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Gastric cancer, causes and signs

  1. Gastroepato
  2. Oncology
  3. Gastric cancer
  4. Colon carcinoma
  5. Colorectal and stomach cancer
  6. Gastric polyps
  7. Gastric cancer: macroscopic classification and TNM
notes dr Claudio Italiano

Etiology

There are factors that favor stomach cancer, that is, substances that may favor the onset of stomach cancer in those genetically predisposed. In particular, there are some young individuals who already fall ill before the age of 40 because they have a gene mutated in a single copy and can pass cancer on to their children in 50% of cases:
- Hereditary Widespread Gastric Carcinoma (HDGC)
- gastric carcinoma may also constitute one of the clinical manifestations of some inherited cancer predisposition syndromes: HNPCC, Li-Fraumeni syndrome, FAP, Peutz-Jeghers syndrome and Cowden syndrome.

a) to feed on sausages, without observing a proper diet (see food pyramid) that contain the nitrites that interact with some amino acids and form the nitrous mines, substances that can denature and alter the DNA.
b) Substances of smoked meat and fish, polycyclic hydrocarbons, benzopyrene and dibenzantracene, for example in subjects who love roasted "steak" or smoked meat.
c) Even a savory diet, in addition to exposing you to the risk of arterial hypertension, causes slow gastric emptying and predisposes to stomach cancer, due to slow emptying.
d) Mycotoxins, contained in foods contaminated by aspergillus flavus, ie molds that contaminate foodstuffs, for example certain grains and grains imported from the east!
e) Carbohydrates, rice and potatoes that modify the production of gastric mucus and predispose to cancer.
f) Industrial workers, those in oil refineries (see cancer and petrochemical risk), workers in nickel and coal mines, asbestos and solvent workers.
g) Helicobacter pylori, responsible for epithelial repair and proliferation processes and chronic gastritis.
h) Male gender
i) smoking
j) Age> 60 years
k) Blood group A Rh positive or group 0 Rh positive

There are precancerous lesions that are the antechamber of stomach cancer, that is a state of the gastric mucosa, intended as alteration histopathology that are similar as risky conditions.

They are:
a.. Chronic atrophic gastritis
b. Intestinal metaplasia. It is characterized by the substitution of gastric epithelial cells of the glandular type and of the surface with cells similar to those of the intestinal mucosa.
c.Helicobacter pylori.
d. Polyps. Two types of gastric polyp have been identified: the hyperplastic (or regenerative) polyp and the adenomatous polyp.
Endoscopic.

Symptoms

The early symptoms are vague and nonspecific, often underestimated by the doctor: vague epigastric disorders (ie pains located in the upper left abdominal quadrant, at the "mouth" of the soul, ie immediately below the breastbone), sense of belly swollen, sense slow and laborious digestion, replenishment, heartburn, nausea and vomiting, anorexia and disgust or rejection of meat and meat broth, anemia and chronic blood loss anemia with positive occult blood. The most frequent site is the lower third (49%), followed by the middle third (23%), the carcinomas spread to more regions of the organ (10%), the cardias (6%) and the fund (4.5% ).

Diagnosis

Neoplastic markers.
They are laboratory serum exams whose sensitivity and specificity increases if associated with each other. Some authors believe they do not have a diagnostic weight, but then in clinical practice they are required together with the search for occult stool blood. They are: CEA, CA19-9, CA 72-4
Endoscopy.
Endoscopy is a method that today is very well tolerated and safe, very accurate and precise, with accuracy, even in expert hands, of 98%. It can be associated with chromoendoscopy, a vital staining technique to better clarify the pictures and to the echo endoscopy, which allows a study of the wall and the lymph nodes. Biopsy is essential: every ulcer, even if considered benign, must be bioptized if it is located in the stomach.

CT abdomen and thorax
Examination of great value in the neoplasms of the upper third or bounded by the gastric wall with compression or infiltration of nearby organs.

cfr topic on tumors

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