National Cancer Institute®
Last Modified: May 1, 2002
UI - 11865338
AU - Flucke U; Monig SP; Baldus SE; Zirbes TK; Bollschweiler E; Thiele J;
TI - Dienes HP; Holscher AH Differences between biopsy- or specimen-related Lauren and World Health Organization classification in gastric cancer.
SO - World J Surg 2002 Feb;26(2):137-40
AD - Department of Visceral and VascularSurgery, University of Cologne, Joseph-Stelzmann Str. 9, 50931 Cologne, Germany.
The extent of stomach resection in gastric cancer depends on tumor size, tumor location, depth of invasion, and the histological allocation to intestinal or diffuse type according to Lauren. As the latter is based on preoperative findings we performed a retrospective histomorphological study to quantify the differences between biopsy-related and surgical specimen-related Lauren classification. Additionally the World Health Organization (WHO) classification of preoperative endoscopic biopsies and surgical specimens were compared. Preoperative biopsies and resected tumor specimens from 100 patients with primary gastric carcinoma were retrospectively classified according toLauren and WHO. The reclassification was independently performed by three pathologists who were not aware of the previous diagnoses. In 74% the Lauren classification of pre- and postoperative specimens was identical, whereas 26% of the cases showed a disagreement. Out of 48 tumors with preoperative diagnosis of an intestinal type, 10 tumors (20.8%) exhibited a diffuse growth pattern in the gastrectomy specimens; and 16% of the cases showed a disagreement of the pre- and postoperative histopathological type according to the WHO classification. Preoperative biopsy-related and surgical specimen-related Lauren classification differ in about one-quarter of the cases. Mostly, the preoperative diagnosis of an intestinal tumor type must be corrected into a diffuse or mixed type according to Lauren. Since this may have consequences for the surgical strategy, the extent of surgical resection, rebiopsies, and reconfirmation of an intestinal type should be performed at least in those cases with any doubts of this classification.
UI - 11910474
AU - Samson PS; Escovidal LA; Yrastorza SG; Veneracion RG; Nerves MY
TI - Re-study of gastric cancer: analysis of outcome.
SO - World J Surg 2002 Apr;26(4):428-33
AD - Department of Surgery, East Avenue Medical Center, East Avenue, Diliman 1100, Quezon City, Philippines. firstname.lastname@example.org
Cancer of the stomach (CaS) is a dreaded disease. Fortunately, there is a decreasing incidence, except in the East. The authors did a re-study of CaS, a widely investigated but unresolved gastrointestinal malignancy. The clinicopathologic features were evaluated to identify and measure the prognostic factors that would help the surgeon decide optimal therapy. Among 383 admitted for CaS at the East Avenue Medical 149 underwent radical resection with curative intent. (As historical control, the experience in 136 cases was reviewed during the immediately preceding 5-year period [1982-1986] when extended lymphadenectomy was not the standard policy.) For staging, the TNM system (tumor-node-metastasis) was used; to describe anatomy and surgery of stomach lymphatics, the "Japanese Rules," as modified, were adapted. Curative radical gastrectomy would include removal of the diseased stomach and regional lymphatics as defined by frozen section, including subtotal (or total) gastrectomy and "extended" D2 (with no. 12) node dissection. The clinicopathologic factors were statistically analyzed, using the accepted methods: Kaplan-Meier for survival, univariate analysis, and multivariate analysis for independent predictors. Of the 12 risk factors assessed by univariate analysis, the following were identified by multivariate analysis as independent prognosticators of survival: (1) wall penetration; (2) node invasion; (3) TNM stage; (4) resection margin; and (5) tumor size. After curative resection, the operative mortality was 5.3% and the complications, 19.4%. The 5-year survival was 60.4%, and recurrence, 15.4%. The results have shown that the pathology-related factors, (1) wall penetration; (2) node invasion; and (3) resection margin, are independent prognosticators of survival, remarkably affecting outcome. In conclusion, the study supports radical gastrectomy with extended D2 lymphadenectomy for CaS as safe and effective. Survival and recurrence are a function of pathology and adequate resection; operative mortality is defined by the patient's condition.
UI - 11910475
AU - Matsumoto K; Murayama T; Nagasaki K; Osumi K; Tanaka K; Nakamaru M;
TI - Kitajima M One-stage surgical management of concomitant abdominal aortic aneurysm and gastric or colorectal cancer.
SO - World J Surg 2002 Apr;26(4):434-7
AD - Department of Surgery, Keio University School of Medicine, 35 Shinanomachi, Shinjuku-ku, Tokyo 160-8582, Japan. email@example.com
One-stage surgical management of concomitant abdominal aortic aneurysm (AAA) and gastric or colorectal cancer should provide certain benefits. We reviewed the records of 21 patients with both AAA and gastric or colorectal cancer who underwent one-stage surgical management. Four had distal gastrectomy, 2 had total gastrectomy, and 5 had abdominoperineal rectal resection transperitoneally; 3 had total gastrectomy transperitoneally and AAA repair extraperitoneally. Two underwent right hemicolectomy and thromboexclusion of the AAA. Two had creation of a temporary ileostomy and implantation of an interposition graft. Two underwent left hemicolectomy, creation of a temporary transversostomy, and implantation of an interposition graft. One had a Hartmann's procedure and implantation of a bifurcated prosthetic interposition graft for AAA. There were no operative deaths or serious postoperative complications. One patient had colorectal ischemia that resolved with conservative treatment. Eighteen of the 21 patients (85.7%) were alive 10 months to 14 years postoperatively. In conclusion, one-stage surgical treatment of concomitant AAA and gastric or colorectal cancer is well tolerated and can avoid the time, financial costs, and patient anxiety involved in a second operation.
