extent the seasonal exacerbations of the pathological process in chronic gastritis and peptic ulcer. The development of a well expressed chronic atrophic gastritis is in direct relation with the greater quantity of Campylobacter pylori in the gastric mucosa. The study reveals the pathogenetic relations between the presence and quantity of Campylobacter pylori and the development and evolution of chronic gastritis and peptic gastric and duodenal ulcer.
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PMID:[Campylobacter pylori in patients with chronic gastritis and gastric and duodenal peptic ulcer]. 276 25


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