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Query: UMLS:C0038358 (gastric ulcer)
 5,179 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

Endoscopic follow-up study of gastric ulcer to detect cancer is held to be mandatory. To evaluate the benefits of this routine strategy, 913 index endoscopies for gastric ulcer in 773 patients during the 3-year period 1985-87 were analyzed. Correctness of diagnosis was verified through surgery, autopsy, or clinical follow-up. Endoscopic follow-up was done in 83% of the cases, totaling 1269 endoscopies, showing gastric cancer in 10 patients. Clinical outcome, however, was poor for five of these (early death). Five additional cancer cases were missed by the endoscopic follow-up. In the same period 63 gastric cancers were found at the first endoscopy; 9 of these were diagnosed through biopsies only. Predictive values of the macroscopic judgements of benign lesion or probable/definite malignancy were 0.98 and 0.40, respectively. Evaluation of case records did not indicate characteristics that would have helped in the correct differentiation between benign and malignant lesions. Thus, each case of curable gastric cancer is found at the expense of approximately 250 follow-up endoscopies. We are in need of sensitive and specific markers for possible malignancy in the patient with apparently benign gastric ulcer.
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PMID:Endoscopic follow-up study of gastric ulcer to detect malignancy: is it worthwhile? 175 56

A Chilean publication in 1969 reported the 5-year survival rate of gastric cancer to be 12% of operated patients and only 3% of all patients diagnosed with gastric cancer. Encouraged by the excellent results obtained in Japan through a massive study of the population, Chile initiated in 1978 a program for massive detection of gastric cancer. From May 1978 to December 1986, 42,492 persons were screened under this system. Gastric cancer was detected in 0.43% in the massive group, and in 1.27% in the symptomatic group. The rate of early cancer detected per all gastric cancer was 14.69% in the former and 11.02% in the latter group. Gastric ulcer was found to be located more in the upper third of the stomach and less in the lower third, which may call attention in comparison with the foreign literature.
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PMID:Gastric cancer mass survey in Chile. 175 81

A new monoclonal antibody has been developed which is capable of detecting structures in gastric mucus glycoproteins expressed in the fetus and in adult gastric mucosa in conditions such as gastric carcinoma. Cancer associated monoclonal antibodies were selected by testing them against various mucous glycoprotein samples from the alimentary tract, including salivary glycoproteins from both secretory and non-secretory subjects, and cancerous and normal gastric juice glycoproteins. They were tested against 1000 samples of gastric juice from an unselected population. Immunochemical characterisation suggested that the glycoproteins picked up by P4 and i11 include one of the compounds reacting with rabbit anti-fetal sulphoglycoprotein antigen serum. On the basis of a clinical trial and immunohistological evaluation further evidence was obtained of P4 as the most promising antibody for further experimentation. A total of 302 gastric juice specimens from patients with various gastric symptoms were analysed using the enzyme linked immunosorbent assay technique and P4 antibody. Of 10 gastric cancers, nine had P4 in the gastric juice. A positive correlation was found between gastric ulcer and the appearance of P4. Duodenal ulcers were not correlated to P4. Atrophic gastritis and P4 coincided less frequently. Raised P4 values were found in between 3% and 9% of subjects, depending on the population. Cancer cases showed high P4 values, which allows adjustment of the lower limit of a positive result to high level whereby a considerable number of non-cancerous P4 positives are omitted.
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PMID:Gastric cancer associated structure in mucus glycoproteins shown as a clinically useful marker. 148 73

Tumor-associated trypsin inhibitor (TATI) was assayed in serum of patients with gastroenterological diseases. Of the patients 92 had gastric cancer, 50 colonic cancer, 38 colitis, 36 polyposis of the colon, and 40 gastric ulcer. The cut-off level established on the basis of the mean concentration +3 SD of a reference population comprising 120 subjects was 32 micrograms/l. In gastric cancer TATI had a sensitivity and specificity similar to that of CA19-9, whereas its behavior in colon cancer was less satisfactory. Like other tumor markers TATI may be elevated in patients with inflammatory diseases. In our opinion TATI is a good tumor marker for gastric cancer and it is a useful complement to CEA and CA19-9.
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PMID:Tumor-associated trypsin inhibitor, TATI, in gastrointestinal cancer and related benign diseases. 178 Jun 97

