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Abramson Cancer CenterNCI CANCERLIT® Search: Diagnosis-Histopathology-Pathogenesis of Gastric Cancer - January 2002
National Cancer Institute®
Last Modified: January 1, 2002
Table of Contents
1
UI - 10601062
AU - Breslin NP; Thomson AB; Bailey RJ; Blustein PK; Meddings J; Lalor E;
TI -
VanRosendaal GM; Verhoef MJ; Sutherland LR
Gastric cancer and other endoscopic diagnoses in patients with benign
dyspepsia.
SO - Gut 2000 Jan;46(1):93-7
AD - University of Calgary, Calgary, Alberta, Canada.
BACKGROUND: It has been suggested that endoscopy could be replaced with
non-invasive assessment of helicobacter status in the initial work up of
young dyspeptic patients without sinister symptoms. AIMS: To determine
the incidence of gastro-oesophageal malignancy in young dyspeptic
patients. METHODS: The Alberta Endoscopy Project captured clinical and
and histological diagnosis in a subgroup of patients under 45 years of
age without alarm symptoms that had undergone gastroscopy was reviewed.
In addition, a random list of 200 patients was generated and their
medical records reviewed in order to assess the proportion with symptoms
suitable for a non-invasive management strategy. RESULTS: Gastroscopy
was performed in 7004 patients under 45 years. In 3634 patients (56%
female) alarm type symptoms were absent; 78.9% of patients had symptoms
amenable to a non-invasive initial approach, giving a corrected sample
size of 2867 patients (correction factor 0.789). Three gastric cancers,
one case of moderate dysplasia, 10 biopsy proved cases of Barrett's
oesophagus, and 19 oesophageal strictures/rings were detected within
this sample. The corrected prevalence of gastric cancer in this select
population was 1.05 per thousand patients. DISCUSSION: Endoscopy yielded
three gastric cancers in this sample of under 45 year old dyspeptic
patients without sinister symptoms. While initial non-invasive screening
with one-week triple therapy for helicobacter positive individuals is
unlikely to have a detrimental outcome the physician is advised to
consider endoscopy in patients with persisting, recurrent, or sinister
symptoms.
2
UI - 11148559
AU - Hsu C; Chen CL; Chen LT; Liu HT; Chen YC; Jan CM; Liu CS; Cheng AL
TI -
Comparison of MALT and non-MALT primary large cell lymphoma of the
stomach: does histologic evidence of MALT affect chemotherapy response?
SO - Cancer 2001 Jan 1;91(1):49-56
AD - Department of Oncology, National Taiwan University Hospital, Taipei,
Taiwan.
BACKGROUND: Although the clinicopathologic features of low grade gastric
MALToma (lymphoma of mucosa-associated lymphoid tissue) recently have
been well delineated, the significance of identifying histologic
evidence of MALT origin in a primary high grade gastric lymphoma is less
clear. The authors sought to address this issue and, in particular, to
clarify if MALT and non-MALT primary large cell gastric lymphoma might
have a different response to systemic chemotherapy. METHODS: The authors
reviewed the pathologic specimens of all patients who had a diagnosis of
primary large cell lymphoma of the stomach and who had been treated
primarily by systemic chemotherapy in our institutions January 1,
1988-December 31, 1998. The patients were divided into two groups by
experienced hematopathologists, based on the presence or absence of
histologic features suggestive of MALToma, including typical
lymphoepithelial lesions and infiltration of characteristic
centrocyte-like cells. Disease staging was done according to the
AJCC/UICC system with Musshoff modification. The median number of
gastric biopsies for each patient was 7 (range, 1-21). RESULTS:
Seventeen patients with and 26 patients without histologic evidence of
MALToma were identified. Clinical features were similar between the two
groups except that a greater proportion of patients without evidence of
MALToma had elevated levels of serum lactate dehydrogenase (50% vs. 12%,
P = 0.01). The median duration of follow-up for the 43 patients was 46.5
months (range, 17-124 mos). All patients received standard systemic
chemotherapy including anthracyclines or anthracenedione. The response
rate was 88.2% for patients with evidence of MALToma and 57.7% for those
without (P = 0.03). The 5-year overall survival rate was 80.5% for
patients with evidence of MALToma and 48.9% for those without (P =
0.02). Multivariate analysis indicated that response to chemotherapy,
disease stage (Stage I and II-1 vs. Stage II-2, III, and IV), and the
presence of MALToma features were independent prognostic factors for
overall survival. CONCLUSION: The results of this relatively small study
series suggested that the presence of histologic features of MALToma in
patients with primary large cell gastric lymphoma might have been
associated with a better response to systemic chemotherapy and a better
prognosis. Further studies to consolidate this conclusion are necessary.