UI - 11819733
AU - Xin Y; Li XL; Wang YP; Zhang SM; Zheng HC; Wu DY; Zhang YC
TI - Relationship between phenotypes of cell-function differentiation and pathobiological behavior of gastric carcinomas.
SO - World J Gastroenterol 2001 Feb;7(1):53-9
AD - The Fourth Laboratory of Cancer Institute, China Medical University, Shenyang 110001, Liaoning Province, China.
AIM: To reveal the correlation between the functional differentiation phenotypes of gastric carcinoma cells and the invasion and metastasis by a new way of cell-function classification.METHODS:Surgically resected specimens of 361 gastric carcinomas(GC) were investigated with enzyme-, mucin-, and tumor-related marker immunohistochemistry. According to the direction of cell-function differentiation, stomach carcinomas were divided into five functionally differentiated types. RESULTS: (1) Absorptive function differentiation type (AFDT): there were 82 (22.7%) patients including 76 (92.7%) aged 45 years. Sixty-nine (84.1%) cases belonged to the intestinal type. Thirty-eight (46.3%) expressed CD44v6 and 9 (13.6%) of 66 male patients developed liver metastasis.The 5-year survival rate of patients in this group (58.5%) was higher than those with the other types (P<0.01). (2) Mucin secreting function differentiation type (MSFDT): 54 (15%) cases. Fifty-three (98.1%) tumors had penetrated the serosa, 12 (22.2%) expressed ER and 22 (40.7%) expressed CD44v6. The postoperative 5-year survival rate was 28.6%. (3) Absorptive and mucin-producing function differentiation type (AMPFDT): there were 180 (49.9%) cases, including 31 (17.2%) aged younger than 45 years. The tumor was more common in women (62, 34.4%,) and expressed more frequently estrogen receptors (ER) (129, 81.7%) than other types (P<0.01). Ovary metastasis was found in 12 (19.4%) out of 62 female subjects. The patients with this type GC had the lowest 5-year survival rate (24.7%) among all types. (4) Specific function differentiation type (SFDT): 13 (3.6%) cases. Nine (69.2%) tumors of this type derived from APUD system, the other 4 (30.7%) were of different histological differentiation. Sixty per cent of the patients survived at least five years. (5) Non-function differentiation type (NFDT): 32 (8.9%) cases. Nineteen (59.4%) cases had lymph node metastases but no one with liver or ovary metastasis. The 5-year survival rate was 28.1%. CONCLUSION: This new cell-function classification of GC is helpful in indicating the characteristics of invasion and metastasis of GC with different cell-function differentiation phenotypes. Further study is needed to disclose the correlation between the cell-functional differentiation phenotypes and the relevant genotypes and the biological behavior of gastric carcinoma.
UI - 11935297
AU - Kang YH; Bae SI; Kim WH
TI - Comprehensive analysis of promoter methylation and altered expression of hMLH1 in gastric cancer cell lines with microsatellite instability.
SO - J Cancer Res Clin Oncol 2002 Mar;128(3):119-24
AD - Department of Pathology, Seoul National University College of Medicine, Seoul, South Korea.
PURPOSE: Aberrant methylation of the promoter CpG island of hMLH1 is associated with gene silencing in colon cancer and gastric cancer with microsatellite instabilities (MSI). We analyzed the pattern of promoter methylation causing gene silencing. METHODS: Comprehensive analysis of hMLH1 promoter was performed by bisulfite genomic sequencing in human gastric cancer cell lines. Altered expression of hMLH1 was examined by the immunocytochemical staining method and RT-PCR, and microsatellite instability was examined using two representative mononucleotide repeat microsatellite markers, BAT-25 and BAT-26. RESULTS: As a result, MSI-positive gastric cancer cell lines were methylated extensively at the overall promoter region. MSI-negative gastric cancer cell lines - except in SNU-620 - were unmethylated completely at the overall promoter region including the more upstream region in contrast to colorectal cancer cell lines. Even though SNU-620 was methylated fully at the overall promoter region - except for partial methylation at the specific region (from -270 to -199) near the transcriptional start - hMLH1 protein was expressed. CONCLUSION: Our data suggest that the methylation density of a specific region plays an important role in gene inactivation of hMLH1 and that the methylation status of the more upstream promoter region and exon 1 start region are not essential for gene inactivation.
UI - 10746728
AU - El-Omar EM; Carrington M; Chow WH; McColl KE; Bream JH; Young HA;
TI - Herrera J; Lissowska J; Yuan CC; Rothman N; Lanyon G; Martin M; Fraumeni JF Jr; Rabkin CS Interleukin-1 polymorphisms associated with increased risk of gastric cancer.
SO - Nature 2000 Mar 23;404(6776):398-402
AD - Division of Cancer Epidemiology and Genetics, National Cancer Institute, Bethesda, Maryland, USA. firstname.lastname@example.org
Helicobacter pylori infection is associated with a variety of clinical outcomes including gastric cancer and duodenal ulcer disease. The reasons for this variation are not clear, but the gastric physiological response is influenced by the severity and anatomical distribution of gastritis induced by H. pylori. Thus, individuals with gastritis predominantly localized to the antrum retain normal (or even high) acid secretion, whereas individuals with extensive corpus gastritis develop hypochlorhydria and gastric atrophy, which are presumptive precursors of gastric cancer. Here we report that interleukin-1 gene cluster polymorphisms suspected of enhancing production of interleukin-1-beta are associated with an increased risk of both hypochlorhydria induced by H. pylori and gastric cancer. Two of these polymorphism are in near-complete linkage disequilibrium and one is a TATA-box polymorphism that markedly affects DNA-protein interactions in vitro. The association with disease may be explained by the biological properties of interleukin-1-beta, which is an important pro-inflammatory cytokine and a powerful inhibitor of gastric acid secretion. Host genetic factors that affect interleukin-1-beta may determine why some individuals infected with H. pylori develop gastric cancer while others do not.
