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

Esophageal manometry with a catheter microtransducer was performed as a functional diagnostic method on 30 patients after total gastrectomy because of gastric cancer (18 men, 12 women with a mean age of 64 +/- 3.7 years). Subsequently their symptoms were recorded. 21 of the patients (70%) complained of reflux discomfort and symptoms of disturbed peristalsis (dysphagia, odynophagia). 29 patients (93%) showed pathological patterns of contraction (repetitive, simultaneous, deformed, multipeak contractions) especially in the distal part of the esophagus. The contractile force was decreased on average by 10 mmHg in that area. The resting pressure of the upper sphincter was also decreased by about 10 mmHg. These results can be explained by an increased postoperative reflux (absence of the lower sphincter) and the changed biomechanics of the esophagus (decreased longitudinal tension) caused by the operation. The results of this study demonstrate the importance of postoperative manometry in total gastrectomized patients.
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PMID:Disturbed esophageal motility after total gastrectomy. 839 29

The pathogenic bacterium Helicobacter pylori, which causes active, chronic type B gastritis and peptic ulcer disease, and increases the risk for development of gastric cancer, could tentatively interfere with growth factors and growth factor receptors of importance for the gastroduodenal mucosa, e.g. heparin-binding FGFs (fibroblast growth factors). H. pylori binds FGF with an extremely strong affinity (3.8 x 10(-12)M), and also heparan sulfate and heparin with higher affinity (Kd 9 x 10(-9)M) than FGFs bind to heparin (10(-8) - 10(-9)M). FGF receptors are also dependent on heparin for their activation. Heparan sulfate binding proteins (HSBP) are exposed on and shed from the surface of H. pylori, which often are localised close to the epithelial stem cells in the gastroduodenal glands. H. pylori could thus efficiently interfere with growth factors and growth factor receptors, tentatively resulting in disturbance of the delicate balance that control the renewal, maintenance and repair of the gastroduodenal mucosa. This mode of action has previously not been considered, but may constitute part of its pathogenic mechanisms. Such a dynamic mode of action of H. pylori may explain the reason for that infected victims may either suffer from gastrointestinal symptoms or lack clinical evidence of disease or discomfort.
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PMID:Helicobacter pylori interacts with heparin and heparin-dependent growth factors. 874 13

We report the unusual case of identical male twins developing early gastric cancers that were found almost simultaneously. A 39-year-old man underwent a barium-swallow examination to investigate the cause of right hypochondrial discomfort; the examination revealed evidence of gastric cancer in the upper body of the stomach. A diagnosis of adenocarcinoma was confirmed by endoscopic biopsy, and a total gastrectomy was performed. Subsequent screening of the patient's asymptomatic identical twin revealed gastric cancer in the lower body of the stomach, for which distal gastrectomy with Billroth I reconstruction was performed. The histopathological types of the two cancers were similar and both had infiltrated the submucosa. The relevant etiological factors contributing to the development of gastric adenocarcinoma in these identical twins is discussed, following the case report.
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PMID:Simultaneous early gastric cancer in identical twins: report of a case. 884 12

We report a case of primary gastric carcinoma with a macroscopic appearance indistinguishable from that of a submucosal tumor. A 48-year-old man visited our hospital with a chief complaint of epigastric discomfort. Endoscopic examination revealed a protruding lesion with a well defined margin on the anterior wall of the gastric antrum. Most of the tumor surface was covered with apparently normal gastric mucosa and a shallow recess with mild erosion was observed on the top. Abdominal ultrasonography showed a hypoechoic lesion with an irregular margin under the gastric mucosa. Laboratory examination revealed an elevated CA19-9 level of 106.9 U/ml. In spite of repeated bouling biopsies, no histological diagnosis could be obtained before surgery. However, gastrectomy with regional lymph node dissection was performed because of the high likelihood of gastric cancer, in view of the markedly elevated CA19-9 level and irregular tumor margin demonstrated by abdominal ultrasonography. The tumor was diagnosed histologically as papillo-tubular adenocarcinoma invasive to the serosa with marked vessel infiltration. No metastasis was found in the regional lymph nodes. Gastric cancer resembling submucosal tumor is rare and often difficult to diagnose. Careful estimation of the possibility of gastric cancer and the informed consent of the patient are critically important, in cases of suspected primary gastric cancer resembling submucosal tumor, in order to decide the form of treatment.
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PMID:A case of advanced gastric cancer resembling submucosal tumor of the stomach. 943 7

Dyspepsia, defined as "pain or discomfort centered in the upper abdomen" is reported by one in four adults in Western societies. The most important causes are non-ulcer (functional) dyspepsia, peptic ulcer, gastroesophageal reflux, and, rarely, gastric cancer. Persons with heartburn alone are not considered to have dyspepsia. The division of dyspepsia into symptom-based subgroups (ulcer-like, dysmotility-like, reflux-like, and unspecified dyspepsia) has proven to be of doubtful value for the clinician, as it has a low predictive value for identifying the causes of dyspepsia. Upper endoscopy remains the "gold standard" test; ultrasound and blood tests have a low yield. The role of Helicobacter pylori in peptic ulcer disease is well known, but the clinical role of the infection in non-ulcer dyspepsia remains very controversial. In uninvestigated dyspeptic patients who are H. pylori infected based on a non-invasive test, empiric anti-H. pylori therapy is a reasonable and probably cost-effective option. In documented non-ulcer dyspepsia, prokinetics are superior to placebo while antisecretory therapy is of less certain efficacy.
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PMID:Dyspepsia: current understanding and management. 950 76

