Gene/Protein Disease Symptom Drug Enzyme Compound
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Query: UMLS:C0024623 (gastric cancer)
 36,219 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

Gastrointestinal bleeding is believed to cause iron-deficiency anemia (IDA). The information concerning ideal evaluation of the gastrointestinal tract and exact findings in patients with IDA is scant. The aim of this study was to prospectively evaluate patients with IDA for gastrointestinal lesions potentially causing IDA at a US Army Teaching Medical Center with Gastroenterology Fellowship. Seventy patients with IDA had esophagogastroduodenoscopy (EGD) and colonoscopy, and if this evaluation was unremarkable, then small bowel biopsy was obtained at EGD to evaluate for celiac disease. Enteroclysis was done if endoscopic evaluation was negative. At endoscopy, at least one lesion potentially accounted for the IDA in 50 (71%) patients. At colonoscopy, 21 (30%) patients had 22 lesions (four colon cancer, seven adenoma > 1 cm, six vascular malformation, four severely bleeding hemorrhoids, one ileal Crohn's); at EGD, 39 (56%) patients had 43 lesions (11 gastric erosion, 10 esophagitis, four vascular malformation, four celiac disease, three gastric cancer, three gastric ulcer, three duodenal ulcer, two gastric polyp > 1 cm, one duodenal lymphoma, one esophageal cancer, and one duodenal Crohn's). Twelve (17%) patients had both upper and lower gastrointestinal tract lesions. Twenty-four of 32 (75%) patients with positive fecal occult blood test had potentially bleeding lesions compared to 24 of 38 (63%) patients with negative fecal occult blood test (P > 0.05). Six of nine patients with malignancy had positive fecal occult blood test. Twenty patients with normal endoscopy and small bowel biopsy had normal enteroclysis.(ABSTRACT TRUNCATED AT 250 WORDS)
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PMID:Prospective evaluation of gastrointestinal tract in patients with iron-deficiency anemia. 778 48

We have evaluated the diagnostic value of the fecal occult blood test (FOBT) in hospitalized patients. We reviewed the medical records of patients who had a positive FOBT not associated with a large gastrointestinal bleed, and who had a subsequent complete evaluation of their gastrointestinal (GI) tract. Of the 50 subjects who met the study criteria, 21 had various GI symptoms and 13 reported weight loss. Patients taking medications that may influence the FOBT result were distributed as follows: 15 were taking nonsteroidal antiinflammatory drugs, eight were taking iron supplementation, three were using steroid drugs, and three were taking anticoagulant drugs. Nonneoplastic lesions were found in 47 patients. Neoplastic lesions were discovered in 11 patients: seven had adenomatous polyps, two had colorectal cancer, one had gastric cancer, and one had duodenal cancer. Only two of seven patients with adenomatous polyps had lesions > 1 cm. In the study population, the positive predictive value of FOBT for finding colonic neoplasms was 18% and for any GI neoplasm it was 22%. Our data indicate that in hospitalized patients (a) the yield of colonic neoplasms from FOBT is approximately 50% less than that in healthy outpatients, and (b) a positive FOBT test is unlikely to lead to the detection of GI malignancy in the absence of suggestive clinical findings.
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PMID:Fecal occult blood testing in hospitalized patients. 787 4

An increased mortality from lung and stomach cancer was found in previous studies on Lorraine iron miners. A detailed analysis, however, was not possible due to the lack of data for survivors. In this study the cohort included 1178 workers selected at random from all the 5300 working miners aged between 35 and 55 at the start of the follow up period, which ranged from 1975 to 1985. Occupational exposures and tobacco consumption, lung function tests, and respiratory symptoms were assessed for each subject in 1975, 1980, and 1985. This study confirmed the excess of lung cancer (standardised mortality ratio (SMR) = 389, p < 0.001) and of stomach cancer (SMR = 273, p < 0.05). There was no excess of lung cancer in non-smokers and moderate smokers (< 20 pack-years) or the miners who worked only at the surface or underground for less than 20 years. A significant excess (SMR = 349, p < 0.001) was found in moderate smokers when they worked underground for between 20 and 29 years. Heavy smokers (over 30 pack-years) or subjects who worked underground for more than 30 years experienced a high risk: SMR = 478 (p < 0.001) for moderate smokers who worked underground for over 30 years; 588 (p < 0.001) for heavy smokers who worked underground for between 20 and 29 years; and 877 (p < 0.001) for heavy smokers who worked underground for over 30 years. This showed an interaction between smoking and occupational exposure. The excess mortality from lung cancer was because there were some subjects who died young (from 45 years old). Comparison with the results of a previous study showed that additional hazards produced by diesel engines and explosives increased the mortality from lung cancer. The SMR was higher than 400 (p < 0.001) from 45 years old instead of from 56 years. A relation was found between a decrease in vital capacity (VC), forced expiratory volume in one second (FEV1) and of FEV1/VC and mortality from all causes and from lung cancer in heavy smokers or men who had worked underground for more than 20 years. Respiratory symptoms were related to mortality from lung cancer among smokers (moderate and heavy) who worked underground for more than 20 years. It is considered that the risk of lung cancer in the Lorraine iron miners was mainly due to dust, diesel engines, and explosives although the role of low exposure to radon daughters could not be totally excluded.
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PMID:Mortality of iron miners in Lorraine (France): relations between lung function and respiratory symptoms and subsequent mortality. 828 Jun 27

