Gene/Protein Disease Symptom Drug Enzyme Compound
Pivot Concepts:   Target Concepts:
Query: UMLS:C0038358 (gastric ulcer)
 5,179 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

Gastric cancer is a disease in which the main treatment is surgical extirpation. The modifications introduced in the surgical treatment over the last decades were accompanied by a clear increase of survival, which reaches global values of 61% at 5 years in Japan. One of the reasons that contribute to this improvement is early diagnosis of the lesions. In the period between January 1, 1990 and December 31, 1999 662 patients with gastric adenocarcinoma were treated in the Service of Surgery 1 of our hospital; 110 were refused surgical treatment. Of the resected patients, 91 (21.4%) were classified as early gastric cancer according to the definition of the Japanese Society of Digestive Endoscopy. There were 30 women and 61 men, with a median age of 60.2 +/- 15 years; 3 patients had a preoperative diagnosis of gastric ulcer; 2 others were operated without recent histology; and 1 patient was urgently resected for a bleeding ulcer. In all the remaining patients biopsy confirmed the presence of cancer (89%) or serious dysplasia (4.6%). The lesions had been distributed essentially in the medium 1/3 (48.3%) and distal 1/3 of the stomach. Subtotal gastrectomy was accomplished in 48 patients, total gastrectomy in 40, total desgastrogastrectomy in 3, and in 9 patients the surgery involved the spleen (8 patients) and the spleen and tail of the pancreas in 1 patient. Lymphadenectomy was not performed in 5 patients, lymph nodes by the first lymph node barrier were removed in 25 patients and by the second barrier in 61 patients (67%). Median tumor size was 26 +/- 1.8 mm. The lesion reached the mucosa in 46 patients and the mucosa and submucosa in 45. In 6 patients the removed lymph nodes were microscopically invaded (6.7%). Five patients died (5.7%). The median follow-up of the patients is 41 +/- 26 months; 7 patients died (8.1%) during this period; 4 died unequivocally of disease progression. The median survival of patients was 85% at 5 years and 80% at 10 years. In our series, survival was affected by the presence of invaded lymph nodes, not by the penetration in depth of the lesion or the size of the tumor.
 ...
PMID:Early gastric cancer: ten years of experience. 1186 70

Hemigastrectomy for benign disease and Helicobacter pylori infection are risk conditions for the development of gastric cancer. Aim of the study was to compare gastric histology and precursor lesions of malignancy in these two conditions. The hemigastrectomy group included 351 consecutively endoscoped subjects operated for gastroduodenal benign disease. Six to ten biopsy specimens were routinely taken from the residual gastric mucosa. The intact stomach group included 2097 consecutively endoscoped symptomatic subjects, who did not receive eradication therapy against H. pylori. The histological findings were classified as normal mucosa (NM), chronic non atrophic gastritis (CNAG), chronic atrophic gastritis (CAG), intestinal metaplasia (IM) and dysplasia (DYS). One thousand and three intact stomachs were H. pylori negative, and 1094 showed H. pylori colonization. The age over fifty was a significant risk factor for the occurrence of IM (OR 2.52, P < or = 0.001) and DYS (OR 3.46, P < or = 0.001), while Hp-positivity was a risk factor for CNAG (OR 1.81, P < or = 0.001) and CAG (OR 3.88, P < or = 0.001). Gastroresection was associated to higher risk for CNAG (OR 1.53, P < or = 0.001) and DYS (OR 4.31, P < or = 0.001) and to a lower risk of CAG (OR 0.49, P < or = 0.001). Both in males and females the risk for CNAG was significantly higher in Hp-positive (males OR 1.92, P=0.000; females OR 1.70, P=0.000) and gastrectomized subjects (males OR 2.06, P=0.000; females OR 2.43, P=0.000). Gastrectomized males, furthermore, showed an increased risk for DYS (OR 5.82, P=0.000). The aged Hp-negative and Hp-positive subjects evidenced a significant risk for IM (respectively OR's 3.42, P=0.000 and 4.85, P=0.000); the risk for DYS was significant in aged Hp-negative subjects (OR 4.09 P < or = 0.020). The Hp-positive individuals evidenced a significant risk for metaplastic mucosal changes (OR 38.17, P=0.000). Subjects aged over forty at the time of surgery and those with a longer postoperative follow up endoscopy presented an increased risk for CNAG of the residual mucosa (respectively OR's 2.75, P=0.000 and 5.25, P=0.000). CNAG and IM were the most frequently observed mucosal lesions both in subjects operated for duodenal and gastric ulcer (respectively OR's 4.02, P=0.000 and 3.00, P=0.000). Our data support that hemigastrectomy for benign disease and H. pylori infection may induce an increased incidence for histological precursor lesions for gastric malignancy and suggest that carcinogenesis in a resected stomach may be different from that in the intact stomach.
 ...
PMID:Cancer precursor lesions in intact stomach Helicobacter pylori gastritis and in resected stomach gastritis. 1458 93