UI - 11916345
AU - Segal I; Ally R; Mitchell H
TI - Gastric cancer in sub-Saharan Africa.
SO - Eur J Cancer Prev 2001 Dec;10(6):479-82
AD - African Institute of Digestive Diseases, Chris Hani Baragwanath Hospital, Johannesburg, South Africa.
Gastric cancer has a variable but generally low prevalence in black populations of sub-Saharan Africa, despite a high prevalence of Helicobacter pylori (the 'African enigma'). Evidence from Soweto indicates that the host response to H. pylori may be protective against a virulent organism and that, in most people, H. pylori does not lead to more serious sequelae. This suggests that there may be host protective/inhibitory factors present, which prevent the progression of H. pylori-induced chronic active gastritis to cancer.
UI - 11916346
AU - Conio M; Filiberti R; Blanchi S; Giacosa A
TI - Carditis, intestinal metaplasia and adenocarcinoma of oesophagogastric junction.
SO - Eur J Cancer Prev 2001 Dec;10(6):483-7
AD - Department of Gastroenterology and Clinical Nutrition, National Cancer Research Institute, Genova, Italy.
Barrett's oesophagus is a precancerous condition in which the normal squamous epithelium is replaced by intestinal metaplasia (IM). IM can then progress through increasingly severe dysplasia to oesophageal adenocarcinoma (EAC). In the gastric cardia the normal gastric mucosa, when inflamed (carditis), can be replaced by IM and can then progress to gastric adenocarcinoma (GAC). The same histopathological sequence can take place on either side of the oesophagogastric junction. Since the location of that junction can be uncertain this can result in confused diagnosis between EAC and GAC. In this review, the diagnostic criteria, incidence and risk factors for Barrett's oesophagus and carditis are discussed, together with the factors determining the risk of progression to adenocarcinoma of the oesophagus or cardia. The risk factors include familial/genetic, environmental and dietary characteristics. Finally, these risk factors are discussed within the context of cancer prevention.
UI - 11825668
AU - Li Z; Wang Y; Song J; Kataoka H; Yoshii S; Gao C; Wang Y; Zhou J; Ota S;
TI - Tanaka M; Sugimura H Genomic structure of the human beta-PIX gene and its alteration in gastric cancer.
SO - Cancer Lett 2002 Mar 28;177(2):203-8
AD - First Department of Pathology, Hamamatsu University School of Medicine, 1-20-1, Handayama, Hamamatsu 431-3192, Japan.
beta-PIX, a newly identified p21-activated kinase (PAK)-interacting exchange factors (PIX), encodes a guanine nucleotide exchange factor for Rho guanosine triphosphatases. Characterization of beta-PIX gene was performed using the BAC Library method. The beta-PIX gene has 17 exons and an A/T polymorphism at the 32nd base upstream of the intron/exon junction of exon 7. The frequencies of genotypes A/T, A/A and T/T were 23.6% (13/55), 72.7% (40/55) and 3.6% (2/55), respectively; these frequencies are in Hardy-Weinberg equilibrium. Two out of 14 informative tumors (14.3%) were shown to have lost their heterozygosity at this locus, but no mutations in the remaining alleles were detected. In addition, we examined the gene-expression profile in another set of 30 gastric samples, but no significant over-expression of either the beta-PIX gene or the alpha-PIX gene was found. Though the beta-PIX gene has been speculated to potentially have tumor-related biological characteristics, the findings of the present study suggest that the involvement of beta-PIX gene in human gastric carcinogenesis is minimal.
UI - 11895856
AU - Shibata A; Parsonnet J; Longacre TA; Garcia MI; Puligandla B; Davis RE;
TI - Vogelman JH; Orentreich N; Habel LA CagA status of Helicobacter pylori infection and p53 gene mutations in gastric adenocarcinoma.
SO - Carcinogenesis 2002 Mar;23(3):419-24
AD - Department of Health Research and Policy, Stanford University School of Medicine, Stanford, CA 94305, USA. email@example.com
Infection with Helicobacter pylori (H. pylori) increases stomach cancer risk. Helicobacter pylori strains with the cag pathogenicity island (PAI) induce more severe inflammation in the gastric epithelium and are more strongly associated with stomach cancer risk than strains lacking the PAI. We examined whether the prevalence of somatic p53 mutation in gastric adenocarcinoma differed between subjects with and without infection with CagA(+) (a marker for the PAI) H. pylori strains. DNA from 105 microdissected tumor specimens was analyzed for mutation in exons 5-8 of the p53 gene by polymerase chain reaction-based single-strand conformation polymorphism followed by direct DNA sequencing. Enzyme-linked immunosorbent assays for IgG antibodies against H. pylori and CagA were performed on sera collected 2-31 years prior to cancer diagnosis. Tumors from CagA(+) subjects were significantly more likely to have p53 mutations than tumors from CagA(-) subjects (including H. pylori- and H. pylori(+)/CagA(-)): odds ratio = 3.72; 95% confidence interval, 1.06-13.07 after adjustment for histologic type and anatomic subsite of tumor and age at diagnosis and sex of subjects. Mutations were predominantly insertions and deletions (43%) as well as transition mutations at CpG dinucleotides (33%). The data suggest that CagA(+) H. pylori infection, when compared with CagA(-) infection or the absence of H. pylori infection, is associated with a higher prevalence of p53 mutation in gastric adenocarcinoma.
