Archive for the ‘Gastroenterology’ Category

SCREENING Annual screening has been advocated in Japan for persons older than 50 years old using barium meal or endoscopy. This enables 40% to 50% of the tumours to be diagnosed in the early stages. This screening has been alleged to account for the recent decline in mortality from gastric cancer. CONCLUSIONS  Despite the decline […]

Chemotherapy: Adjuvant chemotherapy after curative surgery has not been able to show a prolonged disease-free interval or overall survival by meta-analysis. A recent prospective study compared one of the newer chemotherapy regimens, consisting of 5-fluorouracil, leucovorin and epidoxorubicin, with surgery alone in node-positive patients; the result was a significantly improved median survival and delayed time to […]

Surgery: The surgical strategy of the Japanese Research Society for Gastric Cancer was based on gastric lymphatic drainage. D2 radical gastrectomy has been advocated and practised as standard surgery in Japan for the past 30 years. In D2 radical gastrectomy, all of the lymph nodes are retrieved from the resection specimen and examined for micrometastasis, which […]

Genetics events further reinforced the observation that two different pathways exist in the intestinal and diffuse types of gastric cancer. Mutations of the p53 gene were essentially restricted to the intestinal type in the early phase but were involved in both types in the advanced stage. Loss of heterozygosity, mutations of the adenomatous polyposis coli […]

Recent advances in molecular biology lead to a better understanding of the carcinogenesis of gastric cancer. It is the accumulation of multiple gene abnormalities that result in the transformation of a normal epithelial cell to a malignant cell. Progressive accumulations of genetic changes have been evidenced in the different stages of Correa’s model. Microsatellite instability […]

The World Health Organization’s International Agency for Research on Cancer has recently classified H pylori as a group 1 or definite carcinogen. The etiological role of H pylori in gastric cancer was based on Correa’s model: chronic atrophic gastritis to intestinal metaplasia, dysplasia and finally carcinoma. H pylori has been shown to be strongly associated […]

Risk of gastric cancer is associated with socioeconomic status. Subjects from a lower socioeconomic class had approximately twice as much risk of developing intestinal-type gastric cancer as subjects from a higher socioeconomic group. On the contrary, proximal gastric cancers were associated with higher socioeconomic class. Cheapest treatment – buy levaquin 750 mg to always have […]