To assess the evolution of gastric epithelial dysplasia (GED), a prospective multicenter study was based on a protocol of repeated endoscopies and biopsies. To date, 134 cases (0.4% of all patients endoscopically examined in the same period) have been diagnosed as having GED and 80 of those have had an "adequate" follow-up (at least three endoscopies). Mean follow-up time was 18 months. Gastric epithelial dysplasia was mild in 59% of cases, moderate in 25%, and severe in 10%. Six percent of the patients had lesions that were "indefinite for dysplasia." Chronic atrophic gastritis (40%), gastric ulcer (32%), gastrectomy (10%), and polyps (9%) were the most frequently associated lesions. The term "regression" was adopted for GED no longer detectable during follow-up and the term "progression" was used when more severe changes or cancer was detected. Mild GED regressed in 66% of cases, persisted in 15%, and progressed in 19% (three cases to moderate, one to severe, and five to cancer). Moderate GED regressed in 30% of patients, persisted in 30%, and progressed in 40% (one to severe GED and seven to cancer). Severe GED regressed in 12.5% of patients, persisted in 12.5%, and progressed to cancer in 75%. Of the five patients with lesions indefinite for dysplasia, two had no dysplastic changes at follow-up and three had cancer diagnosed. Ten of 21 cases of cancer (48%) were at the early stage. The diagnosis was reached within the first year of follow-up in 14 cases and after 1 year in seven (13 to 39 months). Fifteen of 21 cases of cancer were diagnosed in gastric ulcer patients. In conclusion, GED is an infrequent finding and its biologically neoplastic significance is confirmed by the results of the follow-up study: (1) in its mild form, it tends to regress but adequate subsequent check-ups are mandatory as it may associate with or evolve as cancer; (2) patients with moderate GED require strict follow-up since the lesion shows a higher cancer risk; (3) surgery is indicated for severe GED because gastric cancer develops in 75% of cases; and (4) patients with lesions indefinite for dysplasia should immediately undergo repeat endoscopy and biopsy. Such an approach allows gastric cancer to be detected at an early stage in a much higher percentage of cases than may be expected.
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PMID:Gastric epithelial dysplasia: a prospective multicenter follow-up study from the Interdisciplinary Group on Gastric Epithelial Dysplasia. 184 72

Results of treatment of 571 patients with gastric cancer as well as errors committed during palliative and radical surgery were analysed. General surgeons not infrequently performed distal resection of the stomach for cancer of its proximal part whereas in cases of gastrectomy the distal part of the esophagus was not removed when indicated. On the contrary, in patients with cancer of the distal part of the stomach, surgeons aspired to save as much of the organ as possible, as would be done for the treatment of gastric ulcer. Principles of radical surgery for cancer were violated in those cases.
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PMID:[Radical surgical treatment of cancer of the stomach in surgical hospitals]. 184 46

A 29-year-old homosexual man, with acquired immune deficiency syndrome was admitted to the hospital for evaluation of severe and recurrent epigastric pain, and important weight loss of 3-5 month duration. An upper gastrointestinal GI hemorrhage required an endoscopic examination which demonstrated a larger ulcer of the gastric antrum interpreted as suspicious of malignancy. Gastric cytomegalovirus (CMV) inclusion bodies, indicating CMV infection, were detected in the biopsy tissue from the edge of the gastric ulcer.
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PMID:[Solitary gastric ulcer due to cytomegalovirus: a cause of acute digestive hemorrhage]. 185 23