Dyspepsia is most optimally defined as pain or discomfort centred in the upper abdomen. The symptom complex may be caused by peptic ulcer disease, gastro-oesophageal reflux, or gastric cancer but is most often due to functional (or non-ulcer) dyspepsia. While upper endoscopy is the method of choice to determine the underlying cause of dyspepsia, it is expensive. A more pragmatic approach is needed in the Asia Pacific region where health services are limited. A detailed treatment algorithm is given for managing patients presenting with new-onset dyspepsia and documented functional dyspepsia after endoscopy, and evidence to support this approach is reviewed. Prompt endoscopy is recommended for patients with alarm features. In patients without alarm features, treatment for 2-4 weeks with an empirical anti-secretory or prokinetic agent, followed by investigation using non-invasive Helicobacter pylori testing and treatment for patients who do not respond or relapse, is recommended. Trials of management strategies are now needed to establish the efficacy and cost-effectiveness of the approaches recommended.
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PMID:Management guidelines for uninvestigated and functional dyspepsia in the Asia-Pacific region: First Asian Pacific Working Party on Functional Dyspepsia. 964 Dec 95

Dyspepsia, according to the internationally accepted Rome criteria, refers to pain or discomfort centred in the upper abdomen; patients with predominant heartburn are excluded from this group, although minor or infrequent heartburn is commonly associated with dyspepsia. It is an important condition not only because it is common and costly, but because it may indicate the presence of serious disease such as peptic ulcer or gastric cancer. However, the most frequent causes of dyspepsia are functional dyspepsia and gastro-oesophageal reflux disease. The discovery of Helicobacter pylori has resulted in important advances in the management of dyspepsia. The clinician faced with a patient who has persistent or recurrent dyspepsia needs to differentiate clearly those patients who have not been previously investigated from patients documented to have functional dyspepsia after investigation (fig 1). Here, the management of H pylori positive dyspeptic patients who have and have not been fully investigated will be reviewed.
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PMID:How should Helicobacter pylori positive dyspeptic patients be managed? 1045 33

A 56-year-old male patient with upper epigastric discomfort was introduced to our hospital from the previous clinic due to gastric cancer on July 8, 1998. Several examinations showed massive lung and liver metastases from Type-I gastric cancer beneath the esophagogastric mucosal junction. First we tried transcatheter arterial embolization (TAE) with a single agent, CDDP 20 mg/day for 4 days, but there was no change in the metastatic lesions. We then tried combination chemotherapy of CPT-11 40 mg/day a day with CDDP 15 mg/day for 4 days. After a 6-week interval, we added 4 courses at the same doses. The primary stomach lesion was reduced and was visible as a small nodular flat mass. Moreover, we found that the lung and liver metastatic lesions were already reduced. Three months have passed since CDDP-CPT-11 combination therapy, and we have not found any recurrent tumors so far.
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PMID:[A case of advanced gastric cancer with lung and liver metastasis responding remarkably to combination chemotherapy with CDDP and CPT-11]. 1066 Jul 40

We report herein an unusual case of metachronous triple cancers of the sigmoid colon, stomach, and esophagus. A 60-year-old man was initially admitted to our hospital for investigation of occult fecal blood. This was found to be caused by sigmoid colon cancer which was resected in July 1985 (T3, N0, M0; Stage II). A follow-up endoscopy performed in 1990 showed early gastric cancer, and a gastrectomy was performed in August 1990 (Tis, N0, M0; Stage 0). Another endoscopic examination performed as follow-up in 1993 revealed early cancer of the remnant stomach, and all the remnant stomach was surgically resected in March 1993 (Tis, N0, M0; Stage 0). He presented again in December 1996, complaining of discomfort in the chest which was found to be caused by cancer of the middle thoracic esophagus. Although surgery was considered necessary, the patient refused to undergo any further operations. Instead, radiation was administered from January 1997. An endoscopy after the completion of radiotherapy confirmed that the cancer had almost disappeared; however, it started to grow again from the beginning of 1998. He was hospitalized due to esophageal stenosis in April 1998, and died of carcinomatous cachexia in September of the same year.
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PMID:Metachronous triple cancers of the sigmoid colon, stomach, and esophagus: report of a case. 1079 71

An 84-year-old man presented with complaints of epigastric discomfort. Upper gastrointestinal series and endoscopy showed an elevated lesion at the posterior wall of greater curvature on the gastric fundus. Diagnosed as moderately differentiated tubular adenocarcinoma by biopsy, wedge resection and 4sa regional lymph node dissection were carried out. The tumor morphology showed type I with slight elevation, 2.5 x 1.7 cm in size; histological showed papillary, tubular, and solid formations having clear cytoplasm and large bizarre nuclei invading the deep submucosal layer (sm2). This case was evaluated as T1(sm) N0 M0 stage Ia early gastric cancer. In the 5th month after operation, multiple liver metastases were detected. He died of liver failure by rapid growth of metastatic tumors in the 6th month after operation. The serum alpha-fetoprotein level at recurrence was 1,900 ng/mL, and alpha-fetoprotein-positive cells were immunohistochemically detected in operative and liver biopsy specimens.
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PMID:A case of AFP-producing early gastric carcinoma with rapid growth liver metastasis. 1149 Aug 35


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