Is Early Gastric Cancer, Diffuse Type, a Forerunner of Advanced Gastric Cancer?

Leocata, P; Gallo, Pasquale; Chiominto, Alessandro; Cioccocioppo, R; Saltarelli, P.; C, Di Giacomo; Ventura, Laura

doi:10.1177/030089169307900205

Cited by 2 publications

(2 citation statements)

References 10 publications

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“…The early stage has been attributed to alterations in DNA caused by chronic inflammation, an imbalance between epithelial-cell proliferation and apoptosis, and gastric colonization by enteric bacteria with nitrate reductase activity, which facilitates the formation of carcinogenic nitrosamines in a milieu of atrophy and achlorhydria. It may take many decades for normal gastric mucosa to progress to chronic gastritis, gastric atrophy, intestinal metaplasia, and finally to early gastric cancer (23,24), and it may take an additional 8 years for the early gastric cancer to become advanced gastric cancer (25,26). One of the functions of the p53 protein in a cell exposed to DNA-damaging agents is to induce G 1 arrest to allow the cell machinery to repair DNA damage or, in case of failure, to induce apoptosis.…”

Section: Discussionmentioning

confidence: 99%

Prognostic Value of TP53 Codon 72 Polymorphism in Advanced Gastric Adenocarcinoma

Zhang¹,

Laurence²,

Hollowood³

et al. 2004

Clinical Cancer Research

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Purpose: A common polymorphism of the tumor suppressor gene TP53 at codon 72 has been associated with human cancer susceptibility. The prognostic role of the polymorphism was assessed in 102 patients with advanced gastric adenocarcinoma.Experimental Design: We followed up 102 consecutive Caucasian patients with advanced gastric adenocarcinoma for >5 years and determined the status of the TP53 codon 72 polymorphism in DNA samples extracted from archived gastric tissues.Results: The frequency of the arginine homozygous allele was positively correlated to patient age at baseline (P ‫؍‬ 0.002). However, the age-related increase in the percentage of codon 72 arginine p53 was not correlated to the prognosis for gastric cancer patients. Multivariable analysis in patients who had surgery showed that baseline age may be inversely associated with patient survival (odds ratio, 1.1; 95% confidence interval, 1.0 -1.2; P ‫؍‬ 0.02). Furthermore, alcohol consumption may be associated with reduced survival (P ‫؍‬ 0.06).Conclusions: These findings indicate that codon 72 arginine p53 may not be associated with a prolonged survival in patients with advanced gastric adenocarcinoma, but further study is needed to assess whether this polymorphism is associated with a late onset or slow progress of early gastric adenocarcinoma.

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Section: Discussionmentioning

confidence: 99%

Prognostic Value of TP53 Codon 72 Polymorphism in Advanced Gastric Adenocarcinoma

Zhang¹,

Laurence²,

Hollowood³

et al. 2004

Clinical Cancer Research

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“…This is only marginally older than the mean age in Japan (57.8 years; 3378 cases; three case reports); a surprising finding if one considers their screening programme. EGC probably occurs in younger adults than AGC; two series report a difference of eight years,8 23 a third of 23 years (though only five cases of EGC),35 whereas a fourth found no difference 6…”

Section: Clinical Featuresmentioning

confidence: 98%

Early gastric cancer in Europe

Everett

Axon

1997

Gut

277

157

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Despite mass population screening and an incidence of EGC in Japan that is at least double that of the West, there seem to be no genuine differences in the clinicopathological features of the disease between the two regions. The macroscopic appearance, size, depth of invasion, frequency of lymph node invasion, and histology of EGC are all remarkably similar in Japan, Europe and America, as are sex and age distributions.Patients with EGC are a number of years younger than those with advanced cancer. This is not surprising: Tsukuma et alfollowed 56 cases of EGC that were not surgically treated and estimated that the median “duration of EGC” before becoming advanced was 37 months.87 This suggests that EGC undergoes a period of slow growth before becoming advanced. Further differences between early and advanced cancers include a higher frequency of synchronous cancers and a longer symptom duration in EGC.Unfavourable prognostic factors in EGC include lymph node invasion, and invasion through the muscularis mucosae, though it is not clear whether these are independent. Repeated attempts have been made to identify other prognostic factors, but no clear pattern has emerged, with the possible exceptions of patient age, tumour size, and the presence of ulceration.The postsurgical outcome of EGC in the West is marginally less favourable than in Japan. In view of the similar clinical and pathological features in the two regions it seems likely, therefore, that this is because of the more aggressive surgical techniques traditionally used in Japan. Conversely, however, EMR has recently emerged as an important technique in Japan. Despite the advantages of low operative mortality and normal function of the postoperative stomach, there are also a number of potential disadvantages. It would seem sensible, therefore, to await the results of long term follow up studies before widespread adoption of EMR in Europe. Nevertheless, this technique should be considered for frail patients unfit for more radical surgery.

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Is Early Gastric Cancer, Diffuse Type, a Forerunner of Advanced Gastric Cancer?

Cited by 2 publications

References 10 publications

Prognostic Value of TP53 Codon 72 Polymorphism in Advanced Gastric Adenocarcinoma

Prognostic Value of TP53 Codon 72 Polymorphism in Advanced Gastric Adenocarcinoma

Early gastric cancer in Europe

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