Although gastric cancer incidence is decreasing in the western world, it remains an important cause of death, and there has been debate about screening persons who have undergone gastrectomy for benign ulcers. The authors analyzed risk factors for stomach cancer mortality in an Amsterdam cohort of 2,633 postgastrectomy patients, followed from their initial surgery between 1931 and 1960 until 1975, with 99.7% complete follow-up. Increased stomach cancer mortality was observed in the study population (compared with the general Dutch population) among males 25 years or more after surgery (observed/expected, 5.0; 95% confidence interval (Cl) 2.8-8.3), and among females 15-24 years postoperatively (observed/expected, 3.5; 95% Cl 1.0-9.0). A multivariate Poisson regression analysis showed that after control for age at time of surgery and calendar year of operation, the most important risk factors were time since surgery (0-4 years, relative risk (RR) = 1.0; 5-14 years, RR = 4.1, 95% Cl 0.93-18.5; 15-24 years, RR = 9.4, 95% Cl 2.1-42.3; and 25-46 years, RR = 55.6, 95% Cl 11.7-265.4) and ulcer location (gastric versus duodenal ulcer, RR = 2.6, 95% Cl 1.4-4.8). Surveillance for postgastrectomy cancer could be considered 15-25 years after a patient undergoes surgery for gastric ulcer disease.
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PMID:Multivariate analysis of the risk of stomach cancer after ulcer surgery in an Amsterdam cohort of postgastrectomy patients. 185 56

Peripheral blood monocytes from healthy subjects, patients with gastric precancer disease (chronic gastric ulcer, stomach polyps and chronic atrophic gastritis) and different stages of gastric cancer were used. Spontaneous and lipopolysaccharide (LPS)-stimulated TNF-like factors production by monocytes was significantly higher in the precancer gastric disease patients than in the healthy subjects. At the same time the spontaneous capacity of monocytes to produce NTF-like factors was 2.5 lower in the gastric cancer patients compared to the healthy subjects. Moreover, in 5/13 of the gastric cancer patients in TNF-like factors production by the LPS-stimulated and non-stimulated monocytes was 1 unit/ml less. Spontaneous and reactive CL indexes were higher in the cancer patients monocytes than in the healthy subjects. The obtained results suggest that reactive oxygen species production can be an alternative mechanism by which a cytotoxic action of monocytes is regulated.
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PMID:[Changes in the profile of cytotoxic mediator monocytes in patients with cancer and precancerous conditions of the stomach]. 185 63

Sucralfate, an aluminum hydroxide complex of sulfated sucrose used in the treatment of gastric ulcer, was shown to prevent irradiation-induced diarrhea and bowel discomfort significantly in patients treated for pelvic cancer with external radiotherapy with intent to cure. The double-blind placebo-controlled study included 70 patients with carcinoma of the prostate and urinary bladder without distant metastasis (T1-4NO1xMO) and performance status of greater than or equal to 90% Karnofsky scale. Radiotherapy was administered in a conventional manner with MeV photons and a four-field technique. The total dose was 62-66 Gy and total treatment time of 6.5 weeks. Dose granules of sucralfate or placebo were dispensed to each patient 2 weeks after radiation started and continued for 6 weeks. All analyses were performed blindly. Seven of 34 evaluable patients in the placebo group and 18 of 32 evaluable patients in the sucralfate group did not present with diarrhea during the observation period. The frequency of defecation and stool consistency were significantly improved by sucralfate. Fourteen patients in the placebo group and only three in the sucralfate group required symptomatic therapy with loperamide. There was no evidence of adverse effects associated with the use of sucralfate. Sucralfate can be of beneficial value in diminishing the bowel discomfort during radiotherapy of pelvic malignancies, and the earlier proposed mechanisms of action (e.g., protection of denuded mucosa, cytoprotective properties, binding bile acids) can also be valid for the current effects of sucralfate.
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PMID:Prevention of irradiation-induced bowel discomfort by sucralfate: a double-blind, placebo-controlled study when treating localized pelvic cancer. 188 3


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