What You Really Need to Know about Cancer

Saturday, July 19, 2014

Gastric Carcinoma - the second most common fatal malignancy in the world

Gastric Carcinoma
Gastric Carcinoma is the second most common fatal malignancy (after lung cancer) in the world. There are unexplained wide international variations, being especially common in Japan, China and parts of South America.

Etiology of Gastric carcinoma

Risk factors of Gastric Carcinoma include

Age:  carcinoma of stomach occurs between ages of 40 to 60 years and the average age is 38 years.

Dietary factors: nitrosamides and nitrosamines derived from nitrates used as preservatives in prepared food stuffs. High intake of starch may alter the pattern of gastric secretion and predisposes to cancer of stomach. Smoked and salted meats, rice dusted with asbestos containing talc, low green vegetables predispose to gastric carcinoma. Tobacco smoke, tobacco juice and consumption of alcohol have carcinogenic effect on gastric cancer.

Genetic predisposition: inherited mutation of E-cadherin

Precancerous lesions: chronic gastritis with intestinal metaplasia and H. pylori infection

H. Pylori: chronic gastritis associated with H.pylori infection remains major risk factor for gastric atrophy, intestinal metaplasia and ultimately dysplasia and gastric carcinoma.

Classification of Gastric Carcinoma

Early gastric carcinoma is defined as a lesion confined to the mucosa and submucosa, regardless of the presence or absence of perigastric lymph node metastases.

Advanced gastric carcinoma is  a neoplasm that has extended below the submucosa into the muscular wall and perhaps spread more widely.

Gross types of early gastric carcinoma on the basis of growth pattern

Gross types of early gastric carcinoma






Gross types of  advanced gastric carcinoma on the basis of growth pattern


Gross Types of Advanced Gastric Carcinoma








Metastasis of Gastric Carcinoma

Directextension to esophagus, duodenum, pancreas, and colon by growth along with submucosa and muscularis. It also spread to diaphragm and abdominal wall by direct  continuity and by infiltration.

Lymphatic: to regional   (perigastric) lymph    nodes; supraclavicular  lymph nodes (through     the thoracic duct)-  Virchow’s nodes

Vascular: liver, lungs…

Transcoelomic:   bilateral involvement of the ovaries

Diagnosis of Gastric Carcinoma

Histamine fast achlorhydria
Cytology of gastric secretion
Endoscopic biopsy

Carcino embryonic antigen is increased in the blood in one fourth of patients with advanced gastric carcinoma

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