Gastric peptic ulcer and cancer

The authors report some peculiar features in the diagnosis and surgical treatment for cancer of the gastric stump and gastroenteroanastomosis in 13 patients, previously subjected to gastric resection and gastroenterostomy for duodenal ulcerous disease (4--34 years ago). The radical operation (subtotal or extensive gastrectomy) was performed in 9 patients, 3 of them died in the immediate postoperative period. Of 6 radically operated patients with a favourable outcome, late results were studied in 3. No tumor recurrence was noted. Histologically, there were adenocarcinoma--in 8, solid cancer--in 1, hemangioma--in 1, benign polyps--in 2 cases.     

Quantitative histochemical determination of protein sulfhydryl groups in the gastric mucosa in peptic ulcer and cancer

Cytophotometric quantitative studies were made on the concentration and total amount of protein sylfhydrile groups in the gastric mucosa in different forms of cancer (30) and ulcerous disease (26) on resected stomach specimens. The analysis has demonstrated that the epithelial cells both in the ulcer zone and in cancerous tumor show the increased concentration and total amount of SH-groups. The histograms obtained indicated that in malignant tumor cells there occurs a shift of "the baseline" one class to the right. Changes in the content of SH-groups in the cells is likely to be one of the conditions for metabolic disturbances responsible for alterations in the division of cells and their carcinogenic transformation.     

Comparison of serum trace element spectrum of liver cancer patients and healthy adults

The contents of 15 trace elements in the sera of 30 liver cancer patients and 30 healthy adults were assayed by ICP-AES method. The data obtained were analysed by routine statistical tests, multi-variate discrimination analysis, multi-variate stepwise regression analysis and non-linear mapping algorithm. The results showed that the contents of copper, vanadium, cadmium, stannum, cobalt, nickel in liver cancer patients were significantly higher than those in healthy adults. The serum trace element spectrum of liver cancer patients was different from that of healthy adults. Hence, the liver cancer patients could be differentiated from healthy adults by serum trace element spectrum.     

Comparison of serum trace element spectrum between liver cancer patients and healthy adults

The study of the relationship between trace element and health and disease has attracted more and more interests of scientists. As well known there exist complex interaction between the trace elements, and the trace elements and other substances, so the trace element research must be involved to the comprehensive effect of multifactors, other than single element. We determined the contents of fifteen trace elements in serum from thirty patients with liver cancer and thirty healthy adults by ICP-AES analysis. The obtained data were analysed statistically by not only routine statistical test but also multi-variate discrimination analysis, multi-variate stepwise regression and non-linear mapping algorithm. It is hoped that it can provide some valuable informations for investigation on relationship between trace elements and cancer.     

The vacA i1 genotype of Helicobacter pylori is associated with peptic ulcer and gastric cancer:A meta-analysis

There are two genotypes of the vacA intermediate region, il and i2; however, the association between the genotypes and gastroduodenal disease remains to be elucidated. The aim of this article was to investigate the interaction between the genotypes and H. py/ori-associated diseases such as chronic gastritis, peptic ulcer disease （PUD） and gastric cancer. Methods： The meta-analysis was performed in Review Manager 4.2.2. Results： Eleven （ten articles and one abstract） met the inclusion criteria and were included. The il genotype increased the risk of PUD （OR = 1.70, 95% CI： 1.24-2.33, P 〈 0.001） and gastric cancer （OR = 3.90, 95% CI： 2.64-5.78, P 〈 0.001）. Sub-analysis showed that the il genotype was significantly associated with gastric ulcers （OR = 2.59, 95% CI： 1.05-6.35, P = 0.040）, but not with duodenal ulcers （OR = 1.04, 95% CI： 0.61-1.76, P = 0.90）. In addition, the association between the il genotype and PUD and GC existed in studies not only from Europe but also Asia, except for the association between the il genotype and PUD in Asian population. Conclusion： The vacA il genotype is associated with an increased risk of the development of peptic ulcer disease （mainly gastric ulcer） and gastric cancer. In geographical distribution, the association between the il genotype and PUD and GC existed in studies not only from Europe but also Asia, except for the association between the il genotype and PUD in Asian population.     