UI - 10878546
AU - Endoh Y; Sakata K; Tamura G; Ohmura K; Ajioka Y; Watanabe H; Motoyama T
TI - Cellular phenotypes of differentiated-type adenocarcinomas and precancerous lesions of the stomach are dependent on the genetic pathways.
SO - J Pathol 2000 Jul;191(3):257-63
AD - Department of Pathology, Yamagata University School of Medicine, Japan. firstname.lastname@example.org
To elucidate the relationship between genetic alterations and cellular phenotypes in differentiated-type carcinomas and precancerous lesions of the stomach, mutations of p53, APC and K-ras genes were examined, as well as microsatellite instability (MSI), in 52 tumours of the stomach. Tumours were selected with the following phenotypical features, using mucin histochemical and immunohistochemical analyses, in addition to their morphological features: (1) tumours with an extremely well-preserved gastric foveolar phenotype (foveolar-type); (2) tumours with an extremely well-preserved complete-type intestinal metaplastic phenotype (CIM-type); and (3) ordinary tumours without extreme phenotypes (ordinary-type). MSI occurred in 45% of foveolar-type, 24% of ordinary-type, and 0% of CIM-type tumours. p53 gene alterations occurred in 5% of foveolar-type, 18% of ordinary-type, and 31% of CIM-type. APC gene alterations were detected in 9% of foveolar-type, 6% of ordinary-type, and 0% of CIM-type. No K-ras gene mutation was detected in any of the three types. These results indicate that the genetic pathways are quite different among the phenotypes of tumours of the stomach. The 'mutator pathway', characterized by MSI, plays an important role in the tumourigenesis of foveolar-type, but not CIM-type tumours. The 'suppressor pathway', represented by p53 alteration, could participate in the tumourigenesis of the CIM-type, but is rare in foveolar-type tumours. Copyright 2000 John Wiley & Sons, Ltd.
UI - 11745702
AU - Nabais S; Carneiro F; Nogueira AM; Machado JC; Seruca R; Sobrinho-Simoes
TI - M Re. 'Cellular phenotypes of differentiated-type adenocarcinomas and precancerous lesions of the stomach are dependent on the genetic pathways'.
SO - J Pathol 2001 Dec;195(5):636-7
UI - 11859708
AU - Zheng S; Ke Y
TI - [Localization and analysis of 1A6 gene by dual-color fluorescence in situ hybridization on gastric carcinoma tissue and tumor cell lines]
SO - Zhonghua Zhong Liu Za Zhi 2001 Nov;23(6):454-7
AD - Genetic Laboratory, Beijing Institute for Cancer Research, Beijing University Institute of Oncology, Beijing 100034, China.
OBJECTIVE: To locate 1A6 gene on the chromosome and study its copy number by dual-color fluorescence in situ hybridization (FISH) on three tumor cell lines and 22 gastric tumors patients. METHODS: The single-color FISH of small size biotin-labeled cDNA cloned in plasmid was used to locate the 1A6 gene on one of the chromosomes in C group. Genomic DNA of 1A6 gene was screened by polymerase chain reaction (PCR) in PAC library according to the sequence. The florenscence of green and orange was incorporated into the target gene-1A6 cloned in PAC and chromosome-12-specific alpha-satellite repeat DNA by nick translation, followed by dual-color FISH. 1A6 gene was located in the metaphase chromosome of the normal peripheral lymphocytes. 1A6 gene and chromosome 12 copy numbers were analyzed on touch slide of gastric cancer tissue and cell lines. RESULTS: 1A6 gene was located in 12q23.2-23.3. The chromosome 12/1A6 signal ratio was 0.96-1.01 in breast, ovarian and gastric cancer cell lines. The ratio was 0.93-1.11 in gastric cancer tissue touch slides. The number of chromosome 12 is disomic (87.7%), triploid (7.4%) in BMI cell line; multisomic(100%), including pentasomic (67.6%) in SKOV3; the multisomic (83.1%), including trisomic (71%) in SGC823. There are highly disomic rate in 86. 4% (19/22) of patients. CONCLUSION: 1A6 gene is in 12q23.2-23.3. Neither 1A6 amplification nor deletion in gastric cancer tissue and three cell lines was found. Further study is needed for the understanding of chromosome 12 copy number variation in different cancer cell lines.
UI - 11859302
AU - Belloni M; De Fiori E; Mazzarol G; Curti A; Crosta C
TI - Endoscopic ultrasound and Computed Tomography in gastric stromal tumours.
SO - Radiol Med (Torino) 2002 Jan-Feb;103(1-2):65-73
AD - Istituto di Scienze Radiologiche, Divisione di Radiodiagnostica, Universita degli Studi, Milan, Italy. email@example.com
PURPOSE: Gastric stromal tumors (GIST) have no well defined biological characteristics, from either the pathological or immunohistochemical point of view, which can make their definition by imaging techniques difficult. We evaluated CT and EUS morphologic characteristics and signs of malignancy of eleven cases of GIST and compared the findings to the pathological classification. MATERIAL AND METHODS: EUS was performed with a 100 degrees, 5-7.5 MHz convex probe on a Pentax endoscope and CT using the byphasic spiral technique. RESULTS: The 11 GIST cases were ranked according to the criteria of malignancy defined by each of the two imaging techniques. There was a close correlation between the imaging-based and pathological classifications. CONCLUSIONS: Size and homogeneous pattern prove to be the most reliable criteria to differentiate between benign and malignant lesions. EUS is more accurate than CT in diagnosing the nature of GIST, but CT allows a more complete and comprehensive evaluation. The data provided by the imaging techniques are fundamental to plan the therapeutic approach.