Copyright 2001 American Cancer Society.
3
UI - 11288741
AU - McColl KE; Kidd J; Gillen D
TI -
Gastric cancer in patients with benign dyspepsia.
SO - Gut 2001 Apr;48(4):581-2
4
UI - 11328270
AU - Waldum HL
TI -
The safety of proton pump inhibitors.
SO - Aliment Pharmacol Ther 2001 May;15(5):729-30
5
UI - 11496479
AU - Komarov NV; Maslagin AS; Komarov RN
TI -
[Surgical treatment of patients with complications of peptic ulcer of
the stomach and duodenum under conditions of a regional hospital]
SO - Vestn Khir Im I I Grek 2001;160(2):104-6
The authors made an analysis of the incidence and structure of
complications requiring reoperations after operative treatment of 176
patients (with a perforated ulcer of the stomach and duodenum--125, with
gastroduodenal bleedings--51). The operative technique for the treatment
of different complications is described in detail.
6
UI - 11432666
AU - Chang MS; Lee HS; Kim CW; Kim YI; Kim WH
TI -
Clinicopathologic characteristics of Epstein-Barr virus-incorporated
gastric cancers in Korea.
SO - Pathol Res Pract 2001;197(6):395-400
AD - Department of Pathology, Seoul National University College of Medicine,
Korea.
We evaluated the rate of Epstein-Barr virus (EBV) infection in gastric
carcinomas of Korean patients and investigated the associations between
EBV infection and clinicopathological characteristics, the survival
rates of patients, and p53 overexpression. EBV-encoded small RNA
(EBER)-in situ hybridization and immunohistochemistry for p53 protein
were done in 306 consecutive gastric carcinoma cases, of which 17 (5.6%)
showed EBV infection. Of these 17 EBV-positive cases, one case strongly
expressed p53 protein, while 98 (34%) of 285 EBV-negative cases
overexpressed p53 (p < 0.05). The EBV-positive gastric carcinomas tended
to have lymphoid stroma. They were mostly of the poorly differentiated
type, negative for p53 immunoexpression, more prevalent in male
patients, and diffuse according to Lauren's classification (p < 0.05).
There was no significant difference in the survival rate for the EBV
status. In conclusion, the EBV infection rate among gastric carcinomas
in Korea is similar to that ascertained in other countries. An inverse
correlation between EBV and p53 overexpression was disclosed. Further
study is needed to find out whether or not two genetic changes could be
functionally overlapping during gastric carcinogenesis.
7
UI - 11444469
AU - Kim H; Lim JW; Kim KH
TI -
Helicobacter pylori-induced expression of interleukin-8 and
cyclooxygenase-2 in AGS gastric epithelial cells: mediation by nuclear
factor-kappaB.
SO - Scand J Gastroenterol 2001 Jul;36(7):706-16
AD - Dept. of Pharmacology and Institute of Gastroenterology, Yonsei
University College of Medicine, Seoul, Korea.
