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Abramson Cancer CenterNCI CANCERLIT® Search: Diagnosis-Histopathology-Pathogenesis of Gastric Cancer - May 2002
National Cancer Institute®
Last Modified: May 1, 2002
Table of Contents
1
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.
2
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. samson@skyinet.net
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.
3
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. surgeo@med.keio.ac.jp
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.
4
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.
5
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.
6
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. elomare@mail.nih.gov
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.
7
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.
8
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.
9
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.
10
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. ashibata@stanford.edu
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.
11
UI - 11978357
AU - Rosner I
TI -
Uses of error: early and late.
SO - Lancet 2002 Apr 20;359(9315):1422
12
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.
yendo@med.id.yamagata-u.ac.jp
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.
13
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
14
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.
15
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. massimo.bellomi@ieo.it
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.
16
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.
yokom@imed2.med.osaka-u.ac.jp
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.
17
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.
18
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.
takubo@tmig.or.jp
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.
19
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. masaike@grape.med.tottori-u.ac.jp
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.
20
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.
21
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.
22
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. martin.blaser@med.nyu.edu
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.
23
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.
24
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. d.forman@leeds.ac.uk
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.
25
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.
26
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.
yo40@sh.comminet.or.jp
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.
27
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. r.schwarz@umdnj.edu
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.
28
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
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