Epithelial dysplasia is considered the only one true histological marker of gastric cancer. In the present study we have evaluated the real clinical importance of epithelial dysplasia divided into low-grade (70 patients, mean age 59.2 years) and high-grade (50 patients, mean age 58 years) dysplasia. Furthermore, it has been made a comparison with the corresponding endoscopic picture and an evaluation of the real meaning of p53 positivity. The clinical outcome subdivision of epithelial dysplasia was effected according to the criteria of Rugge: association with or progression to gastric cancer, persistence or regression. The endoscopic patterns have been divided into ulcerous lesions and non-ulcerous lesions. The immunohistochemical study has been carried out with the utilization of a p53 antibody (Dako, Glostrup, Denmark). From the analysis of the data it comes out that low-grade dysplasia is associated with or progressed to gastric cancer in a low percentage of cases (about 8.5%), while high-grade dysplasia is associated with or progressed to gastric cancer in a high percentage of cases (about 74%), by this proving itself to be a real histological marker of gastric cancer. The cases of epithelial dysplasia associated with or progressed to gastric cancer are significantly associated with an endoscopic picture of gastric ulcer (ulcer-cancer). Nonetheless, the cases of epithelial dysplasia in correspondence of non-ulcerous lesions have been noticed to be associated with or progressed to advanced gastric cancer. The evaluation of p53 did not positively correlate with the clinical progression of the epithelial dysplasia and with TNM classification in case of gastric cancer. Therefore, the evaluation of p53 does not represent a useful marker in the clinical practice.
 ...
PMID:[High and low grade gastric epithelial dysplasia: clinical management, endoscopic assessment of p53]. 1497 11

This study was performed to evaluate the implication of anti-H. pylori IgG positivity when CLOtest, histological test, and culture in the antrum and body are all negative, and to find out the specific disease category that is more affected by the hostile relationship of atrophic gastritis and intestinal metaplasia (IM) with H. pylori. Four hundred thirty-six patients (84 controls, 69 with duodenal ulcer, 96 with benign gastric ulcer, 43 with dysplasia, 144 with gastric cancer), who had not received any eradication therapy, were divided into three groups according to H. pylori test: CLOtest or histological H. pylori-positive group (group A; 294 cases), only anti-H. pylori IgG-positive group (group B; 62 cases), and anti-H. pylori IgG-negative group (group C; 80 cases). The grade of neutrophil and monocyte infiltration, atrophic gastritis, and IM was compared according to the updated Sydney system classification. Neutrophil and monocyte infiltrations were significantly severe in the group A. In contrast, the grade of atrophic gastritis and IM in the antrum was significantly higher in group B than the other two groups, A or C. When patients were divided according to the disease outcome in each group, the grade of IM in the body was statistically higher only in the patients with cancer or dysplasia in group B. These results suggest that anti-H. pylori IgG positivity with all negative invasive H. pylori tests represents past infection with H. pylori rather than a false negative, especially in the case of dysplasia and gastric cancer.
 ...
PMID:Progression of atrophic gastritis and intestinal metaplasia drives Helicobacter pylori out of the gastric mucosa. 1708 Feb 49

Results of prolonged conservative treatment of patients with stomach ulcer are analyzed. Two groups of patients have been studied. Group 1 consisted of patients with long-term disease, incidence of stomach cancer in this group was 6.4%. Group 2 consisted of patients operated for stomach cancer and followed-up in cancer dispensary, 12.9% of them had the history of stomach ulcer. Based on anamnesis and results of morphological studies, cases of malignant transformation of chronic gastric ulcer have been revealed. It is demonstrated that prolonged conservative treatment of stomach ulcer in combination with high-grade dysplasia lead to potential risk of malignant transformation. The role of stomach mucosa contamination with herpes viruses was also studied. It is demonstrated that viral contamination is associated with immunodeficiency, maintains chronic inflammation in ulcer and promotes dysplasia progress.
 ...
PMID:[The role of chronic gastric ulcer in carcinogenesis]. 1715 58

The subjects of the study were 104 patients with Helicobacter pylori (HP)-associated gastric pathology, including 30 patients with gastric ulcer (GU), 30 patients with chronic atrophic gastritis (CAG), 20 patients with CAG plus adenomatous polyps (AP), and 24 patients with gastric cancer (GC). All the subjects were examined dynamically; the comparison group consisted of 12 practically healthy people. The study revealed that GU, CAG, AP, and GC were consequent stages of gastric mucosal epithelial cell regeneration disorder which manifested by the fact that the apoptotic activity of these cells was lower than their proliferation rate, and this difference grew with time; the reflection of this was the growth of Ki-67 and Bcl-2 expression. HP eradication improved the process of cell regeneration. Epithelial cell apoptosis/proliferation ratio tended to normalize, which suggests that the processes of mucosal atrophy and metaplasia, and initial signs of gastric mucosal dysplasia in patients with HP-associated pathology may be reversible.
 ...
PMID:[Specifics of apoptotic activity and expression of regulatory molecules (Ki-67, Bcl-2) of gastric mucosal epitheliocytes, in the process of Correa's cascade]. 1815 81