BACKGROUND: Helicobacter pylori infection might activate nuclear
factor-kappaB (NF-kappaB), a transcriptional regulator of inducible
expression of inflammatory genes, interleukin-8 (IL-8) and
cyclooxygenase-2 (COX-2). We studied the role of NF-kappaB on expression
of IL-8 and COX-2 in H. pylori-stimulated AGS gastric epithelial cells
by using antisense oligonucleotide (AS ODN) for NF-kappaB subunit p50
and an antioxidant, glutathione (GSH) as well as a NF-kappaB inhibitor,
pyrrolidine dithiocarbamate (PDTC). METHODS: AGS cells were treated with
p50 AS ODN, GSH or PDTC in the presence of H. pylori. mRNA expression
and protein levels for IL-8 and COX-2 were determined by Northern blot
analysis and Western blot analysis. Levels of IL-8, 6-keto-prostaglandin
F1alpha (6-keto-PGF1alpha) and thromboxane B2 (TXB2) were measured in
the medium by enzyme-linked immunosorbent assay. NF-kappaB activation
was examined by electrophoretic mobility shift assay. RESULTS: H. pylori
induced a time-dependent expression of mRNA and protein for IL-8 and
COX-2 via activation of NF-kappaB and increased the levels of IL-8,
6-keto-PGF1alpha and TXB2, which were inhibited by GSH and PDTC. H.
pylori-induced expression of IL-8 and COX-2 was blocked in AGS cells
transfected with p50 AS ODN. CONCLUSION: NF-kappaB may play a novel role
in expression of IL-8 and COX-2 in H. pylori-induced gastric
inflammation.
8
UI - 11444481
AU - Roussos A; Patsopoulos D; Philippou N
TI -
Pleural effusion as the initial manifestation of gastric adenocarcinoma:
a report of four cases.
SO - Scand J Gastroenterol 2001 Jul;36(7):784
9
UI - 11444744
AU - Wai CT; Ho KY; Yeoh KG; Lim SG
TI -
Palliation of malignant gastric outlet obstruction caused by gastric
cancer with self-expandable metal stents.
SO - Surg Laparosc Endosc Percutan Tech 2001 Jun;11(3):161-4
AD - Department of Medicine, National University Hospital, Singapore.
Gastric carcinoma is among the most common cancers worldwide. Surgery
remains the mainstay of potentially curative treatments. Unfortunately,
most patients have an advanced form of the disease. We evaluated our
experience in palliating malignant gastric outlet obstruction caused by
gastric cancer with expandable metal stents (Wallstent Enteral; Boston
Scientific, Singapore). Six patients with a median age of 68 years
(range, 45-88) underwent the procedure. Three had metastatic gastric
cancer; two recurrent gastric cancer; and one locally advanced gastric
cancer with poor comorbid status. After the procedure, five of the six
patients were able to resume an oral feeding within 24 hours. One
patient with gastric dysmotility caused by linitus plastica required
nasogastric tube feeding. Three patients died during a median follow-up
period of 4 weeks (range, 2-8). The other three patients were still well
at a median follow-up period of 10 weeks (range, 5-12). There was no
procedure-related mortality or morbidity, nor was there any stent
migration or blockage in any of these patients. In conclusion,
palliation of malignant gastric outlet strictures caused by gastric
cancer with expandable metal stents is an effective and safe alternative
to surgery, particularly in patients with postgastrectomy anastomotic
recurrence and in those who are poor candidates for surgery. Patients
who are not expected to survive beyond 1 month and those with linitus
plastica and associated gastric dysmotility may not be appropriate
candidates for such a procedure.
10
UI - 11464624
AU - Onate-Ocana LF; Cortes Cardenas S; Herrera-Goepfert R;
TI -
Aiello-Crocifoglio V; Mondragon-Sanchez R; Ruiz-Molina JM
[Early gastric carcinoma. Analysis of 21 cases]
SO - Rev Gastroenterol Mex 2001 Jan-Mar;66(1):14-21
AD - Departamento de Gastroenterologia, Instituto Nacional de Cancerologia,
Avenida San Fernando 22, Colonia Toriello Guerra, Tlalpan, C.P. 14000,
Mexico D.F. lonate@prodigy.net.mx
BACKGROUND: Early gastric carcinoma (EGC) is defined as a neoplasm
confined to the mucosa and submucosa regardless of the presence of
metastasis. This lesion is found in approximately 3% of cases in Mexico.