UI - 11920609
AU - Murayama Y; Miyagawa J; Shinomura Y; Kanayama S; Isozaki K; Yamamori K;
TI - Mizuno H; Ishiguro S; Kiyohara T; Miyazaki Y; Taniguchi N; Higashiyama S; Matsuzawa Y Significance of the association between heparin-binding epidermal growth factor-like growth factor and CD9 in human gastric cancer.
SO - Int J Cancer 2002 Apr 1;98(4):505-13
AD - Department of Internal Medicine and Molecular Science, Graduate School of Medicine, Osaka University, Yamadaoka, Suita, Osaka, Japan. firstname.lastname@example.org
Heparin-binding epidermal growth factor-like growth factor (HB-EGF) is a member of the EGF family. Juxtacrine activity of proHB-EGF (the membrane-anchored form of HB-EGF) has been shown to be significantly potentiated when it is coexpressed with CD9 in vitro. The purpose of our study was to investigate the issue of whether proHB-EGF and CD9 are coexpressed in gastric cancer. HB-EGF gene expression and protein production in human gastric cancers was investigated, and EGF receptor and CD9 expressions were also evaluated. HB-EGF mRNA levels in gastric cancers were elevated, compared with normal gastric tissues, especially in the intestinal type. ProHB-EGF immunoreactivity was detected primarily in the cytoplasm and plasma membrane of gastric cancer cells. Of 66 patients, 40 (60.6%) exhibited proHB-EGF immunoreactivity and the level of its expression was significantly associated with tumor status (p < 0.01) and histological differentiation (p < 0.001). In addition, proHB-EGF mRNA was detected at high levels in the intestinal type by in situ hybridization. CD9 immunoreactivity was found to be preserved in 26 of 36 patients (72.2%) and CD9 protein expression was inversely associated with lymph node status (p < 0.05). A significant correlation between its expression and histological differentiation (p < 0.01) was found, and the association of CD9 with proHB-EGF was increased in the intestinal type, as evidenced by an immunoprecipitation method. These results indicate that the coexpression of proHB-EGF and CD9 may be involved in the tumorigenesis and/or proliferation of gastric cancers in a juxtacrine manner. Copyright 2002 Wiley-Liss, Inc.
UI - 11938366
AU - Schumacher IK; Hunsicker A; Youssef PS; Lorenz D
TI - Current concepts in gastric cancer surgery.
SO - Saudi Med J 2002 Jan;23(1):62-8
AD - Department of General and Gastroenterologic Surgery, Trauma Center, Warener Str. 7, D-12683, Berlin, Germany.
OBJECTIVE: Current problems in gastric cancer surgery concern the extent of gastric resection, the need for abdominal evisceration, the degree of lymphadenectomy, and an optimal preoperative tumor staging procedure. METHODS: A retrospective clinical trial of 284 patients who underwent surgery at Ernst-Moritz-Arndt-University, Greifswald, Germany for gastric cancer between 1987 and 1996. Main outcome measures consist of epidemiological parameters, data on type of surgery, histopathology, postoperative complications, mortality and cancer survival. Statistical analysis between groups was performed using Chi square test (perioperative risk factors, tumor localization, and surgical treatment) and Mann Whitney U tests (Lauren classification). Survival was calculated according to the Kaplan Meier method. RESULTS: The results are in favor of subtotal gastrectomy performed for all T stages located in the distal or middle 3rd provided that a tumor-free margin of 5 cm in intestinal type and 10 cm in diffuse Lauren's type tumor can be achieved, since this operation carries the lowest postoperative risks and provides the best postoperative quality of life. Resection of adjacent organs are indicated only if they are invaded by the primary tumor (T4). They should not be resected as part of an extended lymphadenectomy procedure. The primary tumor site should guide the degree of lymph node removal. Multimodal therapeutic approaches and high postoperative morbidity and mortality after exploratory laparotomy justify the use of diagnostic laparoscopy in T3 and T4 stage tumors and if diagnostic scans suggest tumor spread. CONCLUSION: Even though surgery for gastric cancer is well standardized, a tailored surgical approach to different extents of gastric cancer appears justified.
UI - 11914623
AU - Takubo K; Honma N; Sawabe M; Arai T; Izumiyama-Shimomura N; Kammori M;
TI - Sasajima K; Esaki Y Oncocytic adenocarcinoma of the stomach: parietal cell carcinoma.
SO - Am J Surg Pathol 2002 Apr;26(4):458-65
AD - Department of Clinical Pathology, Tokyo Metropolitan Institute of Gerontology and Tokyo Metropolitan Geriatric Hospital, Tokyo, Japan. email@example.com
We report 10 cases of an unusual type of gastric adenocarcinoma that occurred in elderly patients 58-81 years of age. Histologically, the tumors were well to moderately differentiated tubular adenocarcinomas with very eosinophilic, finely granular cytoplasm. Immunohistochemical stains for antimitochondrial antibody were strongly positive. Ultrastructurally, the tumor cells had numerous mitochondria in their cytoplasm and occasional intracytoplasmic lumina with associated long microvilli. These histologic and ultrastructural features are similar to those of parietal cells in normal gastric fundic mucosa, but immunohistochemical staining of the tumors using four different antiparietal cell antibodies (anti-H(+)-K(+)-adenosine triphosphatase antibodies) was negative in all cases. Therefore, we think that these tumors were not parietal cell carcinomas but could be termed oncocytic adenocarcinomas, or adenocarcinomas with oncocytic differentiation. Previously reported cases of parietal cell carcinoma have been said to have a favorable prognosis, but it will be necessary to study a larger number of cases to determine the prognosis of oncocytic adenocarcinoma.