A high level of available tissue iron may increase the risk of cancer through its contribution to the production of free oxygen radicals. Serum iron, total iron-binding capacity (TIBC) and transferrin saturation levels were studied for their prediction of different cancers in a cohort of 41,276 men and women aged 20-74 years and initially free from cancer. During a mean follow-up of 14 years, 2,469 primary cancer cases were diagnosed. Excess risks of colorectal and lung cancers were found in subjects with transferrin saturation level exceeding 60%. The relative risks, adjusted for age, sex and smoking, were 3.04 for colorectal cancer and 1.51 for lung cancer, in comparison with subjects having lower levels. The risk of lung cancer was inversely related to serum TIBC, with a relative risk between the highest and lowest quartiles of 0.69 for men and 0.19 for women. For the risk of stomach cancer, we detected inverse relationships with serum iron and with transferrin saturation and a positive relationship with TIBC, but these associations weakened when the cancer cases occurring during the 5 first years of follow-up were excluded. High iron stores may increase the risk of colorectal cancer, whereas low iron stores may be an early sign of occult stomach cancer.
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PMID:Body iron stores and risk of cancer. 831 26

In order to ascertain whether genetic alterations occur during the early stages of gastric carcinogenesis, abnormal accumulation of p53 protein and mutation of its gene in stomach tissue showing intestinal metaplasia were investigated using immunohistochemistry and polymerase chain reaction-single strand conformation polymorphism (PCR-SSCP) analysis. Immunohistochemistry detected 19 foci showing nuclear accumulation of p53 protein in non-neoplastic gastric mucosa in a total of 756 sections (477 of which contained intestinal metaplasia) from 16 resected stomachs containing gastric adenocarcinomas. Of these 19 p53-positive foci, 17 were diagnosed histologically as incomplete-type intestinal metaplasia and 2 as pseudopyloric glands in the regenerative mucosa. Furthermore, 14 such foci were detected in 6 patients with multiple gastric cancers. No correlation between high-iron diamine (HID)-positive sulfomucin production and p53-positive glands was observed. The DNAs were extracted selectively from these p53-positive metaplastic glands and examined for p53 mutations by PCR-SSCP analysis followed by direct sequencing. In only 10 lesions could exons; 5 to 8 be investigated completely, and of these, 4 were shown to possess p53 mutations, which were on exon 5 in 3 cases and on exon 7 in 1 case. These results indicate that irreversible genetic changes had already occurred in morphologically non-neoplastic gastric mucosa with intestinal metaplasia, and are consistent with the hypothesis that intestinal metaplasia, especially the incomplete type, may contain precursor lesions of gastric cancer.
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PMID:p53 mutations in the non-neoplastic mucosa of the human stomach showing intestinal metaplasia. 860 55

A standardized proportional mortality ratio (SPMR) study of 8,887 deaths during 1980-1989 among male workers in a large integrated iron-steel complex in Anshan, China, was conducted to provide clues to occupational risk factors. Accidents and cancer accounted for a higher proportion of deaths among the iron-steel workers than among the general male population (SPMR = 1.21; 95% CI = 1.12-1.31 and 1.14; 95% CI = 1.10-1.18, respectively). Among all workers, SPMRs were significantly elevated for stomach, lung, and colorectal cancers (SPMR = 1.37, 1.37, 1.38, respectively), but not other cancers. Risks of stomach cancer appeared to be highest among workers employed in jobs with exposure to iron and coal dust, whereas significant increases in colorectal cancer were seen for loading and other dusty jobs and for administrative and sedentary jobs without dust exposure. Risks of lung cancer appeared increased for a variety of jobs throughout the complex, especially those with probable high levels of exposure to polycyclic hydrocarbons and asbestos. Risk of esophageal cancer was significantly elevated for fire-resistant brick makers, and risk of nonmalignant respiratory disease was significantly elevated for those employed as furnace workers, foundry workers, and fire-resistant brick makers.
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PMID:Cancer risks among iron and steel workers in Anshan, China, Part I: Proportional mortality ratio analysis. 883 75