The aim of this study is to describe our experience with EGC,
emphasizing early detection as the most useful method to decrease
mortality. METHODS: Retrospective review of records of patients with EGC
treated at an oncologic referral center over a 12-years period. RESULTS:
Twenty-one cases of EGC were retrieved. Mean age was 58.1 years (range,
33 to 84). Twelve were women and nine, men. Lymph node or distant
metastasis were not found. Overall 5-year survival was 66.4%. Twenty
patients underwent radical gastrectomy and only one underwent wedge
resection of the gastric wall. Two patients (9.5%) presented recurrence
and cancer-related death. Mean follow-up was 8.3 years. CONCLUSION: The
prognosis of EGC in our hospital is lower than in countries other than
Mexico and this lesion is found with low frequency. Increasing the
detection EGC is the best method to reduce GC-related mortality.
11
UI - 11456052
AU - Terada R; Yasutake T; Nakamura S; Hisamatsu T; Nakagoe T; Ayabe H;
TI -
Tagawa Y
Evaluation of metastatic potential of gastric tumors by staining for
proliferating cell nuclear antigen and chromosome 17 numerical
aberrations.
SO - Ann Surg Oncol 2001 Jul;8(6):525-32
AD - First Department of Surgery, School of Medicine, Nagasaki University,
Japan. TE0403@aol.com
BACKGROUND: Aberrations in chromosome 17 are important in
carcinogenesis. We recently reported that numerical aberrations in
chromosome 17 were associated with tumor progression in gastric cancer.
The aim of this study was to determine the biological characteristics of
gastric tumor cells with chromosome 17 numerical aberrations. METHODS:
Gastric tumor sections (n = 105) and metastatic lymph nodes (n = 16)
were stained simultaneously for PCNA (proliferating cell nuclear
antigen) and chromosome 17 centromere. Cancers were classified as
follows: Group 1: PCNA(+) and numerical chromosomal aberration(+); Group
2: PCNA(-) and numerical chromosomal aberration(+); Group 3: PCNA(+) and
numerical chromosomal aberration(-); and Group 4: PCNA(-) and numerical
chromosomal aberration(-). RESULTS: The frequency of Group 1 cells
correlated with lymphatic invasion (P < .0001), lymph node metastasis (P
< .0001), and venous invasion (P < .01). The frequency of these cells in
gastric lesions was lower than in metastatic lymph nodes (P < .01).
Logistic regression analysis identified the depth of invasion followed
by the frequency of Group 1 cells were two of the most significant
independent factors that could predict lymph node metastasis and
lymphatic invasion. CONCLUSIONS: The frequency of gastric tumor cells
positive for PCNA and chromosome 17 numerical aberrations may be an
indicator of the metastatic potential of gastric cancers.
12
UI - 11464489
AU - de Manzoni G; Roviello F; Marrelli D; Morgagni P; Di Leo A; Saragoni L;
TI -
De Stefano A; Bazzocchi F; Pinto E
[Influence of histologic type on prognosis of patients undergoing
curative intervention for gastric adenocarcinoma. Italian multicenter
study]
SO - Ann Ital Chir 2001 Jan-Feb;72(1):13-8
AD - Istituto di Semeiotica Chirurgica, I, Divisione Clinicizzata di
Chirurgia Generale, Universita di Verona.
BACKGROUND: The prognostic significance of the histological type in
gastric cancer is still debated. The correlation between
intestinal-diffuse type and tumor recurrence was investigated in a
prospective multicentric study which collects the cases from three
surgical Departments of Italy. PATIENTS AND METHODS: Four-hundred and
twelve patients who underwent a potentially curative resection between
1988 and 1995 were considered; 273 cases were classified as intestinal
type (group A), and 139 cases as diffuse type (group B). Mixed cases
were excluded from the study. All patients were included in a complete
follow-up program for the early diagnosis of recurrence. Clinical,
histopathological and surgical factors were examined for their influence
on tumor recurrence by univariate and multivariate analysis. RESULTS:
Recurrence rate was 41.4% in intestinal type, and 65.5% in diffuse type
cases (p < 0.0001). In group A, multivariate analysis identified nodal
status (p < 0.0001), depth of invasion (p < 0.005), lymph node
dissection (D1 vs. D2-D4, p < 0.01), advanced age (p < 0.01) and male
sex (p < 0.05) as significant prognostic factors. In group B, depth of
invasion (p < 0.0005), lymph node dissection (p < 0.005), tumor size (p
< 0.01) and nodal status (p < 0.05) resulted as significant variables;
no preventive effect on tumor recurrence was found for D2 vs. D1
lymphadenectomy. Multivariate analysis performed on the totality of the
cases demonstrated diffuse type as an independent predictor of poor
prognosis (relative risk: 1.67, p < 0.001). CONCLUSIONS: Diffuse type of
gastric cancer is an independent risk factor for tumor recurrence as
compared with intestinal type; clinical and pathological variables play
a different role as prognostic factors in the two histotypes.