UI - 11773702
AU - Ikeguchi M; Liu J; Kaibara N
TI - Expression of survivin mRNA and protein in gastric cancer cell line (MKN-45) during cisplatin treatment.
SO - Apoptosis 2002 Feb;7(1):23-9
AD - First Department of Surgery, Faculty of Medicine, Tottori University, Yonago, Japan. firstname.lastname@example.org
Survivin is a member of the inhibitor of apoptosis protein (IAP) family. Survivin has been reported to be expressed in many cancers, but not in differentiated normal tissue. Recent studies revealed that survivin correlated with the chemo-resitance of cancer cells. In the present study, the changes in expression levels of survivin messenger RNA (mRNA) and survivin protein in a gastric cancer cell line (MKN-45) during cisplatin (CDDP) treatment were analyzed and compared with the occurrence of apoptotic cell death. Cell growth was inhibited even with a low dose CDDP (0.1 or 1 microg/ml) 1 hr treatment. However, the percentage of apoptotic cells did not change after 48 hr incubation with low dose CDDP. Only with high dose CDDP (10 microg/ml), did the percentage of apoptotic cells explosively increase between 12 and 24 hr treatment. Relative expression levels of survivin mRNA and survivin protein increased after CDDP treatment. The cell expression rates of survivin mRNA after 48 hr treatment with 0.1 and 1 microg/ml of CDDP were 2 to 6 fold higher than that of the survivin mRNA of untreated cells. Also, the relative cell expression level of survivin protein after 24 hr treatment with 0.1 or 1 microg/ml of CDDP was 3 to 6.5 fold higher than that of the survivin protein of untreated cells. These results indicate that survivin expression may correlate with the chemo-resistance of malignant cells.
UI - 11964046
AU - Sato K; Tamura G; Tsuchiya T; Endoh Y; Sakata K; Motoyama T; Usuba O;
TI - Kimura W; Terashima M; Nishizuka S; Zou T; Meltzer SJ Analysis of genetic and epigenetic alterations of the PTEN gene in gastric cancer.
SO - Virchows Arch 2002 Feb;440(2):160-5
AD - Department of Pathology, Yamagata University School of Medicine, Japan.
The PTEN tumor suppressor gene on 10q23.3, responsible for the Cowden and Bannayan-Zonana syndromes, encodes a dual-specificity phosphatase able to dephosphorylate both tyrosine phosphate and serine/threonine phosphate residues. Mutational inactivation of PTEN has been reported in various malignancies, including endometrial cancers, ovarian cancers, and glioblastomas. In this study, we investigated PTEN gene mutations in 10 gastric cancer cell lines and 58 primary gastric cancers by polymerase chain reaction single strand conformation polymorphism (PCR-SSCP). Hypermethylation of promoter region CpG islands, an alternative mechanism of gene inactivation to coding region mutations, was also evaluated by methylation specific PCR (MSP). Only one (1.7%) of the 58 primary tumors carried a somatic 5-bp deletion in intron 7 of PTEN, which did not alter the mRNA sequence, and no mutations were detected in any of the cell lines. Similar levels of PTEN mRNA expression were observed in all cell lines and primary tumors studied by RT-PCR, and PTEN promoter CpG islands remained unmethylated. Therefore, we conclude that PTEN does not participate in gastric carcinogenesis as a tumor suppressor gene.
UI - 11977635
AU - Sun X; Mu R; Zhou Y; Dai X; Qiao Y; Zhang S; Huangfu X; Sun J; Li L; Lu
TI - F [1990-1992 mortality of stomach cancer in China]
SO - Zhonghua Zhong Liu Za Zhi 2002 Jan;24(1):4-8
AD - Cancer Institute (Hospital), Chinese Academy of Medical Sciences, Peking Union Medical College, Beijing 100021, China.
OBJECTIVE: To assess the impact of stomach cancer on the Chinese population by epidemiological analysis of its mortality distribution. METHODS: 1990-1992 data on stomach cancer mortality collected by sampling survey involved one tenth of the total Chinese population. RESULTS: The crude mortality rate of stomach cancer in China was 25.2 per 10(5) (32.8 per 10(5) for males and 17.0 per 10(5) for females), which comprised 23.2% of the total cancer deaths from 1990 to 1992, making stomach cancer the leading cause of cancer death. The stomach cancer mortality rate of males was 1.9 times of that of females. The Chinese mortality rates of stomach cancer adjusted by the world population were 40.8 per 10(5) and 18.6 per 10(5) of males and females, which were 4.2-7.9 (of males) and 3.8-8.0 (of females) times of those in the developed countries. Age-adjusted mortality rates of stomach cancer in China have distinct geographical difference: form the lowest 2.5 per 10(5) to the highest 153.0 per 10(5) in the 263 surveyed localities, 15.3 per 10(5) in urban areas and 24.4 per 10(5) in rural areas giving a difference of 1.9 times. CONCLUSION: The prevention and treatment of stomach cancer in China, especially in the countryside and the under-developed areas in the northwest, should be a long-term focus in control of cancers of the digestive system. Urgent measures for prevention and early detection of stomach cancer should be taken.