Nested case-control interview studies of lung cancer (610 incident cases), stomach cancer (292 incident cases), and 959 controls were conducted to follow up leads from a proportional mortality analysis of deaths among male workers in a large integrated iron-steel complex in Anshan, China. For lung cancer, after adjusting for the significant non-occupational risk factors (smoking, other pulmonary disease, family history of lung cancer, and low consumption of fruit or tea), risks were significantly elevated for those employed for 15 or more years in smelting and rolling (OR = 1.5, CI = 1.1-2.2), in the fire-resistant brick factory (OR = 2.9, CI = 1.4-5.9), in general loading (OR = 2.5, CI = 1.0-6.1), and as coke oven workers (OR = 3.4; CI = 1.4-8.5). For stomach cancer, after adjusting for consumption of pickled vegetables, prior gastric diseases, family history of stomach cancer, low intake of fruits and vegetables, and education, risks were significantly elevated for those employed for 15 or more years in ore sintering and transportation (OR = 2.1, CI = 1.0-4.4), in the fire-resistant brick factory (OR = 2.5, CI = 1.1-5.8), in general loading (OR = 3.2, CI = 1.2-8.9), as boilerworkers and cooks (OR = 2.6, CI = 1.2-5.6), and as coke oven workers (OR = 5.4, CI = 1.8-16.0). For both lung and stomach cancers, significant dose-response gradients were observed for exposure to total dust and benzo(a)pyrene, but not for specific chemical components of dust. Overall, long-term steel workers with exposure to workplace pollutants had a 40% increased risk of both lung and stomach cancers. These case-control studies confirm many of the occupational findings reported in the proportionate mortality analysis, and suggest avenues for further work to evaluate the carcinogenicity of individual components of dust.
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PMID:Cancer risks among iron and steel workers in Anshan, China, Part II: Case-control studies of lung and stomach cancer. 883 76

Complications, prognosis, and efficacy of treatments were retrospectively studied in elderly patients, some of whom had lung, stomach, colon, pancreatic, and liver cancers. Hemoglobin concentration and characteristics of erythrocytes were measured for up to sixty months. Eighty-eight patients died of cancer, and malignant tumors were detected before death in 57. The average survival periods were 11 months for patients with gastric cancer. 9 months for those with colon cancer, and 7 months for those with lung cancer. Malignancies of the digestive organs and lung were often detected in elderly patients with anemia. In elderly people who were without cancer for more than 78 months the hemoglobin concentration did not change significantly, but in those with a malignancy the hemoglobin concentration continuously decreased. Patients with colon cancer who were given blood transfusions survived longer than those who were not given the transfusions, but the same was not true of patients with gastric or lung cancers. Iron therapy, however, was generally effective in patients with malignant tumors of the gastrointestinal tract. Among those who were near death, the red cell distribution widths differed significantly between patients with different types of carcinomas, but differences in mean corpuscular hemoglobin and in mean corpuscular volume were not statistically significant. In conclusion, hemoglobin concentration and characteristics of erythrocytes should not be neglected in the diagnosis and treatment of cancers in the elderly.
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PMID:[Anemia in elderly patients with malignant tumors]. 895 40

Partial gastrectomy is a risk factor for subsequent gastric cancer. The genetic alterations associated with malignant transformation, however, are poorly understood. Ninety-eight biopsies from 22 patients with benign gastric mucosa (BGM) at least 15 years after gastrectomy and resected specimens from 13 patients with postgastrectomy stump cancer (GC), were evaluated for immunohistochemical expression of bcl-2 oncogenic protein and correlated with the presence of dysplasia and subtypes of intestinal metaplasia (IM), categorized using high-iron diamine-alcian blue and alcian blue-periodic acid-Schiff stains. In BGM patients, 91% had chronic gastritis with atrophy, 18% showed complete (Type I) IM, 36% showed incomplete (Type II) IM, and 45% Type III IM. Twelve biopsy specimens from nine BGM patients showed mild-to-moderate dysplasia. Increased bcl-2 expression was present in 27% of BGM patients, with a significant association with increasing grade of IM: 20% in specimens with Type I IM, 30% with Type II, and 40% with Type III (P = .01). bcl-2 overexpression was more often present in the area of the anastomosis than in the body or fundus (P = .06). Of GC patients, 15% had Type II IM and 85% Type III IM. Moderate-to-severe dysplasia was present in adjacent benign mucosa in 46%. bcl-2 was present in 54% of GCs, and increased expression was detected in the adjacent benign mucosa in 60%. bcl-2 expression did not correlate with the presence or degree of dysplasia in either BGM or GC patients. bcl-2 protein is frequently expressed in GC. Increased expression is observed in mucosa adjacent to tumor and, to a lesser extent, in biopsy specimens of BGM, often associated with Type III IM. These findings suggest a possible role for the bcl-2 proto-oncogene in malignant progression.
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PMID:bcl-2 protein expression in gastric remnant mucosa and gastric cancer 15 or more years after partial gastrectomy. 934 82

Two patients with hypochromic microcystic anemia received intravenous iron therapy (Blutal, Yuham Co., An Yang, Korea). These patients demonstrated diffuse hepatic uptake of Tc-99m MDP on bone scintigraphy, which was performed for evaluation of lower back pain in one patient and to rule out skeletal metastases from gastric cancer in the other patient. Blutal is an iron colloid chondroitin sulfate complex and is used to treat iron deficiency anemia in Korea. Phagocytized iron colloid within the hepatic reticuloendothelial system is responsible for the hepatic uptake of Tc-99m phosphate in the two presented cases.
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PMID:Hepatic uptake of Tc-99m MDP on bone scintigraphy from intravenous iron therapy (Blutal). 936 85


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