13
UI - 11464492
AU - Picciocchi A
TI -
["Update on gastric carcinoma"]
SO - Ann Ital Chir 2001 Jan-Feb;72(1):3-4
14
UI - 11464493
AU - Conlon KC
TI -
Staging laparoscopy for gastric cancer.
SO - Ann Ital Chir 2001 Jan-Feb;72(1):33-7
AD - Gastric and Mixed Tumor Service, Memorial Sloan-Kettering Cancer Center,
New York, USA. ConlonK@MSKCC.org
The growing role of multimodal treatment plans for advanced gastric
cancer has contributed to the development of more accurate preoperative
staging strategies. The high diagnostic efficacy of video-laparoscopy as
regards the M factor has been reported by many; preoperative laparoscopy
therefore permits to avoid unhelpful surgical exploration in case of
peritoneal dissemination of tumor or liver metastases undetected by
conventional staging. At Memorial Sloan Kattering Cancer Center
preoperative staging laparoscopy is currently included in the diagnostic
algorithm for gastric cancer. Data from a consecutive series of 103
patients demonstrated metastatic disease in 24 patients (37%) who were
considered to have localized cancer by computed tomography (CT) or
endoscopic ultrasonography (EUS), with an accuracy of 94% with respect
to the M factor. These patients did not require open surgery.
Laparoscopic washings were obtained from 127 patients with gastric
cancer and a positive correlation between the extent of disease and
prevalence of positive cytology was noted (T1/T2: 0%, T3/T4: 10%, M+:
59%). Our experience suggests that laparoscopy has added value in
staging patients with gastric carcinoma. It appears to be a safe and
effective staging modality, avoiding unnecessary explorations and
providing new means of directing appropriate treatment strategy.
15
UI - 11464496
AU - Armuzzi A; Gasbarrini A; Gabrielli M; Cremonini F; Anti M; Gasbarrini G
TI -
[Helicobacter pylori and gastric carcinoma]
SO - Ann Ital Chir 2001 Jan-Feb;72(1):5-11
AD - Universita Cattolica del Sacro Cuore, Roma.
Among the suspected bacterial causes of cancer, H. pylori is the agent
more consistently linked to malignancy. After its discovery in 1983 and
the later confirmation as the leading cause of chronic gastritis,
several studies were performed to prove an association between H. pylori
infection and gastric carcinoma. The epidemiological data have been so
strong that in 1994 the International Association for Research on Cancer
stated that "there was sufficient evidence" to classify H. pylori as a
group I carcinogen in humans. However, the exact mechanisms underlying
the link between H. pylori infection and gastric carcinoma remain still
to be elucidated. The natural history of H. pylori infection shows that,
although roughly half of the world's human population bears the
organism, only a minority of individuals develop clinically important
outcomes (e.g. peptic ulcer, lymphoproliferative diseases, atrophic
gastritis and gastric carcinoma): host's genetic make-up, duration of
infection, diet and differences between H. pylori strains have been
proposed as factors potentially able to influence the outcomes in
different individuals. The damaging agents by which H. pylori could
promote gastric carcinogenesis are produced either by the organism or as
a consequence of the host inflammatory response to the infection.
Gastric mucosal chronic damage may, therefore, lead to changes in the
pattern of epithelial cell kinetic (increase in cell proliferation and
induction of apoptosis) in gastric glands which may induce DNA injury
with irreversible genetic lesions. Finally, a direct association between
H. pylori infection and the induction of gastric carcinoma has been
recently demonstrated in an animal model, giving further credence to the
role of this organism in gastric carcinogenesis.