UI - 11981333
AU - Blaser MJ; Saito D
TI - Trends in reported adenocarcinomas of the oesophagus and gastric cardia in Japan.
SO - Eur J Gastroenterol Hepatol 2002 Feb;14(2):107-13
AD - Division of Infectious Diseases, Department of Medicine, Vanderbilt University School of Medicine, Nashville, USA. email@example.com
Adenocarcinomas involving the oesophagus and gastric cardia are becoming more common in Western countries, but data from Japan are limited. We sought to determine whether the frequency of these cancers in Japan has increased in recent decades. Review of national cancer mortality data, national registries of oesophageal and gastric cancer cases, and records from two large cancer centres for various time periods between 1950 and 1998 did not show increased reporting of oesophageal adenocarcinomas. In contrast, both national and cancer centre data indicate an absolute increase in the number of gastric cancers involving the C-area (proximal third of the stomach). From a national registry of resected primary gastric cancer cases, those arising in the C-area as a proportion of all tumours rose by 41.8% between 1963 (12.2% of all registered cases) and 1990 (17.3%). Analysis of true cardia (<2 cm distal to oesophagus-cardia junction) early cancers from the two cancer centres showed significant increases in both absolute number and in proportion to other gastric cancers over a 36-year period. These data suggest that the frequency of cardia cancers is increasing in Japan. Lack of a parallel increase in oesophageal adenocarcinomas could be due to misclassification artefacts and/or coding preferences for gastro-oesophageal junction tumours.
UI - 11981334
AU - Wijnhoven BP; Louwman MW; Tilanus HW; Coebergh JW
TI - Increased incidence of adenocarcinomas at the gastro-oesophageal junction in Dutch males since the 1990s.
SO - Eur J Gastroenterol Hepatol 2002 Feb;14(2):115-22
AD - Department of Surgery, Erasmus University, Rotterdam, The Netherlands.
BACKGROUND: Worldwide population-based studies suggest that the incidence of oesophageal and gastric cardia adenocarcinomas has increased since the 1970s. OBJECTIVE AND METHODS: We studied time trends in mortality and incidence rates of oesophageal and gastric carcinomas according to subsite and histology in the south-east Netherlands since 1978. RESULTS: The age-adjusted mortality and incidence rates for oesophageal cancer doubled in males over the entire 19-year study period from 2.7 to 5.6 and from 2.4 to 4.8 per 100,000 person years, respectively. In females, a similar trend for the mortality and incidence rates was seen, but at a lower level. The age-adjusted mortality and incidence rates for gastric cancer decreased with time from 20.7 to 12.8 and from 21.6 to 15.9 per 100,000 person years in males, respectively. In females, age-adjusted mortality and incidence rates for gastric cancer also decreased. Analysis of incidence rates by subsite and subtype showed an increase in adenocarcinomas of the oesophagus and gastric cardia, largely restricted to males. In females, the rise in incidence of squamous cell carcinoma of the oesophagus appeared to be more marked than the rise in adenocarcinomas, whereas the incidence of gastric cardia carcinomas has remained stable over the last 10 years. Neither the decrease in the number of unspecified tumours with time, nor the increase in the use of diagnostic endoscopy and imaging techniques, is likely to explain completely the observed increases. CONCLUSION: The increase in incidence of adenocarcinomas at the gastro-oesophageal junction in the south-eastern Netherlands seems, at least in part, to represent a true underlying increase that is restricted largely to males.
UI - 11981331
AU - Forman D
TI - Counting cancers at the junction - a problem of routine statistics.
SO - Eur J Gastroenterol Hepatol 2002 Feb;14(2):99-101
AD - Unit of Epidemiology and Health Services Research, The Medical School, University of Leeds, Northern and Yorkshire Cancer Registry and Information Service, Cookridge Hospital, Leeds, UK. firstname.lastname@example.org
The increase over time in the incidence of cancer arising at the oesophagogastric junction has been the subject of many papers reviewing data obtained from cancer registries and other sources of routine statistics. The analysis of such data is beset with a number of problems, all of which compromise comparability over time and hence complicate interpretation. This makes it extremely difficult to assess with any degree of reliability the quantitative extent to which these cancers really are increasing. Some recent datasets, such as from the Eindhoven Cancer Registry, are now providing higher-quality information that can remedy this deficiency. In the absence of such routine information, useful insights can be obtained from analysis of appropriate clinical datasets that exist in Japan.
UI - 11977555
AU - Ohkura H
TI - [Tumor markers in gastric cancer]
SO - Gan To Kagaku Ryoho 2002 Apr;29(4):637-43
AD - Medical Oncology Division, Ibaraki Prefectural Central Hospital & Cancer Center, 6528 Koibuchi, Tomobe-machi, Nishi-ibaraki-gun, Ibaraki 309-1793, Jaapan.
There are two markers, pepsinogen isoenzymes and antibody against Helicobactor pyroli, for screening of high-risk group for gastric cancer. Most of markers are used in diagnosis, staging, monitoring and differentiating subgroups of gastric cancer. Markers in ascitic fluid are used for diagnosing peritoneal invasion of gastric cancer.
UI - 11944951
AU - Yokota T; Kunii Y; Saito T; Teshima S; Yamada Y; Iwamoto K; Takahashi H;
TI - Takahashi M; Kikuchi S; Yamauchi H Prognostic factors of gastric cancer tumours of less than 2 cm in diameter: rationale for limited surgery.
