Gastric Xanthoma Is Related to the Rapid Growth of Gastric Cancer

Abstract

Early detection of gastric cancer is important. However, rapid growth of gastric cancers that cannot be resected endoscopically occurs even with periodic check-ups. Accordingly, we assessed factors associated with the speed of gastric cancer growth by examining historical endoscopic images. A total of 1996 gastric cancer cases were screened, and characteristics of lesions with slow and rapid growth were assessed. A total of 114 lesions from 114 patients were included in the assessment. Sixty slow-growing and fifty-four rapidly growing gastric cancers were compared. Female sex and incidence of lesions in the lower part of the stomach were significantly less frequent in the rapid-growth group than in the slow-growth group. History of endoscopic treatment tended to be more frequent in the rapid-growth group. Age, body mass index, histology, Helicobacter pylori status, and medications did not differ significantly between groups. Xanthoma was significantly related to rapid growth of gastric cancer, and map-like redness tended to be more frequent in the rapid-growth group in univariate analysis. Xanthoma was significantly related to rapid growth of gastric cancer on multivariate analysis. Further studies are warranted to clarify the pathophysiological mechanisms involved in the speed of gastric cancer growth.

An Unusual Case of a Gastric Xanthoma: A Case Report

“…Histopathological confirmation of xanthomas is needed to rule out malignancy. This is especially true given its association with cancer; it has also been shown that gastric xanthomas are a factor related to the rapid growth of gastric cancer [ 3 ]. This case highlights the necessity of searching for accompanying premalignant lesions when a gastric xanthoma is discovered.…”

“…While immunosuppression has been suggested as a possible risk factor for gastric xanthomas, there has been no cited evidence in the literature about how it might be correlated [ 2 ]. There is emerging evidence that gastric xanthomas could be useful markers for predicting the development and location of early gastric cancer, and they can sometimes also be associated with dyslipidemia [ 2 , 3 ].…”

Xanthomas and precancerous changes of the stomach: an accidental combination or an important prognostic endoscopic marker?

“…Це узгоджується з результатами Sekikawa et al (2016) та інших дослідників, які свідчать про те, що пацієнти з ксантомами мали більш поширений атрофічний гастрит, ніж пацієнти без них [16]. У цілому авторами було виявлено кореляцію між вираженістю й поширеністю атрофії СО шлунка і наявністю ксантом [2,5,15,17,19].…”

“…Існує низка робіт про взаємозв'язок між ксантомами й раком шлунка [4,9,13]. Sekikawa et al (2013) серед пацієнтів з атрофічним гастритом діагностували рак шлунка суттєво частіше в осіб із ксантомами, ніж без них [5,15,16]. Ці результати підтверджено і в роботі K. Yamashita et al (2019), автори припускають, що ксантоми можуть бути корисним ендоскопічним індикатором ризику раку шлунка [2].…”

Histopathological Features of Gastric Map-Like Redness under Image-Enhanced Endoscopy

“…In recent years, increased attention has been paid to gastric cancer cases detected after eradication, including those occurring after eradication and those occurring before but detected after Hp eradication, with a particular focus on cases detected more than a year after Hp eradication [7] . Several studies have identi ed map-like redness (MLR) as an independent risk factor for gastric cancer after Hp eradication [8][9][10][11] . The manifestations of MLR (also called "color reversal" phenomenon or mottled patchy erythema [MPE]) result from Hp-associated gastritis or Hp-associated highly atrophic gastritis, with improvements following Hp elimination through the use of antibiotics.…”