16
UI - 11464498
AU - Napolitano L; Francomano F; Gargano E; Francione T; Angelucci D;
TI -
Napolitano AM
[Our experience regarding biologically inactive gastroenteropancreatic
neuroendocrine tumors]
SO - Ann Ital Chir 2001 Jan-Feb;72(1):61-4; discussion 65
AD - Dipartimento di Scienze Chirurgiche Universita di Chieti.
The Authors present 9 cases of gastro-enteropancreatic neuro-endocrine
biologically inactive tumors. In 5 cases the tumor site was
appendicular. In 4 patients an appendectomy was performed, in one
patient a right hemicolectomy and the patients after a period of 3-9
years are well and disease free. In a patient with a gastric carcinoid
and a single hepatic metastasis a total gastrectomy with an hepatic
metastasectomy were performed but the patient died 16 months thereafter.
In a case localized to the right colon with a single hepatic metastasis
a right hemicolectomy was performed with a metastasectomy but the
patient died after 12 months. In a case localized to an ileal loop a
segmental resection was performed followed by a medical therapy with
octreotide and the patient is well and disease free after 3 years. In a
case localized to the pancreas with widespread lymphatic metastasis it
was performed a simple biliary diversion (coledocho-duodenostomy)
followed by medical therapy with octreotide. Surprisingly after 4 years
the patient is alive and a TC control shows a decrease of the pancreatic
tumor and of the lympho glandular tumefactions.
17
UI - 11471856
AU - Murashima N; Gochi A; Kenmotsu M; Hamazaki K; Funaki M; Ohtsuka S;
TI -
Tanaka N
Schedule-dependent combined sensitivity testing of anti-cancer agents in
human gastric carcinoma cell lines.
SO - J Int Med Res 2001 May-Jun;29(3):189-97
AD - First Department of Surgery, Okayama University Medical School, Japan.
The efficacy of combination chemotherapy for gastric carcinoma has been
unsatisfactory, although the prognosis of advanced and recurrent disease
has improved with the introduction of cisplatin (CDDP). This study
examines the effect of the anti-cancer therapies CDDP, doxorubicin (ADM)
and etoposide (VP-16) on the cell cycle and their cytotoxicity against
two gastric carcinoma cell lines: MKN-28 (well differentiated) and
MKN-45 (poorly differentiated). The treatments have different cytocidal
mechanisms, and they were studied in dual combinations. For all
combinations studied, cytotoxicity against MKN-45 was higher than
against MKN-28. For ADM plus CDDP, or ADM plus VP-16, cytotoxicity was
higher in patients pretreated with ADM than other regimens. The highest
anti-tumour activity against both cell lines was obtained with ADM
followed by CDDP (we have obtained good clinical results with this
regimen). Schedule-dependent combined sensitivity testing of anti-cancer
agents will be useful for the clinical application of therapies.
18
UI - 11471894
AU - Gonzalez Vitores AM; Duro GE; Fraile BB; Carrasco MA
TI -
Prognostic value of the glycoprotein TAG-72 in patients with gastric
cancer.
SO - Int J Biol Markers 2001 Apr-Jun;16(2):121-5
AD - Department of General Surgery, General Hospital Vall d'Hebron,
Autonomous University of Barcelona, Spain.
The specificity of the tumor markers used to date in patients with
gastric cancer has not been satisfactory. For this reason we decided to
evaluate the utility of TAG-72 in this disease. Between 1993 and 1998 we
determined the levels of TAG-72 in 638 subjects (148 healthy volunteers,
33 patients with chronic renal failure (CRF), 149 patients with benign
diseases of the liver, 95 patients with benign gastrointestinal diseases
and 213 patients with gastric cancer). TAG-72 was measured using an IRMA
method. Statistical analysis of the data was performed with the BMDP
package. We established a cutoff for TAG-72 of 3 U/mL, corresponding to
the 92.6th percentile of the healthy controls. We observed that neither
CRF nor benign liver diseases affected TAG-72 levels, while certain
benign gastrointestinal diseases did cause alterations of the marker.