Endoscopic mucosal resection (EMR) is widely accepted as a standard treatment for early gastric cancer or gastric adenoma. However, EMR inevitably results in the formation of large iatrogenic ulcer at the resected area. Although the characteristics of EMR-induced ulceration are not fully understood, this type of ulcer is thought to heal faster and to recur less often than non-iatrogenic gastric ulcer. Current available evidences have suggested that EMR-induced ulcers heal within 2-3 months. Herein, we report two cases of non-healing persistent gastric ulcers after EMR. One is a case of gastric carcinoma which developed at the same site of previous EMR site for the low grade dysplasia. The other is a case in which persistent EMR-induced ulcer was healed in the long run after Helicobacter pylori eradication therapy.
 ...
PMID:[Non-healing iatrogenic gastric ulcers after endoscopic mucosal resection for gastric epithelial neoplasia: report of two cases]. 1834 75

The Helicobacter pylori duodenal ulcer promoting (dupA) gene has been previously described as a risk marker for duodenal ulcer (DU) development and a protective factor against gastric cancer (GC). Recent studies which have assessed the application of dupA in the prediction of clinical outcomes have been controversial. In the current study, the association of dupA with the clinical outcomes and histopathological changes following H. pylori infection was evaluated in Iranian patients. A total of 157 H. pylori-infected patients with DU (n=30), gastric ulcer (n=23), gastritis (n=68) or GC (n=36) were assessed. The presence of jhp0917 and jhp0918 genes was determined by gene specific PCR. Gastric histopathological changes were recorded according to the updated Sydney system. Seventy-eight (49.7 %) and 71 (45.2 %) of the 157 tested strains, respectively, were positive and negative for both genes. The remaining 8 (5.09 %) of the 157 strains were jhp0917-positive/jhp0918-negative. Univariate analysis showed inverse associations between dupA and histological features including dysplasia as the penultimate stage of GC and lymphoid follicles as a consequence of relatively long-standing H. pylori-associated gastritis. The degrees of nucleotide sequence identity of Iranian strains to Colombian, Brazilian and Indian strains ranged from 86.1 to 100 % for the aligned regions of jhp0917, from 88 to 98.8 % for jhp0918 and from 93.4 to 99.5 % for the partial sequences of the dupA gene. Despite the fact that possession of the dupA gene showed no association with any disease category in our population as reported in several other countries, association of dupA-negative strains of H. pylori with pre-malignant lesions calls for additional studies to evaluate the role of this gene as a protective marker against GC.
 ...
PMID:dupA as a risk determinant in Helicobacter pylori infection. 1843 87

Levels were assayed and compared of metabolic enzymes--thymidine and adenosine--in gastric mucosa tissues and blood serum from patients with gastric ulcer disease and gastric cancer (age--30-60 yrs). Enzymatic levels matched to the highest degree in cases of ulcer disease aggravated by chronic atrophic gastritis and precancerous alterations (dysplasia, metaplasia). Elevated concentrations of thymidine kinase and phosphorylase and adenosine desaminase were identified both at foci of ulceration (p > 0.001, p > 0.05, respectively) and in blood serum in all age brackets. Moreover, blood serum assay confirmed the view that changes in serum enzyme levels are suggestive of those in tissue enzymatic profile. Our data established a direct correlation between accumulated effect of level changes, on the one hand, and risk of neoplastic transformation of gastric mucosa in ulcer patients, on the other.
 ...
PMID:[Disturbed metabolism of gastric mucosa DNA precursors as prognosticator of neoplastic transformation of gastric ulcer]. 1852 67

Atrophic gastritis, intestinal metaplasia, autoimmune corpus atrophic gastritis, gastric remnant man 15 years after gastrectomy, hyperplastic or adenoma polyps and gastric ulcer are conditions associated with an increased risk of gastric carcinoma of intestinal or diffuse type. The role of Helicobacter pylori infection is major but the usefulness of H. pylorieradication to revert precancerous lesions is questionable. Except for patients with dysplasia, no consensus exists for endoscopic surveillance of these premalignant conditions in countries with low incidence of gastric cancer.
 ...
PMID:[Premalignant gastric lesions (except lymphomas)]. 1892 29


<< Previous 1 2 3 4 5 6 Next >>