Lipid peroxidation in patients with gastric ulcer and cancer

Levels of certain metabolites of peroxidation of lipids such as diene conjugates malonic dialdehyde, ascorbic acid, dehydroascorbic acid and diketogulonic acid were compared in 39 cases of gastric ulcer, 25 patients with gastric cancer and 14 healthy subjects. Diene conjugates and malonic dialdehyde levels appeared to be increased in cases of gastric ulcer and cancer. This was matched by a decrease in ascorbic acid and dehydroascorbic acid levels. Ulcer patients revealed enhanced diketogulonic acid concentration.     

Hematopoietic cancer and peptic ulcer: a multicenter case-control study.

Helicobacter pylori has been suggested as a cause of gastric carcinoma and gastric non-Hodgkin's lymphoma (NHL). In a previous cohort study, a relative risk of six for gastric NHL was reported among subjects who tested positive for anti-H.pylori antibodies. The association between peptic ulcer and NHL has been studied in a population-based case-control investigation on hemato-lymphopoietic malignancies in Italy, based on face-to-face interviews to 2671 cases and 1718 controls (refusal rates 10 and 19%, respectively). Subjects who reported a diagnosis of peptic ulcer had a relative risk of 5.6 [95% confidence interval (CI) 3.8-8.0] for gastric NHL, whereas the estimate for non-gastric NHL was 1.3 (1.0-1.6). The association with recent diagnosis of ulcer was stronger, but the odds ratio (OR) was as high as 2.1 (95% CI 1.1-4.2) after >/=20 years since such diagnosis. After exclusion of the last 2 years before the diagnosis of NHL, and of ulcers diagnosed before 1978 (when gastroscopy became common in Italy), the OR was still 5.3 (95% CI 3.0-9.2). We found a strong effect modification by educational level, with ORs for ulcer more elevated in higher social groups. Gender was an effect modifier (OR = 4.1 in males, 9.2 in females; P = 0.03 for heterogeneity). The association with other gastrointestinal pathologies was much lower and statistically not significant. Almost all gastric lymphomas were B-cell NHLs of intermediate grade according to the working formulation; the majority belonged to the mucosa-associated lymphoid tissue (MALT) type. The association with ulcer was much stronger among MALT lymphomas, but only for recent ulcer diagnoses (2-10 years). Our study shows an increased risk for gastric NHL, very similar to the estimate reported in a previous cohort study. The risk was higher among more educated subjects.     

微量元素与乳腺癌的临床研究

目的:通过对乳腺癌不同阶段患者体内微量元素铜、锌、铁含量的检测,探讨微量元素与乳腺癌的关系.方法:对2005年6月-2006年12月64例乳腺癌不同阶段患者及65例健康对照采血清标本进行微量元素含量测定.结果:乳腺早期浸润癌和浸润性癌患者血清铜明显高于健康对照组;乳腺浸润性癌患者血清铁明显高于健康对照组;而乳腺非浸润性癌、早期浸润癌和浸润性癌患者血清锌均低于健康对照组.结论:血清中过高的铜、铁及过低的锌均与不同阶段的乳腺癌有密切关系,因此,微量元素可能成为诊断乳腺癌有价值的标志物.     

Serum trace element levels in patients with bladder cancer

Trace elements are essential components of biological structures, but they can be toxic at concentrations beyond those necessary for their biological functions. In the present study, groups of 35 patients with bladder cancer and 34 healthy volunteer controls were measured for trace elements using a furnace atomic absorption spectrophotometer. Serum levels of Cd, Ni and Co were increased (p<0.05) and Mn and Zn were decreased (p<0.05) in patients with bladder cancer. In the present study, a relationship was seen between the level of trace elements and the occurrence of bladder cancer, suggesting that an increase in the serum level of Cd, Ni, Co and a decrease in the levels of Zn and Mn might be important causes of bladder cancer occurrence; however, defining such a cause-and-effect relationship needs several prospective studies to be done, which seems necessary with regard to the high prevalence of this cancer.     