Using Cox multivariate analysis we discovered that the preoperative
TAG-72 level was an independent prognostic variable associated with both
disease-free and overall survival. We conclude that, although TAG-72 is
not useful for the diagnosis of gastric cancer, it is a suitable tool
for disease monitoring and prognostic assessment.
19
UI - 11471664
AU - de Manzoni G; Pedrazzani C; Di Leo A; Bonfiglio M; Tasselli S; Guglielmi
TI -
A; Cordiano C
Metastases to the para-aortic lymph nodes in adenocarcinoma of the
cardia.
SO - Eur J Surg 2001 Jun;167(6):413-8
AD - 1st Division of General Surgery, University of Verona, Italy.
Semchi@Borgotrento.Univr.it
OBJECTIVE: To find out the extent of involvement of the para-aortic
nodes in patients with adenocarcinoma of the gastric cardia. DESIGN:
Open prospective study. SETTING: Teaching hospital, Italy. SUBJECTS: 23
patients with advanced adenocarcinoma of the cardia (type II, n = 10,
and type III, n = 13) who were treated by total gastrectomy with
resection of the distal oesophagus and extended lymphadenectomy (D4)
with advanced carcinoma of the proximal third of the stomach who had
total gastrectomy with D4 lymphadenectomy during the same period. Lymph
nodes were retrieved immediately postoperatively and assigned to the
appropriate station according to the classification of the Japanese
Research Society for Gastric Cancer. MAIN OUTCOME MEASURES: Number of
para-aortic and other nodes involved. RESULTS: 22 of the 23 patients had
lymph node metastases, and in 5 the para-aortic nodes were involved
(N4). N3 lymph nodes were involved in only 1 patient, despite
involvement of para-aortic nodes. Among the 5 patients with N4
metastases, 1 had only N1 metastases in addition, with no involvement of
N2 or N3 nodes. Patients with involved N4 nodes had more nodes involved
overall than those who did not (mean (SD) 17 (5) compared with 8 (12)).
CONCLUSIONS: 5/23 patients with advanced carcinoma of the cardia had
involved para-aortic nodes. This may have some prognostic value, but
larger studies of D4 lymphadenectomy specimens is required.
20
UI - 11484984
AU - Ikeguchi M; Cai J; Fukuda K; Oka S; Katano K; Tsujitani S; Maeta M;
TI -
Kaibara N
Correlation between spontaneous apoptosis and the expression of
angiogenic factors in advanced gastric adenocarcinoma.
SO - J Exp Clin Cancer Res 2001 Jun;20(2):257-63
AD - Dept. of Surgery I, Faculty of Medicine; Tottori University, Yonago,
Japan.
The aim of this study was to investigate whether angiogenic factors
influence the occurrence of spontaneous apoptosis in advanced gastric
cancer. The apoptotic indices (AIs) of 97 tumors from 97 patients with
advanced gastric cancer (pT3, pN0, pM0, Stage II) were analyzed by the
terminal deoxynucleotidyl transferase-mediated deoxyuridine triphosphate
biotin nick end labeling (TUNEL) method. Intratumoral microvessel
densities (IMVDs) of tumors stained with anti-CD34 monoclonal antibody
were quantified under x 200 magnification using computer-assisted image
analysis. The expressions of angiogenic factors, such as vascular
endothelial growth factor (VEGF), thymidine phosphorylase (dThdPase),
transforming growth factor-alpha (TGF-alpha), and p53 were analyzed
immunohistochemically and compared with IMVDs and AIs. The mean IMVD of
the 97 tumors was 365/mm2 (range 147-990/mm2). The mean AI of tumors was
2.1% (range 0-11.3%). A significant inverse correlation between the AIs
and the IMVDs was shown (p = -0.278, P = 0.0064). The mean IMVDs of
tumors with high expressions of dThdPase, TGF-alpha, or p53 were
significantly higher than those of tumors with low expressions of these
factors. The mean AI of tumors with high expressions of dThdPase was
significantly lower than that of tumors with low expressions of dThdPase
(P = 0.023). However, no significant correlations were detected between
AIs and the expression levels of VEGF, TGF-alpha, or p53. In gastric
cancer, dThdPase may play an important role in tumor progression by
increasing microvessels and by suppressing apoptosis of cancer cells.
