Gastrin and Gastric Cancer

Abstract

Gastric cancer although occurring in reduced frequency is still an important disease, partly because of the bad prognosis when occurring in western countries. This decline in occurrence may mainly be due to the reduced prevalence of Helicobacter pylori (Hp) infection, which is the most important cause of gastric cancer. There exist many different pathological classifications of gastric carcinomas, but the most useful seems to be the one by Lauren into intestinal and diffuse types since these types seldom transform into the other and also have different epidemiology. During the nearly 30 years that have passed since the groundbreaking description of Hp as the cause of gastritis and gastric cancer, a continuous search for the mechanism by which Hp infection causes gastric cancer has been done. Interestingly, it is mainly atrophic gastritis of the oxyntic mucosa that predisposes to gastric cancer possibly by inducing hypoacidity and hypergastrinemia. There are many arguments in favor of an important role of gastrin and its target cell, the enterochromaffin-like cell, in gastric carcinogenesis. The role of gastrin in gastric carcinogenesis implies caution in the long-term treatment with inhibitors of gastric acid secretion inducing secondary hypergastrinemia, in a common disease like gastroesophageal reflux disease.Keywords: carcinogenesis, classification of cancer, gastric cancer, gastrin, hormones, neuroendocrine neoplasia Gastric cancer has been one of the most prevalent cancers and combined with a high mortality, gastric cancer has been among the leading causes of cancer death. However, there has been a continuous decline in the prevalence of gastric cancers during the last decades. Unfortunately, in spite of widespread use of upper gastrointestinal endoscopy, the prognosis in patients affected in the western world has not been much improved. This is in contrast to Japan where gastric cancer often is diagnosed at an early phase allowing removal and a better prognosis (1, 2). This is partly due to special screening programs in Japan having a high prevalence of gastric cancer (1, 2), resulting in diagnoses at a curable stage. In most western countries, the prevalence is much lower (3), and therefore, no such program has been implemented. The cause of the geographical differences in the prevalence of gastric cancer most probably is increased prevalence of Helicobacter pylori (Hp) in East Asia as well as a higher frequency of atrophic oxyntic gastritis (4). The prognosis of gastric cancer is better in patients from East Asia even when living in the west possibly due to less aggressive biology (5). In this review, we will focus on the role of gastrin in the etiology of gastric cancer and at the same time give an explanation of the decline in frequency. We will only cover cancers originating from epithelial cells (carcinomas) and will not discuss the importance of Epstein-Barr virus that plays a role neither in gastric carcinogenesis (6) nor in human papilloma virus, which has a less established impact (7).

Gastrin and Gastric Cancer

“…Although hypergastrinemia is associated with the development of gastric neuroendocrine tumors and gastric adenocarcinoma, 84 both animal and human studies have shown the greater incidence of gastric carcinoids in patients with increased gastrin levels. One possible explanation for the more frequent neuroendocrine tumors over gastric adenocarcinoma in patients with hypergastrinemia may be related to the finding that although the CCK-B receptor is present on parietal cells, it is expressed more abundantly in ECL cells of the stomach 85, 86.…”

Mapping brown adipose tissue based on fat water fraction provided by Z‐spectral imaging

“…Over the recent years the study of fat has attracted increasing interest of clinicians and researchers as it grew from being considered a simple energy storage tissue to a much more faceted organ secreting hormones involved in critical functions, from metabolism regulation to motivation and depression(1,2). In particular, the last ten years have seen the resurgence of the interest in brown adipose tissue (BAT).…”

Curcumin suppresses gastric cancer by inhibiting gastrin‐mediated acid secretion

“…Indeed, our data showed an increased proliferation of gastric cancer cells under low pH. The inducer of acid secretion, gastrin, is proven a valuable biomarker in the screening of gastric cancer . Gastric cancer cells overexpress gastrin as a way to remodel microenvironment to facilitate the outgrowth and metastases.…”