The inhibitory effect of peptic ulceration on the growth of early gastric cancer

The correlation between the growth pattern and peptic ulceration occurring in the cancer lesion was studied in early gastric cancer. Although the superficially spreading type (Super), which grows slowly, showed a high rate of being accompanied by peptic ulceration (74.0%), the deeply penetrating type (Pen), with rapid growth, had a lower such rate (Pen A- expansive type 9.7%; Pen B- infiltrative type 16.1%). Deep ulceration accompanied 32% of the Super cases, 12% of the small mucosal cases and no cases of the Pen type. The Super and small mucosal types located at the intermediate gland area had peptic ulceration more frequently than those at the other areas. The rate of the cases of peptic ulceration of undifferentiated adenocarcinoma was high in the Super and small mucosal types, and that of differentiated adenocarcinoma was 64.0% in the Super and only 33.3% in the small mucosal type. This study clarified that the growth of early gastric cancer was inhibitively influenced by peptic ulceration, which was modified by the localization and histologic type of the carcinoma.     

Relative value of repeat gastric ulcer surveillance gastroscopy in diagnosing gastric cancer

Background Gastric cancer can present with the endoscopic appearances of a benign gastric ulcer (GU). Opinion remains divided on the need for follow-up of patients diagnosed with GU, and the aim of this study was to examine the long-term outcomes of patients whose GU proved malignant on follow-up gastroscopy. Methods Between October 1, 1995, and September 30, 2003, 25 579 gastroscopies were performed in one unit. These identified 544 patients with apparently benign GU, of whom 277 (51%) underwent 334 elective follow-up endoscopies. Twelve of these patients (4.3%) were shown to have a malignant ulcer; their outcomes were compared to those of the 296 other patients diagnosed with gastric cancers in this time frame. Results The patients in the GU cancer group had earlier stage disease (stage I, 33% vs 6.4%; χ² = 11.2; DF1; P = 0.001), and were more likely to undergo R0 gastrectomy (50% vs 30%; χ² = 2.064; DF1; P = 0.151) and to survive long term (46% vs 16%; log-rank χ², 5.79; DF1; P = 0.0162) than patients in the comparison cohort. Conclusion Gastroscopic follow-up of 50 patients with an apparently benign GU will identify 1 patient with a malignancy destined to survive for 5 years following R0 gastrectomy. This justifies the diagnostic effort of repeat gastroscopy to ensure complete healing of GU. Presented at: The British Society of Gastroenterology, Birmingham, 2005; The Association of Surgeons of Great Britain and Ireland, Glasgow, 2005; The 6th International Gastric Cancer Congress, Yokohama, 2005.     

消化性溃疡后食管癌的放疗疗效分析

目的 观察消化性溃疡后食管癌的放疗疗效。方法 选择1988年1月至1997年12月收治的消化性溃疡后食管鳞癌患158例。按常规方法设前垂直野及背斜野常规^60Co外照射DT64～68Gy,，结果 1、3、5、10年生存率分别为45．01％、14．6％、8．00％、5．06％，仍健在11例，均生存5年以上。统计分析显示，对生存有影响的因素有性别、病变长度、消化性溃疡治疗方式。结论 消化性溃疡后食管癌的放疗疗效与一般食管癌相同，性别、病变长度、消化性溃疡治疗方式对生存有影响。     

IL-6和IL-8在正常胃组织、胃溃疡及胃癌组织中的表达

目的 探讨白细胞介素（IL）-6和IL-8在正常胃组织、胃溃疡及胃癌组织中的表达情况.方法 采用酶联免疫吸附法（ELISA）测定正常对照组（33例）、胃溃疡患者（30例）和准备手术的胃癌患者（52例）血浆中IL-6和IL-8的表达水平,并随访胃癌患者术后1周的IL-6、IL-8表达水平;免疫组织化学法检测胃癌周围正常组织（45例）、胃溃疡组织（35例）和胃癌组织（45例）标本中IL-6和IL-8的表达.结果 胃癌患者（术前和术后）血浆中IL-6、IL-8的表达明显高于胃溃疡和正常对照组（均P＜0.0l）,胃癌患者术后IL-6和IL-8水平较术前明显降低（P＜0.01）.癌周正常组织、胃溃疡和胃癌组织中IL-6和IL-8蛋白阳性表达率依次上升,且差异有统计学意义（x2=38.87,P＜0.01;x2=42.23,P＜0.01）.结论 IL-6和IL-8在胃癌患者血浆和胃癌组织中均表达上调,检测患者血浆和病理组织中的IL-6、IL-8水平有助于判断病情和评估预后.     