21
UI - 11490786
AU - Lanzafame S; Torrisi A; Favara C; Russo V; Emmanuele C
TI -
Correlation between intestinal metaplasia of the gastric cardia and
gastroesophageal reflux disease.
SO - Hepatogastroenterology 2001 Jul-Aug;48(40):1007-10
AD - Istituto di Anatomia Patologica, Universita di Catania, via Biblioteca
4, I-95124 Catania, Italy.
BACKGROUND/AIMS: IMC (intestinal metaplasia of the cardia) has been a
subject of great interest, given the rapidly increasing incidence of
adenocarcinoma in this location, over the past two decades. Whether this
histological alteration is a consequence of gastroesophageal reflux
disease, or a manifestation of an H. pylori-related multifocal atrophic
gastritis, is unclear. Furthermore, whether IMC should be considered a
premalignant lesion of gastric cardia is still unknown. We performed a
prospective study in order to determine the prevalence of IMC in
patients presenting for elective esophagogastric-duodenal endoscopy and
to evaluate a potential association between IMC and some clinical,
endoscopic and histological variables. METHODOLOGY: Biopsy specimens
were taken from 105 unselected patients undergoing routine diagnostic
endoscopy. Eight biopsies were taken from different sides, for
histological evaluation: 1 above and 3 below the squamocolumnar
junction, 2 from gastric fundus and 2 from gastric antrum. All specimens
were stained with hematoxylin and eosin-Alcian blue and modified Giemsa
to facilitate the detection of H. pylori. RESULTS: Eighty-six patients
(50 males, 36 females) with a mean age of 46.5 years (range: 23-75
years), were included in the study. Twenty-one (24.5%) were found to
have IMC; 4 (19%) of these had concomitant low-grade dysplasia of the
cardiac mucosa. IMC was associated with: males (P = 0.04), endoscopic
diagnosis of esophagitis (P = 0.02), histological diagnosis of
esophagitis (P = 0.008), mucosa of the cardiac type (P = 0.02), chronic
carditis (P = 0.002) and dysplasia (P = 0.04). There was no correlation
with: age, reflux symptoms, activity of carditis, H. pylori infection of
the cardia and intestinal metaplasia of the distal gastric mucosa.
CONCLUSIONS: IMC is common in our area. It is associated with endoscopic
and histological changes of gastroesophageal reflux disease, but not
with H. pylori infection of the cardia. Although 19% of patients
presented concomitant dysplasia (of low grade), long-term follow-up
studies will be necessary to assess the effective risk of IMC for cancer
transformation.
22
UI - 11490828
AU - Isozaki H; Tanaka N; Fujii K; Tanigawa N; Okajima K
TI -
Improvement of the prognosis of gastric cancer with extensive serosal
invasion using left upper abdominal evisceration.
SO - Hepatogastroenterology 2001 Jul-Aug;48(40):1179-82
AD - First Department of Surgery, Okayama University Medical School, 2-5-1,
Shikata-cho, Okayama, 700-8558, Japan. isozakih@md.okayama-u.ac.jp
BACKGROUND/AIMS: The prognosis of gastric cancer patients with serosal
invasion is very poor. In this study, the effectiveness of the LUAE
(left upper abdominal evisceration) procedure for these patients was
evaluated retrospectively. METHODOLOGY: Thirty-seven gastric cancer
patients who had serosal invasion but no massive peritoneal metastasis
or hepatic metastasis, and underwent LUAE, were enrolled in this study
(LUAE group). As a control, 66 gastric cancer patients who had the same
disease conditions as the LUAE group, and underwent conventional total
gastrectomy with the combined resection of the pancreatic body and tail
and spleen (TPS group), were also investigated. RESULTS: The survival
rate (5-year, 42.2%) of the LUAE group was significantly better than
that (5-year, 21.2%) of th
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