SO - Eur J Surg Oncol 2002 Apr;28(3):209-13
AD - Department of Surgery, Sendai National Hospital, Sendai 983-8520, Japan. email@example.com
BACKGROUND: A recent trend in the surgical treatment of patients with early gastric cancer in Japan has been to limit surgery to an extent that ensures complete cure and improvement in the patient's quality of life. If a gastric cancer tumour can be completely eradicated by laparoscopic surgery, the patient can be cured of cancer without major operative stress. A small gastric cancer tumour of less than 2 cm in diameter is an indication for laparoscopic surgery, but little is known about what protocol of surgical treatment is appropriate for this type of tumour. PATIENTS AND METHODS: The clinicopathological features of 150 patients with gastric cancer tumour of less than 2 cm in diameter were reviewed retrospectively from hospital records between 1985 and 1995. The results of retrospective analysis of clinicopathological data of 24 patients with advanced cancer were compared with those of 126 patients with early cancer. Univariate and multivariate analyses of patients with small gastric cancer tumours were performed to evaluate the prognostic significance of clinicopathological features. RESULTS: A significant difference was seen between the gross tumour appearances in the two groups; Borrmann type-4 tumours were more common in the advanced group. Lymph-node metastasis, lymphatic vessel invasion and vascular invasion were found more frequently in the advanced cancer group than in the early cancer group. Scirrhous type was more common in the advanced cancer group. In univariate analysis, unfavourable prognostic factors included deep cancer invasion, presence of lymph-node metastasis, lymphatic invasion and vascular invasion. Using Cox's proportional hazard regression model, only nodal involvement emerged as an independent statistically significant prognostic parameter associated with long-term survival. CONCLUSION: Laparoscopic surgery should not be performed on tumours that are Borrmann type in macroscopic appearance and scirrhous-type histologically. Lymph-node metastasis is an independent prognostic factor. We recommend laparoscopic surgery involving local resection of the stomach without lymphadenectomy for small, early gastric cancer tumours that satisfy the criteria mentioned above. However, the validity of this recommendation should be tested by a prospective randomized control trial in the future. Copyright Harcourt Publishers Limited.
UI - 11944952
AU - Schwarz RE; Zagala-Nevarez K
TI - Ethnic survival differences after gastrectomy for gastric cancer are better explained by factors specific for disease location and individual patient comorbidity.
SO - Eur J Surg Oncol 2002 Apr;28(3):214-9
AD - City of Hope National Medical Center, Department of General Oncologic Surgery, Duarte, CA, USA. firstname.lastname@example.org
INTRODUCTION: Different outcomes after resection of gastric cancer between various ethnic patient groups have been described. It remains unclear whether disparity of treatment forms, disease-related variables, or individual patients accounts for this effect. METHODS: In the 10 years between 1989 and 1999, 75 patients with gastric adenocarcinoma underwent gastrectomy at a single institution, with constant surgical standards during this time period, including complete (R0) resection attempt and extended lymphadenectomy. Ethnicity, disease characteristics, and treatment variables were analysed for their impact on survival. RESULTS: There were 40 males and 35 females, with a median age of 67 years (range 31-97). The gastrectomy extent was total (n=25), proximal (n=18), subtotal (n=17), distal (n=14), and segmental (n=1). The mean lymph-node count was 25+/-17 (SD). There was one post-operative death, and an overall complication rate of 27%; the median hospital stay was 11 days. Overall actuarial 5-year survival was 33% (95% CI: 19-47); potentially curable disease (stage 1A-IIIB) led to a median survival of 49 months. Asian (n=18) and Hispanic patients (n=20) had significantly better survival than Caucasian (n=31) or other patients (n=6) (P=0.01). Ethnicity was linked to the location of the primary tumour ( P=0.002), the gastrectomy extent (P=0.003), and the patient's prior abdominal operation (P=0.01) or tobacco history (P=0.03), but not to resection extent parameters (such as number of lymph nodes retrieved) or differences in pathologic characteristics. When controlling for differences of disease site, stage, R status, and patient comorbidity, ethnicity did not retain an independent prognostic impact on survival. CONCLUSIONS: Obvious survival differences after gastrectomy for gastric adenocarcinoma favouring Asian and Hispanic patients in this experience can be explained by different disease patterns (distal location), the related need for fewer extensive procedures (such as total gastrectomy), and diminished patient risks (tobacco, prior operations, non-cancer deaths). Our therapeutic approach remains an aggressive gastrectomy/lymphadenectomy combination for potentially curable gastric cancer, irrespective of ethnic patient factors. Copyright Harcourt Publishers Limited.
UI - 11959712
AU - Choi D; Lim HK; Lee SJ; Lim JH; Kim SH; Lee WJ; Lee JH; Kim YH; Rhee PL;
TI - Kim JJ; Ko YH Gastric mucosa-associated lymphoid tissue lymphoma: helical CT findings and pathologic correlation.
SO - AJR Am J Roentgenol 2002 May;178(5):1117-22
AD - Department of Radiology, Samsung Medical Center, Sungkyunkwan University School of Medicine, 50, Ilwon-Dong, Kangnam-Ku, Seoul 135-710, Korea.
OBJECTIVE: The purpose of this study was to describe helical CT findings of gastric mucosa-associated lymphoid tissue (MALT) lymphoma and to correlate them with pathologic findings. MATERIALS AND METHODS: We retrospectively reviewed CT examinations of 58 patients with confirmed gastric MALT lymphom