Computed tomography and complicated peptic ulcer disease

Peptic ulcer disease (PUD) can present with many complications including inflammation, ulceration and perforation. Improvements in CT have enabled better imaging of the gastroduodenal area. Three cases of complicated PUD detected on CT are presented with a brief review of the current literature.     

Intestinal metaplasia of the stomach. I: Quantitative analysis in gastric peptic ulcer and in incipient adenocarcinoma in Japanese subjects

A novel method of quantitation of the extent of intestinal metaplasia (IM) was applied to 50 resected stomachs from Japanese subjects; 25 with peptic gastric ulcer, 25 with incipient adenocarcinoma. The total length of the IM was significantly larger (p less than 0.05) in incipient adenocarcinomas than in peptic ulcers; the total length of the gastric mucosa analyzed being similar in the two groups. The intestinal metaplasia index (IMI; i.e. the ratio between IM and the length of the gastric mucosa analyzed) in incipient adenocarcinomas was significantly higher (p less than 0.05) than in gastric ulcers. In incipient adenocarcinomas, the IMI decreased significantly (p. less than 0.001) from lesser towards greater curvature. In peptic ulcers, the decrease was less abrupt. In 12 of the 25 specimens, the incipient adenocarcinoma was classified as intestinal type, and in the remaining 13 specimens as diffuse type. The total length of the IM was significantly larger (p less than 0.01) in specimens with intestinal type adenocarcinoma than in specimens with diffuse type; the total length of the gastric mucosa investigated being similar in the two groups. The IMI was significantly higher (p less than 0.01) in specimens containing intestinal type adenocarcinoma as compared to those with diffuse type adenocarcinoma. This was valid for the lesser curvature, for the mucosa adjacent to the lesser curvature, and for the mucosa by the greater curvature. From the results, it is apparent that intestinal metaplasia is a widely occurring phenomenon not only in specimens with intestinal type incipient adenocarcinoma or with diffuse type incipient adenocarcinoma, but also with benign peptic ulcer. The difference resides in that the metaplastic mucosa is more universally distributed in specimens with incipient intestinal adenocarcinomas (provided that longitudinal mucosal areas are considered in the comparison). The quantitative method herein reported will be applied in the future to compare the extent and distribution of intestinal metaplasia in gastric specimens from various geographical regions having disparate incidences of gastric ulcers and carcinomas.     

TLR4、Caspase-3和Fas在胃癌、胃溃疡中的表达及意义

目的通过检测TLR4、Caspase-3和Fas的表达以及凋亡细胞的情况,探讨胃溃疡与胃癌潜在的关系。方法采用免疫组化SABC方法对胃癌、胃溃疡各30例患者进行TLR4、Caspase-3和Fas表达的检测;用TUNEL技术检测样本的凋亡细胞。结果Fas、Caspase-3、TLR4表达的阳性指数胃溃疡组显著高于胃癌组;TLR4、Caspase-3和Fas阳性表达的凋亡指数显著高于其对应阴性组。在伴有转移的胃癌组织中,Caspase-3阳性率最高。Fas和Caspase-3,TLR4和Caspase-3在胃癌、胃溃疡中表达呈正相关。结论Caspase-3在胃溃疡组织中的阳性率及阳性指数均明显增高,意味着细胞凋亡机制参与了胃溃疡的形成;TLR4表达阳性的胃癌组织中,凋亡细胞数增多,说明TLR4阳性可能有促使胃癌细胞凋亡的作用,由于其阳性率及凋亡指数较低,提高表达率可能有助于胃癌治疗的研究。